Professional Documents
Culture Documents
(Routledge Studies in The Sociology of Health and Illness) Carolyn Mahoney - Health, Food and Social Inequality - Critical Perspectives On The Supply and Marketing of Food-Routledge (2015)
(Routledge Studies in The Sociology of Health and Illness) Carolyn Mahoney - Health, Food and Social Inequality - Critical Perspectives On The Supply and Marketing of Food-Routledge (2015)
Health, Food and Social Inequality investigates how vast amounts of con-
sumer data is used by the food industry to enable the social ranking of
products, food outlets and consumers themselves, and how this influences
food consumption patterns.
This book supplies a fresh social scientific perspective on the health conse-
quences of poor diet. Shifting the focus from individual behaviour to the
food supply and the way it is developed and marketed, it discusses what is
known about the shaping of food behaviours by both social theory and
psychology. Exploring how knowledge of social identities and health beliefs
and behaviours are used by the food industry, Health, Food and Social
Inequality outlines, for example, how commercial marketing firms supply
food companies with information on where to locate snack and fast foods
while also advising governments on where to site health services for those
consuming such foods disproportionately. Giving a sociological underpin-
ning to Nudge theory while simultaneously critiquing it in the context of diet
and health, this book explores how social class is an often overlooked factor
mediating both individual dietary practice and food marketing strategies.
This innovative volume provides a detailed critique of marketing and
food industry practices and places class at the centre of diet and health. It
is suitable for scholars in the social sciences, public health and marketing.
Dimensions of Pain
Humanities and Social Science Perspectives
Edited by Lisa Folkmarson Käll
Forthcoming titles:
Carolyn Mahoney
First published 2015
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
and by Routledge
711 Third Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis Group, an informa
business
© 2015 C. Mahoney
The right of Carolyn Mahoney to be identified as author of this
work has been asserted by him/her in accordance with sections 77
and 78 of the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or repro-
duced or utilised in any form or by any electronic, mechanical, or
other means, now known or hereafter invented, including photocop-
ying and recording, or in any information storage or retrieval
system, without permission in writing from the publishers.
Trademark notice: Product or corporate names may be trademarks
or registered trademarks, and are used only for identification and
explanation without intent to infringe.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
Mahoney, Carolyn, author.
Health, food and social inequality : critical perspectives on the
supply and marketing of food / written by Carolyn Mahoney.
p. ; cm. – (Routledge studies in the sociology of health and illness)
Includes bibliographical references.
I. Title. II. Series: Routledge studies in the sociology of health and
illness.
[DNLM: 1. Food Industry–ethics–Great Britain. 2. Food
Preferences–psychology–Great Britain. 3. Marketing–Great Britain.
4. Obesity–etiology–Great Britain. 5. Social Class–Great Britain. QT 235]
RA645.N87
363.8–dc23
2014034587
Typeset in Sabon
by Cenveo Publisher Services
Contents
List of figures vi
Preface vii
Acknowledgements x
9 Conclusion 216
References 228
Index 258
Figures
As this book went to press in the summer of 2014, a new global study of
obesity and health was published in The Lancet tracing its rise since 1980
(Ng et al. 2014). In the intervening period, no country has succeeded in
reversing this growth, though the rate of increase has slowed in some devel-
oped countries in recent years. But as the authors of the study emphasise,
overall rates do not reveal the continued rise of obesity and diet-related
illness among some subgroups, including low socio-economic groups. Diet-
related illness also affects many who are not obese; nor is a large body-
weight a guarantee of ill health.
That is what this book focuses on – the relationship of diet and diet-
related health to social status, and the supply side contribution to this
relationship. While examining the case of the UK in particular, it encom-
passes many global aspects of obesity and pulls together evidence from
many (mostly developed) countries. As sociological research, it discusses
social status in the language of social class, and explores how class, food
and health are related. It also examines studies from a broad range of disci-
plines which substantiate the food–health–class link, including the particu-
lar role of bodyweight in health.
Although food, health and class have to be discussed in terms of food
consumption and dietary types, or what is sometimes called food behav-
iour, the focus of this book is on the activities and strategies of food produc-
tion: the role the food industry and food marketing play in developing and
targeting the food supply at population groups, and how this might reflect
and influence social and health inequalities. The new global obesity study
itself argued that more effective intervention was needed to tackle the major
determinants of obesity, including not only diet and exercise, but also vari-
ous dimensions of ‘a problematic obesogenic environment’, including ‘the
active promotion of food consumption by industry’ (Ng et al. 2014: 15).
A series of international studies published in The Lancet the same week
as the global obesity study focused on hypertension. An editorial reviewing
the relationship of hypertension to diet and bodyweight concluded that
interventions to prevent and treat hypertension in future should be devel-
oped in the context of the ‘adoption of a healthy food environment’
viii Preface
(The Lancet, editorial, May 2014). Furthermore, ‘stronger advocacy of this
broader approach’ was urged among doctors themselves.
This book discusses how and why our food environment has altered and
the role it plays in influencing dietary ‘choices’. If the food industry is accus-
tomed to researching the power of human psychology in food consumption,
and links between social status, neighbourhood and dietary practices, then
these food industry understandings need to be studied by social scientists of
health, healthcare practitioners, patients and policymakers.
While this is a sociological investigation, it also provides some solid back-
ground on the less familiar, supply side of the coin for public health and
healthcare practitioners interested in this topic, and perhaps especially
those dealing with diet-related illness in patients. Understanding how
people are targeted with a particular range of foods in terms of where they
live and their socio-economic background can give both practitioners and
patients/consumers a deeper understanding of the persistence of dietary
patterns and their health effects.
But to challenge an idea as apparently commonsensical as the one which
posits that people get fat (and possibly ill) because they’ve eaten too much
purely from greed or at least lack of self-control requires a detailed theo-
retical analysis. Not everyone will wish to read Chapters 2–4, in which a
critical methodology and a range of social theories are investigated, but if
they do, they will find that these ideas illuminate empirical reality – and vice
versa – throughout. The theoretical investigation discusses the long tradi-
tion of the food–class relationship and theorises food production and the
role of the food industry in influencing class-differentiated consumption
and health. The following empirical chapters then pull theoretical insights
through to give greater depth and contextualisation to the topic at hand.
This book also raises questions for public policy. What are the contradic-
tions of the ‘nudge’ approach to policymaking where food is concerned?
What are the implications of voluntary agreements with food producers?
How can public health concerns be reconciled with the nature of an ever
expanding food supply? What is public policy’s role in regulating an
increasingly hyperpalatable and omnipresent food supply? Underlying all
these questions is the larger issue of diet-related health inequalities.
The food industry, with its roots in an increasingly industrialised,
globalised agriculture, and then via the activities of food product develop-
ment, food science and food marketing, develops the food supply and
targets it carefully by population group. The extent and type of consumer
research amassed by commercial marketing firms is paralleled by their
increasing role in public health research, commissioned by governments. Is
there something paradoxical in supplying food companies with information
on where to locate foods high in fat, salt or sugar while simultaneously (and
quite separately) advising governments on where to site health services for
those consuming such foods disproportionately? Could commercial market
research be indirectly contributing to a reinforcement of consumption
Preface ix
patterns even while it predicts the need for increased healthcare resources
to deal with the outcome? At the very least, these parallel activities should
be discussed critically by social scientists of health and illness.
Marketing students, academics and practitioners will see frank exchanges
regarding marketing education, goals and strategies alongside critiques
from within both academic and applied marketing (Chapters 6, 7 and 8).
These critiques raise ethical questions about the role and power of market-
ing, and especially food marketing – a lively and continuing debate in the
field. There is also an account of collegial academic and food marketing
research co-operation, which might serve as a useful model for future
efforts to combine the vast potential of industry data with public health
research.
Cumulatively, the texts analysed in this book illuminate the ways in
which developments in psychology and consumer research, food chemistry,
retail siting decisions, industry logistics and marketing campaigns come
together to shape patterns of food consumption. But it is an evolving
picture. The food supply is continually expanding into new areas of our
daily lives: while writing this book in recent years, I observed new snack
and soft drink machines being installed on train station platforms, univer-
sity buildings and in community sports centres – all in places which did not
previously have them. Digitally, too, as we navigate our towns and cities by
day and night, we are constantly informed of the nearby location of restau-
rants or food outlets we have used before, perhaps alongside a discounted
offer. These practices and their effects are difficult to trace and quantify but
I make a small contribution in this book.
There is much more to the exceptional growth in large bodyweights and
chronic illnesses related to diet than simply weak will, emerging some time
after 1980. The food supply has changed dramatically, understanding of
the psychology of food consumption has advanced, and the capacity of the
industry to gather data and target eaters effectively, while normalising large
portion sizes and bundling snack products together, has been immeasurably
enhanced.
At the time of writing, a New York City ban on ultra-large sodas had just
been overturned for a second time, by a second court. Yet the World Health
Organisation had recently launched consultations on reductions in sugar
intake (WHO 2014), and in the UK, lowered sugar intakes had just been
recommended, alongside a suggestion that industry should reduce the sugar
content of processed foods (SACN 2014; PHE 2014b). Consultations will
take place in the coming months on these proposals. But unless the ever
expanding supply and siting of such foods is addressed, alongside the ways
in which they are target marketed, it is difficult to see much improvement
in terms of overall food consumption patterns – or in the class-differenti-
ated health effects inherent in the way we eat now.
Acknowledgements
I would like to thank the ESRC for funding my doctoral studentship at the
University of Sussex, and the University of Brighton School of Applied
Social Science for the award of Visiting Researcher to enable me to com-
plete this book. Professor Gillian Bendelow provided continuing guidance
and wisdom. Thanks also go to Professor John Abraham, the British
Library and the Wellcome Library. Ben Branagan, Maciej Dakowicz, the
Wellcome Trust, and the British Heart Foundation graciously supplied
images used in this book. Melanie Jervis and Eric Davidson took additional
photographs. I am very grateful to them all.
Every effort has been made to contact copyright holders for their permis-
sion to preprint selections in this book. The publishers would be grateful to
hear from any copyright holder who is not here acknowledged and will
undertake to rectify any errors or omissions in future editions of this book.
1 Introduction
The politics of food consumption
and health
...... Men
25%
,.. 20%
j0
'15
15%
.,~
~
...2! 10"A
5%
0% i
Figure 1.1 Trend in obesity prevalence among adults (Health Survey for England
1993–2012; three-year average). Data source: Health and Social Care
Information Centre. Chart by Public Health England.
4.0%
-+-Women
3.5%
....... Men
3.0%
li
i;; 2.5%
J:I
..
0
f
'5l" 2.0%
'0
..~ 1.5%
~
~ 1.0%
0 .5%
0 .0% i
Figure 1.2 Trend in severe obesity prevalence among adults (Health Survey for
England 1993–2012; three-year average). Data source: Health and Social
Care Information Centre. Chart by Public Health England.
6 Introduction
Men Women
30% 40%
35% 0
25% I<] 0
EI (J 0 0
30% 0
..c
0
0 0
20%
..
ii
25%
[ 15% 20%
>-
]
0
10%
~
5% - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5% - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
0% 0% ,.-----r-~,.____r_____,--__._______,--_,______r--_r_____r_____,
1- Professional 11- Managerial technical 0 111M - Skilled manual "'1- Professional "'"- Managerial technical . IIIM - Skilled manual
o IIIN -Skilled non-manual ¢ IV -Semi-skilled manual 0 V-Unskilled manual IIIN -Skillednon-manual IV -Semi-skilled manual Ij V-Unskilled manual
Figure 1.3 Trend in adult obesity prevalence by social class (Health Survey for
England 1994–2009; five-year moving average). Data source: Health and
Social Care Information Centre. Chart by Public Health England.
Note: This chart has not been updated because the social class of respondents was
not noted in subsequent HSE 2010 data (Public Health England 2014a).
markedly higher among lower social classes, particularly for women, and
have been steadily increasing. Among men, the gradient is somewhat less
consistent (see Figure 1.3). One study speculates that male and female
obesity patterns across occupational social class measures may not be
comparable, since women often earn less than men; they may therefore
experience much greater disadvantage (El-Sayed et al. 2012).
Statistics for obesity among children also tell a more nuanced, class-
differentiated story, with those who are most deprived twice as likely to be
obese as those who are least deprived (see Figure 1.4).
These graphic representations of patterns of obesity make the discourse
of individual responsibility (or the lack thereof) appear one-dimensional as
an explanation of food consumption and bodyweight patterns, particularly
where children are concerned. Overall obesity statistics do not reveal the
underlying disproportionate distribution of obesity by social class or differ-
ences in prevalence rates between different categories of obesity.
Studies have long shown that those on lower incomes spend a larger
proportion of their incomes on food. The Food Standards Agency’s Low
Income Diet and Nutrition Survey (LIDNS), last done in 2007, and the
government’s Family Food Survey, carried out annually, also observe social
gradients in the nutritional quality of diets (FSA 2007a; Defra 2012). The
LIDNS survey found that low income earners tend to eat less wholemeal
bread and vegetables and more fats and oils, meat dishes and processed meats,
non-diet soft drinks, pizza, whole milk and table sugar (FSA 2007a: 17).
Introduction 7
25%
. Year 6
Most
decile
deprived
20'70
~
"iii
15%
[
.~
j 10'70
a
5%
0%
Least Most
deprived Index of Multiple Deprivation 2010 decile deprived
Food inequalities have intensified in the years since the economic crisis
began in 2008. Overall, British households are spending more on food since
2007 while purchasing smaller amounts. For 4.2 per cent less food in 2011
(the latest year for which data is available), spending was 12 per cent higher
than it was in 2007 (Defra 2012: 54), the year that food prices began to
rise in real terms after a period of stability since 2001 (ibid.: 67). But, as
with obesity statistics, a more nuanced picture emerges by tracing the
patterns of different income groups. Those in the lowest income decile spent
17 per cent more on food between 2007 and 2011 (ibid.). They also
purchased 29 per cent less fruit and 20 per cent fewer vegetables than in
2007 (ibid.: 51), a greater decline in fruit and vegetable purchases than for
the population overall (4.4 per cent), following a peak in fruit and vegetable
consumption in 2005 in the UK (ibid.: 56).
No income group eats sufficiently healthily according to the recom-
mended ‘eatwell’ plate, but fruit and vegetable consumption showed the
most marked difference by income (ibid.: 59). Defra’s subsequent report
found that all income groups exceeded recommended intakes of non-milk
extrinsic sugars but that the lowest income group had by far the highest
8 Introduction
consumption; the highest two income groups had the lowest consumption
(Defra 2013: 43). Once again fruit and vegetable purchases increased with
income (ibid.: 44–5) and an income gradient was observed for fibre
consumption (ibid.: 46; but no group consumed enough according to the
recommended average). A 2014 study of the cost of living in the UK found
that the cost of food had increased by 26 per cent since 2008, faster than
prices overall, or indeed incomes or benefits payments (Davis et al. 2014).
Throughout this book, the role of social class will be central to the discus-
sion, since it reveals much about how people experience financial pressures,
health and food itself. The inequalities reflected in food consumption are
not cited by governments when individual responsibility for diet and health
is urged. Yet the class-differentiated nature of society is central to under-
standing both ‘lifestyle’ behaviours and the way the food industry designs
and markets its products, as will be discussed in Chapters 6, 7 and 8.
A neoliberal discourse
Neoliberalism has … become hegemonic as a mode of discourse and has
pervasive effects on ways of thought and political-economic practices to
the point where it has become incorporated into the commonsense way
we interpret, live in, and understand the world. (Harvey 2007: 23)
In the neoliberal era described by Harvey, which began in the 1970s, there
was an effort by major Western economies, and particularly the UK and the
US, to ‘liberate’ the market, reducing government interventions aimed at
altering the course and functioning of markets. In addition to the economic
and regulatory policies carried out to achieve this, ‘neoliberal philosophy
has also generated ideas of self governance and citizenship that further
help the neoliberal political-economic project’ (Guthman 2011: 18). This
perspective emerges in the work of Guthman, a geographer, and others who
analyse food systems, beginning with agriculture, and builds on the ideas of
Introduction 11
Harvey, whose writings have theorised neoliberal practices. These ideas
link the liberalisation of markets with an accompanying strategy emphasis-
ing ‘the liberty of consumer choice, not only with respect to particular
products but also with respect to lifestyles, modes of expression, and a wide
range of cultural practices’ (Harvey 2005: 42). Neoliberalism, in social
Darwinist tradition, values ‘individual achievement, entrepreneurial prow-
ess, and competitive spirit’; and as it applied to ‘the care of the self, bodily
practices that seem to indicate self-efficacy and self-control were readily
associated with personal qualities that lead to both individual and collective
success’ (Guthman 2011: 53). Under neoliberalism, people are encouraged
‘to make few demands on the state but rather to act through the market …
by exercising consumer choice … and striving for self-actualization and
fulfilment’ (Rose 1999 cited in Guthman 2011: 18).
With these messages communicated, state intervention could recede as
the individual became responsible for self-improvement, and answerable for
his or her choices, including any risks taken (Dean 1999 cited in Guthman
2011: 54). Nevertheless, neoliberal discourse is somewhat paradoxical.
Alongside the notion of self-reliance, neoliberalism also fosters a role for
the state and, increasingly, multilateral institutions to intervene and set
standards, creating markets and favourable market conditions even while
the accompanying discourse champions the market as ‘the most natural
(and optimal) way to regulate social life’ (Guthman 2009: 1115; McMichael
2000: 23). The state must also, of course, ensure that healthcare is provided.
Seen from this perspective, healthy eating/personal responsibility
discourse, invoked by governments, the food industry, or even well mean-
ing healthcare providers, health researchers and health promoters, is part
and parcel of policy measures and economic strategies which have rede-
signed economies along neoliberal lines in recent decades. Thus an increas-
ingly free market is portrayed as being populated by freely choosing
individuals, who are then, logically, responsible for those choices. When
things started to go wrong in population health terms, as bodyweights and
the risk of chronic diseases increased alongside the accelerated production
of foods high in fat, salt and sugar, the logical (neoliberal) solution was to
point to individual choices and urge behaviour change.
But the discourse of individual dietary ‘choice’ – and therefore
responsibility – is seriously challenged by the epidemiological picture which
emerges linking diet, class and health; by social theory and psychology as
they separately track how food behaviours are formed and become habit;
by developments in agriculture, processing and logistics technologies that
have transformed the food supply; by food industry scientists and product
developers as they concede the role of early and lifelong habit formation in
food consumption, and admit to concerns about health implications of diets
based on snack and convenience foods; and by market research and market-
ing techniques which both track and target consumers according to their
social rank and existing consumption patterns.
12 Introduction
Healthy policy elites and healthy eating discourse
The emphasis in healthy eating discourse on the responsibility of individu-
als for choosing a healthy diet in a foodscape2 which is both omnipresent
and obesogenic has long been reflected in government policy (see DoH
2007 and 2004, both featuring ‘choice’ in their titles, along with talk of
voluntary partnerships with industry, which the present government has
continued to emphasise).
Even the work of the respected health research charity the King’s Fund
reflects the wider, taken-for-granted discourse and focus on ‘unhealthy
behaviours’. A King’s Fund study speaks of ‘helping people to kick bad
habits’, and its solution – ‘the use of commercial marketing techniques to
promote socially desirable outcomes’ (Boyce et al. 2008: vii) – seems
destined to merely shadow much more pervasive and well resourced
commercial marketing campaigns to promote hyperpalatable foods and
efforts to site them ever more conveniently for their targeted eaters. This
key element underlying food consumption is explored in this book.
The King’s Fund report acknowledges that poor diet and obesity are
associated with social class and the latter also with gender (Boyce et al.
2008: 3). As far as the activities of the food industry are concerned, the
report backs the plea made by government to the food industry and adver-
tisers in a 2004 policy document ‘to make healthy lifestyles an easier
option for people’ (DoH 2004 cited in Boyce et al. 2008: xi). The focus in
the 2004 government document is on the role of the NHS in changing
health behaviours, alongside an emphasis on the ‘responsibilities of indi-
viduals in maintaining their own health’ (ibid.). Yet the King’s Fund
report admits that ‘a strong evidence base is lacking’ on the effectiveness
of such interventions; of those evaluations that had been done, few looked
beyond the short term, and some were not considered robust (Boyce et al.
2008: 20). A subsequent King’s Fund study reported that multiple
unhealthy behaviours including poor diet were more prevalent (and
increasing) among those on low incomes and with the least education. The
study acknowledged the ineffectiveness of health promotion efforts which
did not consider the role of social class in such behaviours (Buck and
Frosini 2012).
Two years later, NICE guidelines acknowledged structural barriers to
healthy diets and bodyweights: ‘The environment in which people live may
influence their ability to maintain a healthy weight … Tailoring advice to
address potential barriers (such as cost, personal tastes, availability, time,
views of family and community members) is particularly important for
people from black and minority ethnic groups, people in vulnerable
groups (such as those on low incomes)’ and others at risk of weight gain
(NICE 2014: points 1.1.3 and 1.1.2). The guidance also highlighted a role
for local food suppliers to promote healthy foods and drinks (NICE 2014:
point 1.1.3.7).
Introduction 13
Nevertheless, healthy eating/personal responsibility discourse has
performed the co-ordinating function typical of discourse ‘by providing the
frame within which policies can be elaborated and justified by the key
policy elites involved in the construction of the policy programme’ (Schmidt
2000: 286). These elites then influence the ‘fleshing out [of] the policy
programme … even … promoting a particular discourse and policy
programme’ (ibid.). So the focus is on supporting people to change their
behaviour (possibly helpful in individual cases, but not in itself thus far able
to change population health trends), and calls to food producers to consider
how the food supply might become healthier (the effectiveness of this
approach remains to be seen).
The NHS medical advisory group the Future Forum focused on lifestyles
in a 2012 report, advising medical professionals to ‘make every contact
count’ to emphasise healthy choices, ‘whatever their specialty or the purpose
of the contact’ (NHS 2012: 17). Thus pharmacists might raise ‘lifestyle’
matters (diet, fitness, smoking, alcohol) even with customers picking up
prescriptions for unrelated conditions. The Guardian’s health correspond-
ent accompanies the news report on this policy with a commentary on ‘the
brutal truth that more people are harming and killing themselves with their
lifestyles’ (Guardian 30/12/11), as though there were a conscious death wish
at work. The Patients’ Association acknowledged the need for health advice
but questioned the appropriateness of all contacts being diverted to discus-
sions of lifestyles; they called on government to examine underlying factors
including poverty (ibid.).
A 2004 House of Commons Health Committee report did take account
of the influence of structural factors in rising obesity, citing the obesogenic
environment; ‘the promotional efforts of the food industry’ which drowned
out health promotion messages; inadequate food labelling; and pricing
strategies which made unhealthy foods so attractive (Health Committee
2004: 3). They also located some of the problems in agricultural policy,
which they recommend should be shaped around public health needs
(ibid.: 4). The committee was sceptical of food industry responses to criti-
cism of their products, particularly the frequent statement that
It is also true that unhealthy foods3 are often marketed in combination, for
example as meal deals, or in discounted offers, and consumed dispropor-
tionately by some groups.
The Health Committee’s analysis, specifically mentioning industry influ-
ence on obesity, is unusual (and its influence on public policy seems limited),
14 Introduction
though more characteristic of committees of both houses of parliament.
By contrast, Miller and colleagues trace the greater, if mostly invisible
power and influence of corporate actors via lobbying and public relations,
including that of think tanks, trade associations and front groups which
may appear independent, but are not (Miller and Harkins 2010: 568;
Miller and Mooney 2010: 468). Another factor is that corporations seeking
‘policy capture’ may one day offer board memberships for those leaving
public service, a path many public servants, elected and unelected, have
followed (ibid.).
In a field that has seemingly been studied from every conceivable vantage
point, there was one path of study that remained relatively unexplored: a
sociological analysis of the language and techniques of food market
research and food marketing, and the understanding by food product devel-
opers and food marketers of social ranking and segmentation (the industry
does not speak of class). This is the central task of this book, and is in line
with what Murcott, the British sociologist who led the first major ESRC
research programme into food choice (Murcott 1998), argued for in the
article cited above and again in 2011 (Murcott 2000, 2011). In the inter-
vening period, research agendas in the sociology of food have tended to
focus on consumption rather than production, of which marketing and
market research is one (two-sided) important dimension. The focus on
recent food trends, including healthy alternatives and food behaviours, has
been in evidence at the BSA’s Food Study Group conferences since they
began in 2008. Murcott wonders whether this might be because sociologists
researching food tend to have the concerns of ‘thoughtful, well informed
members of the public’ regarding health and provenance. Their research
interests emerged ‘in the kitchen, the university common room, being ill
now and then, as parents, of a left-leaning political persuasion’ (Murcott
2011: point 3.5).
Thus there has been much sociological interest in farmers’ markets,
organic food, healthy eating and growing food at home, but ‘noticeable by
its absence is attention to the supply side’ (Murcott 2011: point 3.6). This
is also symptomatic of a longstanding and continuing split between the
Introduction 23
sociology of food and the sociology of agriculture (Murcott 2011:
point 4.1). The former has traditionally focused on eating and culture,
while the latter has been guided by agrarian political economy (Carolan
2012: 305). While it is beyond the scope of this book to fully unite these
two bodies of research (Carolan himself does so in his 2012 book), I bring
food production and consumption together and show how they interact
and influence each other. Clearly both sociologies stand to benefit from
extending their focus on agriculture/production or food/consumption, to
take in its opposite.
Notes
1 Fairclough writes of objects of research allowing for various ‘points of entry’ for
social researchers; discourses can be useful points of entry (Fairclough 2010: 5).
2 The term ‘foodscape’ is used by Winson, a Canadian sociologist of agriculture
and food. He defines this term as ‘the multiplicity of sites where food is displayed
for purchase and where it may also be consumed’ (Winson 2004: 301). The
notion of the ever spreading foodscape will be useful in analysing the activities
of the food industry. It is discussed in detail in Chapter 4, ‘Foodscape and
lifeworld’.
3 As the food industry comment cited by the Health Committee shows, these
are contested terms. A UK study by an expert group representing scientists,
nutritionists, the food industry, consumer groups and policymakers, cited on
the government’s food.gov.uk website, consulted a range of terms in developing
a nutrient profiling model and lists of healthy and unhealthy foods (Rayner
et al. 2004 for the British Heart Foundation Health Promotion Research Group,
Department of Public Health, University of Oxford). They wrote: ‘Throughout
this report the terminology of the brief for this project i.e. “foods high in fat,
salt or sugar” and “healthier food choices” has been used. These terms are
cumbersome and in future it might be simpler to use “healthy” and “unhealthy”
foods or “healthier” and “less healthy” foods’ (ibid.: 36). In this book I use both
‘foods high in fat, salt or sugar’ and ‘unhealthy foods’. As future chapters clarify,
it is such foods consumed regularly, in combination and disproportionately to
healthy foods, that pose risks to health; and it is among lower status groups that
this pattern and the attendant health risks are disproportionately observed.
2 Analytical framework and
methodology
Critical realism and critical discourse
analysis in food and health research
Introduction
Since I am arguing against a simplistic reliance on individual dietary choice
to explain population trends in obesity and diet-related ill health, I was
committed from the outset to a critical investigation of underlying explana-
tions for the social gradients in both bodyweights and health and differing
patterns of food consumption. The surface level explanation of obesity
and/or poor health resulting from poor dietary choices ignores a complex
relational context structuring both the production and consumption of
food. So a critical sociology, and in particular critical realism, with insights
from critical discourse analysis, all shape my analytical and methodologi-
cal framework.
A critical sociology finds theoretical grounding in critical theory, broadly
conceived, and critical realism in particular. For critical theorists it is essen-
tial to examine the knowledge ‘which structures our perceptions of the
world’, and analyse the social process of knowledge ‘to reveal underlying
practices, their historical specificity and structural manifestations’ (Harvey
1990: 3–4). Critical social scientists note the potential for scientific knowl-
edge to be skewed by unacknowledged social, political and economic
factors, and they therefore enquire ‘how ideology or history conceals the
processes which oppress and control people’ (ibid.: 6). A critical approach
has ‘distance to (sic) the data … [while] embedding the data in the social’
and aims to ‘root out a particular kind of delusion’ (Wodak 2007: 209).
The notion of ‘hidden forces’ and the need to unmask them is central to
critical theory (Delanty and Strydom 2003: 215) and it has particular
relevance for the enquiries made by this book.
Conclusion
In discourse analysis, the objective is not to outline all possible perspectives
on a problem, but ‘to examine how particular attitudes are shaped, repro-
duced and legitimized’, to seek to expose contradictions within discourses,
and to query ‘taken-for-granted meanings’ (Tonkiss 1998: 253, 259).
Analytical framework and methodology 39
The contradictions of healthy eating discourse were the point of entry
for this research, especially the notion that ‘individual responsibility’ (and
the lack thereof) was either the problem underlying or the solution for
population health concerns, emerging as they did alongside an industrially
transformed and marketed food supply in recent decades. Chapter 5 chal-
lenges an emerging obesity critique among social scientists and presents a
wide range of evidence linking diet with obesity, ill health, social class,
regulatory regimes and even ideology. This evidence poses a strong chal-
lenge to the notion (and discourse) that a little more self-control is all that
is needed to address problems arising from food consumption.
If discourse is also notable for what it conceals, then the systematic,
highly technologised and pervasive market research activities which contin-
ually track and rank consumption habits, food products and consumers
themselves, and the scope for marketing to shape and reinforce those
habits, have remained largely absent from both individual and public policy
understandings of dietary health. Chapters 6–8 analyse these activities,
including marketing discourse regarding consumer choice and healthy
eating, with its range of rhetorical proxies for social class. Both positive and
negative views of marketing and assessments of its influence, intentions and
its inner logic are presented. Many instructive market research studies into
food consumption are cited, along with thoughtful marketing commentar-
ies on these matters.
While critiquing the structuring effects of food industry activities and
especially marketing, it was clear that the food supply is the logical result
of constant advances in an array of technologies, alongside the need for
the industry to grow and profit, and that the context of these activities is
very much a global one, even when examining primarily British consump-
tion patterns and health outcomes. The globalised food industry is itself a
generative mechanism for food product development and food marketing,
for patterns of food consumption and ultimately for diet-related health, so
in Chapter 6 I also set out this larger agricultural/industrial context.
But in Chapters 3 and 4, which follow, I test a range of social theories
on class, habitual behaviour, reflexivity, consciousness, consumerism, the
economy and systems of governance for their insights into food production,
consumption and health.
3 Applying social theory to food
production, food consumption
and social class
Introduction
Behavioural economics and its operationalisation as ‘nudge’ theory have
made a strong case for force of habit and a lapse into routine, unthinking
behaviour in many different contexts, including food consumption. Yet the
discourse of personal responsibility for dietary choice persists and is mobi-
lised as the way forward in dealing with diet-related health problems. It
constitutes the rationale for both food industry and government resistance
to more structural reform of the food supply. Moreover, much academic
study is devoted to the study of eating behaviours, and while much of
this research is insightful, this can reinforce the personal responsibility/
individual choice discourse, however unintentionally, and leave structural
factors insufficiently explored.
In seeking to dislodge the dominant and misleading individual responsi-
bility discourse, which has driven policy (or the lack of it) since obesity
rates began their accelerated increase in the late 1980s, I turn in this and
the following chapter to social theory. Amid some internal debates and
disagreements, sociology has produced a rich vein of argument and ideas
which can strengthen the core of behavioural economics by giving it a social
context – a social structure in which the forces of class and habit are observ-
able as intertwined. This addresses a lacuna in ‘nudge’ approaches where
food consumption is concerned.
But while social class has seen a rebirth in sociological analysis, other disci-
plines, along with political commentary and public debate, do not often
acknowledge class as a formative, structuring force, nor query how class is
perpetuated. Even within sociology, there continues to be much focus on
how culture – excluding both class and economic forces – shapes social life.
This risks giving an incomplete picture of what happens when changing
consumption patterns begin to yield troubling population health conse-
quences, as in the case of diet. If the food industry engages with social struc-
ture, social rank and psychology in developing and marketing food
products, then social scientists need to explore these activities. As a
critical realist framework suggests, structural forces, whether social (class) or
Applying social theory to food production 41
agro-industrial (the nature of the food supply) or psychological (the
emotional resonance and routine nature of foods embedded through family
background, habit and marketing), are not observed or experienced
consciously.
In Chapters 3 and 4, therefore, social theories are applied to the empirical
worlds of food production, food marketing, food choice and health promo-
tion, testing each theory for its capacity to illuminate how food is produced,
consumed and how it influences health. In challenging healthy eating/
personal choice discourse, the theoretical arguments mobilised here reveal
the weakness of assumptions that lifestyles, including diets, are consciously
chosen or easily changed. In subsequent chapters, the disciplines of epide-
miology, psychology and marketing will also call these assumptions and the
resulting dominant discourse into question.
Developments in the sociology of class are debated by Scambler, Savage,
Crompton, Skeggs and others. The central role of the ‘cultural turn’ in
deflecting attention from class is key, along with its interaction with the
sociology of consumption, drawing particularly on Crompton and Edwards.
A persistent analysis of health in the context of capitalism remained in
medical sociology, and this will be traced.
Since much use will be made of official national statistics in Chapter 5’s
discussion of studies of diet, health and class, and because they are incor-
porated into consumer marketing classifications, this book would not be
complete without a discussion of how official national statistics classify
social groups, and in particular, how the Registrar General’s classification
has been reformed in response to sociological critique (Crompton 2008b).
Graham’s analysis of health inequalities also discusses these innovations
(Graham 2007).
