Food and Weight Management

We were unconvinced by the evidence we received from the supermarkets regarding their concerns about the updated nutrient profiling model. The NPM underpins all the government’s regulatory action to prevent obesity, yet the version of the model being used is now nearly 22 years old. Though a new model was developed in 2018, eight years have now passed and that model is still to be implemented. The length of time between the creation of the model and its implementation is concerning and leaves important regulation built on out-of-date scientific advice. (Conclusion, Paragraph 13)

The 2018 nutrient profiling model should be implemented as soon as possible, and certainly no later than by the end of 2027. The government will hear a lot of representations against this, but should hold firm. While we are aware of the debate around free sugars, we do not believe that it should be allowed to delay implementing the 2018 model further and call on the government to publish its preferred way forward on free sugars as soon as possible. (Recommendation, Paragraph 14)

The government should also commit to regularly reviewing and updating the nutrient profile model so that we do not go another 22 years, or more, between updates. Reviewing and implementing an updated nutrient profiling model on a 10-year cycle would strike a sensible balance between reflecting evolving scientific advice and providing certainty to industry. (Recommendation, Paragraph 15)

Healthy sales reporting and targets are the government’s flagship policy for addressing the food environment in the 10 Year Health Plan, with much resting on their implementation and success. It has been over a year since the 10 Year Health Plan was published and no visible progress has been made towards designing, let alone implementing, this policy. (Conclusion, Paragraph 23) 52

Mandatory healthy sales reporting should be launched as soon as possible, with targets set for supermarkets within the next 12 months and for the wider food industry by the end of the Parliament. (Recommendation, Paragraph 24)

If the government is really committed to this policy and in future decides to set targets as a result, those targets are meaningless unless accompanied by a strict enforcement regime for ensuring companies meet targets. This could be overseen by the Food Standards Agency, with, for example, penalties on a sliding scale that could include fines and we would encourage government to use such revenue to make healthy food cheaper. (Recommendation, Paragraph 25)

Price is a key driver in consumer behaviour. It is welcome that action has been taken to reduce the number of volume-price promotions of HFSS foods. However, with healthier foods such as fruits and vegetables still generally being more expensive than HFSS foods, and the proportion of disposable income needed for the most deprived in the population to meet the cost of a healthy diet increasing, retailers should be encouraged to offer more price promotions on healthier foods. (Conclusion, Paragraph 36)

As part of plans for large businesses to report on healthy sales and progress towards healthy sales targets, the government should require those businesses to report on the price promotions it offers, specifically the percentage of such promotions on healthier foods like fruits and vegetables. (Recommendation, Paragraph 37)

Healthy Start is a lifeline to many families who might otherwise struggle to find the budget for healthier foods for their children. It is especially impactful during a time of increasing food prices, with healthier foods often being more expensive than unhealthy foods. However, the scheme as it is currently designed is not reaching its full potential, has not kept up with the rising cost of living and is reaching too few eligible families. (Conclusion, Paragraph 49)

The Healthy Start programme should be updated in the following ways: a. the value of vouchers should be updated to reflect the level of food inflation and there should be an annual review of value to ensure its real terms value is maintained; b. technical barriers must be resolved within 6 months to support retailers to provide top-ups to families where they wish to do so; c. the age threshold for eligibility should increase to the September at which a child begins school, in order to bridge the gap between Healthy Start and universal infant free school meals; 53 d. All children in households that receive Universal Credit should be eligible, as is the case for free school meals; and e. DHSC should work with the Department for Work and Pensions to set out a plan to resolve data sharing issues and remove legislative barriers to implementing auto-enrolment within 12 months. The plan should include milestones and dates to ensure accountability for progress. (Recommendation, Paragraph 50)

The government should also launch a public awareness campaign within the next three months to drive improved uptake of the Healthy Start scheme, modelled on the approach taken in Scotland. The government must also commit to publish annual data on uptake of the Healthy Start scheme, with as granular geographical information as possible, so that the impact of efforts to drive higher uptake can be monitored and evaluated. (Recommendation, Paragraph 51)

Local projects to support access to healthier foods are doing fantastic work in their communities and seeing real results, using local knowledge and building strong community relationships to drive change. Community projects need to be a core part of any work to address the challenges in the food system and the government needs to better recognise their value by providing them with secure, long-term funding. While we welcome that Pride in Place funding can be used for projects that support low-income families to access healthy foods, given the large range of interventions this programme can support, we do not believe that it should be the main mechanism to finance these projects. (Conclusion, Paragraph 59)

