Unpacking The Evidence: a new podcast from the House of Lords

 

Chris van Tulleken:

We have around a quarter of children the age of 10 leaving primary school living with obesity.”

 

Alice Wiseman:

it is costing about £58 billion to our economy to address the issues of overweight and obesity

 

Henry Dimbleby:

By 2035, type 2 diabetes— which is just one condition caused by diet— it’s estimated that it’s gonna cost more to treat than all cancers do today.

 

Harrison:

I am just an 18 year-old from Birmingham. There is not a lot that I can do on my own.We need the Government’s help to protect us.

 

Baroness Walmsley:

 

Welcome to this podcast about the evidence heard by the House of Lords Committee on Food, Diet and Obesity.

 

I’m Baroness/Joan Walmsley, the Committee Chair.

 

The House of Lords Committees are part of the UK’s Parliament, and listen to experts from all over the world in order to give non-partisan recommendations to the government.

 

The committee on Food, Diet and Obesity were appointed in January 2024 to understand how things like ultra-processed foods or those high in fats, sugars and salt affect our health and our lives, and how the government might help.

 

We published our report, and recommendations to the government about action we think they should take, in October 2024. The Government’s response is expected to be published by the end of January 2025.

 

We’ve pulled together some of the evidence from many of the experts we heard from into two podcast episodes to go alongside our report.

 

Baroness Walmsley:

In this first episode, we’re going to hear about how the UK, along with many other countries around the world, is facing a serious problem. One which inspired this enquiry.

 

Henry Dimbleby:

 

The threats from food now completely dominate the health of our population. It’s by far the biggest cause of avoidable illness.

 

Baroness Walmsley:

Former UK Government Food Tsar, and author of the government-commissioned National Food Strategy, Henry Dimbleby.

 

Henry Dimbleby:

If you look at the number of people who are out of work, 2.8 million people long term sick, the Treasury thinks that the four, biggest conditions that are driving that are type two diabetes, musculoskeletal problems, hypertension and mental health.

And three of those are directly caused by diet. And one of them, mental health is exacerbated by diet.

 

So I don't think it is exaggerating to say that this is going to be one of the huge problems, facing society over the next ten years 

 

Baroness Walmsley:

As Christina Vogel, Professor in Food Policy, at City University explained, this is a recent phenomenon:

 

Christina Vogel:

The health survey for England shows that rates of obesity have almost doubled over the last 30 years, from 15% in 1993 to nearly 28% in 2023.

 

Baroness Walmsley:

And it starts very young.

Lucilla Poston, Professor of Maternal & Fetal Health at King’s College London.

 

Lucilla Poston:

Through our very comprehensive national child measurement program, we know now from 2022 to 23 data that, when children go to school, nearly 1 in 10 are already obese. 9.2% of children when they go to reception classes are obese. By the time children get to, 10 to 11, 22.7% of children are clinically obese. And then the evidence in the academic literature suggests that obesity then tracks through to adulthood.

 

Baroness Walmsley:

It’s also a problem that is getting worse.

 

Anna Taylor:

The deterioration in our health over time has been speeding up.

 

Baroness Walmsley:

Executive Director of the charity The Food Foundation, Anna Taylor.

 

Anna Taylor:

We used to call type 2 diabetes “late-onset diabetes”; it was never seen in children before the year 2000. In the year 2000, the first eight cases of pediatric type two diabetes were recorded. We now have over 900 cases.

 

Baroness Walmsley:

And the UK is worse affected than other European countries, as Dr Chris van Tulleken, Associate Professor at University College London, and author of the book Ultra-Processed People, explained:

 

Chris van Tulleken:

Compared to their counterparts in Eastern Europe, in northern Europe and in Scandinavia, children in the UK, at the age of six, are around 7 and 9cm shorter. And we know that that obesity, and that malnutrition and that stunting is driven by diet.

 

Baroness Walmsley:

We heard plenty of evidence, then, that the UK has a huge and growing problem that is leading to increasing amounts of sickness in the population.

 

The experts we heard from also agreed that the current food system we have is clearly the cause.

 

Eric Robinson:

The food industry couldn't be any more influential in terms of driving health outcomes, because we know that diet is one of the leading causes of ill health and the main contributor to obesity.

 

Baroness Walmsley:

Eric Robinson, Professor of Psychology & Public Health at the University of Liverpool:

 

Eric Robinson:

Consumers are completely reliant on the food industry when they're out and about and often eating at home as well. So really, the food industry determines to a large part what we eat, and they shape our food environment. Everybody in obesity, public health research kind of agrees that the reason we have an obesity problem now and we didn't 40 years ago, is because the food environment’s changed.

 

Baroness Walmsley:

Even those within the industry agree.

James Mayer, President of food manufacturer Danone in the UK and Ireland explained how food manufacturers have got into this position.

 

James Mayer:

At the end of the Second World War, the food industry at scale in the UK was challenged to do two things. One was to feed a growing nation, so: plentiful supply at a reasonable cost. And I think if we look back over the last 70 years, arguably it's done an outstanding job in feeding a growing Britain. Of course, sometimes there are unintended consequences of those things. And I think it's fair to say that as a nation, we consume too much product which is high in fat, sugar and salt.

 

Baroness Walmsley:

One of the most worrying problems we heard about, though, was that the health issues related to our diets are now being passed directly to the next generation.

 

Many babies and children today are starting life with obesity and face little chance of then escaping it.

 

We wanted to hear from experts what was going on.

 

Baroness Walmsley:

Hearing that in the UK, children are suffering with obesity and other food-related health problems before they reach primary school, we wanted to start by understanding: what causes obesity at such young ages?

 

Could it be the genes?

Professor Poston from King’s College London.

 

Lucilla Poston:

The genetic contribution, to my mind, is quite small. The major contribution is the actual increase in poor diets amongst pregnant women. There are figures suggesting 20% to 40% of obesity in children is attributable to the BMI of the mother.

 

There is a straight-line relationship between the BMI of the pregnant woman at the beginning of pregnancy and obesity in her child. It is absolutely dramatic. So we're incredibly concerned about the fact that, more than 20% of women antenatally are obese - clinically obese – it’s following the trend in the general population. If we were able to modify that, we would be able to modify childhood obesity.

 

Baroness Walmsley:

This is a very important finding from research. It means that it is possible to protect children from this very poor start in life.

 

Vicky Sibson:

The key thing is that obesity tracks through life. So it's so important to recognize this opportunity that the early years creates.

 

Baroness Walmsley:

Dr Vicky Sibson, Director of First Steps Nutrition Trust explained how that could be achieved.

 

Vicky Sibson:

There's a wealth of evidence that shows that at a population level, breastfeeding protects against overweight and obesity. While bottle feeding and formula feeding has been associated with excess weight gain.

 

So breast feeding is, a responsive behavior - you can't force a baby to breastfeed. They can follow their own satiety cues, and they'll latch on when they want to feed, and they'll stop when they're satiated. Whereas bottle feeding, you can bottle feed responsively. But it's harder.  And some of the evidence shows us there's a tendency for parents to want to finish a bottle.

 

Baroness Walmsley:

Dr Sibson stressed the importance of supporting mothers and mothers-to-be.

 

Vicky Sibson:

It’s not about focusing on these individuals and their choices and behaviours; it is about creating a more enabling environment, so that women can start their pregnancies a healthy weight, so that they can meet their breastfeeding intentions. Because most women want to breastfeed, a lot of women start breastfeeding, and then their intentions are derailed by the environment in which they're trying to breastfeed.

 

Baroness Walmsley:

Dr Sibson talked through how a mother might end up giving up breastfeeding earlier than she’d like.

 

Vicky Sibson:

There’s different reasons for that. But one of the key ones is probably, exposure to formula marketing, knocking her confidence to breastfeed. So an example would be she might have signed up for a baby club from one of the formula companies. And that is a perfectly legal type of marketing. But within those emails will be messages that are making her doubt her self-efficacy to breastfeed.

