We all know the phrase 'the global village', and probably have heard that 'the medium is the message'. Their originator was Marshall McLuhan, the Canadian scholar and prophet of technology and its significance, born 100 years ago. He is this month's hero.

His starting point is that tools, from spears and hoes, through stirrups and crossbows, to print and the internet, are not merely useful. They are extensions of ourselves, and – wait for it – they change who we are. Nearly half a century ago he wrote: 'After three thousand years of explosion, by means of fragmentary and mechanical technologies, the Western world is imploding. During the mechanical age we had extended our bodies in space. Today, after more than a century of electric technology, we have extended our central nervous system itself in a global embrace, abolishing both space and time' (1). In his first books he studied advertisements for globalised products, like Mickey Mouse and Coca-Cola. He would say that we can understand global media, or any transnational industry, only when we realise that the electronic technology that makes them possible, makes them different in nature, and gives them an entirely more profound impact on our ways of thinking and being – on who we are.

Such heady stuff aside, what should we think about industry? The first item below proposes that attacks that isolate industry are liable to be misdirected. There is a lesson here for our attitude to the media – and also to the food and drink industry. After that, and before coming back to Marshall McLuhan, I continue the history begun last month, on the food and nutrition 'movement' in Britain between the mid 1970s and 1990s.

Reference

1. McLuhan M. Introduction. Understanding Media. The Extensions of Man. London: Routledge and Kegan Paul, 1964.

Industry. Media. Governance. Regulation

All games need rules

The powerful and inglorious Murdoch media empire. This is what happens
in democracies when big business of any kind is inadequately regulated

When we criticise industry, and specifically the transnational mass media and food and drink corporations, we may well be right to do so, but we are liable to misunderstand the main issue. This is not commerce, but governance, which is the responsibility not of industrialists but of legislators. The protection of all public goods, including public health, depends on regulation in the public interest. This above all else is what is missing in the world we live in now. The main obstacle in the path of all of us committed to protect public goods, is not avaricious industries. It is incompetent, ignorant, complicit, and sometimes even corrupt national and international governments and their agencies.

The lesson of Rupert Murdoch

My immediate context is the current scandal in which one transnational industrial empire is enmeshed. After banking, now it's the media. The pictures above are of three stages in the astounding career of Rupert Murdoch, perhaps the greatest media magnate of all time (1). On the left he is in London in 1981, when he added the quality newspapers The Times and The Sunday Times to his UK newspaper empire – then including the mass circulation Sunday News of the World, and the daily Sun, purchased in 1969 (2). Next, he is on the cover of Time magazine in 2007, as the purchaser of The Wall Street Journal.

The main complaints against the Murdoch media empire are much the same as those against international banking: monstrous size, influence, greed, and immorality. Rupert Murdoch himself and his executives have always sought and gained special favour, commercially and politically, in return for backing politicians in power and who seek power (1). On the right above, is one reason he has himself been in the news – his decision last month to close the News of the World, after its journalists and agents were shown to have hacked into the cell phone messages, computer data, bank records, and other material of many public and private people – even the voicemail of a young girl who was missing and later found murdered.

Many health professionals may have been thinking something like 'well, this just exposes the nature of the media'. No, it does not. It was after all The Guardian, a far less resourced UK newspaper, that investigated and revealed the scandal. Railing against 'the media' in general is foolish. To have meaning, criticism needs to be precise.

To repeat, the fundamental issue is governance. A 'free press' is a defining characteristic of any real democracy. But what is 'free'? Free to destroy? The term does not – or should not – mean that in any context, those that are biggest and strongest can do whatever they want. Socially, freedom always involves the rule of law. Take sport. Football players are not free to gouge and maim their opponents, but this does not mean that football is unfree. Its success depends on rules that are followed, examined, and sometimes changed, and on knowing that those who break the rules will be stopped.

