PHE report on impact of sugar on obesity published – but David Cameron rules out introducing a ‘sugar tax’

Drinks Cans

Public Health England’s report focusing on the relationship between sugar and childhood obesity has now been published.

The report, ‘Sugar Reduction: the evidence for action’, examines the case for the introduction of a controversial ‘sugar tax’ of 20% on sugary drinks, but also outlines a number of other potential measures which could be introduced to tackle the problem.

PHE says 25% of adults, 10% of 4 and 5 year-olds and 19% of 10 to 11 year-olds are obese – with a BMI of 30 or above. Dealing with the consequences of obesity, including type 2 diabetes, hypertension, cardiovascular problems and cancer costs the NHS £5.1 billion a year.

TV chef and long-term children’s healthy eating campaigner Jamie Oliver confronted the Prime Minister in the House of Commons earlier this week urging him to “be brave” and introduce the levy on sugary drinks to combat the issue. However, a Downing Street spokesman confirmed yesterday that the PM believes there are “more effective ways” of tackling obesity.

In addition to a sugar tax, the report focuses on other measures including changes to food advertising and a reformulation of manufactured foods, which combined could help curb an obesity crisis. For more information on the sugar tax proposals, read our earlier article "Public health england head to face questioning ahead of child obesity strategy".

PHE says part of the reason for the rise on obesity can be linked with gradual changes to how we live, work, shop and eat over the past 30 to 40 years. Today, food is cheaper and more readily available, is heavily marketed on television and online and the majority of us regularly consume processed and convenience foods. These factors, combined with an increase in sedentary employment and leisure activities, is what many experts agree, a recipe for obesity.

While the introduction of such a tax has been backed by many experts, some remain sceptical.Professor Richard Tiffin, Director of the Centre for Food Security, University of Reading, says he is “unconvinced” about the evidence relating to a sugar tax. He says: “The report highlights the impact of soft drinks taxes in France, America, and elsewhere, but does not put much emphasis on economic analysis. While such taxes do encourage high consumers of sugary drinks to buy less, the calories that come from soft drinks are relatively small, meaning that an individual’s overall consumption of calories does not fall by much.

“In a study I was involved in, we found that a 20% tax on sugar-sweetened beverages would only reduce obesity rates by between 1 and 2%. This is a small benefit for a tax that hits poor people hardest, and could lead people to making other unhealthy choices in their weekly shop instead.”

“When speaking to the select committee this week, Jamie Oliver used an excellent visual device to highlight how much sugar there is in soft drinks. I am convinced that this kind of approach, forcing people to confront the amount of sugar in their food and drinks, is more effective for encouraging people to change their habits than the comparatively blunt instrument of government-imposed taxes.”

Fizzy Soft Drinks

The Scientific Advisory Committee on Nutrition (SACN) recommended earlier this year that we cut our sugar intake in half – with amounts not exceeding 5% of our total daily energy intake.

Daily energy intake from sugar currently stands at between 12% and 15% for all age groups, but the report highlights that excessive sugar consumption is particularly prevalent among school age children, which constitutes a time bomb of obesity-related health problems if the issue is not addressed within this generation.

Dr Julian Hamilton-Shield, Professor of Diabetes and Metabolic Endocrinology, University of Bristol, says of the report’s recommendations: “As a doctor who has spent over 15 years treating morbid childhood obesity and its consequences, I welcome this report that targets a series of levers designed to reduce sugar consumption in the whole population but more importantly children.

She adds: “If a tax is needed to reduce sugar consumption, I am right behind it. No one complains about tobacco taxation: sugar should be treated the same way.”

Dr Ian Johnson, Emeritus Fellow at the Institute of Food Research, says of the report: “Public Health England have delivered a rigorous and well-argued response to the evidence provided by SACN earlier this year. Sugar reduction is not the only route to the management of overweight and obesity in England, but it is of great importance. I hope the government will now respond in a brave and timely manner so that we can begin to tackle one of the most serious health problems of our time.”

The Government’s childhood obesity strategy is expected to be published in the New Year.

As well as the sugar tax, what other recommendations does the PHE report make?

The report highlights a variety of ways in which the issue of childhood obesity can be tackled, including what it describes as a ‘universal programme of reformulation’ of manufactured foods, to include reduced amounts of sugar. This approach has already proven successful at reducing salt intake, both in the UK and elsewhere.

Bogof cabbage?

The report reveals that food retail price promotions, such as buy-on-get-one-free, half price or 3 for 2 offers, are more prolific in the UK than anywhere else in Europe, and usually include high-sugar, or otherwise unhealthy foods and drinks. Such offers were found to account for around 40% of grocery expenditure – meaning that up to 40% of food consumed in the home has been purchased via these types of promotion. The report suggests a reduction in the number of price promotions on unhealthy foods in supermarkets could help consumers make healthier choices when shopping.

In addition to reducing the sugar content of manufactured and convenience foods, the issue of portion sizes - which research shows have ballooned in recent years - is also likely to be addressed.

The report also raises concerns around advertising. It says UK children are still regularly exposed to a high volume of advertising across multiple platforms – on television, online and via social media, and through programme and event sponsorship. Evidence shows that such advertising consistently influences preference and purchasing habits of both children and adults. Again, the report suggests a reduction in such marketing could improve health in the long term.

A spokesman for the Advertising Standards Authority told G&M: “We welcome this new report from Public Health England and will consider it carefully as part of our commitment to ensuring continual review of the rules which control food advertising.

“Our sister organisation, the Committee of Advertising Practice, has already announced that it will publicly consult on the introduction of new rules governing the advertising, to children, of HFSS products across non-broadcast media. The decision to consult on those changes comes in recognition of changes in children’s media habits and evolving advertising techniques. It also reflects a growing consensus about the role of advertising self-regulation in contributing to wider initiatives to bring about a change in the nature and balance of food advertising targeted at children.”

The report also mentions setting a clear definition of what constitutes ‘high-sugar’, encouraging catering services to adopt buying standards, for example with limitations on sugar, fat and salt and introducing accredited training for people who work in the catering, leisure and fitness sectors.

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