Ban on surgery for patients who are overweight or who smoke?

(teacher daughter of course)

Wasn't that post deleted for using the n*ve word? I had one deleted for using the n*ve word as according to an anomymous moderator that 'wasn't in the spirit' of this site.



Careful Jayne ....

Never heard that one dd. In my daughter's school they eat in the canteen. I was actually thinking of primary school children. Surely older kids have a say in what goes in their lunch boxes. Or buy food at school, as in GS's school.

Daphnedill up the thread, you ssid to me
"I think you are being extraordinarily naive to think pupils take away messages about good nutrition from cooking lessons in school. Teenagers are more likely to be put off by any messages given out by teachers. Try teaching drugs or sex education to secondary school pupils"

Later you said "Child obesity is falling in every area, except for those from the most deprived families. Public health messages are getting through to young people"

How do you reconcile these two apparently contradictory posts?

I hate to tell you this, jinglbells, but in secondary schools, pupils don't eat what their parents think they will. Sandwiches are discarded in litter bins and sometimes behind cupboards . By the end of the afternoon, schools begin to smell like my food recycling bin.

The Vale of York is in 'special measures' for overspending, which is why NHS England has been able to intervene to get them to review the policy, but can't intervene with CCGs which have the same or similar policy.

There is nothing wrong with a small bag of crisps in a school lunchbox.

Re the lunch boxes, perhaps the parents know what the kids will actually eat to give them enough energy to get them through the afternoon. No point putting salad or veg in if wilted salad and tired looking veg comes home again.

Child obesity is falling in every area, except for those from the most deprived families. Public health messages are getting through to young people. Adult obesity continues to rise.

The Vale of York's rate of hip replacement is 50% higher than CCGs of similar characteristics, despite average rates of osteoarthritis.

www.valeofyorkccg.nhs.uk/data/uploads/publications/commissioning-for-value/cfv-vale-york.pdf

All the CCGs have to complete a 'Commissioning for Value' statement. It looks as though the Vale of York has had much lower thresholds for referral. The new policy brings them in line with other CCGs.

The Vale of York has overspent and presumably the hip replacement rate has been highlighted. They can continue to replace hips at the current rate, but they won't get any money for them, so something else will have to be 'rationed'. The policy now seems similar to other CCGs.

So much for the government giving CCGs control of their own budgets!

Re calories in cardboard - calories are just a way of measuring how much energy there is to burn in stuff (with fire or by digesting it) Everyone knows that cardboard burns well. Rats can and do eat and digest cardboard, as well as enjoying candles and electric cabling, so you can compare how they fare on that compared to corn flakes.

If we could digest cardboard we wouldn't need to throw out all that packaging. However, we would then be charged as much for the box as for the cornflakes so the supermaarket bill would be no lower.

www.theguardian.com/society/2016/sep/06/kids-school-lunchboxes-junk-food-research-england

Despite the shock horror headline, the journalist does concede that there has been some progress:

"The report found some progress: for instance the majority of packed lunches examined by researchers passed the standards for protein (95%) and vitamin C (75%). There was also a significant reduction in sugary drinks, 46% in 2016 compared with 61%, and a reduction in chocolate-based snacks. But there was no improvement for savoury snacks, such as crisps, found in 60% of packed lunches."

Perhaps public health messages in schools and elsewhere are not a complete waste of time, but it just takes a while for people to change their behaviour. It has taken 60 years for cigarette smoking to stop being the norm.

Marks and Sparks have done away with trans fats in their products.

Rice and corn based cereals are the only safe ones to eat if you are going to church later in the morning. Never oats. Fact.

I can't believe that cardboard has got as many calories as cornflakes! Never!

Love Cocopops! Most delicious cereal ever invented.

The government and the food industry need to do their bit, but the final consumer is the person who buys and eats the food.

'You can't ban foods' - no, but Government and the food industry could control what is added to processed food.