Governments that avoid and discard rules and regulations, their main reason for being, and thus surrender responsibility and power to industry, breed 'red in tooth and claw' capitalism – the equivalent of the Roman 'sports' in which gladiators hacked one another to death, and prisoners were devoured by savage beasts. In such societies the most successful industrialists in what is called 'the free market' – freed up for them, that is – will be those that are most like animals bred to kill. The game goes bad, becomes rotten. But those most at fault are not the players. Those who are most guilty are those whose duty is to govern, in the public interest.

Implications for food and public health

In our field there is a lot of loose talk against 'industry' in general. In the societies at least of the types most of us know, industry is central and fundamental. Criticism should be specific, and should I suggest first focus on Big Snack – the transnational and other gigantic companies whose products, consumed in typical amounts, are harmful to health, and whose policies destroy national and local economies. We need to see though, that just as mass-circulation media executives sell more newspapers by making them super-titillating, food processors sell more products by making them super-enticing, even to the point of addiction. That's what they do. Without adequate regulation, the quality of mass-produced products is driven down.

It is outrageous that legislators generally now go along with the idea that industry should regulate itself. Industry self-regulation does not work. It never has and it never will. The only discussion should be on the relative merits of independent and of statutory regulation. Furthermore, either is clearly in the interests of industry as a whole, as well as being in the public interest. Rules that are inadequate or absent make ethical companies the victims of unscrupulous and avaricious competitors.

One task for governments is to strengthen and tighten laws designed to prevent undue concentration in any type of industry. The fact that News International has had 40 per cent of the UK national newspaper market is not Rupert Murdoch's responsibility, any more than the concentration of food commodities and products in the hands of very small numbers of corporations is their doing. It was allowed, by law. Big business always pushes for more concentration and more power, involving penetration and capture of the regulatory process. These are names of its game. The push back has to come from legislators (3).

This can be possible only with sustained support and pressure from well-organised civil society organisations. The policies and actions of the most powerful food and drink corporations, who do not all behave in the same way, should be monitored, and regular reports issued. To be effective this work needs to be supported by relevant UN agencies as well as national governments. Will this be difficult? (4). Sure, but a problem once identified is some way towards its solution.

Notes and references

1. Murdoch has a context. Some leading proprietors of UK national newspapers have been a rascally lot. Lord Rothermere (below, left) and Lord Northcliffe (poster for one of his papers below) boasted of their ability to make and break governments, and Robert Maxwell (below, right) misused his newspaper holdings to aggrandise his businesses and himself.
   
   
   
   
2. The sale in 1981 of The Times and The Sunday Times to Rupert Murdoch was waved through by the then UK government in a deal commonly seen as collusive. An account is in Evans H. Good Times, Bad Times. London: Weidenfeld and Nicolson, 1983.
3. An example of an abusive industry practice that needs to be stopped by law is the advertising and marketing by transnational food and drink corporations of energy-dense ultra-processed products to children.
4. The Transnational Institute rallies support in this area. Its outstanding writer and activist is Susan George. See George S. What other world? Visions of the possible. In: Another World is Possible... If. London: Verso, 2004.

History. Policy. NACNE

This great movement of ours? (2)

Click here for last month's initial episode

Here I continue the story of what PhD student Jerrell B Whitehead calls Food and Health Campaigning and Cooperation in England's New Food Movement, c. 1976-1996. Last month I summarised the stunning success of the Coronary Prevention Group between 1981-1988. Here I tell the tale of a drama within that time, in which I played a walk-on part: the revelation of the 'NACNE' report. Next month I summarise what became known in the UK as 'the food scandal' (1-4), and suggest lessons and warnings from those times that may have value for us now.

2.    The NACNE revelation

NACNE, 1983. In which nutrition became interesting again, and why.
Arthur's Seat's 'gutted haddie'; Jerry Morris, Philip James, Caroline Walker.

