Turning up the heat on unhealthy food
In her annual report, England’s chief medical officer Dame Sally Davies launched a scathing attack on the food industry, accusing it of collectively failing to help deliver healthier diets.
Tougher action is needed to combat the spread of obesity and non-communicable diseases like type 2 diabetes and cardiovascular disease, Dame Davies insisted. The problem is taking a huge toll on population health and the overall economy, she stressed. Half of the country’s chronic disease count and 40% of cancers are attributable to poor diet, smoking, physical inactivity alcohol and air pollution, the report noted.
Significantly, Dame Davies argued that the voluntary approach backed by government and facilitated by Public Health England (PHE) had not worked.
“The food industry has not done enough,” she warned. “They were asked by Public Health England to reduce sugar by 20%. We have recently heard that they have not achieved their present target and we know there is too much sugar and salt in our diet.”
Salt and sugar targets not met
UK food makers often point to the example of salt reformulation as proof positive that a voluntary, collaborative approach between business and government can get results.
“Many of Britain’s biggest and most-loved brands have been reformulated to reduce salt, without making any compromises on taste, quality or safety,” industry body the Food and Drink Federation states on its website. “We are proud of our advancements in technology to facilitate these changes, and are now widely acknowledged to be leading the world in voluntary salt reduction.”
Indeed, data from PHE supports the suggestion that salt consumption has fallen at a population level. Adult intake decreased from 8.8 g/day in 2005/06 to 8.0 g/day in 2014 – an 11% drop, PHE data reveals.
Progress, however, has slowed. According to the latest assessment from PHE, only around half of the salt reduction targets set in 2014 were met by 2017.
In 2014, PHE set specific salt reduction targets for the 28 broad product categories (and 76 sub-categories) that contribute most to people’s salt intakes. These targets were supposed to be achieved by December 2017. The food sector met 52% of the objectives.
“Retailers made more progress than manufacturers towards achieving average targets, meeting 73% of these compared with manufacturers meeting 37%. Performance of individual food categories varied considerably,” PHE concluded.
Sugar wasn’t off the hook either. Dame Davies recommended a ban on added sugar to baby food and formula and an extension of the sugar tax, which applies to soft drinks, to be extended to milk drinks containing sugar.
The report suggested fiscal measures should also be used to promote positive choices – with the possibility of incentives, such as price subsidies, to promote fruit and veg consumption.
Is voluntary approach working?
Dame Davies went on the attack over the government’s approach to salt, linking the slowed progress to changes in policy direction.
Between 2003-11, the Food Standards Agency led work to reduce salt, making the UK a “world leader” in the field. But when the FSA was merged into PHE and the voluntary “responsibility deal” was set up in 2011, Dame Davies believes things started to go south.
“The government moved salt into the responsibility deal. Industry have not delivered. We have a system where people are benefitting from selling unhealthy food and they are not paying for the harm it is doing.”
Growing call for action
Unsurprisingly, the report struck a chord with health campaigners.
Graham MacGregor, professor of cardiovascular medicine at Queen Mary University of London and the chair of Action on Sugar and Action on Salt, expressed strong support for mandated targets for salt, sugar and calories, “particularly given the very weak approach of PHE in enforcing the current voluntary programmes”.
“Unhealthy food – that is, foods that are high in salt, sugar and calories – is now the major cause of death and disability in the UK. We are calling on the government and the food industry to take immediate action and prevent all these unnecessary deaths and suffering.”
While food and farming charity Sustain backed the idea of encouraging healthy eating through fiscal measures.
“Good food should be more affordable, accessible and attractive. Only then will we see a shift in consumption away from unhealthy and unsustainable products, which leave taxpayers to pick up the costs through an overstretched NHS and environmental damage,” the group’s deputy CEO said.
Food industry comes out fighting
In the face of this stinging criticism, the food industry defended its record on reformulation. Over five years FDF, member companies have reduced calorie content in the average basket by 5.5%, and sugar content by 12.1%, Kate Halliwell, FDF Head of UK Diet and Health Policy said. “PHE have themselves said that the industry has made good progress in reducing the amount of sugar in products. Our salt reduction efforts have been described as 'world-leading'.”
She also insisted that taxes were not the way forward: “There is no evidence that additional food taxes can change consumer behaviours over the long-term. McKinsey, in its comprehensive review of policy tools aimed at tackling obesity, ranked tax thirteenth in effectiveness out of sixteen interventions, while portion control and product reformulation were ranked one and two.
“Food and drink companies should focus efforts where they can have the maximum impact, instead of managing the impact of wrong-headed legislation.”
For the time being at least, it doesn’t look like there are any major policy shifts on the horizon.
Speaking on Radio 4’s Today programme this week – following the revelation that the average 10-year-old has consumed the amount of sugar that they should eat throughout their entire childhood – PHE chief nutritionist Alison Tedstone stressed PHE's role is to implement government policy, which remains focused on voluntary targets. Refusing to be drawn on whether this approach was working, she added that judgement on how effective current efforts were should be reserved for when PHE gives its progress update later this year.
Could the tide of opinion be turning towards a more interventionist approach to drive reformulation? Some signs would seem to indicate that this is indeed the case. If so, the food sector could do well to read the room and ramp up efforts to cut salt, sugar and fat levels.