We therefore repeat the recommendation previously made by Sir Henry Dimbleby that the government should establish a “Community Eatwell” programme to provide healthy eating support to families and individuals on low incomes experiencing food-related ill health. The government should also work with industry to secure match-funding for this programme. (Recommendation, Paragraph 60)

Clear and consistent labelling supports customers to make more informed choices about the food they are buying. Existing traffic light labelling is not mandatory, and it is inconsistently applied: this needs to change. (Conclusion, Paragraph 67)

The government should introduce mandatory front-of-pack labelling by January 2028. While we acknowledge that the traffic light approach is not perfect, we nevertheless recommend using the pre-existing label as its template as this is familiar to consumers and widely used by manufacturers in the market, so should cause the least disruption to businesses and support swift implementation. (Recommendation, Paragraph 68) 54

In addition, the government should take steps to explore how to ensure the effectiveness of front-of-pack labelling in the long term, including: a. how to make front-of pack information clear for consumers and ensure it avoids contradictory health and nutrition messaging; b. learning from labelling used in other countries, such as the French Nutri-Score or the Chilean ‘warning labels’ approach; c. regularly reviewing labelling to ensure it takes account of emerging scientific evidence, including changes to the nutrient profiling model. (Recommendation, Paragraph 69)

We acknowledge the efforts that manufacturers have gone to in reformulating products to remove sugar, salt and fat and increase fibre, and the challenges that can come from this for smaller businesses. Taxation has been shown to drive producer behaviour through the soft drinks industry levy (SDIL), and we believe this should continue as a mechanism for driving reformulation. If the government is serious about improving the health of the nation, there is more it can do to support further reformulation, particularly for smaller manufacturers. (Conclusion, Paragraph 77)

To drive further reformulation, we recommend that the government: a. continues to explore how the SDIL can be expanded and sets out a timetable for reducing the threshold to its originally intended 4g per 100ml; b. develops an equivalent of the Scottish Reformulation for Health Programme to roll out to small and medium sized food and drink manufacturers across the rest of the UK. (Recommendation, Paragraph 78) Addressing the obesogenic environment

While some local authorities have already been using the planning system to improve their local food environment, the changes to the National Planning Policy Framework should encourage more local authorities to refuse applications for hot food takeaways and fast-food outlets where further provision would not benefit local population health. However, vague definitions risk undermining local authority attempts to create healthier environments by leaving them vulnerable to challenge from large corporations. Clearer guidance and tighter definitions are needed to ensure local authorities are in the strongest position to face down any challenges. The important voice of public health also needs to be strengthened in local authority planning policy. (Conclusion, Paragraph 90) 55

Working with the Office for Health Improvement and Disparities and directors of public health, we call on the government to: a. develop clearer definitions for the terms “hot food takeaway”, “fast- food outlet” and “reasonable walking distance” and develop guidance and provide practical support for local authorities to identify areas with high volumes of unhealthy food outlets and they should be resourced to develop plans to address these; b. review current use classes to ensure that establishments that are clearly operating as takeaways are not able to operate as Class E establishments and avoid restrictions; and c. mandate the involvement of public health officials in the development of local planning policy and decision making. (Recommendation, Paragraph 91)

The evidence is clear: advertising impacts on the consumption of HFSS foods. The government has already accepted this to some degree given the action already taken to restrict exposure to HFSS advertising, but it must be bolder. Its current approach leaves the majority of advertising untouched and undermines the intention of restricting exposure. No effort has also been made to encourage advertising to be healthier. (Conclusion, Paragraph 112)

Advertising methods are changing quickly, with the rising prominence of social media advertising, digital advertising, sport sponsorship, online gaming and direct marketing through app notification. Existing regulations do not adequately address these forms of advertising. Further delay to strengthening restrictions must be avoided. Given it took nearly five years from announcing to implementing the policy to ban HFSS, waiting another five years for the post-implementation review before taking further action is unacceptable. Action is needed now if the government is serious about protecting children’s health. (Conclusion, Paragraph 113)

On a local level, some local authorities are working hard to improve their own food environment through bans to outdoor advertising, but they are severely limited due to only being able to target council-owned assets. To ensure a consistent approach, to address the fact that areas of higher deprivation have a higher prevalence of outdoor advertising and to protect local councils from challenge from large food businesses, a national approach is needed. (Conclusion, Paragraph 114)