It started for me on Sunday 19 June 1983, when I was an assistant editor on The Sunday Times, specialising in health and fitness, inclined to put my own body as well as mind to the test. On that day I was in Edinburgh to run the Seven Hills Challenge Race: 15 miles, starting on Calton Hill, then up and down the Castle Esplanade, Corstorphine Hill, Craiglockart Hill, Braid Hill, Blackford Hill – and then Arthur's Seat, by the path zig-zagging next to the 'gutted haddie' route (left, above). Gutted was the word. The run took me a couple of minutes over 3 hours.

Rumours of suppression

In the evening I chatted over drams of uisge beatha with my fellow-runner and host, from the Scottish Health Education Group. Like the English Health Education Council, this was a quango (quasi-autonomous non-government organisation). Quangos, funded with public money, are supposed to be sort-of independent while sort-of answerable to government (5). With the Corstorphine endorphins whizzing through our systems, I asked for help. Contacts of mine had been hinting at a secret report, commissioned by government, that denounced the typical British diet, and so had been banned, or something. 'If you only knew' they said. So tell me, I said, but they didn't. Did he know? As I left the next day, he said 'you may receive something of interest', which I did, first post the next Wednesday.

This was the third draft of a report prepared for the National Advisory Committee on Nutrition Education (NACNE), the first draft of which had been completed in April 1981. NACNE had been set up by the new government led by Margaret Thatcher in July 1979 because, as officially stated, 'there is an urgent need for a point of reference that would provide simple and accurate information on nutrition'. Then an expert group, a sub-committee of NACNE, was set up in 1980. Its brief was to synthesise the findings of recent official reports and publications, and to make recommendations.

The group was convened on 9-11 January 1981 by its chair, the distinguished physician and nutrition scientist Philip James (third from left, above), then of the UK Medical Research Council's Dunn clinical nutrition centre in Cambridge. Its secretary was Caroline Walker (right, above), a nutritionist at the Dunn, who also was honorary secretary of the Coronary Prevention Group.

The NACNE committee itself was chaired by the eminent epidemiologist Jerry Morris of the London School of Hygiene and Tropical Medicine (second from left). It included representatives from government, the Health Education Council, the Food and Drink Industries Council, and the British Nutrition Foundation (BNF), a body funded by the food manufacturing industry.

What dietary guidelines?

Lucky for me that the draft arrived when it did; that day, Wednesday 22 June, was the occasion of the BNF annual conference, held at the Royal College of Physicians building by Regent's Park. Its theme was 'Implementing Dietary Guidelines'.

Speed-reading over tea and toast, and in the taxi, I saw that the report was remarkable. While written in relatively technical terms, it outlined a big picture. It broke out of a merely medical model, to public health in the great tradition. It addressed obesity as well as cardiovascular disease, and indicated that other diseases were also preventable by healthy diets (6). It made clear that confining attention to 'at-risk groups' was an error (7). It gave quantified targets, like reduction of fats, sugars and salt by respectively a quarter, a half, and around a half, and corresponding increases in starchy foods, vegetables and fruits (8). Plus it suggested ways and means, like appropriate legislation and regulation to encourage breeding of lean animals, and to require explicit nutrition labelling, and reformulation of fatty processed foods (2,3,9). Reports with such approaches had already been endorsed by governments in the US, Australia and New Zealand, and Scandinavia – but not in the UK (4,10,11).

The report was a breakthrough. It was the first integrated, progressive statement on nutrition and public health that was really useful – that included quantified goals – to be prepared in Britain since the 1939-1945 war. But the breakthrough had not broken through. Apparently, it was 'stuck in the system' (12).

The BNF annual conference programme included speakers who were members of the main NACNE committee. But Jerry Morris and Philip James were not billed, nor present. The first speaker, from the government's Department of Health, said 'there are official recommendations, and the Health Education Council follows them'. Aha. So much for quasi-autonomy (5).

