Contested health advice: celebrity doctor vs celebrity chef

In response to Pete Evans’ advice that “calcium from dairy can remove the calcium from your bones”, Dr Brad Robinson used Facebook to ask Evans.

“Can we make a deal? You don’t give medical advice and I won’t tell you how to best shuck oysters. Agreed?”

Sounds reasonable, yet the lines aren’t so clear.

The medical community has been engaged in a long and ambiguous embrace with celebrity chefs, nutritionists and various other popularizers of medical advice. The dietary advocacy of St. Jamie Oliver (aka mockney gobshite), for example, has been lauded in the British Medical Journal for doing “more for the public health of our children than a corduroy army of health promotion workers”.

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Jamie Oliver in his latest documentary, Jamie’s Sugar Rush. Photograph: Channel 4.

While it is unlikely that Pete Evans will receive similar praise in the Medical Journal of Australia, the medical community has (along with a host of other actors) contributed to the conditions for celebrity life-guides to flourish.

For instance, medical and public health concern over the health-effects of micro-practices such as playing computer games, microwave dinners, dairy consumption, sugary drinks, feeding infants formula, alcohol consumption, or mode of transportation contributes to the production of a population seeking clear and authoritative guidance.

The sources through which such guidance is disseminated extends well beyond the clinic, but it isn’t wholly divorced from the clinic either.

Lifestyle magazines, health websites, television programs and smartphone apps commonly feature “medical experts” as a means of legitimating the guidance on offer. And the use of these tools, especially apps or m-health, is increasingly encouraged by physicians. For example, the Royal Australian College of General Practitioners states that:

M-Health tools can provide continuous, pervasive healthcare at any time or location. By using m-Health, healthcare professionals and patients have the opportunity to continuously monitor health conditions and access health information outside of the general practice environment.

Considering that a significant proportion of the 3 billion apps available via Google Play or iTunes are health-related, the idea of simple demarcation between legitimate and illegitimate advice is naive at best.

The debate over who can give health-related advice is not new. However, the rise of various technologies, coupled with the dual movement of anxiety and fetishization of food in the present, creates an environment where a clear demarcation of legitimate from illegitimate sources of guidance is hard to find.

The fact that Dr Brad Robinson used Facebook to voice his concerns is revealing – especially as his page seems to largely function to promote the success of his private obstetrics and gynaecology practice.

Of course none of this is to suggest that there is no basis from which to judge different guidance or to highlight the spurious nature of Evans’ advice. The point is simply that the medical community has contributed to the creation of life-guide celebrities and that the contest of over medical knowledge and guidance is more complex than simply saying people like Evans should shut up until he has a white coat and stethoscope.

American Vegemite and the “In-Group”: Consumer Ethnocentrism Part 2

Vegemite is a culinary shibboleth of Australian-ness. Paul Rozin and Michael Siegal write that ‘Vegemite may be the best predictor of national identity of any food in the world. That is, if you eat Vegemite, you are almost certainly Australian’.

The cultural significance of Vegemite for Australia is demonstrated by the awkward, yet seemingly obligatory question put to foreign dignitaries – “do you like vegemite?” A quick Internet search reveals that Hilary Clinton and Barack Obama were recently asked for their opinion on the spread, and it formed part of wedding gift to Kate Middleton, Duchess of Cambridge.

Despite this intimate bond with the Australian national identity, Vegemite has been owned by the US-based Kraft Foods since 1935. Partly in response to its American ownership, Australian entrepreneur, Dick Smith launched Ozemite in 1999 as an Australian-made alternative.

The Dick Smith Foods brand replicates other brands and products considered to be Australian, yet are now foreign owned. In outlining the rationale for this endeavor Smith asserted that ‘Australians are patriotic but at the moment the labelling is so deceptive you don’t know what’s Australian. What I can say to people “if you buy a product with a Dick Smith Foods on it – it’s as Australian as you can get”’. “As Australian as you can get” has become the slogan for the Dick Smith Foods brand.

Over the past 12 years Smith has built his brand on a form of ethnocentric consumerism. By appealing to patriotic sentiment, Smith uses and reinforces an “in” or “we” group to direct consumer behavior away from “them” – foreign owned foods, particularly Vegemite – and towards an identification with Australian made and owned foods. The economic success of Smith’s brand is questionable; it is not close to the size of Kraft and many of the products are more expensive.

Smith claims that he is not interested in making money – ‘I have enough money. I’m not greedy, I have adequate money’. Rather he explains that he is ‘doing all this work so a consumer can go into a shop and if it says Dick Smith, it literally means, it’s as Australian as you can get’. A clear focus of Smith’s initiative is to encourage Australian consumers to buy Australian brands and products for domestic economic security, but there is a strong underlying theme of national identity and pride.

