Tuesday, 24 February 2015

Bull sperm and ‘poor parents’: the role of myths in public health practice

Posted by Stephen Crossley, Research Assistant on the Fuse HYPER! Energy Drinks research project and a PhD student at Durham University

One of the most interesting themes, in my opinion, emerging from the current research into young people’s consumption of energy drinks, is the way that different messages about energy drinks – who (supposedly) consumes them and how – circulate and often deliver contradictory images and information. Not only are young people targeted by a range of clever advertising strategies from the companies that produce and sell these drinks, but they also receive information from teachers, parents, public health practitioners, media outlets (including social media) and their peers. Adults also receive information from similar sources.

By way of example, many people are aware that lots of energy drinks contain Taurine. Some people, no doubt helped by internet search engines, social media and classroom rumours, also believe that the taurine that is in energy drinks is extracted from bull sperm. This info lies firmly in the realm of ‘urban myth’, although you can perhaps understand where it originated from, given that taurine was first isolated from ox bile and it is present in bull sperm. It can also be found in fish and meat, and in breast milk, although we’ve yet to come across any young people who believe there is industrial scale maternal ‘pumping’ going on in an effort to give the population wings. Somewhat predictably, the taurine in energy drinks in synthetically produced in labs.

Urban myths, although they contain a degree of plausibility, are relatively easy to disprove due to a lack of robust evidence. But there are other types of myths which are sometimes harder to disprove, despite similarly lacking credible evidence bases. Christopher G. Flood (2002) identified ‘political myths’ as coherent narratives which orient discourses in the one ideological direction rather than another. He argued that political myths:

can be said to exist when accounts of a more or less common sequence of events, involving more or less the same principal actors, subject to more or less the same overall interpretation and implied meaning, circulate within a social group.

Contemporary political myths include there being ‘no alternative’ to austerity, the need to crackdown on ‘skivers’ who are ‘welfare dependent’ and the dangers posed by migrants acting as ‘benefits tourists’ or ‘health tourists’. The idea of a group of ‘poor parents’ (in both senses of the phrase) representing a major public health risk to their children as a result of problematic parenting behaviours is, I would argue, another such political myth. These parents are often marked out as being different from ‘us’ by virtue of their residence in ‘deprived’ areas and by their ‘inferior’ parenting practices. In Flood’s words, therefore, the same principal actors are subject to more or less the same overall interpretation and implied meanings.

During the course of our research, we have encountered a small number of stories about parents blending a MacDonald’s ‘Happy Meal’ or a ‘Sunday dinner’ and putting it in baby’s bottles or parents filling milk bottles with energy drinks or other inappropriate drinks/liquids. Previous experience within the research team suggests that similar stories will probably be familiar to many people working in public health and/or nutrition.

Views about ‘poor parents’ have a long and undistinguished history, stretching back to at least Victorian times when there was concern about a ‘social residuum’ (see John Welshman’s fascinating book Underclass for a comprehensive history). Public health practitioners also have a long history of involvement with these ideas and the roles of Chief Medical Officers in propagating ideas about a ‘social problem group’ in the 1930s and ‘problem families’ in the 1950s are particularly sobering, given that they were influenced and supported by The Eugenics Society. Despite over a century of social scientific research, there is no credible evidence of a large number of families with different cultural values or behavioural norms from ‘the rest of us’.

As noted above, many of these ideas originate from politicians, who are keen to differentiate between ‘skivers’ and ‘strivers’ or ‘troubled’ and ‘hard-working’ families and who would have us believe that there is an ‘underclass’ whose parenting deficiencies are ruining the lives of their children. Unfortunately, some public health practitioners do little more than repeat and embellish these political myths, giving them more credibility and potency than they perhaps deserve.

