Child health u-turn

Written by Louise Mercieca - 28th July 2022

A full list of sources and references can be found at the end of this article.

  

There has never been a more important time to talk about children’s nutrition and the impact this has on future health outcomes, as recently several issues have been raised in the media bringing childhood health to the forefront of our attention.

 

You may have seen headlines or social media activity around the following news items: -


  • Junk food advertising ban pre watershed
  • Ban on junk food ‘buy one get one free’ offer
  • Withdrawal of £300 million in obesity support funding
  • The National Food Strategy

 

Let’s take a look at what each of these are.  What they were proposed as, how they were set to be ‘world leading plans’ and what happens now after each has been withdrawn or delayed. Collectively, this is what is being referred to in the media as ‘The Child Health U Turn’.

 

U Turn 1:  Advertising of unhealthy foods online and pre watershed

 

Back in June 2021, the Department of Health and Social Care issued a statement about ‘new rules on advertising unhealthy foods online and prior to 9.00 p.m.’.  

 

This is an extract from that policy statement dated 24th June 2021: 

 

·       “These restrictions will help protect children from developing long-term unhealthy eating habits and improve nation’s health, and forms just one part of wider plans to tackle childhood obesity.

·       Latest measures to tackle childhood obesity could wipe over 7 billion calories from the national diet every year.

 

The health of children across the UK will be improved as new restrictions will mean they are less exposed to advertising of unhealthy foods, the government has announced today.

 

Following a public consultation, regulations will come into force at the end of next year to introduce a 9pm watershed for advertisements of foods high in fat, salt and sugar (HFSS).

 

Public Health Minister, Jo Churchill, said:

 

“We are committed to improving the health of our children and tackling obesity. The content youngsters see can have an impact on the choices they make and habits they form. With children spending more time online it is vital we act to protect them from unhealthy advertising.

 

These measures form another key part of our strategy to get the nation fitter and healthier by giving them the chance to make more informed decisions when it comes to food. We need to take urgent action to level up health inequalities. This action on advertising will help to wipe billions off the national calorie count and give our children a fair chance of a healthy lifestyle.”

 

Source

  

 So, back in June last year the message was clear: -


  • There is a link between the advertising of junk food and the consumption of such foods in children
  • There is a direct link with these foods and the obesity crisis
  • There is a direct link with these foods and health inequalities 
  • There is a need for urgent action
  • These changes will “give our children a fair chance of a healthy lifestyle”

 

Fast forward to May 2022 and the U Turn on this decision. Despite the recognition of the urgent action needed, this proposal has now been delayed until January 2024. What this means in real terms is that children continue to be exposed to billions of junk food advert impressions, may continue to form unhealthy eating patterns and habits, and may continue to fall into the ‘junk food cycle’. 

 

I reiterate the serious consequences of this U Turn. The policy itself stresses the exposure to HFSS (high in fat and sugar) advertising and excess consumption, it recognises the links to serious future health outcomes, yet it has removed any urgency. Urgency which the government deemed important in terms of the increasing health inequalities “We need to take urgent action to level up health inequalities”.

 

To once again quote from the above report: -


Evidence shows exposure to HFSS advertising can affect when children eat and what they eat and, over time, excess calorie consumption can lead to children becoming overweight or obese.

 

The government estimates there were around 2.9 billion child HFSS TV impacts and 11 billion impressions online - defined as an individual seeing a single advert one time - in the UK in 2019.

 

Restricting the amount of these products advertised will encourage healthier food choices and will help to reduce the number of children living with obesity and going on to develop conditions associated with excess weight, such as type 2 diabetes, coronary heart disease, stroke, colorectal cancer, liver disease and breast cancer later in life.

Source

 

This decision was alas, not the only detrimental decision taken to go back on previously proposed plans.  The second U Turn is outlined below.

 

U Turn 2:  ‘Buy one, get one free’ ban 

 

On Friday 13th May, the government announced a one-year delay – until October 2023 – on the planned ban on ‘buy one, get one free’ deals for food and drinks high in fat, salt, or sugar. They are also delaying the free refills on soft drinks.