With debates continuing over introduction of country-of-origin labelling in Australia, especially in relation to berries from China, the case of Dick Smith and Vegemite demonstrates that in addition to being a mechanism that protects domestic markets, knowledge of the country of origin (and country of ownership) has a potential to tie national or geographic identity to a brand, such as Vegemite. However, country-of-origin knowledge also provides an opportunity to build a brand and gain market share, as in the case of Dick Smith Foods.

While Dick Smith draws on the “in-group” aspect of consumer ethnocentrism, appealing to nationalism to establish a brand and market share, the example of “freedom fries” demonstrates the use of “out-group” to shape consumer behavior.

Part 1 – here

Ivan Illich and the Idol of Lifestyle

Ivan Illlich, the Austrian philosopher, Catholic priest and iconoclast, was asked to give a lecture to a group of American Lutheran pastors on the topic of life. Rather outlining a philosophy of life, Illich called life an idol.

Illich said the pastors were dismayed by his characterisation. After all Jesus is the ‘bread of life’, ‘the way, the truth and the life’, and promises abundant life.

"Ivan Illich" by Source (WP:NFCC#4). Licensed under Fair use via Wikipedia - http://en.wikipedia.org/wiki/File:Ivan_Illich.jpg#/media/File:Ivan_Illich.jpg

“Ivan Illich” by Source (WP:NFCC#4). Licensed under Fair use via Wikipedia – http://en.wikipedia.org/wiki/File:Ivan_Illich.jpg#/media/File:Ivan_Illich.jpg

What could it mean to call life an idol?

For Illich, life is an idol worshiped and used by marketers, theologians, politicians, scientists, journalists, and activist to motivate, reveal and hide all sorts of responses, actions and emotions. Yet, there is never any attempt to provide an adequate definition.

In his acerbic style Illich says ‘when I used the word life today, I could just as well just cough or clear my throat or say “shit”’.

For Illich, life becomes an idol because it is an empty signifier that can be filled with whatever meaning an authoritative and persuasive speaker gives. In his terms, life is an amoeba word. A word that when thrown into a conversation ‘makes waves, but it doesn’t hit anything. It has all these connotations, but it does not designate anything precisely’.

Other amoeba words could be freedom, family, democracy, race, secular, or gender. Illich was not suggesting that the things these words signify or represent are necessarily unimportant or shit. Rather they tend to hide or assume what is at stake.

Amoeba words are imprecise yet produce deep cultural and emotional resonance. Perhaps the more important a topic is the more amoeba words appear.

The use of lifestyle is a case in point. Despite its banal appearance it is a divisive word. It divides lives as “in” and part of “us” from those that are “out” and part of “them”. Sure, lifestyle is used to market insurance or sell funeral packages, but it is also used to identify what is valued and can be disregarded.

The idol of lifestyle is used to justify the careful inclusion of some lives and in the same movement violent exclusion of others.

George H.W. Bush infamously told the 1992 Rio Earth Summit that the American way of life was not negotiable. The rest of the world may burn, but the American lifestyle has such a high value that it will not be compromised.

Tony Abbott’s recent comments about lifestyle choices and remote Aboriginal communities reveal the divisive nature of the term.

“What we can’t do is endlessly subsidise lifestyle choices if those lifestyle choices are not conducive to the kind of full participation in Australian society that everyone should have”

There are lifestyles that ‘fully participate in the life of our country’ and there are lifestyles that are outside of “our country”. Being “inside” grants security, celebration and flourishing, while being “outside” leads to abandonment and exposure. Of course, to be outside is a choice and therefore removes responsibility for care from the “inside”.

Screenshot 2015-03-11 18.26.22

Like Illich’s observations, the idol of life and amoeba words continue to abound in political and popular discourse. Perhaps coughing or saying shit in their stead may interrupt the pronouncements of false prophets and disrupt the flow of worshiping these false gods.

See – Cayley, David. 1992. Ivan Illich in conversation. Concord, Ontario: House Of Anansi

Don’t be surprised by Abbott’s comments about ‘lifestyle choices’

By Christopher Mayes, University of Sydney and Jenny Kaldor, University of Sydney

Prime Minister Tony Abbott’s claim this week that people living in remote communities were making a “lifestyle choice” that taxpayers shouldn’t be obliged to fund was not just the result of an unguarded moment. Rather, the phrase reveals an underlying view that social circumstances are the responsibility of individuals, rather than societies.