I am not denying that there may well be a parent - or maybe even parents - who have blended a Happy Meal or given their child an Energy Drink. What I do doubt is whether the potential, but as yet unfounded, actions of an extremely small number of parents is worthy of repetition from some - though not all - public health practitioners on the scale that we sometimes see. Shouldn’t we be setting the bar a little higher than second or third-hand anecdotes in terms of ‘evidence-based’ practice and policy making? Not believing, or at least questioning, some of things we read on the internet or that we are told by politicians and, in some cases, colleagues, would be a good place to start. Failure to challenge such stereotypes leaves the way clear for the wider political myth that, in the words of Stanley Cohen (1985), ‘the deprived are not much different from the depraved’.

Cohen, S. (1985) Visions of Social Control, Cambridge: Polity

Flood, C.G. (2002) Political Myth, Abingdon: Routledge

Welshman, J. (2013) Underclass: A history of the excluded since 1880, London: Bloomsbury

Thursday, 19 February 2015

Thunder, thunder, Thunderclap: when a blog post hits the campaign trail*

Posted by Mark Welford

A nationwide viral campaign to remove junk food from supermarket checkouts has been launched on the back of the success of a post on this very blog.

The ‘Chuck out the checkout junk’ campaign was born out of a Fuse open science blog post, which described the ‘pester power’ difficulties faced by parents in supermarket checkouts, what supermarkets are or aren’t currently doing about it, and why they should be doing more in the midst of a growing obesity epidemic.

Written by Mel Wakeman, senior lecturer in nutrition and applied physiology at Birmingham City University and Fuse academic Amelia Lake, dietician and public health nutritionist based at Durham University, the post has received more than 500 views and sparked debate on Twitter.

Mel has now started a campaign using the social media tool ‘Thunderclap’ that has already reached close to 30,000 people.

Thunderclap will simultaneously post the health message on social media feeds
On the Thunderclap page Mel writes: “We are still in the midst of an obesity epidemic; poor diet is to blame for overweight and obesity, tooth decay, type 2 diabetes, high blood pressure, cardiovascular disease, cancers and more.

“As a nation we should be reducing much of the added sugar in our diet but we often need help to do this. Making positive changes to our diet is not easy; cutting down our sugar intake is difficult when it is present in so many everyday foods (like sweets and chocolate) and being constantly tempted to pick up confectionery at the checkout undermines much of our efforts to be healthier. Small changes can lead to big differences however, so let's ask more stores to adopt junk free checkouts.

Marks and Spencer, Morrisons, Asda, Sainsbury's Local and Iceland Foods as well as WHSmith and other non-food stores need to take more responsibility for the products they promote. Many stores have signed up to the Government's Voluntary Responsibility Deal but they could do so much more if they want to demonstrate they are truly committed to promoting healthier diets and improving public health.

“The evidence is irrefutable. Asking stores to replace confectionery with healthier foods will be a huge step forward in helping protect the future of the British public.”

Mel is also writing to the above stores, asking them to seriously consider this proposal.

Show your support

If you want to share your support for the campaign visit the Thunderclap page and click the red ‘support with’ buttons (via Facebook, Twitter or Tumblr).

“Let's make Britain healthier. Please remove all sweets from all tills and make EVERY store take responsibility.”

Thunderclap will simultaneously post the message above on your feed along with other supporters on 9 March when the campaign will ‘go viral’.

Still unsure? Below are six points that explain why this campaign is so important:

1. The UK has one of the highest levels of obesity in Western Europe: 67% of men and 57% of women are either overweight or obese.

2. More than half of men and women are at an increased risk of multiple health problems.

3. The level of childhood obesity is a huge concern. In the UK, 1 in 10 children are obese when they start school. By the time they leave primary school, nearly 20% of children are obese with a 75-80% risk of obese adolescents becoming obese adults.

4. According to the latest diet surveys, children and teenagers consume around 40% more added sugar than the recommended daily allowance; much of this coming from snacks and sweets. We are now seeing diabetes, high blood pressure and signs of heart disease in young children.