In addition to the wealth of late twentieth century social theory, explored
here and in Chapter 4 for its application to matters of food consumption
and health, it is also illuminating to turn to the nineteenth century for an
examination of Marx, not least because we will see his insights reproduced
or contradicted by our modern theorists and even by the contemporary and
highly empirical world of food itself. Marx’s thought provides a clear view
of the interlocking relationships between the forces of history, family,
culture and economic change in structuring social life, including eating. It
is a line of thinking which will be traced throughout this book, later illus-
trating how alert food marketers mobilise this understanding even today.
Marx’s theorising of social class was very much of its time, and notoriously
incomplete; a section on classes in Capital is only two pages long and he
42 Applying social theory to food production
never theorises the nature of social classes (Pierson 1997: 15). But his analy-
sis of capitalism and history is grounded in a very empirical concept of
human action and societal development which is still fruitful. For Marx, the
development of human life and indeed history itself is not a matter of
advancing, disembodied consciousness but ‘a quite material empirically
verifiable act, an act the proof of which every individual furnishes as he
comes and goes, eats, drinks and clothes himself’ ([1845]1997: 108). This
wording strikingly reflects contemporary market research techniques which
are now, in the digital age, able to track consumers in highly ‘empirically
verifiable’ ways as they carry out exactly these kinds of actions in their
residential and working neighbourhoods and ‘foodscapes’.
It is natural that Marx’s highly materialist view of history and human life
would include references to food and health. He was conscious of the
central role of food in human history, referring, for example, to the lack of
key commodities contributing to the Napoleonic wars in the nineteenth
century ([1845]1997: 107), and of the significance for human societies of
the shift away from small-scale food production to industrial production
and industrial work.
Marx was also acutely aware of the poor living conditions of industrial
workers, their stunted bodies and shortened lives ([1867]1997: 235) in
which inadequate diets had a major role to play (Burnett 1989; Steel 2009).
‘Capital’, he avowed, ‘is reckless of the health or length of life of the
labourer, unless under compulsion from society’ (Marx [1867]1997: 235).
His concern for the health of workers was not universally shared at the
time; a common view of the poor health and circumstances of some sections
of society was that these resulted from a failure of initiative and resolve.
Popular ideas of human character in Marx’s time included ‘two sorts of
people, one the diligent, intelligent, and above all frugal elite; the other, lazy
rascals, spending their substance, and more, in riotous living’ (ibid.: 236).
The notion that the poor were responsible for their low status and any
problems accompanying poverty, such as ill health, was evident in both the
nineteenth and twentieth centuries (Burnett 1989; Pember Reeves 1913;
Steinbach 2004) and arguably its residues can be traced in the discourse of
individual responsibility regarding diet and health. Giddens refers to a
middle class tendency to deny the importance of social class in people’s
lives, and to believe instead that individual initiative accounts for personal
achievement (or lack thereof). This is a powerful discourse in British society
and politics, one which some of Giddens’s work would subsequently rein-
force (Giddens 1982: 162, 166; 2007).
It has been pointedly displayed in some British television programmes on
the subject of weight, in which lower status overweight people are taken to
task for their nutrition-poor diets by higher status experts; Gillian
McKeith’s You Are What You Eat (Channel 4, 2004–07) was one early
example. The Duchess of York appeared in a 2008 series (The Duchess in
Hull, ITV) in a more sympathetic, less judgemental role, advising a low
Applying social theory to food production 43
income family with multiple diet-related health problems how to make
better food choices.
These are modern versions of the practice of higher social classes
providing a supervisory role regarding the diet of the poor, as depicted in
the nineteenth century illustration in Figure 3.1. It is a social practice
with a long history in the UK. One historian cites the early nineteenth
century example of the politician and journalist William Cobbett, who
wrote a series of ‘cottage economies and penny cookbooks aimed at stop-
ping the working classes from squandering money in the pie shop’
(Hughes 2014).
Even when it was well intentioned, such cross-class intervention could
not resolve food inequalities in the nineteenth century, and cannot do so
now. Televised interventions have, perhaps unintentionally, reinforced an
image of ignorance, incompetence and fecklessness among those of lower
social class who have a poor diet. This in turn bolsters the discourse of
personal responsibility for dietary practices: if these people cannot
Figure 3.1 An image of food and class in the nineteenth century. © Wellcome
Images.
44 Applying social theory to food production
improve their diet even when coached by their ‘betters’, then they must
surely bear the responsibility for their food consumption and diet-related
illness.
Marx portrayed industrial workers as ‘determined and regulated on all
sides by the movement of the machinery, not the other way round’
([1857]1997: 199). In recent decades, a radically altered concept of health
and safety at work and a much higher overall standard of living and health
have transformed the picture – not least because of the ways in which capi-
talism has come under compulsion from society via health and safety stand-
ards. Yet there are parallels: workers in offices now find themselves at the
opposite extreme of physicality – sedentariness – which carries its own
health risks and alienation from the body. Their working days are shaped
by the nature of the technology they use. The link between obesity, seden-
tary lives, including working lives, and health problems including musculo-
skeletal disorders is now widely acknowledged.
In his book Class Analysis and Social Transformation, Michael Savage tries
to answer this vexed question, first tracing the linked history of social class
and the social sciences, and sociology in particular, in Britain. Tracking and
measuring social class after 1945 gave sociology both intellectual credibility
and legitimacy, and supported social policy’s emphasis on ‘political arith-
metic’ (Savage 2000: 5, 6).
Marx’s influence had extended beyond the collapse of communist regimes
around 1990, but the tradition of Marxist class analysis, rooted in the
exploitation inherent in industrial production, as well as class consciousness
and the anticipated culmination of class conflict in revolution, had weakened
by the late twentieth century (ibid.: 9, 43, 58). Class distinctions became less
Applying social theory to food production 51
easy to observe; ‘class relations as generative mechanisms simply do not
straightforwardly express themselves in social worlds which are complex,
dynamic and open systems,’ Savage writes, though arguably this can be
overstated. Food consumption patterns based on distinct products aimed at
different social groups are one example of a ‘straightforward’ expression of
class relations. For Scambler and Higgs, class relations are no less real even
if they are sometimes less visible than they once were (2001: 3).
Bourdieu saw in the retreat from class analysis ‘the expression of the class
interests of a group of relatively powerfully placed professional intelligent-
sia’ (Bourdieu 1988 cited in Skeggs 2004: 54). He rejected criticisms of a
more ‘rigorous’ sociology which some had described as ‘doomed to appear
deterministic and pessimistic because it takes account of structures and
their effects’ (Bourdieu 2003: 36). Bourdieu felt that sociology needed to
resist the ‘de-politicisation’ of the study of economic and social policy, stay-
ing alert to the state’s relaxation of attempts to control economic forces and
retreat from regulatory responsibilities (ibid.: 38). Savage also critiqued an
increasing abstraction within sociology, and the view that social change is
‘beyond anyone’s direct purview or control’ (Savage 2000: 151). This, he
argues, simply releases academics from the moral dimensions of their
research (ibid.: ix).
While medical sociology and some social scientists of food continue to
address connections between class, capital and health, the discourse of indi-
vidual responsibility for dietary intake and health remains dominant. This
is in spite of a critique of industrialised food dating back decades: ‘over-
processed foods treated with chemicals’ were critiqued by McKee in 1988,
as were advertising and marketing of unhealthy foods by a range of authors
between 1978 and 1990 (cited by Lupton 2003: 10). As these analyses see
it, ‘capitalism produces health needs which are treated in such a way as to
obscure their origins’ (Lupton 2003: 10), so in this way, class differentia-
tion in the context of health can be missed.
By 2008, Crompton reported a resurgence of class analysis in sociology
generally, although she regretted the resulting ‘fragmentation’ of class stud-
ies. Studies of cultural aspects of class formation have usefully redressed an
economistic focus (Crompton 2008b: 93). But an interest in culture has
been for some an alternative to class analysis.
Savage acknowledged the problems inherent in contemporary efforts to
trace the salience of class, but felt that broadening class analysis from the
long-established occupational connection might reinvigorate it (Savage
2000: 8). He has analysed the structuring categories of ‘property, organisa-
tion and culture’ and the processes by which they relate to class formation’
(ibid.: 20). More recently, he and colleagues reconstructed Bourdieu’s
research on class and culture in Britain (Bennett et al. 2009). Four years later
they presented a new class schema based on a BBC survey of social class
among self-selected participants and a supplemental survey commissioned
to ensure representativeness (Savage et al. 2013; see next section below).
52 Applying social theory to food production
Most centrally for this book, Savage and other sociologists considered
‘place’ in the context of geodemographic and social sorting by neighbour-
hood (see Chapter 7).
While theories of individualism, social mobility and reflexivity attempted
to displace class analysis, class itself is ‘simultaneously being institutional-
ized and reproduced’ (Skeggs 2004: 53). Even the process of individualisa-
tion involves both ‘differentiation from others and differential access to
resources’ (ibid.: 53). But rather than concentrate sociological energies on
mapping class structures, Savage urges us to ‘see class cultures as contin-
gently embodying forms of individualised identities which operate relation-
ally’ (Savage 2000: 150). This individualising process has led to the paradox
that ‘the structural importance of class to people’s lives appears not to be
recognised by people themselves’ but it has not, he insists, obliterated the
salience of class itself (ibid.: xii).
Alongside research interest in the rise of consumption and culture, other
concepts such as ‘disorganised capitalism, post-Fordism and post-
industrialism’ all assumed the waning of social class (Savage 2000: 6). State
benefits and returns on capital investment (mostly via pension schemes) are
now widely received, though many pension schemes have weakened and
will no longer provide the guaranteed level of income they once did. There
have also been capital increases for homeowners resulting from increases in
house prices (Savage 2000: 44). Self-employment has increased markedly
since the 1980s (ibid.: 48), weakening the labour–capital–exploitation
dynamic. All these factors have influenced perceptions of social class and
the way society is segmented into classes for analytical purposes.
Nevertheless, most people earn their income via their labour, and if share-
holding has expanded, it has also increased economic inequality (ibid.: 51).
But inequality is apparent in gradations rather than between distinct social
groups with uniform interests, so where would one draw class boundaries
(ibid.: 44)?
Conclusion
This chapter has provided some historical-sociological context to the
debate over social class – its trajectory in the academy, the ways it is meas-
ured, and how it is influenced by questions of culture, ethnicity, consump-
tion and social mobility – in preparation for situating the notion of class in
the field of diet and health. Savage urged researchers to find ‘more effective
ways of drawing out the implications of different kinds of empirical
research for class analysis’ while fully theorising developments (2000: ix);
thus the linkage of theoretical and empirical contexts in this chapter. It is a
call broadly echoed by Crompton, though she valued existing methodolo-
gies in pursuing such research (Crompton 2008b: 149–50). Both Crompton
(2008b) and Edwards (2000) see a role for linking analyses of consumption
and social class; this is done in a highly empirical manner in Chapter 5,
which discusses both social and health epidemiology in the context of food
consumption.
But the following chapter pursues the theoretical questions raised in the
present one. I have mentioned the work of Giddens, Bourdieu and
Habermas in passing; their ideas are now discussed in detail, as the insights
of these key theorists are applied to social class, food production and food
consumption.
4 Reflexivity, habitus and lifeworld
Applying the theories of Giddens,
Bourdieu and Habermas
Introduction
This chapter focuses on three key theorists whose ideas, applied to food
production and consumption, can help to reveal some of the contradictions
inherent in the way we eat, why we eat what we do, and the way we are
differently affected by what we eat.
Giddens’s writings on reflexivity are deserving of detailed discussion here
because of their prominence within the academy, their influence on both
discourse and policy, and arguably a degree of inconsistency where ques-
tions of diet and choice are concerned. His references to diet are casual
observations – no more than personal views – but, along with his notion of
lifestyle and individual responsibility, and the influence these ideas and
Giddens himself had on public policy under New Labour, they also merit
close examination. But Bourdieu’s concept of habitus and Habermas’s
analysis of the colonisation of the lifeworld by external forces take us
further in theorising why and how we eat the way we do; their work will
also be analysed in depth in this chapter.
Although Giddens’s thinking on reflexivity is ultimately problematic
in the context of diet, health and class, he devoted himself to an investi-
gation over many years of what drives human action and how to
explain social change. His work is useful for understanding food
consumption and health ‘behaviours’, but his notion of reflexivity is
challenged here.
A disembedding modernity
Giddens admits that ‘disembedding mechanisms’ intrude into our experi-
ence of life. For example, there are ‘foodstuffs purchased with artificial
ingredients [which] may have toxic characteristics absent from more tradi-
tional foods’ (Giddens 1991: 20). Even dietary advice from experts can be
‘disembedding’ in that it is ‘non-local’ and ‘impersonal’ (Giddens 1994:
84–5); this may be why some people reject it. Authentic expert advice can
also be overwhelmed by marketing campaigns promoting certain foods as
healthy, when this is not necessarily the case (Herrick 2009). Nevertheless,
for Giddens, these kinds of challenges simply prompt a continual revision
in our understanding of our lives and identities (Giddens 1991: 20).
Giddens’s prescription
So how are we to emancipate ourselves and acquire the freedom to choose
wisely? Giddens finds some value in both Rawls’s theory of justice, in which
justice is the ‘organising ambition’ of emancipation but human behaviour
is left unaddressed, and Habermas’s theory of communicative action
(Giddens 1991: 213; 1995: 256), in which society aspires to operate on the
basis of clear, open communication among individuals and between system
and lifeworld. Ultimately Giddens finds this inadequate for explaining how
society actually reproduces itself. Instead, he looks to autonomy – freedom
balanced by responsibility to the collective – as the ‘mobilising principle of
behaviour’ (1991: 213).
But by 2007, in a book for non-academic audiences, Giddens was
urging quite radical measures. Beyond improved food labelling, which he
supported, he also suggested that restrictions on advertising, along with
health warnings on some food products, should address the ‘severe
health implications’ of current dietary habits (Giddens 2007: 100). Even
‘quite draconian action’ against calorie-dense foods would be justifiable
(ibid.: 128). Yet he also recommends behavioural ‘remedies’ in addition
to economic ones, including measures to address ‘the failure to take
exercise’ (ibid.: 114, 128). There should be an acceptance of ‘greater
responsibility for one’s own health [as] a fundamental part of active
citizenship’ (ibid.: 132); there was no acknowledgement of the obstacles
to achieving such goals for many people. Lifestyle change should become
the core objective of the welfare state, using both incentives and sanc-
tions (ibid.: 131). In an approach described as ‘positive welfare’,
‘personal autonomy and self-esteem’ should be encouraged. This would
enable people to ‘adapt to change and to make the most of their oppor-
tunities’ (ibid.: 122–3).
Reflexivity, habitus and lifeworld 67
But Giddens acknowledged that a lack of capability can prevent some
people from improving their circumstances (Giddens 2007: 123) and spoke
of the need to ‘invest in people’s capabilities’, citing low self-esteem as a
block to capability (ibid.: 127, 131).
A concluding reference to class notes that the growing use of complemen-
tary healthcare was an encouraging sign that more people are taking
personal responsibility for their health. But this phenomenon ‘is heavily
class-based, with poorer people making much less use of such treatments –
at the same time as they follow less healthy lifestyles’ (Giddens 2007: 132).
The term ‘follow’ seems to indicate an elective character. His earlier
acknowledgement of the limits of reflexivity, and the shaping of choice by
structural forces including power relations, personal circumstance and
locale, recede in these closing remarks on class. Emancipation is only avail-
able through fresh lifestyle choices (Atkinson 2007: 540).
Giddens has been criticised for imposing observations of middle class
experience on other social groups in ways that powerfully situated his ideas
in neoliberal politics (Atkinson 2007: 536). For Skeggs, reflexivity itself
is a mode of living characteristic of middle classes, precisely because of the
resources and privileges available to them (Skeggs 2004 cited in Atkinson
2007: 536, 545). She describes ‘the middle class imperative to produce
oneself as a choosing, self-managing individual’ (Skeggs 2004: 57). Giddens
had once acknowledged this himself, when he critiqued consumption
theorists who saw class distinctions disappearing; new flows of informa-
tion, he insisted, would be differently interpreted by different groups and
this would reinforce ‘patterns of social differentiation’ (Giddens 1981
cited in Atkinson 2007: 543). As Atkinson advises, only empirical research
can really confirm this. Such data is available as evidence for the relation-
ship between diet, health and class and is evaluated in the following
chapter. Food marketing research also discerns subgroups which
practise what Giddens might term reflexive eating habits driven by health
concerns.
Whimster criticises Giddens for taking action theory and mixing it with
ethnomethodology, with the result that ‘Brit (sic) sociology ended up with
the inward-looking idea of reflexivity. That version of action theory is
unable to depict sociological determination and de-mystify the exercise of
power’ (Whimster 2011: 38). But other theorists are able to address these
tasks more satisfactorily, none more so than Bourdieu.
Habitus
As Habermas was to develop the previously existing concept of lifeworld,
so Bourdieu did with habitus, which is also to be found in Weber, Mauss,
Reflexivity, habitus and lifeworld 69
Husserl, Schutz, Merleau-Ponty, Elias, and possibly even Aristotle (Bennett
2010: xix; Scambler 2002: 74; Crossley 2005: 104). Bourdieu’s focus on
habitus reflects his concern with challenging a voluntaristic concept of
agency and demonstrating the underlying ‘pre-reflective’ nature of habitus
(Crossley 2005: 108–9). He includes diet in his empirical research and
shows how it is shaped by the habitus of different social groups.
Lupton describes habitus in the context of food consumption as a set of
‘unconscious preferences, classificatory schemes and taken-for-granted
choices’ as subcultures pass on ‘food practices and beliefs’ (Lupton 2003: 44).
People are not necessarily making free choices (ibid.: 44); the context is given
and practice begins in the absence of conscious thought. This recalls Marx’s
depiction of man finding himself in a set of circumstances which he has not
chosen, but with which he must interact.
An element of routine is generated by the habitus. For Giddens, routine
was an ontological necessity which sustained frail psyches in a challenging
world. For Bourdieu, routine is not something we need so much as some-
thing we naturally do; a practical matter, arising unquestioningly out of our
habitus and our relationship to the world (Atkinson 2007: 545). It is not
that choices in routine contexts such as eating are entirely automatic – but
that those choices, and the capacity for reflection itself, are shaped by the
habitus (Crossley 2005: 110). Whatever degree of choice exists, the ‘prereq-
uisites of choice cannot be chosen’ (ibid.).
Much of the meaning of Bourdieu’s use of the term ‘habitus’ is captured
in its definition as ‘acquired disposition’ (Crossley 2005: 104). This encom-
passes the notion of behaviour as emerging from the set of circumstances
into which we are born and raised; but it also alludes to the tension between
structure and agency. Structure shapes the circumstances we ‘acquire’
through birth, and within those limitations, we are ‘disposed’ to act in a
given way. However, we might acquire resources of one kind or another
during our lives which will allow for degrees of departure from inherited
habitus.
But such acquired dispositions are not necessarily expansive in a positive
way. In the context of food consumption, as agricultural production and
food processing technology advanced, particularly since the nineteenth
century and accelerating throughout the late twentieth century, snack and
meal products emerged which had little or no connection to previous modes
of eating. Some have little recognisable connection to original agricultural
constituents. As the epidemiology will show in Chapter 5, and food indus-
try scientists and marketers will acknowledge in subsequent chapters,
people from the lowest socio-economic groups consume more highly
processed snack and fast foods and are more likely to experience the health
effects of a nutrient-poor diet. Even some of those in higher socio-economic
groups may be consuming a high degree of processed snack foods and
too many calories overall for optimum health. This is where Bourdieu’s idea
of the habitus has its limits. Habermas’s notion of lifeworld colonisation,
70 Reflexivity, habitus and lifeworld
discussed later in this chapter, helps to bridge this gap when we seek to
understand dietary practices which have altered dramatically in recent
decades. At the very least we need to see food industry influences (both
products themselves and the marketing/advertising of them) as phenomena
which can be absorbed into the habitus; as this happens, dietary practices
shift to absorb the products the industry is targeting at us.
But an altered, increasingly industrialised and highly palatable food
supply does not discount early, familial influences on food tastes and prac-
tices. Describing the shaping of human action by the circumstances into
which he is born (and in a way which recalls Marx), Bourdieu concluded
that
Bourdieu, like Freud, believed in the power of the ‘oldest and deepest
experiences’ and noted that tastes in food are ‘deeply rooted in the body
and in primitive bodily experiences’ (ibid.: 73). Food industry scientists
and marketers reach similar conclusions (see Chapters 6–7). Thus a taste
for sweet, fatty foods established in childhood can remain decisive
throughout adult life, even as products containing these elements
constantly evolve in the marketplace. Lustig, an endocrinologist who
treats obese infants, describes a can of infant formula which contains over
43 per cent corn syrup solids and an additional 10.3 per cent sucrose,
and asks if this could be why some six month olds are already obese
(Lustig 2009).
Barker’s epidemiological research backdates the role of habitus in diet
even further, through his investigation of ‘foetal programming’, and in
particular, the connection between maternal ill health, foetal undernutrition
and ill health in adulthood (Barker 1998 cited in Graham 2007: 153).
Other studies show a relationship between early cognitive development and
later socio-economic position, alongside the role of family background in
shaping ‘cognitively strong’ children (Esping Andersen 2004 and Machin
and Vignoles 2004, both cited in Graham 2007: 154). So how does the
‘inherited capital’ that flows from such early experiences interact with or
allow for ‘acquired capital’?
A certain standard of education is generally what equips one to move
from ‘merely knowing’ to valuing ‘ways of using knowledge’ (Bourdieu
[1984]2010: 73). This is a useful way of conceptualising what happens for
some social groups: their diet evolves as they take into consideration and put
into practice information about nutrition. This move from ‘knowing’ to
Reflexivity, habitus and lifeworld 71
‘using knowledge’ about food doesn’t necessarily produce a uniform result:
one group of people might become (possibly overly) concerned about
dietary health risks, amid ever shifting warnings absorbed by those alert
to them; another might more proactively adopt a Mediterranean-type diet
rich in fruit, vegetables, fish and olive oil – possibly for health reasons, but
also for taste reasons. Such practices presume, for Bourdieu, a certain
standard of education. This could be what trumps the restricted diet of a
British childhood (even in a middle class family) from the 1960s, say, in
which Mediterranean food was little known. The educational aspect of the
habitus can be the mechanism for enlarging it beyond its earliest or most
‘primitive’ inputs.
But the habitus can also go ‘backwards’ in nutritional terms. This seems
to be happening with the ever increasing consumption of highly palatable
snack and meal combinations, and the use of prepared foods at mealtimes
which may not represent a healthy diet. This consumption is cued by the
production, marketing and display of new non-nutritious foods, which are
more likely to be consumed in large quantities among those of lower
socio-economic status.
A crucial aspect of the habitus is that it is internalised. However, even if
it is not consciously experienced by individuals, habitus will be observable
in ‘categories of perception and appreciation’ (Bourdieu [1984]2010: 95).
A habitus imposes societal norms and restraints which may conflict with
strong impulses (Crossley 2005: 105). This process may be at work in the
clash between the dominant societal norm regarding slimness and the fact
that increasing numbers of people do not attain it. Overconsumption of
calories, lowered sensation of fullness or satiety, a primitive urge us to eat
as much as we can, while we can, even amid a plentiful food supply – these
factors might have trumped the widespread desire in the late twentieth/
early twenty-first centuries to be thin. Only when this is mediated by
vigilant and, to some degree, class-associated ideas of healthy eating and
slimness is overconsumption of unhealthy foods avoided.
For Bourdieu, culture and class were interconnected in a dynamic relation-
ship. Over time, they create a habitus characterising large social units with
shared conditions and inclinations. Bourdieu refers to ‘a whole set of agents
produced by similar conditions … different conditions of existence produce
different habitus’ (Bourdieu [1984]2010: 166). In the context of taste and
consumption, ‘people who belong to the same social group and who thus
occupy the same position in social space tend to share the same tastes across
all forms of symbolic practice’ (Bennett 2010: xix):
The practices of the same agent, and, more generally, the practices of
all agents of the same class, owe the stylistic affinity which makes each
of them a metaphor of any of the others to the fact that they are the
product of transfers of the same schemes of action from one field to
another. (Bourdieu [1984]2010: 168)
72 Reflexivity, habitus and lifeworld
This insight is striking for its resonance with consumer profiling techniques
(discussed in Chapter 7), in which various aspects of behaviour are traced
in order to predict (then retrace, and reinforce, through marketing) the
kinds of goods and services people will buy. A given consumer group might,
for example, prefer the same types of coffee, newspapers, travel destina-
tions, leisure activities, home furnishings, food retailers and restaurants.
Within an apparently ‘infinite diversity of practices’, Bourdieu finds a unity
and specificity in them by breaking with ‘linear thinking’ and seeing instead
the ‘networks of interrelated relationships which are present in each of the
factors’ (Bourdieu [1984]2010: 101).
Conclusion
Bourdieu has been a lasting influence on health and diet research, but
while benefiting from his insights into how and why we eat the way we
do, we should also consider the role of the food industry and food
marketing, as key forces which interact with and shape the habitus
throughout our lives. Through food product development, food process-
ing, packaging, advertising and marketing campaigns and retailing strate-
gies, a range of images, cues and practices are continually absorbed by the
habitus, altering it over time. Tracing how this process works is the task
of Chapters 6–8.
Habermas analyses how a range of systems including politics, liberal
capitalism, technical progress and even marketing interact with the social
worlds of individuals. His thought illuminates the apparently paradoxical
situation in which a habitus seemingly set in a given social context can
nevertheless, over time, engage in altered social practices, including diet,
with implications for bodyweight and health.
a class structure shifted out of the lifeworld into the system loses its
historically palpable shape. The unequal distribution of social rewards
reflects a structure of privilege that can no longer be traced back to
class positions in any unqualified way … The more the class conflict
that is built into society through the private economic form of accumu-
lation can be dammed up and kept latent, the more problems come to
the fore that do not directly violate interest positions ascribable on a
class-specific basis. (Habermas [1981]1996: 289)
Conclusion
In theorising health inequalities, no new theory is required, but rather a
‘reflexive revisiting of what is already known’; in other words, ‘meta-
reflections, or thoughtful, independent-minded and critical reassessments of
the received theoretical and empirical wisdom delivered by today’s domi-
nant paradigm’ (Scambler and Scambler 2013: 99). In this and the forego-
ing chapter, I have attempted to do just this, testing differing theories of
class, human agency, consciousness and consumption in the context of food
consumption and its implications for health and society.
In sifting through theoretical perspectives to illuminate understandings
of food consumption, that of Giddens offered much insight into the process
of human consciousness, but did not consider the structuring power of
Reflexivity, habitus and lifeworld 89
food production, though he acknowledged the ‘forces of commodification’
in shaping consumption in general (Giddens 1994: 101). The food industry
and food marketing are key influences, alongside class, on individual
‘choice’, even if we are not aware of their activities, hence unable to engage
with them with full, conscious reflexivity.
Giddens’s ideas arguably lend weight to the lifestyles/personal responsi-
bility discourse without illuminating the underlying structural and psycho-
social reality. For a more nuanced picture, which considers the roles of
social class and habit, and how habitual behaviour can be altered,
Bourdieu’s and Habermas’s ideas of habitus and lifeworld respectively
provided greater depth of analysis. Habermas’s theorising of the colonisa-
tion by distorting, disembedding forces can be set and tested in the context
of health, food production and consumption, and social inequality.
Bourdieu’s theoretical work was closely linked to his empirical investiga-
tions of how people of differing social backgrounds live, eat and work,
and the ways in which our food practices throughout life are shaped by
our social and geographic environments. Habermas revealed the power
of manipulation and the linked role of technology in distorting the clear
communication of information as this would unfold in an ideal democracy,
although he was more focused on manipulation by the state than by capi-
tal. Nevertheless, his ideas come closest to theorising the power of market-
ing and help to explain the paradox in which a society which insists on
individual responsibility for diet and health is also able to trace food
consumption patterns and their bodyweight and health consequences via
social strata amid a dramatically altered food supply in recent decades. In
focusing on the distorting effect of manipulated communication, Habermas’s
work also serves to guide us to critical discourse analysis to uncover how
this might be happening with diet.
In the debate over the nature of social class, including conflicts over the
term itself and even dismissal of the concept of class, perhaps the one that
best articulates the way ahead for consumption and health research is a
definition of habitus proposed by Atkinson:
Notes
1 Distinction was first published in English in 1984. The 2010 edition cited here
uses the same translation but a new introduction.
2 ‘Lansley said that big food and drinks companies would not face new regulation
in return for helping meet the cost of Change4Life, the biggest ever healthy
eating and fitness campaign’ (Guardian 30/12/10; also see Observer 24/04/11).
Government funding later resumed, and a firm which also promotes snack
foods and soft drinks was hired to promote Change4Life (Guardian 20/12/11).
Reflexivity, habitus and lifeworld 91
Change4Life’s The Great Swapathon allowed shoppers to exchange vouchers
for food items promoted as healthier choices (www.change4lifewm.org.uk/
resources/The_Great_Swapathon_Resource.pdf).
3 For example, a firm lobbying on behalf of agribusiness in favour of GM foods
was found to have made changes to a draft report by the government’s food
regulatory body, the Food Standards Agency (Observer 06/06/10). These changes
influenced the final report, describing the role for GM foods in keeping food
prices down. Two food regulators subsequently resigned, criticising the close
relationship between the FSA and the lobbying firm. This was a case of regulatory
capture, although these two regulators had resisted capture themselves.
5 The evidence for a
diet–health–class link
Introduction
In challenging the personal choice/individual responsibility discourse where
diet is concerned, various social theories have illuminated the role of social
class in shaping patterns of food consumption, and the intricate relation-
ship between state, capital, food producers/marketers, and the shaping of
individual lifeworlds. Widely varying capabilities, resources and behaviours
result from these interacting influences.
What is the outcome for health? In general terms, socio-economic posi-
tion ‘shapes people’s experience of and exposure to virtually all psycho-
social and environmental risk factors for health – past, present and future’
(House and Williams 2000 cited in Graham 2007: 112). More particularly:
Poor diet is known to influence the risk of cancer, heart disease and
other conditions … around 70,000 fewer people would die prematurely
each year in the UK if diets matched the national guidelines on fruit
and vegetable consumption, and saturated fat, sugar and salt intake.
(Cabinet Office 2008: ES.11)
In 2006, 1.06 million prescription items were dispensed for the treat-
ment of obesity … more than eight times the number prescribed in
1999 … In 2006, around 73% of prescriptions were for Orlistat and
25% prescriptions were for Sibutramine, the two main drugs used for
treatment of obesity. (NHS 2008: iii)
That increase in prescriptions since 1999 was rather steeper than the rate of
increase in obesity, which raises the questions about whether these drugs work.
The evidence for a diet–health–class link 95
If so, why hasn’t obesity decreased and why are obesity-related diseases
predicted to continue to increase? Were the drugs being overprescribed? In fact
the prescribing trend subsequently changed, decreasing for the first time in
seven years (by 24 per cent) between 2009 and 2010. This probably reflects
the withdrawal of two obesity drugs, Sibutramine and Rimonabant, by
European regulators, following concerns over an increased risk of heart
attacks and strokes (NHS 2012: 52).
Bariatric surgery as an obesity treatment has also increased, nearly
doubling from just over 4,200 procedures in 2008/09 to just over 8,000
in 2010/11 (NCEPOD 2012: 5); it could now also be available for
obese people with Type 2 diabetes following proposals by NICE (NICE
2014e).
Yet Monaghan points out weaknesses in the research on which health
warnings over obesity rest, concluding that the science on disease–weight
links is equivocal (Monaghan 2005: 204). Given increased life expectancy
during the past 30 years in many developed countries, a period in which
overweight and obesity increased dramatically, populations are living
longer on the whole – and longer than leaner people did 30-plus years ago
(Gregg et al. 2005 cited in Monaghan 2005: 308).
For obesity discourse critics, it is not that a higher than optimal weight
(even by contested BMI measurements) does not have the potential to affect
health beyond a certain point, which may vary for individuals; but rather,
the way it is assessed may result in inappropriate recommendations to
groups not well measured by BMI categorisations. These may include not
only older people and fit ‘overweight’ people but also some ethnic groups
(Munro-Wild and Fellows 2009).
Obesity research since Monaghan’s 2005 analysis shows that there is
continuing uncertainty in the epidemiology. While obesity is still thought to
constitute a heightened health risk, there are several exceptions to this.
Epidemiologists regularly admit that there is much to be learned about the
relationship between bodyweight and disease risk. A series of systematic
reviews in Obesity Reviews, the journal of the International Association for
the Study of Obesity, has found that:
• Mortality rates are lower in aerobically fit individuals with a high BMI
than in normal weight people with low levels of fitness (Fogelholm
2010). However, a high BMI is associated with a higher risk and preva-
lence of Type 2 diabetes (ibid.).
• Overweight people aged 70–75 were found to have lower mortality
risk than those of normal or low weight (Flicker et al. 2010: 234).
Overweight may offer some protection in old age even for those with
chronic illnesses, possibly because of the ‘metabolic and nutritional
reserves’ it gives them (ibid.: 238). A subsequent review of 312 stud-
ies confirms that finding; BMI standards for younger adults cannot be
meaningfully applied to older people (Donini et al. 2012: 96).
96 The evidence for a diet–health–class link
• An increase in BMI can indicate an increase in lean body mass rather
than an increase in fat (Canoy and Buchan 2007: 3).
• Obese people can be metabolically healthy. It is excess central adiposity
(fat around the waist) that is associated with a significant increase in
heart disease risk (Iacobellis and Sharma 2007).
