Grim data: Vast majority of adults living unhealthy lifestyles, Health Survey for England reveals

06 Dec 2018 --- The Health Survey for England (HSE) makes for grim reading – it reveals the majority of adults in England are putting their lives at risk through a combination of health risk factors such as being overweight or obese, alcohol consumption, not enough physical activity, smoking and a lack of fresh fruit and vegetables. In fact, the survey has revealed that only 18 percent of children were consuming enough fresh produce.

The survey for 2017 shows that 64 percent of adults were obese and finds there is a correlation between childhood obesity and their parents’ weight.

For the first time the annual survey – which asked 8,000 adults and 2,000 children about their lifestyles – has compared the lifestyles of children with their parents and this has led to concerns from health experts.

The majority of adults (64 percent) in England in 2017 were overweight or obese. Men were more likely to be overweight (but not obese) than women, but women were more likely to be obese.

Total diabetes was associated with waist circumference. Twelve percent of men and 9 percent of women with a very high waist circumference had either diagnosed or undiagnosed diabetes. This compared to 6 percent of men and 2 percent of women with high waist circumferences and 4 percent of men and 1 percent of women with an ideal waist circumference.

Thirty percent of children aged 2 to 15 in England were overweight or obese, including 17 percent who were obese. Boys and girls were equally likely to be overweight or obese.

Children’s overweight and obesity were associated with that of their parents, notes the survey. Thirty-six percent of children who have an overweight or obese mother were also obese or overweight. This is compared to 19 percent of children whose mother was not obese or overweight. Meanwhile, 32 percent of children with an obese or overweight father were also obese compared to 17 percent of children whose father was not overweight or obese.

Obesity can lead to a number of health problems, such as raised cholesterol levels, and increased blood pressure, enhancing the chances of developing Type 2 diabetes. All of these are risk factors for coronary disease. Maintaining a healthy diet and regular physical activity can help to curb obesity and maintain a healthy weight.

Responding to latest Health Survey for England findings, the British Heart Foundation’s (BHF) Director of Policy & Public Affairs, John Maingay, says the latest figures are “alarming” and suggests we could be storing up a future of health problems for future generations unless we act now. 

“Obese children are more likely to be obese adults and this, coupled with spiraling diabetes rates, could lead to thousands more people suffering heart attacks and strokes in the coming years,” he notes. 

“The Government’s Childhood Obesity Plan is taking us in the right direction but, as these latest figures tell us, there is a huge amount of work to be done to ensure children of obese parents are supported in making healthier decisions. This can be achieved through tighter regulation of sugar and fat content in food, and by developing stricter regulations in marketing and promoting unhealthy food to children. Action needs to be taken today to curb obesity, or it will present a formidable challenge to the NHS for years to come,” Maingay notes.

The UK sugar tax on soft drinks came into effect in April which pushed up the price of sugar-sweetened soft drinks across Britain. It has two tiers; a lower rate of 18 pence (€0.20) per liter for beverages with a total sugar content between 5-8g per 100ml and a higher price of 24 pence per liter for drinks with total sugar more than 8g per 100ml.

It is too early to tell the effects the sugar tax is having on consumption as there is very little data so far, however, one of the key reasons it has been introduced is to reduce the amount of sugar consumed by children. 

The health survey findings closely follows the British Dietetic Association (BDA) urging the government to ban sales of energy drinks to children. And the Royal College of Paediatrics and Child Health (RCPCH) says its “disappointed” with the recent findings from the UK government’s Science and Technology Committee which concluded that energy drink consumption among minors should be reduced, but found a lack of evidence for a statutory ban.

Although energy drinks do contain high levels of sugar, this issue is more focused on the negative effects of increased caffeine consumption on mental and physical health.

Other findings in the survey that are also a cause for concern, according to the BHF, including the proportion of adults reporting doctor-diagnosed diabetes which has increased between 1994 and 2017. There has been some year-on-year fluctuation, from 3 percent to 8 percent among men and from 2 percent to 5 percent among women. The percentage increase has been largest for those aged 65 to 74, increasing from 5 percent in 1994 to 15 percent in 2017.  

Fruit and vegetable consumption
The protective health benefits of a diet rich in fruit and vegetables have been long recognized for both adults and children. The five-a-day UK guidelines were developed more than a decade ago based on the recommendation from the World Health Organization (WHO) that consuming 400g fruit and vegetables a day can reduce risks of chronic diseases, such as heart disease, stroke and some cancers.

These guidelines state that people should eat at least five portions of a variety of fruit and vegetables every day. However, there are other studies that have shown even higher proportions of fresh produce could help stave off a myriad of health problems. 

The report shows that in 2017, 29 percent of adults ate five or more portions of fruit and vegetables a day, with fewer men than women having done so. Since 2008, the figures for men have remained stable at around 24-26 percent. For women, the proportion increased to 32 percent in 2017. 