5. In 2014 Public Health England reported 12% of children under three have tooth decay and an average of three teeth in these children are decayed, missing or filled.

6. Obesity can reduce life expectancy by 8-10 years. This is equivalent to the effects of lifelong smoking.

*A headline for children growing up in the 1980s

Thursday, 12 February 2015

Could your partner be bad for your health?

Posted by Amelia Lake

With Valentine’s day approaching, what better time than this to discuss the potential effect that moving in with your loved one could have on your health, and in particular on your eating habits. In 2006 I wrote an article for the nutrition publication Complete Nutrition summarising the evidence around the co-habitation effect. In 2006 I was not co-habiting nor was I a mother - how times have changed! Following on from last week’s Fuse blog and my mini rant about supermarket tills, I can feel a whole body of research emerging about the ‘children effect’ on eating, but for now, back to co-habitation.

My 2006 publication was based on research findings from the UK, North America and Australia which looked at the eating and lifestyle habits of co-habiting heterosexual couples, including married couples. Women eat more unhealthy foods and tend to put on weight when they move in with a male partner. On the other hand, a man’s diet tends to become healthier when he starts co-habiting with a female partner - and her influence has a long-term positive impact.

The reason for the change in dietary habits is that both partners try to please each other during the ‘honeymoon period’ at the start of a co-habiting relationship, by adjusting their routine to suit their partner and eating food that he or she likes.

However, women have the strongest long-term influence over the couple’s diet and lifestyle, mainly because the majority of female partners still assume the traditional role of food shopper and cook. Many of you will now be thinking about your own domestic (bliss) situation and who has made more changes and where. I can reflect on the issues we have, especially around portion size! In those early days of co-habitation, it was hard not to have a second helping as I sat at the table waiting for my much more active and taller husband to finish his first helping.

But this co-habitation thing isn't all bad news, or is it? A recent study of around 4,000 older married and co-habiting couples participating in the English Longitudinal Study of Ageing, reported a more positive spin. The participants - aged 50 and above - were more likely to make a positive health behaviour change if their partner did the same. There is an important message from this research, that involving partners in behaviour change interventions may help improve outcomes. However, this study didn't explore the negative effects.

So negative effects aside, it’s that time of year for love and romance. Hold that partner tight and let them know what an amazing team you can be for making positive lifestyle changes. When you are working up public policies, or if you are practitioners seeing your patients/clients or designing interventions, don’t forget about the co-habitation effect and the importance of partners.

Happy romancing everyone!

Tuesday, 3 February 2015

Time to chuck out the checkout junk?

Posted by Mel Wakeman (introduced by Amelia Lake)

As mum to a toddler I usually avoid any kind of supermarket. I am lucky enough to have a local fruit and veg shop (where I welcome pester power!). However the other week whilst waiting at the till in Marks and Spencer I had to summon all my powers of distraction to keep my two year old son occupied so that he didn’t spot the masses of high sugar, energy dense food and have (another) melt down. Hours later, I started venting via twitter (@lakenutrition) and I vowed to write a Fuse blog post on the topic. I got a standard response from Marks and Spencer but more interestingly I got a response from Mel Wakeman (@MelWakeman2) a Senior Lecturer in Nutrition and Applied Physiology at Birmingham City University. Mel had written about this topic on her own blog. Her piece was eloquent and summed up my frustrations and so I asked her to write a piece for our Fuse blog. Happy reading and let's turn the pester power on the supermarkets!

