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“2020health is an important and thoughtful contributor to the health debate”

Dr Sarah Wollaston MP, Chairman, Health Select Committee

 
 

Round-Table on Public Health: Have we got the right food and drink policy?

Nov 07. till Nov 07.

Invitation Only Event

Host: Dianne Abbott MP, Shadow Minister for Public Health

Speakers: Dr Nick Sheron, Head of Clinical Hepatology & Senior Lecturer,
Clinical & Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine

Lucy Jones, Former Chairman, British Dietetics Association, London Branch, Presenter on Channel Four programme The Food Hospital

Date
November 7, 20122012-11-07T08:30:33 - November 7, 2012 2012-11-07T10:00:21
Time
8:30 AM 2012-11-07T08:30:33 - 10:00 AM 2012-11-07T10:00:21
Location
House of Commons

Meeting Notes

INTRODUCTION
The United Kingdom experiences the worst obesity rate in Europe. Some of the reasons for this are: health inequalities and the society seeing obesity as the norm. We have to identify solutions that will help people improve their eating habits and change their views on food. 

In 2004, the World Health Organisation (WHO) ranked obesity as number ten in their behavioural risk factors. In 2012, the top risks were increase in blood pressure; tobacco consumption; alcohol consumption and obesity.

Due to an expanding obesity epidemic, the NHS alone has spends £5 billion each year on treating this problem.

GENERAL DISCUSSION
The varieties of food available to eat today is limitless, we can walk down a street and find any number of food chains, coffee shops and convenience stores. This is a recent phenomenon, in the 70’s and even in the 80’s food was not as accessible as it is now. 

There are a number of factors that cause a person to be overweight, there are ones that are self inflicted (the amount food a person consumes) inherit (an illness that increases a person’s risk of becoming obese) and also our environment (availability and quality of food) all play apart in our attitudes towards food and being overweight.

The population as a whole does not fully understand what causes an individual to become overweight; and there is a paucity of simple easily understood information, e.g. skipping breakfast, eating after 7pm, consuming 100-150 calories a day more than you need, eating between meals – (many people eat about 400 calories between meals).

We are not doing enough as a society to address this growing problem, we need to change the way people think. While this may be possible, do we have the will to do this? One of the most effective ways to address obesity is by targeting children. Parents often reward a child with food for good behavior; this is the wrong kind of example to set. By giving a child a sweet when they have done well, we are creating an unhealthy habit and consequently setting a pattern for life.

The best way for children to understand the importance of healthy eating, and making good decisions about food is by providing them with good education on the topic, and not just handing out leaflets for them to read on their own. By providing these easy to understand lessons in schools or clubs they will come to understand the different food groups that are available. We also need to educate children not to associate food with emotion.

When addressing obesity we need to look at the services we provide to help people lose weight as well as consider what ingredients we are using in our foods.

It is also important that the professionals who are providing advice to patients about weight issues are fit themselves. Overweight people giving advice to other overweight people will only create a disconnect.

ALCOHOL AND TOBACCO
When thinking about how we address food it is useful to think about how we have tackled smoking and alcohol. As the statistics below show, a large number of doctors that provide counseling on smoking and alcohol consumption have to also provide their patients with dietary advice, due to the large number of patients that are overweight.

• 99% of doctors have counseled patients about tobacco use
• 91% of doctors have counseled patients about alcohol use
• 61% of doctors have counseled patients about diet

FIZZY DRINKS
Fizzy drinks are commonly consumed by the population and they can have an influence on a person’s weight and other health matters such as oral care. There is a common misconception that if a person replaces full-fat drinks with the non-fat drinks this is better for them in regards to weight gain. What is not known is that the sugar in full-fat drinks represses appetite; however this is not the case in the low-fat drinks. Subsequently a person who consumers these drinks will replace this void with a snack, consequently causing a double hit, eating badly and drinking a drink of no value.

Dentists see the effects of fizzy drinks and the consumption of too many sweets; therefore they could prove to be a valuable resource particularly on dietary advice to children.

MARKETING
The marketing of products is designed to have an effect on the population. Currently, we have in place the traffic light system, this system was designed so the consumer can know by glancing at a product whether it is a healthy option. However, the people that are overweight are not the ones that pay attention to this information. Furthermore, even through some products have been given a green light on the traffic light system, this does not mean the product has all the nutrition that a person will need for a meal. 