The World Cancer Research Fund has acknowledged the role of body
composition and body fatness as distinct from BMI, and notes that inter-
nationally, ‘healthy ranges of BMI varied between populations’ (WCRF
2007: 212). By contrast, waist circumference measures both subcutaneous
and intra-abdominal fat stores: the size of the latter predicts the risk of
chronic diseases such as metabolic disorders and cardiovascular
disease better than overall indicators of body fatness, such as BMI
(WCRF 2007: 213). In the UK, NICE guidelines advise that waist circum-
ference should be measured along with BMI in assessing weight-related
health risks (NICE 2006, 2010).
Jutel is critical of the health value placed on thinness and, suspicious
of the overweight–disease link, shows via a content analysis of medical
articles that overweight is itself becoming a disease entity (Jutel 2006:
2268–70). She speculates that BMI measurement may have contributed
to this phenomenon and traces its emergence in nineteenth century prac-
tice and ideas; a quantitative ‘certainty’, it enabled doctors to disregard
unreliable patient reports of diet/exercise (ibid.: 2272), a purpose it
could still serve, as unreliability on this point remains a concern. Like
Monaghan, she critiques the medical and social construction of the ideal
body, which ‘underpin[s] a multi-billion dollar diet, gym, self-help,
television and pharmaceutical approach to weight maintenance’ (Jutel
2006: 2275).
Monaghan finds the medical profession guilty of ‘fat bigotry’, especially
against those of ‘inferior social status’ and argues that fitness levels achieved
by overweight and obese people should be acknowledged (Monaghan
2005: 308). Aphramor, a research dietician, critiques the evidence base for
clinical guidelines on obesity and urges governments to address underlying
social injustices rather than focusing on weight (Aphramor 2005 cited by
Monaghan 2005: 308). Huizinga et al. (2009) found that physicians were
less respectful of patients with a high BMI, and ask whether this affects
quality of care.
Jutel urges healthcare practitioners to help people to change their diets and
to exercise, but without focusing on weight loss per se (Jutel 2006: 2275).
Gaesser points to the health risks of dieting (and the tendency of diets to fail)
and believes people should be encouraged to adjust their diets and exercise
moderately to improve metabolic health – not to lose weight (Gaesser 2002
cited in Monaghan 2005: 310–11). This view contrasts sharply with the
fitness–weight-loss discourse; the relationship between the two is thus worth
investigating in some detail.
The evidence for a diet–health–class link 97
Fitness, obesity and health
One way of understanding the implications of large bodyweights is by
examining the costs of associated health conditions. A recent study ranked
physical inactivity lower than poor diet, high alcohol consumption and
smoking in terms of its cost impact on the NHS. The authors estimated that
‘the largest economic burden to the NHS is due to poor diet [£5.8bn] and
much of this food-related burden is due to overweight and obesity. Physical
inactivity asserts a considerable burden on the NHS [£0.9bn], but not as
high as other behavioural risk factors’ (Scarborough et al. 2011: 531).
Research by Metcalf and colleagues has shown that exercise was not
effective in achieving weight loss among 200 children in a longitudinal
study (Metcalf et al. 2008, 2011). They did, however, find that exercise
improved the children’s metabolic health.
What do large-scale studies say about fitness, obesity and health? A study
of 115,000 US nurses (Hu et al. 2004) found that obese but active women
had a lower mortality rate than obese but inactive women, but higher than
normal weight, active women. Lean, inactive women were also at higher
risk than lean, active women. ‘This data does not support the hypothesis
that if you are physically active, you don’t have to worry about your
weight’ (Hu cited in Guardian 09/03/10). However, exercise does reduce
mortality risk even among the overweight.
Sui et al. (2007) carried out treadmill fitness tests on 2,600 people aged
60 and over rather than using self-reported fitness levels. Results showed no
definitive link between overweight and higher mortality, though an inverse
relationship was observed between levels of fitness and obesity. As weight
increases, there is a decreasing tendency for people to be fit, but ‘among
class II obese individuals (BMI 35–39.9), about 40–45% are still fit’ (Blair,2
a contributing author to Sui et al. 2007, cited in Guardian 09/03/10).
Despite ‘higher rates of mortality, chronic diseases, heart attacks and the
like, in people with high BMI … when we look at these mortality rates in
fat people who are fit … the harmful effect of fat just disappears’ (ibid.).
Hu et al. would dispute this, citing several studies which disprove such
claims (Hu et al. 2004: 9). Sui et al. note that their study participants were
mostly white, educated and middle class or higher, and that this might have
skewed their findings (Sui et al. 2007: 2515). They were also unable to
track diet or medication (ibid.). They do, however, rely on a more objective
measurement of fitness (treadmill tests) than the Hu study, which based its
findings on self-reported exercise. Such data may be unreliable. Nevertheless,
both studies find significant value for exercise in reducing illness and
mortality risks, even if bodyweight is not affected.
A 2008 study of 39,000 women, none of whom had coronary heart
disease at the outset, found that overweight active women were 54 per cent
more likely to develop heart disease, and obese active women had an
87 per cent greater risk, compared to normal weight active women over a
98 The evidence for a diet–health–class link
ten-year period (Weinstein et al. 2008; fitness was self-reported). They
concluded that ‘the risk of CHD associated with elevated body mass index
is considerably reduced by increased physical activity levels. However, the
risk is not completely eliminated’ (ibid.: 884).
If physical activity is effective in lowering health risks even among the
overweight, how likely is it that this group does exercise? The Health
Survey for England 2008 shows that self-reported levels of physical activity
were higher for those of normal BMI than those classed (according to BMI
measurements) as overweight or obese (HSE 2008: 21). The 2012 survey
found similar trends, as well as an increase in aerobic activities as house-
hold incomes increased (HSE 2012a: 1). There is also an association
between low levels of physical activity and a ‘raised waist circumference’
(>102cm in men, >88cm in women (HSE 2008: 100)). This in turn is asso-
ciated with a higher risk of metabolic syndrome,3 including heightened risk
for Type 2 diabetes and heart disease (HSE 2008: 184).
Devices which record exercise are beginning to allow researchers to verify
self-reported fitness efforts, and they are found to be much lower in actual-
ity. A Canadian study which fitted accelerometers onto nearly 2,800 adoles-
cents found that all participants over-reported their exercise activities; those
who were the most inactive were also more likely to over-report exercise
(Leblanc and Janssen 2010). Similarly, the WCRF has found that self-
assessed bodyweight tends to be underestimated (WCRF 2007: 214).
There is some dispute over the extent of the mitigating effect of fitness on
bodyweight. However, there is clear potential for public health discourse
and practice to shift the focus away from weight loss on its own and
towards the health benefits of exercise.
The Christakis and Fowler research was done before this kind of food
advertising via social networks was happening on any great scale; such
techniques seem destined to further the patterns of food consumption
observed in social network research (although word-of-mouth among
friends and acquaintances long predates social media).
Christakis and Fowler suggest that the dynamics of social networks
could be harnessed to address obesity and stop it spreading, with interven-
tions that feature peer support – ‘that is, that modify the person’s social
network’ – designed to encourage weight loss (Christakis and Fowler
2007: 378). They propose that their findings could address social inequal-
ities. Since their interest is in behavioural rather than structural matters,
this would presumably involve dietary/weight loss interventions designed
with socio-economic status in mind. A UK health behaviours study also
The evidence for a diet–health–class link 107
recommends targeting such interventions at those with the lowest levels of
education and income, among whom ‘unhealthy behaviours’ are increas-
ing (Buck and Frosini 2012).
These insights may helpfully inform future health promotion approaches.
However, thus far, interventions which focus on behaviours have not been
successful in reversing population bodyweight and diet-related illness trends;
arguably the power of a highly palatable, omnipresent, large-portioned and
targeted food supply is simply too great. Nevertheless, social network
research has made a strong impact, and in this process has reinforced the
focus on human behaviour, but in a decontextualised manner – divorced from
either social structures or the nature, supply and marketing of food itself.
the CAP largely controls the type, volume and price of food produced
in the [European] Community … it would be quite feasible to increase
The evidence for a diet–health–class link 109
the supply and lower the price of healthier foods such as fruit and
vegetables, in order to encourage greater consumption, and conversely
to discourage the consumption of tobacco, sugar and fats (especially
saturated fat). (Joffe 1993: 60)
Others have proposed that Europe’s CAP be regularly assessed for its influ-
ence on health and nutrition, and subsidies used to increase consumption of
fruit and vegetables (Hautvast et al. 2000).
The WHO’s study of saturated fat production/consumption in Europe
found that a substantial portion of cardiovascular disease could be attrib-
uted to the CAP (Lloyd-Williams et al. 2008). Most policy and food industry
representatives interviewed for the (2006) Porgrow study thought that the
CAP might be influencing overconsumption of unhealthy foods ‘but there
was little confidence that the CAP will be reformed in ways directly benefi-
cial to public health in the short- to medium-terms’ (Lobstein et al. 2006: 9).
These studies, drawn from diverse research programmes and disciplines,
show the role played by public policy and the ideology which shapes it, for
public health problems such as obesity. But even these innovative investiga-
tions have not been able to seriously challenge the discourse of personal
responsibility and a focus on behaviour which continues to prevail in the
context of dietary health and bodyweight. Christakis and Fowler’s work on
social networks and Brooks’s stance on the power of the individual were
both embraced by Britain’s leading political parties; neither addressed
structural forces of any kind.
• Salt is the major factor increasing blood pressure, a greater risk than
low fruit/vegetable intake, obesity, sedentariness or high alcohol intake.
• High blood pressure (HBP) causes 62 per cent of strokes in the UK.
There is increasing evidence that salt is independently associated with
stroke. Older people, those with HBP, diabetics, smokers and those
who smoke and have a high salt intake are more likely to be from lower
socio-economic groups.
• A 2009 meta-analysis of 19 cohort samples totalling 177,000 partici-
pants demonstrated a link between high salt intake, stroke risk and
cardiovascular disease. HBP is responsible for 40 per cent of cardio-
vascular disease.
• There is evidence of a link between salt consumption and kidney
disease; high salt intake increases protein in urine (a risk factor for
kidney malfunction) and HBP also increases the risk of kidney disease.
• There is a link between high salt intake and cardiovascular disease and
diabetes; people with hypertension are 2.5 times more likely to develop
diabetes.
• High salt intake causes thirst and may increase sugary drink consump-
tion, which may contribute to both obesity and diabetes.
• Salt intake may contribute to osteoporosis via calcium excretion. This
association has also been observed among teenage girls; lowered salt
consumption among this group could reduce their risk of osteoporosis
later in life.
• High salt intake raises the risk of stomach cancer. This risk is higher
for those in the most deprived social groups, for men overall and for
the over-55s.
The evidence for a diet–health–class link 111
• For most of the UK population, 80 per cent of salt consumed is in
processed foods; for Africans living in the UK, most salt consumed is
added during cooking and at the table, suggesting a need for culturally
targeted health information on salt intake.
The Scientific Advisory Committee on Nutrition, FSA, and NICE all recom-
mend a maximum salt intake of 6g per day, less for children (CASH 2012).
This would be a substantial reduction from high levels registered in a 2008
National Centre for Social Research/MRC study (9.7g for men and 7.7g for
women on average). NICE calls for a further reduction of salt intake to a
maximum of 3g per day by 2025 (NICE 2010).
Marmot also cites a range of birth cohort studies showing the influence of
early life on subsequent states of health (Marmot 2004: 55). Weight is not
necessarily a factor.
A 2008 study analysing Whitehall II data found that a diet characterised
by processed foods high in fat, salt and sugar was associated with both
insulin resistance and, prospectively, with Type 2 diabetes; the study was
not primarily concerned with bodyweight, though the authors noted
evidence that those who drank diet soft drinks tended to be overweight
(McNaughton et al. 2008: 1346).
The WCRF systematic review cited previously found evidence that ‘some
types of vegetables and fruits in general probably protect against a number
of cancers’ (WCRF 2007: 114 full report). This finding is unrelated to
obesity per se.
A study of nearly 3,000 UK adults (Shaheen et al. 2010) tested for links
between dietary patterns and lung disease as reported in questionnaires,
rather than the consumption of individual foods. The authors found that a
pattern they described as ‘prudent’, containing a high degree of fruit,
vegetables, fish and wholemeal cereals, may offer some protection against
impaired lung function (ibid.: 277). Again, weight is not mentioned.
A study commissioned by the FSA and the Department of Health described
teenage girls’ diets as the worst of all population groups. While consuming
112 The evidence for a diet–health–class link
too much sugar and fat, they lack key nutrients. Nearly half did not consume
minimum recommended levels of iron or magnesium, and only 7 per cent ate
five portions of fruit and vegetables per day (FSA/DoH 2008/09: points 5.5.2
and 5.3). Overall, this group does not eat enough, according to the FSA’s
head of nutritional research – the opposite of obesity, but still a problematic
diet with the potential to harm health (Guardian 09/02/10). The report
further noted that only about a third of adults eat their ‘five a day’ and
that all population groups are eating too much saturated fat, although
mean levels have dropped as a percentage of overall food intake (FSA/DoH
2008/09: points 5.3 and 5.4.7).
Other illnesses relating to poor diet include anaemia due to lack of iron,
a particular risk during pregnancy; mothers with inadequate nutrition
giving birth to low-weight babies (low birthweight in turn carrying future
health risks); dental problems; eczema; asthma; cataracts – all connected to
poor nutrition (Lobstein cited in Lawrence 2008c).
One study predicted that a diet containing more fruit, vegetables and
fibre, and less salt and fat, could save 33,000 lives per year (Scarborough
et al. 2012: 420). The study assesses the differing role these nutrients could
have in saving lives:
Conclusion
This chapter has taken an empirical look at what is proposed in this book:
that diet affects our health; that much more than individual choice is
involved; that the discourse of personal responsibility obscures both social
gradients in diet-related illness and the real suffering experienced in such
illnesses, often over many years. By tracing the links between particular
aspects of poor diet and specific health problems, and drawing further links
with social structure and even governance as a factor in experiencing both
poor diet and illness, the material discussed in this chapter clarified the firm
empirical grounds for addressing the health and social consequences of the
modern diet.
Poor quality foods, consumed disproportionately to healthy foods, and
in the context of sedentary lives, are associated with chronic diseases, with
or without the presence of overweight or obesity. The mortality risks of
obesity may not be as pronounced as obesity discourse would imply,
though they are higher for those of lower social class. Joint, circulatory,
metabolic and other categories of health risk can also be heightened by the
quantity and type of food we eat – and these risks are more likely to be
experienced by those of lower social class. Our dietary options are shaped
by the social and physical worlds we inhabit, and some social groups are
eating a substantially less healthy diet than others.
The risk of disease varies significantly according to fitness level, disease
category, ethnicity, class and age. There is a consensus on the value of exer-
cise for metabolic health, but reservations about its effectiveness for losing
weight, and an acknowledgement of the health risks for older people of
losing weight. These nuances do not seem to have permeated the obesity
discourse of a weight-obsessed society. But there is much rigorous, balanced
epidemiological analysis of the links between obesity and the major disease
groups discussed in this chapter. This work is characteristically open about
areas of uncertainty and the scope for future clarification.
Overly rigid bodyweight measurements, moral judgements, exhortations
to lose weight and the blaming and stigmatisation of fat people are worthy
of attention and critique by social scientists. Scholars from a range of disci-
plines addressed these problems forcefully in a 2011 collection, under the
rubric of critical weight studies (Rich et al. 2011). The activities of both
weight loss and pharmaceutical industries in addressing obesity are also
deserving of critical investigation. Based on the evidence that weight loss is
difficult and usually unsustainable, and to address the stigma suffered by
those with large bodyweights, Bacon and Aphramor (2011) make a power-
ful case for a Health at Every Size approach for improving health, rather
than weight loss per se.
116 The evidence for a diet–health–class link
But social scientists should not be diverted from investigating the role of
the food industry in shaping dramatically different patterns of food
consumption – and their health and bodyweight consequences. As one of
Monaghan’s fellow critics of obesity discourse observed: ‘Should we … be
unconcerned that fast food multinational companies target poorer commu-
nities in order to sell more low quality food?’ (Gard 2009: 34).
This chapter has given empirical substance to the theoretical analysis of
class, capital, governance, consumption and health in the previous two. In
the following three chapters, various dimensions of the food industry will
be examined for their understanding of and engagement with these matters.
There is much surprisingly common ground, with food scientists acknowl-
edging health concerns and food marketing offering a highly operational-
ised, commercial, empirical grounding for the theoretical analysis in
Chapters 3 and 4.
Before discussing how food marketing engages with notions of social
class and helps to shape dietary patterns, I will outline the broader context
from which food marketing strategies emerge, beginning with agricultural
production, the processing and merchandising of foods, and industry’s
understanding of both health and limitations to the consumer’s capacity to
choose freely.
Notes
1 Effectiveness of these programmes varies: the longer people persist with them,
the more effective they are (NICE 2014c). However, ‘the weight difference with
untreated comparison groups diminishes over time’ (NICE 2014d: 7). No studies
examined the effectiveness of such weight-loss programmes by socio-economic
status; and ‘there is a lack of high quality reviews on the effectiveness of weight-
loss maintenance interventions’ (NICE 2014c: 19). If the weight were to be
regained in the long run, then the effectiveness of these programmes would be
seriously challenged; but at the moment this cannot be known.
2 Blair acknowledges that he has received honoraria for board membership and
research grants from US fitness company Jenny Craig (Sui et al. 2007: 2515)
3 Metabolic syndrome: ‘a combination of medical disorders that increase the risk
of developing cardiovascular disease and diabetes. Abnormal fat levels in the
blood can lead to arteriosclerosis (fatty plaques) on the walls of blood vessels,
high blood pressure and insulin resistance or glucose intolerance’ (HSE 2008:
19). Differing criteria had developed under the metabolic syndrome label,
provoking much debate (Nichols 2006). But by 2009, a harmonisation of the two
most widely used definitions required three out of five criteria to be met (in the
categories of ‘population and country-specific waist circumference, triglycerides,
HDL cholesterol, blood pressure and fasting blood glucose’) (Thankamony et al.
2011: 301).
6 How the agri-food industry
shapes our diets and influences
our health
Introduction
I serve the same to everyone, for when I invite guests it is for a meal, not
to make class distinctions. (Pliny the Younger, cited in Steele 2009: 221)
There are many [consumer] segments and subsegments, each with differ-
ent motivations, different need states and different purchase drivers …
age, income, family status, ethnicity, education, employment … and
other factors shape consumers’ beliefs, goals and purchases. (Schmidt
2009: 222; advice to food marketers)
These statements were made two millennia apart but each observes the
concept of social ranks and distinctions where food consumption is
concerned. In fact, Pliny’s dismissal of class did not reflect the typical
Roman view – in ancient Rome, as now, class distinctions did emerge at
mealtimes (Steele 2009: 221). The marketing advice in the second quotation
reflects how food products are conceived and segmented for marketing,
with social rank denoted by the use of terms such as status, education,
employment and income.
The previous chapter traced the health implications of qualitatively
different diets and their link to socio-economic position – a manifestation
of the role of social class in driving not only food consumption but also the
varied nature of the food supply. Political and historical forces were also
identified as factors influencing food consumption. The current and subse-
quent two chapters take a further step back from the act of eating and the
social factors which influence it in order to examine the changing nature of
the food supply and how it is financed, structured, processed, distributed
and marketed. I discuss critiques of these activities, explore how the food
industry understands consumption, and investigate concerns revealed by
industry regarding human health.
The way agriculture has developed since the mid twentieth century has
dramatically changed the nature, quality, quantity, availability and pricing
118 How the agri-food industry shapes our diets
of the food supply. But there are also historical continuities in the ways
industry, forms of governance and technology have engaged with the food
supply, altering consumption practices – and health – in class-specific ways.
These continuities are also traced in this chapter.
Having reviewed the evidence in Chapter 5 for a link between social
class, diet and health, and even political ideology and bodyweight trends,
these insights need to be situated within the context from which they
emerge: namely, that of agriculture and, subsequently, the way food is
designed, processed and retailed. In this chapter, industry texts which
discuss these technical and scientific matters reveal an almost Bourdieuan
grasp of how food ‘choices’ arise, and they raise concerns about the food
supply resulting from industrial processes and the health of those who
routinely eat the poorest quality processed foods.
There are opportunities in this discussion to link the role of agricultural
and food industry strategies with the theories of both Bourdieu and
Habermas: agricultural and food industry trends and practices are forces
interacting with and shaping the habitus, and altering the lifeworld, in
terms of dietary practice. Concrete examples of the effects of the food chain
from agriculture to arteries – from the changing ways food is grown to the
health implications of the way it is processed, retailed, consumed and
digested – link theoretical insights with the empirical world of food produc-
tion and the way industry understands its health effects.
While it is certainly possible to prepare food from original ingredients,
and to eat outside the norms for our social group or consumer segment,
much of our diet is processed, consumed both in and outside of the home
in an omnipresent foodscape, and targeted at us based on population track-
ing and segmenting techniques. Chapters 7 and 8 analyse these processes in
detail. However, food marketing is one of the later stages in a process that
begins much farther upstream. So it is useful to get an overview of the
globalised, agro-industrial context in which food is produced and consumed
so that food product development and marketing are fully contextualised.
The blanketing of British foodscapes with highly processed foods and the
rise of bodyweights accompanied the growth in production of key commod-
ity crops which are the basis, along with additives, for an array of snack
foods, both sweet and savoury. The food and agriculture writer and jour-
nalist Felicity Lawrence describes this process: ‘The same half-dozen heavily
subsidised commodities – soya, rapeseed, palm oil, corn, sugar and rice –
are broken down into their individual parts and endlessly reconstituted.
They are sold back to us as processed food or turned into animal feed’
(Lawrence 2008b).
Trade and investment policies play a major role in a globalised agricul-
ture, food processing and food merchandising industry, and are traced in
this chapter. The changing nature of British supermarkets and their role in
shaping the food supply has in turn influenced consumption patterns, and
is discussed here. Finally, the health effects of processed food as discussed
How the agri-food industry shapes our diets 119
by food industry scientists and others will be analysed. These reflect the
epidemiological linkage between food consumption and health made in the
previous chapter, and Bourdieuan ideas about how food tastes and habits
are formed, but further concerns are revealed about processed foods which
food scientists have identified.
Gard, a critic of obesity discourse observing such trends, queries the conclu-
sions of nutritionists
who argue that human brains are ‘hard wired’ to crave sugar, fat and
salt [when] there is no convincing evidence that the amount of sugar,
fat and salt in modern fats and convenience foods is anything other
than the product of successful marketing and the global over-
production of these substances. (Gard 2009: 34)
124 How the agri-food industry shapes our diets
In fact, both of these trends are real: we do crave these macronutrients, but
they had never been supplied in such omnipresent and affordable quantities
before the late twentieth century. This has in turn cued food consumption,
increasing it along with the increase in the food supply.
The former Coca-Cola executive interviewed by Kessler seems to
substantiate Gard’s point, suggesting that the low cost of fats and sugars is
at least partly responsible for the prevalence of fast/convenience foods:
If McDonald’s could sell anything and make money at the same rate
that they’re doing now, they couldn’t care less whether it was fat- or
sugar-laden. It just happens to be that fats and sugars and flours are
some of the least expensive food items we have in the world. (Kessler
2009: 129)
Figure 6.1 Vending machines in a community sports centre sell Fairtrade crisps
and chocolate (Fairtrade stickers are on the machines). Photograph by
Melanie Jervis.
where 71.4 per cent of organic food is sold (Soil Association 2012).1 Ethical
considerations may not have the same appeal during times of austerity
(Marketing Magazine 14/03/12). Only 29 per cent of consumers said social
responsibility figures in their purchases, down from 43 per cent in 2008
(Ipsos MORI poll cited in ibid.). So while a sense of social responsibility had
been absorbed into the habitus of some consumers, financial pressures stem-
ming from the economic crisis pushed this consideration regarding food
consumption back out again. It is another illustration of how the habitus can
be influenced by events external to the individual or social group.
Historical context
The earliest techniques and tools for harvesting, processing and preserving
foods appeared after 11,000 BC, mostly to allow consumption of wild cere-
als in the Fertile Crescent (Diamond 1999: 110–11). Fermentation of foods
dates back 9,000 years; cured meats, salt cod, sausages and marmalade
have a long history (Saberi 2011). Food processing was the result of natural
developments (animal extinctions, climate change); domestication of wild
plants; new technologies (cutting, grinding, roasting, storage); a rise in
population as food production increased; and displacement of hunter-
gatherers by food producers (Diamond 1999: 111–12). Diamond identifies
an ‘autocatalytic process’ in an accelerating cycle of positive feedback as
food production expands (ibid.). This is one illustration of what another
analyst has termed the ‘adjacent possible’: it is what happens when techno-
logical and scientific progress collide with cultural and societal forces to
produce incremental but ultimately decisive change (Johnson 2010). This
process is now happening so rapidly and at such high levels of technical
complexity that the implications of changes taking place may not be
grasped while they are unfolding. Arguably, this is what has happened with
the predominance and merchandising of foods high in fat, salt and sugar.
As Habermas noted previously, such progress takes place ‘without being
reflected upon’ in societies lacking political consciousness.
Interlocking technological and social developments define food produc-
tion and consumption at any stage in history. In eighteenth century British
towns, little food preparation was carried out in many households. Instead,
‘there was a large market in ready-cooked food, both take-away and pub
food’ and ‘a multiplicity of cookshops’ serving the urban poor (Laurence
2002: 149–50). Technology, housing and market conditions combined to
produce prepared food for the home in this very public way.
In another example of the ‘adjacent possible’, by the late nineteenth
century, technological and transport advances meant that Britain was the
130 How the agri-food industry shapes our diets
world’s major importer of preserved and processed foods, primarily tinned
fruit, meat and condensed milk (Steel 2009: 92). This was quite apart from
massive imports of wheat and sugar by that time. Prepared foods made
locally were also popular in the nineteenth century. Many industrial work-
ers, living in cramped housing without cooking facilities, survived on bread,
tea and small amounts of cheese, salted fish and meat (Burnett 1989: 28).
Many town-dwellers had no hot food unless they took it to a bakeshop for
cooking or bought pies, bacon or baked potatoes from cookshops (Steel
2009: 164–7; Gaskell [1848]1970). Wilson’s study of food adulteration in
the nineteenth century shows that the quality of foods for the poor was low,
with meat often past its best, and they were victims of swindling more than
other social groups (Wilson 2009: 100–1). This gives some historical
contextualisation to the role of societal structures and practices in deter-
mining the type and quality of foods consumed.
Yet a newspaper report from 1864 bemoans the lack of cooking skills
among working-class girls, who, in adulthood, supposedly become reliant
on prepared foods such as ‘relishes, cooked meat from the shop’ and beer
or spirits (Guardian [1864]16/01/07). A similar criticism in 1901 describes
‘the combination of careless methods and downright waste which passes for
cookery among the poorer classes’ (Guardian [1901]03/09/10). These are
early illustrations of a tendency to blame the poor for their own
predicament.
Experience of land enclosures in the nineteenth century had seen tradi-
tions of foraging and peasant cooking lost, changing dietary habitus and
altering lifeworlds in an alienating way. During industrialisation, workers’
inadequate diets and limited cooking facilities were of little concern to most
employers or authorities (Wilson 2009: 21).
Britain’s industrialised palate had made it a ready market for American
processed foods long before the rest of Europe (Steel 2009: 237). From
1860 to 1960, British consumption of sugar doubled, fat consumption
increased by 40 per cent, and 90 per cent less fibre was consumed (Porter
1999: 559), a dramatic illustration of how, over a 100-year period, dietary
practices were altered by a changing food supply fuelled by developments
in technology and trade. The dietary practices emerging from the habitus of
the time were highly permeable to such change. Nor were these changes all
palatable ones: recalling Bourdieu’s observation that people develop a taste
‘for what they are anyway condemned to’ (Bourdieu [1984]2010), by the
1930s many British people apparently preferred tinned milk, peas and fish
to fresh versions (Orwell 1937 cited in Steel 2009: 237). Friedmann contex-
tualises today’s poor quality diets by finding their origins during the 1930s:
had the poor been able to purchase enough horticulture and meats
from local farms beginning in the 1930s, their purchases would have
strengthened regional fresh markets in ‘advanced’ countries, leaving
major grains and livestock to industrial agriculture. Instead, those
How the agri-food industry shapes our diets 131
farmers and markets were decimated by half a century of industrializa-
tion of food and farming, and the poor (in the US) were given surplus
industrial food, which came to dominate the diets of the poor in the
[global] North. (Friedmann 2009: 341)
She finds this process now happening in the global south, as food supply
chains there are colonised by transnational companies, affecting farmers,
markets and consumers alike. Thus ‘the growing masses of the poor who
can no longer access fresh foods find that if they can afford any commercial
food at all, it is the least healthy and most durable commodities’ (Friedmann
2009: 341).
Your meat is more likely to come pumped with hormones and water.
Your bread is more likely to be bleached … Your fat is more likely to
be hydrogenated. Juice is too expensive, so your children drink squash
laced with colourings and sweeteners. (Wilson 2009: 100)
The satiety research being carried out by the scientist cited above aims to
curb appetite via ‘an aqueous solution that gels into a solid structure in the
stomach’ (Guardian 19/01/10). But having made processed foods ‘taste so
good’, industry scientists must now turn their attention to more functional
matters, such as the manner and speed at which food is transported through
the digestive system, for those who are trying to lose weight. Other research
136 How the agri-food industry shapes our diets
is looking into the functionality of food components, food structure, taste,
texture and flavour. The food industry’s development of healthy products
naturally focuses on technological processes used in food processing. This
section highlights industry activities and commentary which focus on the
potential for technology to address consumer interest in healthy eating.
Guthman and DuPuis set these activities in a neoliberal context, describ-
ing industry responses to consumer concerns about weight. One approach
is to create functional products like the ones described above – ‘food prod-
ucts that do not act like food’ (Guthman and Dupuis 2006: 441). Thus
the substance used as fat in low-fat ice cream or … the new low-calorie
sugar, break right through the problem of inelastic demand … the
commodity simply passes through the body, enabling the product to be
consumed with no weight-gaining effect … New pharmaceuticals …
and nutritional supplements designed to reduce the body’s absorption
of fat (along with essential vitamins and minerals) fulfill a similar func-
tion. By thwarting the body’s metabolizing functions, these products
allow producers to sell much more of these products per person.
(Guthman and Dupuis 2006: 441)
Another strategy is to commodify dieting itself, with low fat products targeted
at concerned eaters, even while foods such as fruit and vegetables are
neglected (Guthman and DuPuis 2006: 441). Fruit and vegetables are impor-
tant in a healthy diet, but it is expensive to chop and prepare them: ‘that’s why
it’s so hard to run a business that sells fresh and healthy foods on a mass scale’
(Kessler 2009: 122). So in Habermasian terms, the food lifeworld of those
targeted with diet foods is disrupted as emerging health concerns are colo-
nised not by overtly healthy foods, but by industrialised foods which them-
selves constitute a growing market for individuals worried about their weight.
Food industry scientists note a growing interest in healthy eating, as
‘poor choices in foods have been damaging the health of the average
consumer’ (Watzke and German 2009: 148). Yet public food intake data
and consumer research data show that healthy eating is increasingly appeal-
ing to some, but not all, population groups. Nevertheless, the greatest
growth area in the food industry is in foods considered (by consumers,
according to industry research) to be health-promoting (ibid.: 149). But this
notion hinges on perceptions of healthy products: ‘If we can understand the
consumer’s lifestyle and perception of health we can develop products with
functional ingredients that will address these needs and create value for the
consumer – from the consumer’s perspective – as well as the food industry’
(Wennstrom and Mellentin 2002: 31). Industry needs to
Figure 6.3 Energy drinks and snack vending machine in a community sports centre,
occupying previously empty spaces. Photograph by Melanie Jervis.
Emulsifiers are used to suspend oils and fats in aqueous solutions, and
vice versa (Whitehurst 2004). In recent decades, the quantities of emul-
sifiers used in the food supply have risen markedly, and so too has the
fat content of consumers’ diets … The incidence of obesity in all indus-
trialised countries is also rising rapidly, so if the use of emulsifiers was
more tightly restricted, that might make a significant contribution to
combating the obesity epidemic … While emulsifiers may well be toxi-
cologically innocuous, they may nonetheless be exerting a significant
and collective adverse impact on public health nutrition, but that issue
is currently outside the scope of official risk assessment. (Millstone
2009: 632)
The food industry’s concern is to avoid acute toxicity in which cause and
effect is clear, usually in the short term. But is there a longer term, chronic
sense in which foods can be considered ‘toxic’? Alongside Millstone’s
concern with emulsifiers and obesity, Lustig, a paediatric endocrinologist,
raises similar points about sugar: sugar (and his particular research interest,
high fructose corn syrup) is not toxic in the short term and is not therefore
regulated. But could it be a chronic toxin, taking some years and a high
degree of consumption to alter our biochemistry and increase the risk of
metabolic syndrome, due to the way it is metabolised (Lustig 2014: 30)?
Lustig is convinced that it is (ibid.: 127).
Cancer researchers Parkin and Boyd estimate a ten-year span between
low fruit and vegetable intake and the appearance of cancers, and a similar
latency for cancers related to red and processed meat consumption (the ten-
year latency is ‘the average interval between “exposure” and the appropri-
ate increase in risk of the cancers concerned’) (Parkin and Boyd 2011,
Parkin 2011a, 2011b: S4). Parkin notes that ‘detailed quantification of risk
is not available for most exposures’ and that categories of risk for popula-
tion groups would be impossible to establish (2011b: S4). Nevertheless, the
ten-year period gives some shape to the notion of extending concepts of
toxicity to encompass longer timespans.
