Action on Salt and Sugar: The need for nutritional transparency in the UK’s OOH food sector
30 Aug 2024 | Action on Salt and Sugar
A recent Action on Salt and Sugar report, “Healthiness Assessment in the UK Out of Home Sector,” reveals that as much as 75% of popular takeaway foods are unhealthy. We sit down with Dr. Monique Tan, Lecturer in Public Health Nutrition at Queen Mary University of London’s Centre for Public Health and Policy and the lead author of the report, to better understand how nutritional transparency in out of home (OOH) foods could impact public health outcomes.
I'm Bradford Nichols, the editor for Nutrition Insight, and I am here today speaking with Doctor Monique Tan, a National Institute for Health and Care Research Fellow, a lecturer at Queen Mary University of London's Center for Public Health and Policy, and one of the lead authors of the recent Action on Salt, Action on Sugar report titled Healthinesss Assessment in the UK Out of the Home Sector.
Hello, Doctor Tan.
How are you today?
Hello, I'm , and you?
I'm great.
We're excited to talk to you.
I have a lot of questions, and if it, if it's OK, I'd like to just jump right in.
Yes.
All right.
Can you just maybe give us a quick summary of some of the main findings regarding the healthiness of the out of home or OOH food sector?
Yeah.
So, just for, just to set the scene for contextual knowledge.
So the project which is completed is about what we call out of home foods and drinks.
So, that's, you know, we're talking about foods from restaurants, pubs, cafes, takeaways, which we eat in increasing amounts, you know, here in the UK at least, but up until now, we didn't know much about what's in it.
So, our work is actually one of the first forays into the healthiness of these foods.
And in the UK a quarter of our calorie intake as a population comes from out of home food.
60% of the population eats out of home at least once a week.
So, this means that dining out or having takeaway food may have been an occasional treat in the past, but that's not the case anymore.
It's much more ingrained in our daily life.
So, what we've done in our research is that we've looked at the top selling products currently dominating the UK out of home market.
So, I'm talking about the best selling products of the largest companies operating here and key findings are two things.
So, one, it was incredibly hard to find publicly available data, nutrition data to fully assess how healthy the products were.
So, we had to contact the companies to ask for more nutrition information and then even then we still had to actually purchase, order 3 of the products for like manual measurements.
So, nutrition data in and out of home is really lacking, which is also why this sector is disproportionately under-researched and underregulated given how much influence it's got in our diets.
Second key findings is that when we did obtain all the data, we found that by any metric of happiness measurement, a substantial share of these bestselling products would not be healthy.
So, we've used several metrics because there's no official healthiness metrics for the out of home sector.
So, we've trialed several governmental metrics.
Some of them were really stringent and resulted in almost 80% of the products considered unhealthy.
And some others are too lenient.
So, for example, if we only use the UK nutrient profile model, which is used in a lot of policies here in the UK we found that it's not good enough on its own because what you do, like the nutrient profile models will only tell you whether it's a good balance between Beneficial versus harmful nutrients, but it's completely blind to portion sizes and portions tend to be oversized in the outer form.
So, the finding here is that the nutrient profile model is not good enough to assess product healthiness in the out of home sector.
You will also need to add maximum caps for the amount of harmful nutrients per portion.
So for example, calorie caps, salt, sugar caps per serve and according to that approach that we recommend, about 60% of the best sellers in the out of home in the UK out of home would be unhealthy.
That is fascinating, and what an intense process you had to go through to gain all that information.
Thank you for doing it.
So, based on your findings, how do you think increased nutritional transparency could impact public health outcomes?
So, 3 ways.
First is for consumers, so that would help them make more informed choices, so going beyond just calories.
So, in the UK it's currently monetary for large out of home businesses to display the amount of calories per serve at the point of choice.
But say if you need a low salt or a low sugar diet, then you may not be able to find this information as easily.
But then in terms of population health, individual consumers making individual choices will only take you so far.
So, if we try to zoom out a bit and if we think of companies having to display nutrition information more transparently, that could actually help incentivize them to either reformulate their products to let them to make them look less bad, essentially, or at least not promote so aggressively.
The less healthy options in terms of more like corporate social responsibility and then third and finally, better data will make it so much more easier for government and any other group to independently monitor the nutritional quality of out of home food, which will then help develop better, like better tailored, more effective and fairer policies to help improve our out of home food environment, which will then improve our diets and therefore improve public health outcomes.
That's also very interesting.
And speaking to that, I know that every time we talk about this, or every time it's brought up, someone always asks, isn't it the individual's responsibility to kind of monitor what they're eating themselves?
How does nutritional, how do you think nutritional informational or information could influence consumer choices in the OOHH sector if it's, if it's broadcast and, and properly labeled?
So, hypothetically, in the short term, consumers could make, you know, more informed choices and that choice actually could be at the product level.
So, you know, swapping for a healthier alternative product or choosing a smaller a smaller size if given the choice or the consumer choice could be at the company level.
So say if you have a pizza place that only has very high salt pizzas, then Consumers may choose another pizza place that offers healthier options.
So, that's choice at both the product level and the company level.
And then I also think over the long term, what you may start seeing is greater consumer demand for healthier options because what you eat when you're outside of home is pretty much dictated by what's available and at the moment, it's very hard for consumers to demand healthy options if they don't realize how unhealthy the current options are.
That, that's, that's a great point.
And, yeah, thank you for bringing that up.
Every time someone mentions that it's, it's up to the consumer, you know, I, I always think, yeah, it's up to the consumer to drive , but that doesn't mean we make unsafe vehicles, you know.
So, yeah, thank you.
So I, I think my last question here for you today.
Would be what specific policy measures do you recommend to help improve nutritional transparency and encourage healthier outcomes and healthier choices within the out of home sector?
OK, so from our research and also from our consultations with stakeholders, so both out of home industry stakeholders and also non-industry stakeholders, we issued recommendations around 3 areas.
So, first area is nutrition data availability.
So, we need standardized requirements for companies to display nutrition information at the point of choice, just like it is required of the rest of the sector of the food sector.
Second area is healthiness assessment.
So, a nutrient profile model is not good enough for the out of home context because it's applied to portion sizes.
So, we'll also need maximum caps for certain nutrients of concern and actually we recommend that these maximum caps should take priority over nutrient profiling, especially calorie caps.
So, first, establish these caps.
For example, in the UK we have maximum targets and guidelines for calories, salt and sugar.
And then worry about the nutrient balance because that and that's a recognition that healthiness is not just the absence of harmful nutrients, but also the presence of beneficial nutrients.
But if we have to start somewhere, The priority are the maximum caps.
And 3rd and final area of recommendation is around reporting.
So we recommend that governments make it mandatory for companies to report on the healthiness of their portfolio in a standardized way.
For example, using the healthiness assessment approach that we recommend.