For over 20 years, supermarkets have been criticised for displaying sweets, confectionary and other unhealthy items at their checkouts. Back in 1994, TESCO was the first British supermarket to remove sweets and chocolates from checkouts but only at the larger stores. As of January 1st 2015, they have finally applied this policy to all their smaller stores, i.e. TESCO Express. Their research revealed 65% of their shoppers wanted confectionery removed from checkouts to help them make healthier choices. 67% said it would help them choose healthier options for their children. It only took 21 years but this is definitely a case of better late than never. So well done TESCO for finally stepping up to the plate! Lidl also carried out similar research and found that 7/10 customers would choose a sweet-free checkout over the traditional one laden with chocolate. 68% of parents reported they were pestered by their children for chocolate at the checkout and 66% gave in some or all of the time. So in January 2014, Lidl committed to clearing out the junk from their tills. Great stuff and Aldi have just followed suit with their ‘healthy tills’ campaign. So we are making progress, albeit pretty slow but it's positive. We can do so much better though!

In 2013 the Co-op stopped displays of high fat, sugar or salt products from their checkouts and kiosks. Waitrose and Sainsbury’s also have a policy of no sweets or chocolate next to checkouts now but not in the smaller Sainsbury's Local stores. Why is this? If you make a decision to do something, just do it! You can’t give with one hand and take it away with the other. To me this screams of a half-hearted commitment, where they prioritise their profits over customer health. We are in the midst of a growing obesity epidemic; poor diet is one thing to blame for overweight and obesity, tooth decay, type 2 diabetes, high blood pressure, cardiovascular disease, cancers.......I could go on. As a nation we should be reducing unnecessary sugar, saturated fat, salt and calories from our diet but we need help to do this. Many supermarkets have signed up to the Government's voluntary Responsibility Deal where they have committed to making some of their ranges lower in sugar, fat and salt. They have pledged to help customers make healthier choices and eat more fruit and veg. Joining the deal implies they accept responsibility for promoting better health, so what's with all the checkout junk?!

One way the supermarkets can make a real difference is to curb our impulse buys. You know the ones - standing in a queue, twiddling your thumbs as they check a price for the customer in front. The three for two chunky Kit Kats or £1 bags of liquorice allsorts are staring at you. They suddenly seem so necessary and such good value too! They effortlessly land onto the conveyor belt. These impulse buys at the checkout can add several hundred unplanned calories to a family shopping basket. Yes, we have freedom of choice but the supermarkets that are sticking with the unhealthy are simply undermining all the efforts anyone is making who wants to follow a healthier diet. And it’s not all about adults either. When it comes to the checkout, colourful character laden sweeties are positioned around one metre from the ground; perfectly placed at eye level of a young child. Crafty. I really don't want to hear it is the fault of the parent and they should just say ‘NO’. If only it was that easy. For anyone that has taken their child shopping and encountered the relentless pestering and lie-on-the-floor-screaming-abdabs as we try to unload, pack up and pay for the shopping on four hours sleep, will appreciate how the whole experience can become impossible. Rather than blame and judge the parents (or grandparents etc.) for this disruptive behaviour (yes I have seen the stares, eye rolling, tutting and suggestions as to why my child is having a massive tantrum), blame the shop!

So let’s name and shame. Marks and Spencer, Sainsbury's Local, Asda, Morrisons and Iceland are all refusing to step up and do their bit. Why?! Their lower calorie, ‘lighter’ and ‘fuller for longer’ ranges obviously sell well. Surely offering healthier snacks at the tills will not cause their annual profit to plummet? It's not as if we are even asking them to stop selling these products; just move them to an aisle (preferably far away from the tills!) This is really not rocket science is it? The Government’s responsibility deal is obviously not working because it’s far too accommodating. Stores are reluctant to change and are getting away with it. If nothing happens soon, another 20 years will go by and we will have moved no further on. It really is time to get the junk off the checkouts once and for all.

Tuesday, 27 January 2015

You’ve lost that curry feeling: smell, memory and food research

Posted by Duika Burges-Watson

Grant Achatz, a survivor of head and neck cancer and one of the world’s most adventurous chefs, serves a dish in his Chicago restaurant Alinea that frequently makes people cry. Why would pheasant with shallots, cider and burning oak leaves do this and why should we care about some zizzy restaurant food? The principle is based on a neurological fact – our olfactory system is linked directly to the amygdala-hippocampus complex – the ‘substrate of emotional memory’ (Herz 2004, Soudry et al 2011). Research shows that autobiographical memories evoked by odour are significantly more emotional than those recalled with visual cues. It is sometimes called the Proust phenomenon – after a literary anecdote involving a Madeline biscuit and the recall of a powerful childhood memory. In Achatz’s restaurant, burning oak leaves are not eaten - they take you straight to the excitement of autumn.