 

This was another shock move to delay a proposal which had clearly outlined the links between the offers on HFSS foods and health outcomes. When foods are marketed for price and convenience, they become the only option available for some, whether that is purely down to product placement and availability, the affordability element or both. There’s clear evidence that offers on ‘junk food’ contribute to the escalating obesity crisis and widens the gap between health and wealth. 

 

The argument used by the Government on this delay was that removing offers during a cost-of living crisis was not helpful to families on a budget. This is not an argument that holds much weight amongst health campaigners, many of whom have accused the government of failing to tackle childhood obesity.

 

Prof Graham MacGregor, a cardiologist at Queen Mary University of London and chairman of Action on Sugar, said the delays contradicted the government's "levelling up" agenda.

 

"Boris Johnson could have left a legacy of being the first prime minister to address obesity in a meaningful way, particularly in restricting advertising and promotion of unhealthy food which were his flagship policies," he said.

 

"Instead, he has given in to his own MPs, and an aggressive food industry, who, ironically, were starting to comply with these new policies."

 

Barbara Crowther, of the Children's Food Campaign, said ministers should be urgently curbing multi-buy offers instead of "delaying and dithering".

 

Source - Junk food: Ministers to delay ban on multi-buy deals BBC News

 

The reality for many families is that these offers make-up the bulk of their shopping as they may be the only affordable and convenient option open to them. However, it’s also important to recognise that this type of food intake not only contributes to the obesity crisis but can have an overall detrimental impact on childhood health and development.  Not only are the foods high in fat, salt and sugar, they are also low in fibre, essential fatty acids, vitamins, minerals and antioxidants. We are increasingly seeing obesity and malnutrition within the same populations, and this is an extremely dangerous combination for negative future health outcomes.

 

 With this in mind, the government needs to take responsibility for what types of foods families are exposed to and needs to prioritise minimising offers on unhealthy options and instead open them up to affordable, yet healthy options. Unfortunately, at the moment these unhealthy offers are justified as ‘affordable treats’, which are in fact more affordable than fresh healthy options. This makes an impossible situation for many families to be able to put healthy food on the table, whilst shopping on a tight budget.

 

U Turn 3: £300m funding of weight-management services 

 

The next U turn is removal of financial support promised by the government to provide weight-management services via the NHS and local councils. The funding was considered low when it was announced, but to remove the £100m per year commitment for the 3 years (£300m total) has been met with disbelief and outrage amongst experts.

 

Preventative cardiologist Susan Connolly pointed out that obesity costs the NHS £6bn a year at last count. “Doesn’t that register with them?” she tweeted.

 

Cambridge university geneticist and obesity expert Giles Yeo tweeted: "£100m was a drop in the bucket to begin with. Now even that drop has been removed. Ignoring obesity is not going to make it go away.”

 

Source: Outrage over £100m weight management funding cut

 

The view to withdraw funding has been met with concern at how ‘short-sighted’ it is to remove pro-active help to a situation that will inevitably lead to more expensive future health outcomes and interventions for the individuals in need of support.

 

Professor Jim McManus, president of the Association of Directors of Public Health, described the government's "last minute" decision not to extend the funding as "deeply disappointing".”

 

He said: “The link between excess weight and Covid-19 severity is clear and provides renewed impetus to address the challenge.”

 

Directors of public health are deeply concerned that planned services will have to be cut or savings found elsewhere from extremely stretched public health budgets, limiting access for those who need support and exacerbating pressures on the wider health and social care system.

 

Source: Outrage over £100m weight management funding cut

 

The removal of the £300m obesity support funding could turn out to be a very costly decision for the Government but unfortunately it is not just the financial cost but the very real human one too.  I spoke with Professor Paul Gately on this subject on my podcast (see link below for full episode). Paul was very concerned at the removal of funding and the real costs involved.

