Translator: Ana Filipa Wong Reviewer: Ellen Maloney
Good evening, ladies and gentlemen.
There's an old saying that is older than every single person
in this room tonight, that says: "You are what you eat".
It dates back to 1826 in France,
and the first printed phrase of this, in English, was in 1923,
almost a full century ago.
We know that we are what we eat, we understand this,
we watch TV programs about it all the time.
But what are we actually doing about it?
At the moment, the food that we eat today is our choice.
We choose the food that we put in our supermarket trolleys.
yet there are huge numbers of us that continue to fill our trolleys
full of foods that we know are inherently bad for us.
Does this have consequences?
Yes, it does and I'll talk about them today.
But what if I ask you this question:
Will the choices that we make about the foods
that we put in our shopping trolleys today, limit or even eliminate
the kind of choices that we might have about our food in the future?
In order to answer this question,
we need to look at what's happened to our food,
we need to look at what's happened to our food choices,
and we need to look at what's happened to us.
When was the last time you were in the supermarket?
The choice of foods can be overwhelming for some,
but is our supermarket experience really different this century
than it was last century?
If we look at a picture like this, where we see people shopping in the 1950s
and shopping now, we might say there's not much difference.
If we look at another picture and look at some of the products
that people were buying in the 1950s,
staples like eggs, bread, milk, cheese,
hugely dependent on the dairy industry,
we might say, "Well, those are the kind of things we buy in supermarkets today."
But if we look more closely, we have choices in our supermarkets today,
that we couldn't possibly have imagined in the last century.
We have foods that are fortified with extra vitamins.
We have foods that are full of Omega-3 fats.
We have foods with cholesterol-lowering properties,
and we even have foods stuffed full of probiotic bacteria.
We could never have imagined this in the last century.
These are our new foods, these are functional foods,
these are the types of foods that confer extra health benefits to you,
over and above the nutritional value that they serve when you eat them.
Other foods have boomed over the last century,
the era of processed foods.
And if we look at these foods,
we see that, almost every week in the supermarket,
there's a new processed food on our shelf.
What's different about these foods?
How have these foods changed?
Well, one key change that's happened in these foods,
is what I call the "trans fat revolution."
Trans fats are made when you take oils,
you put them through a hydrogenation process,
and you turn them into a solid state.
These are really good for putting in processed foods.
They give food structure, texture, taste,
and they even lengthen the shelf-life of food.
And they are cheaper.
These are every food-manufacturers' dream ingredient.
But let's look at what's happened to trans fats over the last century.
1911 was the first time that trans fats were publicly available to buy.
Skip forward a couple of decades later,
and let's look at something significant that happened in 1943
around trans fats: World War II.
Glycerin was needed to make explosives.
Glycerin is made from fats.
Butter is essentially fat.
The U.S. government asks the Americans to support their troops
by not eating butter, and instead, eating trans fat alternatives.
So, the sale of trans fat alternatives went through the roof during this decade.
Because they were a cheaper alternative, people continued to buy them
long after the war was over.
And decades later, health experts even said
that these trans fats were really, really good for your health.
And started to brand saturated fats and animal fats, as the demon.
If you look at the cover of "The Times" magazine in 1984,
what you'll see is that animal fats and saturated fats are demonized.
Decades later, after the integration of these trans-fats
into so much of our food chain,
trans fats became the new bogey man of the food world.
Scientific research said: "Trans fats are really bad for your health,"
and this research became so convincing over the following decades,
that last year, in 2015,
the FDA actually banned trans fats,
and they've given food manufacturers everywhere
three years to take them out of their products.
What else happened during this time?
So, we were told that animal fats and saturated fats were really bad for us.
And there was the dawn of the low-fat era.
Food manufacturers everywhere jumped on the bandwagon
and started making low-fat versions of absolutely everything.
Now, we all know that fat tastes really good.
That's why we eat it.
So why, when we took all the fat of these foods,
did they not taste like cardboard?
Well, if we look very closely at the label and zoom in,
we see that, yes, the saturated fat contents of these foods are very low,
but look at what happened to the sugar.
In order to maintain the taste of these foods,
manufacturers pile sugars into all these low-fat alternatives.
And we all know now that sugar is the new bad kid on the block.
So, we changed the amount of fat we were eating,
we changed the type of fat we were eating,
but what happened to us while we were doing all of that?
Most of you will have seen a picture like this before:
It depicts the evolutionary timeline of man.
It took millions of years for this evolutionary timeline to happen.
But look at what's happened in the last century,
as we changed our food.
We've pushed that timeline further.
So, when the era of looking at the kind of fat we were eating
and thinking we were doing the right thing by changing it,
what happened to obesity?
Low-fat guidelines came in in the 70s,
and obesity rocketed in the decades that came afterwards.
In parallel with that,
the incidents of chronic disease all over the world went through the roof.
And this trajectory is set to continue over the coming decades.
