Select committee inquiry

The impact of physical activity and diet on health

Closed

Health and Social Care Committee · Opened 19 November 2014 · Closed 25 March 2015

16 recommendations · 10 conclusions
Inquiry on parliament.uk ↗

What the inquiry looked at

“There are growing concerns about the burden of disease as a result of unhealthy diets and physical inactivity; not only the impact upon individuals but the consequences for the NHS and for wider society. A significant proportion of our population takes too little exercise and many people’s diets are unbalanced with, for example, too much fat, sugar and alcohol. This in turn contributes to high and rising levels of obesity and an increase in avoidable illness and health inequality. This inquiry looks at evidence of the impact of diet on health and the most effective way of conveying healthy eating and drinking to the public in order to achieve a more healthy weight, and evidence of the impact of physical activity on health, including its impact independent of weight. Among other things, the inquiry looks at trends in body mass index and conditions related to obesity, the role of schools and parents in encouraging active play, and the role of NHS organisations and Public Health England in improving levels of physical activity and diet. View the full terms of reference for this inquiry”

The committee's words, from the inquiry page on parliament.uk ↗.

What it found

In the committee's words, from the summary of 6th Report - Impact of physical activity and diet on health ↗

Diet, obesity, and physical activity all have important impacts on health. For too long however, physical activity has been seen merely in the light of its benefits in tackling obesity. A core message from this inquiry is the compelling evidence that physical activity in its own right has huge health benefits totally independent of a person’s weight. The importance of this—regardless of weight, age, gender or other factors—needs to be clearly communicated.

Interventions focused on encouraging individuals to change their behaviour with regard to diet and physical activity need to be underpinned by broader, population-level measures.

Whilst both are important, population-level interventions have the advantage of impacting on far greater numbers than could ever benefit from individual interventions. We recommend that the next Government prioritises prevention, health promotion and early intervention to tackle the health inequalities and avoidable harm resulting from poor diet and physical inactivity. Tackling these problems will require action at all levels and must also be core business for the NHS and local authorities.

The Committee regards it as inexplicable and unacceptable that the NHS is now spending more on bariatric surgery for obesity than on a national roll-out of intensive lifestyle intervention programmes that were first shown to cut obesity and prevent diabetes over a decade ago. All tiers of weight management services should be universally available and individual clinicians should use every opportunity to help their patients to recognise and address the problems caused by obesity and poor diet, and to promote the benefits of physical activity.

What the government said

The government responded on 16 July 2015.

How the inquiry ran

Each dot is a dated item listed on this page, from the inquiry's opening on 19 November 2014 to 16 July 2015. Written evidence is not charted: only the latest 50 submissions are listed here.

