Lords Committee says UK needs a plan to fix food

The House of Lords Food, Diet and Obesity Committee has released a new report – Recipe for health: a plan to fix our broken food system – which demands that the UK Government develop a comprehensive, integrated long-term new strategy to fix our food system, underpinned by a new legislative framework.

The report finds that obesity and diet-related disease are a public health emergency that costs society billions each year in healthcare costs and lost productivity.

The report notes that:

  • England has one of the highest rates of obesity among high-income nations, driven primarily by unhealthy diets. Two-thirds of adults are living with overweight or obesity, and 29 per cent are living with obesity.
  • More than 20 per cent of children start primary school with overweight or obesity, rising to over 36 per cent by the time they leave.
  • After tobacco, diet-related risks now make the biggest contribution to years of life lost.
  • In economic terms, the annual societal cost of obesity is at least 1–2 per cent of UK GDP – billions each year in healthcare costs and lost productivity.
  • The Lords Committee says that the aim of their report is to ensure that everyone can access affordable healthy food so they can live healthier lives.

Baroness Walmsley, Chair of the Food, Diet and Obesity Committee, said, “Food should be a pleasure and contribute to our health and wellbeing, but it is making too many people ill. Something must be going wrong if almost two in five children are leaving primary school with overweight or obesity and so many people are finding it hard to feed healthy food to their families. That is why we took a root and branch look at the food system and analysed what had gone wrong over the past few decades.

“Over the last 30 years successive governments have failed to reduce obesity rates, despite hundreds of policy initiatives. This failure is largely due to policies that focused on personal choice and responsibility out of misguided fears of the ‘nanny state’. Both the government and the food industry must take responsibility for what has gone wrong and take urgent steps to put it right.

“We hope, given the recent comments from the Prime Minister, Lord Darzi and the Secretary of State for Health, that there is now an appetite to shift towards prevention of ill health. We urge the government to look favourably on our plan to fix our broken food system and accept that not only is it cost-effective, but that it would lead to a lot less human misery.”

Key recommendations
As part of the new comprehensive strategy, the government should:

  • Make large food businesses report on the healthiness of their sales and exclude businesses that derive more than a defined share of sales from less healthy products from any discussions on the formation of policy on food, diet and obesity prevention.
  • Give the Food Standards Agency (FSA) independent oversight of the food system.
  • Introduce a salt and sugar reformulation tax on food manufacturers, building on the success of the Soft Drinks Industry Levy. The government should consider how to use the revenue to make healthier food cheaper, particularly for people living with food insecurity.
  • Ban the advertising of less healthy food across all media by the end of this Parliament, following the planned 9pm watershed and ban on paid-for online advertising in October 2025.
  • Commission further research into the links between ultra-processed foods (UPFs) and adverse health outcomes and review dietary guidelines to reflect any new evidence. The rapidly growing body of epidemiological evidence showing correlation between consumption of UPFs and poor health outcomes is alarming. Beyond energy and nutrient content, causal links between other properties of UPFs and poor health outcomes have not at the present time been clearly demonstrated. To understand any links, more research is needed.
  • Immediately develop an ambitious strategy for maternal and infant nutrition and drive up compliance with the school food standards. This will help break the vicious cycle by which children living with obesity are five times more likely to become adults with obesity.
  • Enable auto-enrolment for Healthy Start and free school meals and review the costs and benefits to public health of increasing funding and widening eligibility for both schemes. This is essential to help families living in poverty afford healthy food and to begin closing the gaping inequalities in unhealthy diets and obesity rates.

In more detail – Five key areas that the report says need to be addressed

A new food strategy
Between 1992 and 2020, successive governments proposed nearly 700 policies to tackle obesity. Despite this, obesity rates have continued to rise.

This failure was the result of relying on individual responsibility, rather than tackling the reasons why people eat unhealthily.

Less healthy, processed foods are typically more profitable for businesses than healthier foods because they are cheap to produce and sell and are highly palatable.

Dr Rob Ralston, Lecturer in Public Policy at the University of Edinburgh, said in oral evidence to the Committee, “It is often not in the interests of corporations to promote healthier food products, simply because the profit margins are lower and corporations have a fiduciary duty to shareholders to maximise profits.”