 

And it's also evidenced that introduction of formula does hasten the end of breastfeeding. So her breastfeeding journey will be shorter than she would have wanted it to be.

 

So then fast forwarding, at four, maybe five months of age, she'll probably start weaning. And that's important because that's earlier than the NHS recommends. It's meant to be around six months of age that you introduce solids. And again, there'll be different influences there, but one would be walking down the supermarket aisle and seeing fruit and veg purees marketed for four months plus. Again totally legal and also labelled no added sugar and other marketing slogans that are suggesting that it's a good choice - this is an appropriate choice for when you start giving your baby foods.

 

Baroness Walmsley:

The government’s Scientific Advisory Committee on Nutrition recently produced a report on the diets of one to five year olds in the UK. They found that on average children were being given too many calories, sugars, proteins and salt – often in the form of commercial baby foods. The Chair, Professor Ian Young, outlined their recommendations.

 

Ian Young:

Firstly, sugar should not exceed 5% of total dietary energy intake should apply from age one, so in all of the 1 to 3 year olds. Secondly, that children aged 1 to 5 should not be given sugar sweetened beverages at all. Thirdly, that dairy products such as yogurts and fromage frais, etc. given to children aged 1 to 5 should ideally be unsweetened. And fourthly, that formula milks-  which includes infant formula, follow on formula, growing up, other toddler type milks - are not required by children aged 1 to 5 years.

 

We also recommended that snack foods that are energy dense and high in saturated fat, salt, or free sugars, should be limited in children aged 1 to 5, which really means given as little as possible to children in that age group.

 

Baroness Walmsley:

Unfortunately, our relationship with food is deep and complex. Bee Wilson is a food writer and co-founder of a charity that works to introduce fresh foods to children in schools.

 

She told us her concern about the psychological effects of marketing tactics for foods aimed at children.

 

Bee Wilson:

It tells us that the way that we express love is to give our child a treat. And that's an extremely powerful message, because every parent ultimately wants two things: they want to see their child eat, and they want to see their child made happy through food. And there's this problem with children's food, which is that there's a short term thing, which is you want to see your child smile and have a full tummy, which is what happens today, and then this long term thing of the person they're ultimately going to become.

It's very, very hard for a parent to be thinking about that long term thing when you've got a sad little face not wanting to eat what's in front of them. And I think unless we engage with this love relationship, which plays out through ultra processed food, healthy eating initiatives run into difficulties.

 

Baroness Walmsley:

Professor Young agreed.

 

Ian Young:

In a personal capacity I think it's critically important that children are introduced early to a wide range of foodstuffs, and in particular, not introduced to sugary foodstuffs in early life, because it will develop a whole association of sugary sweet foods. It will alter the whole approach to diet in later life. So, you know, I'd like to see sugars removed as much as possible from products aimed at those age groups.

 

Baroness Walmsley:

Dr Sibson again.

 

Vicky Sibson:

All socioeconomic status families use baby foods; it is completely the norm. . and then that actually even continues in the first year of life, second year, third year of life. You've got products marketed for 12 months plus… 24 months plus. In the last year or so, we've seen a proliferation of products marketed for 36 months plus. They're all snacks, snack foods. They just basically look like crisps, but they're marketed for young children. And then you've got a whole set of products clearly aimed at preschool children because they have cartoon labels.

Baroness Walmsley:

From the experts we heard from, it seemed clear that there is an important opportunity to avoid early weight and obesity issues in children, through supporting families during pregnancy, infant feeding and the early years.

 

It is also an opportunity to set young children’s food preferences in a healthy direction. In part 2 of this podcast we will hear the evidence about what government policies might help.

 

But first, what happens as children grow older and go to school?

 

Baroness Walmsley:

Once children are at school, there is the potential for breakfast clubs and school lunches to help ensure they get a healthy diet. We heard a lot about the issues with these, particularly in secondary schools.

 

Caroline Woollam is an ambassador for the charity The Food Foundation.

 

Caroline Woollam:

They'd have like a mid-morning snack that was given to their children at no cost to the parent. So they will be given a piece of fruit or a snack or, half a bagel. So that would be classed as a free snack in primary school.

 

Baroness Walmsley:

Children from households with an annual income - before benefits - of less than £7400, are offered what are known as ‘free school meals’. However, this doesn’t mean that a nutritious meal is offered to these children for free.

Dominic Watters, another ambassador for The Food Foundation, has a daughter at school on these so-called ‘free school meals’.

 

Dominic Watters:

Free school meals aren’t free. The amount awarded to each child is 3 pounds a day. That hasn't changed since the 45 year fastest increase in the price of food, which places schools in problematic positions especially around kind of the canteen and everything. I get a text at least every other week, if not a couple of times a week, saying, “Dad, can you top up my thumb?”

 

Baroness Walmsley:

Children often pay for food at school using their thumbprint, and parents have to make sure they have enough money in their account to be able to buy lunch.

And the food choices they have may not be healthy, especially given the money they have available.

Naomi Duncan, Chief Executive of the charity Chefs in Schools:

 

Naomi Duncan:

A study by Imperial College found that around about 64% of the calories that kids were taking in from meals provided by the school were coming from ultra processed food, and many of those were foods that were high in fat, sugar and salt, much worse in secondary schools, I have to say, because of the kind of marketplace of food available.

 

Baroness Walmsley:

Emmanuel is a member of the youth board at charity Bite Back.

 

Emmanuel:

I would have certain friends who, because of the amount of money that they were given as an allowance for the day hadn't increased, but the prices of food in the canteen had increased with inflation, they would be trying to get more with less money. And because of that, they would then have to make decisions: okay, am I going to eat at breaktime and then skip out lunch because I don't have enough money to get both? Or am I going to eat at lunch and then skip out break and some of my friends would even message me the day before and be like, oh, Emmanuel, what lessons do we have in the morning? I just wanted to know if I've got PE in the morning so I know whether it's, something at break time because I don't eat breakfast at home. So do I get something to eat at break time, which is then going to give me enough energy to get through PE, and then I'll just skip out the rest of the day. Or do I soldier through up until about lunchtime and then get enough energy to get through my exam that I have period five? And that was and still is the reality for, a lot of young people in the UK.

 

Baroness Walmsley:

For families struggling to afford good food in schools, the alternatives are packed lunches or nipping out to buy something locally from a fast food outlet. Because time is short in the school break.

 

Wendy Wills, Professor of Food and Public Health at the University of Hertfordshire has been studying what typically happens.

 

Wendy Wills:

In one of our studies of several hundred young people, around 40% of young people in more affluent areas were leaving school regularly, sort of more than twice a week to go and purchase food or drink outside at lunchtime. But this was more than 90% of young people who were at schools that were in deprived neighbourhoods.

 

Baroness Walmsley:

With more than 90% of school children going out of school to buy lunch, it sounds tempting to ban all outlets within walking distance.

But if those outlets were not available near schools, Professor Wills told us they saw something else.

 

Wendy Wills:

We saw a typical pattern where a young person might have a hot drink before they go to school, drink water at the mid-morning break, have an energy drink or another sort of high sugar drink at lunchtime and have no food whatsoever during that part of the school day.

 

Baroness Walmsley:

It seems as though some schools are failing to provide what their pupils need. But it’s not all purely about food.

We heard that there’s a deeper, more social relationship involved.

 

Wendy Wills:

In the schools that were in lower socioeconomic areas, the staff in food outlets around schools built up a really good relationship with young people. Young people were a really important part of that lunchtime economy, before, during and after school, actually. So they knew young people's families. They'd seen the children grow up. They were part of that sort of area, that neighbourhood. So it was more than just about buying the food.

 

Baroness Walmsley:

Emmanuel explained.