Food scientists note the influence on metabolism of ‘even small changes
in food structure’: food materials ‘containing large-sized emulsion
particles … produced a more rapid appearance of lipids in blood than the
same quantity of dietary fat in smaller sized emulsions’ (Armand et al.
1999 cited in Watzke and German 2009: 157). This study by Armand et
al. found that fat globule size influenced digestion and assimilation of fat
in the body: ‘Fat emulsions behave differently in the digestive tract depend-
ing on their initial physicochemical properties’ (Armand et al. 1999: 1096).
By July 2014, this article had been cited 152 times. I trawled these articles
for reviews of the research.
How the agri-food industry shapes our diets 149
Eleven years after Armand et al.’s study, a review of 144 studies
(Golding and Wooster 2010) found that there remained ‘surprisingly little
consideration … given as to how food structure impacts on fat digestion and
metabolism’. Yet there was a ‘pressing need for the food industry to develop
strategies to combat obesity’ (ibid.: 93). The review concluded that ‘quite
profound differences in lipid digestion can be observed based on emulsion
design’. But this has been seen only in highly modelled (in vitro) systems; the
challenge was to replicate these findings in actual foods (ibid.: 99).
Another review assessed 240 studies on fat digestion to reveal ways in
which food industry engineers ‘can adjust the digestive behavior of emulsi-
fied fat, focusing on food structuring, for example to change the digestibil-
ity or to make it more satiating’ (Van Aken 2010: 259). This review concurs
with the Armand study but concludes:
The discussion of these matters in the literature among food scientists inside
and outside the industry makes it clear that the very nature of processed
foods may be an important, overlooked contributor to both overconsump-
tion of food and diet-related ill health.
Conclusion
Agricultural developments have led to changes in the food supply, with
implications for food processing, retailing and eating habits. While the
growth in bodyweight among the population overall, and the widespread
experience of health consequences of overconsumption, are unique in
history, there is a dimension of historical continuity in the globalisation and
processing of food. This chapter has cited early examples of the reliance of
lower classes on unhealthy processed foods. Food suppliers in the nine-
teenth and early twentieth centuries altered foods and lowered their quality
and safety until regulations challenged these practices.
Advances in food production technologies encompassing both agriculture
and processing, and the globalised nature of their structure and financing,
have combined with food product development to enable dramatic changes
in the food supply to suit the tastes of groups identified as likely consumers
for a given product. Current trends in diets and bodyweights are rooted in
dramatic changes to food production, and this linkage has been traced in
this chapter.
Marketers and food scientists engaged with what is recognisable as a
commercial version of Bourdieu’s habitus and industry’s awareness of the
need to interact with it as it designs and markets its products. Food industry
texts acknowledge the lifelong influence of flavour and dietary preferences
established in childhood, the reinforcing nature of purchasing behaviour,
and the limits to conscious thought in these processes.
Food industry science and marketing naturally encompass and study all
these phenomena in their continuing desire to design appealing products
and understand and shape consumption behaviour. Thus the psychological
dimensions of food choice, socially shaped as they are acknowledged to be
even by the food industry, are not a separate category from industry activi-
ties or the nature of processed foods – they are intimately connected. Food
product developers and marketers aim to cue and reinforce food behav-
iours, interacting with and shaping consumer psychology where food
choice is concerned. The habitus can most easily absorb new products
modelled on existing ones which are already part of food consumption
patterns, but can also be expanded to include new foods; it is a matter of
How the agri-food industry shapes our diets 151
engaging with the habitus of a target group and positioning the food as
something that, despite being new, is appropriate for people like them (and
may well build on products they already consume). The lifestyle in which it
is contextualised in marketing and advertising campaigns is recognisable to
target purchasers. The portrayal of others like them (or as they may see
themselves) eating the product allows them to assimilate it into their habi-
tus without resistance.3
Some marketers acknowledged consumer confusion regarding the health
implications of functional food and drink products, and advised working
with that confusion so that ‘energy drinks’, for example, are promoted to
and apparently understood by consumers as healthy, even though they are
not. Low fat products may not originally have been seen as a prompt for
overconsumption, but that evidence is now well established. Yet the
language and imagery of such products continues to construct a ‘health
halo’ effect around it, adding to consumer confusion and potentially
increasing consumption.
Observations regarding the nature of choice and habit prompted industry
scientists’ concerns about the health implications of diets based on
processed foods; they identified low income groups as particularly at risk.
Their own surveillance of developments in the field led them to identify
emulsifiers as a potentially significant factor in overconsumption; research
into emulsifiers and the biology of digestion by scientists outside industry
proposed lessons to be learned in a public health context. The focus on
foods high in salt, fat and sugar is important in understanding how health
is put at risk by overconsumption of these foods. But there are additional
potential problems for health stemming from the chemical structures of
processed foods and their influence on digestion.
The following chapter focuses on marketing, placing it in its historical
and political economy context. It further explores the role of psychology
and consciousness research in illuminating food consumption and the
particular use made of it by food marketers. Chapter 7 additionally inves-
tigates the applications and expertise of market research, its capacity to
track consumption in terms of place, rank and, given digital platforms, even
time, and how all of this informs marketing interventions which reinforce
class-differentiated consumption.
Notes
1 In 2013, sales grew again after four years of decline (Soil Association 2014).
2 Adipocyte hyperplasia: increased production of fat cells, found in some types of
obesity (Naaz et al. 2004).
3 This does not always succeed – marketing failures are discussed in Chapter 7.
7 Critical perspectives on
marketing and market research
Introduction
The pervasiveness of food marketing and the consumption of snack and
convenience food is often commented upon by researchers in social sciences,
nutrition and epidemiology. In addition, advertising to children has been the
target of much debate, and some regulation. But the detailed activities of
food product development and food marketing have not been studied by
social scientists in terms of their role in shaping the relationship between diet,
class and health. In this chapter, all these activities are put in context, begin-
ning with a historical overview of how marketing emerged alongside the
growth of consumer industries, and how it has flourished in a neoliberal age.
A key dimension of neoliberalism is the discourse of personal choice and
individual responsibility for one’s choices (Chapter 1). This discourse has
suited the food industry well in its defence of its own practices, and has
been backed by public health promotion campaigns and commentary which
emphasise personal responsibility, often in a positive and encouraging way,
for a healthy diet. But the powerful role of the industry in transforming the
food supply and shaping our diets and, indirectly and unintentionally, our
health – by social class – is too often missed.
In this chapter, I focus on the growth and flourishing of marketing,
analysing both critiques of its power and marketing’s claims of its own
weaknesses and limitations, alongside its capacity to mobilise the insights
of psychology and the complex algorithmic techniques of market
research and consumer purchase data in support of corporate goals.
A critique of marketing by marketing scholars assesses the claims and
discourse of applied marketing and insists that marketing must be under-
stood – and should be taught – in the wider context of corporate power
in a neoliberal age.
Hackley, for example, decries marketing’s lack of acknowledgement of its
activities as emblematic of a neoliberal society and business model (2001,
2009, 2010). Skalen et al. (2008) challenge marketing’s claims to be
consumer focused, pointing instead to the larger goal of increasing capital
accumulation. They explore the internal contradictions and self-referentiality
Critical perspectives on marketing and market research 153
of marketing discourse, supplying what is essentially a critical discourse
analysis, as urged by Fairclough (though they do not call it that).
From food marketing practitioners cited in this chapter, analysis of
industry activities tends to be instrumental in nature, as one might expect:
they are naturally interested in how companies can operate most effectively
to increase or sustain product sales, though the language of engaging with
customers and satisfying consumer needs is also regularly invoked. But in
this chapter practitioners also supply valuable insights into how the indus-
try operates.
In Chapter 6, corporate food scientists discussed their concerns about the
health implications of a diet based on processed foods. In this chapter,
marketing practitioners recommend research methods that social scientists –
and indeed some marketers – might consider invasive or manipulative.
Chapter 8 discusses in greater detail the debate among marketing academics
and practitioners about the ethics of marketing, but marketers air some of
their disquiet in the diet-related examples given in the present chapter.
Having set out a critical framework for evaluating the contribution of
marketing to consumption, this chapter then provides an overview of how
the industry sustains and reinforces both larger socio-economic structures
as well as individual business goals. Examples from food industry texts
illustrate how the industry interacts with an array of cultural, technological
and social forces to shape our diets and, ultimately, if not intentionally,
influence our health. A detailed examination of market research, and espe-
cially geodemographics, is included, because this is the (ongoing) stage in
the marketing process when consumers are closely and continually tracked,
and data is amassed for the purpose of targeting and segmenting consumer
groups. The leading firms which carry out this research are very large-scale
and global in nature; they are major players in the consumer economy and
increasingly influential in a public policy context as there is a growing
public sector demand for their services in researching social and health
problems.
Lang and colleagues (Lang et al. 2009: 224; Lang 2009: 328) refer to
marketing and advertising as consciousness industries, with a vastly
increased penetration throughout the twentieth and twenty-first centuries.
Marketing is key to the development and retailing of food products, and to
mobilising class distinctions while doing so (while almost never using the
language of class); this has been understudied by social scientists. In seeking
to understand its role and significance in a food–health context, a look at
the origins and development of marketing offers valuable insights.
154 Critical perspectives on marketing and market research
While the marketing techniques of today might rely on highly sophisti-
cated tracking technologies, marketing a product or service to its most
likely buyers is ‘as old as commerce’ (Egan 2008: 4). Georgian pottery
entrepreneurs Boulton and Wedgwood used ‘market segmentation, product
differentiation, [and] prestige pricing … [to create] interest in their innova-
tive ware’ (Hackley 2009: 37). Advertisements and promotions using
persuasive slogans and images can be traced back hundreds of years
(McFall 2004 cited in Hackley 2009: 37).
In the nineteenth century, many new foods arrived in the UK and were
advertised by their purveyors. Additives and adulterations were common
(Wilson 2009), often aiming to make food appear more palatable.
Marketing was sometimes very aggressive, with purveyors and advertise-
ments making outrageous claims about their products (Blythe 2006: 58).
By the early twentieth century, it became clear that mass production
would require mass consumption. What might be viewed as a crisis of accu-
mulation – more was being produced than there was a demand for –
required the nurturing of desire in the consumer. Crucially, this desire
needed to be ‘increased and manipulated by factors … other than the mere
existence of supply’ (Egan 2008: 4). One early marketer wrote that ‘the
more progressive businessman is searching out the unconscious needs of the
consumer, and is then producing the goods to gratify them’ (Shaw 1912
cited in Egan 2008: 5). Marketers today continue to speak plainly on this
point, alluding to more than just passive tracking of consumer ‘need’.
Instead, companies must try to ‘discover what consumers either cannot
find, or do not know yet that they need’ (Cox and Delaney 2009: 286). The
latency of need, the nature of free choice, and implications for marketing
ethics are subjects of longstanding debate in marketing.
Demographic profiling arose after World War Two, with an increasingly
statistical orientation beginning in the 1950s (Cox and Delaney 2009: 286).
Claims of a scientific basis to marketing and the development of theoretical
frameworks also started around that time, and continue today (Egan 2008:
6; Hackley 2001; Blythe 2006).
Market segmentation as we might recognise it nowadays arose in the
1950s, and what is still called the marketing mix was defined in 1960 as the
‘four Ps’: price, product, promotion and place (McCarthy 1960 cited in
Egan 2008: 8). Marketing was increasingly seen as the way to ensure that
‘consumption kept up with output’ (Packard 1957 cited in Egan 2008: 8).
Kotler, a leading marketing educator in the later twentieth century, began
writing textbooks in the 1960s and shaped marketing research by combining
statistical techniques with behavioural sciences (Wilkie and Moore 2003
cited in Egan 2008: 9). Academic marketing thrived, and is itself today a
huge market for textbooks, journals, universities, research funding and
marketing education and training (Hackley 2001, 2009; Skalen et al. 2008).
In the 1950s in America, Dichter applied Freudian psychology, an inter-
est in the unconscious and psychoanalytic methods, to introduce motivation
Critical perspectives on marketing and market research 155
research, which ‘tapped into the consumer’s subconscious to discover feel-
ings about products’ (Stern 2004: 165). A trained psychoanalyst himself,
Dichter found that ‘Freud’s notions of subconscious urges and socialised
inhibitions seemed to make intuitive sense’ (Economist 2011). This thinking
contributed to a growing understanding, even in Dichter’s time and
acknowledged more recently in ‘nudge’ theory, of the limited consciousness
underlying some consumption behaviours.
As competitive pressures intensified, the new goal for marketing became
to secure ‘competitive advantage’, with market share ‘its primary indicator’
(Ambler 2004 cited in Egan 2008: 10). But in the past decade, marketing
has been articulated as a process in which ‘value is defined by and co-created
with the consumer’ (Egan 2008: 14). The strategic realities of corporate
goals and the mission of marketing in a neoliberal era do not generally enter
this discourse of a partnership with consumers, which features strongly in
the way marketers understand and speak about their work and role (regu-
larly, for example, in Marketing Magazine). Certainly much effort is
devoted to finding out what consumers want and ‘need’, not only by track-
ing their activities and purchases in ways in which consumers remain
unaware; but also by engaging with them creatively online and in product
launches, campaigns and public events. There is often an element of enter-
tainment and fun in these activities, and marketers find that they can learn
a great deal about their consumers while promoting a given product or
brand. But ultimately – naturally – the aim is to increase sales, and in a
larger sense, in many cases, to provide sufficient returns to shareholders.
Consumers may not always be aware (and if they are aware, they may not
mind) that they are being both studied and marketed to.
Marketing increasingly permeates our lifeworlds, to use Habermas’s
term. According to one marketing textbook, 25–33 per cent of civilian
workers in Europe and the US carry out marketing activities (Dibb and
Simkin 2009: 14). Globally, market and opinion research is worth about
£10 billion annually, with a few international agencies dominating the field
(ibid.: 206). Put another way, of the 70 per cent of a British family budget
(before taxes) spent on goods and services, half that amount finances
marketing activities (ibid.: 16).
The above quotes, the first from a marketing academic and the second,
expressed ironically, from a marketing practitioner turned academic, reflect
156 Critical perspectives on marketing and market research
the debate within marketing about its role and power. These authors
acknowledge criticisms of marketing, as well as marketing’s defence (i.e. the
insistence that it often fails, so cannot be accused of successfully manipulat-
ing consumers; or that marketers are only focused on meeting consumer
needs). Marketing undergraduates are told in one textbook that:
People know that rich foods are bad for them and that moderate exer-
cise is beneficial. But people get positive sensations from eating foods
164 Critical perspectives on marketing and market research
that are laden with calories or excess salt, while, on the other hand,
finding the time to exercise is difficult. No one escapes this psychologi-
cal conflict. (Maio et al. 2007: 1)
If the use of marketing data and techniques used to influence behaviour are
added to the list of ‘social factors’ referred to here, then the process
described in the Foresight report is recognisable from the social theories of
Bourdieu and Habermas and their analysis of how habits are formed, and
how they are altered and permeated by external forces.
Coveney and Bunton note the potential for studies of ‘food, pleasure and
the problems posed for health promotion intervention’ (Coveney and
Bunton 2003: 175). Such studies would benefit from investigating the
food industry’s understanding of the experience of palatability, which has
Critical perspectives on marketing and market research 165
been mobilised to stretch our capacity for consumption by appealing to our
pleasure response. Effective health promotion interventions would also
acknowledge the differing status of food products, how they are targeted at
social groups of different status, and the insights of psychology which chal-
lenge the notion of conscious choice where food is concerned.
One food industry psychologist, discussing the role of psychology in
enhancing the appeal of food products to consumers, lists food behaviour
fallacies, including that of conscious choice (Koster 2009: 73). He describes
seminal research between the 1970s and 1980s which found that ‘intuitive
thinking and decision-making … is characterised by operations that are “fast,
parallel, automatic, effortless, associative, implicit (not available to introspec-
tion) and often emotionally charged; they are also governed by habit and
therefore difficult to control or modify”’ (Kahnemann1 2003 cited in Koster
2009: 76). This characterised Kahnemann’s system 1 in his dual process
model; system 2 was ‘slower, rule-governed, deliberate and effortful’
(Kahnemann 2010). System 1 is prone to generating error; system 2, when
activated, may spot and correct these errors. There is an interplay between
intuitive and reflective systems which ‘sometimes allows biased judgments
and sometimes overrides or corrects them’ (ibid.). Kahnemann’s work lies at
the heart of ‘nudge’ thinking, and the growing acceptance that some behav-
iours are largely intuitive. Thus, from a sociological perspective, varying
degrees of reflexivity are mobilised to incorporating health considerations to
food consumption. There can be a social class dimension to this process, and
food marketing engages with the intuitive, class-differentiated nature of food
consumption. The food industry more broadly addresses health matters only
when subgroups of consumers cite health as a concern in their food purchases,
or when it is pressed to do so by regulatory requirements or public policies.
Consciousness-based methods are inadequate for sensory consumer
research, and especially hedonic research, which investigates the pleasure
and reward experiences of food (Koster 2009: 80). Koster’s interest is a very
instrumental one – improving the appeal of food industry products to
consumers – but it is possible to apply these observations to a public health
understanding of why people eat the way they do. For example, policies
which focus on advising people to ‘choose’ to eat a healthier diet and exer-
cise fails to acknowledge gaps in consciousness where such choice is
concerned, as well as the powerful hedonic appeal of some foods.
Koster’s and Kahnemann’s ideas substantiate the Foresight psychologists’
conclusions, who refer to a high degree of implicitness and automaticity lead-
ing to unreflective behaviours, and observe that health promotion campaigns
which encourage people to think about what they are eating, rather than
telling them what to eat, might be more effective (Maio et al. 2007: 31).
This observation was tested by a team of psychologists who found that
when people who ate little fruit were instructed to imagine themselves
eating fruit, their fruit intake increased (Knauper et al. 2011: 614).2 This
study provides a healthy eating version of a marketing technique which
166 Critical perspectives on marketing and market research
aims to embed images of products in target consumers’ minds. For example,
packaging is designed to appeal to a given consumer group; the design and
marketing/advertising messages lead them to imagine people like them
eating the food. Some people eat little fruit or vegetables (perhaps for
reasons other than cost), relying largely on ready meals. Could ‘targeted
mental imagery’ overcome the imaginative gap which they are not even
aware exists (i.e. ‘people like me don’t eat fresh fruit and vegetables’)? The
study illustrated a dimension of what happens subconsciously with food
consumption: we eat what we can picture ourselves eating. We imagine
eating foods that we see reflected in marketing campaigns and advertise-
ments which are targeted at people like ourselves.
Once the patterns of our diets are established, we experience an impulse
to eat when visual cues with sufficient ‘incentive salience’ are triggered
(Kessler 2009: 52–3). This may include seeing the food itself, or the restau-
rant where we’ve eaten it, or an advertisement for the restaurant (ibid.).
Food is omnipresent now; we are rarely far from a food retailer, restaurant,
vending machine, or snack foods and drinks even in non-food stores. A
weight management scientist tells Kessler that ‘the number of cues, the
number of opportunities to eat have increased while the barriers to consump-
tion have fallen … the environmental stimulus has changed’ (ibid.: 128).
Additional cues include TV advertisements or a pop-up ads on the internet,
food-product ‘advergames’ promoted via social network sites, or smart-
phone alerts from fast food retailers. The use of images is crucial:
The food industry understands exactly what it’s doing when it markets
foods with such compelling imagery, said my source [an industry
consultant]. In the face of the pleasure that pizza promises, consumers
‘suspend more rational thought and are drawn to the indulgence of
it’ … ‘Indulgence is the primary driver in premium products’, he says.
‘Generally they’re higher in flavour and often higher in fat, and a lot of
imagery goes with them. It’s a very profitable place for the food and
beverage industry’. (Kessler 2009: 79)
The result was several ‘distinct consumer profiles’ which were still used by
the company’s product development teams (Schmidt 2009: 225). This could
be one illustration of how marketers work with consumers to ‘co-create’
value. Marketers are genuinely interested in consumer experiences so as to
improve products and increase sales. They are, in a sense, learning about the
habitus of the target group so that they can understand not just what prod-
ucts might appeal, but how these products would be used and absorbed into
their purchasers’ lives. However, one food industry consultant acknowl-
edged that the increasing success of market research techniques has come at
the cost of public objections to invasive approaches and breaches of privacy;
he describes ‘a rebellion against consumer researchers’ hunt for information
about people’s habits and a growing feeling on the part of some consumer
groups that customers/consumers are being manipulated’ (Fuller 2001: 77).
One consumer product company has used video diaries to observe how
customers use their products. Company researchers ‘hope this direct obser-
vation approach will help them identify and address problems that consum-
ers do not even know they have’ (Dibb and Simkin 2009: 204, emphasis
added). Excerpts are then made available to staff on a secure website (ibid.).
Others affirm the importance of observing consumers in the right context
during the product development phase:
walk gently with the person … To value them as people and to create
a comfortable and engaging situation that allows them to be close to
who they are while we are with them, as they were before we came into
their lives, and the way they become when they leave. (Beckley and
Ramsey 2009: 244, authors’ emphasis)
Critical perspectives on marketing and market research 169
In commercial-ethnographic research, marketers are urged to engage with
participants to learn about their tastes in food, their skills, time and space
for food preparation and consumption, and which products might suit these
circumstances. This will enable products to be presented and packaged so
that they are absorbed seamlessly into consumers’ lives, and indeed habitus;
they will, for example, be relevant in terms of convenience and time-saving
features as well as sensory appeal. Products and brands can be designed to
appeal to particular groups and marketing strategies appropriate for reach-
ing those groups can be developed (Dibb and Simkin 2009: 169).
In supermarkets, researchers may position hidden cameras to follow shop-
pers, tracking the aisles they visit, how their eyes move and how long they
view a product: ‘areas where they are attracted … or sections that they bypass
entirely or visit less frequently are carefully noted’ (Fuller 2001: 53–4). Food
retailers also need to know ‘what items are purchased together, so that
customer flow can be laid out strategically within the store’ (ibid.: 55).
The UK marketer who piloted eye-tracking technology in stores, now used
worldwide, claims that without it, many products failed. Eye-tracking allows
retailers to go beyond what shoppers say to looking at what they do, under-
standing why they bought or passed by products: ‘shoppers obey the law of
entropy: understanding that they conserve momentum is the key to designing
spaces that help them shop more effectively’ (Scammel-Katz 2012: 28).
Long before eye-tracking technology, telemarketing services were devel-
oped for fuller consumer profiling. As long ago as 2001, US companies
could subscribe to a service which gave them the phone numbers of callers
to a 1-800 service – caller and address could be identified from this which
allowed the food company to identify the person’s socio-economic status as
well as that of their neighbourhood. With this information, ‘Food manufac-
turers can then develop products that fit the demographic niche’ (Fuller
2001: 56). Clearly, consumer tracking technologies have advanced consid-
erably since then. Yet in Christakis and Fowler’s influential research as late
as 2009 (discussed in Chapter 5), the ‘amazing’ power of social networks,
as they described it, was not linked to this capacity to differentiate the food
supply by neighbourhood and socio-economic status.
Marketers are advised to develop ‘consumer personas’ for each target
segment: this ensures that the ‘entire marketing mix (product development,
promotions, packaging, communications and pricing strategies) reflects the
needs and wants of the target consumer’ (Schmidt 2009: 225). This is what
large marketing firms do in their constant updating of consumer profiles
based on a vast array of data. This aims to build a complete picture of types
of consumers, how they live, their tastes, family type, neighbourhood,
ethnicity, etc. – it is a marketing version of the habitus. Then each step of
the marketing chain can be tailored as much as possible to the nature of
each type of consumer.
Word of mouth is a vital marketing tool among all consumers, including
children: ‘we learn by seeing people we know/respect try something and we
170 Critical perspectives on marketing and market research
think we will, too’ (Urbick 2009: 258). This reflects how social networks
operate in a food context. Word of mouth regarding foods in a given neigh-
bourhood or among a group of friends is likely to have a class dimension,
reflecting the class status of the area or group.
Other dimensions of the consumer are also central to marketing efforts.
Many ‘brands have a natural gender fit’, though it is possible to target men
while still reaching female consumers by addressing women through witty
advertisements during TV programmes women are known to watch (they
cite Dancing on Ice), as well as more traditionally male ad spots (football
matches) (Marketing Magazine 02/03/11a). An advertising campaign for
chocolate bars featured the slogan ‘Yorkie: it’s NOT for girls!’ which, used
and interpreted in an ironic way, resulted in increased sales among both
sexes (ibid.).
McCain’s Rustic Oven Chips brand was aimed at young women inter-
ested in healthy eating (Marketing Magazine 02/02/11); whereas Ginsters’
new filled, breaded snack products targeted men and students (Marketing
Magazine 08/06/11d). Women may eat these products as students, then, but
grow out of them, while men apparently do not; social class may (re)assert
itself in food consumption for educated women in a way that it does not to
the same degree among educated men. Obesity statistics show a clear social
gradient among women, but it is less clear among men; here we may have
food industry evidence of these diverging trends in early adulthood. It has
long been the case that ‘men are more likely to purchase impulse items, to
spend more on food shopping, and to purchase certain types of food, espe-
cially snacks and convenience products’ (Michman and Mazze 1998: 5).
Subway has traditionally targeted young men working in offices and
students but they have also begun marketing to women, aiming to appeal
to those interested in healthy eating by including calorie information on
menu boards (Marketing Magazine 25/01/12). But there is no plan to stop
catering for traditional customers with indulgent products (ibid.). As
Hawkes et al. (2012: 350) concluded, ‘food consuming industries’ are
unlikely to change their emphasis on ‘energy-dense, nutrient-poor foods’
without the ‘incentive’ provided by health standards aimed at the entire
supply chain (see Chapter 6).
The market research methods described here are aimed at assessing
customer ‘needs’, whether consciously expressed or latent; meeting consumer
need is a dominant feature of marketing discourse. But the accompanying
assumption is that although commercial decisions to develop and market a
given set of products results in consumption of those products, consump-
tion itself – and its effects – is the responsibility of the consumer. An ethical
role for the firm, or its marketers, is not always central to the discussion,
though the concerns of many marketers are cited in this book.
The focus on serving customer needs can also divert attention from larger
business goals. One brand marketer describes commercial-economic
pressures:
Critical perspectives on marketing and market research 171
We don’t get given this money [marketing budgets] to entertain the
public. We get given it to build strong businesses that make bigger
returns to shareholders and pensions and bigger tax for governments –
and more secure employment for people who work for it. (Marketing
Magazine 23/02/11d)
Such data is also used in the marketing of foods, one of the last stages in
food production and the one which must help to foster consumption of a
continually developing food supply.
An emphasis on lifestyle choices and personal responsibility for dietary
health was a natural outgrowth of neoliberalism (Guthman 2011). To recap
this discussion from Chapter 1, a free market (however imperfectly designed
or functioning) needs to be populated with freely choosing individuals who
are encouraged to be less reliant on the state. Ideally, then, they will avoid
making choices which will result in problems like ill health. While data
gathering of the scope of market research tracks ‘choices’, these choices are
a response to a food supply constituted by the agricultural–financial–retail
forces discussed in Chapter 6, and one which is marketed according to
consumer type (including social status). The data is then used to further
refine consumer profiles which will be used, in turn, to further shape future
choices. While Murcott (2000: 122, see Chapter 1) observed that it is diffi-
cult for academics to get access to commercial market research data, we can
learn about techniques like geodemographics, and what they mean for
consumption and health.
Clustering is a key geodemographic concept. Socio-residential patterning
is repetitive – similar social groups live in similar types of neighbourhoods
in different cities. People tend to live among other people like themselves,
and separate themselves from those who are different (Phillips and Curry
2003: 143). However, there are exceptions. One commentator observed
that the consumer profile for his postcode did not describe his purchasing
patterns accurately (Lawson 2009). A similar finding was reported by a
group of sociologists when they gave residents in four streets in different
parts of the UK their consumer profiles: many said the classification did not
describe them but it did describe their neighbours (Parker et al. 2007: 913).
Ethnographic observation led the researchers to conclude the classifications
do give some socio-economic and cultural understanding of who lived in
the four areas (ibid.: 913): ‘In general, we and the residents thought they
Critical perspectives on marketing and market research 173
were frighteningly accurate’ (Burrows, who worked on the study, cited in
Guardian 11/09/07). This comment was considered to be of interest to
marketers and reprinted in Marketing Magazine (02/10/07).
In fact, the characteristics of any given household can differ from the
neighbourhood average or consumer profile for a given neighbourhood
(Longley and Goodchild 2008: 178). Mosaic descriptions of consumer
groups are ‘pure examples to which individual cases approximate only with
various degrees of exactness’ (Mosaic cited in Burrows and Gane 2006:
800). A neighbourhood may be assigned to a category ‘because it is the
most similar of the available options … [but] within each class [category]
there is substantial variation around any mean or median value’ (Longley
and Goodchild 2008: 180).
Nevertheless, geodemographic profiles provide useful guidance for retail-
ers and service providers: ‘improvements in targeting of goods and service
offerings [using geodemographics] improve measured profitability’ (Longley
and Goodchild 2008: 190). However accurate the original profiles are to
begin with, the more they are used, the more ‘true’ they become:
The use of these classifications is thus a ‘deeply political and ethical’ matter
(Parker et al. 2007: 914). In developing and applying them, the ‘classifica-
tions interact with the classified’ in a kind of ‘dynamic nominalism’
(Hacking 2002 cited in Parker et al. 2007: 915–16).
Figure 7.1 Young people eating fast food in a UK city centre at night. Maciej
Dakowicz ©. Photograph reproduced with kind permission from the
photographer.
in the first three months of launching our iPhone ordering app, we took
more than £1m, purely through natural adoption … the opportunity to
target and home in on our potential customers through demographic
and behavioural targeting, as well as using time and new location
propositions, is exciting. (Marketing Magazine 19/01/11)
Conclusion
This chapter has revealed the role of marketing in selling products and
services, but also, having mined the insights of psychology, in nurturing
desire itself. Hackley’s critique noted the power of marketing not only in
driving consumer purchases but beyond that, in laying the foundation for
capitalist economies, even as it underestimates its own role and influence.
Marketing shapes dietary patterns but is not usually observed by those
whose lifeworlds are permeated and altered by it – that is, all of us.
I have cited examples of marketing strategies which normalised the
consumption of HFSS foods – in meal deals; foods targeted at low status
people; and the language of marketing discourse, which masks the ways in
which foods are designed for and targeted at differing population segments.
Yet higher status people are also tempted by ‘indulgent’ (HFSS) foods,
despite an expressed interest in healthy eating. Marketers grasp this contra-
diction and, in co-operation with food product developers and retailers,
cater to it. As discussed in Chapter 5, many higher status people are over-
weight or obese. Marketers will not be surprised by this phenomenon. They
describe the persistently health-seeking eater as only a subset of higher
status consumers, recalling Skeggs’s notion of the subset of middle class
people characterised by a reflexive approach to social life.
By tracking and classifying consumers by social group, market research
has a role in reinforcing those groupings and the consumer identities and
182 Critical perspectives on marketing and market research
purchasing patterns that flow from them. Geodemographic research reveals
neighbourhood consumption but also – separately, for different clients –
neighbourhood health profiles, even when medical records are lacking
(among those who have little contact with health services), partly by assess-
ing things like food purchases and dietary patterns by household. These
distinct yet complementary types of market research may contain a contra-
diction, as the unhealthy foods which blanket some neighbourhoods and
dominate the diets of residents also generate diet-related illness over time.
In this case, the market, broadly conceived, leverages both the food supply
and the health policy solutions to problems flowing from it.
Social scientists who research food consumption should be aware of
commercially oriented research engaged in the same task. This research and
the influence it has on consumption is, in critical realist language, a genera-
tive mechanism shaping diet, yet people are mostly unaware of the degree
to which they are tracked and supplied based on consumption identities
that are continually updated through purchase data and geographic and
online roaming. Nor is this research all quantitative; in this chapter, exam-
ples of qualitative, ethnographic research were described, amid the stated
aim of marketers to identify ‘needs’ consumers are not yet aware they have.
Doubtless many of those who carry out market research and analysis are
trained in social sciences. Those who practise these disciplines within the
academy are well placed to research the researchers who inhabit the
commercial world and the techniques they use. Their research is used not
only to market products and influence consumption practices but also to
market health analysis and health policy advice to government. The mate-
rial presented here has highlighted the pervasiveness, quality, resources and
reach of commercial marketing research.
Such research perhaps unintentionally strengthens the argument for look-
ing at consumption in class terms. The marketing classifications sampled in
this chapter depicted the inhabitants of deprived neighbourhoods in terms
which did not try to imply that these people were all making free choices;
indeed, the types of housing and amenities they experience, their education,
family structure and employment profiles, are all listed as part and parcel
of their classification. Patterns of food consumption, characterised by poor
nutritional quality, are described alongside the health risks arising from
them. Though it is not the stated aim of these classifications, they illustrate
in a Bourdieuan way the package of life experiences and environments in
which such behaviours arise.
The following chapter focuses in greater detail on one of the key tasks of
marketing: segmentation. The discussion will reveal how marketing targets
consumers and how consumer segments relate to concepts of social class;
how supermarkets and food products are ranked and distinguished both by
consumers and producers of food, and how consumers identify and interact
with their segmentation profiles in their shopping and eating habits. The
chapter concludes with a review of an ethical debate among marketers
Critical perspectives on marketing and market research 183
regarding the role of their discipline in altering norms and contributing to
problematic consumption.
Notes
1 Daniel Kahnemann’s work on prospect theory formed the basis for ‘nudge’ theory
(discussed in Chapter 1), uniting psychological insight with economic behaviour.
Unusually for a psychologist, he won the 2002 Nobel prize for economics for this
work.
