When it comes to moving the public’s perception on what constitutes healthy eating, it still feels like a seismic shift is required if we’re ever to see the end of the chronic diseases that plague Western society.

Before I delve deeper, I need to acknowledge that I’m prompted in my line of thinking by the previously published comments of expat Kiwi Dr Garry Welch (Hartford, Connecticut) and this piece by Dr Daniel Dawley from Ohio.

Dr Welch says, “It’s not possible to turn around a patient with poorly controlled chronic disease by only treating them with pharmaceuticals, surgeries, and medical treatments. Traditional medical care will always be around, but we need to begin focusing on lifestyle medicine as the way forward.”

Although the sentiments are similar, Dr Dawley approaches it from a different perspective. While he cites evidence from a broad range of diet types and doesn’t deny they can have a positive nutritional impact, he concludes that a whole food plant-based diet “would yield far better and more far-reaching results.”

Dr Welch’s position was perhaps more fully explained in a Substack post by science journalist and author Nina Teicholz on July 11. In it, she mused that Dr Jay Bhattacharya, the sparkling new director of the National Institutes of Health (NIH), must be scratching his head over why, with all the zillions spent by the NIH since its establishment in 1948, they haven’t yet solved the problem of chronic disease. It’s a good point.

Although the chronic health question cuts across both left and right sides of the political spectrum, it doesn’t make the issue any less divisive overall. Over the 77-year history of the NIH, and likely throughout most other health establishments around the world, the problem of commercial sector interest, academic one-upmanship and political influence persist.

Not only has this produced flawed science, but also poor decisions by successive governments and generally, a very confused public.

On the bright side, there are organisations like The Chef Ann Foundation in the US, which is clear and unequivocal about what is needed, particularly in schools where Chef Ann is focused.

On April 25 this year, the Foundation issued a new policy roadmap for increasing scratch cooking in schools, a vital step, they say, towards “unlocking the academic, environmental, economic, and social benefits scratch cooking offers children and communities.”

Schools must serve students more minimally processed meals cooked from scratch, they say. It’s a sentiment we believe should be embraced by everyone with an addiction to the Standard American Diet. It starts with the basics, and ideally, it needs to start from a young age.

But here’s the thing: can you force it? Can any government anywhere actually force (i.e. mandate) such a change? We think not.

At best, all a government can do is stomp on the things that are known to be unhealthy. Smoking, for one, and red dye may be another, but where does butter fit? For Vegans, it’s off the table, but Keto fans love it. At what point do the regulators stop, and personal preference takes over?

While advocates like Teicholz say the answer should have been clear by now, others don’t doubt that it already is – the problem is the public isn’t buying it. For the general masses, there is either complete confusion or lack of interest. For most others, a pill must be the answer.

As we see it, the entire issue can be wrapped up in a homophone with the penultimate letter of the alphabet – Y.

Why do food and grocery companies lobby governments over food regulations? Why are health insurance companies continuously raising their charges? Why is everyone so concerned about the availability and the cost of healthcare? Why are so many snake oil sellers writing best-selling books about health?

Well, if you guessed that the answer to those questions and many others like it began with the letter M, then lights are flashing – money rules it all.

Forgive me if I sound a little cynical and make light of what is, in reality, a serious situation. Putting it more bluntly, you only need to check out what the New Zealand Grocery Council did to internationally recognised NZ academic and public health advocate, Professor Boyd Swinburn, to know the extraordinary lengths big business will go to preserve space on the supermarket shelf.

From the wider public’s perspective, health professionals like Dr Dawley have no illusions about how hard it is to change eating habits. And he knows that we need to look at much more than just the food alone.

“It is not clear to me that we have learned the importance of ongoing and detailed counselling for changes that are difficult for everyone to make,” he says.

I would dearly love to see a de-escalation of the conflict between the two main camps in the food debate. If everyone continues to hold to the ‘my way is right’ mindset, we leave the door open for commercial interests to drive a wedge between, and for politicians to walk all over us.

I can’t see a successful conclusion here that doesn’t allow for both sides to choose their own ‘poison’, so to speak. What we need, especially at primary healthcare level, is a clear and agreed way to measure the outcome.