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The childhood obesity ill-health time bomb

Action on Sugar and Action on Salt have called for all food and drink products sold in the public sector, including hospitals, to meet strict nutritional guidelines.


This is part of a seven-point evidence-based plan published by Action on Sugar and Action on Salt in response to Public Health England’s first assessment of progress made on the government’s sugar reduction programme that aims to help cut childhood obesity.


With an annual spend of around £2.4 billion each year – approximately 5.5% of UK foodservice sales – the public sector provides a widespread opportunity, with significant purchasing power, to influence the diets of those that use these services and improve the overall food chain to provide foods with far less fat, salt and sugar, and more fruit, vegetables and fibre.


The plan published by Action on Sugar and Action on Salt says: “Current government policy does not set strict, regulated guidelines for public sector food to ensure that they are lower in fat, salt and sugar. It is therefore essential that guidelines are set by government and implementation is closely monitored. The public sector must lead by example, particularly in schools and in the NHS.” 


The following actions are among those recommended:


* Food and drink provided in public sector should meet strict standards for fat, salt and sugar.


* Sugar and calorie reformulation targets should be included in procurement standards for government buying standards (as salt reduction targets are currently).


* Hospital food standards should be enacted, on the same legal basis as school food standards, to ensure hospitals must mandatorily meet minimum standards for the food served to patients, staff and visitors. 


* The hospital food standards should be independently monitored and enforced.


* Soft drinks containing more than 5% sugar, and all sweet and chocolate confectionery should not be sold on any NHS settings.


* Only healthy products should be put on promotion (including price promotions and multi-buy and extra-free deals) in any NHS settings.


* Vending machines on all public sector premises should meet government buying standards.


* Free water should be made available in all public sector settings. 


The seven-point plan also calls for the soft drinks industry levy to be escalated and for the introduction of a confectionery levy; for restrictions on marketing, advertising and promotions so that only healthy products should be marketed across all platforms – including TV, digital and print; for mandatory, uniform colour-coding on front of pack on all products sold in retail and out-of-home, with stricter criteria for high fat, salt and sugar; and for incremental reformulation of products to reduce calorie and salt intake.


Progress so far


Kawther Hashem Nutritionist at Action on Sugar based at Queen Mary University of London says: "Whilst we welcome PHE’s first assessment of progress on the government’s sugar reduction programme, it’s evident that much more must be done – particularly on biscuits, chocolate confectionery, puddings and the large portions of high sugar products sold in the out of home sector. It’s unfair and ridiculous that the out of home sector products are not being reformulated to the same extent. Much stricter measures need to be in place to ensure progress is being made by the food industry and that the 20% sugar reduction target is met."


The government’s sugar reduction programme challenged the food industry to cut 20% of sugar from a range of products by 2020, with a 5% reduction in the first year. The first year of this programme was from August 2016 – 2017. PHE’s assessment shows what it calls “an encouraging initial start from retailers and manufacturers.” But at a 2% reduction in average sugar content and calories the achievement is short of the 5% ambition. 


For the eight food categories where progress has been measured, five have shown reductions in sugar levels, with yoghurts and fromage frais, breakfast cereals and sweet spreads and sauces all meeting or exceeding the initial 5% ambition. However, in the out of home sector, portion sizes in products likely to be consumed in one go are larger – on average more than double – those of retailers and manufacturers. 


PHE has also reported on the drinks covered by the soft drinks levy. Sugar has been reduced by 11% and average calories per portion by 6% by retailers and manufacturers. Data also shows people are buying more drinks that have sugar levels below the soft drinks levy cut-off of 5g per 100g.


New statistics released


Today (May 29), the Local Government Association (LGA) has warned that severe child obesity rates are contributing to a multi-billion pound ill-health time bomb.


Figures show that more than 22,000 children aged 10 and 11 in Year 6 are classed as severely obese. For most adults, a BMI of 40 or above means a person is severely obese - at least 60% higher than the upper healthy weight BMI limit of 24.9.


The first data of its kind for 2016/17, obtained by the LGA and supplied by the National Child Measurement Programme (NCMP), reveals that 22,646 out of 556,452 (4.1%) of 10 and 11 year-old children in Year 6 are classed as severely obese. This is nearly twice that of the 14,787 out of 629,359 children (2.35%) of four and five year-old children in Reception classed as severely obese, showing children are gaining weight at a drastic rate as they go through schools.


Severe obesity rates vary significantly by area and are highest in children living in the most-deprived towns and cities, and those from BME groups, suggesting a need for the development and evaluation of more targeted interventions.


The LGA says that the figures should serve as a “wake-up call” for concerted action to tackle the obesity crisis which is costing the NHS more than £5 billion a year.


Despite budget reductions, councils are spending more on running effective prevention schemes to help children stay healthy, which is key to tackling the child obesity crisis and reducing future costs to hospital, health and social care services.


But this essential prevention work, including the ability of councils to provide weight management services for children and adults, is being hampered by a £600 million reduction in councils’ public health budgets by central government between 2015/16 and 2019/20.


The LGA is calling for reductions in public health grants to be reversed by the Government and for further reforms to tackle childhood obesity. This includes councils having a say in how and where the soft drinks levy is spent, better labelling on food and drink products, and for councils to be given powers to ban junk food advertising near schools.