2 I accessed this study after reading about it in a ‘Bad Science’ column by Ben
Goldacre, a medical doctor, in The Guardian (09/07/11). Though small-scale, the
study was good science, he concluded.
3 Citations are from an excerpt of Pariser’s book in The Observer (12/06/11), so
page numbers are not given.
8 Social class in food retailing and
marketing and reflections on
marketing ethics
Introduction
The homogenizing and illusory notions of the consumer and of the
consumer interest will tend to come up against differences of income,
gender, race, region, nationality, class, etc. (Fine 2006: 306)
There is nothing wrong with this practice; indeed it might well be experi-
enced as good customer service. Tesco has been alert to the changing ethnic
make-up of populations local to its stores, for example.
But Tesco and other supermarkets also serve distinct social class groups.
For one business commentator, Tesco ‘has succeeded in making itself
largely classless, with price ranges designed to cater across the board’
(Observer 25/04/10). In fact, it appeals to several different social groupings
with products of varying quality and status; this is not the same as being
classless. An ad agency executive describes the appeal of Tesco products for
different groups of shoppers: ‘The middle classes buy their wine, petrol and
insurance from Tesco. The working classes buy their food, clothes and
everything else from Tesco’ (Marketing Magazine 09/03/11b).1
Tesco tracks customers via its Clubcard and its own market research
group, with customer demographics, location and preferences being gleaned
from its consumer data (Marketing Magazine 09/03/11a). Detailed tracking
of shopper behaviour is also carried out by market research firms. In the
67 household types and 15 groups listed in Experian’s Mosaic publicly
available profiling tool, descriptions of typical food consumption feature in
most categories. The same is true for CACI’s ACORN segmentations,
which also describe how each profile would be educated, employed, and
housed, without referring to social class per se.
One problem with using segmentation to target consumers is that it can
have the effect of ‘cocooning’ them – potentially stultifying broader
consumption by offering people the kinds of products that only reaffirm the
kinds of consumers they already are, as one marketing commentator
186 Social class in food retailing
observed (Marketing Magazine 04/03/09). Marketing does seem to have
some capacity to reinforce both personal identities and consumption
patterns.
Edwards, a sociologist of consumption, queries the ‘tendency of contem-
porary patterns of consumption to individualize every activity into a life-
style miscellany’ and finds that ‘the creation of a plethora of mutually
exclusive lifestyle categories seems paradoxically to reinforce the economic
inequalities it seems to undermine’ (Edwards 2000: 186). There are many
ways in which consumer groups can be segmented, but the social ranking
of potential customers is fundamental for product developers, marketers
and retailers. This chapter examines how marketing academics, marketing
practitioners and retailers engage with concepts of social class via segmen-
tation, and the role it plays in food consumption.
25%
25%
25%
25%
25%
25%
25%
25%
25%
25%
25%
25%
Figure 8.1 A rendering of social class and marketing classifications using differing
styles of cutlery to represent each group. Image by Ben Branagan and
Gareth Holt (originally appeared in RANK: Picturing the Social Order
1516–2009, Northern Gallery for Contemporary Art, Sunderland).
National Readership Survey/Ipsos Mori.
Alphabetical socio-professional classification, updated 2008. Social class: A, upper-
middle class (higher managerial/professional; doctor, director); B, middle class (inter-
mediate managerial; teacher, engineer); C1, lower-middle class (supervisor, clerical
or junior; salesman, artist). C2 skilled working class (skilled manual worker; brick-
layer, electrician). D, working class (semi-skilled and unskilled manual; operative,
machinist). E, subsistence levels (state pensioner/no other income; casual labourer).
In this way, she says, there is a link between the vodka people drink and their
social class (ibid.). But class is rarely addressed overtly within marketing
discourse. Consumer marketing literature, marketing profiles, and the media
more broadly use a range of alternatives when referring to different social
groups: terms such as premium, discerning, educated, affluent (and less afflu-
ent), upmarket, high end, good taste, ABs (highest status marketing cate-
gory), DEs (lowest marketing category), low income, disadvantaged,
deprived and vulnerable denote the social and economic status of consumers.
These terms are arguably proxies for social class, including socio-economic
Social class in food retailing 189
status, and link questions of taste and dietary type with status, housing type
and geographic location.
The way class is approached in marketing education is worth examining,
since it is not often referred to in marketing practice itself. The undergradu-
ate marketing textbook cited below describes it in quite instrumental and
simplistic terms:
Within all societies, people rank others into higher or lower positions
of respect. This ranking results in social classes. A social class is an
open group of individuals who have similar social rank. A class is
referred to as ‘open’ because people can move into and out of it … In
the UK, many factors are taken into account, including occupation,
education, income, wealth, race, ethnic group and possessions … To
some degree, people within social classes develop and assume common
patterns of behaviour … Social class influences many aspects of
people’s lives … whom they marry, their likelihood of having children
and the children’s chances of surviving infancy … Social class affects
the type, quality and quantity of products that a person buys and uses.
Social class also affects an individual’s shopping patterns. (Dibb and
Simkin 2009: 126)
they reproduce the conditions for their own domination. Here, the
consumer is determined, controlled, and even alienated by marketing
practices. Ultimately, consumers do not choose their consumption life-
styles; it is the system of marketing practices that chooses for them.
(Studies cited in Cherrier and Murray 2004: 520–1)
Figure 8.2 ‘What goes into crisps goes into you.’ Image from 2006 BHF campaign,
supplied by BHF for use in this book.
194 Social class in food retailing
Sales of crisps overall in the UK rose by 27 per cent between 2006 and
2011, reaching £3.16 billion (Marketing Magazine 04/04/12); two-thirds of
purchasers look for price promotions (ibid.). The trajectory for upmarket
crisps was flatter; but ‘the premium segment has performed well … so it
would seem that consumers are paying little heed to the government’s
healthier-eating messages where crisps are concerned’ (Marketing Magazine
16/03/11). As sales figures indicate, crisps are big business. In recent years
Kellogg bought the crisp brand Pringles for $2.7 billion from Procter &
Gamble (Marketing Magazine 30/05/12).
The biggest buyers of crisps are families with children aged 5–15. Because
of restrictions on selling such foods in schools, consumption outside the
school environment has increased, with sales of crisps expected to increase
another 21 per cent by 2015 (Marketing Magazine 30/05/12).
In further examples of how marketing links food consumption and social
group, ‘women, over-35s and the D socio-economic group are the most
ardent sweet biscuit eaters … [while] women, the over-55s and the lowest
(E) socio-economic group’ buy more savoury biscuits (Marketing Magazine
15/06/11a). Nuts, seeds and dried fruit ‘are more popular with the affluent
and the over-45s’, although ‘retailers have launched “value” ranges of
mixed nuts and fruit to cater for more cash-strapped consumers’ (Marketing
Magazine 10/11/10). In the magazine this comment is illustrated with
pictures of a packet of Red Hot Chilli Big Nuts and the contrasting dried
fruit and raw nuts; the juxtaposition of these images represents in graphic
terms their differing consumer categories. The Big Nuts packaging is a fun
image in strong colours, in sharp contrast to the austere simplicity of the
unadorned fruit and nuts.
One less visible category of consumption is the food produced by inde-
pendent food restaurants/fast food providers, especially those supplying
fried chicken, burgers, kebabs and curries. These businesses are very local-
ised, often set up by people who know the area and customer base well,
although they may make use of a discounted neighbourhood profiling
service offered by market research firms (Interviewee A, 2011).
The salt and health research charity CASH found high salt concentra-
tions in a study of 784 curry products from both grocery stores and inde-
pendent restaurants (CASH 2010). An Iceland curry meal contained 7.2g
of salt; a takeaway curry from a London restaurant had 6.81g (6g is the
recommended daily maximum salt intake); at the other end of the spec-
trum, Sainsbury’s Be Good to Yourself range included a curry meal with
.91g of salt. While the government’s discussions about health with food
manufacturers and retailers have focused on chain stores and restaurants,
independent providers are not so easily reached. Nor are they visible in
lists of voluntary participants in the government’s Public Health
Responsibility Deal. However, the Department of Health notes that it
‘has produced guidance for SMEs and is seeking to engage with them
through relevant representative bodies. We are also exploring how action
Social class in food retailing 195
might be taken at a more local level to broaden the scope of participation’
(DoH 2011a).
M&S has also announced a refit of its stores according to local demograph-
ics and preferences, based on insights from focus groups and online
purchases, and a demographic analysis (Marketing Magazine 08/06/11b).
M&S’s marketing director, commenting on the value of segmenting, said,
‘Segmenting based on [people’s] lives, attitudes and actions at least gives a
credible way to maximise relevancy of the message’ (Sharp cited in
Marketing Magazine 23/03/11). Meanwhile, some less upmarket retailers
have also embraced segmentation (ibid.). Morrisons is assessed by an
anonymous marketing director as ‘a little downmarket’; as it considers
stocking clothing merchandise, it is urged ‘not to try to push too far upmar-
ket’ (Marketing Magazine 16/02/11).
Marketers are essentially observing here that grocery stores are them-
selves ‘classed’; nor is this a recent phenomenon. The grocery company
advertised in the Figure 8.3 describes itself as ‘high class’. The image is a
reminder that the association between class, status and food retail opera-
tions is not new. The woman pictured and the house and neighbourhood
she occupies represent the desired (prosperous) clientele.
What is different today is that high status grocery stores such as Waitrose
or Marks & Spencer do not describe themselves in the language of class; it
is instead implied. Marketers comment more directly on the matter:
Waitrose has ‘an upmarket image and attracts middle-class customers’ with
Social class in food retailing 199
Figure 8.3 The women pictured and the house and neighbourhood she occupies
represent the desired (prosperous) clientele © Wellcome Images.
Lidl opened in quite a posh road and met with strong opposition from
local residents … [Admittedly] the layout’s weird, e.g. there were crates
of ring binder folders and plug extensions plonked amongst the fruit
and veg. But … the snobbery surrounding these kinds of places isn’t
justified. I’d go to Lidl before Asda. (Guardian 24/06/11)
This and other comments showed that it was important for the participants
in this discussion to shop in a place in which their sense of their own social
status does not clash too strongly with the social status of the store itself.
Challenging the association and image of working class people and poor
quality foods, a group of organic companies placed an advertisement in a
grocery store magazine (Real Food, Spring 2011, back cover). The man is
shown at work as a painter and decorator; he acknowledges that he might
not look like the sort of person who eats organic food, but that it is impor-
tant to him and his wife to buy it, even if they have to pay a little more for
it, for the good of their children. The image and message of the advertise-
ment is aimed at people not normally associated with eating organic food.
It also reflects the notion that in order to get people to change their eating/
shopping patterns to adopt new foods, they need to see other people like
them doing so, even if only in advertisements.
One geodemographic profile for a low income group describes them
shopping mainly at Asda, Somerfield or Co-op. This reflects the usually
unspoken classing of supermarkets and their shoppers; certainly the middle
class Guardian-reading, Waitrose-accustomed shopper in the excerpt
above felt that Asda and its shoppers were of a different (lower) social
dimension.
Supermarket advertisements naturally do not discuss their social or class
differences in such terms, but shoppers know which stores they feel most
comfortable in. As the shoppers’ comments above indicate, it is not just a
matter of choosing the store which supplies the foods suitable for us; it is
also important that other people like us will be there – people of a similar
social status, who dress and behave more or less as we do. Some middle
class people are prepared to endure discount store environments for certain
items at lower prices, but only up to a point. In the Guardian example,
foods recommended for purchase at discount stores are those which are
purchased more frequently by higher status groups, such as fruit, vegeta-
bles, olive oil and smoked salmon; readers are advised to shun the discount-
ers’ meat for both quality and animal welfare reasons.
But overall, a switch from Waitrose to Lidl is made more reassuring by
the observation that other people like themselves have also made this
switch. The habitus has been expanded to take on unfamiliar, slightly
uncomfortable surroundings, but the lifeworld is not disrupted – the foods
Social class in food retailing 201
purchased are not of a different order or quality, they are merely presented
in more basic surroundings and at lower prices. But a healthy and varied
diet is still being consumed by such consumers. Their purchases did not
vary widely even when they crossed a class divide to shop at a discount
store; healthy foods can be purchased there, too, and they could return to
higher status retailers when delicate matters such as meat quality were at
stake. While higher status people may make some purchases at lower status
supermarkets, they are unlikely to switch to what they would consider a
lower status diet, with inferior foods which people like them simply would
not eat.
Yet a commitment to healthy eating is not always demonstrated by this
group. Some consumers who might prefer organic chicken will not usually
find organic meats in ready meals, which they nevertheless buy. As one food
industry analyst noted, ‘Consumers want healthy but buy convenience’
(Fuller 2005, citing industry newsletter). Another comments on consumer
interest in healthy eating: ‘upscale and sophisticated buyers prefer fresh
vegetables’, for example, but where fast food is concerned, they may ‘say
one thing and do another’ (Michman and Mazze 1998: 34). These authors
identify ‘a small health-conscious segment’ but ‘the overriding majority of
consumers indulge themselves’ (ibid.: 184). Similarly, in food industry tast-
ing panels, participants might say they avoid fat, but in blind tastings, they
tend to prefer foods with a higher fat content (Kessler 2009: 101). In a
marketing survey, only 20 per cent of those buying pizza look for low calo-
rie options and fewer still check fat content, yet 43 per cent said they would
buy a pizza with a wholegrain crust and 39 per cent would like lower salt
content (Marketing Magazine 14/09/11c). There seems to be interest in
healthier options, but there is an apparent contradiction between an articu-
lated preference for such foods which purchasing behaviour does not
always bear out.
Advising readers on food and drink innovations, a Business Insights
report (2011) describes what motivates affluent consumers: health concerns,
convenience and indulgence. A market research firm spots the inconsist-
ency: ‘the desire for health and indulgence represents a trend clash …
consumers looking to satisfy seemingly contradictory desires represent an
important market opening’ (Datamonitor cited in Kessler 2009: 130). They
may be describing the significant proportion of people of higher social
status who are obese or overweight.
In any case, food retailers know their customers well through purchasing
data. Loyalty cards have ‘vastly increased the capability of supermarket
operators to target promotions more closely at consumers’ (Euromonitor
2004e cited in Hawkes 2008: 679): each supermarket transaction can be
analysed ‘to determine which products are likely to attract their attention,
which promotions could find appeal, and then the consumer receives
promotional information particularly targeted at him/herself or their
family’ (Euromonitor 2004e cited in Hawkes 2008: 679).
202 Social class in food retailing
In UK supermarkets, such sales promotions may increase sales by
200–300 per cent (Cooper 2003 and Competition Commission 2000, both
cited in Hawkes 2008: 679). This may be one way in which supermarkets
are contributing to weight gain – promotions aim to increase consumption,
so with this technique supermarkets ‘counter the health promotion message
to eat in moderation’ (Hawkes 2008: 684).
With a team of researchers, Winson quantified the dietary quality of the
foodscape, measuring the amount of shelf space in Canadian grocery store
chains stocked with what he terms ‘pseudo foods’ – products high in sugar
and fat but low in nutrients (Winson 2004). Results ranged between
26 per cent and 37 per cent of total shelf space stocking edible products;
70 per cent of shelf space was occupied by ‘pseudo foods’ in convenience
stores, which are more commonly found in poorer neighbourhoods
(ibid.: 306–7).
The UK foodscape is one in which petrol stations, book/stationery shops,
public transport networks from large city centre stations to commuter station
platforms, universities, fitness/leisure centres, offices and even hospitals – and
routes to and from these spaces – are sites of an ever increasing array of
snack foods. This is a further illustration of the visual cues provided by such
installations, and in unlikely places (see Figures 8.4, 8.5, 8.6, 8.7 and 8.8).
Habermas’s notion of the lifeworld being colonised is evidenced by this
phenomenon, as with the snack displays which appeared in previously non-
food shops and spaces. People’s instinctive reaction to visual cues, as
marketers themselves described in the commercial version of ‘nudging’ in
Chapter 1, can be tapped into to expand food merchandising opportunities,
increasing sales and consumption of snack/convenience foods.
Apart from simply placing products before consumers wherever possible,
there are marketing techniques to address consumer ‘extremeness aversion’
(tendency to avoid large or small sizes and consequent increase in mid-
range sizes/volumes) and ‘bundling’, which offers processed foods in combi-
nation with each other (i.e. meal deals, which also increase consumption)
(Sharpe et al. 2008: 420).
In addressing problematic societal eating patterns, less attention has been
focused on structural factors such as an omnipresent, targeted foodscape
than on individual behaviours, as even marketing academics have observed
(Hoek and Gendall 2006: 415). Indeed, marketers themselves are conduct-
ing a robust debate on marketing ethics, which is discussed below.
Figure 8.8 Snack food displays in a UK suburban commuter station. The candy and
crisps racks are downstairs in the same station as the image in Figure 8.7,
having arrived in recent years in a previously empty space. Photograph
by Melanie Jervis.
Marketing to children
All consumers base their interpretation on what is familiar, on knowl-
edge already stored in memory. (Dibb and Simkin 2009: 118)
Parents’ brand preferences create comfort in children and set the stage
for compliance with their children’s request for a brand (McNeal
1999). The formation of children’s attitudes and beliefs about fast food
in the context of family life may imbue the attitudes and beliefs with
Social class in food retailing 209
sustaining characteristics over time (Moore, Wilkie, and Lutz 2002).
Accordingly, the fast-food industry focuses on children because child-
hood memories of fast-food products may translate into adult visits.
(McNeal 1999, Schlosser 2001, cited in Grier et al. 2007: 224)
This recalls the theories of Marx and Bourdieu in terms of family food
provision, but also the conclusions of food industry scientists regarding the
powerful, lifelong role of early years food consumption.
Fast food marketing aims not simply to sell more fast food, but also tries
to shape perceptions so that eating fast food is normalised among target
consumers:
So even if marketing does not create an interest in fast food, these authors
are concerned that it can reproduce it (ibid.: 230). Thus consumption of a
given food or meal becomes embedded in a target consumer’s way of life
and dietary routines – and those of their children.
This process requires repetition. An article about marketing food to chil-
dren emphasises the importance of repeating exposures and behaviours: ‘it
can take between 8–13 positive exposures for kids to be strongly familiar
with a food or beverage’ (Urbick 2009: 257). This could be conceived in
terms of the habitus – that is how long it takes for the habitus to be
expanded to assimilate a new product and for it to be considered a normal
dietary practice. Once this familiarity has been achieved, food companies
can build on it by modifying products: this technique ‘seems to be highly
successful in developing new food trends with kids’ (ibid.). Furthermore,
marketing should target boys separately from girls: ‘when you must target
both, always skew the positioning to boys. Girls are more accepting of
“boy” products, yet boys are more likely to reject something that is “too
girly”’ (ibid.: 258). An example of this same strategy in adulthood was the
overt (but ironic) marketing of a chocolate bar brand to men, with the
intention (and achievement) of increasing sales among both men and
women (Chapter 7).
The advertising of food products for children has been limited by regula-
tion in recent years. An Ofcom ban on television advertising of HFSS foods
to children under 16 came into effect in 2008. The text of the ruling refers
to the psychological content of advertising and engages with ethical matters,
210 Social class in food retailing
describing the need ‘to reduce children’s emotional engagement with HFSS
advertisements, and reduce the risk that children and parents may misinter-
pret product claims, and to reduce the potential for pester power’ (Ofcom
2007: 3). As a consequence, ‘manufacturers have boosted their marketing
presence across other media, such as outdoor and online’ (Marketing
Magazine 19/10/11). A subsequent study, not suggesting any influence from
the food industry but exploring food cues presented to children, has also
observed a high degree of consumption of unhealthy (unbranded) foods
portrayed in children’s television in both Ireland and the UK, reflecting a
similar pattern previously observed in the US (Scully et al. 2014).
While 305 dairy, confectionery and ready meal products for children
were introduced in 2008 in the UK, there were just 220 in 2010, a fall of
32 per cent, raising concerns among marketers about the potential for UK
regulation to block innovative products (Marketing Magazine 23/02/11b).
However, some brands are still increasing sales by introducing adaptations
of existing products such as individualised serving sizes or film character
licensing (ibid.). Kellogg’s was unable to promote Coco Pops to children,
so introduced Coco Pops Choc’n’Roll, with reduced quantities of sugar,
salt and saturated fat (ibid.). It also developed Krave, a chocolate cereal
(Marketing Magazine 19/10/11) aimed at young adults who had eaten
chocolate cereals as children but who do not want to eat cereals aimed at
older age groups (Marketing Magazine ‘Revolution’ supplement 09/10b)
and to whom advertising is not restricted. Alongside TV ads for the prod-
uct, an accompanying Facebook campaign invited consumers to bid for
various prizes (ibid.). This campaign was later criticised by the British
Heart Foundation (2014) in a report which critiqued internet marketing of
such products to children in general.
When the children’s drink Fruit Shoot was battling an unhealthy image,
its producer, Britvic Soft Drinks, developed a website offering interactive
games for children, aimed at developing skills, and a link to a parents’
website (Marketing Magazine 08/06/11c). A back-up TV ad also directed
children to the site. Sales increased.
the marketing of fast food … can and should be reined in. And this
means much more than curtailing advertising. The entire marketing
effort has to be scrutinised: product design, distribution, pricing strate-
gies and packaging – as well as communications – have to be put under
the public health microscope. (Hastings 2006: 5)
Conclusion
This chapter has revealed evidence for class-based food consumption and
illustrated some of the contradictions of marketing highlighted in an ethical
debate among marketing academics and practitioners. Together with the
preceding two chapters, it aimed to substantiate the earlier theoretical,
exploratory context-setting work of the book.
To summarise the narrative of the argument thus far: the introductory
chapter outlined the dominant power of healthy eating/personal responsi-
bility discourse driving both public understanding and public policy, and
highlighted its weakness in addressing problematic consumption–health
trends. The second chapter established the analytical framework, identify-
ing discourse as an object of analysis, and outlining the guidance provided
by critical realism and critical discourse analysis in tracing mechanisms
which are often unobservable (or at least unobserved) in the formation of
diets and their health consequences.
The third and fourth chapters challenged a powerful yet misleading
healthy eating discourse via an exploration of social theories, analysing
the role of social class in consumption for which marketing literature later
provided much evidence. In providing a social context for behaviour – and
behavioural economics – and explaining how communication about
public issues can mask deeper truths, these theories illustrated how the
activities of the food industry could play a major role in shaping our class-
differentiated diet, and the health that flows from it, even if we are not
normally aware of this. The very notion of reflexivity, a cornerstone of
sociology in recent decades, was called into question.
Chapter 5 discussed epidemiological and other evidence for the link
between food consumption, health, class and political and market ideolo-
gies. Chapter 6 revealed how the food industry interacts with consumer
214 Social class in food retailing
interest in health and the emerging health concerns of food scientists
regarding the consumption of industrialised food, particularly among lower
status groups, who consume more of it. It also traced the origins of this
phenomenon in the changing nature of the food supply, relating agricul-
tural developments to food product changes, food marketing techniques,
changing dietary patterns, and public health. Chapter 7 investigated the
growing technological power and psychological insights of market research
in tracking and ranking populations, learning where and how we live, how
we move about our cities and towns and what we eat, alongside a theo-
retical critique of marketing by academic marketers.
This chapter revealed marketing’s ‘proxies’ for the language of class
and linked these proxies to the quality of food and even the supermarket
experience for shoppers and how this interacts with their ideas of their
own social rank. The ranking of consumers, products and food retail
outlets is an essential part of positioning products successfully in the
marketplace.
But what is important in public policy and population terms is the effect
of diet on health. This book has discussed the strong links between poor
diet and poor health and has traced growing bodyweights alongside an
omnipresent supply and normalised consumption of snack and convenience
foods. The earlier epidemiological evidence for social class as a factor in
diet quality and health was reflected in this chapter’s discussion of the
marketing of foods by consumer segment in stores and outlets that them-
selves are socially ranked.
Limits to the marketing of HFSS foods to children have been set, but this
chapter traced the activities of some companies in seeking to find other
ways to sell their products: marketing to parents; developing creative
content to engage children online; and targeting slightly older groups of
young people with products traditionally aimed at children.
The concluding chapter which follows brings together the insights of the
varied perspectives and disciplines explored throughout this research
regarding the problems of food consumption and diet-related ill health in
order to distil the lessons of this investigation and suggest how it might be
carried forward.
Notes
1 In 2014 Britain’s traditional food retailers are being seriously challenged by
discount food stores such as Lidl and Aldi. Tesco’s profits have been falling
for three years and Sainsbury is working with the Danish discount retailer
Netto. Lidl has just announced a major UK expansion (Guardian 28/06/14a,
28/06/14b). See below in this chapter, ‘Food quality and the classing of
supermarkets – and shoppers’, for a further discussion of social class and
grocery retailers.
2 There had been a previous report and a subsequent one in 2008. The NCC merged
with other organisations to become Consumer Focus in 2007 and after 2008 the
Social class in food retailing 215
reports were not continued. The merger had resulted in food being dropped as a
policy focus because food policy was thought to be sufficiently studied by other
organisations and the new Consumer Focus needed a smaller list of priorities.
This was a missed opportunity to continue the work and achievements of the
NCC investigations. Consumer Focus later became renamed Consumer Futures
and was closed in April 2014. Its functions were transferred to Citizens Advice
(Consumer Futures 2014).
3 With parental approval, 4,000 children were interviewed online, ranking 166
household brands: ‘Children enjoy participating in surveys online, they spend a
great deal of time online and feel at home in front of a PC’ (Marketing Magazine
24/08/11b).
4 Institute of Practitioners in Advertising.
9 Conclusion
Summing up
… the task is to deepen collective understandings … (Harvey 2005: 198)
This book has revealed several areas for further research and future
policy development. In food science, the structures and constituents
of processed foods can be studied and altered to lessen the damage to
public health, as food industry scientists are urging. In local areas, licens-
ing of fast food businesses and snack installations can be more closely
monitored and restricted in the interests of public health. In schools and
Conclusion 225
universities, young people can learn about nutrition and develop an
awareness of how they are targeted as consumers. In medical and other
healthcare training institutions, healthcare professionals can be taught to
think critically about the role of the food industry in structuring the
problematic diets of prospective patients, and the social class, body-
weight and health effects of food targeting and siting. Health and social
researchers can ensure that the activities of the food industry are central
to diet and health research.
But will this address the deep inequities in food consumption in the UK?
The limitations of personal resources and capabilities, combined with the
power of habitus, studied and catered to by an alert food industry in its
many manifestations, cannot easily be tackled, though more attention could
be given to a sufficient wage to allow those on low incomes to eat a nutri-
tious diet. Nor can the influence of the industry on public policy be easily
traced or challenged. A significant employer and a sophisticated lobbyist,
its power will remain formidable. There is a long tradition of industry
resisting public intervention on the grounds of health, as the history of both
pharmaceutical development and food provision describes. Eventually,
accounts of the health consequences of flawed industrial products, growing
ethical concerns and the leadership of key individuals combined to bring
about change, as happened in the nineteenth century.
A more recent example of this was the ban on transfats in 2006 in
New York City, which prompted subsequent reductions even by UK food
producers (Guardian 01/06/12). But a subsequent New York City ban on
the sale of soft drinks larger than 16oz/500ml by restaurants and cinemas
was overturned by a state judge following lobbying by soft drink companies
(Reuters 2013). The city’s Board of Health appealed, but in June 2014 the
Court of Appeal upheld the earlier decision (BBC 2014).
The argument against the ban was that it limits free choice. In this book I
wanted to challenge arguments like that. There is something un-free about
the way we eat, based on the nature of the food supply and the class-
differentiated way in which diets are formed and health influenced, as
discussed in the research from a range of disciplines cited here. Not only is it
connected subconsciously to the way we are raised to eat, and the social class
of which we are a part; but it is also true that new foods are normalised by
tapping into this same subconscious nature of the way we consume food and
make our food ‘choices’. There was nothing normal about bucket-sized soft
drinks until recent decades. But now it is normal to drink them, at least
among those at whom they are targeted. Technical agricultural developments
lowered production costs, and marketing’s achievement was to make it seem
normal to drink such large sizes. Coffee and other food and drink items have
also increased dramatically in size. The ever spreading siting of snack foods
and drinks is another growing phenomenon influencing consumption.
On the same day the New York soda supersizing was upheld, the
UK’s Scientific Advisory Committee on Nutrition released a consultation
226 Conclusion
document and scientific literature review which proposes renaming
added sugars (or non-milk extrinsic sugars) ‘free sugars’ (SACN 2014). This
would include sugars added during food processing. The committee also
recommends lowering daily intakes of such sugars and raising intakes of
dietary fibre, citing evidence that this would lower rates of ‘cardiovascular
disease, type II diabetes and bowel cancer’ (ibid). This dimension of nutri-
tion policy had not been considered since the early 1990s.
Another report the same day, by Public Health England, also considered
sugar consumption. While set to issue formal recommendations to the
Department of Health in 2015, which will also build on the SACN research
and recommendations, PHE is taking immediate health promotion meas-
ures and will be reviewing research on a range of topics including the role
of the food industry in sugar consumption (PHE 2014b).
Industry activities will need to be closely monitored. In the UK, minimum
alcohol pricing had been mooted by the Coalition government, for which it
was criticised by one marketer who observed, ‘Cameron has become the
teacher who makes the entire class stay behind after school, in the hope that
the perpetrator of some misdemeanour will confess’; the government is risk-
ing ‘a confrontation with the drinks industry’ (Marketing Magazine
04/04/11). Plans to introduce such pricing were announced in March 2012.
But a few months later, the government dropped these plans, instead intro-
ducing in May 1914 a ban on ‘deep discounting’ of alcoholic drinks (in
which beverages are sold at below cost price) (Guardian 10/02/14;
Parliamentary Business 2014). Campaigns and research in support of mini-
mum pricing continue. Resistance to regulation from industry will not
disappear, as it adapts to new challenges regarding health, ethics and
sustainability, and develops new tactics to influence policy, not all of them
overt (Miller and Harkins 2010; Miller and Mooney 2010).
An emerging standard for a healthy diet is the Alternative Healthy Eating
Index (AHEI), developed and studied by Akbaraly et al. (2011). It shows
the importance of fruit, vegetables, fish, nuts and soy foods for avoiding
cardiovascular disease. Few of these foods require much value added by the
industry. Some social groups have the information, social and economic
resources to locate, purchase, prepare and absorb these foods into their
diets. The question for social, nutritional and health scientists, for political
leaders, policymakers and food providers alike is this: in a foodscape much
more likely to feature crisps and soft drinks than raw nuts and fresh fruit,
how do we set about restructuring the supply and retailing of food to
provide healthy options accessible to all to purchase, prepare and consume?
A healthy diet makes a strong contribution to better lifelong health and
longer lives; the AHEI study provides strong evidence for this. Can the food
industry carry on blanketing public space with a preponderance of
unhealthy foods in the face of evidence such as this? Can government main-
tain its resistance to implementing higher standards for the food supply,
and continue its voluntary reductions policy, given its expressed concern
Conclusion 227
about obesity and its health effects? The answer to both questions, at least
for the foreseeable future, seems to be: yes.
As long as the discourse surrounding diet-related health remains power-
fully centred on a reflexive, choosing, conscious individual, decisive change
in food–health policy or industry practice is unlikely. This discourse is rooted
in neoliberal ideas that have become so pervasive that they are seen as a
matter of common sense; as Harvey stated, ‘We’re all neoliberals now, with-
out altogether knowing it’ (Harvey 2010). In tracing the role of social class
and habituation of food consumption from the overlapping perspectives of
sociology, history, epidemiology, nutrition, food systems, psychology,
economics, geodemographics, food science, product development and
marketing, it becomes clear that these fundamental industry influences on
diets need to be taken into account as a matter of course, challenging
accounts of irresponsible food ‘choice’. The similarity of findings in this range
of disciplines makes a cumulatively strong case for the limits of the individual
choice model, and the need to understand the nature of consumption and the
food supply itself, while monitoring the activities of industry more closely.
By setting the structuring influences driving food consumption in the
context of global neoliberal industrial and economic forces, a deep, inter-
locking context for understanding unbalanced food consumption, large
bodyweights and high rates of metabolic and other diet-related illness has
been revealed. There is a strong case to be made for investigating the
commercial forces which are inscribed onto the social landscape in which
we live, and which shape our diets and our bodies, via our social status,
throughout our lives. From agriculture to arteries, the strategic production,
processing, retailing, marketing and consumption of food is indissolubly
linked to questions of industry strategies, technologies and goals, but
also – as the food is designed, packaged and delivered to where consumers
purchase it – social status and class. Health outcomes are also connected to
these processes going back to agriculture, and to neoliberal influences on
agriculture and on industry activity throughout the food chain.
Paradoxically, inadequate nutrition is often experienced, even in an omni-
present foodscape. Even healthy eaters encounter environments in which it
is not easy to locate healthy food. But those who are routinely targeted with
unhealthy foods are often multiply disadvantaged, and more likely to face
the long-term health consequences of poor diet than if they were more pros-
perous, higher status people. Indeed, the King’s Fund study showed that
multiple disadvantage and multiple unhealthy behaviours including poor
diet are linked – and increasing in prevalence among the lowest status groups
(Buck and Frosini 2012). The present analysis of the complex role of the
food industry in structuring consumption aimed to help shift the focus away
from the individual’s assumed capacity to make good choices, and towards
the realm of production and governance, where decisive power to improve
population dietary health in a class-structured society rightfully rests.
References
• (1845) The German Ideology (unpublished until the 1930s), pp. 94–118.
• (1846) Letter to Annenkov, pp. 121–7.
• (1852) The Eighteenth Brumaire of Louis Bonaparte, pp. 156–76.
• (1857) Grundrisse, pp. 182–202.
