Currently browsing posts about: UK

I’m just getting around to reading this report from three groups in the UK: Action on Smoking and Health (ASH), the Obesity Health Alliance (OHA) and the Alcohol Health Alliance (AHA): Holding us back: tobacco, alcohol and unhealthy food and drink.

I learned about it from an article in The Guardian:

The report gives the health statistics: 13% of adults in England smoke, 21% drink above the recommended drinking guidelines, and 64% are overweight or living with obesity,.

NOTE: this report—unlike so many others—examines the political and economic causes of poor health.  It says practically nothing about personal choice or responsibility.  Instead, it focuses on industry profits and the costs of industry profiteering to society.

Big businesses are currently profiting from ill-health caused by smoking, drinking alcohol and eating unhealthy foods, while the public pay the price in poor health, higher taxes and an under-performing economy.

The wage penalty, unemployment and economic inactivity caused by tobacco, alcohol and obesity costs the UK economy an eye-watering £31bn and has led to an estimated 459,000 people out of work.

Meanwhile each year, the industries which sell these products make an estimated £53bn of combined industry revenue from sales at levels harmful to health.

The press release emphasizes the need to curb industry practices: More needs to be done to tackle the unhealthy products driving nearly half a million people out of work.

It recommends, among other things:

• The Government should take a coherent policy approach to tobacco, alcohol and high fat, salt and/or sugar foods, with a focus on primary prevention.
• Public health policymaking must be protected from the vested interest of health-harming industry stakeholders.

To do this, it suggests these actions to decrease sales of harmful products (my summary):

• Restrict advertising
• Set age limits  for purchase.
• Do not allow prominent placement in shops.
• Raise prices; tax.
• Educate the public about risks (the one place where personal responsibility is considered).

The U.K.’s Scientific Advisory Committee on Nutrition (SACN) has released its statement on ultra-processed foods.

It dealt with the NOVA classification system (the one I used in yesterday’s post to define ultra-processed foods).  The committee does not like it much.

Assessment beyond the initial screen identified that the literature is currently dominated by NOVA, raising the risk that any limitations or biases present within the NOVA classification system may be replicated throughout the research literature.
While NOVA also met criterion 2 on a clear, usable definition and criterion 4 on the availability of data on inter-assessor agreement, assessment beyond the initial screen dentified less certainty on the clarity, reliability and feasibility of the system.

The SACN’s conclusions:

The SRs identified have consistently reported that increased consumption of (ultra-) processed foods was associated with increased risks of adverse health outcomes. However, there are uncertainties around the quality of evidence available. Studies are almost exclusively observational and confounding factors or key variables such as energy intake, body mass index, smoking and socioeconomic status may not be adequately accounted for.

…In particular, the classification of some foods is discordant with nutritional and other food-based classifications. Consumption of (ultra-) processed foods may be an indicator of other unhealthy dietary patterns and lifestyle behaviours. Diets high in (ultra-) processed foods are often energy dense, high in saturated fat, salt or free sugars, high in processed meat, and/or low in fruit and vegetables and fibre.

…The observed associations between higher consumption of (ultra-) processed foods and adverse health outcomes are concerning – however, the limitations in the NOVA classification system, the potential for confounding, and the possibility that the observed adverse associations with (ultra-) processed foods are covered by existing UK dietary recommendations mean that the evidence to date needs to be treated with caution.

Comment: Kevin Hall  et al’s well controlled clinical trial of ultra-processed versus merely processed diets is neither discussed nor cited in this statement.  Once again, I have no personal knowledge of how this statement was developed, but the U.K.s Soil Association has published a statement with the provocative title, Sticky fingers of food industry on government ultra-processed food review.

While we’re pleased that SACN has prioritised this review, and has acknowledged that ultra-processed foods are of “concern”, we’re disturbed that the committee’s conclusions may have been skewed by industry ties, conflicted financial interests, and a narrow framing of the science.

…But the committee is also guilty of losing the wood for the trees, failing even to raise concern about how ultra-processed foods have overtaken their own nutritional advice….Most people in the UK are failing to eat such a [healthy] diet, precisely because these foods have been displaced by ultra-processed products. The average child’s diet is more than 60% ultra-processed, and rates of obesity and ill health are rising sharply in turn. …SACN is oddly silent on case for re-balancing the diet and addressing the corporate capture of children’s food.