 

Emmanuel:

 

The guy who owns a takeaway shop. I don't actually know his name and I've been going to his takeaway shop for maybe the last - I'm 19, so I'll say around 17 years - but I always call him Bossman every time I enter into the shop. And that's just our way of communicating. Everyone in the community, they always call him Bossman. He's the local boss man who owns the pizza shop and, me and him, we have like a really, really good relationship. And that's because each and every time I go into his shop, I'm not just going there for food. These takeaway shops and fast food outlets are a social hub for the whole community together and talk.

 

Baroness Walmsley:

An alternative for school children is to bring food in from home – a packed lunch. Unfortunately, we heard that these are also dominated by less healthy, manufactured foods, because of price, convenience, marketing and peer pressure.

 

Kathleen Kerridge, an Ambassador for The Food Foundation, explained.

 

Kathleen Kerridge:

Marketing and influence around food, especially for school-aged children, matters very much ‘cause sending your kids to school with a healthy pasta salad or a rice salad or a turkey wrap, for example, will actually cause them to stand out from their peers somewhat. They don't want that. They want the name brand, bright kids-marketed stuff in their lunchbox, and mine were always very, very upset with me that they did not get that because I wouldn't buy it because of the price. I wouldn't buy it because of the ingredients. And they absolutely hated school lunch time as a result of that.

 

Baroness Walmsley:

Food manufacturers know well how to market their products to children, and also to target our desires for something convenient, affordable, and tasty.

Unfortunately, that doesn’t take into account its effects on our health.

 

Baroness Walmsley:

Anna Taylor demonstrated the trade-off between health and price.

 

Anna Taylor:

We looked at the five big supermarkets and we looked at all of their single-pot yoghurts.

Cheapest product: 7p per pot. Look at the ingredients, which are highlighted there, quite a few of those are ultra- processed. Next up: lower sugar but three times the price: 21p per pot. That has half the amount of sugar than the cheapest one, so definitely good from health, but you are paying three times more.  Your unsweetened one: 60p. So that's, almost ten times more expensive than the very cheapest one. If you’re a parent and you've got a budget of maybe 50 pounds a week for your family shop, these pennies really matter, You've got a tough set of choices. This is not working in your favour as a parent.

 

Baroness Walmsley:

And it’s not just the cost of buying the food, there’s the costs of preparation to take into account. For those that have to watch every penny, we heard how they have to trade time and health for cost.

 

Dominic Watters:

The shop on our estate, it doesn’t sell anything fresh. It is all the lowest quality, processed food; white bread. It can be like a full time occupation just to travel, to get fresh food and ingredients.

 

Baroness Walmsley:

Food Foundation ambassador Dominic Watters again.

 

Dominic Watters:

I’ll be on my bus and I'll be hearing neighbours talking about how they spend all day on the buses with their free bus pass to get to different supermarkets to get the best deals on microwave meals. This is because as we’re pay as you go on gas and electric, we can see that the amount it cost to cook from scratch. I'm actually quite arguably a good cook. My daughter really likes my cooking. But to cook fresh ingredients from scratch, boiling, frying chicken, rice, pasta. We can see that it costs a lot more, on your electric or gas than it does to cook a microwave meal.

 

Baroness Walmsley:

Fast food retailers know this, and they specifically target those who need to keep costs down, making their food time- and money-saving.

Youth Board member at Bite Back, Anisah:

 

Anisah:

I literally live smack in the border between two neighborhoods, Kilburn and West Hampstead. Now turning left at the end of my road takes you into a much more deprived area, Kilburn, that is not exactly massively healthy, Every of the storefronts is either fried chicken shop, or we might have a convenience store or a fast food outlet or a burger joint. The street just simply flooded with these unhealthy options lined up right next to one another. And in fact, within a few minutes’ walk, I can already count about five fried chicken shops and four fast food outlets.

However, if I was to turn right at the end of my street, it takes me into the much more affluent West Hampstead, where there is an abundance of healthy food options and shops and restaurants, you name it. The only difference is, the irony here, is the fact that actually, nothing in that area is actually affordable for the residents living in Kilburn.

 

Baroness Walmsley:

Fellow Youth Board member, Harrison:

 

Harrison:

One thing you can't do is deny the tactics that these big junk food companies use to put this junk food in a starring role in my mind. So as I walk to the bus stop, I see McDonald's advert. I, like, get on the bus, to go to uni, I look out on the streets, I see more adverts.

 It's literally, our high streets are flooded with junk-food advertising. So why should we have to protect ourselves?

 

Baroness Walmsley:

And Emmanuel:

 

Emmanuel:

During exam season, during A-levels, these big food corporations, they knew that I was doing exams. They knew the whole country was doing, exams. And the amount of texts, emails, notifications I got on my phone, things I saw on social media about two-for-one deals for kids doing exams, if you come with your exam results we’ll give you a half off deal or whatever. They know this and they actively target young people, especially at times such as exam season when young people and students are the most vulnerable, that's when they target you the hardest.

 

Baroness Walmsley:

And this targeting has effects.

Professor Vogel from City University again.

 

Christina Vogel:

There's really some stark inequalities that are shown through data with childhood obesity, in particular children living in the most deprived areas, being much more likely to be overweight and obese than children living in the most affluent areas. And that, again, that difference has, almost doubled in the last 15 years, going from 9% to 17% difference over the ten years of 2008 to 2019.

 

Baroness Walmsley:

Everyone we heard from agreed that there is a big problem with the food that we are now being served by the food industry. Much of it is high in fat, salt, and sugar and calorie-dense.

Some, though, see a further issue than just the nutrients in it: the way that those are processed.

‘Ultraprocessed food’ is a term that many of us will have started hearing recently. So what is it, and what – if anything - is the problem with it?

 

Henry Dimbleby:

One way of thinking about ultra processed food is that after the Second World War, we created a new form of farming that made with the cheapest things, the cheapest forms of calories are refined vegetable oil, refined wheat and refined sugar.

 

Baroness Walmsley:

Henry Dimbleby again.

 

Henry Dimbleby:

And we can see ultra -processed food as a way of taking those cheap calories and making it palatable by adding as little other food as possible. And in some senses, that was a huge success. So we do not have the malnutrition, that that form of farming was invented to stop. We have solved the calorie problem. And I think when you talk to older people in the food industry, they kind of think how did I become the bad guy? I was the hero, like through the 40s and 50s and 60s. We were the heroes. We solved this existential problem. And now we’re the bad guys. But it is impossible not to draw the conclusion that actually the way in which that developed is now causing huge harms.

 

Baroness Walmsley:

It’s not just the UK that has seen this rapid change in foodstuffs.  It was particularly noticeable in South America - which is why it was researchers in Brazil who developed a classification called NOVA, which describes the level of processing of various foods, completely aside from the nutrients they contain.

Professor Carlos Monteiro led the team.

 

Carlos Monteiro:

Nova classifies all foods we eat into four food groups. So this goes from the first group where it's very easy to understand a fresh or minimally processed foods. Going to the fourth group, which is ultra processed foods.

 

So the first group is easy, it’s foods like they are produced in nature while they are slightly modified without addition of anything. So frozen vegetables, pasteurized milk, anything.

 

The second group is the group of processed culinary ingredients. So we are talking here about salt, sugar, oils and fats and why this group is important? Because it’s with this group that people in their homes or in restaurants, they season, they cook, they prepare NOVA group one foods. They are not consumed by themselves.

 

The third group is made by the industry using, adding, salt, sugar, oils or fats to Nova Group one foods and, and these are all, you could say, relatively simple and very old products and they could be made by people at their homes.

 

And traditional dietary patterns, all over the world, since the Mediterranean diet until the Japanese diet, they are made from group one, two and three. Of course, most group one, some group two, some group three.

