How the poor eat

The UK’s obesity crisis is getting worse. And the government is doing less and less.  Meanwhile, just as they were in Edwardian Britain, the poor are blamed by the well-fed for their irresponsible behaviour.

In 1901, social reformer and chocolate magnate, Joseph Rowntree, calculated, from a comprehensive survey, how much money a family in York would need a week in order to sustain “physical efficiency”. It was 21s and 8d (£1.08 in today’s money). By his calculation, a little more than half of that would be spent on food. But such an income, he asserted, would only provide a meagre diet, less varied than that enjoyed by able-bodied paupers in workhouses.

Rowntree concluded that around half of York’s population were living in poverty and 28% In extreme poverty, unable to acquire even basic necessities, such as food, fuel and clothing. Echoing the conclusions of a similar survey, conducted by a wealthy shipping line owner, Charles Booth in the East End of London between 1886 and 1903 this assertion caused shock and, in many cases, frank disbelief, among the affluent.

How could this be possible? These people must be improvident or feckless, the wealthy opined, in their favourite newspapers, wasting their money on alcohol, tobacco and trips to the music hall. In any case, if they were educated in healthy diets, they would not need to go hungry. 

In reality, the poor lived on white bread, tea, sugar, stewed greens and cheap cuts of meat. The thrifty and eagle-eyed would shop at antisocial times, such as Saturday nights when spoiled food was disposed of. They would buy food in tiny quantities. Groceries were generally bought by the ounce, meat and fish by the halfpennyworth. Popular purchases included cheese crumbs from the grocer and cods' heads for fish cakes, 'pairings' from the tripe shop and bones from the butcher that could be boiled into a watery soup. No KFC or McDonald's then.

Life on a pound a week

For the poorest, bread could account for an eighth of family income. Some food was, frankly, weird. In Birmingham, a dish called 'slosh' or 'slop' consisted of the leavings of a tea pot, poured over a slice of bread and drained off, with the addition of a knob of margarine. Universally, a stale loaf would be toasted and mashed with tea and sugar (milk was too expensive) to provide an alternative to rusks for babies. 'Cag-mag' was butchers' trimming, often of dubious quality, parcelled together. A shilling's worth of cag-mag could be made into a stew on a Saturday night and served up for breakfast on a Sunday morning. Yum.

For comparison, Edward VII, Britain’s monarch from 1901 to 1910, known by his subjects as ‘Bertie’ and ‘tum tum’, enjoyed four meals a day and dinners of 12 or 14 courses – pheasant stuffed with truffles, quails filled with foie gras, sole poached in Chablis garnished with oysters and prawns and boned snipe with Madeira sauce were favourites. He would have a cold chicken placed at his bedside, in case he became hungry in the middle of the night.

An Australian-born journalist and feminist, Magdalene Reeves, researched typical expenditure and diet in south London in 1911. It was the year after King Edward, died, aged 68, his demise hastened by his heavy smoking and gluttony.

Her pamphlet for the Fabian's Women's Group, ‘Family Life on a Pound a Week’,  breaks down the 50p that were spent by a city warehouse worker, Mr W, and his wife every week on food. At 15p, meat made up the largest part of the budget. In descending order, came bread, butter, flour, milk, tea, sugar, dripping, potatoes and greens. She writes: "Cold meat, with bread and butter and tea, would be provided for the evening meal. The "eternal bread, butter and tea” would be breakfast.

Life wasn’t that different for the hard up when author George Orwell travelled to industrial Lancashire and Yorkshire in 1936 to research, ‘The Road to Wigan Pier’. Publisher Victor Gollancz had commissioned an account of unemployment and social conditions in the north of England. It was. But he took violent exception to Orwell’s description of how ordinary people perceived socialists – as bearded sandal-wearers, vegetarians and nudists.

Orwell’s description of the psychology of the poor and their attitude to food is acute. Like Booth, Rowntree and Reeves, he carefully itemises the weekly budget of an unemployed Yorkshire miner and his wife. It totals £1.60 with almost a third allocated to rent. He observes: “The miner's family spends only tenpence a week on green vegetables and tenpence halfpenny on milk and nothing on fruit; they spend one and nine on sugar and a shilling on tea. The basis of their diet is white bread and margarine, corned beef, sugared tea and potatoes.”

He adds: “Would it not be better if they spent more money wholesome things like oranges and wholemeal bread, saved on fuel and ate their carrots raw? it would, but the point is that no ordinary human being is ever going to do such a thing. The ordinary human being would sooner starve than live on brown bread and raw carrots. When you are underfed, harassed, bored and miserable, you don’t want to eat dull wholesome food. You want something little bit ‘tasty’.” Like “three pennorth of chips” he suggests – in today’s terms, a Deliveroo Big Mac or a pizza.

Obesogenic environment

Our food choices are not rational. They are governed by emotions and volitions that we do not understand and by simple proximity and convenience. The same arguments that were deployed against Booth and Mayhew are still used today – that the poor could eat healthily, if they wanted or chose to. But the odds are stacked against them more than ever.