Commentators as well as Abbott’s top advisers on Indigenous affairs were quick to criticise the characterisation. Others suggested it was just another prime ministerial gaffe that shouldn’t distract us from the real issues.

Abbott is infamous for his gaffes and “dad jokes”, but this was not one of those moments. A day after he made the remark, the prime minister defended his use of the phrase on the Alan Jones Show.

“Lifestyle choices” was not a gaffe but a neoliberal mechanism of government that adopts a consumer logic to: i) shift responsibility for ‘closing the gap’ on to individuals; ii) trivialise Aboriginal ontological connection to land; and iii) ignore the effects of colonization, while “continuing settler colonial ‘logic o elimination’“.*

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Lifestyle choice: a brief note

I’m currently completing a book manuscript called ‘The Biopolitics of Lifestyle’. So when Tony Abbott made his comments that Aboriginal’s living in remote communities are making a ‘lifestyle choice’, I thought “great, I may need to write another chapter”.

This is not simply a poor choice of words, but reflects a governmental rationality that seeks to place responsibility on to individuals. Education, health, welfare, employment all become ‘lifestyle choices’ for which the individual is responsible.

The affluent, gainfully employed, highly educated sections of society make good ‘lifestyle choices’, while the poor, sick, Indigenous and asylum seekers are characterised as making bad ‘lifestyle choices’.

Abbott is not the first to use this phrase to justify . In 2002, Philip Ruddock described asylum-seekers as making ‘lifestyle choices’.

“In the main, people who have sought to come to Australia and make asylum claims do not come from a situation of persecution; they come from a situation of safety and security,” he said.

“They may not be able to go back to their country of origin but they are making a lifestyle choice.” The Australian, ‘Ruddock blames “lifestyle” refugees’ by Alison Crosweller and Megan Saunders

This governmental rationality shifts responsibility away from governments and communities, and on to individuals. It also serves to trivialize some claims (living in a remote community or seeking asylum) by comparing them to frivolous consumer lifestyle choices (Pepsi or Coke, holden or ford, apple or pc).

Of course, when we talk about the Australian Lifestyle of ANZACs, footy, beach, sun, boats, and weekends, things get very serious. Governments use this notion of lifestyle to build monuments, go to war, and demonize minorities. But that is another matter all together.

In the current context the rationality of ‘lifestyle choice’ shifts responsibility onto individuals in remote communities and justifies the Western Australian government’s decision to cut services and remove people.

Morally Indigestible Listicles: Food, Experts, and the Burden of Choice

Never Eat

The Sydney Morning Herald (via the Telegraph, London) has published another “no-nonsense-straight-shooting-science-based” listicle of the foods YOU SHOULD NEVER EAT AGAIN! These lists seem to appear at least once every week on some form of news website.

This current list is prefaced with references to recent British Medical Journal studies that turned upside down “everything we thought we knew about eating and drinking healthily”. Instead of saturated fats being “the killer”, it turns out carbohydrates are!

Put down that bacon & egg roll and get yourself a KFC Double-Down sandwich!

Surprisingly the article doesn’t question why these new claims have a stronger knowledge base than previous claims or how we can be sure that in a week there won’t be another “nutritional revolution” that will turn this all on its head and finger protein as Grandpa’s real killer.

Leaving aside the science-base of these claims – not to imply this is unimportant – what is most disturbing about these articles (and this article in particular) is the emphasis on individual food choices as the determining factor of health. “Expert” claims that “every bacon sandwich you eat knocks half an hour off your life” reinforce ideas that my heart disease or your diabetes are reducible to that sandwich or chocolate bar eaten six years ago.

When these factoids are spoken by folks in white coats during times of austerity cuts to health services there is a real danger of compounding already existing public health policy problems by pretending that structural influences can be addressed via a nice social marketing campaign or a Jamie Oliver TV show that teaches people how to cook, garden and “never eat those foods again”.

In the UK (where this article originated) David Cameron recently flagged that sick benefits may be cut from people who are obese and do not lose weight. The rationale for this idea is that obese people can lose weight simply by making “correct” and “healthy” food choices. However, according to Cameron, they aren’t making these choices because life is too good on benefits. Hence, cut the benefits and healthy food choices will be made.

While these listicle articles may be dismissed as “not too serious” or “a bit of fun”, they depend on and reinforce a moralistic and biopolitical perspective on the relation between food, choice and health. This perspective is often used to justify budget cuts to health services due to the expectation that health is simply a matter of individuals making the right choices.

In an article for Public Health Ethics, my colleague Donald B. Thompson and I argue that this perspective is morally and scientifically unjustified. Below is the introduction. If you’d like read the whole thing but the pay wall gets in the way send me an email.

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