How can the teenagers BEWE be linked to our taxation.
An individual's tooth erosion and how to treat it is more prevalent now than in the 1980s when I qualified. It's a gift that keeps on giving for our income stream. But if they become diabetic or obese with a reduced working lifespan which may affect their taxable income, and take up more NHS resources care in our old age?
While our grandchildren may ask, "why did you ruin our planet?", it will be more devastating to both of us when they ask why did you not promote healthy eating? We know UPFs( Ultra processed foods), and UPDs (Ultra Processed drinks)  cause increases in obesity, type 2 diabetes, and many other health problems. 
We are in a prime position to promote health. Long lectures on sugar's evils have rarely worked in the surgery environment. We need to give consistent nudges to support general health advice. We can influence our patients who trust us by using modern technology to support our messages, promote specific information, and allow the user to make their choices for the sake of their health and the health of our national economy. 
The food industry learnt from big tobacco how, when, and where to intervene to maintain their profits. For example, Save the Children withdrew its concerns about sodas following a $ 10 million payout for local Bangladesh funding. Multi-national food companies don't have to pay for the long-term health consequences. It made commercial sense to help maintain their $47 billion worldwide revenues ( from Soda Politics around 2010).
Is it different in the UK? Have we just backtracked on UPFs? Is the consumption of UPDs going down? Is history repeating itself? Can we do anything?

As the highest growth in obesity is in the teenage group, should we be concerned for their health, our pension, or both?
To help us all get better, why not help one another, similar to how Team GB won so many cycling medals in 2012. It wasn't one person. It was a team effort of coaches and diverse experts in their field, collaborating outside their specific areas with other professions and making many minor improvements. As we are in the sphere of influence and trusted health professionals, can't we suggest a few simple nudges to encourage the public to consider the consequences of their actions for themselves and their families?

More recently, due to global warming, governments worldwide have intervened and introduced policies that have promoted disruptive innovations such as electric cars and bikes.
Why not for health? With life expectancy decreasing, increasing the pensionable age does not seem like a great solution, although it will help balance the books. Many of us are retiring while we can. We could help those who may never make it? We can market healthy living at every opportunity using advanced digital media and digital sensors that weren't available in the 80s. 

It needs collaboration to agree on essential health advice that a consensus can decide on concerning oral health and general health.
We can deliver it for free with some focussed videos on oral health, as well as dietary advice with some reference to the evidence and how to self-monitor for other diseases such as Oral Cancer.
We don't need to be experts in all fields, but we can share our experiences and expertise to help improve our general health even if the government no longer has the funding to support dentistry, or mental health, or social care. It's worth a try. Do you want to help?
Perhaps our collective action on libertarian paternalism will prompt a government into prevention rather than cure. Governments worldwide have been brave enough to take on the motoring industry, promoting disruptive transport innovation ($2.7 trillion global market value 2021). Why not the food industry ($ 8.7 trillion global market value 2021).

Alternatively, could DLP focus their energy on bigger fish such as Coca-Cola and Pepsi, who inflict far more damage on our nation's smiles than any stressed-out individual dentist. The Tobacco companies settled for a minimum of $206 billion in 1998 in the USA.

https://en.wikipedia.org/wiki/Tobacco_Master_Settlement_Agreement

Is todays evidence, tomorrows poor advice? It’s difficult to keep track on what is not necessarily the optimum way to live your life, but a way that is feasible with achievable goals.
I am old enough to have been told to “go to work on an egg”, then told to avoid due to cholesterol, but now eggs are OK, and anyway I have the miracle statin to avoid a stroke that the drug protects 1 in 286 of us. I take it to ward off dementia. I take it to ward off dementia.
I know we are all time poor, it’s why I made the App to save time supporting my oral advice health advice, and market my dental services. But why stop there? We can point anyone who follows our oral health advice, to more current basic health advice. Every little helps, but not always when it comes to BOGOF, there is a massive long term problem not dissimilar to Tobacco or OxyContin.
Sugar produces far worse diseases than caries, lets engage with the public and help them enjoy better health with simple messages, as with UPFs Ultra Processed Foods. 
Marion Nestle, the former Professor of Nutrition, Food Studies and Public Health at New York University fifteen minutes into this podcast talks about how we are poisoning children, and how we are paying for it. 


https://www.bbc.co.uk/sounds/play/p0c98rrz


The simple message for all of us as advised by Micheal Pollan in his book In Defence of Food,
"Eat food. Not too much. Mostly plants."
And avoid UPDs ( carbonated drinks), which is where explaining the BEWE is of further value.
This is recent evidence on UPFs and weight gain and the start of the disease process.
 And if you like reading, the link is below.

https://www.cell.com/cell-metabolism/pdfExtended/S1550-4131(19)30248-7


If you prefer watching, try this for Diabetes from a doctors view on living with Obesity.
https://youtu.be/da1vvigy5tQ 
There is more with our time do talking to patients and leading them to useful information that may help improve their quality of life than writing masses of needless notes which are of little value to you, your patient, and ultimately your defence organisation.
Another explanation with the general simple advice below.
https://youtu.be/tic7X3ET4gE​