 

Ultra-processed foods, which is the fourth group is entirely different. They are not modified foods. You cannot identify one single whole food in these products. So they are formulations of different ingredients. In these ingredients we have many food substances derived from foods like starches, like protein isolates, like oils and fats and also additives, many additives.

 

Baroness Walmsley:

In South America, we heard that these ultra-processed foods very quickly had a huge effect on people’s diets.

 

Camila Corvalán:

In Chile, over three decades, we observed how most families spent money on natural foods and then, in three decades, most of the money was spended on ultra-processed food.

 

Baroness Walmsley:

Professor Camila Corvalán, from the Institute of Nutrition and Food Technology at the University of Chile.

 

Camila Corvalán:

And that was very related, to the opening of our markets and the expansion of these big corporates, unfortunately, in the country. We could see at the same time that our obesity rates were increasing, our metabolic diseases, our cardiovascular diseases, so we had to take some action.

Baroness Walmsley:

The suspicion was that the rise in obesity and diet-related diseases was linked to the rise in these foods.

 

And they are very common in our diets in the UK – in children’s lunchboxes and as convenient snacks and meals.

 

Katherine Jenner is Director of the Obesity Health Alliance, a group of 60 health-related organisations. She brought us some examples to show how we can recognize them from their ingredient lists and marketing.

 

Katherine Jenner:

So I did a little trip to my local convenience store this morning, on the way to the station. First example here, these apple pie cookies that were on the shelf: very long lasting, quite energy dense products. It says that it's 25% apple, but when you read closely, it's 25% apple filling which only contains 5% actual apple. The rest is things like corn starch, modified corn starch and stabilizers, and various different ingredients. The next example I've got is this: it’s a, apple sauce - again, just like mum used to make at home, a nice apple sauce. Except I don't think your mother made it with: potassium sorbate, glucose, fructose syrup and modified corn starch. and that is 25% sugar in that as well. It does contain some apples in it, at least.

 

Baroness Walmsley:

In the UK most of what we now eat is ultra-processed food.

Anna Taylor from Food Foundation again.

 

Anna Taylor:

Actually, when you delve in to different subsections of the population, you don't see huge amounts of difference. So no subgroup, whether they're older or younger, richer or poorer, living in the North or living in the South has less than 50% of their calories from ultra processed food. That's from the dietary data that we have. Ethnicities, a mark of a slightly lower proportion, about 45%. But this is a majority experience. And then if you even dive into the data and you say, well, who are the lowest consumers? So the academics have looked at the spread and taken the lowest quarter. They're eating about 35% of their calories come from, ultra processed foods. The top quarter's about 75%.

 

Baroness Walmsley:

And it starts very young. Dr Vicky Sibson again.

 

Vicky Sibson:

We know that ultra- processed foods dominate diets from early in life. So one statistic drawing on the National Diet Nutrition Survey data is that 61% of total mean energy intake of 2 to 5 year olds in the UK come from UPFs.

 

Baroness Walmsley:

And the reason that these sorts of foods have come to dominate our diets is quite simple. It is down to how the global food industry works.

 

Dr Rob Ralston, lecturer in public policy at the University of Edinburgh, explained.

 

Rob Ralston:

Over the past four decades, the ultra processed food industry is, doubled in size and it's now over $1.1 trillion. and within that industry, we see, roughly eight key corporations who hold very central positions, and dominant positions within that industry, which are, consumer brands that we're all familiar with.

 

In terms of the influence of industry, or why ultra processed foods might be important within the portfolios of these companies is that they're, very palatable, they have very long shelf lifes, and they're also very highly marketable.

 

What we've seen is multinational corporations devote huge sums of money to marketing ultra processed foods. To give you an example, between 2015 and 2019, Nestlé devoted about $100 billion just to marketing. And the reason that they're doing this and the reason ultra processed foods are so important to these companies, is simply that higher profits come from processed foods, in comparison to, say, fresh foods or whole foods. So it's often not in the interest of corporations to promote healthier food products simply because the profit margins are lower and corporations have a fiduciary duty to shareholders to maximize profits.

 

Baroness Walmsley:

Charlie Bigham, whose company makes food from fresh ingredients emphasized that you don’t have to use ultra-processed foods to make profits – but they might be lower without them.

 

Charlie Bigham:

Our profit margins, are, you know, a matter of public record because we’re a limited company so they’re available at Companies House, and you’ll see that we don’t make the same levels of profit that a large, global business might make – global food business.

 

Baroness Walmsley:

The global food businesses that dominate our diets in the UK predominantly sell the more profitable ultraprocessed foods or UPFs. The rise of these co-incides with the rise of food-related health problems in many countries and there’s good evidence that the rises are directly linked.

 

But what is causing that effect? What is it that makes food healthy or unhealthy?

 

 Is it the level of nutrients – being high in fat, salt and sugar – known as HFSS?

 

Is it the synthetic ingredients like additives? Or is it something about the processing?

 

Our experts generally agreed the current definition, which is based on nutrient content, is well-supported by the evidence.

But there is still a live debate over the relative contributions of these nutrients, processing and additives in the healthiness of individual foods.

 

Professor Robinson again.

 

Eric Robinson:

There is significant overlap, and lots of the foods that we think of as junk food would fall into both the HFSS category and the UPF category. But the reason the distinction is important, is ‘cause there’s a number UPFs that would not be classed as HFSS. Supermarket bread, whether wholemeal or white, would be UPF but it wouldn’t be an HFSS.

 

Baroness Walmsley:

Foods that are HFSS – high in fat, salt and sugar, are already not recommended as part of a healthy diet and the government regulates how they are marketed, because there is good evidence on how they cause health problems.

 

Senior Nutritional Epidemiologist at the University of Oxford, Dr Keren Papier.

 

Karen Papier:

We know very well about sodium and salt and its impacts on our blood pressure and cardiovascular disease risks, and also saturated fat, increasing lipids and cardiovascular disease. We have evidence around processed meats and colorectal cancer. I mean, the list really does go on.

 

Baroness Walmsley:

But does ultraprocessed food – UPF – that doesn’t contain high fat, sugar or salt still cause problems in our diets?

 

One issue that has been raised is what they don’t contain – and hence what we might miss out on if we replace whole foods with UPFs. Katherine Jenner from the Obesity Health Alliance again.

 

Katherine Jenner:

The biggest evidence for me around UPF is around the lack of fibre, which slows down the digestion of it, the fact that they may use less healthy ingredients to bulk it out, therefore pushing out more nutrients from the food.

 

Baroness Walmsley:

Then there’s the fact that in many cases, foods classed as UPF contain a lot of calories per portion.

 

And we also heard about emerging evidence that they are manufactured to be especially tasty: something called hyperpalatability.

 

Tim Spector, Professor of Genetic Epidemiology at King’s College London:

 

Tim Spector:

There's a researcher in Kansas called Dr Fazzino who looked at a large number of studies in the US that dealt with hyperpalatability— and from that, used the US database to work out there were three outstanding ratios of food that the industry use to make their food hyperpalatable: 25% of calories from fat, plus 0.3% of sodium; 20% of calories from fat, plus 20% from sugars; and 40% from carbs and 0.2% of sodium. So these are very precise measures that are quite easy to put out there. And these’re making  foods designed specifically so that people will overeat them.

 

Baroness Walmsley:

But we heard about more subtle issues that UPFs might be causing.

 

The combinations of fats, sugars, carbohydrates and salts that are put together, often along with additives, may have unexpected effects on our bodies, because they are not combinations our bodies have evolved to deal with.

 

Professor Barry Smith, Director of the Centre for the Study of the Senses at the University of London, described some examples.

 

Barry Smith:

When we're getting those artificial sweeteners, our bodies are then thinking they're going to get sugar: no sugar comes. And if you're taking carbohydrates at the same time, having a diet Pepsi, say, with, you know, a fatty lunch, the body will start storing that fat more because it's getting a signal that it was going to get a lot of that energy. Didn't get it. And then it starts trying to find it. Chase the calories.