Jess mentioned high fructose corn syrup - this is added to shop-bought cakes and cereal bars and biscuits because it extends their sell-by date, but it has been shown to be much more harmful than the ordinary sugar that is used in homebaking, because of the way fructose is metabolised.

Another example is trans fats. In the US there is much more awareness of these fats and things are labelled 'no trans fats' but I've never seen that in the UK.

People may have knowledge of what a good diet consists of and may choose a good diet or a bad one, but rather less knowledge of what has happened to the food they buy and what it really contains.

It would be very interesting if GN did another of their surveys and gave us access to a spreadsheet of the replies (anonymised of course)

It could have columns for exactly what people eat, and whether thay have eaten similar diets all their lives, whether they smoke, what exercise they do, what their occupations are, their attitudes and reactions to risk and stress, then also their medical history and current health position. They could also add the same details about their parents, linked into their own details.

If could be searchable on multiple combinations of details. There are so many members on GN, with lifestyles, experiences and medical history going back many decades, that it would make interesting reading to see whether lifestyles and choices could be correlated with levels of health.

Ah. Thank you, elegran, for mentioning control freakishness. I didn't dare. I'm in enough trouble already for having a mind of my own.

But I did think about it.

Knowing what is good or bad for you is completely different from acting on that knowledge and choosing the good over the bad. Too much urging to eat this or not eat that is likely to have a negative effect, "Oh to hell with them, I'll eat what I like!"

There are regulations on what information should be displayed, and food is mentioned frequently in schools. If people choose to close their ears and eyes and ignore the information, they can hardly be flung in jail for their negligence, can they? Or is that in the pipeline for legislation?

One person may choose to eat a particular "bad" item as an occasional treat in their otherwise "good" diet. Another may live on the stuff. You can't police both of them as they shop and only allow one purchase per customer per week. Adults do the shopping, and adults are not helpless infants.

You can't ban foods that are not perfect nutritionally in every way (according to this year's standards) unless you also control every other aspect of everyone's lives. (Control freaks and food police - fall out of parade and report at once to Big Brother for the orders of the day and your deployment detail. The rest of you 'orrible lot, dismiss to quarters and await further orders. At the double! and no muttering in the ranks or you'll be on a charge.)

PPS i grew up on cornflakes with sugar and whole milk for breakfast. It doesn't seem to have compromised my health. One can worry too much.

Not that chocolate has no nutritive value of course. It's great mountain food. People (me, for instance) eat it for energy (calories) and because it's nice. Ditto cocopops. Manufacturers of cocpops do add some vitamins too, I suppose.

"the real nutritive value of a bowl of cocopops"

I love that . Bit like 'evaluating' the nutritive value of a bar of chocolate. Who cares? Really? People don't eat cocopops for their nutritive value!

My GP brother told me while he was still training that experiments had been done on the nutritive value of a bowl of cornflakes and that the experiments showed that you might as well eat the cardboard box they came in. The experiments were done with rats. The rats eating the cardboard did just as well, healthwise, as those eating the cornflakes.

Seriously though, I think the only difference between us is that I think freedom of personal choice (even when influenced by big business food producers) is important even when the choices people make can be seen as not good. I think food industry advertising is balanced by the fact that children are taught about healthy eating from when they go to nursery school at three or four years old until they leave school in their teens. And with many kids the food education starts even earlier, at home.

I also think that, as well as 'bad' food industry advertising and promotion, there is a lot of well-meaning but ultimately rubbish 'information' thrown at Jo Public from all sorts of other sources, including government. And I still think that encouraging personal responsibility for decisions that we already know will affect our health is a better way to go, in general, than central government law-making on the subject. I think (like you if I've understood your posts correctly) attempts to restrain the worst excesses and misleading claims by advertisers is a good thing to do too.

It's just that, from my point of view, as with all other controversial subjects I ever discuss, it's not a simple choice between right and wrong, in this case between government responsibility for the nation's health and personal responsibility. You seem to think it is.

Jess I think you massively under-estimate the knowledge of ordinary people, leave alone the "intellectual and highly intelligent" ones.