These chronic diseases that I'm talking about are diabetes,
cardiovascular diseases, cancer, inflammatory diseases,
neurological diseases, all on the rise.
And a scary statistic is that almost 50% of the world's population
now has at least one of these diseases.
So, is this just happening in adults?
What about our future generation?
What are our children eating?
What is their life expectancy?
This is a scary infographic.
I'm only going to point at one statistic on it,
and that in U.S. children in the last decade alone,
the incidents of juvenile diabetes had increased by 23%.
Juvenile diabetes is driven by food choices and lifestyle choices.
These children have no choice about what they're eating.
Their parents are making these choices for them.
What's the life expectancy for these children
when they're starting off with this health status?
What quality of life can we expect for these children?
This is Freida. Freida is my Nana.
She lived until she was a 101, with a life free of chronic disease.
Huge amount of this was down to the lifestyle choices that she made,
and the food that she ate.
Can these children really aspire to live the life that Freida did
and have that quality of life?
You may say that, looking at these health stats,
the answer is no.
But the real question is, can we change their destiny?
So, we changed all our food,
we had a massive impact on our health status,
and now 50% of the world's population lives with chronic disease.
So, it is really clear that food has had a massive influence.
Now, food is not the only thing that determines our health.
Our lifestyle choices, where we live in the world,
and indeed, what's written in our genes.
But the difference about food is that it's a choice that we make.
So, why do I care?
I'm an immunologist. I study the immune system.
What's all this got to do with fats and chronic disease?
Well, it turns out, a lot.
This is why I'm interested. This is fire.
All the fats that I've been talking about
are able to light a fire in your immune system,
and switch on a process called "inflammation."
Now, inflammation is a really good process to have switched on
when you get bacteria and viruses invading your body.
But, the way in which your body sees these bacteria and viruses,
is the same way that it can see and recognize fats
that you put into your body.
So, when you eat these fats,
they activate your immune system to light this fire,
drive this inflammation, and keep this inflammation switched on.
So, why is this a problem?
Why do we care so much about inflammation?
What's it got to do with all this "chronic disease" I keep mentioning?
Well, we now know that inflammation is, basically
the driver of all of these disease states.
When you switch on inflammation,
you make yourself susceptible to developing cancer,
diabetes, cardiovascular disease, and a whole host of other diseases.
What we need to do is make sure
that we find ways of extinguishing this fire,
and making sure that we don't have inflammation that gets out of control.
This is a real chance for us to be able to try
and change the line that's on this graph,
try and change the trajectory of where chronic disease is going.
And make a line look more like this.
So, that's a lot of bad news.
A lot of bad news about fats,
a lot of bad news about our chronic disease, and it's at epidemic proportions.
So, I hear you ask, "Is she going to tell us any good news?"
And the short answer is "Yes."
So, scientific research showed us
where trans fats were really bad for your health.
They show that they were detrimental.
But the same scientific research is showing
what might be good for your health in our food products.
And there is the dawn of the era of good fats.
At last, we have fats that are good for us.
We've probably all heard of Omega-3's.
And food manufacturers, once again, jumped on the bandwagon
and fortified as many foods as possible with Omega-3's.
What's great about these Omega-3's?
These are also fats that are recognized by your immune system.
Except they don't light the fire of inflammation,
they extinguish that fire.
They are anti-inflammatory.
So, they pose a real possibility for us to be able to control that inflammation,
to be able to try and prevent, and lower our risk
for developing those chronic diseases in the first place.
They're part of the functional food family that I showed you at the start.
We've all heard of these functional foods,
we see ads on the telly all of the time telling us,
"They're good for your heart, for your brain health,
they're good for your gut health."
These functional foods
have been a revelation for food manufacturers everywhere,
because they've shown that science sells.
When you have a food product,
that has scientific evidence to show that it confers a health benefit,
And indeed, the functional food market has exploded in the last decade,
and is set to grow exponentially over the next few decades.
But scientific research has also looked at naturally occurring foods.
What's happening in other foods
that might be able to suppress this inflammation?
And we now know that there are a whole host of anti-inflammatory foods
that, if we consume, can again be recognized
by your immune system and suppress this inflammation
thereby, lowering our risk for chronic disease.
There's real power in foods. But did we not know this already?
Well, Hippocrates did.
Back in 431 BC, he said,
"Let food be thy medicine, and medicine be thy food."
This was long before we had the research know-how,
and even the technology to be able to prove
that this, in fact, might actually be true.
So, what does the future look like?
If you trawl through the Internet and look for what our futuristic shopping
might be like in the future, you'll find pictures like this:
Nice, neat rows of food with displays overhead,
giving you every piece of imaginable information
that you might want about that food.
Where it was sourced, where it was grown,
the nutritional value, added health benefits,
how often should you eat it, when should you eat it.
This is all futuristic shopping.