The final speaker called for a national body to be officially responsible for national nutrition education, and said this should be the British Nutrition Foundation. Whereupon a young woman sitting next to me stood up, and said no. What she said of the BNF, in her own later words, was: 'Because it was sponsored by the food industry entirely... it was not a suitable body to give nutrition education to the public'. She added: 'This is what the whole conference was geared towards. They wanted the government to donate to them the whole field of education on food and health' (3). The chair of the meeting, BNF president Albert Neuberger, a distinguished biochemist, rose up, said that her statement was libellous, and demanded that she withdraw it. The atmosphere in the lecture theatre was electric. No, she said, she would not, she stood by what she said. This was Caroline Walker (13).

Aha. Later on I stuck up my hand, and explained that I worked for The Sunday Times, which had three and a half million readers, and I had a question. This was: Why had a whole day conference on implementation of dietary guidelines made no reference to any specific guidelines, including um, what is it called, the National Advisory Committee on Nutrition Education report? In which, as the gentleman behind me, an official in the nutrition unit of the Department of Health confirms, the government is a partner? The report in which I understand quantified targets are proposed for consumption of fats, sugars, salt, dietary fibre, and so on? Wasn't this, how to say, relevant? This seemed odd to me, could somebody explain? Prudently, I did not flourish the document in my pocket.

The BNF director-general responded from the platform. Yes he said, this document was under discussion. No, it would not be published by NACNE. Dr James was free to publish it himself, he said (2,14). What impressed me was his manner – the way he said what he said. He obviously was not expecting the question. He was incoherent. In the expressive phrase, his wheels were falling off. Aha.

The front page news lead

The next day in the Sunday Times offices I went to see Tony Bambridge, the chief news editor. He was reading proofs. 'Tony' I said 'I've got the front page lead news story next week, and it's about nutrition'. He did not look up. 'I guess you think that nutrition is about meals on wheels, vitamin C, and Asian schoolchildren with rickets?' I said. He looked up. 'Well, isn't it?' 'What if I were to tell you' I said 'that a report originally commissioned by government has concluded that the food we typically eat in Britain is a major cause of killer diseases, starting with heart disease, and that this report is being suppressed by government because of its implications for the food industry?' Explaining that I had the exclusive, I flourished my copy of the third draft of the report. 'I think you've got the lead story' he said.

So I had, ten days later. Meanwhile I obtained all three drafts, with associated notes and background material (13), and interviewed people in the know, including members of the NACNE committee and the Coronary Prevention Group, senior staff from the Department of Health and the Health Education Council, and executives from the British Nutrition Foundation. All this assured the Sunday Times editors that we had an impregnable exclusive story – a scoop

On Thursday the next week, Sunday Times news feature editor Don Berry shaped and cut 12,000 words of notes into a 2,000 word full page story together with striking tables: 'Revealed – the diet' and 'Revealed – the risks' (of colorectal cancer, diabetes, hypertension and stroke, and other conditions, as well as of obesity and heart disease). On Saturday night I descended to the press room with night news editor Bobby Campbell, draft copy for the front page in hand. He agreed the title 'Censored – a diet for life and death' and positioned the story as the lead. The presses rolled, and around midnight I walked out into the Gray's Inn Road, a first copy of the paper in my hands (2,15).

What then happened was seismic. Hundreds of follow-up stories appeared that month in the broadcast and print media. The next month the Lancet published most of the third draft of the report, in four weekly instalments (16). Thus forced, government instructed the Health Education Council finally and officially to publish the report, on 10 October (2,17). In the next months – and into 1984-1986 – UK television, radio, newspapers and magazines at all levels carried what must have amounted to thousands of stories. The media was fascinated by the sizzle – the suppression of the report (12) – and also engaged with its substance and implications.

Even then, the pendulum began to swing back. In 1981 Times Newspapers had been taken over by Rupert Murdoch. The legendary campaigning Sunday Times editor Harold Evans had departed. His successor was a buttoned-up foreign editor, whose response to the NACNE scoop was 'We are not the Nutrition Gazette' (18). My later big UK newspaper stories appeared in The Times, The Observer, The Independent, and The Daily Telegraph.