 

But again, the problem is we used to have ordinary systems that told us what was in our food and helped us regulate when we were getting it, and we could stop. So what we're doing is tampering with those systems and bypassing them in some way, and that's not good.

 

Baroness Walmsley:

Some of the additives themselves may be bad for us. Dr Mathilde Touvier, Head of the Nutritional Epidemiology Research Team at French governmental research institute, INSERM.

 

Mathilde Touvier:

We’ve been able, for the first time at the international level, to measure the additive exposure to a wide range of food additives. And we have showed associations between a higher intake of several artificial sweeteners, several preservatives such as nitrates - nitrites, and also some food emulsifiers, and a higher risk of different diseases—hypertension, cardiovascular diseases, type-2 diabetes, some cancers.

 

Baroness Walmsley:

We heard from the Chief Scientific Advisor to the Food Standards Agency – or FSA – Professor Robin May. He told us about the issues with testing the safety of additives like emulsifiers and preservatives.

 

Robin May:

In terms of new products—additives in particular, which are the things that extend shelf life—so any product has to come into the FSA as a regulator. We look at possible DNA damage, liver impacts, kidney impacts. I think I can say, hand on heart, that individual components are very carefully assessed and safe. What no regulator, no science base anywhere in the world, as far as I am aware, has achieved yet is the ability to look at them in the full complexity of all the different components in there. That is essentially a problem of scale. In the United Kingdom, we have something in the order of 320 licensed additives. So even if you had only two additives always at the same concentration in the food, you are looking at something like 100,000 combinations that would need testing. So the scale is really quite overwhelming.

 

Baroness Walmsley:

It’s clearly very difficult to pin down how much the link between high amounts of ultra-processed foods in our diets and high levels of obesity and ill-health is down to the fats, salts and sugars, and how much to something else. What is needed is actual experiments.

 

And the most famous experiment done so far is one led by Dr Kevin Hall, Senior Investigator at the National Institutes of Health – the U.S. Government research body.

 

They divided volunteers into two groups. Both groups were allowed to eat as much or as little as they liked and they were offered a diet that had the same calorie density; salt, sugar, fat and fibre content; and glycaemic load.

 

The difference was that for one group it was all ultra-processed and for the other group, none of it was – and then the two groups swapped over.

 

Kevin Hall:

The surprise to me was that despite matching for the various nutrients of concern that we matched for, that people spontaneously chose to eat many more calories on the ultra processed diet, gaining weight and gaining body fat. Whereas when the same people were exposed to a food environment that had no ultra processed foods but were matched for various nutrients of concern, they spontaneously lost weight and lost body fat.

 

Baroness Walmsley:

Dr Hall’s team admit that this was only a first study, and was small, and there were differences in the diets that need to be teased apart, such as using drinks within the diets to help make up the nutrient numbers.

 

They are following up that initial study with others now to try to identify potential causes for the effects he saw.

 

Kevin Hall:

We need um, you know, some real devotion to some research to really try to figure out what are the main factors in our food environment that drive us to overconsume calories, and gain weight and have all the downstream consequences of obesity as well as some of these other independent factors of ultra- processed foods that may lead to other deleterious health consequences, whether that be through systemic inflammation, whether it be changes in the gut microbiome et cetera et cetera. That mechanistic information is crucial. It does not mean that we cannot act now from a policy perspective, but I think to act most effectively one needs to understand the mechanisms as well as the potential consequences of interventions in terms of what it’s being replaced with.

 

Baroness Walmsley:

Given the need for further research into exactly what the link is between industrialised diets and poor health. - and if the label ‘ultraprocessed’ can’t be used to reliably categorise individual foodstuffs in a black and white manner - where does this leave us in terms of policymaking?

 

Baroness Walmsley:

Many experts we heard from reflected on whether defining individual products as ‘ultraprocessed’ or not was practical or even useful.

Dr van Tulleken

 

Chris van Tulleken:

It is important to say that the definition of ultra- processed food wasn’t developed as a consumer tool. It wasn’t developed as a policy instrument. It was a definition developed in order to test a hypothesis that came out of data: that a paradox was observed that families in South and Central America that were buying more oil and more sugar were healthier than families that weren't. And so the scientists in Brazil, led by Carlos Monteiro and his team, they created a definition to describe this new influx of food that had broadly followed the North American Free Trade Agreement and, had driven this very rapid expansion of diet related disease, where in a single generation, obesity went from being really almost unheard of to being the dominant public health problem. So that that was where the different definition started. It was to try and delineate this very big category of diverse foods.

 

Baroness Walmsley:

Susan Jebb, Professor of Diet and Population Health at of the University of Oxford.

The key point that I’d make is that ultra-processed food is a very binary system: yes or no. That means we can spend an awful lot of time arguing which side of the line a particular food will fall. Some of the research on ultra-processed food is beginning to try to look at specific categories of food, but to be honest I think we’re a long way off being able to link individual foods to particular health outcomes, so I think it is quite challenging. My worry, I suppose, is if we throw out the HFSS nutrient profiling model in favour of UPF as the basis for our food policy, is that we’re going to spend another however many years trying to agree the definition.”

 

Baroness Walmsley:

Dr van Tulleken again.

 

Chris van Tulleken:

We need to do more research, absolutely. However, we are in a moment where I think, whether you believe the evidence on ultra-processed food is sort of irrelevant, because the regulatory tool, in my view, should be fat, salt, sugar and calories. And we all agree on that, and we know that there is this catastrophic tragedy that we have been living with for two or three decades. We should definitely do more research, but we do not need to wait for more research before we act.

 

Baroness Walmsley:

So, although we do need research into the health effects of additives and ultra processed foods, that shouldn’t be an excuse for lack of action now.

 

But with less healthy foods often being the cheapest and most convenient, how can the government best take action without making life very difficult for people?

 

Baroness Walmsley:

In the next episode we’ve pulled together some of the evidence we heard from experts around the world, including from within the food industry itself, on what action the government might take.

 

There are opportunities to break the cycle of increasing ill health and costs to society. And many in the food industry are calling for urgent action.

 

You can also find our report: “Recipe for health: a plan to fix our broken food system” online for more details about all the evidence we heard, and our recommendations to government.

 

 

Anna Taylor:

Time is not on our side with this problem. We’ve got this huge wave that is now crashing into the NHS. We ‘ve got to have the leadership and, the care for our children to really drive some of these policies through.

 

Susan Jebb:

I worry that, in arguing over the definitions, we are losing time and wasting energy when we ought to be focusing on just taking policy action.

 

Eric Robinson:

If we’re really serious about addressing obesity and poor health in the UK, we desperately need legislation, and we need, probably, quite a lot of it.

 

Julian Metcalfe:

These people will fall into line. They just need you to be tough and clear. Honestly, promise you.

 

Baroness Walmsley:

Welcome to this podcast about the evidence heard by the House of Lords Committee on Food, Diet and Obesity.

 

I’m Baroness Joan Walmsley, the Committee Chair.

 

The House of Lords Committees are part of the UK’s Parliament, and listen to experts from all over the world in order to give non-partisan recommendations to the government.

 

The committee on Food, Diet and Obesity was appointed in January 2024 to understand how things like ultra-processed foods or those high in fats, salt and sugar affect our health and our lives, and how the government might help.

 

We published our report, and recommendations to the government about action we think they should take, in October 2024. The government’s response is expected to be published by the end of January 2025.

 

We’ve pulled together some of the evidence from many of the experts we heard from into two podcast episodes to go alongside our report.

 

Baroness Walmsley:

In this second episode, we’re hearing opinions and evidence about what might be done to deal with the UK’s problems of unhealthy diets and obesity.

