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JEREMY:
Hello and welcome to another episode of Eat This Podcast with me,
Jeremy Cherfas.

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There's a strand of thought about people who eat a bad diet that runs
along the lines of, well, why don't they just make a good dish of

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lentils and a nice green salad?

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Or else let's just ban all advertising for junk food.

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Or even, we should ban the manufacture of addictive, hyper palatable,
ultra processed stuff.

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Now, while each of those may have its merits, none of them really
takes into account the way people actually encounter food in their

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daily lives and how they choose what to eat.

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So in this episode, I'm talking to Corinna Hawkes, director of the
Division of Agri-Food Systems and Food Safety at FAO here

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in Rome. We last spoke back in 2016 when she was professor of food
policy at City University in

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London, developing the idea of the complete food environment.

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Her group's research in the years since has now resulted in a paper
in Nature Food with a nice, bold title.

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"The full picture of people's realities must be considered to deliver
better diets for all." And that's a far

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cry from simple solutions.

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CORINNA:
I got into this because, for a couple of reasons.

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One was because I was doing a lot of work on food environment
policies -- restricting marketing to kids, taxes, nutrition labelling,

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school meals programmes -- and wanting to understand how they could
have more impact.

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The other aspect was just like we need to ...

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was from a food environments perspective, and I was convinced it was
all about like, if we got the food environment policy sorted, it was

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going to solve the problem.

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Just take the unhealthy food away, it's fine.

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But then you realize that when you are doing that, you are actually,
in a strange way, undermining women's agency because they've no longer

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got a choice to choose something that's convenient, that helps solve
other problems, like energy poverty.

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So in a way, the multinational food industry is providing solutions
for women.

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And so we have to think, okay, what ...

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let's embrace that complexity rather than just saying this is just a
single cause and it's evil, let's actually embrace that complexity and

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see what we need to work with in order to make change.

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JEREMY:
In your paper, you say that despite all the policies and

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interventions and initiatives, most people still are not eating
according

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to government-approved guidelines.

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But why is that?

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CORINNA:
There are many different elements that influence what people eat, and
collectively they are not aligned to help people eat

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well. Well, the starting point of the paper, the starting point of
the ideas that went into the paper, was that the reason for that was

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because we live in an unhealthy food environment in which the ...

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When we're walking down the street or whatever we're doing, we're not
surrounded by foods that help us be healthy.

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But what we discovered through the research that I was doing at that
time was that it's really an interaction between a whole range of

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different realities of people's lives.

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So I can live in the same food environment as somebody else and
interact with it in a different way, depending on how much money I

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have, what kind of material resources, what my health is like, what
my mental health is like, the kind of social relations that I have,

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whether there's gender equity.

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There's so many different elements that shape what we eat.

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And we as a world haven't taken that seriously.

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We just think that somehow people just decide what they eat.

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That's not the reality of how people make decisions about what to
eat.

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JEREMY:
So if you take an example like, oh, I don't know, ultra-processed food
or convenience foods,

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there does seem to be more evidence than ever that they're not really
very good for us, but people choose them nevertheless.

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And that's despite even ...

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I mean, there's not much advice to avoid them yet, but people choose
them for good reasons.

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CORINNA:
That's right. I mean, the really important finding of the work that we
were doing at that time was that it's actually very logical to choose

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ultra-processed foods.

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And sensible.

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We were doing some work in South Africa, in really low income
communities.

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And in those communities, people are living in very difficult
housing, tiny little places that are very vulnerable

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and -- shacks really, to be absolutely honest.

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And if you are in that circumstance and you're ...

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you've got someone saying, yes, you should cook a really nice meal
with lots of vegetables and so on.

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Well, yes.

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You know, actually that that's what you want to do, but then you have
instant noodles and you think, I'm going to save money on energy --

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and by the way, my energy supply is completely unreliable -- so I can
make myself and my kids instant noodles.

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Or I can put on a dodgy gas stove which might not even be reliable,
and prepare some food.

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It's actually very logical and it's also safer.

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These are places where gas means that if something sets alight, the
whole place burns down and then you have no home.

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So why not eat instant noodles?

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It's sensible.

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It makes sense.

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JEREMY:
But that's also true, people are also eating instant noodles in
countries where their houses are not going to burn down, their energy

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supply is OK.

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CORINNA:
There's always many different realities, and one of them is time and
labor.

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So in many industrialized countries, women, because it is still
typically women, often work a lot of jobs

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And they're often low pay jobs.

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So they have to work a lot of them.

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And if they're living in households where there's gender inequity,
where they're still responsible for feeding their kids, and when they

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come back from a busy day, it's the middle of the night or whatever
it is when their shift finishes, or where they have to  leave food out

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for their kids.

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Well, of course, ultra-processed food is convenient and packaged.

