The fat keeps flowing

CAMPAIGNERS SAY that politicians’ fear of the big food companies is clogging up efforts to curb obesity. Is it time for a more radical approach?

Foodservice Footprint P22 The fat keeps flowing  Features Features  The National Institute for Health and Care Excellence Tam Fry Public Health Responsibility Deal NICE Mars Cadbury Bournemouth University










If the opinions of our experts opposite prove anything it’s that there is precious little agreement on how to solve the problem of obesity. The policy options put forward range from soft measures that encourage businesses to act more responsibly to more draconian actions to curb the sale of foods high in salt, fat and sugar.


In the UK, the soft approach currently holds sway. The government’s flagship Responsibility Deal puts the onus on industry to voluntarily improve the health profile of its products. This has undoubtedly produced some positive results, particularly in portion control, with the likes of Mars and Cadbury committing to meeting a 250kcal limit for their single-serve portion confectionery. However, the criticism often aimed at voluntary action is that the industry-agreed targets are not ambitious enough and fail to engage the entire business community.


“We need a carrot and stick approach,” says Tam Fry, a spokesman for the National Obesity Forum and a keen advocate of legislation. “The industry needs to be set a timeframe for reformulation and the incoming government [in 2015] has got to legislate” if the targets are not met.


The National Institute for Health and Care Excellence (NICE) recently endorsed carrots rather than sticks, with its latest guidance on maintaining a healthy weight consisting of lots of advice for consumers such as reducing TV viewing and following the principles of a Mediterranean diet. There was very little in the way of bold, potentially paradigm-shifting actions that the likes of Fry say are now absolutely necessary.


What isn’t on the table, in the UK at least, is the use of fiscal measures to change behaviour – as advocated by Fry: “We need to tax junk food to the hilt” – which would be at odds with the UK government’s pledge to reduce burdens on businesses.


It’s hard to see that changing any time soon. Although a change of government in 2015 could bring a shift in policy, any moves to tax junk foods or drinks are likely to meet fierce resistance from the private sector and to be deeply unpopular with the public.


Left-leaning policy professionals will be keeping a close eye on Mexico, where a tax on soft drinks was enacted in January to curb the alarming rise in obesity there. Should the tax prove successful it may provide the evidence needed to justify fiscal measures in other countries, but it will be a brave government that acts to raise the price of food at a time when, as Martin Caraher from City University notes, more and more people are using food banks.


One area that receives less focus, but could have long-term potential, is addressing the social and environmental conditions that shape people’s food choices. This could mean a more progressive planning framework so that low-income people living in food “deserts” have access to cheap and varied food; ensuring that those living in social housing have access to adequate cooking facilities and utensils; or requiring that all children are taught cookery skills as part of the national curriculum.


Sean Beer, a senior lecturer at Bournemouth University, advocates raising the age at which children go to school from four to seven so that the young children could attend pre- schools where the emphasis would be on active learning physically and socially. This may seem like a radical proposal but with conventional policy responses showing little sign of reversing the rise in obesity, maybe a radical approach is just what the doctor ordered?


What one food or health policy would you change or introduce in order to curb the rise in obesity, and why?


The campaigner: Fines for failure to reformulate


“The most outstanding omission in food policy since obesity became an issue is the failure of successive governments to regulate the food and beverage industries and ensure that no food product available in the UK contains dangerous and excessive amounts of fat, sugar and salt. Companies who currently lace their products with unacceptably high levels of such ingredients should be required to reformulate within an agreed time or face taxes/fines if they wilfully fail to comply. Removing the excesses would not only dramatically reduce UK obesity levels but also simultaneously lower the potentially more dangerous, and expensive to treat, comorbidities triggered by obesity. A few companies have voluntarily reformulated and have demonstrated that it can be achieved. The majority however have not. Without being this radical, 60% of UK men and 50% of women may well be obese by 2050 as predicted by the 2007 Foresight Report.”


Tam Fry is spokesman for the National Obesity Forum


The caterer: No need for change


“There is no one thing we would necessarily amend or introduce. We truly believe that as an industry we have a responsibility to help all our customers make informed choices when it comes to diet and lifestyle; in particular in the schools where we operate we recognise the part we can play in educating children from an early age about the importance of a healthy balanced diet. We work closely with our supply partners and government through initiatives such as the Responsibility Deal on public health to do this. Through the deal we need to leverage the partnership we have developed and promote what our industry can do and the impact our services have on the day-to-day wellbeing of the British people. It is also an opportunity for us to let the government know what we can’t do, as not everyone outside of it truly understands the complexities of our industry.”


Wan Mak is head of nutrition and dietetics at Sodexo UK and Ireland


The policy expert: Tackle food poverty


“The key to improving health at this time of financial austerity is to help those most in need, which means extending state provision of food aid through means such as free school meals to more people including the working poor and not referring people to charitable outlets such as food banks. In 1939 Le Gros Clark and Titmuss [in their book Our Food Problem: A study of national security] said there were two ways of tackling the food crisis: ‘The first is to lower the prices of foodstuffs upon the retail market; the second is to provide food to certain sections of the community through the medium of social services.’ There is no reason, of course, why these methods should be mutually exclusive. Their message remains as pertinent today as it was then. This would stop the growth of food banks as the means of delivering emergency food aid and the continuing roll-back of the welfare state and the rise in philanthropy.”


Martin Caraher is professor of food & health policy at City University, London


The nutritionist: Shrink the servings


“To have A swift and practical impact on cutting calories, I would take the draconian step of developing a policy that created a range of standard portion sizes across the food industry. This would be for everything from chips served in fast-food outlets to sizes of croissants in coffee shops, takeaway pizzas, ready meals, biscuits, cakes, packs of chocolate and bottles and cans of sugary drinks. Clearly this would trigger emotional uproar from those dead set against such nanny-state interference as well as huge one-off financial investment required for repackaging and policing once legislation was in place. But this would need to be set against the potential savings in the long term that a reduced calorie intake and its potential effect on individuals’ weight would have in costs to the health service. Anyone who wanted more could buy more portions. And would do so knowing they are consuming more than the recommended serving size.”


Amanda Ursell is an independent nutritional consultant