Unhappy humans are still governed by perverse instincts of immediate gratification from energy-rich sugar and carbs, as identified Orwell, but they face additional problems that he did not anticipate. We live in a world which encourages us to eat unhealthily from every supermarket aisle and billboard and in which sugar and salt-laden, ultra-processed and additive-filled foods are relatively cheap and ubiquitous. It has been called an obesogenic environment.

A hundred years after Orwell’s journey to Wigan, the food landscape has changed radically. Today, just eight companies control 90% of UK food supply. A quarter of places to buy food on the high street are fast-food outlets and food advertising is dominated by confectionery, snacks, desserts and soft drinks.

According to The Food Foundation, the most deprived fifth of the UK population would need to spend 50% of their disposable income on food to meet the cost of the government recommended healthy diet – a metric that is worsening year by year. This compares to just 11% for the least deprived fifth. The default UK diet – low in vitamins and minerals, high in starchy carbohydrates, fat and sugar, has produced an epidemic of obesity. And it’s getting worse.

A Defra select committee reported this July that rising food prices caused by the Covid pandemic, Brexit, climate change and the Ukraine mean that a fifth of UK households are resorting to unhealthy, high-calorie diets, due to trouble in accessing good quality food at reasonable prices. The report says: “The promotion of cheap, calorie-dense foods lacking essential nutrients has resulted in 30% of the population becoming obese. This figure is expected to rise to 40% by 2035, with NHS spending on Type 2 diabetes treatments outweighing current expenditure on treating all cancers.

Government retreat

The government has retreated in the face of this unravelling catastrophe. Attempts to modify our obesogenic environment appeared, in a modest form, in 2011 in the form of a ‘voluntary public health responsibility deal’ for the food industry. In 2016, a sugary drinks tax was introduced. But in June 2022, Henry Dimbleby’s 300-page Defra commissioned food strategy, proposing taxes on salt and sugar, free fruit and veg for those on low incomes, advertising restrictions and expanded free school meals was kicked into touch, causing Dimbleby to resign.

Introducing, in his Conservative party conference speech, a modest progressive restriction on the sale of cigarettes, Rishi Sunak said that the smoking is the UK’s biggest entirely preventable cause of ill-health, disability, and death. However, as campaigners pointed out, obesity costs £27billion a year through its knock-on effects – £10bn more than tobacco.

Why act on one public health issue and not another and fail to save the NHS billions? Put on the back foot in an interview with the BBC, Sunak said that here is “no safe level of smoking” and it “isn't the same as eating crisps or a piece of cake”. These statements are misleading and disingenuous. The argument that we are “free” to choose junk food, or not to, is a fig leaf – especially for the poor. 

The tobacco industry is also in retreat and has shifted its gigantic marketing budgets in wealthy countries from smoking to vaping, especially among the young, with flavoursome addictive options. The UK food industry, led by the Food and Drink Federation has lobbied hard, and successfully, against measures that would risk reducing its profits, so that nearly all healthy food options are more expensive than the alternatives. Where is the freedom in that?

Will Hatchett has been a journalist since 1986 He was editor of Environmental Health News from 1998 until 2018. The views expressed here are purely his own.

This blog was posted on the RHE Global website

On ‘Bread 2’ and the rise of alt-carbs

The launch, this month, of the Superloaf by Oxford-based company, Modern Baker, turned the thoughts of this blogger to the topic of the role of bread in the politics of health. It's pretty important – most of us eat it everyday – and, in some ways, it defines countries and their cultural attitudes to health and food – the French stick, sold and consumed each day, versus the British long shelf-life polywrapped sliced loaf.

 

Well a new player has just entered the crowded bread ‘space’ on these shores. The Superloaf, now available in branches of M&S and through Ocado has been billed by its creators, with a degree of marketing hyperbole, as ‘smart bread’, an ‘alt carb’, and ‘Bread 2’. So what is it?

 

First, it’s sliced bread in a poly wrapper, like we’re us used to. It’s made with standard white flour on high-speed machinery using the Chorley Wood bread process (invented in 1961 and used for 80% of British bread). It is co-manufactured by Hovis. However, the Modern Baker company uses what it describes at ‘targeted fermentation’. It omits refined sugars and adds fibres and bioactive plant compounds, to create a product that, the makers maintain, is better for blood sugar levels, more nutritious and has fewer carbohydrate than standard, mass-produced bread.

 

Its ingredients include psyllium husks, pumpkin seeds, brown flax seeds, apple cider vinegar and kelp – which would all be at home on the shelves of a health food shop. It does contain salt, which is bad for blood pressure, but far less than conventional bread.

 

Backed by funding of nearly £1m from Innovate UK, Modern Baker has grown to a 15-strong workforce and can make up to 20,000 loaves a week. The makers say that their product has the fluffy deliciousness of mass-produced bread – that claim has yet to be put to the test by this blogger.