Julian Metcalfe, founder and CEO of restaurant chain Itsu

 

Julian Metcalfe:

This is an incredibly complex subject and there will need to be an enormous amount  more legislation and intervention, I am afraid. I think what you are doing is fabulous. I hope and pray that you can really give some very solid, robust advice once your conclusions are all drawn, because this is a really serious subject.

 

Henry Dimbleby:

We spend £2.2 billion a year on fresh fruit and vegetables in the UK; we spend £3.9 billion a year on confectionery, which is just one small category.

 

Baroness Walmsley:

Henry Dimbleby, former UK Government Food Tsar, expressed the views of many of the experts we heard from, about the urgency of the need for government action.

 

Henry Dimbleby:

We have an appetite that evolved in a time of calorie scarceness. It rewards us for finding calorie-dense foods. And food companies have, over time, invested more and more and more of their resources in developing and marketing those products.

 

Baroness Walmsley:

He called for action to break this ‘junk food cycle’

 

Henry Dimbleby:

If you want to tackle it, you have to break that feedback loop. That is necessary for the state to do that if we are to solve this problem.

 I fear what will happen if there is a lack of action to improve the food system is that we will increasingly drug our way out of the problem.

If you talk to doctors, they will tell you that no drug has ever ended up doing what you thought it would do at the beginning. They will inevitably cause problems down the line.

 

Baroness Walmsley:

Rob Percival, Head of Food Policy at the Soil Association, gave us a warning as well.

 

Rob Percival:

This inquiry has been formed over and over again over the years. Another committee, another conversation about diet and health. We’ve gone round and round and round in circles and have got absolutely nowhere. So my invitation to you is to think not just about the relation of diet to health but about why all these past inquiries have failed.

 

Baroness Walmsley:

We asked experts their opinions about why this critical issue has so far not been solved.

Katherine Jenner, Director of the Obesity Health Alliance, a group of 60 health-related organisations.

 

Katherine Jenner:

The main reason why we haven’t had any success in government policy is because government hasn’t done a lot about it; so it’s either not enacted the policies, or they’ve been largely focused on trying to change individual behaviour and they’ve not been weighted towards the health inequalities to try to make people in worse situations do better.

 

Baroness Walmsley:

This previous focus on trying to put the responsibility on individual people to regulate their diet is one that has always failed.

 

Baroness Walmsley:

Susan Jebb, Professor of Diet and Population Health at the University of Oxford.

 

Susan Jebb:

The challenge we’ve got is that we need to both change the food industry but we also need to change consumer preferences. And I think over time, there has been a sort of assumption that somehow that should start with consumers, and if we just got consumers to change, then actually that would drive the market. But it patently hasn’t worked out like that. So I think we’ve got to recognise the challenge now is how do you make changes in the food industry - so that the healthier food becomes the default - and then you hope that palates will follow from that, just as, when you stop taking sugar in your tea, suddenly added sugar becomes unpalatable.

 

Baroness Walmsley:

Some experts talked about how we could learn from UK initiatives in other areas.

Alice Wiseman, Director of Public Health at Gateshead & Newcastle Council.

 

Alice Wiseman:

A good example of cross-governmental department working is the Joint Combating Drugs Unit, which has brought together a whole range of colleagues from across government at a national level, and then it’s replicated again at a local level, which is asking everybody to consider addressing the issue from their perspective.

And I think that an approach like this would be really helpful in ensuring that the Treasury are able to hear the evidence that’s been provided by the Department of Health and Social Care; that you’ve got all the other departments that have an interest in the food environment and the food industry involved and sharing the same understanding of the problems, challenges and potential solutions.

 

Baroness Walmsley:

And we heard several times about work that aimed to listen to public opinions on the topic to bring their voices to policy-making.

Anna Taylor, Executive Director of charity The Food Foundation.

 

Anna Taylor:

Policymakers are hearing, “Nanny state, nanny state, nanny state” - they are not actually talking to people. If you talk to the citizens, that is not their view at all. It is completely different; they want this to improve for them.

 

Baroness Walmsley:

Given calls from public health experts and the public for government action, and some models for what that action could look like, we asked: what is causing existing legislation not to be acted on, and slowing down the bringing in of other policies?

We heard one answer from many sources.

 

Fran Bernhardt:

We have industry lobbying and it is a serious threat, even to incredibly well-established and well-evidenced policies.

 

Baroness Walmsley:

Fran Bernhardt, Commercial Determinants of Health Co-ordinator from Sustain – an alliance of those concerned with better food and farming.

 

Fran Bernhardt:

For example, we have seen industry lobbying that has successfully delayed the TV and online advertising restrictions on national government’s policies. KFC challenged 43 English local governments’ planning policies, and overturned over half of them—that is just since 2017.

 

Baroness Walmsley:

This influence from the food industry on food policy can take many forms. Henry Dimbleby again.

 

Henry Dimbleby:

At one point, there is direct opposition, saying, “This is nonsense”, but the next level up there’s throwing just a bit of grit in the wheels. “This is a hard area to make policy in. It is not going to win you many voters. A lot of your own party is against it.” So, like, if you just throw enough grit into the wheels, you slow everything down.

 

Baroness Walmsley:

Professor Barry Smith, Director of the Centre for the Study of the Senses at the University of London.

 

Barry Smith:

I was invited to the UK Food and Drink Federation dinner this year and all the major players from the multinational food companies were there. There was a politician at every table. So I think lobbying is strong.

 

Baroness Walmsley:

It’s important that policy-makers and those that might benefit commercially from influencing policy have clear guidelines and checks in place to prevent undue influence.

 

Some experts had suggestions on how such contacts might be managed. Dr Rob Ralston, Lecturer in Public Policy at the University of Edinburgh.

 

Rob Ralston:

You might think about ensuring that any meetings with industry are public and transparent. You might think about guidelines that seek to ensure that interactions between public officials and industry maintain the credibility, the integrity and the independence of government and public agencies. Maybe the kind of questions that you would seek to ask, that might inform guiding principles, are whether an actor’s core activities are compatible with public health, or whether engagement with a food industry actor offers a clear benefit for public health policy.

 

Baroness Walmsley:

Many experts said that there was a time and a place for dialogue with industry, and it was not in the design of policy. Professor Camila Corvalan, from the Institute of Nutrition and Food Technology at the University of Chile, explains.

 

Camila Corvalan:

Chile is one of the countries with the highest burden related to nutrition, so we had to take some action. And in that action, really, the ones deciding what to do were those interested in the health of the population: because of economic reasons - so we had the Economy Minister sitting with us, the Minister of Health, stakeholders like policymakers, the civil society—but not the industry. The decisions of the regulations were made by those who really were willing to promote healthier diets.

 

After that step - the definition of the regulations - there was, of course, an important dialogue with the industry. And the Government actually, talked to them and arrived to a definition of how to make things happen in a way that would be sustainable so that they could achieve the goals they had designed for the policy.

 

Baroness Walmsley:

Experience makes it clear that the UK government needs to learn from the past, and from the experience of other countries and lay clear rules for those who are involved in the design of food policy around conflicts of interest – and ensure that they are upheld.

 

Companies that rely on selling less healthy food should be excluded from the design of food policy.

 

Only after the aims of the policies have been set, should those involved in the manufacture and sale of less healthy foods be consulted on how to implement the policies.

 

Baroness Walmsley:

Experts told us about another reason that they think UK food policies have failed in the past.  They have often involved voluntary – not mandatory – measures.

Sophie Lawrence, Stewardship and Engagement Lead at Greenbank – a sustainable investment firm.

 

Sophie Lawrence:

If we just look at the last 30 years we have had 14 UK Government obesity strategies in that time, 689 policies, the majority of which have been voluntary, yet in that time obesity has doubled. That tells us all we need to know about mandatory versus voluntary.

 

Baroness Walmsley:

As someone with 50 years’ experience as an advertising creative and businessman, Sir John Hegarty gave us some straight talking.

