The world faces a crisis in obesity and type 2 diabetes, almost entirely due to the consumption of cheap, processed food full of sugar and fat. These foods are marketed cleverly, but are very high in calories and give no feeling of fullness. Unsurprisingly, they cause many people to become obese.
More than a year and a half ago, the UK’s health minister, Jeremy Hunt, asked the health group I head, Action on Sugar, for advice on preventing childhood obesity. This was provided. Yet despite Hunt’s assertion that this issue was one of his highest priorities, both he and Department of Health officials have refused to discuss the report or take any action.
Later, Hunt asked government agency Public Health England (PHE) for a plan, based on scientific evidence, for preventing childhood obesity. This was due to be published with the long-awaited Scientific Advisory Committee on Nutrition (SACN) report on carbohydrates and sugar.
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When the final version of the SACN report was released in July this year it recommended radical reductions in sugar intake. But PHE remained silent and said there was a delay in the publication of its obesity report. It later transpired that the Department of Health had requested that the report be top secret. There was an outcry and it has finally been released, calling for a sugar tax among other measures.
In the run up to the UK election earlier this year both Hunt and the prime minister, David Cameron, ruled out such a tax without specifying why and, according to some sources, without looking at the evidence.
Success stories
Several countries have a sugar tax, particularly on sugar-sweetened soft drinks. In Mexico, consumption of such drinks fell by 12 per cent in the first year after the introduction of a 10 per cent tax. Consumption in France has also fallen after a much lower tax was brought in. Finland has a tax on both sweetened soft drinks and confectionary. One can only speculate as to why Cameron and Hunt ruled out a sugar tax in the run up to an election.
With all the hype about a tax, the other remedies that both Action on Sugar and PHE have suggested have been ignored. The most important way of reducing calorie intake from sugar would be to reformulate foods. This has successfully been carried out with salt in the UK: most of the products that we now buy from supermarkets have 30-40 per cent less salt, without the consumer necessarily being aware of it.
The result has been a fall in salt intake in the UK and a fall in population blood pressure. With colleagues, I have calculated that this has prevented approximately 9000 stroke and heart attack deaths per year.
The same reformulation could be done for sugar, particularly in sugar-sweetened soft drinks, as removing the sugar doesn’t reduce the drink’s volume. Some supermarkets have already started the process. The sweetness of artificially sweetened drinks would also have to be reduced, as there is increasing evidence that artificial sweeteners stimulate appetite. A 40 per cent reduction in the amount of sugar added to drinks and food, which could be done over the next five years, would reduce calorie intake by 100 kcal per day per person in the UK.
Independent agency
The problem we have, however, is that there is no agency to oversee this. The independent Food Standards Agency (FSA) was responsible for nutrition and led the world in salt reduction. But in 2010, then health secretary Andrew Lansley took nutrition away from the FSA and gave it to the DoH. He also made the food industry responsible for policing itself. This unsurprisingly has failed, with the supermarkets calling for a regulated system in order to have a level playing field. We desperately need an independent agency for nutrition in order to oversee calorie intake in a coherent, structured way.
We also need a restriction on marketing – ideally a ban on marketing of all unhealthy foods, just like cigarettes. Unhealthy food is now a much bigger cause of death in the UK than tobacco. Price promotions in supermarkets that focus on the unhealthiest foods and encourage greater consumption should be stopped. And we should limit availability and portion size. If all of these actions were in place we could prevent the development of obesity and type 2 diabetes.
The prime minister needs to intervene and come up with a strong obesity plan with an independent nutritional agency that will be able to further reduce the consumption of salt, sugar, saturated fat and unhealthy products. That way the health service, teetering on the verge of bankruptcy, has some possibility of being saved, and the UK would once again be leading the world in health.
Image credit: Katie Cawood/Getty
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