It is only in the last few years that the government has taken positive action to reduce obesity. However, since the turn of the century there has been an increasing, although still insufficient, efforts by government to reduce obesity in the UK. Currently the emphasis is on childhood obesity and the reformulation of food. CancerWatch will continue to campaign and interact with government to ensure that more is done to reduce levels of obesity in the UK.
The background to the battle against obesity in the UK lies in a series of reports dating to the turn of this century. Much of the concern over obesity lay in determining which government department was responsible for tackling it – was it a medical matter or did the costs of its effects make it a financial one? The key reports emanating from government are highlighted below:
In 2001 the National Audit Office published a paper called “Tackling Obesity in England”. This did not offer solutions but highlighted problems caused b obesity. It recommended a number of National Health Service (NHS) strategies and the preparation of national guidelines. The thrust of the paper was that obesity was a medical problem and responsibility lay with the NHS.
The Wanless Reports of 2002 “Securing our Future Health” and 2004 “Securing Good Health for the Whole Population” were commissioned by the Treasury in order to determine the long term resource requirements of the NHS. Obesity again was identified as an economic problem like to put pressure on NHS budgets.
In 2004 the House of Commons Health Select Committee published a report on obesity. This was fully comprehensive and acknowledged that solutions were multi faceted and must address environmental as well as individual factors. It recommended many of the issues that now underpin campaigns against obesity: legislation to promote an improved labelling system; tighter controls on food advertising and promotion; better standards for school meals, and solutions to the problems of physical inactivity.
Various reports and initiatives were drafted in the ensuing years. Policy was now directed to help people choose better lifestyles. This proposed a range of initiatives – better health education (eg “5 a day”) etc to help people make the right choice and pt more emphasis on physical activity.
In 2007 the government commissioned Foresight, a government think tank, to review obesity. Foresight produced “Tackling Obesities – Future Choices. This report demanded an approach from the whole of society and emphasised the importance of partnership between government, science, business and civil society.
In 2011 the government published “Healthy Lives – Healthy People – A call to action on obesity in England”. The tenets of this report we’re based on the 2007 Foresight report, and again emphasised the need to involved the whole of society, but also emphasised the need to involve local government.
The Government’s Responsibility Deal
The Dept. of Health Responsibility Deal was launched in 2011 and has been established to tap into the potential for businesses and other organisations to improve public health through their influence on food, alcohol, physical activity behaviour and health in the workplace. The core aims to reduce obesity are:
Reducing harmful ingredients eg salt and fat; Encourage more people to eat more fruit and vegetables; Putting calorie information on menus; Helping people to eat fewer calories (eg changing the portion size or the recipe for products.
Many food firms agreed a series of voluntary pledges with the Dept. of Health to “reformulate” their products. Additionally, many of the pledges include the provision of information, and raising awareness.
It could well be argued that regulation and taxation would have been more effective but successive governments have been reluctant to legislate and indeed have replied on various voluntary “responsibility deals” with industry.
Legislation to Regulate School Food
In 2000 concerned about the poor quality of school meals, government regulations introduced nutritional standards for school lunches. In July 2013 the School Food Plan was published and when new school food standards came in to force in January 2015 the Plan was updated. The majority of schools are now subject to School Food Standards although some academies and free schools are not.
Soft Drinks Industry Levy (Sugar Tax)
At the beginning of 2013, a campaign was launched focusing on ring dancing money for children’s health through a date paid on sugary drinks. The campaign received backing from over 60 organisations including the British Dental Association and the British Health Association.
In September 2015, an e-petition seeking to ‘introduce a tax on sugary drinks to improve children’s health’ was launched jointly by celebrity chef and campaigner Jamie Oliver and Sustain, the charity for better food and farming. The petition attracted over 150,000 signatures.
The petition was referred to the House of Commons Health Select Committee which agreed to look into the issues it raised. The Committee made recommendations in a number of different areas including: “A sugary drinks tax on full sugar soft drinks, in order to help change behaviour, with all proceeds targeted to help those children at greatest risk of obesity”.
In the 2016 budget, legislation was introduced for a tax on sugar sweetened drinks, from April 2018 as part of a new child obesity strategy spearheaded by Public Health England. There are two bands – one for soft drinks with more than 5g of sugar per 100ml who will pay 18p, and a higher one for drinks with more than 8g per 100ml at 24p. Pure fruit drinks will be exempt. Likewise sugary milkshakes and yogurt drinks will be excluded as they contain high levels of calcium.
Examples of drinks that were then expected to fall under the higher rate of the sugar tax included full strength Coca Cola and Pepsi, Lucazade and Irn Bru. The lower rate would catch drinks such as Dr Pepper, Fanta, Sprite, Schweppes Indian tonic water and alcohol-free shandy.
The government estimated it would levy £520m in the first year. In practice most companies had already begun to reduce the sugar content in their drinks so that the amount of money raised was lower than expected. The money raise was spent on increasing the funding for sport in primary schools in England. The devolved administrations could spend the money as they liked.
This is a broad sugar reduction programme, ostensibly to reduce levels of sugar from foods that children eat, but in practice is used as a ‘stalking horse’ to reformulate most sugary foods.
The programmed was led by Public Health England (PHE) and was initiated in January 2017 and in being introduced over time. The policy will apply to nine identified areas that contribute most to children’s sugar intake – breakfast cereals, yoghurts, biscuits, cakes, confectionaries, morning goods (eg pastries), puddings, ice creams and sweet spreads. In August 2017, reformulation was taken further and was applied to ready meals, pizza, burgers, savoury snacks and sandwiches. It is also expected to be applied to juices and milk drinks which are exempt from the sugary drinks levy. There has since been greater emphasis on everyday products such are sold in supermarkets. They are encouraged to cut portion sizes, making recipes healthier or shifting sales to lower calorie alternatives. The Food and Drink Federation has promised to work with PHE on this.
Alongside the child obesity programme further targets are being set on updating the ‘nutrient profiles’ which inform the restrictions on food and drink advertising to children, recommitting to the Healthy Start programme of food vouchers for the under privileged and committing to physical exercise for primary school children. however, it is relayed that there needs to be far greater evidence of progress in the “out of home” sector and restaurant sector, where little action has been taken and where high calorie count and large portions have become a major source of excess calories in people’s diets.
Strict new rules were initiated in July 2017 banning the advertising of HFSS (high fat, sugar and salt) foods or drink products in children’s media, which also includes online and social media. Additionally, further regulations have been introduced regarding similar advertising before the 9pm watershed on television.
Clear food labelling is important to enable people to make healthier food choices. The label can also help clearly show people the differences that portion size can make. There are two different types of nutritional from of pack labelling. First, the ‘traffic light’ labelling scheme which lists the amount of fat, saturated fat, sugar and salt with easy to understand red, amber and green traffic lights. Additionally, there is a system based on the percentage of each food in someone’s guideline daily amount (GDA) of a nutrient.
The basis elements of a label on the front of a pack have been laid down by EU law. Colour coding traffic lights and guideline daily amounts are UK interpretations of that law. The EU legislation goes further. For example the word ‘sodium’ for salt is no longer permitted and nutritional health claims have to be substantiated e.e. if the claim ‘high in Omega 3’ is made, the amount per 100g would have to be given. Likewise claims of high fibre, reduced fat, low salt were set out in EJ legislation. Claims also had to be approved by the EU Food Safety Authority (EFSA), the EU risk assessment body for food safely. An EFSA approved list of health claims has been published the EU Commission. It is expected that following Brexit, this legislation will be copied in to British law.