 

“£300 million investments could save our economy £4.2 billion. These decisions aren’t just costing the economy, they’re costing people’s health. The recent U-turns have created serious concerns for health experts across the UK.” - Professor Paul Gately 

           

Source

 

So far, we have looked at three areas in which previously agreed plans to support health and obesity have been postponed or removed but sadly, this isn’t the end of the tale. There’s one more item to cover which, for many, has been hailed as yet another missed opportunity – the announcements relating to the National Food Strategy.

 

 

National Food Strategy

 

This is a statement from chapter 16 (pg. 142) of the National Food Strategy – independent review:

 

“In this report we have examined at length the things that have gone wrong with the food system. Now we must address an even more urgent question: how do we put them right?

 

The food system of the future must meet these goals: 

·       Make us well instead of sick. 

·       Be resilient enough to withstand global shocks. 

·     Help to restore nature and halt climate change so that we hand on a healthier planet to our children. Meet the standards the public expect, on health, environment, and animal welfare.”

 

There are many elements to the report; for the purposes of this article, I am just focusing on the elements relating to the other health U Turns. Primarily, the report has been branded ‘disappointing’ and as a ‘missed opportunity’. Many aspects of the report highlight the health inequalities and refer to the ‘junk food cycle’, recognising the health implications of the current food landscape but the recommendations outlined are not all being acted upon and this is leading to yet more disappointment from health organisations. It is being referred to as a ‘watered down version’ of what should have been an excellent opportunity for change.

 

The main factors causing concern are relating to the following not being implemented, despite recommendations to do so by Henry Dimbleby (report author): -

 

  • Despite strong recommendations on the importance of the expansion of free school meals, this remains as “Free School Meal eligibility under review”. This leaves around 800,000 children living in poverty, who are currently excluded from free school meals. 


  • None of the proposals have been adopted from the recommended raft of measures from the Healthy Start Scheme to support low-income children and pregnant mothers to afford healthy food.  Henry Dimbleby had recommended improving the scheme including extending who can access it.


  • Sugar and salt reformulation tax – Henry Dimbleby’s review had recommended taxing salt and sugar used in processed foods, restaurants and catering.  The manufacturers would carry the financial weight of the tax not the consumer and the money raised should be spent on addressing the inequalities around food, by expanding free school meals, funding holiday activity and food clubs, and providing healthy food to low-income families.  This proposal has not been implemented.

 

Summary

 

The UK was all set with a number of ‘world leading’ obesity support strategies. We were going to remove junk food advertising, thus reducing our children’s exposure to billions of online and TV adverts.  We were also going to ban the unnecessary promotion of unhealthy foods. These offers do not save money but promote overspending and over consumption on foods that are nutritionally devoid yet contribute to both obesity and malnutrition.  Stating that these offers are helpful to those on low-incomes is an argument that often comes back but, what would be helpful, would be a range of offers on convenient fresh fruit and veg, economical ways to buy healthy proteins, healthy options targeted at children and ready-meals (for those who need quick options) to be available that are not three times more expensive if they are healthier than their ultra-processed alternatives.

 

We had £300million offered to local authorities and the NHS to support three years of obesity support packages, these packages would have had a direct impact to millions of individuals and families and finally we had a National Food Strategy with lots of strong evidence-based data on the links of the ‘broken food system’ with health inequalities and obesity.  Many of the recommendations have not been acted upon, leading to responses such as this one from the Chairman of Action on Salt: -

 

“Today is a sad day for the UK and public health.” 

-Chairman Professor MacGregor on the release of the disappointing Food Strategy

 

It does indeed feel a sad day and a disappointing time for the UK’s public health as world leading plans are nothing if they remain on paper and not acted upon.  There is still time for the government to U Turn on their U turns and implement the proposals, which health organisations are crying out for to support the future health of a generation and prevent an avalanche of health issues descending onto the already over-burdened healthcare systems. 

 

What can we do? 