These omissions should prompt us to look more closely at the composition of the committee. SACN has sixteen members. One is a paid consultant working for Cargill, Tate & Lyle, and CBC Israel (a manufacturer and marketer of fizzy drinks such as Coca-Cola and Sprite); two are in receipt of funding from the meat and dairy industry; one is a shareholder in Sainsbury’s; and five are members of the American Society of Nutrition, which is funded by Mars, Nestlé, and Mondelez. Among SACN’s members is the Chair of International Life Sciences Institute (ILSI) Europe, a body that receives funding from some of the world’s largest food companies, such as Barilla, Cargill, Danone, General Mills, Mondelez, and PepsiCo; and two individuals with financial relationships with the British Nutrition Foundation, an organisation funded by British Sugar, Cargill, Coca Cola, Danone, Greggs, Kellogg, KP Snacks, Mars, McDonald’s, Mondelez, Nestlé, PepsiCo, Tate & Lyle, and Tesco. Two SACN members have been funded by Danone, one of the largest ultra-processed food companies in the world; one sits on the council of the Nestlé Foundation; and another is a former employee of Unilever, with current shares in the company worth “more than £5000”.

These declared interests do not imply corruption or bias on the part of SACN members, but they illustrate how pervasive are industry ties at the interface of science and policy.

For some reason, I’ve only just run across this account of food industry lobbying in the UK.

The introduction explains what the paper is about:

In this Discussion Paper, we examine the interactions of businesses with three major UK government departments, identify  weaknesses in the current disclosure process, and compare UK procedures with the more stringent disclosure requirements in two other English-speaking countries, Ireland and Canada, which tend to produce more specific and transparent data.

The authors are not trying to stop food industry lobbying; they just want it to be disclosed and at least as transparently as is required in Ireland and Canada.

In the United States, the best (only?) way to find out about food industry lobbying is to check the Open Secrets website.  It takes some exploration to find what you might be looking for, but it’s worth the trouble for this kind of result.

Or the top ten food and beverage spenders on lobbying.

If you can find it, the site identifies lobbyists, issues, and notes the revolving door between industry lobbyists and government positions.  It’s good to know these things.

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For 30% off, go to www.ucpress.edu/9780520384156.  Use code 21W2240 at checkout.

I’m just getting caught up on reports.  Here’s one from The Food Foundation, an “independent charity working to address challenges in the food system in the interests of the UK public.”

Its report: The Broken Plate 2022: The State of the Nation’s Food System  “documenting the health of our food system, how it impacts on our lives, and why we must change the food environment so that it delivers healthy and sustainable diets for everyone, everywhere.”

Three things about this report make it of special interest: comprehensiveness, clarity of presentation, and forthright statements about what needs to happen.

For example:

The report covers issues such as price and affordability, food availability (in schools and shopping areas), and health and environmental effects (chidren’s weight and growth, diabetes amputations, life expectancy, climate change).

The UK government has just published its long-awaited food strategy to almost universal disappointment.

But first, some background. Nearly a year ago, I wrote about the UK’s strategy proposals.  These had been commissioned from Henry Dimbleby, a restaurateur with a deep interest in food policy (the British version of Jose Andres?).

To summarize what I said in July 2021.

Henry Dimbleby described the UK’s National Food Strategy as  a “bit of a labour of love.”  It came a slide deck of 175 items.

A separate document. summarizes the report’s 14 recommendations.  Most of the recommendations dealt with school feeding and feeding programs for the poor.  Others:

Recommendation 1. Introduce a sugar and salt reformulation tax.  This came with a separate report on the impact of such a tax; it recommended using revenues to help get fresh fruit and vegetables to low income families.

Recommendation 11. Invest £1 billion in innovation to create a better food system.

Recommendation 13. Strengthen government procurement rules to ensure that taxpayer money is spent on healthy and sustainable food.

So, does the strategy do any of these things?  I have to confess finding the report unreadable.  It is extremely wordy and imprecise, talks a lot about objectives, but says almost nothing specific.  Here is just one example:

The strategy comes at a time of significant increases in food prices, largely because of energy prices and exacerbated by events in Ukraine, which is very challenging for people across the country. We are engaging closely with the food industry to understand price impacts and any mitigating measures, including through our Food Industry Resilience Forum and UK Agricultural Market Monitoring Group. We are also working closely with third sector organisations to understand challenges related to food access.

One section gives action items (I have edited these for clarity):

• Keep producing domestic food at current levels
• Promote job training for the agri-food industry.
• Reduce childhood obesity by half by 2030; reduce diet-related disease; increase healthier food
• Reduce greenhouse gas (GHG) emissions and the environmental impacts of the food system
• Export £1 trillion of food annually by 2030
• Maintain high standards for food consumed in the UK

How?  It doesn’t really say.  The one action item I could locate is to create a Food Data Transparency Partnership.

The partnership will champion consumer interests, providing people with the information they need to make more sustainable, ethical, and healthier food choices, and incentivise industry to produce healthier and more ethical and sustainable food….This partnership will join up with existing work across government to promote healthier food choices, so that government can speak with one voice to industry. It will also support further measures to strengthen incentives to reformulate food, promote healthier food and turn the trend on the overconsumption of calories to tackle obesity.

