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Wednesday, 6 February 2013

When “Healthy Eating” Becomes Police Business



We’ve had a wonderful summer in New Zealand, with one of the driest Januaries on record. So we Kiwis get out to the beaches as much as we can, soaking up the life-giving rays of the sun and marinating in the surf. 

Music: Forever Changes by Love (opens in new window). 

We usually drive to get any great distance; in fact we’re high in the stats for vehicle ownership thanks to our acceptance of cheap, excellent quality, second hand Japanese car imports. Consequently the roads get a bit busy and, now and then, unsafe on holidays.

Last Monday was Anniversary Day, and I was driving back to Auckland after enjoying sun and surf at Papamoa near Tauranga. The weather was hot, the road still not so busy, as I cleared the Karangahake Gorge and headed into Paeroa. Suddenly, I found myself in a thick stream of traffic that had slowed to a crawl on the outskirts of Paeroa.

[Digression, for entertainment purposes only. Note the Boer War memorial, the rock on a plinth in the upper right corner. This monument bears two plaques; one to commemorate the consecration of the monument on the date of the coronation of King Edward VII, the other, of equal size, to advise that the coronation was in fact delayed due to illness and to correct the information on the first plaque. Obviously didn't have Twitter in those days. Edward was operated on for appendicitis by Sir Frederick Treves of Elephant Man fame, assisted by Joseph Lister, and made a full recovery. Apropos of the King, as wikipedia states in its inimitable house style:
"The tradition of men not buttoning the bottom button of waistcoats is said to be linked to Edward, who supposedly left his undone due to his large girth.[9] His waist measured 48 inches (122 cm) shortly before his coronation.[44] He introduced the practice of eating roast beef, roast potatoes, horseradish sauce and yorkshire pudding on Sundays, which remains a staple British favourite for Sunday lunch
."]

To continue:
Some minutes later we could see the cause of this obstruction: a police checkpoint. This would normally be expected to relate to testing for alcohol, or checking vehicles and warrants of fitness for roadworthiness, or investigating a recent crime. Police business. 

My car was waved over and stopped. With the clear sense of innocence that comes from imperfect recall, I wound down my window and listened to the police officer.
A campaign against driver fatigue; would we like a bottle of water for each person in the car, and a leaflet on avoiding fatigue? Yes please, and I drive off.

Later I looked at this leaflet. (pdf download). Tips for healthy eating, published by the Accident Compensation Corporation in 2007.

In other words, the New Zealand Police were detaining motorists to give them a leaflet printed by another arm of government, the ACC, that contained “healthy eating” propaganda information that is usually the responsibility of the Ministry of Health. Very interesting.
Now let me just say straight out, I don’t have a problem with the Police doing this. Anything that makes their presence felt on the roads on these holiday weekends reduces the crash rates (I don’t believe there were any serious crashes between Paeroa and Auckland that day), the water was a welcome gift for many, they would be able to weed out really intoxicated drivers or unsafe vehicles or loads through the checkpoint if such appeared, and the “softly softly” approach to policing is good for public relations.

Nor do I have too much of a problem with the leaflet. The “healthy choices” specified are generally more nutritious than the foods they are meant to replace, and even if the message has an anti-fat bias, the fat you’ll find in a donut isn’t its saving grace. My own breakfast that day was fried bacon, eggs, black pudding and tomatoes, and I stayed alert and didn’t get “so hungry” or eat at all till dinner time; which is a contrast to how I used to feel driving long distances on the old “healthy” diet – tired and hungry and somewhat sick.

What interested me most was the sole “scientific” claim in the leaflet.
A study of a truck fleet showed that the number of serious crashes soared half an hour after the drivers ate fatty or sugary foods

No reference given. My God, I thought, what truck fleet has so many serious crashes that these sorts of statistics are able to be generated? Whatever they eat, this company sounds like a public menace.
On the face of it, there are other flaws in the argument; most accidents involving trucks are not the trucker’s fault, and there are increased accident rates at certain times of day, due to circadian factors, which may coincide with meals. Did they separate sugar from fat, from starch, from total calories?
The study is mentioned online in terms suspiciously similar to those in the leaflet, but never referenced, and seems to be immune to my normally productive search style. I am only able to learn that it took place in the UK.

This called for a phone call to ACC, then an email to their statistics department, which received a prompt acknowledgement and began a wait for information. Meanwhile, I checked out references to driving safety in David Benton’s “Food for Thought”. Too much or too little blood glucose is associated with accidents. Lowered cholesterol levels (by drug or diet) are associated with a doubled risk of death by vehicle accident, homicide, or suicide (pdf), probably due to increased aggression (I suspect this might not be the case if increased fish consumption caused the drop, but only if it was due to polyunsaturated seed oils, or statins and other drugs).