To turn the tide, the government needs to take a new approach to the food industry, regulating businesses that rely on sales of less healthy food and giving businesses incentives to produce and sell healthier food.

The government must publish a comprehensive and integrated food strategy led at the highest level, setting targets for a healthy food system and plans to achieve them.

Ultra-processed foods
Recently, there has been intensive public and scientific debate on the health effects of ultra-processed foods (UPFs). UPFs are estimated to make up more than half of average energy intakes in the UK.

Academics at the University of São Paulo first proposed the concept of ultra-processed foods in 2009 to test the hypothesis that rising consumption of industrially processed foods was driving increases in obesity and diet-related disease in Brazil.

Multiple studies have shown correlation between consumption of UPFs and adverse health outcomes. Many UPFs are already considered less healthy in dietary guidelines and regulation because they are high in calories, fat, salt and sugar (HFSS).

Apart from energy and nutrient content, causal links between other properties of UPFs and poor health outcomes have not been demonstrated with certainty. To understand any links, more research is needed.
More broadly, less healthy, highly processed foods are often the affordable and convenient option, particularly for people living with food insecurity.

The government’s new strategy must seek not only to reduce sales of less healthy foods but to make healthier, often unprocessed and minimally processed foods affordable and accessible for all.

Taxing unhealthy food businesses
Health taxes can be a powerful way to drive business to sell healthier food and drink.

The Soft Drinks Industry Levy led to a reduction of more than a third in the sugar content of soft drinks in just four years. The tax is also linked to reductions in sugar consumption and in obesity in year 6 girls.

By contrast, voluntary sugar and salt reduction programmes led to little to no change.

A new tax on businesses using salt and sugar could reduce calorie intakes and help people live longer in better health. It could also free up funding to make healthier food cheaper, for example by subsidising fruit and vegetables or extending free school meals.

Charlie Bigham, founder of ready meal maker Charlie Bigham’s, said in oral evidence, “If we had to pay more for sugar and salt, perhaps that would encourage us and the whole manufacturing industry to use less.”

The government should introduce a salt and sugar reformulation tax and consider how the revenue can be used to make healthier food cheaper, particularly for people on low incomes.

Healthy infancy and early years
It’s critical to act early to reduce the risk of obesity and diet-related disease. Children living with obesity are five times more likely to become adults with obesity.

The Committee heard that more could be done to support families with healthy infant feeding.

At population level, breastfed babies are significantly less likely to develop childhood overweight or obesity.

Although exclusive breastfeeding is recommended until the age of six months, only around half of babies are still fully or partially breastfed after six to eight weeks.

For formula-fed babies, responsive bottle feeding is key to avoiding over-consumption.

Dr Vicky Sibson, Director of First Steps Nutrition Trust, said in oral evidence, “In infancy, we have this window of opportunity where we need to help children to learn to eat, both physiologically and socially.”

Some commercial infant foods have more sugar than biscuits or confectionery and it’s legal to market them for use from four months of age, even though government dietary guidance says solid foods should only be introduced from six months.

Marketing often suggests such foods are healthier than they really are.

The government must set ambitious new goals on maternal and infant nutrition, develop a comprehensive strategy to achieve them, and set strong mandatory compositional and marketing standards for commercial infant foods.

Tackling food insecurity
The most deprived children are more than twice as likely to be living with obesity than the least deprived.

Almost a fifth of children live in food insecure households. Per calorie, healthier foods have been estimated to be more than twice as expensive than less healthy food.

There is an urgent need for measures to help families in poverty to afford healthy food.

The Healthy Start scheme plays an important role in enabling pregnant women and families with babies and young children to access fruit, vegetables and milk.

However, the value of payments has not kept up with soaring prices and too many families may be missing out.

In too many schools the free school meals allowance does not cover the cost of a nutritious meal and about a third of children in poverty aren’t eligible for free school meals.

Harrison Wright, Bite Back Youth Board member, said in oral evidence, “A lot of my friends were on free school meals […] You would get a chicken burger for £2. You might think of a chicken burger with mayo, lettuce and all the extras, but no, it was a fried chicken breast in a white bun. That is it.”

The government must enable auto-enrolment for Healthy Start and free school meals and immediately review the costs and benefits to public health of increasing funding rates and widening eligibility for them.

Read the report, Recipe for health: A plan to fix our broken food system

 

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