  1. Oral evidence 3 sessions
  2. Report 25 Mar 2015
  3. Government response 16 Jul 2015

What it recommended 16 recommendations · 10 conclusions

1For too long, physical activity has been seen merely in the light of its benefits...
Concluded (the committee's words)
For too long, physical activity has been seen merely in the light of its benefits in tackling obesity. However, there is compelling evidence that physical activity in its own right has huge health benefits totally independent of a person’s weight—in fact research recently published suggested that increasing physical activity levels could have greater impact on reducing mortality than reducing weight. The Chief Medical Officer’s guidelines recommend levels of activity which will help people derive the greatest health benefits; but even small increases in activity levels can have a dramatic positive impact on health.
2Diet, obesity, and physical activity all have important impacts on health.
Recommended (the committee's words)
Diet, obesity, and physical activity all have important impacts on health. However, it is vital that the importance of physical activity for all the population—regardless of their weight, age, gender, health, or other factors—is clearly articulated and understood. We recommend that the Government, Public Health England and health professionals, in particular GPs, take urgent action to communicate this crucial message to the public.
3It is clear from the evidence we have heard that interventions focused on encouraging individuals...
Concluded (the committee's words)
It is clear from the evidence we have heard that interventions focused on encouraging individuals to change their behaviour with regard to diet and physical activity need to be underpinned by broader, population-level interventions. Individual interventions include provision of information about the health benefits of exercise, workplace incentives, or referral to a lifestyle weight management scheme. Broader measures include pricing and availability of unhealthy foods, and redesigning environments to promote physical activity, which aim to make the healthy choice the default choice. Population-level interventions have the advantage of impacting on far greater numbers than could ever benefit from individual interventions, and may also be more effective at tackling health inequalities than individual interventions.
4NICE has produced a comprehensive raft of guidance on cost-effective interventions that can be introduced,...
Concluded (the committee's words)
NICE has produced a comprehensive raft of guidance on cost-effective interventions that can be introduced, either by the NHS or by local government, to improve diet and physical activity. These have included interventions on an individual level— changing individual behaviour, and weight management, and also more ‘upstream’ environmental interventions, such as changes to the local environment that may improve access to healthier foods or encourage active modes of transport such as walking and cycling.
5While we welcome NICE’s guidance, it is disappointing that there has to date been little...
Recommended (the committee's words)
While we welcome NICE’s guidance, it is disappointing that there has to date been little assessment of how far these guidelines are being implemented. We have heard that NICE’s forthcoming Quality Standards will produce a clear framework against which progress towards implementing NICE guidance can be measured. We recommend that the next Government shows its commitment to improvements in 54 Impact of physical activity and diet on health this area by auditing progress against Quality Standards in the areas of diet and physical activity across the country to allow benchmarking and drive progress.
6There is a danger that the current financial pressures on local authorities will lead them...
Recommended (the committee's words)
There is a danger that the current financial pressures on local authorities will lead them to deprioritise all but the mandated public health services to the detriment of prevention and health improvement. We recommend the next Government prioritises prevention, health promotion and early intervention and provides the resources to ensure it happens.
7We also heard that local authorities need more powers to limit the proliferation of outlets...
Recommended (the committee's words)
We also heard that local authorities need more powers to limit the proliferation of outlets serving unhealthy foods in some areas; Public Health England told us that they too had concerns about this. We recommend that the next Government works closely with the Association of Directors of Public Health and the Local Government Association to ensure local authorities have the planning powers they need for the control of food and drink outlets and for the preservation of open spaces for physical activity for public health purposes.
8One commentator told us that in her view, it is "at best anomalous and at...
Concluded (the committee's words)
One commentator told us that in her view, it is "at best anomalous and at worst negligent" that that NHS properties continue to serve foods high in sugar, fat and salt, with some hospitals even having fast-food outlets on their premises. The NHS should lead by example and manage its estate in a way that stops promoting the over-consumption of energy dense nutritionally poor food.
9Beyond the NHS, workplaces are where working age people spend the majority of their time...
Recommended (the committee's words)
Beyond the NHS, workplaces are where working age people spend the majority of their time and as such can represent a powerful resource for health promotion. We urge the next Government to work with NICE and Public Health England to find the best options for achieving this in a range of workplaces, including the use of financial and other incentives.
10While local authorities now have the lead public health role, there is an ongoing need...
Recommended (the committee's words)
While local authorities now have the lead public health role, there is an ongoing need for the NHS to provide both prevention and treatment services but greater focus needs to be given to discussing inactivity or overweight. The NHS is this country's largest employer and has a crucial role to play both in terms of promoting the health of its workforce, and in setting a wider example. More broadly, there is clearly potential for other workplaces to do more. We recommend that Primary Care takes the lead, as it has does for smoking cessation, in promoting physical activity and preventing obesity—these topics should not be off limits during consultations.
11While there now is widespread recognition of the health impacts of diet, obesity and physical...
Concluded (the committee's words)
While there now is widespread recognition of the health impacts of diet, obesity and physical activity, and the scale of the problems we now face in these areas, these problems are not "owned" by a single Department or agency. A successful strategy for tackling these problems needs to mirror the successful strategy on tobacco, and be multi-level, spanning national and local government down to every citizen. A successful strategy may to need to incorporate elements as diverse as public education, regulation, fiscal measures, legislation, messaging and campaigns, evidence based behaviour change, changes to the school curriculum, and changes to planning arrangements.
12Given the breadth of these issues, it is essential that the strategy must be cross-...
Recommended (the committee's words)
Given the breadth of these issues, it is essential that the strategy must be cross- governmental and integrated laterally and vertically, and given the importance of these issues, led from the very top of government. We call on the next Government to introduce a co-ordinated government-wide programme to tackle poor diet and physical inactivity; this programme should be given the resources and authority necessary to secure collaboration with all relevant Departments and bodies, and should report at regular intervals on health improvements to the Prime Minister, and to Parliament.
