Childhood obesity: UK's 'inexcusable' strategy is wasted opportunity, say experts

Medical experts and campaigners have criticised the government’s childhood obesity strategy as weak and embarrassing, and accused policymakers of throwing away the best chance to tackle the culture of unhealthy eating that is crippling the NHS.

The government’s measures, centred on the sugar tax announced by George Osborne in March, rely on voluntary action by the food and drink industry and are shorn of any restrictions on junk food marketing and advertising.

The industry, which has lobbied hard against regulation for months, has undertaken to reduce by 20% the amount of sugar in products such as cereals, desserts, yoghurts and sweets. The strategy document makes clear that manufacturers that reduce sugar in their products will escape the sugar tax, which is not due to come in for two years.

The money accrued by the levy on sugary drinks will go to fund breakfast clubs and sport. Schools will be asked to give pupils an extra 30 minutes a day of physical activity, and parents and carers will be encouraged to get their children moving for a further 30 minutes.

Citing the triumphs of Team GB at the Olympics and the example of St Ninians primary school in Stirling where children walk or run a mile every morning, the public health minister, Nicola Blackwood, said: “Initiatives like this will make a huge difference to children’s health and fitness and we hope our new measures on school sport will help to create future Team GB Olympians.”

But the strategy contains neither of the two measures that Public Health England (PHE) said would have the most impact on the childhood obesity epidemic.

A third of children leaving primary school are overweight or obese and at risk of a lifetime of health problems including diabetes, heart disease and cancer. Asked to investigate the issue and make recommendations on what should be done, PHE backed a sugar tax and reductions in sugar content of foods but prioritised two other measures:

• Banning price-cutting promotions of junk food in supermarkets, such as multipacks and buy one get one free, as well as promotion of unhealthy food to children in restaurants, cafes and takeaways.
• Restricting advertising of unhealthy food high in salt, fat and sugar to children through family TV programmes such as Britain’s Got Talent and The X Factor, as well as on social media and websites.

Neither appears in the strategy.

Campaigners likened the strategy to the responsibility deal brought in by Labour and continued throughout David Cameron’s premiership, which was widely condemned as a failure. Food and drink companies were encouraged to pledge to make their food healthier by cutting salt, fat and sugar. There has been little in the way of monitoring, but health groups believe the deal has not significantly contributed to improving the nation’s diet.

“After the farce of the responsibility deal where Andrew Lansley made the food industry responsible for policing themselves, it is sad to see that this is just another imitation of the same responsibility deal take two,” said Prof Graham MacGregor, chairman of Action on Sugar and Consensus Action on Salt and Health.

“It is an insulting response to the UK crisis in type-2 diabetes, both in children and adults. This will bankrupt the NHS unless something radical is done.”

Action on Sugar called on the prime minister to rescue the childhood obesity strategy. “Theresa May launched her prime minister campaign by saying that she wanted to tackle health inequalities, obesity being a major factor in this,” said Jenny Rosborough, the group’s campaign manager and a registered nutritionist. “The UK should lead the world in tackling obesity and type-2 diabetes and this is an embarrassing and inexcusable waste of a fantastic opportunity to put the nation’s health first.”

Although the childhood obesity strategy was a flagship initiative of Cameron’s and originally the work of staff in Downing Street, May has chosen not to launch it. It has been published by the Department of Health while she is on holiday in Switzerland.

The Children’s Food Campaign, a member of the Obesity Health Alliance, which includes charities and health organisations such as the royal colleges, fought hard for tough action on cut-price junk food and a ban on TV adverts for unhealthy food before 9pm, when viewing by children tends to drop off.

“Price promotions were one of the big issues that Public Health England majored on,” said Malcolm Clark of the campaign. “It looks like the government is failing to listen to its own public health experts.

“Industry likes to paint us as nanny-statists, but PHE is not a campaigning organisation. They have done a very thorough literature review of peer-reviewed evidence and come up with a recommendation on that.”

Sir Harpal Kumar, Cancer Research UK’s chief executive, said: “While encouraging more exercise in schools is to be welcomed, the evidence is compelling that we also need restrictions on the marketing and promotion of unhealthy foods. We need stronger action to protect children from junk food advertising if we want to make a difference. So for the government to ignore these aspects is inexcusable.

“The government had a chance to protect the next generation from diseases like cancer and reduce the crippling burden of obesity on the NHS. We need the game-changing strategy it promised a year ago. As it stands, our children will witness a rising tide of ill-health from obesity well into the future.”

The strategy document nods to the thinking underlying the focus on voluntary measures and physical activity. It aims to “significantly reduce” childhood obesity within 10 years, it says. “We are confident that our approach will reduce childhood obesity while respecting consumer choice, economic realities and, ultimately, our need to eat.”

The president of the Royal College of Physicians, Prof Jane Dacre, said: “I am disappointed that after such a long wait for the childhood obesity strategy, the government has published a downgraded plan.”

The British Medical Association described the strategy as weak. “Given the UK has the highest level of obesity in western Europe, with one in three children overweight or obese by the time they leave primary school, the government should be doing everything in its power to tackle this problem. Instead it has rowed back on its promises by announcing what looks like a weak plan rather than the robust strategy it promised,” said Prof Parveen Kumar, the BMA board of science chair.

“Although the government proposes targets for food companies to reduce the level of sugar in their products, the fact that these are voluntary and not backed up by regulation, renders them pointless. Targets are also needed to reduce levels of saturated fat and salt in products – these must be backed up by regulation.

“Poor diet has become a feature of our children’s lives, with junk food more readily available, and food manufacturers bombarding children with their marketing every day for food and drinks that are extremely bad for their health. It is incredibly disappointing that the government appears to have failed to include plans for tighter controls on marketing and promotion.”

The British Soft Drinks Association, meanwhile, said it was unhappy that the sugary drinks levy was going ahead. “Given the economic uncertainty our country now faces, we’re disappointed the government wishes to proceed with a measure which analysis suggests will cause thousands of job losses and yet fail to have a meaningful impact on levels of obesity,” said Gavin Partington, its director general.

He said manufacturers were already cutting the sugar content of their drinks.

Ian Wright, director general of industry body the Food and Drink Federation, said:
“The proposed tax on soft drinks is a disappointing diversion from effective measures to tackle obesity. Soft drink companies are already making great progress to reduce sugars from their products, having achieved a 16% reduction between 2012 and 2016.

“However the target set for sugars reduction in the plan is flawed. It focuses too strongly on the role of this single nutrient, when obesity is caused by excess calories from any nutrient. Moreover the target is unlikely to be technically practical across all the selected food categories.

Reformulation is difficult and costly: there are different challenges for each product; recipe change can only proceed at a pace dictated by consumers. We will of course do everything we can in the next six months to work towards a practicable reformulation solution while continuing to urge the government to adopt a ‘whole diet’ approach.”