Manufactures that produce products that are deemed bad and consequently given a red traffic light symbol, are beginning to remove these products from the store shelves. They are then reducing the amount of unhealthy ingredients in the product and re-releasing them to gain a better rating.

Along with the traffic light system the high end food stores (i.e. Mark and Spencer’s and Waitrose) are promoting food that is healthy by reinforcing the traffic light system with additional nutritional information on their food, which will encourage consumers to purchase their products.

The amount of salt content in food has been linked to ethnic background. Minority ethnic groups demonstrate an increase in obesity due to the ingredients and types of food that they eat. Black ethnic groups have a high amount of salt in their food, and often their food packages do not have labels with their nutrition values on them.

When reviewing advertising of products 68% of Pepsi sales are now for the non-fat drinks. Pepsi no longer adversities full-fat drinks. When looking at the timing of adverts, 62% of ads are on before 9pm, consequently children are being exposed to marketing. This might explain why 30% of children spend their pocket money on food.

All available data on obesity needs to be released so we can work together and tackle the problem. However we cannot base all our understanding on the current data that is available, because all of the statistics that have been shown our one sided. Supermarkets are the best places to do experiments to gain a better understanding about what is happening. However we need to think outside of the box. Supermarkets and companies want to know what is in it for them to change their products.

POLICIES
The Responsibility Deal has been the vehicle by which the Government has tried to influence supermarkets and suppliers.

There have been some benefits from the Responsibility Deal i.e. when ordering a drink at a coffee shop; consumers now have to ask for full-fat milk to be used in their drink. The Responsibility Deal has been successful in agreeing the salt and nutrition table. In spite of these positive outcomes, companies can still choose which parts of the deal they agree to undertake. This means that some companies might provide nutritional information on their drinks, but not on their food, and vice verse. Without legislation it is difficult to compel compliance.

The Responsibility Deal appears to be the vehicle by which we think we will see improvements, yet not everyone is involved in the Responsibility Deal. Companies that are involved in the deal are frustrated because they feel it’s not working. The companies that are not involved in the deal slip under the radar and there are no sanctions.

There are some gains where companies have decreased the unhealthy ingredients in their food by partaking in product redesign. Large companies are helping smaller companies achieve these gains by sharing their knowledge and experience. This knowledge is beneficial to small and medium enterprise (SME). The Scottish parliament is helping Scottish suppliers by providing funding for a person to work with SME. SME is not currently engaged with the Responsibility Deal and there is no way to incentivise them at present.

The past two years have been spent fighting the Health and Social Care Bill and we have not focused on the public health issues. The change in the way public health policy is managed is important because next year’s policy will be formulated at a local level.

RECOMMENDATIONS
The main fizzy drink companies should agree to part take in a survey where they increase their prices to see if this impacts on the amount their products are consumed.

We should look at the environment obese people live in. Poorer environments tend to have the low end stores accessible to them, which consequently produce the high calorie, poor nutrition food. These types of stores also display their food different to the high end stores; they tend to have junk food at the front of the store.

Nutrition education should be provided to children so they are equipped with this knowledge for later life.
We need to come up with better solutions to minimum based pricing.
We need to encourage companies to share their agenda with other companies. The reason why they are not currently doing this might be because there is a breakdown in trust.
The planning positions for corner shops should be reviewed. Corner stores should be banned from school locations.

SUMMARY
There was a consensus that there is a growing problem around obesity within the UK. Even though there are current policies in place to try and fix the current weight epidemic we are facing i.e. the Responsibility Deal, this is not enough to tackle this problem.

Some of the attendees believed that the solution involves the environment and not just the people. It is the environment that is the problem. Others felt that the solutions to conquer alcohol problems are the same for obesity. However, the main point that was echoed was that the public requires a better understanding about food. By providing education on this subject at a young age we can stop the problem spiraling out of control. Therefore it would be beneficial for us to provide education on this subject to children.

Another point that was ricochet was that the Royal colleges need to find short term solutions rather than trying to sort everything out at a population level.

In short we need to act fast because time is running out, we need to start educating the public and advocating exercise to try and stop the weight issues within the UK getting further and further out of control.