Some pages on the Internet go as far as to suggest that
we'll have 'drive-thru supermarkets'
where you don't even need to leave your car.
But what'll happen when we walk into a supermarket in the future,
if functional foods are giving us a real possibility
to be able to control our health?
The aisles that we have in the supermarket at the moment;
what will the new aisles look like?
Now when you go into a supermarket,
we have aisles you probably didn't see ten years ago.
Gluten-free, organic, whole foods.
Aisles with different foods that we never saw before.
So, what would our futuristic shopping experience be like?
What if we categorised our food
according to the health benefit it had?
Could you actually go down an aisle of foods
that were all good for your heart?
Or improves your metabolism, improves your brain health,
and lots of other things beyond?
Is this a real possibility?
Will we have the freedom to be able to choose the foods
that we think confer a health benefit to us?
But wait,
don't we have that freedom already?
Don't we know what food is good for us?
And yet, chronic disease is at epidemic proportions.
What are we really doing with our food choices?
Now, the development of what happens with our foods
and our future shopping market experience,
won't happen in isolation.
It will happen in the midst of major global challenges that we're facing today.
One of those is aging.
All of our populations are getting older around the world.
If we look at the stats just for Ireland, we will see that by 2050,
there will be 1.4 million of our citizens over the age of 65.
And with increasing age
comes increasing incidence of chronic disease.
What else might happen and develop over the next century
in tandem with this?
Well, there will be an explosion of technology.
We've already seen what's happened in the last 100 years.
We use technology today that we couldn't have even envisaged 100 years ago.
So, what will our technology look like in the future?
We're all starting to wear FitBits,
people are starting to take notice of their own health.
We now have technology that will measure and monitor our own health,
and give us some information and feedback.
A possibility in the future
is that we will be able to have wearable technology,
that will be able to detect every single aspect of our health,
real time, every single day.
We will be able to see for ourselves the impact of things
that we do every day, and what we eat every day,
has on our health.
This will generate a huge amount of data.
So, who would be interested in all these health data?
You'd like to think your healthcare providers would.
You'd like to think that this data would be useful to your clinicians, your GPs,
that'd help them make decisions about the kind of healthcare you should get.
But chronic disease is making healthcare unaffordable.
Healthcare systems are spending upwards of 80% of their health budgets,
caring for people with chronic disease.
The situation is unsustainable.
Health insurers in the U.S. are saying
that they spend three out of every four dollars in payouts,
for people with chronic disease.
And they say that this is not sustainable.
So, what's gonna happen to our health insurance?
Well, we already have a system,
whereby your economic status might dictate your acess to healthcare,
the speed of that access to healthcare,
and indeed, the quality of your healthcare.
What if our health status is adding another layer onto this in the future?
What if we were able to look and see what kind of risk we had
for developing chronic disease?
And what if health insurers started to factor this in?
What if the onus was on us
to take responsibility for managing that risk,
and making sure that we did everything possible
to make sure we didn't get that disease?
And what if refusal to do that,
and making bad food and lifestyle choices, renders you uninsurable?
Risk is everything.
[What's going to happen to health insurance?]
What have the insurance sectors done about this risk?
Let's look at what's happened in the car insurance sector.
Motor insurers are now providing a technology
that you can put into your car,
that monitors your performance and your driving.
The same way health insurers may be able to monitor your health
on a daily basis.
Here, the information that they get
shows them how carefully you are, and what a good driver you are.
The more careful you are, the lower risk you are,
the lower your premiums, and you are very, very insurable.
What if health care insurers take this approach in the future?
What if this information that we're generating
with all this futuristic health technology,
is going to be able to provide them with information
about how your health is changing on a daily basis,
about the impact of what you're doing every day
is impacting on that?
What if they were allowed to have that data?
What if it was compulsory for them to have that data,
in order to avoid a complete collapse of our healthcare sector?
What if all of our national health insurers,
and our national healthcare systems, took the same approach?
They could potentially use this data,
and generate very sophisticated algorithms,
that might be able to predict your risk of chronic disease.
But more importantly, and what's relevant to here,
is that they may be able to dictate the kind of strategies
that you might have to undertake
in order to manage and minimise your risk of actually getting sick.
A huge part of this would be around your food,
because we know how much the food that you eat
impacts on your health and determines your risk for disease.
So, will our compliance with food dictate how we manage our risk,
and will that allow us to have access to healthcare?
The question is:
who's going to be making your food choices in the future?
Will your health insurer be dictating what you eat,
and will food no longer become a choice, but rather a way of life,
in order to be able to fulfil the criteria
to make sure that you get access to health care?
Is this actually a real possibility?
Could this happen?
Can we avoid this?
Well, the answer is "Yes."
The next time you go supermarket shopping,
think very carefully about what you're putting in your trolley.
And ask yourself the question:
"Is the food choices that I make and put in this trolley tonight,
goning to dictate whether my future generations
will have any choice at all?"
Thank you very much.
(Applause)