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And another circumstance, you might have lots of time, you might not
even be working, but you might experience mental health problems -- we

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live in a difficult world -- and find it really difficult to cope
with all of the different aspects of our lives.

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And the idea of then preparing food just becomes too much.

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Or you may be having a sense of identity as a mother where you say, I
want to be a

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good mother, so I'm going to make my kids some nice food, and then
the child doesn't like the food.

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And so you feel like a bad mother because you're feeding your kids
some bad food.

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So you say, I'm going to feed my kid the food that they like.

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And as a mother, I am doing the right thing by feeding my children
the food that they like.

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So there's just so many reasons that drive people towards ultra
-processed foods.

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And because we are treating people as atomized individuals with
responsibility for feeding their children, rather than it being a

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social project, that we should help the world, you know, whether it's
children, ourselves or whatever (it's not only about children) eat

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better, and that collectively we need to be saying, how in the world
can we help us all eat better, as opposed to that individual should be

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doing better to feed their children?

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Very judgmental.

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We need to get away from that.

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JEREMY:
That's an incredible observation that actually, if you're dealing with
a difficult toddler, the food industry's

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got you covered because they know how to make stuff that even
toddlers will like.

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CORINNA:
They know how to make things that toddlers will like.

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And they also understand what it's ...

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how hard it is to be a parent.

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And they understand that if you are finding it difficult to be a
parent and you go into a place

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that's selling these foods, they understand the psychology so that
they say they know that mothers want to have a bonding moment with

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their child, and you're more likely to have a bonding moment over
something that a child immediately brings a smile to their face rather

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than a carrot. It's just, they know that.

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And so what happens is they exploit them.

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They don't say, you know what?

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We get that, but it's not really right.

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How do we create bonding moments over food that's really going to to
help kids be healthy, help families be healthy?

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They say we're going to exploit that.

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And because we can and there is a need, there is an emotional need, 
and we will exploit that.

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And even though they might not use that term and they might just say
we're just giving people what they want, it's kind of weird because

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they are giving people what they want, and they're also exploiting
them at the same time.

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So it's not simple.

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It's quite a complex picture.

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JEREMY:
But when the toddler gets older and goes to school, that's when they
sort of have less choice over what they're going to eat.

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And that's an opportunity maybe -- maybe -- to step in and say, okay,
when you're at school, at least once a day, you're going to eat

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healthy. So why don't school feeding programmes work so well?

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CORINNA:
They can work well.

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And I think there's a lot of evidence that they should be in place,
but they don't work well when they don't take take into account

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children's realities.

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So if they say, I know I've got a great idea, I'm going to put
healthy food and I'm going to just change the menu and put ...

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They don't take into account that children might not be accustomed to
that food, especially if you're from a from a more marginalized, more

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vulnerable family, where you haven't been exposed to healthy foods so
much.

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Then you've got this food on the table and you're like, I don't like
it.

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And so people ... The kids haven't got accustomed to it, so it takes
time.

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So that means that you have to do extra measures to help kids learn
how to like it.

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But the other key element here is the social element.

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If you're with other kids who are laughing at you for eating that
food as opposed to being with you, then you're not going to do it.

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If you're in a social space that is unpleasant, that you don't want
to be in, and you're a teenager, you're just going to leave the

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school, and all over the world, whether it be India or the UK or
whatever, and you find that unhealthy food grows up around the school.

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And what happens is that the kids say, I want to take some autonomy.

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I want to enjoy time with my friends.

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I'm going to exert my identity by going out and showing that I'm
independent and going and buying this unhealthy food, as opposed to

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eating the potentially healthy food in schools.

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Or the food in schools just tastes terrible, and nobody's modeling it.

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Teachers disown it.

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You know, they're not interested in it.

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So what the evidence says is very clear, that you can design a school
meal programme with kids co-created with kids and young people, put it

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in a nice environment, make it socially acceptable.

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It works. If you don't, it doesn't work.

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JEREMY:
But there may well be a problem then, with some kids who are having to
pay for their meals because their parents are relatively well off, and

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others who are getting free meals, and there's a stigma associated
with that.

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CORINNA:
Yeah, certainly in Western contexts that's very widespread.

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I can't talk for all contexts, but certainly in Western contexts.

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And so this is again understanding the reality of social relations
that you can say, right, okay, we're going to give the kids ...

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it's, we're just going to see it as purely as an economic thing.

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So there's a narrative.

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It's all about food prices.

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Food prices is incredibly important.

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But you can make something free for someone and if you don't take
into account social relations, then you're missing this picture, which

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is that it's stigmatised.

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It's like, oh, they're the free -- it was like this when I was at
school -- they're the kind of kids with the free school meals.

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And then if you're in that free school meals place, you're like, I
don't want to be here.

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I'm not going to go and get that meal.

