Our nation is sick, our lives and our economy are burdened, and our planet is dying from poor eating – all of which could be prevented. We desperately need a new food system and an obesity strategy that promotes and supports good health. Yesterday. This includes a healthcare system that is not only gold standard for treating ill health, but also becomes the gold standard for preventing illness and promoting good health.
They provide hope as positive next steps. But they don’t go far enough.
We urge Boris Johnson and Henry Dimbleby to be even braver – to go much further and faster for these strategies to be truly comprehensive and impactful on the long-occurring yet preventable food and health crises.
They’re both pretty meaty strategies (pardon the pun), so here we’ll focus on the obesity strategy report: where it needs to go further, and what it ignores altogether. We’d love to hear your thoughts too.
No single action is going to have true impact: this needs a 360 degrees approach if we’re going to successfully bring obesity levels down.
Where the obesity strategy needs to go further
1. We need for adequate resourcing for policing the advertising ban
We welcome banning the advertising of foods high in fat, sugar or salt (HFSS) being shown on TV and online before 9pm, and the fact that there will be a short consultation as soon as possible on how we introduce a total HFSS advertising restriction online.
But the government needs to take this further and consider how it will be policed. There will be little use in this new ban without appropriate resourcing via Ofcom and the Advertising Standards Agency.
2. We need to extend the advertising ban beyond TV – including sporting events and celebrities
The ban needs to be extended to any kind of promotion at any time of day, full stop. We particularly urge the government to consider sporting events – influential locations where there is no place for advertising of HFSS products.
We also call on the government to ban celebrities and influencers from promoting HFSS products.
3. We need to ban advertising alcohol and alcohol promotions
We welcome the government introducing legislation to require large out-of-home food businesses, including restaurants, cafes and takeaways with more than 250 employees, to add calorie labels to the food they sell. The government have committed to consult before the end of the year on their intention to make companies provide calorie labelling on all pre-packaged alcohol they sell, so when consumers shop for alcohol, they have all the information they need to make healthier choices. The consultation will also cover introducing calorie labelling on alcoholic drinks sold in the out-of-home sector, for example bought on draught or by the glass.
However, this is too little action on alcohol. Alcohol is highly calorific and damaging to lives the health care system. In 2017 in Great Britain, data from a report by Alcohol Change UK found an estimated 29.2 million adults (57% of the population) drank alcohol in the week before being surveyed, and around 10% drank on five or more days. Although 16-24 year olds are less likely to have drunk alcohol in the past week, when they do drink, they are more likely to drink at high levels.
Aside from the health risks associated with excessive alcohol consumption itself, alcohol itself contains seven calories per gram, and many alcoholic drinks contain added sugar and contribute further to calorie intake.
It’s estimated that for those that drink alcohol, it accounts for nearly 10% of the calories they consume. Each year around 3.4 million adults consume an additional day’s worth of calories each week from alcohol ¬– nearly an additional two months of food each year. Despite this, in the UK alcoholic drinks are not required to provide any information about how many calories they contain.
Alcohol advertising is glamorised and positioned commonly on prime-time adult programme viewing. Promotion of alcohol is also seen commonly at end of retail aisle promotions. Common sense alone tells us that we are beyond just simply labelling for calories.
4. We need targets for the health and sustainability of food shopping baskets
It’s great that the government is legislating to end the promotion of HFSS foods – restricting volume promotions (such as buy one get one free) and the placement of these foods in prominent locations intended to encourage purchasing, both online and in physical stores in England. This is long overdue. It will start to bring a level playing field to retail and manufacturing, so that there is no longer a competitive disadvantage to stopping such promotions. We hope this will include all eating out of home suppliers as well as retailers.
However, we call on the government to go further to improve the nutritional quality of the whole food supply chain. To set targets now for the health and sustainability of customers’ average shopping basket annually over the next 20 years. This should include own and branded supply chains. To go further and set a target for retailers to become B corp certified by 2030 – considering the impact of their decisions on their workers, customers. Suppliers, community and the environment.
Supermarkets have the opportunity to influence suppliers to make changes too and imbed healthy eating across the whole supply chain, so there is a more holistic approach. It is our view that they need support from government legislation in terms of creating a level playing field to allow this to happen.
5. Calorie labelling needs to be accompanied with portion guidance labelling
We welcome government confirming that they will introduce legislation to require large out-of-home sector businesses, including restaurants, cafes and takeaways with more than 250 employees, to provide calorie labels on the food they sell. Calorie labelling alone can be meaningless unless accompanied with portion size guidance. Portion sizes in the UK have increased dramatically over the past 40 years.
We call on the government to bring in legislation to require retail, manufacturers and out of home services to provide guidance on suitable portion size along with calorie labelling.
