Solutions to obstacles preventing good nutrition must be sought if the cycle of poverty, obesity and further social exclusion is to be overcome, writes Ian Gibson MP

Almost every day we hear or read about yet another food scare on the one hand, and another "novelty" food product on the other. Cholesterol-lowering spreads, cider containing anti-oxidants, yoghurt enriched with "good" bacteria, breakfast cereals with folic-acid, and so on, all are being marketed to the anxious consumer trying to get it right. And yet, despite all these "healthy" products, Britain is still lingering at the top of the league on diet-related disease tables.

Poverty and health remain intrinsically linked. In Britain rates at all ages are two to three times higher among disadvantaged social groups than their more affluent counterparts. These inequalities were once again uncovered and highlighted by an inquiry into health inequalities lead by Sir Donald Acheson. This report highlighted a range of contributing factors: the quality of the physical environment - housing, working conditions and pollution; economic and social influences; level of unemployment, quality of social relationships and social support; and access to effective health and social services.

Let's just take obesity as an example. In the UK almost a quarter of the population is obese, and that number grows by 1000 people every day. NICE estimates that obesity costs the economy £1.9 billion and the NHS half a billion a year. Obesity is a good example of a protracted health inequality problem, because bad eating habits obviously lead to obesity, with obesity leading to ill health. Poorer people have a worse diet and are thus more likely to be obese. However obesity in turn also leads to further social exclusion, posing obstacles to marriage, employment and promotion. Health inequalities are thus the outcome of and the cause of social exclusion.

Many of the health problems suffered by the poorer citizens seem to be the result of life-style choices: lack of breast feeding, smoking, physical inactivity, stress, obesity, hypertension, poor diet. However we must not forget the constraints and difficulties of struggling on a low income. Portraying the problems of the poor as mere self-inflicted damage is problematic. Poverty is not a lifestyle choice.

What is needed is a move away from mere individualised consumer education, telling people what to do, towards a more population based approach to nutrition and health. Structural obstacles to good nutrition must be overcome. And there are many of those around. They range from bad transport links to shops - leading to so-called food deserts - to advertising and marketing directed straight at children. Nutritional messages need to be simplified. We need to get away from lots of half and hidden truths about "pure" juice and drinks, crisps that are 80 per cent fat free or "wholesome" ready made chicken pies that contain pork proteins. Realistically we cannot expect the majority of consumers to read every small-print label on every product.

Foods that are good for people - and despite all the hype over food scares and novelty products, it is still fairly clear what these foods are - need to be brought within easy reach of everybody, both financially and geographically. We might also have to consider making "bad" foods (high saturated fat, high salt, high sugar contents) more expensive. Suggestions like a tax on advertisements for fatty foods are well worth considering.

There is also a real problem with a lack of "food skills". Children are growing up without ever seeing properly cooked, home-made food. Maybe there really was a need to overhaul the home economics curriculum on offer in our schools. But the fact that children these days do not get taught at all how to make a meal from raw ingredients poses a real problem for the nation's health.

We need good research into our food and health. How do bodies take up the nutrients and additives contained in diets? How do bodies react to too much food of certain types? Based on this sound knowledge we have to ensure that the food industry is properly regulated and controlled and that the swingeing claims made about "new" products are put into perspective.

Government and health sector activity in the area of nutrition and health have for far too long been focused on either preaching to the converted (the well-off middle classes) or have ignored the structural obstacles in the way to good eating habits for those less well-off. We need to break the cycle between poverty, bad diets and health.