 

John Hegarty:

Companies are there to create greater returns for their shareholders. That’s it. Once you understand that, you can begin to develop legislation that’s gonna force the shareholders to go: “We’re not going to make so much money if we keep making this rubbish”.

 

Advertising keeps getting blamed and I am not saying that advertising is blameless, it is a tool, but it keeps getting blamed and that is a diversion. And people in advertising say, “Why do they not just stop people making crap? Wouldn’t that be a better idea? Then we could sell something good”. Nobody in advertising wants to sell shit. They want to sell good things.

 

So, devising a simple structure for saying, “This is what we want. It’s to be mandatory, and you’re going to be taxed”. Companies will respond only when it hits their pocket.

 

Baroness Walmsley:

And we heard from several experts that some companies are keen for the government to bring in firm legislation that will set a level playing field. Anna Taylor again.

 

Anna Taylor:

A small number of companies—big companies—are going, “Right, we see this problem. We see this diet crisis happening on our watch, and we wanna try and do something about it”. And they’re trying and they’re failing. And they’re talking more openly about the fact that they are failing and the reasons why they are failing: they are worried that if they do certain things they’re definitely gonna lose market share or footfall.

 

Baroness Walmsley:

This was echoed by Andrew Opie from the British Retail Consortium.

 

Andrew Opie:

We would like to go further and faster, but we are in a competitive food market. We need others to come with us to be able to make that... So I am not blaming others. What I am saying is that it’s government’s responsibility to develop an overall strategy that engages all those food businesses.

 

Baroness Walmsley:

And British ready meal manufacturer, Charlie Bigham, spoke of how it was possible to make a healthy food business work.

 

Charlie Bigham:

It’s very simple. The challenges in creating healthier food are principally around price and how long food lasts, shelf life. You know, healthier food is more expensive to make, and therefore to the consumer, and also will last a shorter amount of time. Can manufacturers make healthier foods which are a little bit more expensive and last perhaps a bit less time on the shelf? And I would say, the fact that we are a thriving, growing business, you know, 28 years in would be evidence that it can be done.

 

Baroness Walmsley:

But we did hear warnings that legislation alone is not everything.

Eric Robinson, Professor of Psychology & Public Health at the University of Liverpool:

 

Eric Robinson:

We can’t trust the food industry to follow legislation, it transpires. That’s based on recent policy research. What we found, when we sent researchers across the country, is that there are a number of businesses just don’t follow the legislation. There are no labels when there should be, and when there are labels there, they are often put on in such a way as it compromises the whole point of the label being there, because it’s so small that you can’t really see it.

Another really good recent example is the legislation round placement of unhealthy food in supermarkets. A sensible piece of legislation. If you go into supermarkets, you will quickly see that, after several months of the policy being in place, compliance is slack.

 

Baroness Walmsley:

Enforcement requires funding and prioritisation.

 

Professor Christina Vogel, Professor in Food Policy, at City University, studied the problems with the implementation of the 2022 regulations on placement of unhealthy food in big stores.

 

Christina Vogel:

In the first year, all 317 local authorities were given a total of £179,000 to actually actively enforce this legislation. When we spoke to enforcement officers, they said to us very clearly; “we have knife crime, we have Natasha’s allergy legislation. They are an immediate risk and an immediate threat to the lives of people in our local areas, so we’re not really going to do this one”. It is not through a lack of will. There was a conscious want to do this, but it is about having inadequate resources.

 

Baroness Walmsley:

So, what is needed are mandatory policies that will change the incentives by making the less healthy foods less profitable and the more healthy ones more so, allowing businesses to move towards healthier foods without concern about losing competitive advantage by doing so.

 

What sorts of policies might those be?

 

Baroness Walmsley:

One possible pathway of regulation is increasing taxes on less healthy foods – defined by the levels of fat, salt and sugar. It’s something that the UK has already tried – and it actually worked.

Nikita Sinclair from the health foundation Impact on Urban Health.

 

Nikita Sinclair:

The most powerful thing that we’ve seen happen over the last few years has been the soft drinks industry levy. So, proper regulation through the taxation system that has forced industry to make change. And we’ve seen that whilst sales of drinks may have increased, actually the amount of sugar that’s being sold through those drinks has massively reduced, I think it’s about 35%.

 

Baroness Walmsley:

Putting taxes on the sale of foods with harmfully high levels of certain nutrients encourages industry to reformulate them to avoid those.

 

But so far the UK has used this powerful lever in only a tiny way.

Professor Robinson again.

 

Eric Robinson:

The sugar-sweetened beverage levy—the sugar tax: very good idea based on lots of convincing evidence, already showing benefits. Sugar-sweetened beverages are a tiny part of the UK diet. We’re getting our calories from lots of other food sources, so what we need that policy to apply to all unhealthy food, not just drink.

 

Baroness Walmsley:

The UK’s sugar tax was much more effective than voluntary sugar reformulation programmes.

 

Dr Ralston again.

 

Rob Ralston:

Public Health England had a sugar reduction programme nd their target there was for a 20% reduction in sugar. Public Health England’s evaluation showed that only a 3% reduction in sugar had actually been achieved. And if we compare that to the soft drink industry levy, we see a 43% reduction in sugar. From my perspective, I think the reasons for that are that for the soft drink industry levy there was a financial cost for non-compliance. I actually think, more importantly, as public demand for action, political interest increases, and the salience of an issue increases, it becomes increasingly harder for business actors to either oppose or undermine policies.

 

Baroness Walmsley:

Although we’ve heard about lobbying and push-back from some industry players, others in food manufacturing and retail would be happy to see this kind of levy extended.

 

Baroness Walmsley:

Julian Metcalfe of Itsu again.

 

Julian Metcalfe:

I am a restaurateur and I’m a manufacturer, and all my career I wouldn’t advocate – I don’t particularly like interference and bureaucracy, but in this case I think incentives would be great and there could be a great many, and in many cases higher taxes on some stuff would work. As long as there is clarity, we can react, and we will react and we do react. It is incredible how quickly the industry will react if we get clarity and incentives.

 

Baroness Walmsley:

There seemed to be agreement that there need to be mandatory targets or strong tax incentives to reduce the levels of things that we know are unhealthy, like sugar and salt.

 

But we did hear some concerns about this approach.

Professor Jebb.

 

Susan Jebb

That tends to take you quite strongly down a reformulation route, and in the UK we’ve been pretty keen on that. It has, for sure, had some benefits, but I think we also have to acknowledge that the reformulation of foods is in part what’s led us towards some ultra-processed foods, so that’s tricky.

 

Baroness Walmsley:

Some experts told us they were concerned that reformulation of industrially-made foods wouldn’t address issues such as over-consumption, or the use of additives.

Professor Smith.

 

Barry Smith:

The bump will come up elsewhere in the carpet, because you’ll still be putting in additives and using techniques and methods that are driving consumption. One side of that equation, HFSS, tells about you what is in a product, how many calories and what they’re consisting of in terms of salt, fat and sugar. And they can be offset by other good things, such as protein, fibre, fruit and so on, but it does not tell you how much of it you will eat or what will incline you to consume them.

Baroness Walmsley:

And Rob Percival.

 

Rob Percival:

Instead of focusing on foods, we are fretting about nutrients of concern, nutrients of benefit, seeking to modify what is essentially an industrialised food supply in ways which aren’t ultimately going to benefit our health.

So the good work of nutrition scientists, who have revealed the complexity of food; the necessity of a healthy dietary pattern, is being twisted into a policy paradigm where we just think that if we throw in some fibre over there, squeeze out a few calories over here, we might be healthy. And it’s not working. And it’s leading us ever deeper into this epidemic of dietary ill health.

 

Baroness Walmsley:

Dr Ralston sees the potential for this sort of conversation to be part of deliberate stalling.