6. We need affordable training of health professionals to Improve referral pathways into weight management services
The government say they’ll be working to expand weight management services available through the NHS, so more people get the support they need to lose weight. We hope they ensure this is resourced with suitably-qualified health professionals and evidence-based services.
We particularly welcome plans to offer all Primary Care Networks the opportunity to train their staff to become healthy weight coaches, plus incentives for GPs and referral pathways into weight management services in every local health care system.
As the report suggests, GPs and other healthcare professionals – particularly practice nurses and health visitors – are often the first port of call when you need health advice and support. They play a key role in raising the topic of obesity and behavioural interventions, including referrals to appropriate services and support.
However, this needs to be supported with suitable, evidence-based, affordable training, We’ll be speaking to the government about how we can help.
What’s missing from the obesity strategy?
1. Make sugar tax on food mandatory
There is a lot of potential with reformulation of food. As yet this is untapped since the sugar tax on food is voluntary (vs. mandatory on drinks). Only an outlying 2.9% of foods have been reformulated (vs. 29% of drinks) to date. It is time to make sure tax on food is mandatory.
2. Develop inspiring communications
There is a need to reframe the food and health messaging in the UK and we believe this should be a core focus aligning across all government campaigns.
Healthy choices are often regarded as being unappealing and uninspiring. Citizens are making a compromise on taste, pleasure and value by choosing them instead of their regular options.
We must move to a place where making a healthy choice becomes an active, positive choice and not a compromise. Messaging around healthy foods has to have the same fun and pleasure in order to inspire the public to make a switch / make a healthier choice.
3. Connect citizens with food and the agricultural community
As a nation, we have lost touch with knowing about our food. We don’t truly understand how and where our food comes from and the impact its origins and production might be having on health, nutrition and the planet.
We need to fall in love with food all over again resulting in much greater appreciation and value for it.
We need to help people connect much more closely with the way their food is grown and produced, so they can understand it better and make better choices as a result. Opportunities need to be created across society and prioritised in terms of reaching the most deprived and vulnerable through targeted and measurable community campaigns, especially with schools and families.
The government needs to help the nation become more aware and armed with the right information to help them make healthier, more nutritious and sustainable choices.
In general, there is a divide between agriculture communities and urban customers – consumers simply don’t know where their food comes from or how it’s produced. We call upon the government to incorporate communications that overcome this.
4. Strengthen school food standards and bring in a mandatory school-to-home programmes, particularly for the vulnerable
There is nothing in the report about strengthening School Food Standards. We’d like a reduction in sugar to be universally applied and to close the loophole that exists for some academies.
The government needs to go further overall to protect children, families and vulnerable people. A life course approach is essential if we are to tackle the underlying causes of overweight and obesity – and this should start with our youngest children. Almost a quarter of children are already overweight on starting school. At this age, simple interventions can help slow weight gain and avoid the path to obesity. As children grow older it becomes harder to reverse obesity as lifestyles become ingrained.
Alongside the changes proposed, children and families should have the help and support they need to live a healthy life through programmes designed to impact the child and link to the home, designed appropriately for all, particularly the vulnerable.
5. Further measures around early years and the first 1,000 days of life, including targets to improve rates of breastfeeding in England
6. Strengthen Government Buying Standards for Food and Catering Services to address wider, systemic issues
It’s helpful that the strategy suggests that there will be more discounts on foods like fruit and vegetables, but this is not enough. The overall strategy fails to recognise the huge health inequalities that exist – and the fact that those with lowest income struggle the most to access a healthier diet.
The poorest in society are most at risk of obesity from a food system which actively encourages HFSS and less healthy foods by making it cheaper, more heavily promoted and easier to buy. One in five people lives in poverty and Britain has one of the highest rates of food insecurity – worries about getting enough to eat in Europe. We hope the government will consider poverty as a root cause, particularly in light of the recent House of Lords report: Hungry for change, fixing the failures in food.
7. Don’t place all emphasis on the individual. And take care with language around weight.
We welcome positive measures described in the plan, but more detail is needed. While individual responsibility is a cog in the wheel of obesity, we urge the government to avoid placing all the emphasis on the individual, and to recognise more openly the impact of the obesogenic environment that we live in and the complex nature of obesity.
Equally importantly, politicians and the media must avoid stigmatising and discriminatory language around weight, which we know has a serious impact on the physical and mental health of those living with obesity.
8. Finally, there should be the establishment of a Cabinet-level committee to review the implementation of the Obesity Strategy plan, ensuring it gets the high-level traction it requires.
Do you agree? Disagree? Did we miss something? Not go far enough? Is it realistic? Please share your thoughts. It’s a conversation we expect to be having for many months and years to come.