13We have heard the hugely positive message that increasing physical activity has significant health benefits...
Concluded (the committee's words)
We have heard the hugely positive message that increasing physical activity has significant health benefits and does not necessarily mean playing organised competitive sport three times a week—it encompasses a diverse range of activities, including everyday activities such as walking. The point was made that raising heartrate was the most important thing, but any increase in activity is beneficial.
14For some people it can be easier to fit physical activity in if it is...
Concluded (the committee's words)
For some people it can be easier to fit physical activity in if it is “a means to an end” rather than an end in itself. The key message from witnesses was to “just do more”, in a way that fits with your lifestyle.
15NICE has clearly recommended that offering brief advice in a primary care setting is a...
Recommended (the committee's words)
NICE has clearly recommended that offering brief advice in a primary care setting is a cost effective way of getting people to increase their levels of physical activity. It is clear that clinicians have a crucial role to play in promoting physical activity. Better undergraduate and postgraduate education is now required, both to ensure clinicians’ understanding of the medical benefits of physical activity, and to teach them how to promote physical activity to their patients in an effective way, particularly when some patients may be sceptical of such a “low tech” approach. We recommend that the next Government works with the royal colleges and Health Education England to achieve this.
16In relation to NHS Health Checks, we heard of a “tick box” approach to physical...
Recommended (the committee's words)
In relation to NHS Health Checks, we heard of a “tick box” approach to physical activity, with clinicians carrying out Health Checks lacking the skills to support people in actually changing their behaviour. We recommend that, given the considerable investment of public resources in NHS Health Checks, NICE should be tasked with assessing their clinical and cost effectiveness.
17We have heard that the physical environment can have a significant impact on activity.
Recommended (the committee's words)
We have heard that the physical environment can have a significant impact on activity. Open spaces are needed for recreation and play, and the built environment, including road infrastructure and speed limits, all impact on how easy or attractive it is to walk or cycle. We call on the next Government to make a clear commitment, together with appropriate long term funding, to significantly increase the levels of cycling and walking.
18Physical activity must be seen in its totality, and a flexible and inclusive approach is...
Concluded (the committee's words)
Physical activity must be seen in its totality, and a flexible and inclusive approach is needed to enable individuals to choose a way to increase physical activity that is right for them. Nowhere is this more important than in promoting physical activity amongst groups of people who seldom take part. The most obvious is the disparity between men and women, but inequalities in physical activity levels exist between other sectors of society too, and children fare worse than adults in terms of meeting physical activity recommendations.
19Fear of judgement is a key barrier preventing women from being more active.
Concluded (the committee's words)
Fear of judgement is a key barrier preventing women from being more active. Some barriers may be quite simple such as the lack of availability of sports clothes in larger sizes or mixed changing rooms. The Government-wide programme on diet and physical activity should include a specific workstream focused on identifying and tackling inequalities in relation to physical activity, and it should begin with work to examine how women, those with disabilities and overweight people, can be encouraged and supported to be more active.
20According to Public Health England, there is an unmet population need for support for weight...
Recommended (the committee's words)
According to Public Health England, there is an unmet population need for support for weight loss and sustaining a healthier weight. NICE have recommended cost- effective interventions in this area and we recommend that these are funded and implemented as a matter of urgency. The Committee regards it as inexplicable and unacceptable that the NHS is now spending more on bariatric surgery for obesity than on a national roll-out of intensive lifestyle intervention programmes that were first shown to cut obesity and prevent diabetes over a decade ago. All tiers of weight management services should be universally available, and need to be well integrated.
21We have heard that the Government’s Responsibility Deal has achieved some successes, but should be...
Concluded (the committee's words)
We have heard that the Government’s Responsibility Deal has achieved some successes, but should be seen as a complement to regulation rather than a substitute for it. We agree with the UK Health Forum, that we cannot hang all our expectations in terms of all the things we need to achieve in public health on voluntary pledges.
22Progress has been made on introducing a traffic light nutrition labelling system.
Recommended (the committee's words)
Progress has been made on introducing a traffic light nutrition labelling system. We recommend that Public Health England backs this up with a campaign to explain Impact of physical activity and diet on health 57 and reinforce this scheme to the public to assist them in using the new labelling to make healthy food choices.
23We recommend that Public Health England should take the lead by introducing clear targets for...
Recommended (the committee's words)
We recommend that Public Health England should take the lead by introducing clear targets for reductions, and the Government should use regulatory measures to enforce this, if voluntary approaches do not yield swift progress. The Committee strongly recommends that the first focus of this work should be on reducing the sugar consumed by children in sugar sweetened drinks.
24The evidence we have received has also called for wider restrictions on promotion of unhealthy...
Recommended (the committee's words)
The evidence we have received has also called for wider restrictions on promotion of unhealthy foods to children–in both broadcast and non-broadcast media, particularly social media. We recommend that the next Government takes steps to stop the marketing of unhealthy food and sugary drinks to children.
25The area on which we have heard the least progress has been made, but one...
Recommended (the committee's words)
The area on which we have heard the least progress has been made, but one which has the potential for a significant impact on diet and health, is retail price promotions on food. Voluntary agreements have been tried, but now we need to look to harder policy options to secure progress. We recommend that the next Government commissions either Public Health England or NICE to review policy options in this area as a matter of urgency.
26We have received evidence from organisations supporting the introduction of a tax on sugar-sweetened drinks.
Recommended (the committee's words)
We have received evidence from organisations supporting the introduction of a tax on sugar-sweetened drinks. We look forward to the publication of Public Health England's review of the evidence base for introducing a sugar tax, which is expected later this year, and we do not seek to pre-judge its outcome. We welcome the fact that Public Health England is carrying out this review. Given the scale of the public health challenge and growing health inequalities we urge the next government not to shy away from difficult decisions around proportionate regulation if these are supported by the emerging evidence.

