Speakers: Professor David Walker, Deputy Chief Medical Officer for Health in England, and Professor Jack Winkler, Former Professor of Nutrition Policy, London Metropolitan University
8th April 2015 – meeting notes
All-Party Parliamentary Group on a Fit and Healthy Childhood
‘How do we reduce childhood sugar consumption?’
The Chair introduced the speakers who made introductory addresses, emphasising that the importance of the meeting would be to stimulate dialogue and questions.
Lifestyles in UK are more sedentary, the Foresight report set out how complex the problem is;
- Planning issues: environments can be obesogenic
- Is enough done to incentivise healthy foods?
- Do products which have become unhealthy need to be re-formulated?
- The ‘normalisation’ of obesity should be challenged. Dress sizes have gone up, whilst size labels remain the same.
- Aeroplane seats are being made bigger.
What is the government doing?
- The Government’s ‘Change for life’ campaign had been successful
- Other useful programmes included Childhood XYZ programme
- The Responsibility deal
- Cross government initiatives, the ring-fencing of money at local government level
There are other questions still to be answered:
- Is sugar addictive?
- What is the role of sugar-sweetened beverages?
These and other related issues are subject to ongoing review by the Science Advisory Committee.
Jack Winkler – (supplemented by a summary provided by Prof. Winkler however any errors are ours)
There should be hard and honest thinking about the issues at hand. We have been discussing how to reduce obesity for decades, but it has continued to rise for decades. It is time to assess what is not working and what to do instead.
Overwhelmingly, everywhere, the main instruments have been education programmes for consumers, urging them to eat healthier foods. This is particularly unpromising with children and sugar.
Many urge taxation of soft drinks. But the effects are small. (There have been 2 serious modelling studies on taxation; a 10% tax reduced consumption of sugary drinks by 7.5ml per person; a 20% tax reduced consumption of sugar by only 1g per person.)
New taxes are politically difficult and therefore unlikely to be adopted; especially after the notorious “pasty tax” revolt of 2012, involving as it did, the perceived disparaging of Gregg’s bakery. New food laws in a political climate that no longer sees regulation as consumer protection, but rather, as a “burden” on industry will be difficult to achieve.
In summary, the three main policy levers are either ineffective or unacceptable.
If people will not eat different foods despite decades of education programmes, we must start from the foods they do eat, and improve nutrient profiles of these products. Urging food manufacturers to adopt voluntary “nutritional reformulation” of popular products is the principal strategy proposed by the Chief Medical Officer, Dame Sally Davies, in her recent annual report.
In the case of sugar, there are two routes to reformulation – slow and fast. The first is the gradual, incremental reduction in the amount of sugar added to foods, de-habituation, as urged by an advocacy group, ‘Action on Sugars’.
Much more is underway than is widely recognised, because companies usually do not make claims about the changes. One example is the reduction of sugar in the children’s breakfast cereal, Sugar Puffs. In the early 1990s it contained 49% sugar. Now it uses 31%. That is still a lot of sugar, but there has been a 37% cut.
With sugary foods, there is also the option of substitute ingredients, sweeteners – either traditional sweeteners like aspartame, or new more natural forms, like stevia. Despite controversy, they have been repeatedly tested and found safe. Many in public health say nothing helpful about aspartame, despite it being the most tested product in history.
Anyone seeking to reduce sugar intakes in children should take a position, for or against, on the use of sweeteners. If the movement is to be against sweeteners, there should be a viable programme of de-sweetening products, without using sweeteners. If the movement is to be pro sweeteners, there needs to be a discussion as to why it is not in more foods. In the speaker’s opinion, based on current evidence, the proven health risks of sugar far outweigh the unproven concerns about sweeteners.
For additional information, see the following:
- “Brutal Pragmatism on Food”, British Medical Journal, 29 Jun 2013
- “Making the Healthy Choice the Cheaper Choice”, The Grocer, 20 Dec 2013
- “Nutritional Reformulation”, Food Science & Technology, June 2014
Shouldn’t labels help consumers to make better choices? There is a feeling that “if it is on the shelf it is good”, whilst, in reality, some labelling is misleading.
There was some merit in helping people to make better choices via information on labels, but also potential challenges; such as the effort made by vested interests to obscure information, consumer lack of basic understanding and knowledge; how would they assess a product, such as yoghurt which is high in sugar but low in fat? The speakers stressed that labelling programmes – the so-called ‘traffic lights’ have not been proven to be sufficiently effective.
Sources of sugar
There are 4 major sources of sugar in the British Diet:
- soft drinks
- baked goods
- breakfast cereal
The meeting also discussed current new ‘cooking programmes’ set to be established within the school curriculum. It was emphasised that these would not be effective if they were just to be ‘recipe-based’, without corresponding nutritional education and elements from former successful ‘home economics’ syllabuses.
The desirability of incentivising ‘virtuous foods’ was raised as a possibility, rather than using the taxation as a stick with which to beat advocates of offending products such as sugar! Making ‘healthy’ foods cheaper would also make them more appealing to families and individuals on tight financial budgets.
Opposition Health Shadow Minister, Andy Burnham had recently pledged to monitor the nutritional content of children’s’ food and the speakers were keen to know what plans he might have to achieve this. It would not be easy.
The Chair thanked the speakers and mentioned that Andy Burnham would be the Group’s next speaker. It was hoped that he might be able to provide a steer at the subsequent meeting in May.