• (1859) Preface to a Contribution to the Critique of Political Economy,
pp. 119–20.
• (1867) Capital, pp. 203–48.
Mayhew, H. ([1851]2008), London Labour and the London Poor, Ware: Wordsworth
Editions.
McCullough, M. L. and Willett, W. C. (2006) ‘Evaluating adherence to recom-
mended diets in adults: the Alternate Healthy Eating Index’, Public Health
Nutrition, 9(1A) pp. 152–7.
McDonald, S. D., Han, Z., Mulla, S. and Beyene, J. (2010) ‘Overweight and obesity
in mothers and risk of preterm birth and low birth weight infants’, BMJ Online,
341(7765) c3428 (pp. 1–20 in pdf).
McMichael, P. (2000) ‘The power of food’, Agriculture and Human Values, 17,
pp. 21–33.
McMichael, P. (2005) ‘Global development and the corporate food regime’,
Research in Rural Sociology and Development, 11, pp. 265–99.
McMichael, P. (2009) ‘A food regime analysis of the “world food crisis”’,
Agriculture and Human Values, 26, pp. 281–95.
McNaughton, S. A., Mishra, G. D. and Brunner, E. J. (2008) ‘Dietary patterns,
iInsulin resistance, and incidence of Type 2 diabetes in the Whitehall II study’,
Diabetes Care, 31(7) pp. 1343–8.
Meiselman, H. L. (2009) ‘Recent developments in consumer research of food’, in
H. R. Moskowitz, I. S. Saguy and T. Straus (eds) An Integrated Approach to New
Food Product Development, Boca Raton: CRC Press, pp. 345–69.
Metcalf, B. S., Voss, L. D., Hosking, J., Jeffery, A. N. and Wilkin, T. J. (2008)
‘Physical activity at the government-recommended level and obesity-related
244 References
health outcomes: a longitudinal study (Early Bird 37)’, Archives of Disease in
Childhood, 93(9) pp. 772–7.
Metcalf, B. S., Hosking, J., Jeffery, A. N., Voss, L. D., Henley, W. and Wilkin, T. J.
(2011) ‘Fatness leads to inactivity, but inactivity does not lead to fatness: a longi-
tudinal study in children; Early Bird 45’, Archives of Disease in Childhood,
96(10) pp. 942–7.
Michman, R. D. and Mazze, E. M. (1998) The Food Industry Wars: Marketing
Triumphs and Blunders, Westport, Quorum Books.
Mick, D. G. (2007) ‘The ends of marketing and the neglect of moral responsibility
by the American Marketing Association’, Journal of Public Policy and Marketing,
26(2) pp. 289–92.
Mikkelson, B. E. (2011) ‘Foodscape studies: a powerful tool to improve our under-
standing of the impact of food environments on our behaviour’, Perspectives in
Public Health, 131(5) p. 206.
Milburn, A. (2012) Fair Access to the Professions: A Progress Report by the
Independent Reviewer on Social Mobility and Child Poverty, London: Cabinet
Office.
Miller, D. and Harkins, C. (2010) ‘Corporate strategy, corporate capture: food
and alcohol industry lobbying and public health’, Critical Social Policy, 30(4)
pp. 564–89.
Miller, D. and Mooney, G. (2010) ‘Introduction to the themed issue. Corporate
power: agency, communication, influence and social policy’, Critical Social
Policy, 30(4) pp. 459–571.
Millstone, E. (2009) ‘Science, risk and governance: radical rhetorics and the realities
of reform in food safety governance’, Research Policy, 38(4) pp. 624–36.
Millstone, E. (2010) ‘Can science and politics keep each other honest?’, professorial
lecture (11/05), University of Sussex, Brighton, www.sussex.ac.uk/newsande-
vents/sussexlectures/2010?lecture=50&fmt=qt (accessed January 2012).
Millstone, E. and Lang, T. (2008) ‘Risking regulatory capture at the UK’s Food
Standards Agency?’, The Lancet, 372(9633).
Milton, A. (2010) Speech to the World Health Organisation Forum on Salt by the
Parliamentary Under Secretary of State for Public Health, www.dh.gov.uk/en/
MediaCentre/Speeches/DH_117312.
Monaghan, L. (2005) ‘Discussion piece: a critical take on the obesity debate’, Social
Theory and Health, 3(4) pp. 302–14.
Moore, E. A. (2007) ‘Perspectives on food marketing and childhood obesity’,
Journal of Public Policy and Marketing, 26(2) pp. 157–61.
Moore, E. A. and Rideout, V. (2007) ‘The online marketing of food to children: is
it just fun and games?’, Journal of Public Policy and Marketing, 26(2) pp. 202–20.
Moore, K. and Sheron, N. (2009) ‘Why we need a national strategy for liver
disease’, British Journal for Hospital Medicine, 70(12) pp. 674–5.
Moore, L. V., Diez Roux, A. V., Nettleton, J. A., Jacobs, D. R. and Franco, M.
(2009) ‘Fast-food consumption, diet quality, and neighborhood exposure to fast
food: the multi-ethnic study of atherosclerosis’, American Journal of Epidemiology,
170(1) pp. 29–36.
Moran, J. (2007) Queuing for Beginners: The Story of Daily Life from Breakfast to
Bedtime, London: Profile Books.
Munro-Wild, H. and Fellows, C. (2009) ‘The London findings of the National Child
Measurement Programme 2006 to 2008’, London: London Health Observatory.
References 245
Murcott, A. (ed.) (1998) The Nation’s Diet: The Social Science of Food Choice,
London: Addison Wesley Longman.
Murcott, A. (2000) ‘Understanding life-style and food use: contributions from
the social sciences’, British Medical Bulletin, 56(1) pp. 121–32, London:
Routledge.
Murcott, A. (2011) ‘The BSA and the emergence of a “sociology of food”: a
personal view’, Sociological Research Online, 16(3) 14, www.socresonline.org.
uk/16/3/14.html.
Murray, C. J. L., Richards, M. A. and Newton, J. N. (and 39 others) (2013) ‘UK health
performance: findings of the Global Burden of Disease Study 2010’, The Lancet,
http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673613603554.pdf?
id=5bbe37e152166496:4555a725:13d3abc88a2:1d401362493966118.
Naaz, A., Holsberger, D. R., Iwamoto, G. A., Nelson, A., Kiyokawa, H. and
Cooke, P. S. (2004) ‘Loss of cyclin-dependent kinase inhibitors produces adipo-
cyte hyperplasia and obesity’, Journal of Federation of American Societies for
Experimental Biology, 18(15) pp. 1925–7.
Narkiewicz, K. (2006) ‘Diagnosis and management of hypertension in obesity’,
Obesity Reviews, 7(2) pp. 155–62.
National Centre for Social Research/Medical Research Council (2008) ‘An assess-
ment of dietary sodium levels among adults (aged 19–64) in the UK general
population in 2008, based on analysis of dietary sodium in 24 hour urine
samples’, www.food.gov.uk/multimedia/pdfs/08sodiumreport.pdf.
National Centre for Social Research (2011) British Social Attitudes 28
http://ir2.flife.de/data/natcen-social-research/igb_html/index.php?bericht_
id=1000001&index=&lang=ENG (accessed 7/12/11).
National Child Measurement Programme England (2013) London, Health and
Social Care Information Centre, Public Health England, www.hscic.gov.uk/
catalogue/PUB13115/nati-chil-meas-prog-eng-2012-2013-rep.pdf.
National Confidential Enquiry into Patient Outcome and Death (2012) ‘Bariatric
surgery: too lean a service?’, www.ncepod.org.uk/2012report2/downloads/
BS_report_summary.pdf (accessed 19/06/14).
National Consumer Council (2006) Short-changed on Health? How Supermarkets
Can Affect Your Chances of a Healthy Diet, by J. Pitt, London: NCC.
National Consumer Council (2008) Cut Price, What Cost? How Supermarkets Can
Affect Your Chances of a Healthy Diet, by L. Yates, London: NCC.
National Diet and Nutrition Survey: see Food Standards Agency 2010.
National Heart Forum: see Brown et al. (2010).
National Obesity Observatory (2010) ‘Adult obesity and socioeconomic status’,
www.noo.org.uk/uploads/doc/vid_7929_Adult%20Socioeco%20Data%20
Briefing%20October%202010.pdf (accessed January 2011, rechecked 25/05/12).
National Obesity Observatory (2012a) ‘Adult obesity and socioeconomic status’,
www.noo.org.uk/uploads/doc/vid_16966_AdultSocioeconSep2012.pdf.
National Obesity Observatory (2012b) ‘Slide sets for adult and child obesity’,
www.noo.org.uk/slide_sets (accessed 10/03/13).
NCC: see National Consumer Council.
NCEPOD: see National Confidential Enquiry into Patient Outcomes and Death.
NCMP: see National Child Measurement Programme.
Nelson, M., Erens, E., Bates, B., Church, S. and Boshier, T. (2007) Low Income
Diet and Nutrition Survey, London: FSA (also see Food Standards Agency above).
246 References
Nestle, M. (2002) Food Politics, Berkeley: University of California Press.
Ng, M. et al. (collaborators number approximately 170) (2014) ‘Global, regional,
and national prevalence of overweight and obesity in children and adults during
1980–2013: a systematic analysis for the Global Burden of Disease Study 2013’,
The Lancet, early online publication (29/05).
NHS (2008) Statistics on Physical Activity, Obesity and Diet: England 2008, The
Information Centre, Lifestyles Statistics, www.ic.nhs.uk/webfiles/publications/
opan08/OPAD%20Jan%202008%20final%20v7%20with%20links%20and%
20buttons%20-%20NS%20logo%20removed%2020112008.pdf (accessed
22/10/10).
NHS (2010) Statistics on Physical Activity, Obesity and Diet: England 2010, Health
and Social Care Information Centre, www.ic.nhs.uk/webfiles/publications/
opad10/Statistics_on_Obesity_Physical_Activity_and_Diet_England_2010.pdf
(accessed 23/05/12).
NHS (2012) Future Forum Summary Report – Second Phase, London: Department
of Health, www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/
digitalasset/dh_132085.pdf (accessed 23/03/12).
NHS NDA (2011) National Diabetes Audit 2003-04 to 2009-10 (2011) London:
NHS Information Centre, www.ic.nhs.uk/news-and-events/news/up-to-24000-
people-with-diabetes-suffer-an-avoidable-death-in-england-each-year.
Ni Mhurchu, C. N., Capelin, C., Dunford, E. K., Webster, J., Neal, B. C. and Jebb,
S. A. (2011) ‘Sodium content of processed foods in the United Kingdom: analysis
of 44,000 foods purchased by 21,000 households’, American Journal of Clinical
Nutrition, 93(3) pp. 594–600.
NICE (National Institute for Health and Clinical Excellence) (2006, modified
2010) ‘Obesity: guidance on the prevention, identification, assessment and
management of overweight and obesity in adults and children’, http://publica-
tions.nice.org.uk/obesity-cg43/guidance#clinical-recommendations (accessed
2010 and 2012).
NICE (2010) ‘Cut salt and saturated fat levels in processed food to save thousands
of lives, says NICE’, www.nice.org.uk/newsroom/pressreleases/PressRelease
CVDPrevention.jsp (accessed 23/05/12).
NICE (2011) ‘Behind the headlines: is salt good for you?’, www.nice.org.uk/news-
room/features/BehindTheHeadlineIsSaltGoodForYou.jsp (accessed 18/08/12).
NICE (2014a) ‘Obesity: guidance on the prevention, identification, assessment
and management of overweight and obesity in adults and children’ (CG43),
http://publications.nice.org.uk/obesity-cg43/guidance (accessed 09/06/14).
NICE (2014b) ‘Overweight and obese adults: lifestyle weight management’ (PH53),
http://guidance.nice.org.uk/ph53 (accessed 09/06/14).
NICE (2014c) Evidence statements for ‘Overweight and obese adults: lifestyle
weight management’, www.nice.org.uk/nicemedia/live/14530/67799/67799.pdf
(accessed 09/06/14).
NICE (2014d) ‘Managing overweight and obese adults: update review. The clinical
effectiveness of long-term weight management schemes for adults (Review 1a)’,
by J. Hartmann-Boyce, D. Johns, P. Aveyard, I. Onakpoya, S. Jebb, D. Phillips,
J. Ogden and C. Summerbell, www.nice.org.uk/nicemedia/live/14530/67812/
67812.pdf.
NICE (2014e) Draft guideline for consultation, www.nice.org.uk/guidance/gid-
cgwave0682/resources/obesity-update-draft-guideline-nice2.
References 247
Nichols, G. A. (2006) ‘Syndrome or no syndrome: clustering of metabolic risk
factors predicts diabetes and cardiovascular disease’, Medscape Diabetes and
Endocrinology (07/25), www.medscape.org/viewarticle/540923 (accessed
February 2013).
NOO: see National Obesity Observatory.
Oakley, A. (2000) Experiments in Knowing: Gender and Method in the Social
Sciences, New York: New Press.
The Observer newspaper (London): see news reports listed by date at the end of the
References.
OECD: see Organisation for Economic Co-operation and Development.
Ofcom (Office of Communications) (2007) ‘Television advertising of food and
drink products to children: final statement’, http://stakeholders.ofcom.org.uk/
binaries/consultations/foodads_new/statement/statement.pdf (accessed 25/05/12).
Offer, A., Pechey, R. and Ulijaszek, S. (2010) ‘Obesity under affluence varies by
welfare regimes: the effect of fast food, insecurity and inequality’, Economics and
Human Biology, 8(3) pp. 297–308.
Organisation for Economic Co-operation and Development (2011) ‘Divided we
stand: why inequality keeps rising’, www.oecd.org/dataoecd/40/22/49170234.pdf
(accessed 6/12/11).
Osborne, G. (2008) ‘Nudge, nudge, win, win: why are Conservatives hooked on
these new economic-psychological ideas? Because they work’, Guardian (14/07).
Osborne, G. and Thaler, R. H. (2010) ‘We can make you behave: our plan is to
embed the insights gleaned from behavioural economics throughout government’,
Guardian (29/01).
Outhwaite, W. (ed.) (1996) The Habermas Reader, Cambridge: Polity Press.
Pariser, E. (2011) The Filter Bubble: What the Internet is Hiding from You,
London: Penguin, excerpted in Observer (12/06, pp. 20–21).
Parker, S., Uprichard, E. and Burrows, R. (2007) ‘Class places and place classes:
geodemographics and the spatialization of class’, Information, Communication
and Society, 10(6) pp. 902–21.
Parkin, D. M. (2011a) ‘The fraction of cancer attributed to lifestyle and environ-
mental factors in the UK in 2010’, British Journal of Cancer, 105(Suppl.2)
pp. S77–S81.
Parkin, D. M. (2011b) ‘Cancers attributable to dietary factors in the UK in 2010:
meat consumption’, British Journal of Cancer, 105(Suppl.2) pp. S24–S26.
Parkin, D. M. and Boyd, L. (2011) ‘Cancers attributable to dietary factors in the UK
in 2010: low consumption of fruit and vegetables’, British Journal of Cancer,
105(Suppl.2) pp. S19–S23.
Parliamentary Business (2014) ‘Alcohol: minimum pricing – Commons Library
Standard Note’, by P. Ward and J. Woodhouse (19/05), www.parliament.uk/
business/publications/research/briefing-papers/SN05021/alcohol-minimum-
pricing.
Paterson, M. (2007) Foresight: Tackling Obesities: Future Choices – Food Chain
Industries’ Perspectives on the Future, London: Government Office for Science.
Pember Reeves, M. (1913) Round About a Pound a Week, London: G. Bell and
Sons, republished London: Persephone Books (2008).
PHE: see Public Health England.
Phillips, D. and Curry, M. (2003) ‘Privacy and the phenetic urge: geodemographics
and the changing spatiality of local practice’, in D. Lyon (ed.) Surveillance as
248 References
Social Sorting: Privacy, Risk and Digital Discrimination, London: Routledge,
pp. 137–52.
Pierson, C. (ed.) (1997) The Marx Reader, London: Polity Press.
Pietrykowski, B. (2009) The Political Economy of Consumer Behaviour, Abingdon:
Routledge.
Pitts, M., Dorling, D. and Pattie, C. (2007) ‘Oil for food: the global story of edible
lipids’, Journal of World-Systems Research, XIII(1) pp. 12–32.
Pollock, A. (2005) NHS plc: The Privatisation of Our Health Care, London: Verso.
Porter, R. (1999) The Greatest Benefit to Mankind: A Medical History of Humanity
from Antiquity to the Present, London: Fontana.
Public Health England (2014a) Note accompanying slide portraying ‘trend in
adult obesity prevalence by social class’ (PHE_Obesity_AdultSlideSet), see
www.noo.org.uk/slide_sets (accessed 11/06/14).
Public Health England (2014b) ‘About obesity: health inequalities’, www.noo.org.
uk/NOO_about_obesity/inequalities#d6888 (accessed 11/06/14).
Public Health England (June 2014c) ‘Sugar reduction: responding to the chal-
lenge’, www.gov.uk/government/uploads/system/uploads/attachment_data/
file/324043/Sugar_Reduction_Responding_to_the_Challenge_26_June.pdf.
Rayner, G. and Lang, T. (2011) ‘Is nudge an effective public health strategy to
tackle obesity? No’, BMJ, 342, d2177, pp. 1–2.
Rayner, G., Hawkes, C., Lang, T. and Bello, W. (2007) ‘Globalization for health:
trade liberalization and the diet transition: a public health response’, Health
Promotion International, 21(S1), pp. 67–74.
Rayner, M., Scarborough, P. and Stockley, L. (2004) Nutrient Profiles: Options for
Definitions for Use in Relation to Food Promotion and Children’s Diets: Final
Report, Oxford: British Heart Foundation Health Promotion Research Group,
Department of Public Health, University of Oxford.
Real Food, Tesco Magazine (Spring 2011) London: Cedar Communications.
Reuters (2013) ‘New York court to hear Bloomberg’s appeal to restore soda ban’, www.
reuters.com/article/2013/10/17/us-nycsodaban-appeal-idUSBRE99G0T620131017
(accessed 28/05/14).
Reyes, O. (2005) ‘New Labour’s politics of the hard-working family’, in D. Howarth
and J. Torfing (eds) Discourse Theory in European Politics, Basingstoke, Palgrave
Macmillan, pp. 231–51.
Rich, E. and Evans, J. (2005) ‘“Fat ethics”: the obesity discourse and body politics’,
Social Theory and Health, 3(4) pp. 341–58.
Rich, E., Monaghan, L. F. and Aphramor, L. (eds) (2011) Debating Obesity:
Critical Perspectives, Basingstoke: Palgrave Macmillan.
Richards, C., Bjørkhaug, H., Lawrence, G. and Hickman, E. (2013) ‘Retailer-driven
agricultural restructuring: Australia, the UK and Norway in comparison’,
Agriculture and Human Values, 30(2) pp. 235–45.
Rigby, N. J., Kumanyika, S. and James, W. P. T. (2004) ‘Confronting the
epidemic: the need for global solutions’, Journal of Public Health Policy, 25(3/4)
pp. 418–34.
Rose, N. and Miller, P. ([1992]2010) ‘Political power beyond the state: problem-
atics of government’, British Journal of Sociology, 61 (60th anniversary issue)
pp. 271–303.
Saberi, H. (ed.) (2011) Cured, Fermented and Smoked Foods: Proceedings of the
Oxford Symposium on Food and Cookery 2010, Totnes: Prospect Books.
References 249
SACN: see Scientific Advisory Committee on Nutrition.
Sandwich News website, www.sandwichnews.com/sandwich-facts-and-trivia
(accessed 10/04/14).
Savage, M. (2000) Class Analysis and Social Transformation, Buckingham: Open
University Press.
Savage, M. and Burrows, R. (2007) ‘The coming crisis of empirical sociology’,
Sociology, 41(5) pp. 885–99.
Savage, M. and Williams, K. (2008) ‘Elites: remembered in capitalism and forgotten
by social sciences’, in M. Savage and K. Williams (eds) Remembering Elites,
Oxford: Blackwell, pp. 1–24.
Savage, M., Devine, F., Cunningham, N., Taylor, M., Li, Y., Hjellbrekke, J.,
Le Roux, B., Friedman, S. and Miles, A. (2013) ‘A new model of social class?
Findings from the BBC’s Great British Class Survey Experiment’, Sociology, 47(2)
pp. 219–50.
Scambler, G. (2001) ‘Class, power and the durability of health inequalities’, in
G. Scambler (ed.) Habermas, Critical Theory and Health, London: Routledge.
Scambler, G. and Higgs, P. (2001) ‘“The dog that didn’t bark”: taking class
seriously in the health inequalities debate’, Social Science & Medicine, 52(1)
pp. 157–9.
Scambler, G. (2002) Health and Social Change: A Critical Theory, Buckingham:
Open University Press.
Scambler, G. (2007) ‘Social structure and the production, reproduction and durabil-
ity of health inequalities’, Social Theory & Health, 5(4) pp. 297–315.
Scambler, G. (2012) ‘Review article: health inequalities’, Sociology of Health and
Illness, 34(1) pp. 130–46.
Scambler, G. and Scambler, S. (2013) ‘Marx, critical realism and health inequali-
ties’, in W. Cockerham (ed.), Medical Sociology on the Move: New Directions in
Theory, New York: Springer.
Scammel-Katz, S. (2012) The Art of Shopping: How We Shop and Why We Buy,
London: LID Publishing.
Scarborough, P., Bhatnagar, P., Wickramasinghe, K., Smolina, K., Mitchell, C. and
Rayner, M. (2010) Coronary Heart Disease Statistics, Oxford: British Heart
Foundation Health Promotion Research Group.
Scarborough, P., Bhatnagar, P., Wickramasinghe, K., Allender, S., Foster, C.
and Rayner, M. (2011) ‘The economic burden of ill health due to diet, physical
inactivity, smoking, alcohol and obesity in the UK’, Journal of Public Health,
33(4) pp. 527–35.
Scarborough, P., Nnoaham, K. E., Clarke, D., Capewell, S. and Rayner, M.
(2012) ‘Modelling the impact of a healthy diet on cardiovascular disease
and cancer mortality’, Journal of Epidemiology and Community Health, 66(5)
pp. 420–6.
Schmidt, C. (2009) ‘Defining and meeting customer needs: beyond hearing the
voice’, in H. R. Moskowitz, I. S. Saguy and T. Straus (eds) An Integrated
Approach to New Food Product Development, Boca Raton: CRC Press,
pp. 217–32.
Schmidt, V. A. (2000) ‘Democracy and discourse in an integrating Europe and a
globalising world’, European Law Journal, 6(3) pp. 277–300.
Scientific Advisory Committee on Nutrition (2003) Salt and Health, London: The
Stationery Office for the Food Standards Agency and Department of Health.
250 References
Scientific Advisory Committee on Nutrition (2014) ‘New draft report from the
Scientific Advisory Committee on Nutrition recommends more fibre and less sugar
in diet’, www.sacn.gov.uk/pdfs/sacn_press_release_carbohydrates_and_health.pdf.
Scully, P., Reid, O., Macken, A., Healy, M., Saunders, J., Leddin, D., Cullen, W.,
Dunne, C. and O’Gorman, C. S. (2014) ‘Food and beverage cues in UK and Irish
children: television programming’, Archives of Disease in Childhood (published
online 01/07).
Seifert, S. M., Schaechter, J. L., Hershorin, E. R. and Lipshultz, S. E. (2011) ‘Health
effects of energy drinks on children, adolescents, and young adults’, Pediatrics,
127(3) pp. 511–28.
Seldon, A. (2012) ‘The big society must be grounded in goodness’, Guardian
(03/01), www.guardian.co.uk/commentisfree/2012/jan/03/big-society-goodness-
government-morality?INTCMP=SRCH (accessed 25/01/12).
Sen, A. (2004) ‘Why health equity?’, in S. Anand, F. Peter and A. Sen (eds) Public
Health, Ethics and Equity, Oxford: Oxford University Press.
Sesame (Open University alumni magazine) (2010) ‘Brand appeal’, interview with
Fiona Ellis-Chadwick, Senior Lecturer, Retail Management, issue 246 (autumn)
pp. 40–2.
Shaheen, S. O., Jameson, K. A., Syddall, H. E., Aihie Sayer, A., Dennison, E. M.,
Cooper, C., Robinson, S. M. and The Hertfordshire Cohort Study Group (2010)
‘The relationship of dietary patterns with adult lung function and COPD’,
European Respiratory Journal, 36(2) pp. 277–84.
Sharpe, K. M., Staelin, R. and Huber, J. (2008) ‘Using extremeness aversion to right
obesity: policy implications of context-dependent demand’, Journal of Consumer
Research, 35(3) pp. 406–22.
Shilling, C. (2003) The Body and Social Theory, 2nd edn, London: Sage.
Singh, G. K., Siahpush, M., Hiatt, R. A. and Timsina, L. R. (2011) ‘Dramatic
increases in obesity and overweight prevalence and body mass index among
ethnic-immigrant and social class groups in the United States, 1976–2008’,
Journal of Community Health, 36, pp. 94–110.
Skalen, P., Fougere, M. and Felleson, M. (2008) Marketing Discourse: A Critical
Perspective, Abingdon: Routledge.
Skeggs, B. (2004) Class, Self, Culture, London: Routledge.
Skidmore, P. M. L., Hardy, R. J., Kuh, D. J., Langenberg, C. and Wadsworth, M. E. J.
(2007) ‘Life course body size and lipid levels at 53 years in a British birth cohort’,
Journal of Epidemiology and Community Health, 61(3) pp. 215–20.
Sklair, L. and Miller, D. (2010) ‘Capitalist globalization, corporate social responsi-
bility and social policy’, Critical Social Policy, 30(4) pp. 472–95.
Soil Association (2012) ‘Organic market report 2012’ (summary), www.soilassocia-
tion.org/marketreport (accessed 26/05/12).
Soil Association (2014) ‘Organic market report 2014’, www.soilassociation.org/
marketreport (accessed 14/04/14).
Steel, C. (2009) Hungry City: How Food Shapes Our Lives, London: Vintage.
Steinbach, S. (2004) Women in England 1760–1914: A Social History, London:
Phoenix.
Stern, B. (2004) ‘The importance of being Ernest: commemorating Dichter’s contri-
bution to advertising research’, Journal of Advertising Research, 44(2) pp. 165–69.
Su, D., Esqueda, O. A., Li, L. and Pagan, J. A. (2012) ‘Income inequality and obesity
prevalence among OECD countries’, Journal of Biosocial Science, 44, pp. 417–32.
References 251
Sui, X., LaMonte, M. J., Laditka, J. N., Hardin, J. W., Chase, N., Hooker, S. P.,
Blair, S. N. (2007) ‘Cardiorespiratory fitness and adiposity as mortality predic-
tors in older adults’, Journal of the American Medical Association, 298(21)
pp. 2507–16.
Sustain (2012) ‘Asda, Morrisons and Iceland named as “worst offenders for under-
mining children’s healthy eating”’, www.sustainweb.org/news/apr12_checkouts_
checked_out_survey_report/ (accessed 26/04/12).
Thaler, R. H. and Sunstein, C. R. (2009) Nudge: Improving Decisions about
Health, Wealth and Happiness, London: Penguin.
Thankamony, G. N. A., Williams, R. and Dunger, D. B. (2011) ‘Metabolic
syndrome in children unravelled’, Pediatrics and Child Health, 21(7) pp. 301–5.
Thompson, C. (2011) ‘Investigating food shopping and food consumption using the
“go-along” interview’, BSA Conference presentation, London (07/04), transcript
provided by C. Thompson.
Tomlinson, M. (2003) ‘Lifestyle and social class’, European Sociological Review,
19(1) pp. 97–111.
Tonkiss, F. (1998) ‘Analysing discourse’, in C. Seale (ed.) Researching Society and
Culture, London: Sage, pp. 245–60.
UCL Institute of Health Equity (2012) The Role of the Health Workforce in
Tackling Health Inequalities: Action on the Social Determinants of Health,
London: UCL.
UCL Institute of Health Equity (2013) Working for Health Equity: The Role of
Health Professionals, by M. Allen, J. Allen, S. Hogarth with M. Marmot,
London: UCL.
Urbick, B. (2009) ‘Getting the food right for children: how to win with kids’, in
H. R. Moskowitz, I. S. Saguy and T. Straus (eds) An Integrated Approach to New
Food Product Development, Boca Raton: CRC Press, pp. 247–62.
Van Aken, G. A. (2010) ‘Relating food emulsion structure and composition to the
way it is processed in the gastrointestinal tract and physiological responses’, Food
Biophysics, 5(4) pp. 258–83.
Van Boekel, M. A. J. S. (2009) ‘Innovation as science’ in H. R. Moskowitz,
I. S. Saguy and T. Straus (eds) An Integrated Approach to New Food Product
Development, Boca Raton: CRC Press, pp. 37–52.
Veenstra, G. (2006) ‘Neo-Marxist class position and socio-economic status:
distinct or complementary determinants of health?’, Critical Public Health, 16(2)
pp. 111–29.
Wang, Y., Beydoun, M. A., Liang, L., Caballero, B. and Kumanyika, S. K. (2008)
‘Will all Americans become overweight or obese? Estimating the progression and
cost of the US obesity epidemic’, Obesity, 16(10), pp. 2323–30.
Wann, M. (1998) Fat! So? Because You Don’t Have to Apologise for Your Size,
Berkeley: Ten Speed Press.
Wansink, B. and Chandon, P. (2006) ‘Can “low-fat” nutrition labels lead to
obesity?’, Journal of Marketing Research, 43(4) pp. 605–17.
Warde, A. (1997) Consumption, Food and Taste: Culinary Antinomies and
Commodity Culture, London: Sage.
Watzke, H. J. and German, B. (2009) ‘Personalizing foods’ in H. R. Moskowitz,
I. S. Saguy and T. Straus (eds) An Integrated Approach to New Food Product
Development, Boca Raton: CRC Press, pp. 133–74.
WCRF: see World Cancer Research Fund.
252 References
Wearing, S. C., Hennig, E. M., Byrne, N. M., Steele, J. R. and Hills, A. P. (2006)
‘The impact of childhood obesity on musculoskeletal form’, Obesity Reviews,
7(2) pp. 209–18.
Weaver, D. and Finke, M. (2003) ‘The relationship between the use of sugar content
information on nutrition labels and the consumption of added sugars’, Food
Policy, 28(3) pp. 213–19.
Webber, R. (2007) ‘The metropolitan habitus: its manifestations, locations and
consumption profiles’, Environment and Planning, 39(1) pp. 182–207.
Webster, A. (2007) Health, Technology and Society, Basingstoke: Palgrave Macmillan.
Weinstein, A. R., Sesso, H. D., Lee, I. M., Rexrode, K. M., Cook, N. R., Manson,
J. E., Buring, J. E., Gaziano, J. M. (2008) ‘The joint effects of physical activity
and body mass index on coronary heart disease risk in women’, Archives of
Internal Medicine, 168(8) pp. 884–90.
Weissberg, P. (2011) ‘Foreword’, in Trends in Coronary Heart Disease, 1961–2011,
London: British Heart Foundation.
Wennstrom, P. and Mellentin, J. (2002) The Food and Health Marketing Handbook:
Five Strategies to Enter the Market and the Four Success Factors to Position your
Brand, Brentford: New Nutrition Business.
Whimster, S. (2011) ‘Desert island discourse’, Network: the magazine of the British
Sociological Association, 108, pp. 38–9.
White, R. (2011) ‘No fat future? Anti-social queer theory and fat activism’, BSA
conference presentation, London (07/04).
WHO: see World Health Organisation.
Wilkinson, R. and Pickett, K. (2009) The Spirit Level: Why More Equal Societies
Almost Always Do Better, London: Allen Lane.
Williams, J. D., Crockett, D., Harrison, R. L. and Thomas, K. D. (2012)
‘Commentary: the role of food culture and marketing activity in health disparities’,
Preventive Medicine, 55(5) pp. 382–6.
Williams, S. J. (1995) ‘Theorising class, health and lifestyles: can Bourdieu help us?’,
Sociology of Health and Illness, 17(5) pp. 577–604.
Williams, S. J. (2003) ‘Beyond meaning, discourse and the empirical world: critical
realist reflections on health’, Social Theory & Health, 1(1) pp. 42–71.
Wills, W., Backett-Milburn, K., Roberts, M. and Lawton, J. (2011) ‘The framing of
social class distinctions through family food and eating practices’, Sociological
Review, 59(4) pp. 725–40.
Wilson, B. (2009) Swindled: From Poison Sweets to Counterfeit Coffee – the Dark
History of the Food Cheats, London: John Murray.
Winson, A. (2004) ‘Bringing political economy into the debate on the obesity
epidemic’, Agriculture and Human Values, 21(4) pp. 299–312.
Wodak, R. (2007) ‘Pragmatics and critical discourse analysis’, Pragmatics &
Cognition, 15(1) pp. 203–25.
World Action on Salt and Health (2009) ‘New research reveals huge differences in
salt contents in global brands’, www.worldactiononsalt.com/less/surveys/2009/
international/index.html (accessed 26/07/09).
World Bank (2010) Worldwide governance indicators, http://info.worldbank.org/
governance/wgi/mc_chart.asp (accessed 2010 and 14/08/12).
World Cancer Research Fund (2010) ‘Cancer charity warns that women more likely
to have large waists’, www.wcrf-uk.org/audience/media/press_release.php?recid=136
(accessed January 2011).
References 253
World Cancer Research Fund/American Institute for Cancer Research (2007) Food,
Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective,
Washington: AICR, www.dietandcancerreport.org/cancer_resource_center/
downloads/Second_Expert_Report_full.pdf (accessed 2010 and May and August
2012).
