‘Footlong’ size does matter

Dr Ruairi Hanley

As Dr Ruairi Hanley’s exhaustive, radomised research in Subway bears out, portion size really does matter when it comes to taking the measure of the obesity ‘epidemic’.

There are some things about modern Ireland that I simply cannot get my head around. For example, what is the attraction of RTÉ presenter Craig Doyle? How can anyone actually enjoy country and western music? Why does my local radio station start every day on a positive note by reading out death notices? And why is it seemingly impossible to drop Robbie Keane from the Irish team?

Some readers will agree these questions are hard to answer. However, they all pale into relative insignificance when we consider what I believe to be the greatest mystery of all: why is there such a lack of basic cop-on when it comes to obesity?

An eight-year-old child can pretty quickly understand that if you eat too much and take too little exercise, you will become fat. Such behaviour is the cause of the vast majority of cases of obesity. Unfortunately, in Ireland we try our best not to acknowledge this. Indeed, the word ‘fat’ is so politically incorrect that I imagine a GP could well find himself before the Medical Council if he dared to say it aloud.

Instead, in our great little Republic, we prefer to talk about our ‘obesity epidemic’, as if the entire population has been infected with a previously unknown virus that causes us to consume more and move less.

Furthermore, I understand that vast amounts of research may have been written on such subjects as portion size. Call it a hunch, but I suspect such academic effort reached the amazing conclusion that if people don’t eat as much food, they tend not to gain as much weight. The Nobel Prize committee should take note.

The latest example of this type of woolly thinking surrounds a campaign to have restaurants display the calorie count of every food item on their menu. Apparently, this will have a dramatic impact on the obesity epidemic.

Well, I can now exclusively reveal that I have undertaken extensive studies of this matter in my local Subway over the past year and the results are fascinating.

For those unfamiliar with Subway, it should be explained that the nutritional value of every one of their products is highlighted, along with various low-fat options. Indeed, their website gives a detailed and informative breakdown of the calorie content of almost all of their products.

However, I am afraid to say these developments appear to have made little difference to the behaviour of the people with whom I queue-up on a regular basis.

My basis for this conclusion goes back to the ground-breaking portion size discovery that I referred to above. In Subway, this complex issue is actually very simple; one has a choice between ordering a six-inch or a foot-long sandwich. Obviously, the shorter version is cheaper.

Now, having attended this establishment several times a week for the past 12 months, I can reveal the following fact. I seem to be the only person ordering a six-inch sub.

Incredible as it may sound, I have never actually witnessed any other customer demand anything except a ‘footlong’. In many cases, this is accompanied by a large bag of crisps and a fizzy drink.

Now I must ask myself a question: are there days when I walk into Subway and think, ‘I have had a really bad morning and maybe I’ll treat myself to a footlong for a change?’ Yes there are, dear readers. But if I succumbed to that temptation, I fear I would inevitably become overweight in a matter of weeks.

That type of approach to decision-making is known as exercising self-discipline and lack of it is the cause of a large proportion of illness, distress and suffering in our country today. Unfortunately, my more left-wing colleagues would probably regard such analysis as a shining example of evil ‘judgemental thinking’. They would undoubtedly say what is needed here is more education. Alas, it is precisely this type of political correctness that gives us calls for detailed nutritional content on menus. They should take a trip to Subway and see how that one has worked out.

I am afraid the only solution to this problem is to stop waving the carrot and start using the stick. As I have said in the past, a true fat tax must be introduced that financially punishes those who opt for the ‘footlong’ over the ‘six-inch’ sandwich.

That, and not more namby-pamby, educational hand-wringing, is how we should truly deal with our obesity epidemic.

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Shafting of hospital consultants
I would like to conclude this week by addressing the burning issue of the massive salary cut being proposed for new entrants to the consultant ranks. As has been pointed out by others, it is hard to escape the conclusion that young doctors have been sold down the river by these changes.

As a result, many of my friends and colleagues who are now gaining expertise in overseas countries may never return.  I shall miss them, but their country will miss them far more in years to come.

Alas, I fear the genesis of this fiasco took place many years ago when some liked to claim that NCHDs were not interested in money, but were solely concerned with training or reduced hours.

This ill-conceived public relations gesture has now come back to bite future consultants on the backside. With hindsight, perhaps it might have been better to have vigorously defended the well-earned incomes of some of the brightest and most hard-working people in the State, rather than to suggest that they really didn’t care about such material issues.

In any case, it is too late now. The level of hostility directed towards senior medical professionals in our national media has reached an all-time high. In one of the most unfair developments of modern times, consultants are well on their way to replacing bankers as the most hated group of professionals in Ireland.

This relentless campaign of begrudgery has undoubtedly been successful, in that it has emboldened the State to shaft new entrants to the highest ranks of our profession. Perhaps those doctor-hating journalists, who so eagerly put the boot in on this issue, might ask themselves a question: Having driven these medical professionals from our land, what standard of consultant do they think will look after them and their loved ones in their old age?

Well done, lads. Enjoy your victory. And in 20 years’ time, when you might actually need a world-class doctor, good luck finding one.