Pheasant with shallots, cider and burning oak leaves

In the Fuse-led NIHR/RFPB-funded head and neck cancer ‘Resources for Living’ project, we have been running food play workshops to explore the potential of modern cooking techniques and ideas to improve survivors' eating and experience of food . In our workshop next week we are talking curry – it’s what many survivors have told us they miss the most.
As one of our survivors said:

The first meal I ever had with my husband was a curry. I had never been to an Indian restaurant until he took me in the early eighties. I couldn't believe the aroma the flavours and textures. He said he'd never seen anyone so small eat so much. I was hooked!

I used to hate it when people ordered their own curry and rice and put it all on their plate and didn't share. I liked to try a bit of everything to experience all the different tastes and textures. However I didn't like anything too hot and spicy. I found that too much heat from spice destroyed the rich flavours. So a Madras or anything hotter just seemed to lose taste.

The only thing I can eat now in an Indian restaurant is a bit of poppadum. It's a killer, watching my husband and daughter getting stuck in to a really delicious curry on the curry mile and me sitting with a glass of water. Help!

We will be using knowledge about food and memory, clever cooking skills and some of what social science can offer on food and eating, to create, and explore, a curry experience that cancer survivors can participate in. Curry is, after all, more than about the physical experience of eating. It’s where many Brits get to feel Britishness (speaking here as an Australian we do something similar with South East Asian food). We socialise around take-outs and eat-ins. Curry is also pretty intensely flavoursome, spicy and exciting to eat.

We knew when we started the ‘Resources for Living’ work that our research would have resonance beyond this patient group - head and neck cancer survivors have problems with chewing, swallowing, sore mouths, throat narrowing and damage, taste alterations, smell function decline and more (in various combinations) so their experiences are particularly relevant to understanding how we can cope with altered eating difficulties (think loss of taste and smell in ageing, neurological damage etc). But even for so called ‘normal’ eaters there is interest here. For starters (excuse the pun), do people with ‘normal’ eating habits talk about the relationship between food and emotion, food and thinking? This could be a component of food literacy, particularly in the context of modern manufacturing processes where odours can be created at will. Just think of the experience of supermarket shopping near the bakery section. Does the emotional trickery of circulating the odour of baking bread get you to buy more high fat/salt/sugar foods that you don’t need?

As people age, altered taste sensation can lead to all manner of new habits around food – how might the experience of smell be employed to re-engage those that have lost interest in food? Another example: taste disturbance amongst smokers is well documented; why don’t we employ food therapy to increase desire for a more flavoursome smoke-free life?

Remembering an odour memory yet? Perhaps not, but next time you are transported to a sweet childhood memory, perhaps you’ll notice the smell of it.

Thursday, 22 January 2015

ESRC vision includes plans to promote bold new approaches to knowledge exchange

Posted by Mandy Cheetham
An ESRC grant writing workshop last week organised by Durham University gave us some insight into the ESRC's vision and priorities for 2015 / 2016.

In a helpful overview, Sally Johnson at Durham Research Office, summarised the plans, which include a continued focus on excellent research, quality, timeliness, value for money and potential impact, both in and outside academia. ESRC’s vision is to support ‘transformative’ research, pioneer methodological and theoretical innovation, extend partnerships in priority areas and deliver new, more effective approaches to knowledge exchange. And you don’t have to be a senior academic to submit, as fresh ideas from Early Career Researchers are encouraged. Proposals which include international collaboration are particularly welcomed. There’s more guidance available on the ESRC website.

