Cutting calories now “critical” to UK childhood obesity strategy

18 Aug 2017 --- The health agency Public Health England (PHE) has shifted its focus away from solely targeting sugar to cutting excess calorie consumption from all sources in its anti-obesity strategy for children in the UK. “A third of children leave primary school overweight or obese and an excess of calories – not just excess sugar consumption – is the root cause of this,” says Duncan Selbie, Chief Executive of PHE. “We will work with the food companies and retailers to tackle this as the next critical step in combating our childhood obesity problem.”

One year from the start of its healthy eating plan, PHE will now consider the evidence on children’s calorie consumption and try to use the calorie reduction program to remove excess calories from the foods children are known to consume the most. Ready meals, pizzas, burgers, savory snacks and sandwiches are the kinds of foods likely to be included in the program.

PHE will publish the evidence in early 2018. Following this, it will then consult with the food industry, trade bodies and health NGOs to develop guidance and timelines for the calorie reduction program.

The agency sees grounds for optimism. “The process of voluntary engagement with the food industry to reduce levels of nutrients in foods has worked before,” Public Health England Communications Officer Naomi Ramage tells NutritionInsight. “The salt reduction program launched by the Food Standards Agency in 2003 has seen people consume 11 percent less salt, which has contributed to a significant reduction in cardiovascular disease, bringing savings to the NHS, and has been described by the WHO as being ‘world leading.’”

Building on progress
The plans come at a time when adults currently consume on average between 200 to 300 calories too many each day and children are following suit, with food more readily available than ever before, according to the PHE’s press release.

Reducing calorie consumption from sources other than sugar is said to be critical to reversing the country’s worrying childhood obesity trend. One in three children are either overweight or obese by the time they leave primary school in the UK; more children in the UK than previously are being diagnosed with type 2 diabetes, some as young as 7 years old; and children from disadvantaged backgrounds are more likely to be obese.

The agency hopes to replicate the progress that has been made over the past year on reducing the level of sugar in many products.

The Soft Drinks Industry Levy has become law and will come into effect in April 2018 and PHE has formulated a comprehensive sugar reduction program with the aim of a 20 percent reduction in sugar in key foods by 2020. Leading retailers and manufacturers have also announced they are lowering, or have already lowered, the amount of sugar in their products as a result of these programs.

“There are three options for industry to reduce sugar consumption: taking sugar out of its products, reducing product size or shifting their portfolio to healthier options with less sugar,” Ramage notes. “This affords companies the flexibility to approach sugar reduction to shift the sales weighted average sugar content downwards.”

Sugar reformulation was a vital first step under the childhood obesity program; however, the agency notes that an overconsumption of calories will continue to have a detrimental effect on the health of UK children without further action.

“To build on the successful engagement with food and drink businesses as part of the sugar reduction program, PHE will continue to widen business engagement, with the aim to help address a level playing field across the food industry. We expect to see more businesses actively approach reducing sugar, salt and calories as the wider reduction and reformulation program develops,” Ramage notes.

The UK Department of Health has also funded a policy research unit – the £5 million (US$6.45 million) National Institute for Health Obesity Research Policy Unit at University College London – which will look to develop a deeper understanding on the causes of childhood obesity. It will include: marketing to children and families; social inequalities; and the early years of childhood.

“Obesity is one of the greatest health concerns of our time and we welcome this considerable and very timely investment from the government,” says Professor Russell Viner, Policy Research Unit Director and Professor of Adolescent Health, UCL Great Ormond Street Institute of Child Health. “We are delighted that the UCL Great Ormond Street Institute of Child Health will host the new Obesity Policy Research Unit (OPRU). Preventing obesity in early life is key to turning the tide on this modern epidemic.”

Thin gruel
The announcement of the updated plan comes at a time when not all are happy with the first anniversary of the government’s publication of its Childhood Obesity Plan.

“Beyond passing a sugary drinks tax into law, the Government has so far provided thin gruel for parents and health professionals keen to see significant progress on tackling childhood obesity,” Malcolm Clark, Coordinator of the Children’s Food Campaign, says of the progress made in the UK. “The leadership on sugar reduction efforts shown this year by Public Health England and the NHS has not been matched by other Government departments or from Number 10 itself.”

Clark cites the fact that the proposed healthy ratings scheme for primary schools has yet to be drawn up, despite plans to bring it in from this September, and a funding cut for the Healthy Schools Capital Fund as among the reasons for skepticism.

“We remain to be convinced that the calorie reduction program announced today, welcome in principle but short on detail, will change this leadership deficit,” Clark adds.

In response to the announcement, Graham MacGregor, Professor of Cardiovascular Medicine at Queen Mary University of London and Chairman of the campaign group Action on Sugar says: “The greatest health threat to the UK is obesity and type 2 diabetes. While everyone acknowledges this, one year ago Theresa May watered down David Cameron’s plan for entirely political reasons. We need a much more robust plan with enforcement of the sugar and calorie reduction targets, at the same time, the sugar sweetened soft drinks levy needs to be extended to confectionery, the second biggest contributor of energy intakes in children. We must also have watertight restrictions on marketing unhealthy foods to children, with uniform front of pack labeling.”
 
“Without the above, our children will continue to become obese and die prematurely from type 2 diabetes, heart disease, strokes and cancer.”
 
Katharine Jenner, Campaign Director at Action on Sugar says: “We are pleased that PHE are launching a program to tackle excess calorie consumption, which we hope will be ambitious. But more children are becoming obese and developing type 2 diabetes, and yet the food industry continues to pump out unhealthy, calorific food at cheap prices. Fast food chains, takeaways, manufacturers and supermarkets must not wait until next summer to start making their food healthier, they should start reducing calories today.”
 
“PHE, who will be responsible for this work, must be fully resourced, and there must be strict enforcement and independent monitoring to ensure the food industry isn’t let off the hook.”

By Paul Creasy