 

Is this baking innovation a good thing? Hell, yes. As I may have mentioned before, ultra-processed food, especially in carbohydrate-rich forms, such as the nation’s favourite, sliced white bread, is a major contributor to the obesity-linked conditions which are clogging up the NHS. But the Superloaf is not cheap. Its recommended retail price for a 400g loaf, £2.30, compares unfavourably to Ocado’s M&S soft white medium sliced loaf, which costs 85p and weighs in at 800g.

 

In other words, it is four times more expensive – placing the gut microbiome-friendly Superloaf at the costly, niche end of the bread market, rather than in the school lunch box. In a more sensible and healthier world, the UK government would intervene in the bread market with taxation. A loaf of medium-sliced white bread would cost more than twenty cigarettes and the Superloaf would be less than a quid.

 

Don’t expect such a fiscal intervention to happen any time soon. No government in history has been elected on a manifesto promise of making bread more expensive.

 

Revolting bugs

 

Before trading standards services took on the job, environmental health practitioners and their predecessors used to tackle the mis-selling of food. It was a serious business – bread could lose most of its nutritional value by being adulterated with chalk dust or alum, milk was routinely watered down.

 

In some cases, adulterated food was highly toxic. In 1858, the nation was shocked when 21 people died in Bradford after eating the products of ‘Humbug Billy’ – sweets to which arsenic had been mistakenly added, instead of a popular sugar substitute, powdered gypsum, called ‘daff.

 

The case brought to light the need for specific, food-related legislation and a spur for this was provided by the work of chemist and pioneer microscopist, Arthur Hill Hassall, who carried out the UK’ first comprehensive food sampling programme, in the 1850s.

 

Hassall had previously appalled the public by discovering, through his lens, a new universe of weird-looking bacteria and other micro-organisms in water from the Thames. His equally alarming discoveries concerning food were published in The Lancet and led to the Food Adulteration Act of 1860.

 

The pioneering act of 1860 was strengthened in 1872, by the addition of sampling officers and public analysts, and, in 1875, the Sale of Food and Drugs Act introduced meaningful sanctions for those adding injurious substances to food or drugs.

 

The war against food adulteration and mis-selling is far from over – as the ‘horsegate’ scandal of 2013 made clear and this year’s discovery of rotten pork being sold for human consumption. A country disrupts relations with its main trading partner and abandons food controls imports to avoid bureaucracy – what could possibly go wrong?

 

What it says on the box

 

Adding extra ingredients to a staple of life to make it healthier, has a more recent history. The fluoridation of water to reduce tooth decay is a classic example. It was speculated in the nineteenth century that diets supplemented with fluoride would protect populations against tooth decay. Experiments in the US in the 1940s, confirmed the hypothesis and the fluoridation of water was born.

 

By 2008, more than 70 percent of the US population was served by fluoridated public water supplies. In England, as of 2023, only 10 percent of the population benefits from this scientifically-validated public health measure. Its opponents, who were the anti-vaxxers of their day, have been spreading a trail of disinformation since the 1960s.

 

Food fortification, or enrichment, has been less controversial, although it is opposed by some on civil liberties grounds. UK regulations of 1998 require that all flour, except wholemeal and some self-raising flours, is fortified with calcium, iron, thiamine (vitamin B1) and niacin (vitamin B3). It’s not uncommon to see niacin, riboflavin, thiamine, vitamin B6 and folate among the lists of ingredients of ultra-processed and extremely sugary cereals. In 2011, Kellogg’s made a commitment to add vitamin D to all of its children’s cereals.

 

Adding folic acid, which produces vitamin B9 in the human body, to bread has been adopted in more than 80 countries in the last two decades. It is proven to reduce birth defects, such as spina bifida, and anaemia. The US was the first country to mandate folic acid in bread, in 1998. Australia, New Zealand and Canada, followed suit. The UK government is currently consulting on a proposal to add 250 micrograms of folic acid per 100 grams of non-wholemeal flour.

 

You could say, as some food campaigners do, that much of this chemical fortification is merely adding nutrients back to ultra-processed foods from which they have been stripped, in a less bioavailable form. This blogger could not possibly comment.

 

The latest, and controversial to some, gene-editing technology known as CRISPR now enters the picture. CRISPR, is already being used to biofortify cereal crops such as rice, wheat, barley and maize, for example, adding carotenoids to rice, which convert to vitamin A and can prevent blindness. Tomatoes engineered to contain high amounts of gamma aminobutyric acid (GABA) are designed to reduce blood pressure.

 

The Superloaf, which is the product of five years’ research into the relationship between producing and baking dough and the gut biome, is a good example of ‘food as medicine’ – a trend which will certainly continue. EHPs and their colleagues, trading standards officers, will be tasked, as they have been since the nineteenth-century, to protect the public and to test marketing statements against reality.

 

Will Hatchett has been a journalist since 1986. He was editor of Environmental Health News from 1998 until 2018. The views expressed here are purely his own.