This would seem to contradict the message in the leaflet if the first part of the lipid hypothesis were to actually be true (I suspect that cholesterol and diet are not so predictably linked at the individual level).

Less fatigue in the short term perhaps, but more aggression and self-harm on our roads as healthy eating works its dark magic over time.

My advice for safe driving would be to avoid foods that cause blood sugar slumps (refined starch and sugar), skip anything deep fried, go for a little protein (cold meat, smoked fish, boiled eggs, cheese), raw vegetables and fresh fruit if you’re hungry on the road. Eat a filling breakfast like I did but otherwise don’t fill’er’up till you get where you're going. Drink plenty of water, if for no other reason than to make you stop and stretch your legs whenever you pass a toilet. Drink coffee, black or with cream, rather than uber-sweet energy drinks, but not too much too soon . And, over the longer haul, unless you are under the care of a competent cardiologist for good and proper reasons (perhaps time to reconsider whether you should be driving precious or heavy loads on long trips at all), avoid the temptation to tamper with your “cholesterol”. That’s a form of self-abuse with the potential to lead to mental and physical degeneration.

Look, I’m no Zoe Harcombe. I’m not even very good at math, so I’m not going to wait till the study arrives and post the analysis that’s been lacking, I’m just going to post this review of the leaflet. When the study turns up, I’ll link it and discuss it in the comments section of this post. The thing I find interesting here is the insight into how government departments turn epidemiology into action (or, perhaps, how they select epidemiology that supports actions decided on for other reasons). As I said, I don’t have much of a beef with the pamphlet itself (except for the sloppy citation).

11 comments:

Galina L. said...

I liked the phrase "marinating in the surf". I also live close the ocean shore but in Florida. Still I didn't get used completely to the heat, and rather stay in the water than soaking sun on the beach.

George Henderson said...

The proportions of the electrolyte salts in the sea are very close to the ratios which surround the cells of animals. It's got to be good for you; it's also a relaxing form of exercise.

Wout Mertens said...

So why avoid anything deep fried? Even if it's potatoes in tallow?

George Henderson said...

Are you going to find potatoes in tallow at a truck stop or a roadside cafe?
There might also be an issue about digestion of heavy meals and concentration. Diversion of energy to the gut, carbs and serotonin drowsiness, and so on.

Wout Mertens said...

Well, in the South of Belgium you actually might find tallow-fried fries, although not near the highways. So we're talking hypothetically here :)

Digestion, yeah possibly. I haven't really noticed it when I eat home made fries, I'll pay attention next time...

George Henderson said...

Well I remember when I was a kid in 60s New Zealand we had chips (i.e. fries, the other things were called crisps) cooked in dripping from fish and chip shops. No-one thought of them as health food even then but it was cheap energy. And they sat fairly heavily on the gut, but then they were very cheap and moreish too (and you'd usually get something battered with it).
I suspect that if you ate no more than a handful and gave the rest to the birds it might be a different story, but no-one I know did that, we needed to store the energy because we knew we'd be up early next morning walking 40 miles to school in the snow in bare feet. Well I did do a lengthy paper run then rode my bike to a school across town. Activity is a dirty word in some circles for various reasons but it's silly to ignore it.

George Henderson said...

I received a reply about the leaflet from ACC on the weekend; here is the relevant part.

The publication Better Fuel ACC4309 was developed in 2006. ACC sourced the reference to the study from the AKILLA Drowsy Driving Educational Campaign website. ACC have contacted New Zealand Sleep Safety Ltd the company who runs the website and they no longer have access to a copy of the research used to support the phrase in question. Therefore, ACC cannot provide you with a copy of the study referred to in the publication Better Fuel ACC4309. This decision complies with section 18(e) of the Act.

As the supporting research for the statements concerned can no longer be sourced, ACC will review the Better Fuel ACC 4309 brochure to see if it is still appropriate to retain the reference to the study. Thank you for bringing this issue to ACC’s attention.

George Henderson said...

The website that supplied the information to ACC:

http://www.akilla.co.nz/

NIKA SHALIKIANI said...

Saved as a favorite, I really like your blog!

George Henderson said...

Sleep Disorders as a Cause of Motor Vehicle Collisions

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3634162/

It is possible that sleep loss drives any eating habits connected with unsafe driving. Sleep loss (e.g. apnoea) perhaps being caused by those habits in the first place, in a vicious cycle?

Wout Mertens said...

That's easy to believe... a couple of bad sleep nights and I turn into a carb fiend, too tired to make/acquire proper food and craving chocolate, french fries, rice noodles, ice cream, creme brulee...
afterwards I sleep well :-)