Why restrict our advice to teeth and gums?
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We can take a central role in delivering better health, nudging the public who trust us to give health advice. Such as options as outlined here using the research on the effect of Ultra processed foods (UPFs), which Britain consume in higher quantities than any other European country. The increase in availability of this food packaging has a clear correlation with the increase in childhood obesity, with multiple alarming research and evidence ignored for many years. Just as many of todays youth may blame us about the world climate change, they will complain about their individual poor health.
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Is todays evidence, tomorrows poor advice? It’s difficult to keep track on what is not necessarily the optimum way to live your life, but it is feasible with achievable goals.
I am old enough to have been told to “go to work on an egg”, then told to avoid due to cholesterol, but now eggs are OK, and anyway I take 10mg daily of the miracle statin to avoid a stroke that the drug protects 1 in 286 of those who are on the medication. I take it to ward off dementia, I'd rather not wait for the evidence. Although there is now evidence that taking the statin, omega 3, and a mini aspirin helps our immunity which therefore may help my gum health, and all three are relatively cheap.
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We are all time poor, it’s why I made the App to save time supporting my oral advice health advice, and market my dental services. But why stop there? We can point anyone who follows our oral health advice, to more current basic health advice.

Earlier this year the government made a U turn on BOGOF deals at supermarkets on the basis of inflation, but more likely following intense lobbying from the multinational food suppliers. These UPFs, generally have created a massive long term problem not dissimilar to Tobacco or OxyContin.

Sugar produces far worse diseases than caries, lets engage with the public and help them enjoy better health with simple messages, as with UPFs Ultra Processed Foods. 

Marion Nestle, the former Professor of Nutrition, Food Studies and Public Health at New York University has multiple YouTube talks about how we are poisoning children, and how we are paying for it. The books on Food Politics & Soda Politics are long, and deeply depressing. For more info this is her website . 
Her Nobel Talk has the repeated theme of ADVOCACY where we as a profession have a potential huge role to play in helping improve our nations health from explaining the BPE, NEWS, and signposting trustworthy resources for our society to "take back control" of our health.


The simple message for all of us as advised by Micheal Pollan in his book In Defence of Food,
 
"Eat food. Not too much. Mostly plants."

This is recent evidence on UPFs and weight gain and the start of the disease process.
The link to Kevin Halls research is here.

https://www.cell.com/cell-metabolism/pdfExtended/S1550-4131(19)30248-7

Which includes this text
Interestingly, the appetite-suppressing hormone PYY in- creased during the unprocessed diet as compared with both the ultra-processed diet and baseline. Also, the hunger hormone ghrelin was decreased during the unprocessed diet compared to baseline.


In conclusion, our data suggest that eliminating ultra-pro- cessed foods from the diet decreases energy intake and results in weight loss, whereas a diet with a large proportion of ultra-pro- cessed food increases energy intake and leads to weight gain.

This podcast from the excellent BBC podcast " A thorough examination" with the Van Tullekem doctors is easier to follow, with a brief explanation by Kevin Hall. 

Listen to the whole series, or their YouTube video on UPFs, as well as excellent videos which also explain erosion for children.




If you prefer watching, try this for Diabetes from a doctors view on living with Obesity.
The screenshot is from the final advice. Its passionate.

There is more value using our time do talking to patients and leading them to useful resources that may help improve their quality of life than writing masses of needless notes which are of little value to you, your patient, and ultimately your defence organisation.
We should work differently and collaboratively. We have the technology to make a cloud based diet history that not only noted the sugar intake and frequency, but the general quality of the diet. Tesco made the club card, and it helped improve their profits. The same data could help give advice on your health, but there is a clear conflict between your health, and their profits. Perhaps we could have access to our shopping habits via an NHS club card? When it comes to our health, Every little helps.

Another explanation with the general advice on sugar and diabetes.
Ted talks are a great source of learning from people working in their field of interest with evidence of their experience.

More references. 
https://www.theguardian.com/business/2023/mar/12/revealed-experts-who-praised-new-skinny-jab-received-payments-from-drug-maker?CMP=Share_iOSApp_Other
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My calculations based on
In some cases, adults with a BMI of 30 or above will be eligible for the drug, for example individuals with a lower BMI but still qualify as obese. It is important to remember that even though up to a quarter of all UK adults have a BMI greater than 30, not all of them will need this drug.
-53million adults, approx 13.25 million obese.

Annual potential cost for NHS 13.25 million adults BMI >30 = £25 billion
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As it can be bought over the counter, once the NHS no longer funds the drug, the public will. And while many with a BMI over 30 will not be eligible on the NHS, many below 30 will self medicate. Just like botox, once you have started you may find it difficult to  stop and it's the reason the share price has grown exponentially over the last few years. It is not a cure, that is not in their commercial interest.
When a company with a commercial value greater than the GPD of a country the size of Pakistan advertises their product, we need to market alternative health options constructively and collectively in a manner that benefits society as a whole.
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