World Health Organisation (2014) ‘Draft guideline: sugars intake for adults
and children’, www.who.int/nutrition/sugars_public_consultation/en/; www.
who.int/mediacentre/news/notes/2014/consultation-sugar-guideline/en/ (accessed
30/06/14).
Xtreme Impact (2011) Marketing, promotions, strategies, www.xtremeimpakt.
com/index/Capabilities/Strategic-Services/Consumer-Segmentation (accessed
16/03/11).
Interviews
Interviewee A: consultant, market research firm, June 2011.
Interviewee B: consultant, market research firm, May 2012.
Marketing Magazine
• 02/10/07 (online) www.marketingmagazine.co.uk/news/742967/
Quotes/?DCMP=ILC-SEARCH (accessed 09/09/10).
• 18/02/09(a) ‘Brand termination: knowing when to swing the axe’, by N. Clark,
pp. 30–1.
• 18/02/09(b) ‘Bringing brands to life’, by B. Wilkerson, pp. 35–8.
• 04/03/09 ‘It’s the same difference’, by A. Walmsley, p. 12.
• 03/03/10 ‘Walkers Sensations’, by J. Lee, p. 17.
• ‘Revolution’ supplement 09/10a, ‘Facing up to facebook’, by T. Clawson, pp. 40–1.
• ‘Revolution’ supplement 09/10b, ‘Smarter digital marketing: case studies –
Kellogg’s Krave’.
• 22/09/10 ‘Out of home, top of mind’, by S. Bashford, p. 28.
• 27/10/10 ‘A new consumer champion’, by H. Edwards, p. 19.
• 10/11/10 ‘Sector Insight. Nuts, seeds and dried fruit’, by J. Bainbridge, pp. 32–3.
• 17/11/10 ‘Not only but also: Marks & Spencer’s latest strategy has echoes of
the brand’s past’, by R. Barnes and E. Owen, p. 16.
• 11/01/11 ‘Will sweeteners turn sour? Sprite’s roll-out of a drink containing
sugar substitutes Truvia is not without its risks’, by J. Thomas, p. 16.
• 12/01/11 ‘Tomorrow’s world: cautious and resourceful, tomorrow’s consum-
ers will be forced to find ways to live without a floodtide of prosperity’, by
J. Walker Smith, p. 15.
254 References
• 19/01/11 ‘Brands on location: marketers at three major brands assess the
opportunities created by mobile payment’, by E. Owen, p. 14.
• 26/01/11 ‘The perils of virtual stalking’, by A. Walmsley, p. 12.
• 02/02/11 ‘In brief: McCain’, p. 4.
• 16/02/11 ‘A fashionable strategy: Morrisons could add clothing to build on its
strength in food’, by L. Eleftheriou-Smith, p. 18.
• 23/02/11(a) ‘Consumer surveillance: don’t let relevance blind you to privacy’,
by A. Mitchell, p. 26–7.
• 23/02/11(b) ‘Thinking inside the box: strict policing of the content of children’s
food is forcing brands to innovate’, by N. Hughes, p. 18.
• 23/02/11(c) ‘Kids’ health needs NPD agenda’, by N. McElhatton, p. 25.
• 23/02/11(d) ‘A glass half full kind of guy’, by G. Charles, pp. 22–3.
• 02/03/11(a) ‘Eyeing up the opposite sex’, by J. Reynolds, p. 14.
• 02/03/11(b) ‘Lucozade targets social media users via Spotify’, by G. Charles, p. 7.
• 09/03/11(a) ‘Memo to new CEO: tips from the trade’, comment by Tracey
Follows, VCCP, p. 14.
• 09/03/11(b) ‘Memo to new CEO: tips from the trade’, comment by Dave Trott,
CST The Gate, p. 15.
• 16/03/11 ‘Flavour of the month: cash-strapped consumers are skipping health-
ier options in favour of the affordable indulgence offered by premium crisp
brands’, by J. Bainbridge, pp. 36–7.
• 23/03/11 ‘Defining the new middle class’, by G. Charles, pp. 14–15.
• 30/03/11 ‘UK brands splash $4.1bn on online ads’, by S. Shearman, p. 1.
• 04/04/11 ‘David Cameron’s plan to curb binge drinking runs contrary to many
of the ideas of behavioural “hedonic consumption” theory’, by H. Edwards,
p. 18.
• 13/04/11 ‘United we understand: conducting research with, rather than on,
people can give incisive glimpses into their behaviour’, by H. Edwards, p. 19.
• 04/05/11 ‘Domino’s to integrate behavioural economics’, by A. McCormick, p. 5.
• 11/05/11 ‘Coca-Cola in “meals” push’, by L. Eleftheriou-Smith, p. 1.
• 18/05/11(a) ‘Analysis – Behavioural Economics: when push comes to nudge’,
by A. McCormick, pp. 16–17.
• 18/05/11(b) ‘Readers say: Coca-Cola encourages mealtime consumption’, letter
from J. Filmer, p. 27.
• 25/05/11 ‘Marketing’s new mindset: brand marketers can now analyse
campaigns in real time, but they need more than logic to succeed’, by A.
Walmsley, p. 13.
• 08/06/11(a) ‘Looking ahead: can your customers become your field-marketing
agents?, p. 35.
• 08/06/11(b) ‘We know where you live’, by B. Bold, p. 17.
• 08/06/11(c) ‘Brand revitalisation: Robinsons Fruit Shoot’, p. 11.
• 08/06/11(d) ‘Ginsters debuts Bara’, p. 11.
• 08/06/11(e) ‘Winner, Brand: Walkers. Agency: Abbott Mead Vickers BBDO’,
p. 22.
• 15/06/11(a) ‘Sector Insight: biscuits, cookies and crackers’, by J. Bainbridge, pp. 38–9.
• 15/06/11(b) ‘Consumer behaviour: how to navigate the customer journey’, by
C. Smith, pp. 28–9.
• 22/06/11 Conference leaflet, ‘Appeal to Kids and Sell to Parents’, 5th Annual
Kids Conference.
References 255
• 29/06/11 ‘Waitrose: the supermarket brand has adopted an “honestly priced”
strategy to stand out from the crowd’, p. 18.
• July 2011 conference supplement: (a) ‘Social media – playtime’s over!’, letter
from Michael Saylor, MicroStrategy Inc.; (b) ‘Social CRM – the ultimate
customer engagement’, by D. Peppers.
• 06/07/11 ‘Working-class heroes’, by G. Charles, pp. 18–19.
• 27/07/11 ‘Asking the right question’, by W. Gordon, p. 9.
• 03/08/11 ‘Top 10 marketing U-turns’, by G. Carson, p. 13.
• 10/08/11 ‘Changing the recipe at Kraft’, by D. Fielding, pp. 22–3.
• 24/08/11(a) ‘Greggs: the bakery chain must arrest a drop in profits if it is to
realise expansion plans’, by R. Barnes, p. 18.
• 24/08/11(b) ‘Kids Brand Index 2011’, by C. Bussey, p. 26.
• 07/09/11 ‘Should brands that add to the obesity crisis subsidise healthier food
options?’, p. 28.
• 14/09/11(a) ‘Best behaviour’, by K. Benjamin, p. 29.
• 14/09/11(b) ‘Going cold turkey on price promotions’, by D. Benady, pp. 26–7.
• 14/09/11(c) ‘Price gives pizza solid base’, by J. Bainbridge, pp. 38–9.
• 19/10/11 ‘Ticking the healthy box’, by J. Bainbridge, pp. 30–1.
• 26/10/11 ‘Will the plan to cut 5bn calories from the nation’s daily diet by 2020
work?’, p. 24.
• 07/12/11 ‘Don’t expect a peaceful 2012’, by A. Walmsley, p. 12.
• 25/01/12 ‘Manaaz Akhtar: Subway’s UK head of marketing cites health and
value as the main selling pts that will broaden the chain’s consumer base’, by
G. Charles, pp. 29–31.
• 15/02/12(a) ‘Mars UK to cut calories across chocolate lines’, by G. Charles, p. 5.
• 15/02/12(b) ‘Twitter’s branded adventure’, by S. Shearman, pp. 10–11.
• 14/03/12 ‘Transparently green’, by E. Jeffries, pp. 32–3.
• 04/04/12 ‘Sector insight: crisps and salty snacks’, by J. Bainbridge, p. 14.
• 25/04/12 ‘Red Bull set to roll out Editions offering in UK’, by L. Eleftheriou-
Smith, p. 4.
• 02/05/12(a) ‘Polman: marketers are “losing ground”’, by R. Barnes, p. 5.
• 02/05/12(b) ‘After years promoting bigger pack sizes as offering better
value, it appears food and drink marketers may do better to think small’, by
H. Edwards, p. 22.
• 30/05/12 ‘Kellogg chief departs amid global rebrand’, by S. Shearman, p. 5.
The Guardian
• 16/01/07 ‘The wretched price of failing to educate girls’, by E. Brotherton,
p. 30, reprint from 16/01/1864.
• 11/09/07 ‘Do postcodes define how you live?’, by I. Sample, www.theguardian.
com/science/2007/sep/11/postcode.
• 23/07/09 ‘Study finds big variations in salt contents in global food products’,
by R. Smithers, p. 8.
• 19/01/10 ‘Food scientists develop appetite-curbing gel’, www.guardian.co.uk/
education/2010/jan/19/gel-curb-appetite-scientists?INTCMP=SRCH.
• 09/02/10 ‘Teenage girls eat less healthy food than any other group, survey
reveals’, by R. Smithers, p. 9.
• 09/03/10 ‘Is it healthier to be slim but unfit or fat and fit?’, by P. Daoust, p. 14.
256 References
• 03/09/10 ‘The domestic education of girls’, reprint of ‘From A Correspondent’,
03/09/1901, www.theguardian.com/theguardian/2010/sep/06/the-domestic-
education-of-girls.
• 15/11/10 ‘Advertising: time for advertisements to go up a gear’, by J. Silver, p. 5.
• 30/12/10 ‘Speed of NHS reform means Andrew Lansley has faced a
bumpy ride’, www.guardian.co.uk/politics/2010/dec/30/andrew-lansley-nhs-
reform?INTCMP=SRCH (accessed 02/06/12).
• 18/02/11 ‘Britain’s fried chicken boom’, by T. Meltzer, p. 6.
• 23/03/11 ‘Boost for convenience stores as shoppers top up on the move’ (report
of a study by Britvic), by R. Smithers, p. 29.
• 23/05/11 ‘Cut red meat and don’t eat ham, say cancer researchers’, by
D. Campbell, p. 5.
• 25/05/11 ‘Supermarket sandwich maker takes bigger slice of lunch money’, by
S. Bowers, p. 28.
• 04/06/11 ‘The Social Animal by David Brooks – review’, by A. Beckett, p. 7.
• 24/06/11 (online) Money blog: ‘Are discount supermarkets any good?’, www.
guardian.co.uk/money/blog/2011/jun/24/discount-supermarkets-lidl-aldi#start-
of-comments (accessed 11/07/11).
• 02/07/11 ‘Personal effects’ column, Money section, p. 2.
• 09/07/11 ‘Effective things can come from silly places’, by B. Goldacre, p. 46.
• 01/12/11 ‘Starbucks to brew up 5,000 jobs’, by J. Treanor, p. 20.
• 20/12/11 ‘Matthew Freud picks up £1m-a-year contract with Department
of Health’, www.guardian.co.uk/media/2011/dec/20/matthew-freud-contract-
department-health?INTCMP=SRCH.
• 22/12/11 ‘Revealed: how supermarkets plan to build thousands more stores
(mostly out of town)’, by R. Neate, p. 3.
• 31/12/11 ‘Patients with unhealthy lifestyles must be warned, say experts’, by
D. Campbell, p. 2.
• 15/01/12 ‘Ad men use brain scanners to probe our emotional response’, by
R. Neate, p. 29.
• 05/03/12 ‘Facebook: if you don’t like it, don’t like it’, by A. Senior, p. 32.
• 07/03/12 ‘Krispy Kreme cashes in as Britain falls in love with the doughnut’,
by J. Moulds, p. 32.
• 14/03/12 ‘Greggs drops 2% after bakeries group says like for like sales fell in
first ten weeks’, by N. Fletcher, www.guardian.co.uk/business/marketforces-
live/2012/mar/14/greggs-profits-up-sales-dip?INTCMP=SRCH.
• 01/06/12 ‘Sweet, surrender: New York mayor plans to ban the sale of super-
size fizzy drinks’, by E. Pilkington and K. Rogers, p. 3.
• 02/03/13 ‘Bring on the nanopayments: are we giving up too much economic
power to the big digital companies, asks Lawrence Scott’, p. 7 (Review of Who
Owns the Future? by Jaron Lanier).
• 22/01/14 ‘Subway to create 13,000 jobs as it doubles outlets in UK and Ireland’
(Press Association).
• 10/02/14 ‘Minimum alcohol pricing would save 860 lives a year, study finds’,
by S. Bosely.
• 28/06/14(a) ‘Tesco chairman promises to turn around ailing supermarket
giant’, by Z. Wood, p. 41.
• 28/06/14(b) ‘Lidl to spend £220m in new challenge to big four rivals’, by
S. Butler, p. 41.
References 257
The Independent
• 04/04/12 ‘Hot dog stuffed crust pizza helps Domino’s unveil tasty results
during cold snap’, by J. Thompson, www.independent.co.uk/news/business/
news/hot-dog-stuffedcrust-pizza-helps-dominos-unveil-tasty-results-during-
cold-snap-8560085.html.
The Observer
• 25/04/10 ‘Recession-beating strategies pay off as store reveals record profits
again’, by J. Finch, p. 42.
• 21/11/10 ‘Facebook is stealing a march on Google in the battle for ad revenue’,
by J. Naughton, p. 21.
• 09/01/11 ‘UK’s taste for austerity helps the pieces fall into place for Domino’s
Pizza’, by A. Clark, p. 36.
• 24/04/11 ‘Obesity policy under attitude from two government advisers’, by
D. Boffey, p. 10.
Index
ABCDE classifications 186, 188 agents/agency 44–5, 61, 69, 75, 77, 79
academic marketing 154 agribusiness 85, 91n3, 120
academic research: analysis of power of agricultural developments 35, 45,
advertising 210; cooperation between 117–18, 119–22, 150
market research and 224; of the agricultural liberalisation 120–1
foodscape 87; geodemographics and agricultural oversupply 123–4
173–5; on social behaviour 92, see agricultural policy 13, 33, 108–9, 124
also individual studies agricultural subsidies 108, 122, 123
Academy of Medical Royal Colleges 127 agro-food activism 126
access: to health and lifestyle expertise alcohol consumption 97, 110, 219
63; to health-enhancing diets 143; to alcohol pricing 226
means of self-actualisation 63 alienation 44, 47, 57, 85, 190
Acheson Report 3, 55 alternative (green) food consumption 126
achievement (individual) 42 Alternative Healthy Eating Index
ACORN 171, 176, 185 (AHEI) 226
acquired dispositions 69, 72 alternative producers and eaters 126–8
acquired food preferences 144 American Marketing Association 213
action theory 67 anaemia 112
added fats 113 anti-fat discrimination 108
additives 135, 154 anti-GM protests 88
adipocyte hyperplasia 145 anxiety 107
adiposity 96, 211 arteriosclerosis 116n3, 145
the ‘adjacent possible’ 83, 129–30, 221 arthritis 100, 101
adulteration of food 130, 135, 154 The Art of Shopping: How We Shop
adver-games 208 and Why We Buy 157
advertising: analysis of the power of associations 137, 142
210–13; colonisation of domains attitudes 160, 208
of social life 34; and consumption austerity 128
106; as a counterbalance to habits autocatalytic process 129
132; nudging in 18; online 179; autonomous public spheres 84
supermarket 200; to children
152, 208, 209–10, see also food bariatric surgery 95
advertising; television advertising BBC survey: of social class 51
affluence 63 behaviour 39; academic research
affluent consumers 93, 113, 188, on social 92; as emerging from
194, 201 circumstances 69; government
affordability 135, 164 approaches to obesity 36, see
Africans (British) 111 also consumer behaviour; eating
age/ageing 9, 55, 101–3, 145 behaviour(s); health behaviours
Index 259
behavioural change 11, 18, 138, 144, calorie-dense foods 66, 134
164, 176, 212 calories 123, 140
behavioural economics (BE) 17, 18, 19, cancer(s) 92, 99, 100, 101, 102, 110,
40, 178, 216 111, 112, 148, 226
behavioural insight team (Cabinet capability 67, 192
Office) 17 capital: agriculture as dominated by
behavioural remedies 66 45; capacity to distort discourse 218;
behavioural weight management interaction of inherited/acquired 70;
programmes 94 social, cultural and economic 18, 53,
Bhaskar, R. 28, 29, 30, 31, 32, 35, 38, 61 72, 73, 75, see also health capital
biopower 36 capitalism: analysis of health 41; class
birth cohort studies 111 and inequality 54–5; generation of a
birth risks 100 class society 60; Marxist analysis 42;
blood pressure see hypertension production of health needs 51; and
BMI (body mass index) 9, 95, 96, 98, social change 57; systemic powers 50;
99, 100, 104 tension between democracy and 81;
bodily practices 216 the welfare state and the lifeworld
bodily reflexivity 65–6 80–1, see also disorganised capitalism;
body composition 96 late capitalism; liberal capitalism
body control 36 carbohydrates 140–1
body fatness 96 cardiovascular disease 9, 33, 96, 99,
bodyweight: deprivation and high 102, 109, 110, 116n3, 226
3; diabetes and 9; food industry carotenoids 114
response to concerns about 136; category management 211
lower status people and large 1, category switching 210, 211
32; personal responsibility 3, 6; causal structures 31
structural barriers to healthy 12, see cheese-filled pizza crusts 133
also obesity; overweight; weight gain; chemical/industrial substances 135
weight loss chewing 134
Bourdieu, P. 23, 27, 29, 44, 45, 46, 47, childhood 217
51, 53, 56, 58, 59, 62, 63, 67–77, 78, childhood obesity 6, 7, 101–2, 102,
89, 118, 119, 121, 122, 123, 126, 103, 145
130, 133, 138, 139, 143, 144, 150, children: advertising to 152; crisp
156, 164, 182, 187, 188, 190, 209, consumption 193; exercise and
217, 218, 221 weight loss 97; influence on buying
bowel cancers 99, 226 breakfast cereals 156; iron deficiency
box delivery schemes 88 114; marketing to 207–10; maternal
brand switching 210 diet and future health 145; mean
brand-based Facebook groups 106 intake of saturated fatty acids 113;
brand-promoting games 208 rewards for health eating 17
branded pages 181 Children’s Food Campaign report
brands: and class distinctions 188 (2012) 197
breakfast cereals 21, 156, 210 chilled ready meals 192
British Heart Foundation (BHF) 193, choice(s): capacity for reflection 79;
208, 210 cited by food industry in defence of
British Social Attitudes Survey its activities 142; food, drink and
(2011) 61 nature of 44–6; globalization and
budget products 196, 197 broadening of 113; habitus and
bundling 15, 143, 202, 211, 220 69; nudge theory 17–18, 19, see
Burrows, R. 8, 75, 171, 173, 174, 175, also conscious choice; consumer
177, 224 choice; food choice; forced choice;
free choice; healthy choices; lifestyle
caffeine 137 choices; personal choice/individual
calorie reduction 2, 21 responsibility discourse
260 Index
choice architecture 18 communication 34, 79, 83–5, 181
choice-editing 143 communicative action 66, 83
cholesterol 9, 10, 114, 140 competitive advantage 155
Christakis, N. and Fowler, J. 14, 92, complementary healthcare 67
104, 105, 106, 109, 169 ‘compulsiveness of modernity’ 62
chronic disease 11, 96, 97, 115 conditioned hypereating 109–10
chronic illness 95, 103, 158, 219 conscious choice 23–4, 143, 164, 165
chronic stress 107 conscious reflexivity 73
circulatory disease 9, 102, 109, 176, 219 consciousness 39; in context of
citizen: and consumer 85–6, 126 food consumption 45–6, 47,
citizen participation 84, 85 50; unreflected 79, see also class
class: capitalism and inequality 54–5; consciousness; political consciousness
and consumption 57; culture and consciousness industries 18, 143, 153
71; denial or unconsciousness of consciousness-based methods: sensory
29; diet and health 4–10, 12, 32, consumer research 165
92–116, 220–1; food and 192; food Consensus Action on Salt and Health
consumption 1; gender and ethnicity (CASH) 110, 194, 196, 197
versus 55–6; in Giddens’ work 60, constraints 75
61–2; marketing and 184, 186–90; consumer behaviour: cooperation
Marx, food and 41–50; nutrition and between economics and psychology
health 112–15; obesity, gender, age 162; tracking 124–5, 155, 169,
and 101–3; pack size 206; sociology 179–81
of 41, 50–8; statistics and drawing consumer choice 11, 127, 142–3,
of class lines 52–4; and status 56, see 189, 216
also middle classes; ruling classes; consumer culture 127
working classes consumer demand 125
class analysis 51, 52, 60 consumer economy 18, 153
class conflicts 54, 80–1 consumer groups 14, 173
class consciousness 50, 54 consumer identity 46
class cultures 52 consumer marketing 212
class inequality 53 consumer needs 154, 163, 170, 171,
class racism 76 176, 190
class relations 29, 51, 55, 81, 187 consumer panels 147
clinical gaze 93 consumer perceptions 136, 137, 211
clinical guidelines: on obesity 96, see consumer personas 169
also NICE guidelines consumer profiles/profiling 60, 64, 72,
clustering 172 73, 105, 168, 169, 171, 176, 178, see
co-creation of value 155, 156, 171 also market segmentation
co-operative (tracking) approach 180 consumer research see market research
Coalition government 2, 3, 16, 20, 21, consumer sovereignty 125, 126
82, 216, 226 consumerism 39, 64, 204–5
‘cocooning’ consumers 185–6 consumers 85–6; benefits from shift
cognitive development 70 in power to food retailers 125–6;
colonisation: of discourse by promotion consumption and differentiation of
37; of the domains of social life 34; workers and 46; learning history 143;
of institutions in the public domain recruited as field researchers 180;
207; of lifeworlds see lifeworld(s) relations with 221–2; unawareness of
commercial forces 227 true desires 163
commercial research see market consumption: and alienation 57; class
research and 57; differentiation of consumer/
commodification 89, 136 workers 46; and the division of
Common Agricultural Policy (CAP) labour 46–7; of energy drinks
108–9, 124 137; fluidity of social status 56;
Index 261
Giddens on 61–2; habitus, reflexivity Crossley, N. 28, 36, 69, 71, 72, 77,
and 72–4; identity formation 57; 105, 106
lifestyle miscellany 186; market cultural capital 53, 72, 73, 75, 190
research and investigation and cultural norms 196
reinforcement of 166–71; modernists cultural practices 68, 73
and postmodernists on 68; new cultural turn 41, 56–7
needs engineered to increase 45; cultural values 56
production and 68; as a site of social culturally targeted health information:
stratification 68; and socio-economic need for 111
groups 74, 104–5; symbolic aspects culture: capacity for reflection 80; and
57; technology and 46, see also food class 51, 71; and dietary type 74;
consumption; mass consumption; power of marketing to engage with
overconsumption 159, see also class cultures; consumer
contrastive social demi-regularity 32 culture
control 58; marketing and question of customer flow 169
156, see also body control; self-
control; technical control Darmon, N. and Drenowski, A. 112,
convenience foods 21; consumption 113, 114, 164
of 152; expansion of habitus 134; de-politicisation 51
gender and purchase of 170; low cost decision-making 165
of fats and sugars and prevalence deep discounting 226
of 124; overconsumption of ‘virtue’ ‘deeper ontological levels of enquiry’ 35
141; siting of, as an obstacle to deferred gratification 72–3
nudging 18 deformed public realm 83
cookery skills 130 DEFRA (Department for the
copycat behaviour 141 Environment, Food and Rural
corn 122 Affairs) 7, 18
coronary heart disease (CHD) 97, 98, demand creation 211
100, 111, 112, 115 demi-regularities 31–3
corporate actors 14 democracy 81, 82–3
corporate capital 126 demographic profiling 154
corporate food 87 deprivation: disease risk 9; food
corporate food science 132 consumption and high bodyweights
corporate influence 27–8 3; and mortality 29; and obesity 6, 7,
corporate social responsibility (CSR) 93, 102
48, 206–7, 213 deprived communities: marketing of
cost of food 8 fast foods in 208
cost of living study (2014) 8 diabetes 100, 145, 219; and avoidable
craving for sugar: fat and salt 123, 124 death 29; risk factors 9–10; salt
crisps 193–4, 208 intake and 110; social marketing
critical discourse analysis (CDA) 26, initiative to raise awareness of 177;
34–6, 37, 38, 84 Type-2 10, 95, 98, 99, 100, 111, 226
critical realism 26, 28, 29, 30, 31, 32, diet(s): access to health-enhancing 143;
33, 34, 37, 61 as cultural practice 68; food industry
critical reflection 79, 160 influences 14–15, 16; Giddens on
critical research: retroduction in 33–4; 62–5; individual responsibility and
values and objectivity in 37–8 choice of 11; industry solution to
critical sociology 26, 27, 28, 37, 38, 216 problematic 3; Mediterranean-type
critical theory 26–7, 38 71; role of habitus in 70; sub-optimal
critical weight studies 115 144, 147; unbalanced 146, see also
Crompton, R. 41, 48, 51, 52, 53, 56, healthy diet(s); poor diet
57, 58, 68, 72 diet-related health: class and 4–10, 12,
cross-class intervention 43 32, 43, 51, 92–116; lifestyle and
262 Index
lifestyle choices in discussions on 47; early life/years: influence of 111, 209
low fat products and 139–41; personal eating behaviour(s): automatic nature
responsibility 3; research 14, 224 of 204; factors influencing (Foresight
diet-related ill health: concerns report) 3; health effects of food
expressed by professionals 1; consumption 4; public health and
inequality, obesity and 135; lower campaigns lack of success in altering
status people and 1; micronutrient 212; research 1, 4; tension between
deficiencies 146–7; non-obese 109– health, commercial interests and
12; obesity and see obesity; pathology 144–5, see also conditioned
and timing 30; social gradient 1 hypereating; healthy eating; overeating
dietary advice 66 eating habits: public awareness of good
dietary costs 114 14; support for good 14
dietary information 192 eating patterns: addressing problematic
dietary profiling 15 societal 202; foodways and 73;
dietary reflexivity 74 product modification and altering of
dietary type 74 138; unconsciousness in 50
dieting 96, 136 ‘eatwell’ plate 7
digestion 140–1, 146, 148, 149 econometric techniques 105
digestive system 149–50 economic capital 53, 72, 73, 75
digital marketing 19 economic crisis 7
digital tracking 179–81 economic development 55
discount stores 200, 214n1 economic inequality 52, 55, 186
discounted offers 13 economic life 45
discourse(s): distortion of 218; and economic polarisation 54
food consumption 1–2; food industry economic tools: to support healthy food
3, 24, 125; and health 36; ideology consumption 14
and 37; neoliberal 10–11, 32, 227; economy: state and the lifeworld 81–2
obesity 33–4, 93, 95, 102, 103, education: and cultural practices 73;
115, 116, 123; public health 33, see and food consumption 70–1, 113;
also dominant discourse; marketing food technology 49; of healthcare
discourse; personal choice/individual staff 222–3; marketing 161, 189;
responsibility discourse and obesity 102, 104; poor diet and
discourse analysis 38, see also critical least 12; private 61; of young people
discourse analysis 223–4, 224–5
disease(s): inequality, diet and 8–10; Edwards, T. 41, 46, 57, 58, 68, 186
nutrition-related 92, 146; obesity and elites 12–14, 49, 53, 61, 81
8, 94, 98–101; rates, country-wide embodiment 76–7
differences in 114; risk 115, see also empirical reality 30
individual diseases empirical world 85, 217
disembedding mechanisms 66 employment status 53
disempowerment 191 employment-based insecurity 108
disorganised capitalism 52, 55 emulsifiers 148, 149, 151
distortions (communicative) 34, energy drinks 137–40
83–5, 181 energy-boosting products 137
division of labour 46–7, 53, 68 energy-dense foods 113, 120, 122, 163,
DOH (Department of Health) 105, 164, 170
111, 194, 226 environmental factors 104, 105
dominant discourse 88 epidemiology 27, 129; critique of
dominant ideal 47 obesity discourse 33–4; individual
dominant ideas 48, 49 choice discourse challenged by 11;
Drewnowski, A. 112, 113, 114, 122, 164 partial regularities 32; weight-health
drink(s): nature of choice 44–6, see also link 95
energy drinks; soft drinks ethical trading 127
drug treatment (obesity) 94–5 ethics 18, 38, 77, 128, 154, 202–7, 213
Index 263
ethnic stores 185 fish fingers 192
ethnicity 12, 55–6, 208 fitness 36, 97–8, 114
ethnographic research 167, 169, 172 ‘five a day’ 112
ethnomethodology 67 flavor preferences 144
Europe 109 focus groups 144, 167, 178, 188,
evolutionary preference 163 189, 198
exercise 97, 98, 115 foetal programming 70, 111
Expenditure and Food survey 176 food: adulteration of 130, 135,
experiences (consumer) 70, 142–3 154; and class 74–6, 190–5, 192;
‘experiential’ marketing 221 expenditure 6, 7; as a ‘field’ 72;
expert advice 66 fortification of 144; health promotion
extremeness aversion 202 interventions and product status
eye-tracking technology 169 165; health warnings 66; increase
in cost 8; Marx, social class and
Facebook 106, 179, 181, 210 41–50; move from knowing to using
failure (marketing) 157, 190 knowledge about 70–1; and poverty
Fairclough, N. 25n1, 34, 35, 37, 38, 135; presentation 87; product
48, 153, 207, 223, 224 development 131, 147; promotion
fairtrade movement 127 of fatty, sugary and salty 197, 198;
Family Food Survey (DEFRA) 6, 8 regulatory regimes, and obesity 108;
family profiling 176 sociology of 50–8; supermarket
farmers’ markets 88 positioning of 206; tastes in 70,
fast food(s): ethical issues 206; see also convenience foods; organic
exposure to and poor diet 222; FDI, foods; processed food(s); snack
trade and availability of 122; fried foods; unhealthy foods
chicken 195–6; low cost of fats food advertising: call for controls on
and sugars and prevalence of 124; 14; expertise 19; nutritional analysis
market freedom and low price 107; 191; restrictions on 66
marketing 208, 209; socio-economic food choice: advertising and 211;
group and consumption of 69, 176 population-wide interventions and
fast food companies 87; effectiveness access/availability to healthier 114;
of outdoor media 160; launching price and 114; sensory preferences
of non-selling health products 139; 144; sociology of 23–5
target market segmentation 157; food consuming industries (FCIs)
targeting of poorer communities 116 119–20, 170
fast food outlets 123, 127, 222, see food consumption: calculating effect
also hutch-style food outlets; vending on health 31; and class 1, 51;
machines colonisation of the lifeworld and
fast moving consumer goods understanding of 55; consciousness
(FMCG) 156 in context of 45–6, 47; and
fat: consumption 113, 114, 130, 193; construction of the food lifeworld
craving for 123, 124; digestion 78; countervailing, structural forces
146, 148, 149, see also added fats; 19; critical discourse analysis 34–6;
saturated fats; transfats; visceral fat critical realist approach 32; diabetes
fat bigotry 96 9; discourses and 1–2, 3; division
fat emulsions 148, 149, 151 of labour 47; and food industry 15,
fat stores (body) 96, 109 49, 116, 118, 125; food supply and
fat-on-sugar-on-fat-on-salt-on-fat 4; green/local 126; habitus in the
132, 134 context of 69–72; health effects/
fatty foods 163, 197, 198, 208 outcomes 1, 4, 32, 38; influence
the field 72 of early years 209; marketing and
filter monitors 180 the alternation of norms 211–12;
filters (Internet) 179 measurement of food intake and
fish 112 alteration in 31; metabolic testing
264 Index
addressing under-reporting of 143; pervasiveness of 152; reality
113–14; normalisation of new kinds in 31; research 67; systemic powers
of 158; in obesogenic foodscape of capitalism 50; urge for stronger
62; patterns, explaining change regulation of 14
and continuity in 47; personal food preferences 73–4, 144, 179
responsibility 4, 6; psychology 20, food processing 128–35; consumer
162, 163–6; purchasing power 57; centred model 131–2; and consumer
relational dimensions 35; as a routine identity 46; globalisation 150;
50; and socio-economic groups 75, health implications 147; historical
105; structure/agency 61 context 129–31; hyperpalatability
Food and Drug Administration (US) 132 132–5; substitution of cheaper items/
food governance 125 ingredients for more costly ones
food industry: activities and health 119; technology and psychology 35,
outcomes 219–20; discourse 3, 24, 131–2, see also processed food(s)
125; and food consumption 15, 49, food production 31; and pathologies in
116, 118, 125; FSA board membership the lifeworld 85–6
86; globalised 39; incapability of food provision: alternative systems
addressing risks of HFSS diets 20–1; 126–7; changing nature of 79
influences 13–14, 16, 70; invitation food quality: and classing of
to fund health promotion campaigns supermarkets 196–201; gradations of
82; lack of political leadership in 192–3; and societal structures 130
82–3; lack of research on 1; opting food retailers/retailing: consumer
out of the mainstream 126–8; as a psychology and success of 138;
productive force 49–50; publishing customer flow 169; developments and
of sales information of processed and permeation of habitus 122; expansion
snack foods 21; response to weight 121, 123; food safety 125; influence
concerns 136; responsibility for over consumption 125; as moral
dietary health 81; role in shaping diet guardians to consumer sovereignty
14–15; scepticism of strategies 164; 126; power 124, 205–6; social
solutions to overweight/overeating networking 106; tension between
146; solutions to problematic diets 3; health, behaviour and commercial
strategies for selling calories 123; urge interests 144–5, see also supermarkets
for stronger regulation of 14, see also food safety 125, 147
food retailers/retailing Food Safety Act 1990 (UK) 125
food inequalities: cross-class food science 46, 90, 121, 123, 132,
intervention 43; economic crisis and 149, 150
intensified 7 food service outlets: FDI and expansion
food intake: lean people 109–10; of 121
measurement of, and alteration Food Standards Agency (FSA) 6, 86,
in food consumption 31; unequal 111, 197
societies and 107; unreliability of food structure: and metabolism 145–7
reporting 8 food suppliers: NICE guidelines to 12
food labelling 13, 66, 140, 191, 198 food supply: agricultural developments
food lifeworlds: colonisation of 77–88, and 117–18, 119–22, 150; historical
158, 197, 202, 218; commodification continuities in 118; need for focus on 4
of dieting and alteration of 136; food food technology: education 49
processing and alteration of 132, foodscape(s) 25(n2), 47; conditioned
134–5 hypereating and omnipresent 110;
