Not so long ago, Denmark made playful fun of neighbouring Sweden for strictly limiting access to alcohol and forcing pizzerias to serve salads. Today Danish citizens accept
far-reaching health initiatives without much complaint. Why did it change?
By Markus Bernsen. Focus Denmark magazine June 2012.
“We drink as frequently as southern Europeans, and we drink as wildly as the Vikings.” So said Denmark’s Minister for Health in 2010 about alcohol consumption in the country. It was true then and it still is: alcohol consumption in Denmark is among the highest in Europe, while the average life span of its citizens – 78.4 years – is among the lowest.
The people of Denmark have never been known for their healthy lifestyle. The Danish queen smokes 20 a day and her husband is a inegrower who writes cookery books simmering with richly exotic recipes. Spring in Denmark begins on the day when Danish brewery Carlsberg releases its Tuborg Easter beer, and likewise the Christmas season begins with the appearance of Christmas beer. Both beverages are designed to accompany traditional Danish lunchtime fare of herrings, roast pork and cheese, washed down with liberal quantities of aquavit.
The attitude of the Danes to food, alcohol and tobacco is generally more relaxed than their Scandinavian neighbours. It has given them the reputation of being “the Italians of the North”. But things are changing. In the last fi e years the Danish government has introduced a ban on smoking and a tax on fat, and has proposed a tax on sugar. Prime Minister Helle Thorning-Schmidt has a vision to see Denmark among the 10 countries worldwide with the highest average life expectancy.
Much of it is to do with the times we live in. In the last ten years a wave of health consciousness has swept across the European continent, and has hit the free-living Danes with particular force.
Since 2007, smoking has been banned in cafés and restuarants over a certain size.
Stone age food
Denmark’s agricultural roots are still visible in the food that the population eats. More pork and milk products are consumed than in most countries, but even so, the nation’s diet has changed in the last ten years and has become signifi cantly healthier. The consumption of cakes and sweets in Denmark has dropped, and more fruit and vegetables are eaten. The consumption of sweets has decreased so much that the average citizen in neighbouring Sweden consumes almost twice as many sweets (8.2 kilos per year) as the average Dane (4.8 kilos).
The change in diet is most visible among children and youngsters. They drink far less soft drinks, and among young people smoking has declined. One in five people still smoke, but the next generation no longer thinks that smoking is cool and part of adult life. One of the best-selling books in Denmark in recent years is Kernesund familie [The fighting fit family], which is full of salad recipes with vitamin-rich vegetables. Danish chefs have returned to their roots in the “New Nordic Kitchen”, with its fish, game, berries and herbs. They also make “Stone Age food”, where processed carbohydrates such as flour and pasta are avoided. Healthy living has also become part of politics. In 2007, Denmark’s previous government banned smoking in schools, in trains, and in cafés and restaurants over a certain size.
In April this year, the new government extended the smoking ban to include single occupancy offi ces. In autumn 2011, it introduced a fat tax, with the eff ect that for every kilo of saturated fat purchased in shops, the state receives EUR 2.15. In addition, the government plans to introduce a tax on sugar in 2013 covering all foods – from ice cream and cakes to yoghurt and pickled cucumbers. Things have changed rapidly. Fifteen years ago Denmark made playful fun of neighbouring Sweden for strictly limiting access to alcohol and forcing pizzerias to serve salads. Today Danish citizens accept health initiatives with hardly a murmur of complaint. But why?
Nanna Mik-Meyer conducts health research at Copenhagen Business School. She thinks that a change began around the start of the new millennium, and has since accelerated.
“The Danish welfare state became increasingly occupied with the health of the individual. The government could see the money being spent on smokers and obese citizens, so these became obvious focus areas for the state. Later the private sector joined in. They wanted to attract the right people and used health at the workplace as a sort of fringe benefit.”
Such initiatives include organic lunch schemes, employer-paid fruit and vegetables, jogging clubs and off ers to receive massage during working hours. Around the same time, something similar happened across Europe and in North America. In the US, Canada and Great Britain in particular, governments discovered obesity and decided that it required immediate action. They worried about obesity epidemics and the costly long-term lifestyle diseases that result.
In Denmark the approach was slightly different. Initially, the focus was less on obesity and m ore on exercise. Most Danish doctors and health experts considered that exercise was the most important factor, and that the population’s diet didn’t necessarily need much change.
“Other countries have made significant eff orts to fight obesity, while in Denmark it was quickly agreed that weight is not always the key issue. Physical activity is just as important,”
says Professor Bente Klarlund Pedersen, chairman of Denmark’s National Council for Public Health. Denmark continues to diff er from other countries by assigning particular importance to exercise. The motto is
“Rather fat and fit than thin and inactive”.
In Denmark, one third of the population exercises at least four times a week.
A new religion
There are concerns among some however that eagerness for health has gone too far, and that health has become almost a religion. We have stopped questioning the health wave, thinks Nanna Mik-Meyer.
“Today, our unquestioned preoccupation with health has become the most natural thing in the world. We have practically forgotten that the change happened, even though it was only 15 years ago. It has spread like wildfire. Health has occupied every sphere of life: at work, in our spare time, in the family.”
But health is actually a very diffi cult thing to defi ne, argues Nanna Mik-Meyer. What is healthy for some can be unhealthy for others. This becomes clear when one looks at Europe: in some countries people smoke a lot, but nevertheless have a higher life expectancy than in countries where people smoke less. There is also a big diff erence between men’s and women’s health in the various countries, and across Europe as a whole women are generally healthier than men.
One trend is clear in Europe today: the more northerly the country, the higher the proportion of the population that takes exercise. According to a new survey, 70 percent of the population in Denmark, Germany and Finland exercise at least once a week. In comparison, the figure is less than 40 percent in Italy, Spain, Austria and the Netherlands.
In Denmark, one third of the population exercises at least four times a week, and two thirds exercise at least once a week. Italy and Greece are among the countries where people exercise the least.
In Greece, less than one fi fth of the population exercises regularly. While alcohol consumption and smoking occur in all social strata, exercise is closely connected with economic means and education. The healthier the fi nances and the better the education of a population, the more they exercise. History also plays a signifi cant role.
In Denmark, exercise has always involved a social element. In the 1800s a wave of sports associations were established where Danish farmers were encouraged to straighten their backs and get to know each other. These associations became gathering points in small rural communities. In contemporary health surveys in Denmark, women say that they exercise to lose weight or stay youthful, while Danish men say that their primary purpose in taking exercise is to be with other people.
When foreign visitors come to see Bente Klarlund Pedersen in Copenhagen, they are often surprised to see how people get around the city – that they use their legs as a means of transport. This is a form of exercise that few think about, but it is prevalent in Denmark. Half an hour’s cycling trip here, a quarter of an hour’s walk there.
“People walk and cycle to and from work, and that is very diff erent from many other countries,” says Professor Pedersen.
“Only in Denmark and the Netherlands do people generally transport themselves around in this way. People cycle in other countries, but it is more a spare time activity. In Denmark bicycles are used as a means of everyday transport – a way to get from A to B.”
Danish cities are also designed for cycling. In Copenhagen for example, road layouts are being redesigned to better accommodate pedestrians and cyclists. A lot can be learned about public health in a country by looking at its cities, thinks Pedersen:
“It is immediately visible that a city like Copenhagen is full of pedestrians and cyclists. And it is also clear to see in cities where there are no pavements or cycle lanes, that people do not exercise much. In some places you have to take a taxi to go 500 metres, simply because there are no pavements.”