Consumption among children aged five to 16 showed 18 percent ate the recommended five or more portions of fruit and vegetables a day. The mean number of portions consumed per day was 3.2. This is similar to recent years.

Ongoing questions are raised in the UK (and around Europe) about how to increase consumption of fresh produce among populations, particularly how to encourage children to eat more fruit and vegetables. The European Fresh Produce Association, Freshfel, works a lot in this direction while the European Commission’s school fruit, vegetables and milk scheme is designed to help children follow a healthy diet. The scheme supports the distribution of fruit, vegetables and milk to schools across the EU.

The UK and Sweden were not allocated any funding for the 2017/2018 as they run their own programs. 

The extremely low consumption of fruit and vegetables by children comes as demand for plant-based products and consumer trends towards health and wellbeing are skyrocketing in many sectors within the food and beverage industry. Vegan and vegetarian NPD is abundant as the rising number of flexitarians, and people wanting to cut down on meat, continues apace.  

Big brands and foodservice giants are also tapping into the increasing demand for vegan products as more consumers seek out meat and dairy-free alternatives on supermarket shelves and while eating out. The jump in vegan eating is also pushing up new product development in this space.

However, there is very little data on how this translates to children’s diets but it’s clear that the demand for healthy snacks for children is a market in itself. 

Some NPD is targeting children's consumption of fresh produce but this is often in terms of using fresh produce as an ingredient. The bakery segment is tapping into trends for fruit and vegetable inclusions while the snacking category is pushing the use of fresh produce ingredients. 

For instance, Boboli has launched Veggie Focaccias, a line of bread that is full of vegetables. Varieties available are Beetroot, Carrot, Cauliflower, Curly Kale and Pumpkin. Faisal Ouertani of Boboli recently discussed the product’s launch with NutritionInsight’s sisterwebpage, FoodIngredientsFirst. Watch the full interview here. 

Dutch-based start-up Fruitfunk saw that there was an increasing need for an alternative to sweets snacks and launched its Fruitfunk snack range which is made entirely from fruit. The moisture is removed from the fruit within a short time, a process which keeps the fibers, minerals and a large part of the vitamins from the fruit intact. More often than not, “responsible snacks” are aimed at adults, but Fruitfunk believes that by putting popular children’s characters on its packaging, it can help make sweets and snacking fun for children. “With this, we hope that children will choose a responsible alternative themselves,” says the company. 

Just last month, UK-based supplier of fresh fruit, ingredients and fruit snacks, J.O. Sims Ltd, launched Crunchy Cranberries by Ocean Spray in the British market. Tapping into sensory trends toward texture and crunchiness, the crunchy ingredient format has been created using a new drying process and is intended to provide food manufacturers with new application and innovation opportunities, based on the fruit’s distinctive texture.

The new format can be used across multiple applications including cereal and confectionery segments and is a healthy alternative to potato chips as well as a good choice as a crunchy ingredient in mueslis, chocolate, salads and yogurt.

What we do know is that in addition to fruit and vegetable consumption being very low among children, it is one of the highest factors contributing toward food waste as perishable goods regularly get thrown out of household fridges. 

In fact, a Joint Research Centre (JRC) article, published in August, revealed that EU households generate roughly 35.3kg of fresh fruit and vegetable waste per person per year, 14.2 kg of which, is avoidable. 

Alcohol consumption
Alcohol has been identified as a causal factor in many medical conditions, including cancers, cirrhosis of the liver, high blood pressure and depression. Additionally, alcohol increases the risk of accidents, violence and injuries. There is interest and concern about the impact of alcohol consumption among policymakers, health professionals and the general public, notes the survey.

In 2016/17 there were 337,000 estimated admissions where the main reason for admission to hospital was attributable to alcohol, with men more likely than women to be admitted for this reason.

The UK Chief Medical Officer’s guidelines on drinking are that men and women should not regularly drink more than 14 units a week. This level is considered to be “low risk.”

Increased risk is drinking is over 14 units and up to 50 units a week for men, and over 14 units and up to 35 units a week for women. Higher risk drinkers are men who drink more than 50 units a week, and women who drink more than 35 units a week.

The Chief Medical Officer’s guidance on consumption of alcohol by children and young people is that alcohol consumption during any stage of childhood can have a detrimental effect on development, and young people may have a greater vulnerability than adults to the harmful effects of alcohol use. An alcohol-free childhood is the healthiest and best option and children under 15 should not drink alcohol at all. 

The survey showed that the proportion of both men and women drinking at increased or higher risk of harm (more than 14 units per week) decreased between 2011 and 2017; from 34 percent to 28 percent of men, and from 18 percent to 14 percent of women.

In 2017, among adults that drank alcohol, the average (mean) amount typically drunk in a week was 11.8 units. Men consumed more units (15 units) on average than women (8.6 units).

By Gaynor Selby