Unsurprisingly, reactions have been fierce: not a strategy, disappointing, nothing concrete about obesity , health, or reducing meat as a means to address climate change.  If those things are there, I couldn’t find them.

I also couldn’t find The Guardian’s most amusing criticism of the report:

Among its few policy proposals are the suggestion there could be more fish farming, which is environmentally controversial, and an increase in the use of “responsibly sourced wild venison”.

Is that in the report?  I can’t find any reference to venison or deer, however sourced.

Other critiques in The Guardian are here and here.

This is a lost opportunity, and a big one.  Disappointing, indeed.

Last month, the UK government announced guidance for the food industry on compliance with its new policies on dealing with foods High in Fat, Sugar, or Salt (HFSS): Restricting promotions of products high in fat, sugar or salt by location and by volume price: implementation guidance.  

The food industry is not happy about these policies.

Kellogg has launched a legal challenge.

Kellogg has launched a legal challenge against the Government’s upcoming restrictions on retail promotions for food and drink high in fat, salt and sugar (HFSS), claiming the rules unfairly represented breakfast cereals.

On what basis?

The manufacturer argued that the formula used tomeasure the nutritional value of food was wrong when it came to breakfast cereals, as the Nutrient Profiling Model (NPM) only accounted for portions of dry cereals and not for a bowl of cereal and milk…Breakfast cereals are dehydrated foods, that are intended to absorb milk to make the food more palatable and give the food its intended flavour and texture.  Hardly anyone sits down to a bowl of dry breakfast cereals in the morning – cereals are almost always eaten with milk.

What’s really at stake?

From October this year, new legislation will restrict retail promotion of HFSS products. The changes could lead to a reported loss of 1.1bn per year.

The food industry is also arguing that the new regulations will cause a consumer backlash.

These restrictions might escape public scrutiny, but consumers will get a horrible shock when they wake up one day and find their favourite brands have been ruined by regulation and cost more.  Unless manufacturers fight back, be it in the courts or out in the public square, it’ll be too late to do anything about it.

And that the HFSS regulations won’t do any good.

The soft drink industry, however, sees the regulations as no problem: “The soft drinks category will be affected by new HFSS legislation coming into force in England. But having already done plenty of work in reformulating and innovating for the UK sugar tax, the sector is well placed to turn a challenge into an opportunity.”

What’s all this about?  Here’s a quick review of the HFSS history:

2018: In Chapter 2 of the Childhood Obesity Plan,  the UK government set out its intention to end the promotion of high fat, sugar and salt (HFSS) products by location and by price.  It committed to consult on how this should be implemented.  This was based on evidence that food retail price promotions are widespread and effective at influencing food preferences and purchases (particularly for children), and on previous reports recommending reducing and rebalancing promotions towards healthier food and drink to help prevent obesity in children.

2019: The consultation on restricting the promotion of HFSS products was held.

2020:  The government theld a consultation on technical enforcement of the restrictions.  It announced in Tackling obesity: empowering adults and children to live healthier lives, that it would legislate to end promotion of HFSS products by volume (for example, “buy one get one free”) and location both online and in store in England.  It published a formal consultation response.

2021: The government introduced legislation to restrict the promotion of HFSS products by volume price both online and in store in England., based on the nutrient profiling technical guidance 2011.) These regulations will come into force on 1 October 2022.

2022: The new restrictions on HFAA promotion. 

Yesterday’s post was about the UK’s efforts to restrict the marketing of junk foods to children.  This is part of a larger effort to establish a rational framework for improving the entire food system.

In 2020, the government published Part One of the Food Strategy Report it had commissioned from Henry Dimbleby.  The report comes with a 3-minute film explaining what it is about.

The Part One report announced a forthcoming Part Two to evaluate the current system and set recommendations, and explained its philosophical basis:

Should nanny tell us what to eat?

The already complex job of working out how to help different people in different circumstances is complicated by one of the fundamental questions of political philosophy: what role should the state play in the private lives of its citizens? Libertarians and public health campaigners have fought a running battle for years over this question. But when it comes to diet, even fierce opponents of the “nanny state” now recognize that the problem is serious enough to warrant greater state intervention….The vast majority of those we spoke to (and almost every parent) said they were fed up with being bombarded by junk food marketing and thought the state should intervene.

Henry Dimbleby’s Part Two report is now out (he described it to me in an e-mail as a “bit of a labour of love”).  Here it is: The UK’s National Food Strategy

His report is based on evidence summarized in a slide deck of 175 items.