food manufacturers: preparation of geodemographics and individual
own-brand foods 125; shift of power 178; highly processed foods and
to food retailers 124 blanketing of British 118; and
food marketing: discursive element 35; lifeworld 86–7; studies 87, 202
energy-dense foods 113; expertise foodways 73–4
19; healthy foods 141; influences 24, forced choice 76
Index 265
foreign investment 120–1, 122 habitus: and choice 144; competence
Foresight report (Tackling Obesities, to operate in a given field 72; in
2007) 3, 143, 163, 165 context of food consumption/dietary
fortification of foods 144 practices 68–72, 130, 138; and
Foucault, M. 36, 88, 93 embodiment 76–7; expansion of
Framingham Heart Study 104 134, 200; factors/forces altering and
free choice 11, 38, 64, 75 shaping 121–2, 139, 150–1, 158,
freedom: influence on health behaviour 161, 196; internalized dimensions of
75, see also individual freedom; 74–5; lifestyle choices 63; permeation
market freedom through food science and retailing
fried chicken consumption 195–6 123; reflexivity and consumption 72–
frozen foods 192 4; and repetition in marketing 209;
fruit consumption: and cancer 99, 111, revealed through market research
148; health risks of low 9; income 168; scepticism of food industry
and 7, 8, 113; psychological study strategies 164; social responsibility
on 165–6; role in saving lives 112; 128; tracking behaviour and insight
teenage girls 112 into 125
functional magnetic resonance Hackley, C. 152, 153, 154, 155, 159,
imaging 162 160, 161, 162, 163, 167, 171, 181,
functional products 136, 137, 138, 151 185, 204, 212, 224
Future Forum 13 Harvey, D. 10, 11, 49, 172, 192, 216,
224, 227
gender 5, 6, 55–6, 101–3, 170, 209 Hawkes, C. 14, 33, 119, 120, 121, 122,
generative mechanisms 30, 34, 39, 124, 125, 158, 170, 197, 201, 202,
51, 182 211, 217
geodemographics 52; and the academy health: advice 12, 13, 63; awareness
173–5; and control 58; and health 197; capitalism and analysis of 41;
market research 175–7; power of and class 220–1; expertise, access to
177–8; tracking consumption 171–3 63; food consumption and 1, 4, 31,
Giddens, A. 42, 44, 47, 58, 59–67, 68, 38; information 111; marginalization,
69, 76, 77, 80, 83, 88–9 as a supply chain issue 119; obesity
global standards 120 and see obesity; processed foods and
globalisation 113, 126, 150 118–19; responsibility see personal
globalised agriculture 118, 119, 120 choice/individual responsibility
globalised food industry 39 discourse; tension between food
Google 179, 180 behaviour and commercial interests
government: approaches to obesity 144–5, see also diet-related health; ill
2, 15, 20, 36, 196; resistance to health; public health
implement higher standards for the Health at Every Size approach 115
food supply 226–7; use of market health behaviours: appearance in health
research data 8, see also Coalition research 38; class and imitation of
government; New Labour 57; psychosocial influences 19–20;
governmentality 178 role of habit and control 164; role
green consumption 126 of NHS in changing 12; UK study
grocery stores 198, 199 106–7, see also unhealthy behaviours
Guthman, J. 10–11, 126, 136, 172, 216 health capital 29
health charities 98
Habermas, J. 34, 38, 44, 54, 55, 58, 59, health foods 129
62, 65, 66, 68, 69, 77–88, 89, 118, health impact assessments: trade
122, 126, 129, 136, 155, 164, 167, arrangements 122
178, 181, 191, 197, 202, 207, 218, health inequalities: Acheson Report
220, 221, 223 3, 55; class relations 81; critique of
habit(s) 18, 27, 40, 64, 65, 132, 142, policies addressing 84; Foresight
158, 165 report 3; lack of awareness of 29;
266 Index
Marmot review 3, 114; structural heart attack 9, 95, 97
forces 29; theorising 88 heart disease 10, 92, 97, 98, 114, see
health and lifestyle survey 57 also arteriosclerosis; cardiovascular
health market research 175–7 disease; circulatory disease
health needs 51, 212 hedonic calculus 162
health outcomes: food industry hedonic research 165
activities and 219–20; NS-SEC and hegemonic power 48
prediction of 53; political ideology, HFSS (high in fat, salt and sugar) 11,
history and 93; and quality of food 20, 93, 209, 210, 211
consumption 32 hidden forces 26
health policy 27–8, 49 hierarchy of needs (Maslow’s) 159–60
health policy elites 12–14 high blood pressure (HBP) 9, 110,
health problems: of ageing population 116n3
145; low status, refined grains and high fructose corn syrup 70, 119, 122,
112; sedentariness and 44, see also 134, 148, 158
disease(s) high income 113, 114
health promotion: campaigns 82; higher status groups: diet and health
discourses 36; food industry and 32; effectiveness of health and diet
drowning out of 13; ineffectiveness messages 63; and obesity, in US 104;
of 12; interventions 164–5; public- reduction of unhealthy behaviours
private partnership 15–17 219; supermarket switching 201;
health risks: dieting 96; energy drinks supervisory role regarding diet 43
137; inequality, diet and 8–10; quantity higher status supermarkets 197
and type of food consumed 115 history 42, 56, 93
health status: of energy drinks 137; low history of food processing 129–31
fat products 140; social status and House of Commons Health Committee
107, 108 (2004) 13–14, 16
Health Surveys for England 9–10, House of Lords Science and Technology
98, 100 Committee (2011) 16, 18, 19, 144–5
health warnings 66, 94, 95 human action: Bourdieu on 68, 70, 75;
health-promoting foods 137 Giddens on 59, 60, 66; Habermas on
healthcare professionals/staff 1, 94, 55, 77, 218; market transactions and
222–3 172; Marx on 42; structural influence
healthy choices 143; dietary 217; understanding of power in
information 192; support 3 social class 54
healthy diet(s): affordability 135; hutch-style food outlets 87, 203
emerging standard for 226; hyper colonization: by pseudo food
responsibility for see personal choice/ corporations 86
individual responsibility discourse; hyperpalatability 12, 20, 132–5, 164
structural barriers to 12 hypertension 99, 100, 110, 111, 145
healthy eating: class and commitment
to 201; food industry interest in identity(ies): construction/formation
136; initiatives, response to 20–2; 46, 52, 57, 68, 75, 178, 217, see also
messages 17, 63, 124, 141; nudges self-identity; social identity
17; range of 139; rewards for 17 ideology: as common sense 48; critique
healthy eating discourse 2, 36; and 38; and discourse 37; and health
contradictions of 39; corporate social outcomes 93; nudge theory 18
responsibility 48; critical perspective ill health: class-obesity 55; explanatory
140; non-mention of class 29; policy factors 108; lower status groups
elites 12–14; underlying assumption 176; maternal ill health and 70; the
of 142, see also personal choice/ poor as responsible for their own 42;
individual responsibility discourse social gradient of 114, see also diet-
healthy foods: differing understandings related ill health
of 139; marketing of 141 impulse buying 156, 170
Index 267
incentive salience 166 late capitalism 28, 54, 80, 83
income: and consumption 73, 75; late modernity 62, 63, 84, 86
identification and measurement lean body mass 96
of social groups 60, see also high lean inactive women 97
income; low income lean people 109–10
income inequality 33, 54, 107, 108 learning history 143
individual freedom 44 liberal capitalism 54, 77, 78
individual initiative 42 libertarian paternalism 17
individualisation 52 life chances 53, 63, 175, 188
individualised serving sizes 210 life expectancy 1, 9, 95, 103
individualism 52, 64 lifelong dietary patterns 208–9
indulgent foods 73, 93, 166 lifestyle weight management 94
industrial foods 123–4 lifestyle/lifestyle choice: appearance in
industrial workers 42, 44 health research 38; and cancer 30;
industrialisation 85, 130 change, evidence review on 163–4;
inequality see social inequality cited in discussions on diet-related
infant obesity 70 health 47; diabetes and avoidable
input-manufacturing firms: fusing of death 29; Future Forum focus on 13;
agribusiness and 120 Giddens on 62–5, 63; marketing and
institutional reflexivity 65 160, 190; Marx and 47–50; spatial
insulin resistance 111, 116n3 disconnectedness of modern life 62
‘integrated set of practices’ 64 lifeworld(s): colonisation 55, 62, 65,
interacting systems 44 69–70, 122, 167, 178; distortion of
internalization: of habitus 71 79, 80; permeation of marketing 155,
international agreements see also food lifeworlds
(agricultural) 120 ‘limited edition variants’ 156
intra-abdominal fat stores 96 limited reflexivity 79–80
Ireland 123, 210 lipid consumption 113
iron 112, 114 lipid digestion 149
liver disease 101
justice: Rawl’s theory of 66 living conditions 42, 188
local consumption 126
Kahnemann, D. 165, 183n1 local food movements 88
Kessler, D. 109, 110, 124, 132, 134, locally prepared foods 130
135, 136, 139, 147, 156, 158, 163, location: of food outlets 195; and
166, 201 lifestyle 62, see also geodemographics
kidney disease 10, 110 London 87, 102
Kids Brand Index (2011) 208 long-term illness 103
King’s Fund 12, 219, 223, 227 longevity 28
knowledge: capacity for reflection 80; low fat products 139–41
of consumer behaviour 156; critical low income: affording a healthy diet
research 38; geodemographics and on 135; class and consumption 191;
use of 177–8; move from knowing dissatisfaction with limited options
to using 70–1, see also scientific 76; fast food consumption 176;
knowledge; technical knowledge fat consumption 113, 114; food
Koster, E.P. 143, 165 expenditure 6, 7; fruit and vegetable
consumption 113; non-milk extrinsic
Labour see New Labour sugar intake 7–8; poor diet 1, 9,
labour-capital-exploitation dynamic 52 12; price and food choice 114; and
land enclosures 130 unhealthy behaviours 12
Lang, T. 14, 18, 86, 120, 143, 153, 207 Low Income Diet and Nutrition Survey
language: lifeworlds structured through (LIDNS) 6, 113
78; and marketing 160, 181, 192, low self-esteem 19, 20, 67
212–13, 219 low-fat dairy products 112
268 Index
lower status groups: and diet 32, market segmentation; to children
42, 112, 113, 164, 176, 192; 207–10, see also advertising; digital
disempowered tendency to self- marketing; food marketing; social
restrict 190–1; health/ill health marketing; targeted marketing
1, 32, 55, 176; likelihood of marketing discourse: challenge to 25;
overconsumption 206; and pack class in 188; concealing of inherent
sizes 158–9; unhealthy behaviours power 161; language 181; meeting
219, 227 of customer needs 170, 171; product
lower status supermarkets 196 longevity 157; reference to marketing
loyalty cards 125, 201 categorisations 186; self-referentiality
lung disease 111 152–3; social relations 171
Marketing Magazine 19, 157, 173, 189,
macromarketing perspective 213 198, 207, 210
macronutrient imbalances 146 marketing mix 154, 169, 195
macrosocial forces 9 Marmot, Sir M. 3, 9, 55, 80, 102, 103,
magnesium 112 108, 111, 114
male obesity 55, 102 Marx, K. 41–50, 57, 60, 68, 69, 70, 81,
market freedom 11, 18, 33, 107, 216 85, 187, 209, 216, 217
market liberal countries 107–8 Maslow’s hierarchy of needs 159–60
market liberalisation 10, 11, 119 mass consumption 85, 254
market research: absence from mass production 127, 154
individual and public policy material reproduction of the lifeworld 85
understandings of dietary health maternal diet 108, 145
39; cooperation between academic maternal ill health 70
research and 224; data 8, 23, 224; meal deals 13, 15, 158, 181, 202,
expertise 15; food consumption 211, 219
182; food product development meat consumption 148
131; geodemographics see media 56, 84, 106, 160
geodemographics; governmentality medical construction: of the ideal
178; investigation and reinforcing body 96
consumption behaviour 166–71; medical profession 96
people’s interaction with food supply medical sociology 28, 35, 36, 41, 51
72; recruitment of consumers as Mediterranean-type diet 71
researchers 180; social class in 187; metabolic disease 109
social networks/networking 106; metabolic health 96, 97, 115
transactional technologies 175, see metabolic risk factors 99
also health market research metabolic syndrome 98, 116n3, 149
market segmentation 56, 154, 157, metabolic testing 113–14
185–6, 198 metabolic ‘triage’ 146
marketing: academic legitimacy 159; metabolism 145–7
AMA definition 213; behavioural micronutrient deficiencies 146–7
economics 19; and class 57, 184, middle classes 53, 67, 73, 74, 185, 189,
186–90; colonisation of domains 192, 200
of social life 34; and consumption Millstone, E. 21, 86, 148
106; ethics 38, 154, 202–7; failure minimum alcohol pricing 226
157, 190; and generations-old food mobile handheld devices 180
preferences 73; historical context mobility see social mobility
153–5; ‘integrated set of practices’ modernity 62, 64, 66, see also late
as a basis of 64; language 160, 192, modernity
212–13, 219; managerial discourse Monaghan, L. 93, 94, 95, 96, 98,
159; messages 160; nudging in 18; 108, 116
power and weaknesses of 155–61; moral debate: consumerism 204–5
psychology and 161–3; relations with motivation 3, 19, 143–4, 154–5
consumers 221–2; segmentation see multi-vitamin supplements 147
Index 269
multidisciplinary (marketing) approach nutritional analysis: food
159–60 advertisements 191
multilateral institutions 11 nutritional information: alertness to 65
multiphase mixtures 146 nutritional quality: of diets, and social
multivariate statistical research 188 class 6
Murcott, A. 22, 23, 172 nutritious-conscious group 73
muscle mass 145 nuts 194
National Centre for Social Research/ obesity 20; bariatric surgery 95;
MRC study 111 challenging link between ill health
National Child Measurement and 93–6; clinical guidelines 96;
Programme 102 concerns expressed by professionals
National Consumer Council (NCC) 1; diet and class 93; diet and social
196, 197, 214n2, 222 class 12; diet-related ill health
National Diabetes Audit 29 4; discourse 33–4, 93, 95, 102,
National Food Survey 74 103, 115, 116, 123; disease risk
National Health Service (NHS) 12, 97 8, 98–101; drug treatment 94–5;
National Heart Forum report 100 emulsifiers and 148, 149; energy
National Obesity Observatory 93 drinks and 137; fitness and health
National Statistics Socio-Economic 97–8; food-based scientific research
Classification (NS-SEC) 52–3, 186–7 135; Foresight investigation
The Nation’s Diet (1998) 23, 24 (2007) 3; gender, age and class
necessity 75 101–3; government approaches
needs: Maslow’s hierarchy of 159–60, 2, 15, 20, 36, 196; growth in 4,
see also consumer needs; health 5; industry influences 13–14; and
needs; new needs inequality 107–9; mortality rates
neighbourhood location 104, see also 95, 97; mortality risks 115; NICE
geodemographics guidelines 223; palatability and
neo-positivisms 28 hyperpalatability 135; professional
neoliberalism 10–11, 32, 35, 57, 119, background and 103, 114; Public
125, 152, 172, 227 Health Responsibility Deal 16;
Nestle, M. 14, 140 role of marketing on future 212;
neuromarketing 162 sedentariness and 44; social gradient
New Labour 3, 59, 63 1, 4–6, 55, 92, 105, 135, 170; and
new needs 45 social networks 92, 103–7; strategies,
new social physicists 106 as counterproductive 94; structural
NHS 12, 97 factors in rising 13, see also
NICE guidelines 12, 94, 95, 96, 111, 223 childhood obesity; infant obesity
non-milk extrinsic sugars 7–8, 113, 226 Obesity Reviews 95
normalisation: of consumption 158, 193, obesogenic environment 13
209, 211, 219–20; of ideologies 37 obesogenic foodscape 12, 62, 86
norms: marketing and alteration of objectivity: in critical research 37–8
143, 211–12; self-serving 206, see observational research 168, 172
also cultural norms; social norms occupation 52–3, 60, 102
Nudge: Improving Decisions About Ofcom 209
Health, Wealth and Happiness 17, office workers 44
92, 216 older people 95, 110, 113, 114
nudge thinking 14, 17–20, 37, 40, 87, olfactory preferences 144
163, 165 online advertising 179
Nurses Health Study 99 ontological security 64
nutrient-poor foods 69, 170 operant conditioning 211
nutrition 27; health and class 112– opportunity: and healthy choices 3
15; influence of agriculture and oppression 26, 63
agricultural subsidies 108–9 organic foods 88, 127–8
270 Index
osteoarthritis 101 political consciousness 83, 129, 221
osteoporosis 110, 112, 145 political engagement 221
outdoor media 160 political leadership 82–3
overconsumption 9, 71, 141, 206 politically effective discussion 83
overeating 36, 146 politicized citizen 126
overweight 95, 146, 220 poor diet 97; and class 12; disease risk
own-brand products 125–6 9, 92, 174; exposure to fast food
222; holistic intervention 219; low
pack sizes 158–9, 206 income/status 1, 9, 12, 164, 176;
packaging 166, 194 origins of 130–1
palatability 147, 158, 164–5, see also poorer communities: fast food
hyperpalatability companies and targeting of 116
palm oil consumption 122 population-wide interventions 114
parental influence 208–9 Porgrow study 109
partial event regularity 32 positivism 27, 28, 30, 32
partial, post-event rationalization 31 post-Fordism 52
participatory action research 168 post-industrialism 52
partnership governance 16 postmodernism 28, 56, 57, 68
pathologies in the lifeworld 85 postprandial metabolism 146
Patients’ Association 13 potassium 114
peasant: separation from the soil 45 poverty 13, 42, 64, 102, 135, 171
peer support: weight loss 105, 106 power: of advertising, analysis of
perceptions (consumer) 136, 137, 211 210–13; of corporate actors 14; of
perfect panopticon 178 experiences 70; of geodemographics
person-to-person interaction: and 177–8; health effects of food
obesity 105 consumption 38; hegemonic 48;
personal autonomy 66 marketing discourse 161; medicine
personal choice/individual responsibility and weight loss industry misuse of
discourse 29, 39; bodyweight 3, 94; of retailers 205–6; shift from
6; challenges to 11, 92, 93; food food manufacturers to food retailers
consumption 4, 6; government 124, 125–6, see also biopower;
backing of 12, 15, 16, 20; healthy purchasing power; systemic powers
eating 2, 3, 6, 48; inability to explain power elites 81
class-related dietary patterns 4; precariat 53, 105
lifestyle 63; neoliberalism 11, 32, pregnant mothers 100, 107, 112, 114
227; obesity 6, 36; persistence/ premium foods 166, 194, 197, 198
mobilisation 40, 216; policy presentation of food 87, see also visual
elaboration/justification 13; state cues
intervention as unnecessary 50; prestige pricing 154
televised interventions and 43 price/pricing 13, 107, 114, 121,
personalisation 179 147, 154
pharmaceutical industries 115 privacy 168, 177
pharmacological agents: energy private autonomy 85
drinks 137 privatisation of food governance 125
physical activity 98 processed food(s): alternatives to 88;
physical inactivity 9, 97 blanketing of British foodscapes
physical strength: association of energy 118; call for calorie reduction
drinks with 137 21; colonisation of diets 78; ease
pizza hierarchy 193 of chewing 134; FDI, trade and
pizza stylings 132–4 availability of 121, 122; health
place see geodemographics effects 118–19; insulin resistance
pleasure/pleasure seeking 163, 166 111; lower priced 147; Public Health
policy see public policy Responsibility Deal pledge 16;
political autonomy 85 publishing of sales information 21;
Index 271
salt intake and 111; survey of pie, Public Health Responsibility Deal 16, 194
mash and gravy 197–8, see also food public policy 28, 33, 39; nudge thinking
processing in 17, 18, 19, 37; tracking influence
‘processes of unlearning’ 78, 223 of elite on 49, see also agricultural
producers (alternative) 126–8 policy; health policy
product developers 167 public sector geodemographic
product development 131, 147, 168 approaches 172
product differentiation 154 public space(s) 19, 22, 72, 86, 87, 160,
product failure 157 222, 223, 226
product innovation 78, 119, 133, 134 public sphere(s) 84, 85
product longevity 156, 157 public-private partnerships 15–17
product modification/reformulation 21, purchasing power 19, 57, 186
134, 139, 150, 158
product siting/positioning 18–19, 21, qualitative research 33, 167
157, 198, 206 quality of diet 6, 32, see also food quality
product size/sizing 21, 159, 210 quantitative research 33, 87, 188
product success 157
product variants 157 readiness to change 164
production: and consumption 68; as ready meals 124, 131, 192
determining force of social life 45; refined foods 112, 113, 134
technology and 46, see also food reflection 80
production; mass production reflexive body 65–6
productive forces 44, 45, 49–50 reflexivity 39, 44, 52, 192; Giddens
professional background: and obesity on 59–67; habitus and consumption
103, 114 72–4; limited 79–80
projective techniques 144 Registrar General’s system:
promotional discourses 34 occupational rankings 52
promotional information 201 regulatory capture 49, 86, 91n3
promotional intent 34–5 regulatory quality 108
promotional organisations 86 repetition: in marketing to children 209
promotional pricing 121 research: areas for future 224–5; data 8;
promotions 202 diet-related health 14, 224; on eating
prompted choice 19 behaviours 1, 4; on food industry 1;
protein content: and metabolism 145 food marketing 67; points of entry 2,
provocative threat 78, 79 25n1; textual approach 218; use of
pseudo foods 86, 202 choice in relation to diet 142, see also
psychographic testing 161–2 academic research; critical research;
psychological experiences: low status, market research; sensory consumer
consumption and ill health 29 research
psychological responses: hyperpalatable Researcher’s Guide to the National
foods 132, 133 Statistics Socio-Economic
psychology 27; food consumption Classification 53
20, 29, 163–6; in food processing resistance: of industry to public health
131–2, 134; Freudian 154–5; market interventions 225; to association
failure and study of consumer 157; of obesity and ill health 93–6; to
and marketing 159, 161–3; nudge ban on transfats 225; to lifeworld
thinking 17; and retail success 138 colonisation 87–8; to political
psychosocial influences 19, 28 engagement 221; to weight loss 163
public debate 34 responsibility: acceptance of 66; of food
public health: campaigns 212; discourse industry for dietary health 82; health
33; interventions 219, 223, 225; lack effects of food consumption 38,
of cooperation between agriculture see also personal choice/individual
and 119 responsibility discourse; social
Public Health England 226 responsibility
272 Index
retail licensing measures 14 self-identified class 189, 190
retailers see food retailers/retailing self-identity 64
retroduction 33–4, 35 self-improvement 11
rewards: for health eating 17 self-reliance 11
routines(s) 40, 50, 64, 69 self-reported fitness efforts 98
ruling classes 48, 49 self-restriction 191
sensory consumer research 165
sales: promotions and increased 202 sensory enhancement 132
salt: academic-commercial study 224; sensory preferences 144
craving for 123, 124; health risks 9 severe obesity 4, 5
salt consumption: average daily 21; size acceptance movement 93–4
and health 110–11; individual Skalen, P. 152–3, 154, 159, 161, 162,
responsibility 15; recommended daily 163, 167, 204
intake 21 Skeggs, B. 41, 51, 52, 56, 57–8, 62, 63,
salt content: curry products 194; 64, 67, 73, 79, 93, 181, 192
Kellogg’s breakfast cereals 21; small world problem 105–6
sausages 196–7, 198; Waitrose steak smart phone technologies 180
pies 197 smoking 97, 110, 115, 219
salty foods 197 snack foods 21; consumption 69, 71,
sandwiches 192 152, 158; displays 197, 202, 204;
satiety 135, 146, 149, 163, 164 ethical issues 206; expansion of
saturated fats 33, 109, 112, 113, 114, habitus 134; gender and purchase of
197, 208 170; publishing of sales information
Savage, M. 8, 41, 48, 50, 51, 52, 53, 21; siting of, as an obstacle to
54, 55, 56, 58, 60, 90, 105, 171, nudging 18; vending machines and
174, 175 spread of 127
Scambler, G. 28, 29, 32, 33, 37, 38, 41, social action 77
48–9, 51, 55, 61, 69, 75, 80, 81, 84, social area analysis 171
88, 90, 216 social capital 18, 53, 72, 73
Scambler, S. 61, 80, 84, 88, 90 social change 51, 57, 59, 83, 127, 216
school meal campaigns 88 social class see class
science 45, 82, 137; and agriculture social constructionism 94, 96, 175
120; capacity to distort discourse social division of labour 53
218; and health-promoting foods social elites 61
137; transcendental analysis 31, see ‘social exclusion’ discourse 63–4
also food science social identity 47, 63, 178
Scientific Advisory Committee on social inequality: class and capitalism
Nutrition (UK) 111, 225 54–5; diet and health 8–10; the field
scientific information 82–3 as characterised by 72; NS-SEC and
scientific knowledge 26, 137 incomplete portrayal of 53; and
scientific progress 83, 129, 220 obesity 107–9, 135, see also class
sedentariness 44, 103, 110, 145, 219 inequality; economic inequality;
segmentation: public health food inequalities; health inequalities;
interventions 223, see also market income inequality
segmentation social marketing 176, 177, 211–12
self-actualisation 11, 63, 159–60 social mobility 47, 52, 57–8, 60, 61
self-assessed bodyweight 98 social movements 88
self-control 11, 216 social networks: energy drinks and
self-deception 88 targeted marketing 138–9; in food
self-efficacy 11 context 170; obesity and 92, 103–7;
self-employment 52 as a rich source of data 179
self-esteem 19, 20, 29, 66, 67 social norms 17, 71
self-governance 10 social organisations 85, 106
Index 273
social psychologists 143 state: economy and the lifeworld 81–2;
social relations 35, 47, 106, 171 intervention 11, 16, 50; manipulation
social responsibility 128, see also of communication 84; organisations/
corporate social responsibility campaigns 86
social safety nets 108 state sovereignty 125
social scientists 14, 24, 26, 33, 116, statistical classifications (socio-
175, 182 economic) 52–3, 175, 186–7
social stratification 65, 68 status 61; and class 56; consumption
social theory: and the empirical and fluidity of 56; of food products,
world 217; food production, food health promotion studies and 165,
consumption and social class 40–58 see also employment status; health
societal developments: and threats to status; socio-economic status
the lifeworld 78 status groups: and consumption 56, 62,
societal structures: and quality of see also higher status groups; lower
food 130 status groups
society: power of marketing to engage stimuli foods 132
with 159 stockpiling: of low fat foods 141
socio-economic groups: fat stomach cancer 110
consumption 113; fitness levels 114; stress 107, 108
marketing and food consumption stroke 9, 10, 95, 100, 110, 111, 112
194; marketing and references structural factors 93; barriers to healthy
to 188; neighbourhood and diets and bodyweights 12; food
consumption pattern 104–5; salt consumption 19; health inequalities
intake 110; sausage consumption 29; limiting of mobility 61; rising
74; snack and fast food obesity 13; shaping of habitus 122
consumption 69 structural inequalities 54
socio-economic indicators 53 structural influences 56, 78, 82, 217, 227
socio-economic status: cognitive structuration theory 61, 65
development 70; diet 32, 112; health structure 61, 69, 77
107, 108; health inequalities 3, sub-optimal diets 144, 147
55; higher BMI in adulthood 102; subconscious urges 155
lifestyles 65 subcutaneous fat 96, 109
socio-residential patterning 172–3 ‘subjective and accidental character of
sociological determination 67 uncomprehended events’ 86
sociology 28, 29, 40, 56, 217; of class sugar: craving for 123, 124; masking of
and food 23–5, 41, 50–8; marketing’s unpalatable tastes 140
plundering of 159; Mosaic sugar consumption: doubling of (1860-
classifications and 175; on pleasure/ 1960) 130; England 108; healthy
pleasure seeking 163; preoccupation eating messages and reduced 124;
with body control 36; and reflexivity salt intake, drinks and 110; sugar
67, see also critical sociology; information, food labelling and
medical sociology decreased 191–2; toxicity of long-
soft drinks 99, 100, 111, 119, 158 term 148
soybean market 121, 122 sugary foods 197, 198
spatial turn 175 Sunstein, C.R. 17, 92, 104
spheres of activity (labour-related) 46–7 supermarkets: alternatives to 88;
The Spirit Level: Why More changing role of 124–6; consumption
Equal Societies Almost Always patterns 118; and demand for
Do Better 107 processed foods 121; food quality
‘staged or manipulated publicity’ 84, 85 and classing of 196–201; planning
stalketing 206 permissions 123; refrigerated ready
standards 11, 14, 44, 120, 125, 126, meals 192; research in 169; and
162, 226 segmentation 185
274 Index
supersizing (packaging) 206, 225 transfats 114, 121, 208, 225
supply side factors 14–15 transnational corporations 49, 120–1
surveillance 93, 177, 178, 180, treadmill fitness tests 97
181, 206 Type 2 diabetes 10, 95, 98, 99,
sustainability 76 100, 111
Sustain’s Children’s Food Campaign
report (2012) 197 unconscious nature: of consumption 50,
symbolic capital 72 69, 143–4, 157; of social action 77
symbolic practice 71 unhealthy behaviours 107; health
System 1 and 2 (Kahnemann’s) 165 research and focus on 12; and low
system: uncoupling from the lifeworld income 12; persistence of 19; status
80, 81 groups and 219, 227
systemic powers 50 unhealthy diets 15, 32, 65
unhealthy foods: availability , and
take-away foods 113, 129, 176, see also likelihood of consumption 19;
fast food outlets marketing of 13, 210; toolkit for
targeted consumer research 167–8 monitoring marketing to
targeted marketing 19, 125, 138–9, 180 children 208
targeted mental imagery 166 United Kingdom 7, 8, 54, 123, 137,
targeted promotional information 201 202, 210, 222
taste(s) 56, 70, 71, 75–6, 130, 190 United States 99, 104, 210, 222
technical control 82, 178 up-sizing 211
technical information 82–3 upmarket crisps 194
technical knowledge 82, 83 upmarket retailers 198
technical progress 77, 82, 83, 129,
147, 220 value (co-created) 155, 156, 171
technological development 82, 119 value products 196, 197
technology: in agriculture 120; and values 37–8, 56
capacity to distort discourse 218; vascular disorders 100
democracy and lifeworld 82–3; vegetable consumption: and cancer
Habermas on 77; health-promoting 99, 111, 148; decline in 113; health
foods 137; market research 175; risks of low 9; income and 7, 8,
production and consumption 46, 47; 113; role in saving lives 112;
and psychology in food processing teenage girls 112
131–2, 134, see also eye-tracking vegetable oils 122
technology; food technology vending machines 87, 127, 137,
telemarketing 169 138, 204
televised interventions 42–3 ‘vertical integration and sourcing’ 121
television advertising 170, 208, 209–10 visceral fat 109
tendencies: and demi-regularities 31–3 visual cues 87, 166, 197, 202
Thaler, R.H. 17, 19, 92, 103
thinness 96 waist circumference 96, 98
tinned foods 130 waist obesity 99, 107
toxicity(ies) 147, 148 weak satiety 163, 164
tracking: consumer behaviour 124–5, ‘weak theory’ of advertising 211
155, 169, 171–3, 179–81, 185; the weight see bodyweight
foodscape 87; influence of elite on weight gain 12, 22, 30, 86, 104, 107,
policy 49 140, 141, 145, 163, 202
trade arrangements: health impact weight loss 97, 99, 105, 106, 115, 163
assessments 122 weight loss industry 94, 115
trade liberalisation 121, 122 welfare state 54–5, 80–1, 85
transcendental analysis of science 31 well-being 213, 219
transdisciplinary research 35 Whitehall study see Marmot
Index 275
whole grains 112 World Cancer Research Fund (WCRF)
‘will to govern’ 36 96, 98, 99, 111
Winson, A. 25n1, 86–7, 197, 202, 211 World Health Organization (WHO)
women 97–8, 194, see also pregnant 109, 141, 208
mothers World Obesity Federation 14
word of mouth 169–70
working classes 53, 130, 185, 189, young people: educating 223–4, 224–5,
190, 200 see also children
eBooks
from Taylor Est Francis
Helping you to choose the right eBooks for your Library
eCollections eFocus
Choose from 20 different subject We have 16 cutting-edge interdisciplinary
eColiections, including: collections, including:
~l ~:
-I ' •
J' '0
,,11 j).
:.~
Econom ICS ~~ •••
Health Studies Islam
•• Korea •
••••••• • • • •
www.tandfebooks.com