New UK Evidence Review of Measures to Reduce Sugar Consumption

23 Oct 2015 --- An evidence review of a broad range of measures to reduce the nation’s excessive sugar consumption has been published today by PHE.

The review, Sugar reduction: the evidence for action, concludes that a range of factors, including marketing, promotions, advertising and the amount of sugar in manufactured food, is contributing to an increase in sugar consumption. A correspondingly broad range of measures is needed in response.

The report follows on from Jamie Oliver’s appearance at the Health Select Committee hearing on childhood obesity where he reinstated his call for the Government to introduce the sugar tax. The government has come under increasing pressure from MPs on the Health Select Committee to published the report.

The evidence review shows that action to reduce sugar consumption levels could include, but is not limited to, reducing:

• the volume and number of price promotions in retail and restaurants
• the marketing and advertising of high sugar products to children
• the sugar content in and portion size of everyday food and drink products

The review also suggests consideration of a price increase, through a tax or a levy, as a means of reducing sugar intake, though this is likely to be less effective than the three measures set out above.

Other conclusions from the review include setting a clear definition of high sugar foods; adopting the government buying standards for foods and catering services; delivering accredited training on diet and health to all who work in catering, fitness and leisure sectors; and continuing to raise awareness of practical steps to reduce sugar consumption.

Dr Alison Tedstone, Chief Nutritionist at Public Health England (PHE), said: “PHE’s evidence review shows there is no silver bullet solution to the nation’s bad sugar habit. A broad and balanced approach is our best chance of reducing sugar consumption to healthier levels and to see fewer people suffering the consequences of too much sugar in the diet. We’ve shared out findings with the Government and are working with them on its childhood obesity strategy.”

Children and young people consume 3 times the recommended amount of sugar on average, with adults consuming more than double. The Scientific Advisory Committee on Nutrition (SACN) recently recommended that sugar makes up no more than 5% of daily calorie intake: 30g or 7 cubes of sugar per day. The Government adopted the advice as official dietary advice in July this year.

Consuming too much sugar can lead to weight gain and related health and dental problems. In England, almost two-thirds of adults are overweight or obese; a tenth of 4 to 5 year olds and almost a fifth of 10 to 11 year olds are obese. Treating obesity and its consequences alone currently costs the NHS £5.1 billion every year.

If the nation dropped its sugar intake to recommended levels within 10 years, over 4,000 early deaths and over 200,000 cases of tooth decay would be avoided and the burden of diseases associated with obesity such as diabetes would be reduced, saving the NHS around £480 million every year.

The Department of Health commissioned the evidence review from PHE following publication of the draft SACN report on Carbohydrates and Health in June 2014. PHE has since reviewed hundreds of studies from around the world. Some of the findings include:

1. Children are exposed to a high volume of marketing and advertising in many forms.
2. Marketing in all its many forms consistently influences food preference, choice and purchasing in children and adults. End of aisle displays, for example, leads to a 50% increase in purchases of fizzy drinks.
3. Food promotions are more widespread in Britain than anywhere else in Europe, accounting for around 40% of all domestic food and drink spending. This increases the size of families shopping baskets by a fifth and means they are taking home 6% more sugar.
4. A structured sugar reformulation programme could lead to a significant reduction in sugar consumption. The evidence showed if the sugar content of soft drinks was reduced by half, the sugar consumption of children under 10 and adults over 19 would decrease by 5g and for those in between, 11g.
5. Increasing the price of high sugar food and drink, through taxation or a levy, is likely to reduce purchases of these products, at least in the short term.
6. The public sector spends £2.4 billion a year on catering. Requiring caterers all to follow the government buying standards for food and catering services will ensure accountability for providing food meeting nutritional standards.

The government will use the PHE evidence review to inform its development of a childhood obesity strategy, due in the coming months.

Malcolm Clark, co-ordinator of Children’s Food Campaign, welcomed the release of Public Health England’s ‘Sugar Reduction: the evidence for action’ and said:

“Finally all politicians, as well as parents, teachers and the food industry, have the opportunity to look at the evidence themselves and understand why tough measures to tackle the marketing, advertising and promotion of less healthy food and drink to children and their families are necessary. All options should be on the table to protect children’s health. So it is irresponsible of the Government to continue to refuse to consider a sugary drinks tax, especially now Public Health England’s lists it as one of their eight areas for action.

We want to see healthier and more sustainable food made as available and affordable as less healthy options currently are, and better marketed too. So we welcome Public Health England’s recognition that price promotions, checkout and aisle-end displays, TV advertising on programmes children watch and the loopholes companies exploit to market their products online all increase the sugar and calories children consume, and thus should be ‘significantly reduced’.

The economic and human costs of continuing softly-softly approaches and further inaction are well set out by PHE in their report. The Government’s childhood obesity strategy needs to take PHE’s eight action areas and run with them all immediately – including introducing a 20p per litre duty on sugary drinks, bringing in a 9pm watershed for junk food ads on TV and ensuring that there are strong marketing rules across all forms of media. Although not part of PHE’s review remit, universal infant free school meals and additional support for food and nutrition education in schools should also be core parts of the Government’s agenda.”

Chris Askew, Diabetes UK Chief Executive, said: “We welcome the publication of Public Health England’s evidence review on reducing sugar intake across the population. As the report makes it clear, diets that are high in sugar are fuelling the rise in obesity, and in turn the dramatic rise of Type 2 diabetes, a serious health condition that can lead to devastating complications such as blindness, amputations and stroke. These complications are not only life threatening and debilitating, but are also extremely costly to the health service. The NHS spends billions every year on treating diabetes, and unless we get better at helping people to live healthy and active lives this figure is set to rise to unsustainable levels.

“This is why we want to see the Government act on the strong recommendations in the report including restricting marketing of unhealthy foods to children, reducing and rebalancing the number of price promotions offered on unhealthy foods, implementing a clear and transparent programme for reformulating unhealthy foods and reducing portion sizes. The Government should also take action to reduce sugar consumption from soft drinks, which could include a tax on products that are high in sugar. As well as this people should also be supported to undertake regular physical activity and be given support to help them choose healthier foods, such as through a clear and consistent food labelling system. Unless this happens we will continue to see the seemingly inexorable rise of type 2 diabetes, with all its human and financial costs.”