You say ‘bold’, they say ‘knee-jerk and unfair’

The outgoing chief medical officer wants to beat industry with a big regulatory stick to help tackle childhood obesity. Many will therefore be hoping for a prime minister that ignores her evidence and laughs off the crisis as yet more piffle-waffle.

The title of Professor Dame Sally Davies’ last report as chief medical officer told the story: Time to Solve Childhood Obesity. Critics of efforts to date might well have prefixed this with “it’s about”.

Indeed, the report comes just weeks after businesses were criticised for their painfully slow progress in meeting the 20% by 2020 sugar reduction targets under the government’s childhood obesity plan. Last week, data published through the national childhood measurement programme showed the prevalence of obesity has increased from 9.5% to 9.7% in the past year among four- and five-year-olds, and stayed the same for 10- and 11-year-olds.

“The government ambition is to halve childhood obesity by 2030 – in England, we are nowhere near achieving this,” the outgoing CMO noted. “I want to see our children’s health, not companies’ profits, put at the forefront of government policy.”

Dame Sally called on politicians to ensure that children have access to healthy and affordable food, are protected from marketing of unhealthy foods, and have the opportunity to run, bike and play safely. Regulation is the only way to rebalance the scales in favour of healthy options, she suggested.

Included in her recommendations are:

  • an extension to the Soft Drinks Industry Levy to capture milk-based drinks with added sugar
  • standardised packaging for unhealthy products if the reformulation programme continues to struggle
  • an upper calorie cap on all food and drink sold out-of-home (OOH)
  • a rebalancing of VAT rates to favour healthy options
  • mandatory nutrition labelling OOH
  • a ban on eating and drinking on urban public transport
  • updating the National Planning Policy Framework so there is a distinction between business that sell healthy food and those that don’t
  • tax reliefs only for advertising of healthy products
  • bans on advertising unhealthy food and drink at major public venues and public-funded events
  • a review of free school meals and all schools and nurseries to comply with Government Buying Standards.

Campaigners have called the proposals “bold”, but industry said some of the more radical ones are “knee-jerk, impractical and unfair”. There are certainly questions surrounding the effectiveness of calorie labelling on menus, but those eating OOH do have less nutritional information available to them than when they’re in a supermarket. The benefits of the sugar tax on drinks are also well-reported: a 28.8% reduction in total sugar per 100ml in take-home products and a 27.2% fall in average total sugar content for drinks consumed outside of the home.

The Obesity Health Alliance said: “This bold report clearly lays out how our environment is flooded with unhealthy food and drink and how this is overwhelming families and damaging children’s health. This report makes crystal clear that the target will be missed and children’s health will suffer unless the government fully delivers existing plans and goes much, much further.”

UKHospitality chief executive Kate Nicholls had a rather different take: “A blanket cap on calories for all portions of food and drink consumed out-of-home sounds like a knee-jerk, impractical and unfair measure.”

However, some of the ideas merited further consideration, said Nicholls: “Reducing the rate of VAT for healthier options on menus could be a good way to promote healthier choices. We would certainly be interested in exploring options to reduce costs for businesses providing healthy food and drink for customers.”

Kate Halliwell, head of UK diet and health policy at the Food and Drink Federation, insisted that her members are “working hard to implement what has already been asked of them by government in three chapters of a childhood obesity plan published in just three years”. She said manufacturers are selling 57.3 million fewer kilograms of sugars and one trillion fewer calories than they were back in 2015, adding: “As Public Health England acknowledges, reformulating products takes time, and we must always take the consumer with us.”

In Scotland, ministers are currently mulling over new measures to make food eaten OOH healthier. Food Standards Scotland has put forward a number of proposals, some of which mirror the CMO’s new report. Again, there is a feeling that industry is reacting far too slowly: portion sizes are too big, information is too sparse and voluntary targets are too easily avoided. Since a commitment to halve childhood obesity was made there has been an increase in the number of children at risk of obesity.

Dame Sally said it is time to get tough: “Government must not shy away from regulation,” she said in her report. “When government sets targets or legislates, business innovates and can still make a profit – for example, when it develops better and healthier foods. But currently the playing field is not level – it is too easy to make money from selling unhealthy food and too hard to make money from selling healthy food.”

Politicians have been told and businesses have been warned. As Footprint noted in its analysis of the sector’s poor track record on sugar, the case for voluntary action of food “hangs by a thread”. The sector “needs a miracle” turnaround to resist new regulations. Either that, or a prime minister that ignores the evidence and laughs off this crisis as yet more piffle-waffle.

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