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And then overall, there is a sense that, you know, these are not
meals that are desirable.

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So the point is that when you're designing an intervention and a
policy, you need to take into account all of these different elements;

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the quality of the food, yes.

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Create access.

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But if you only make healthy food accessible, it's not enough.

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If you only make it affordable, it's not enough.

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You need to think about the social aspects.

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You need to think about the identity aspects, the meaning, all of
these different things.

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JEREMY:
So the kids, the kids who are getting free meals and don't want free
meals, in a way that kind of relates to the people who probably

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can't afford it, but see processed food as modern and upper class,
maybe higher status.

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CORINNA:
This is particularly the case in lower and middle income countries
where new foods, new processed foods have come in and are

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seen as modern and desirable because they upset the the standard
social, very often very hierarchical, social relations.

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Now, I'm not saying that that isn't the case in Western cultures.

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I'm saying that, and the combination of these new foods coming in,
which have been around in other places for a longer time.

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And so in places like India, for example, and many Asian countries,
the new foods come in and you think, I want to be modern, I want to

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identify with the future and this is my future.

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Going back to, you know, adobo or, you know, kind of fish or
whatever, like rice.

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That's the past.

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And for some people who are living in more impoverished
circumstances, that past is associated with hunger.

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So even though the food might have been healthy, there wasn't enough
of it -- healthier -- there wasn't enough of it.

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So you might have had rice, you might have had, you know, protein if
you were lucky, you know, a bit of vegetables and you didn't have

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enough. So you when you think about the future, you think ...

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you want to associate with having enough food.

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And then what happens again is that the modern food industry
understands that.

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And they come in with advertising, and they advertise these foods in
a way that says, if you want to be modern, if you want to aspire to

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be better -- which everybody does, we all do -- eat these foods.

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And so it's a combination of something that's really genuine in
people about wanting something better, a frustration with perhaps kind

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of very structured social relations but particularly gender
inequities and where young people are kind of kept down, with the

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advertising companies coming in.

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So it's this combination of things that then flip people, and then we
see dietary change as a result of that.

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JEREMY:
When you consider people who are growing their own food ...

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I mean, there's been a lot of noise over the past decade or so about
so-called nutrition-sensitive agriculture, which is persuading people

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to grow more nutritionally interesting things rather than what they
were growing before.

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That seems like a good idea.

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Does that work?

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CORINNA:
Well, look, everything can work.

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It all depends on whether you take people's daily realities into
account.

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So that's a really good example of how absolutely it makes intuitive
sense.

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People are growing, just growing too many staple foods.

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And that's an important part of the diet.

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But it's not diverse enough.

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We know that dietary diversity is associated with good nutrition.

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The science is very clear on that.

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So how do we improve nutrition diversity for these really low income
families?

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Let's do nutrition-sensitive agriculture, have them grow more
nutritious foods.

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But if you do that without taking into account social relations, in
particular gender relations, in these contexts, you wouldn't be

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successful because it's the women who feed themselves, feed their
families and feed their children.

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And it is women who are often responsible for growing foods for the
family.

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So if you say, okay, get families growing, growing this, this food,
and you don't take into account the labour

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demand of what is required.

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And women are running around doing a hundred and one other things,
then it's just not going to be successful.

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But if you're encouraging women to grow in order to generate income,
in other words, they have to sell at markets in order to generate

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income, and it is men who control the income, then you end up with a
situation where women are still having to do the work, but then men

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take the income and that doesn't improve the nutrition at all.

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JEREMY:
Coming away from poverty in a way, people in people in rich countries,
rich people, are also not

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eating as well as they might.

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And one of the great examples in the paper is about trying to reduce
the consumption of meat, especially red meat.

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You'ld think that would be ...

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I mean, once people agree to it ...

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that would be a kind of easy one, meatless mondays, whatever it might
be.

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But even that doesn't work on a kind of institutional level.

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CORINNA:
And that, again, I mean, there's a range of reasons for that, but that
comes back to the identity and meaning that we associate with food.

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And meat is a high status food in pretty much ...

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not every culture, but in many cultures.

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And in the example that I give in the paper, it's an example which is
a well-reported, well-evidenced association between masculinity and

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meat, in this case in the military, in the armed forces.

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But it could be any situation where masculinity is important and
where taking away meat was viewed

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as, but hang on, you know, I associate that with being masculine,
with being strong, and you're taking it away from me.

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And you're basically saying, I'm taking that away from you, and that's
taking away someone's masculinity.

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And you're also taking away, in this case, the idea of a comfort food
that people really enjoy.

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So people have these very strong senses of associations with food,
and that's fine.

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That's reasonable.

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Again, it's not this, oh, these stupid people, they don't understand
that meat is damaging the planet.

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It's let's understand why people are coming from, you know, why is
this?

