David Burrows runs through the key lessons we learned about health policy at November’s conference.
1) Beauty is in the eye of the beholder
The UK has a childhood obesity plan and it’s the envy of the world. According to those who helped to write it. So is our salt reduction programme. According to the government. And our rules to prevent marketing of junk foods to children: well, they’re the toughest anywhere in the world (though research just published by the Obesity Health Alliance suggests otherwise). With all these wonderful policies in place, one wonders how the UK is currently the most obese country in western Europe, and record numbers of kids are leaving primary school either overweight or obese.
2) Love is in the air
But whether you think the strategies are wimpy or wonderful, there does appear to be a renewed sense of urgency about the need to tackle a problem that costs the NHS £6.1 billion a year (£27 billion if the wider social impacts are factored in). Speakers from the government at November’s Food Matters Live conference bigged up big food’s appetite for change. Forty percent of the drinks that would have been captured in the new levy on sugar-sweetened drinks have already been reformulated, said the government’s deputy chief medical officer, Dr Gina Radford. “So far the signs are positive.”
3) A sweet stick … and no more carrots
But will a voluntary approach work? The government’s representatives at FML certainly believe so: there is a “more structured approach” this time around, while the sugary drinks levy has stimulated action among the food companies voluntarily committing to cut sugar content. As such, policymakers have backed themselves into a corner: if the reformulation programmes on sugar and, in due course, calories don’t work, then regulation will be the only way out. Businesses are clearly being given due notice.
4) How sweet can turn sour
Behind every compliment there came a threat. We can’t forget that “our teenagers glug sugary drinks with gay abandon”, said Radford. “We haven’t ruled out further action.” Dr Alison Tedstone, the national director with responsibility of diet, nutrition and obesity in the health and wellbeing directorate of Public Health England (PHE), had obviously been given the same briefing note. We don’t know if the voluntary sugar reformulation programme is going to work, but “data monitoring and transparency is at the absolute heart of the programme. It’s very important the biggest sellers change,” she warned.
5) The burger bombardment
In March, PHE will publish progress being made by the 20 bestselling brands in each of the nine product categories involved in the programme to remove 20% of sugar from the products children eat most by 2020. Some will inevitably struggle, and there are perhaps even bigger headaches ahead for those in the out-of-home (OOH) sector. There’s going to be a calorie reduction programme. “We need to tackle pizzas. We need to tackle burgers,” Tedstone said. “Parents are being bombarded the minute they walk into a shop or down the high street … to just buy more sugary products.”
6) Shhh, don’t tell anyone
Research presented by the NPD Group, for example, showed that just 4.1% of people chose a lunch outlet because they wanted a healthier option. “The foodservice industry is still a treat industry,” said Cyril Lavenant, the company’s director of foodservice for the UK and France. “Health is more about reassurance.” Louise Pilkington, the marketing director of Compass, told the tale of a client that asked for 80% of the menu to be healthy, and then faced “a riot because chips weren’t available” at one of the sites. Pilkington wants to see more “health by stealth”. “Working quietly behind the scenes actually has more influence,” she said. On that front, decent progress is being made to replace meat with more vegetables, but again the question many firms are asking is: “Do we tell people?”, explained Baxter Storey’s head of nutrition, Gabriella Roberts. “As soon as you label something vegan or meat-free you can lose customers. Some people … see it as a cost-cutting exercise.”
7) Out of home and in the know
While a label promoting a dish as “less meat” could send the marketing teams mad, there is room for more transparent nutritional information. Putting calories on menus was part of the Public Health Responsibility Deal, of course. Some embraced the concept, some seem to have struck a halfway house (Marks & Spencer has information for the food at its cafés but not its hot drinks), and many still haven’t bothered at all. (Scotland, incidentally, may well go for a mandatory approach as part of a new sector-specific strategy for OOH). Tedstone might be tempted too: “Out of home is a largely an information-free zone,” she suggested. “I’d strongly argue that calories on a website does not enable healthy choices.” And speaking of the internet, the government seems keen to catch the tech companies “making a lot of money out of food” in its pseudo-policy net.