Special circumstances

The NACNE report, with the astounding media attention its story and contents received, marked the time when public health nutrition was revived in the UK (19). In two aspects the story is unlikely to be repeated.

The first was the culture of secrecy in the UK, and the fact that this had been breached. The official UK line on diet and heart disease had already alienated and infuriated a number of eminent or influential scientists and physicians, so much that some of them were already organised as media-friendly activists. So I was able to get statements on the record, expressed in clear, strong language.

The second was the influence of The Sunday Times itself which, in the pre-electronic days when UK newspapers had few pages and there were just three television channels, habitually set the national news agenda. When it led its front page with a scoop, and when there was 'meat left on the bone', the rest of the media followed. In any other national newspaper, my story would not have caused such a stir.

This said, I think there are lessons and warnings arising from the NACNE story that are of use and value to us now. I summarise these next month, after telling the story of the UK 'food scandal' period, from 1984 to 1986.

Notes and references

1. The NACNE story and the subsequent UK 'food scandal' period can be dated as from 1979 to 1986. The story is told in two books (2,3), with background in a report (4).
2. Walker C, Cannon G. The Food Scandal. What's Wrong with the British Diet and How to Put it Right. Paperback edition. London: Century, 1985. Available on-line at www.cwt.org.uk
3. Cannon G. The Good Fight. The Life and Work of Caroline Walker. London: Ebury, 1989. Available from Amazon.
4. Cannon G. Food and Health: the Experts Agree. London: Consumers' Association, 1993. Some is at: www.mcspotlight.org/media/reports/food.health1.html.
5. The government minister responsible for public health had, the month before, alienated Health Education Council executives. He had told them, in a specially called private meeting, that in all matters of nutrition policy they had to toe any line specified by government.
6. Philip James and his colleagues had support from on high. In October 1982 Sir Richard Doll, the eminent British epidemiologist, gave the Harveian Oration to leaders of the medical profession. In it he stated: 'Whether the object is to avoid cancer, coronary heart disease, diabetes, hypertension, diverticular disease, duodenal ulcer, or constipation, there is broad agreement among research workers that the type of diet that is least likely to cause diseases is one which provides a high proportion of calories in whole grain cereals, vegetables and fruit; provides most of its animal protein in fish and poultry; limits the intake of fats, and, if oils are to be used, gives preference to liquid vegetable oils; includes very few dairy products, eggs, and little refined sugar'. Doll R. Prospects for prevention. British Medical Journal 1983; 286: 445-453.
7. The 'whole-population' approach was a feature of a WHO report published the previous year. This was the work of a committee chaired by British epidemiologist Geoffrey Rose. It was the one non-UK report used as a basis for the NACNE report. World Health Organization. Prevention of Coronary Heart Disease. Report of a WHO expert committee. Technical report series 678. Geneva: WHO, 1982.
8. The third draft also included modest short-term goals. Jerry Morris had insisted on these, in an attempt to get government and industry on board.
9. The first good summary of the NACNE recommendations and their implications was Walker C. Nutrition: the changing scene. Implementing the NACNE report. 3: The new British diet. Lancet 1983; II: 1354-1358. The paper is included in The Good Fight – see (3).
10. NACNE was circumspect – inevitably, given its brief. Elsewhere statements were more forceful. Thus in 1977 a US government report concluded: 'Too much fat, too much sugar or salt, can be and are linked directly to heart disease, cancer, obesity and stroke, among other killer diseases... Those of us within Government have an obligation to acknowledge this'. Select Committee on Nutrition and Human Needs. Dietary Goals for the United States. Washington DC: US Government Printing Office, First edition, 1977.
11. The thinking of the NACNE report was developed some years later in a WHO report produced by a group of which Philip James was chair and chief contributor. It was distilled from the world literature. It addressed diabetes, osteoporosis, bowel disorders and dental caries as well as cardiovascular disease, while also addressing deficiency diseases. World Health Organization. Diet, Nutrition and the Prevention of Chronic Diseases. Report of a WHO study group. WHO Technical report series 797. Geneva: WHO, 1990.
12. Before she entered politics, Margaret Thatcher worked for the cake maker J Lyons at its Hammersmith factory, devising fillings for swiss rolls and other confections. Her crowning success was as a member of a team that worked out how to add economic value to ice-cream by aeration, a formula of which one version is branded as 'Mr Whippy'. Brilliant, air is free! Here it is, below. Could the instruction to block the NACNE report possibly have come direct from the food chemist in 10 Downing Street?
    