A holistic, consistent and watertight approach to restricting the exposure of children to all HFSS advertising needs to be developed. It should include: 56 a. bringing brand and range advertising into the scope of existing regulations as soon as possible and certainly not waiting for the five- year implementation period to gather evidence on this: evidence is already plentiful; b. developing new regulation, or updating existing regulation, to ban all outdoor advertising of HFSS foods, to be implemented by July 2027; c. launching a consultation on extending regulations to restrict exposure to HFSS foods to other forms of advertising, such as sports sponsorship, social media, mobile phone app notifications and online gaming; and d. updating advertising regulations to require food companies to dedicate resource to advertising healthy products. (Recommendation, Paragraph 115)

Existing regulation could be better used to play a more active role in building healthier retail environments. While we are encouraged that changing shop layouts is one of the government’s suggested ways of achieving healthier sales, given there will likely be some time before the healthy sales targets are set, action should be taken now. (Conclusion, Paragraph 121)

It is concerning that HFSS foods continue to feature prominently on pages on retailer websites that are not covered by existing regulations, particularly special offers pages. We know that price is a driver of shopping habits and so believe that special offers pages should be included as an example of a ‘prominent’ location online. (Conclusion, Paragraph 122)

The Food (Promotion and Placement) (England) Regulations 2021 should be updated no later than January 2027 to: a. include a requirement to place fruits and vegetables in prominent instore locations like checkouts and store entrances; and b. extend the definition of a prominent location on a website to include ‘special offers’ pages. (Recommendation, Paragraph 123) Prioritising health in food policy

Policies to support a reduction in the consumption of HFSS foods stand no chance of success if they are not strongly enforced. Businesses need to be clear that there will be consequence for failing to meet their legal requirements to create healthier environments in their stores. (Conclusion, Paragraph 133) 57

We are concerned by the lack of enforcement of policies and recommend the government review the extent to which its policies are being enforced and, in its response to us, set out detail on resources available for enforcement. (Recommendation, Paragraph 134)

The government needs to build and fund a more robust enforcement regime for existing and upcoming regulation, which should include: a. improved, ring-fenced funding and an improved training offer for local authority trading standards and environmental health teams to improve their capacity to address all enforcement issues; and b. stronger penalties that act as a real deterrent for businesses, with a move away from fixed penalties towards a penalty based on the size of the business. (Recommendation, Paragraph 135)

The Food Standards Agency’s role should be expanded to cover the healthiness of food, as well as food safety. It should report to Parliament on progress towards healthier food production and on meeting targets for healthy food sales. This expanded role should be accompanied by additional funding and staff. (Recommendation, Paragraph 136)

The current regulatory framework does not create a level playing field across all settings where food is purchased, largely ignores the out-of-home sector, has a blind spot around delivery apps and is littered with loopholes that ultimately undermine the intended health improvement outcomes from these policies. We are concerned by insufficient thinking about the role that the out-of-home sector might play in improving the nation’s diet and urge the government to work to better understand this sector. (Conclusion, Paragraph 141)

A more strategic and holistic view of food policy that seeks to improve the healthiness of food and the food environment is needed. The government should either extend the scope of existing regulation or create new regulation to ensure that the prominence and promotion of HFSS foods is reduced across all food retailers and not only supermarkets. It should also work to better understand what role the out-of-home sector and delivery apps can play in improving diets and set out how it will work to improve the healthiness of food in out-of-home settings, including better data collection, new policy ideas and relevant support for those businesses to implement any changes within 18 months. (Recommendation, Paragraph 142)

Throughout our inquiry we have seen examples where time and time again policy that has been designed to protect and improve children’s health and the health of the population is delayed or diluted in the face of threats from the food industry about the impact on food prices, jobs or the economy. Governments have consistently chosen to put those interests ahead of 58 health interests. This government cannot continue that pattern. It must be bolder and show unwavering commitment to the cause of preventing obesity. (Conclusion, Paragraph 148)

We agree with the House of Lords Food, Diet and Obesity Committee that the government should exclude food businesses that derive more than a certain proportion of sales from less healthy products from any discussions on the formation of policy on food, diet and obesity prevention. This should also apply to the industry associations that represent these businesses. Engagement on the practical application of regulation once it has been decided may be appropriate and must be subject to full transparency and clear rules of engagement. (Recommendation, Paragraph 149)

While we acknowledge the costs of policy changes to the food industry, these are marginal when compared to the huge costs of inaction on obesity to society, the economy and the health service. In the event that policy relating to the healthiness of food is delayed or substantially changed, Parliament must be given a timely update as to the reasons why and what impact these changes would have on the effectiveness of the measure in reducing obesity, and costs to the NHS and the wider economy of not proceeding as originally planned. (Recommendation, Paragraph 150) 59