The report’s 14 recommendations are summarized, with rationale and references, in a separate document.  Most of the recommendations deal with school feeding and and feeding programs for the poor.  Some are likely to get focused attention:

• Recommendation 1. Introduce a sugar and salt reformulation tax. Use some of the revenue to help get fresh fruit and vegetables to low income families.
• Recommendation 11. Invest £1 billion in innovation to create a better food system.
• Recommendation 13. Strengthen government procurement rules to ensure that taxpayer money is spent on healthy and sustainable food.

The first recommendation comes with its own, separate report on the impact of a tax on added sugar and salt.

The responses:

From The Guardian

The government-commissioned National Food Strategy, drawn up by the restaurateur Henry Dimbleby, says the UK population’s “malfunctioning” appetites and poor diets – fuelled by consumer and manufacturer’s reliance on processed food – place an unsustainable burden on the NHS and contribute to 64,000 deaths each year.

Its most eye-catching recommendation is a levy of £3 a kilo on sugar and £6 a kilo on salt sold wholesale for use in processed food, restaurants and catering, which it says would be a world first. This would raise up to £3.4bn a year, some of which should fund an expansion of free schools meals to an extra 1.1 million children and an overhaul of itain’s food and cooking culture… Dimbleby believes the tax would incentivise manufacturers to reduce salt and sugar levels by reformulating products.

From FoodNavigator.com: From taxing salt and sugar to reducing animal proteins: The controversial proposals in the UK’s National Food Strategy paper.  In 2019 the UK government commissioned a review of the country’s food system. Today, the results are in – and the far-reaching paper includes some controversial recommendations…. Read more  [note: This has a good summary of the 14 recommendations].

From FoodManufacture.com

• National Food Strategy Part 2: sugar and salt tax plans: The National Food Strategy Part 2 has been published, revealing proposals for a sugar and salt tax on all processed products, except ingredients for home cooking, and on foods sold through foodservice channels…. Read more
• National Food Strategy Part 2: reactions: The National Food Strategy Part 2 has provoked mixed reactions, with big grocery retailers backing calls for mandatory reporting of key information, while others have criticised sugar and salt tax proposals…. Read more

And for a broad look at what’s happening in UK food policy, see: Testing Times for UK Food Policy: Nine principles and Tests, by Tim Lang, Erik Millstone, Terry Marsden.  This deals with holding governments accountable.

The Discussion Paper examines the state of post-EU UK food security and policy. It applies a multi-criteria approach, seeing food not as a matter that can be reduced to one overarching goal – cheapness, say, or supermarket availability – but as an issue on which public policy has to weigh up and include several equally worthy and evidence-based concerns. The report offers an approach to ensuring UK food security in the years ahead. It offers nine public-interest Principles which should guide future food policy. These propose that it is possible to capture a consensus on the need for change and what it entails. Each Principle leads to a Test that the UK public and policy-makers could apply to any policy proposals for the food system that emanate from Government in coming months.

Tim Lang’s book, Feeding Britain, is essential reading to understand what’s happening—and not happening—in the UK.

The UK government is thinking and acting on food policy issues.  If only ours did too.

The UK government is actively trying to promote healthier diets.

On June 24, the British government announced:  Introducing further advertising restrictions on TV and online for products high in fat, salt and sugar [HFSS]: government response

Rationale: “Current advertising restrictions for HFSS products during children’s TV and other programming of particular appeal to children are insufficient to protect children from seeing a significant amount of unhealthy food adverts on TV, and do not account for the increasing amount of time children spend online. Analysis from September 2019 demonstrated that almost half (47.6%) of all food adverts shown over the month on ITV1, Channel 4, Channel 5 and Sky1 were for HFSS products and this rises to nearly 60% during the 6pm to 9pm slot.”

Research basis: The Advertising Standards Authority’s  position paper on Advertising to Children.

The final policy

• By the end of 2022, establish a 9:00 pm TV watershed for HFSS products [meaning this applies until 9:00 p.m.] as well as restrict paid-for HFSS advertising online.
• The HPSS ad watershed applies to all on-demand programme services (ODPS) under the jurisdiction of the UK.
• The restriction of paid-for HGSS ads onlinealso  applies to non-UK regulated ODPS.
• The policy will be evaluated 5 years post implementation, in 2027.

Critique

From the food industry: Will the UK’s junk food marketing clampdown combat childhood obesity?  The UK Government announced plans to limit the advertising of unhealthy foods last week. The food and advertising industries expressed ‘disappointment’ at ‘draconian’ measures, while health campaigners welcomed the news but voiced concern over possible future loopholes. With so many complex and interlinked issues driving childhood obesity rates, the most important question remains: Will it work?… Read more 

From The Guardian: “UK government’s plans for pre-9 pm ban on junk food TV adverts criticised,”