All children have underdeveloped social filters, with Chloe being no exception. You may remember her very loud conversation about — how shall I put this — male anatomy, during a quiet moment in La Trattoria. This week’s gem was only marginally less embarrassing. “Uncle Richie?” said Chloe, “What does it feel like when your hair falls out?”Fortunately, you’re easily forgiven as a kid. As an adult, you’re held accountable for your moments of conversational bravery. And there I was, wondering what to write about, when the Health Minister came out with a pretty bold statement. Tax junk food 500 percent. I do hope he ducked for cover. In my experience, standing in between Bermudians and junk is asking for trouble. Front-line, bulletproof vest, beg-for-mercy kind of trouble! One thing is for sure, he’s no longer on the Christmas card list at KFC.The thing is, without a more compelling statement that deals with the bigger picture in a more positive way, reaction to this topic tends to be negative. Minutes after the story appeared online, websites and Facebook exploded with comments and two main arguments prevailed. The first being that the government shouldn’t be able to dictate what people put in their mouths and the second being that it would be better, surely, to subsidise healthy food instead.I understand the former (no one likes being told what to do) but the irony is that the government already dictates (to a degree) what you put in your mouth. Current policies influence cost and availability but we don’t react to it in a rebellious way because it’s our existing “normal”. The challenge is, of course, that we need a new normal.When it comes to the idea of subsidising healthy food, I’m a big fan. All the research (and it’s prolific) shows us that making junk food less accessible or more expensive doesn’t necessarily make it easier or cheaper to be healthy. If you want to instigate permanent behaviour change, you have to create a supportive environment. That sounds simple enough but it’s actually very tricky.I am lucky enough to have a Bermudian colleague (Joshua Bell) who has a master’s in social epidemiology from UCL in London. He is now pursuing his PhD. This week he sent me slides presenting research that clearly shows myriad social, economic, cultural and political factors influencing obesity. One fact really stood out — that lower socio-economic groups in higher income countries (like ours) tend to have a greater prevalence of risk factors, diseases and mortality.There’s no two ways about it. If you are going to improve accessibility to healthy food — especially for lower income households — then you have to make it cheaper. Yes I agree, tax the junk, but you have to — transparently — use that revenue to make the costly healthy items cheaper.I have argued for a long time that it doesn’t have to be more expensive to be healthy here. If you’re having a snack, an apple, some nuts and a glass of water are cheaper than a chocolate bar and a soda. If you know how to combine healthy grains (eg brown rice, quinoa) with beans and pulses, then you can also make very economical, comparatively healthy main meals. And yet, aside from the challenge of overcoming junk food preferences, where this theory falls down (especially on our little Island) is when it comes to the wider cost of fresh produce.I ask almost everyone I work with to add berries to their breakfast and to make half their plate (at lunch and dinner) full of green, or non-starchy, vegetables and salad. This is where the dollars pile up. There are some economical options (and I make a great effort to point those out) but berries, fresh green veg and yellow peppers are just a few of the examples of the ultra-expensive produce items here. That’s a crying shame as they are ultra-healthy too. So while I think it would be difficult (but not impossible) to put categories in place that determine what’s junk and what’s not, I think the items for subsidy could be simple. Just make it more affordable for people to fill up on fruit and vegetables, rather than heavily processed carbohydrates. While we’re at it, let’s make sure our local farmers are able to farm in a way that keeps their produce competitively priced.Of course, in the long-term, education is critical. It’s so much easier to maintain healthy habits established young than to change unhealthy habits ingrained over decades. We have another major issue here though. Changing the way we eat in Bermuda also means changing — or at least shifting — our dietary culture. With an anthropological background, that makes me uncomfortable. Surely we should be preserving traditions rather than changing them? But at a time when our lifestyles have moved on to a point where they are no longer compatible with what we eat, and when our diets have become increasingly polluted by heavily processed, refined carbohydrates and all the chemicals that go with them, maybe we don’t have a choice. We can’t go on eating mac ‘n’ cheese with every meal and raiding the vending machine for snacks.When I say we can’t go on, I mean that literally we can’t go on. In 2010, the healthcare spend in Bermuda surpassed $628 million. The projection for 2020 is $1.5 billion. Can you afford for your health insurance premium to double in that time? Your salary certainly won’t.So yes, I think that taxing junk, so long as it goes hand in hand with healthy subsidies, could be a good thing. We have to understand the limitations to that strategy though too. Without considering the wider social context, with manufacturers, suppliers, farmers, families, workplaces, churches and the government all stepping up to the plate, we’re only putting on a band aid. In the meantime, taxing Cheetos and discounting strawberries would send one hell of a message.The advice given in this article is not intended to replace medical advice, but to complement it. Always consult your GP if you have any health concerns. Catherine Burns BA Hons, Dip ION is the managing director of Natural Ltd and a fully qualified nutritional therapist trained by the Institute for Optimum Nutrition in the UK. Please note that she is not a registered dietitian. For details visit www.natural.bm or call 236-7511. Join Catherine on Facebook: www.facebook.com/nutrifitandnaturalnutritionbermuda.