Evidence

Oral evidence sessions 3

Written evidence 100 submissions

Listed here by submitter; the evidence itself is on Parliament's website. Showing the latest 50 of 100 recorded submissions. Browse the inquiry on Parliament.

  • 18 Mar 2015University of OxfordIDH0100Full text not held
  • 18 Mar 2015Nice - Supplementary EvidenceIDH0105Full text not held
  • 18 Mar 2015Mrc Epidemiology Unit / Centre For Diet And Activity Research - Supplementary EvidenceIDH0106Full text not held
  • 18 Mar 2015Mrc Epidemiology Unit / Centre For Diet And Activity Research - Further Supplementary EvidenceIDH0107Full text not held
  • 13 Mar 2015Uk Faculty Of Public HealthIDH0083Full text not held
  • 25 Feb 2015Dr William Bird MbeIDH0104Full text not held
  • 11 Feb 2015Dr Dagmar ZeunerIDH0103Full text not held
  • 11 Feb 2015Prof Jane MooreIDH0102Full text not held
  • 11 Feb 2015Nhs EnglandIDH0101Full text not held
  • 11 Feb 2015British Masters Athletic FederationIDH0099Full text not held
  • 11 Feb 2015Dairy UkIDH0096Full text not held
  • 11 Feb 2015Marks And SpencerIDH0095Full text not held
  • 11 Feb 2015Greater London AuthorityIDH0094Full text not held
  • 11 Feb 2015Dr Dianna SmithIDH0089Full text not held
  • 11 Feb 2015Arthritis Research UkIDH0088Full text not held
  • 11 Feb 2015Living StreetsIDH0087Full text not held
  • 11 Feb 2015Cycle East SussexIDH0086Full text not held
  • 11 Feb 2015Croydon CouncilIDH0085Full text not held
  • 11 Feb 2015Aleksander CoxIDH0084Full text not held
  • 11 Feb 2015Cancer Research UkIDH0082Full text not held
  • 11 Feb 2015Breakthrough Breast CancerIDH0080Full text not held
  • 11 Feb 2015Jack WinklerIDH0079Full text not held
  • 11 Feb 2015Department Of HealthIDH0078Full text not held
  • 11 Feb 2015North Lincs Council/ School Sports PartnershipIDH0077Full text not held
  • 11 Feb 2015Diabetes UkIDH0076Full text not held
  • 11 Feb 2015British Soft Drinks AssociationIDH0074Full text not held
  • 11 Feb 2015Professor Theresa M MarteauIDH0073Full text not held
  • 11 Feb 2015University Of BedfordshireIDH0072Full text not held
  • 11 Feb 20152020HealthIDH0071Full text not held
  • 11 Feb 2015Mrc Epidemiology Unit / Centre For Diet And Activity ResearchIDH0070Full text not held
  • 11 Feb 2015Mrc Epidemiology Unit / Centre For Diet And Activity ResearchIDH0069Full text not held
  • 11 Feb 2015Cycle To Work AllianceIDH0068Full text not held
  • 11 Feb 2015SportaIDH0067Full text not held
  • 11 Feb 2015Advertising AssociationIDH0066Full text not held
  • 11 Feb 2015Sugar Nutrition UkIDH0065Full text not held
  • 11 Feb 2015Youth Sport TrustIDH0064Full text not held
  • 11 Feb 2015Public Health EnglandIDH0063Full text not held
  • 11 Feb 2015Macmillan Cancer SupportIDH0062Full text not held
  • 11 Feb 2015Association Of Directors Of Public HealthIDH0061Full text not held
  • 11 Feb 2015Cambridge Weight PlanIDH0060Full text not held
  • 11 Feb 2015Institute For Food Brain And BehaviourIDH0059Full text not held
  • 11 Feb 2015LighterlifeIDH0058Full text not held
  • 11 Feb 2015AjinomotoIDH0057Full text not held
  • 11 Feb 2015London Borough Of CamdenIDH0056Full text not held
  • 11 Feb 2015Tom WhiteIDH0055Full text not held
  • 11 Feb 2015Amateur Swimming AssociationIDH0054Full text not held
  • 11 Feb 2015London Health CommissionIDH0052Full text not held
  • 11 Feb 2015Sport And Recreation AllianceIDH0051Full text not held
  • 11 Feb 2015ThsgIDH0048Full text not held
  • 11 Feb 2015School And Nursery Milk AllianceIDH0047Full text not held