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Why is this?

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And actually, if you work with that, you probably can work with
communities to move them away from meat.

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It's perfectly possible.

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And you should do that because the fact is, high meat consuming
populations, it's neither healthy nor good for the planet.

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And but let's not do it in a patronizing way.

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Let's understand where people are coming from and see how we can work
with that.

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JEREMY:
You list in the paper, you and your colleagues list twelve different
things that you ought to

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consider in developing food policy.

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That that's a lot of things to consider.

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But I mean, do you have any advice for policy makers?

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Are they supposed to consider all twelve or can they focus on one or
two?

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How does that work?

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CORINNA:
Yeah. You can't focus on twelve.

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It's too many. It's unrealistic.

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So what we try, and the point that we make in the paper, is actually
a process of prioritization that will vary between contexts.

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And so, we were talking about gender earlier, in certain contexts,
you'ld say look I'm putting this policy into place.

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If I don't take into account gender relations, I'm really, really not
going to have much impact.

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So it's just going to be inefficient to do it.

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So if I want something, if I want to get bang for my buck, I just
need to take this into account.

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Now there's all of these other things around here too, but in this
context, they're just not as important.

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The idea is that you step into people's shoes.

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So in the work that we were doing in other publications, we were
tracing the daily lives of people.

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So if as a policy maker, you remove yourself from it's just because
they can't cook, they're just not educated or it's just that, you

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know, the food prices or whatever, and you actually try and stand in
someone else's shoes and you might actually begin to understand what

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the issues are.

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So that's really what we're saying.

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And then you can think, in this community, in this place, these are
the areas that are really we really need to focus on.

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JEREMY:
The big problem with that is that every community, every situation is
different.

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And all you hear from people in big policy think tanks and whatever
is: it has to work at scale.

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If you want it to work at scale, you can't take account of 
communities.

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CORINNA:
The question that you raise is one that I struggle with.

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I mean, I began and I worked for many years on national policies, and
that's, as I said earlier, that was my entry point

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in the sense that, like, no one should have exposure to junk food
marketing and so on.

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And I still adhere to that.

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So what we're really talking about is deciding on what the biggest
problem is

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and among who and saying for that, what do we need to do?

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And then understanding the situation in those communities.

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You can't solve all of these problems all differently.

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But just let me give you an example again, of a situation that we were
-- I think it was in the Philippines -- that we were, I was working

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with Unicef on this, where there was a situation of people living in
rural, more rural communities,

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of not having accessible transport to markets that sold food at
affordable prices.

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The local markets were, the local stores were very expensive.

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So this is very inherently local.

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But when you think about it, that's really about a rural
transportation issue.

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So then you think, okay, how does this then connect in with the
people who are looking at rural transportation?

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There were people who were looking at that issue.

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So we should get out of the idea that all of the solutions lie in the
Ministry of Health and think about who it is that we need to work

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with in order to scale these solutions, to think, well, rural
transportation, it's not just about food, it's about a whole load of

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things, about employment, livelihoods.

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So there's other people looking at that.

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Let's connect in with other people looking at other issues.

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Because if we just say, this is just from the Ministry of Health,
looking at health problems in our little community, then you're not

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able to start to see the bigger picture.

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So that's that's that's good policy making.

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But you are right.

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And I get, you know, get stuck in this sometimes in the process.

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Like how do you actually, you know ...

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We call it evidence of lived experience.

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How do you gather this evidence of lived experience, you know.

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We agree that this is difficult, but we say at the end of the paper
that the least that can happen is for policy makers

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to come into communities and actually to try and get a sense of the 
...

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of, you know, how these things are.

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I remember giving a talk when I was first ...

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quite soon after starting this work, to some policy makers, and they
were really ...

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They said to me afterwards, they said, I'm really taken with what
you've said.

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We're going to arrange some walks through this, through this
neighbourhood.

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And just that is a move in the right direction.

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JEREMY:
Corinna Hawkes on how food policy makers can begin to address the
reality of people's lives.

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I'll put a link to her paper in the show notes at EatThisPodcast.com.

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It is behind a paywall, but I'm sure if you ask nicely I can find you
a copy.

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I'll also link to the 2016 episode, which marked a turning point in
the high level food policy conversation, from hunger

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to diet and nutrition.

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And here's a thing.

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When I went looking for that episode, I realized with a bit of a
shock that there are now almost 300 past episodes in the archive.

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If you're a relatively new listener, there's a lot there that you
might want to dig into.

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And a final question.

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Last year I offered a little quiz, one question per episode, and some
people seem to find that fun.

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So should I do that again this year?

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Yes or no?

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Let me know.

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Jeremy at EatThisPodcast.com.

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Okay, that'll do for now.

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So from me, Jeremy Cherfas and Eat This Podcast, goodbye and thanks
for listening.