 

There is a desire for change and a growing movement to support this. We have seen large supermarkets take it upon themselves to implement the ban on ‘buy on get one free offer’ rather than wait for the Government to act.  Some towns have even moved to ban junk food advertising; five local authorities have now taken this into their own hands following London.

 

It is much harder for an individual consumer to implement a change though, as that would indicate there is a choice, which for many there isn’t.  With economics dictating, the change needs to come from the larger organisations; supermarkets, food manufacturers and restaurants.  We cannot simply say that individuals should ‘choose healthier options’, as that isn’t financially viable. 

 

We can vote in numbers though, a good way to do that is via a petition or by writing to your local MP, even if a petition date has passed you can still get involved.  If we all do a small thing, together it can become a big thing.

 

Some petitions that you can get involved in: 

 

 


Reference sources

 

How to move forward


https://www.politicshome.com/members/article/escaping-the-junk-food-cycle-is-it-possible

 

https://www.theguardian.com/food/2022/jul/24/children-junk-food-holidays-uk-government-campaign-supermarket-deals?CMP=Share_iOSApp_Other

 

Advertising of junk food policy statements

 

New rules on advertising unhealthy foods online and before 9pm on TV across the UK after public consultation.

https://www.gov.uk/government/news/new-advertising-rules-to-help-tackle-childhood-obesity 

 

The Food (Promotion and Placement) (England) Regulations 2021

https://www.legislation.gov.uk/uksi/2021/1368/made 

 

Department of Health and Social Care guidance for HFSS 

https://www.gov.uk/government/publications/restricting-promotions-of-products-high-in-fat-sugar-or-salt-by-location-and-by-volume-price/restricting-promotions-of-products-high-in-fat-sugar-or-salt-by-location-and-by-volume-price-implementation-guidance 

 

Sugar reduction: from evidence into action

https://www.gov.uk/government/publications/sugar-reduction-from-evidence-into-action 

 

Making a move themselves 

https://www.thegrocer.co.uk/health/the-towns-taking-junk-food-bans-into-their-own-hands/666492.article

 

The response to these moves by health organisations 

 

https://www.bbc.co.uk/news/uk-61443047 

 

https://www.more-life.co.uk/disappointed-by-government-u-turns-on-obesity/ 

 

https://www.publicsectorcatering.co.uk/news/jamie-oliver-sends-open-letter-pm-over-junk-food-advertising-u-turn 

 

https://foodfoundation.org.uk/news/junk-food-u-turn-risks-abandoning-generation-young-people-poor-health 

 

https://foodfoundation.org.uk/news/our-reaction-policies-protect-childrens-health-are-delayed-government 

 

https://www.independent.co.uk/news/uk/politics/boris-johnson-junk-food-jamie-oliver-b2083754.html 

 

Obesity funding removal 

 

https://www.bmj.com/content/377/bmj.o984 

 

 

National Food Strategy & Response

 

National Food Strategy White Paper 

https://www.gov.uk/government/publications/government-food-strategy/government-food-strategy 

 

 

https://www.thegrocer.co.uk/health/health-groups-vent-fury-over-watered-down-national-food-strategy/668365.article#:~:text=Health%20groups%20vent%20fury%20over%20'watered%20down'%20National%20Food%20Strategy,-By%20Ian%20Quinn&text=Health%20and%20sustainability%20groups%20have,grips%20with%20the%20obesity%20crisis. 

 

https://foodfoundation.org.uk/news/opportunity-safeguard-childrens-diets-overlooked-governments-food-strategy 

 

 

 

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Louise Mercieca is a Nutritional Therapist, Author of How Food Shapes Your Child, Early Years Nutrition Consultant, and Founder of The Health Kick. The Health Kick is a business driven by the mission of providing understandable, practical nutritional advice, in a world driven by diet culture and convenience eating. Louise is influential in early-years health, making an impact that can influence the next generation’s eating habits. She is the author of ‘How Food Shapes Your Child’ and is hugely passionate about spreading the message that kids can make healthy food choices.