We heard about a range of current ESRC funding opportunities, including the Transformative Research call which encourages novel developments of social science enquiry, and supports research activity that entails an element of risk (closing date 19th Feb 2015).

Information about all the ESRC funding streams is available here on the ESRC website.  If you’re not sure whether and how your plans fit, you can email remit queries to: esrcremit@esrc.ac.uk
Drawing on their experiences of ESRC grant writing Emma Flynn and Peter Tymms from Durham University shared some of their reflections on lessons learned. Thanks for their permission to share these top tips;
  • Take your time, plan ahead and identify the appropriate funding stream for your proposal. 
  • Identify stakeholders and possible co-applicants with interest and expertise. Engage them early on in the development of the research.
  • Look at other people’s successful grant applications, if available.
  • Turn up at public meetings and events organised by the funding board.
  • Start small and build up towards larger grants over time. Be realistic.
  • Apply for seed corn funding from your University to start to build a track record. Make step changes into new and different areas.
  • Write clearly, avoid jargon. Think about content, structure, headings and format. Put yourself in the position of the reviewer.
  • State clearly why you, why this research, why now, why this university?
  • Seek comments from those with a track record from the relevant funder. 
  • Read, re-read, revise, revise and revise again.
  • Think about who to suggest as reviewers. Build in time to approach them and seek permission before you submit the application. Send them a draft outline copy of the proposal for comment.
  • Learn from reviewers comments, even when (perhaps especially when) they are critical. Rejections are common and everyone gets them. Treat them as a learning experiences. Don’t take them personally, reviewers are not perfect, and keep trying.
  • Accept constructive feedback in a positive spirit. Work from it. Be persistent.

There’s helpful guidance on the ESRC website too about how to write a good research grant proposal.

Good luck!

Tuesday, 13 January 2015

Feeling welcome, getting lost and being my own woman: My first week as a Professor

Posted by Dorothy Newbury-Birch

On Monday last week I was asked to introduce myself to a room full of fellow new starters at Teesside University. For the first time, officially I said: ‘I’m Dorothy Newbury-Birch, Professor of Alcohol and Public Health Research’. WOW!!
Making the news
I remember when I started my last post as a Senior Research Associate at Newcastle University, seven and a half years ago and I was asked to do a presentation to introduce myself to the department and my very clever (I thought anyway) title was ‘I’m a criminologist let me into here’. I’ve been thinking about that presentation a lot over the last few days – not least because I am going to give a professorial inaugural lecture on the 26th January (have you booked yet?). What it has made me realise is that unlike when I have started jobs in the past this one is different.

You know that feeling you have in the first week you start a new job? The feeling of not fitting in; being afraid that people are going to realise you don’t know what you are doing? That feeling of wondering what you are supposed to be doing? That feeling you have that says, please let me in, please accept me which I think is what I was asking in my presentation all those years ago.
My new office
Well I’ve been in post for a week and for the first time in my career I feel that I have fit in from day one; that I do know what I’m doing (well mostly!) and that I am in the perfect place in my career, my institute and my life. I’ve been wondering why that is? Of course it’s because I have been made to feel so included and welcome in my new department. It's also because I was lucky enough to have a colleague come with me at the same time so we were able to share the asking of questions, and spend an hour driving around Middlesbrough looking for a car-park that we had been assigned and laughing so much about not being able to find it. But it's more than all this, it's about knowing that the time is right for me to lead the work I want to lead, to develop my own team to lead work that makes a difference to society. I’m also lucky to have told by my line manager that ‘I am my own woman’ in this job. What does that mean? Well for me, it means that I can spend some time working out a plan for my research and developing a team of likeminded people. I want to be moving forward, to interact with the people who can help me do this and I know that I will be supported to do this.

I can only see good things ahead. I will let you know in a couple of months how it is going and remember if you are at Teesside come and say hello – I’d tell you where I’m based but I keep getting lost!