In the UK, the majority of adults are overweight or obese. According to recent NHS data, 67% of men and 60% of women fall into these categories.
In 2020, 20% of year six children were classified as obese, with prevalence more than twice as high in the most deprived areas, compared to the least deprived.
At the same time, the British Dietetic Association estimates that three million people are either malnourished or at risk of malnutrition across the country.
While ‘no single action’ will resolve these issues, Dr Anthony Laverty from Imperial College London’s School of Public Health believes mandatory fat, sugar and salt targets should be a key part of the Government’s strategy.
‘Self-regulation doesn’t work’
The reason for Dr Laverty’s position is at least two-fold: firstly, the health expert says voluntary reformulation targets haven’t worked, and secondly, that their mandatory counterparts have.
In an editorial published in the British Medical Journal (BMJ) yesterday, Dr Laverty referenced the latest Public Health England (PHE) report on the voluntary sugar reduction strategy 2015-19. The strategy challenged the food industry to cut 20% sugar from foods that most contribute to children’s intake. To achieve this target, PHE suggested manufacturers reformulate, change product size, or shift consumers to low or no sugar options.
Analysing PHE’s findings reveals that certain categories achieved greater sugar reduction than others. The sugar contents of yoghurts and breakfast cereals, for example, achieved a sugar reduction of 13%.
However, other categories indicated ‘disappointing progress’, noted Dr Laverty. Between 2015 and 2019, total sugar per 100g fell by an average of just 3% in foods sold in retail. For foods eaten outside the home, sales fell just 0.3%.
In September last year, PHE published its second report on salt reduction – a strategy the British Nutrition Foundation (BNF) said showed ‘little progress’. In 2018, retailers and manufacturers combined met 28 out of 52 average targets, which is the same number as in 2017.
BNF senior scientist Anne de la Hunty told FoodNavigator at the time that the reason certain categories performed poorly, just as meat products, could be related to technical challenges. “This is the case where salt has a role other than just providing taste, for example food preservation and safety, and these functions need to be maintained.”
For Dr Laverty, PHE’s progress reports to date highlight the ‘deficits’ of industry self-regulation. The same cannot be said, he noted, of mandatory targets.
The sugar tax comparison
An interesting comparison can be made between PHE’s sugar reduction efforts and the UK’s Soft Drinks Industry Level (SDIL), suggested the health expert. Introduced in April 2018, the levy taxes products with more than 5g sugar/100ml 18p per litre. Those with more than 8g sugar/100ml are taxed at 24p per litre.
Research indicates that between 2015-2018, the total amount of sugar sold in soft drinks dropped by 29%, with six of the top 10 soft drinks companies in the UK having reformulated 50% or more of their products subject to the sugar tax.
“Research clearly shows that a robust independent regulatory system is required, with targets set by government and progress publicly monitored,” noted Dr Laverty. “When industry is allowed to decide and set targets, real change is often avoided and minimal progress is made.”
However, the sugar tax strategy is not without its faults, the health expert stressed. While it has proven to be more effective than policies focused on consumer choice, and indeed, it has reduced total sugar content, the food industry responded by increasing advertising to maintain customers and profits. “This means that policies need to be continually monitored and adapted to respond to industry activity and to any unintended consequences or regressive effects.”
Pressure on PHE replacement
Moving forward into a post-Brexit world – one in which PHE is rejigged – Dr Laverty stressed the agency’s successor must have the freedom to take a ‘more robust’ approach with the food industry and ‘abandon the failed experiment of self-regulation’.
“Without mandatory measures, the food industry will continue to prioritise profit over health and drive unsustainable increases in diet related diseases.”
Campaign groups Action on Sugar and Action on Salt similarly highlighted the importance of ‘preventing’ rather than ‘treating’ disease moving forward.
“The UK has an opportunity to be world-leading again, with the potential of developing and implementing mandated national nutrition improvement measures like the SDIL to replace the current voluntary programmes,” said Campaign Director Katharine Jenner.
“Improving nutrition is good for individuals, good for the economy and, as we have seen with the sugar levy can even be good for business. It’s therefore imperative that whoever is responsible for tackling the biggest cause of premature death and disability in the UK when PHE is dissolved, prevents disease and not just treats it.”
Industry responds: ‘Reformulation takes time’
From the UK F&B perspective, industry has been reducing the amount of salt, fat and sugars in their products, making more healthier options available, and limiting portion sizes, for the last two decades.
UK trade association Food and Drink Federation (FDF) stressed its commitment to the cause ‘cannot be doubted’. “Compared to 2015, FDF members’ products now contribute 11% fewer calories, 11% fewer sugars, and 14% les salt to the average shopping basket,” FDF chief operating officer Tim Rycroft told FoodNavigator, referencing Kantar Worldpanel data.
“The UK reformulation programmes – which have always been voluntary – are regarded world-leading.” Indeed, according to a 2019 supplement article published in World Obesity, in a global comparison, packaged food and drink in the UK was ranked the healthiest, with the lowest sugar and energy content, between 2013-2018.
“Food and drink manufacturers’ efforts should be recognised and celebrated, as businesses continue their efforts towards the latest ambitious targets,” said Rycroft.
At the same time, reformulation targets must be ‘realistic’ and ‘achievable’, noted the COO. As BNF’s de la Hunty suggested, some products are easier to reformulate than others – a sentiment that Rycroft echoed.
“Reformulation takes time and must carry loyal consumers with it; if you change the recipes of the UK’s best loved brands and people don’t like it, they won’t buy it. That’s why manufacturers dedicate so much time and expense developing and testing reformulated products before they come to market.
“Government should incentivise companies to continue to reformulate and resist creating barriers, such as the proposed advertising and promotional restrictions, which will limit companies’ ability to bring these to the market successfully.”
‘Industry self-regulation fails to deliver healthier diets, again’
Published 6 January 2021
Author: Dr Anthony A Laverty
‘A comparison of the healthiness of packaged foods and beverages from 12 countries using the Health Star Rating nutrient profiling system, 2013-2018’
Published 22 July 2019
Authors: Elizabeth K. Dunford, Cliona Ni Mhurchu, Liping Huang, Stefanie Vandevijvere, Boyd Swinburn, Igor Pravst, Lizbeth Tolentino-Mayo, Marcela Reyes, Mary L’Abbé, Bruce C. Neal