    
    
    
13. Caroline told me afterwards that she was one of a group determined to 'out' NACNE that had targeted me. After the BNF conference I told her, and Philip James, that the decision to publish had been taken by the Sunday Times. Before that time I had not met or contacted Philip James, and I did not receive any information from him.
14. Later I learned that at a meeting of the main NACNE committee held nine days previously, the Department of Health representative and the BNF director-general had repudiated the report. Hence their remarks at the BNF conference.
15. Cannon G. Censored: A diet for life or death. The Sunday Times, 3 July 1983.
16. Nutrition: the changing scene. Extracts from NACNE report. Lancet 1983: II: 719-721, 782-784, 835-838, 902-905.
17. With a title so boring as to be tantalising: Health Education Council. A discussion paper on proposals for national guidelines for health education in Britain, prepared for the National Advisory Committee on Nutrition Education by an ad hoc working party under the chairmanship of Professor Philip James. London: HEC, 1983.
18. At that time, when in London Rupert Murdoch was in the habit of visiting the Sunday Times editor around midnight as the first edition came off the press, and making 'suggestions'. Who thought of the term Nutrition Gazette?
19. Before and during the 1939-1945 war, what we now call 'public health nutrition' was a UK national priority. Of various pioneers the most important was John Boyd Orr, founder-director of the Rowett Research Institute, Aberdeen, later the founding director of the Food and Agriculture Organization of the United Nations, and a Nobel peace prize winner. Philip James was a successor to Boyd Orr as Rowett director in 1982, appointed during the NACNE period, serving until 1999.

Marshall McLuhan

Seer of globalisation

Writing in the mid-20th century, Marshall McLuhan saw the future, and how it would work. At first a university teacher of English, and a devotee of James Joyce – hence a passion for plays on words, evident above – he became a scholar of technology and how it changes the world and changes us, focusing on mass communications (2,3). He was a seer: he envisioned the impact of electronic technology on the world and ourselves long before the internet. He would say, I'm sure, and rightly, that global media and transnational industry change the felt world and make us different creatures, in ways that still need to be understood – hopefully not too late.

References

1. McLuhan M. The Mechanical Bride. Folklore of Industrial Man. London: Routledge and Kegan Paul, 1967. First published 1951.
2. McLuhan M. The Gutenberg Galaxy. The Making of Typographic Man. London: Routledge and Kegan Paul, 1962.
3. McLuhan M. Understanding Media. The Extensions of Man. London: Routledge and Kegan Paul, 1964.

Acknowledgement and request

You are invited please to respond, comment, disagree, as you wish. Please use the response facility below. You are free to make use of the material in this column, provided you acknowledge the Association, and me please, and cite the Association’s website.

Please cite as: Cannon G. All games need rules, and other items. [Column] Website of the World Public Health Nutrition Association, August 2011. Obtainable at www.wphna.org

The opinions expressed in all contributions to the website of the World Public Health Nutrition Association (the Association) including its journal World Nutrition, are those of their authors. They should not be taken to be the view or policy of the Association, or of any of its affiliated or associated bodies, unless this is explicitly stated.

This column is reviewed by Fabio Gomes and Claudio Schuftan, both of whom say I am being much too nice to industry. At the time of the NACNE revelation The Sunday Times, where I worked, was owned by News International, also known as the Murdoch Empire.