 

Rob Ralston:

Industry will often devote a significant amount of attention to the very specific design, the definitions, issues around standards—quite technical, complex issues. And where politicians or policymakers have maybe limited technical information or understanding of an issue, that’s really where business actors can exercise influence. So we really see that with issues such as reformulation.

 

Baroness Walmsley:

So, taxation of foods containing high levels of fat, sugar, salt and calories is important, but is only one action. And the experts we heard from agreed that there were many more that needed to be taken to make the big change required in our diets and health.

 

The next biggest is advertising.

 

Baroness Walmsley:

Member of the Youth Board of charity Bite Back, Anisah described the problem eloquently.

 

Anisah:

No amount of education is ever going to compete with those billions of pounds that these big junk food companies are basically pumping in. They are very good at what they do. They are very good at, you know, how much money they spend, all their well-crafted messages – it’s all there. So it’s more so that we need protections from those big food companies in the first place.

 

Baroness Walmsley:

Advertising is a subtle art, and very powerful. Sir John Hegarty.

 

John Hegarty:

It’s shown, if you advertise something it makes it acceptable. That is part of what it does. And it isn’t just making it acceptable to the people who are buying it, but the people who are knowing about it, who are seeing it. We call that the fame factor, and its, its function is to make something more acceptable.

 

Baroness Walmsley:

Professor Emma Boyland from the University of Liverpool agreed about its deep powers.

Emma Boyland:

We respond to food marketing on an emotional level. We’ve done studies to show that it activates areas of children’s brains responsible for emotional processing, so we can’t rationalise ourselves out of this.

 

Baroness Walmsley:

And the only way to deal with it is through mandatory regulations.

Sir John Hegarty explained.

 

John Hegarty:

One’s got to understand - the function of a company is to make a product for as little as it possibly can and sell it for as much as they possibly can. That is the function of commerce.

 

People in advertising can’t do much about it. Their function is to answer a client’s needs “Here is a product. Please promote this in a way which is, most effective”. So we rely upon regulations that govern what we can and cannot say.

 

All the people I work with in advertising say: “We want proper regulation, because we can’t force clients to do it. If you leave it voluntary, they’ll just say if you won’t adhere to this, someone else around the corner will.

 

Baroness Walmsley:

Yet governments have been slow to enact even planned restrictions on advertising unhealthy foods. Restrictions agreed in 2022 have been pushed back to 2025.

James Mayer, President of Danone in the UK and Ireland.

 

James Mayer:

What was pushed backwards was advertising after the watershed, so you can still advertise whenever. So we would advocate for that to be put in place as soon as practically possible. At the same time, what was also delayed was the advertising of products high in fat, sugar and salt - on buy-one-get-one-frees, two-for-ones and all those kinds of activities. The only thing that has been enacted so far is the location in a supermarket.

So bring forward what already sits on the statute book and make that. That would start to make an impact. Those rules were created for a reason. They’ve just been kicked down the road.

 

Baroness Walmsley:

And we heard from several experts about the need to consider particular restrictions around the use of branding for foods and drinks aimed at children and young people.

Professor Boyland again.

 

Emma Boyland:

We have done some studies on both brand characters, so those are the ones that are made by the brand and used only by that brand, and licensed characters, so, you know, Peppa Pig or a Disney character for example. When placed on a pack, they influence children’s choices and taste preference and drive their likelihood of requesting that purchase from parents. So I would suggest the legislation needs to get much tighter around how those sorts of characters can be used to entice children to request and consume unhealthy products.

 

Baroness Walmsley:

And Amelia Lake, Professor of Public Health Nutrition at Teesside University

 

Amelia Lake:

Marketing and advertising is a very powerful tool. Of course it is, otherwise companies wouldn’t use it. And one particular interest of mine and my colleagues is around the marketing, advertising and uptake of energy drinks by ever-increasing young children. Energy drinks are drinks that typically contain sugar as well as caffeine, and these are everywhere: sport, music, extreme sports, anything that’s cool. They do say on them that they are not to be sold to young people, but again that’s down to the individual. You know, we’ve got quotes from children we interviewed in County Durham saying, “If it says it’s not for us, why are people selling it to us?”

 

Baroness Walmsley:

Advertising alongside sport, to promote a healthier image, is a big problem.

As Dr Ralston explained, companies are clever at getting round regulations.

 

Rob Ralston:

To use an example from alcohol, in France you have the Loi Évin which bans alcohol sports sponsorship, and alcohol companies in, say, the Champions League advertise their 0% alcohol products but nevertheless they still have product logos on it. So there’s various ways in which they can subvert these types of regulations.

 

Baroness Walmsley:

This kind of brand marketing – rather than product marketing – does not currently come under regulations.

Professor Boyland again.

 

Emma Boyland:

We already know brand advertising is exempt, and that’s a huge exemption, because it is all about the brand.

 

Baroness Walmsley:

And it needs to be across the board.

 

Emma Boyland:

I think one thing that we should be mindful of is the need to regulate at ecosystem level, not channel by channel, because that is simply not workable anymore. Marketing doesn’t work that way, in isolation on individual channels. It is an integrated system across multiple different, particularly now digital, settings and the regulation needs to reflect that. And it needs to be mandatory and to happen quickly.

 

Baroness Walmsley:

As well as digital and media advertising, we heard how unhealthy food advertisements on our streets and transport systems need tackling.

 

Alice Wiseman:

We know that the environment around us influences the choices that we make. There is so much evidence that is emerging now about greater exposure to ultra-processed food associated with higher levels of consumption.

 

Baroness Walmsley:

Alice Wiseman from Gateshead & Newcastle Council again.

 

Alice Wiseman:

There are also some great examples of practice, such as Transport for London, which has reduced promotions, which has an impact in the reduction in household calorie consumptions.

 

Baroness Walmsley:

Several experts told us about the success of policies to restrict physical adverts, like the ban on the Transport for London network in 2019.

Fran Bernhardt of Sustain.

 

Fran Bernhardt:

On the Transport for London policy, evidence has shown that it will lead to 100,000 fewer obesity cases, 3,000 fewer diabetes cases, 2,000 fewer heart disease cases and a £218 million saving for the NHS in London alone and that’s just for the Transport for London policy.

 

Baroness Walmsley:

We heard how other local authorities were attempting to do the same, and that they needed support.

 

Fran Bernhardt:

The other really exciting thing about this policy is that it has maintained advertising revenues too. So we know it is often a balance of health versus the economy, but actually we’re actually managing to do that with this policy. So we strongly recommend that the Government learns from this and brings in an unhealthy food advertising restriction in full across all media, including streets and transport, as well as radio, online and TV.

 

Baroness Walmsley:

And it’s not just about advertising. Alice Wiseman again.

 

Alice Wiseman:

In Gateshead, we were one of the first local authorities to restrict the availability of hot food takeaways, but it was in recognition of the fact that we already had more than most places in the country. We said that it wasn’t just about the availability around schools but we looked at where children and young people congregated. We looked at where there were high levels of obesity. We looked at where there was an over- proliferation of hot food takeaways already, and we looked at clustering of hot food takeaways and working alongside our planners, since 2015 we have not had a single new hot food takeaway agreed for Gateshead, and actually what we have seen is a reduction in the overall number of takeaways in the area.

 

Baroness Walmsley:

But again authorities need legislative support.

 

Alice Wiseman:

We were challenged by one of the big companies, if you like, that do not provide hot food takeaways. They are classed as restaurants, because they provide seating, but they have more money than we have at local authority level to challenge some of these things. And we were lucky that the inspector who looked at our supplementary planning document actually upheld our position, whereas I know that there are other parts of the country where this has not been the case.

 

Baroness Walmsley:

We heard how important it is that local authorities are given the support they need to deal with planning challenges like this.

Julia Thrift, Director of Healthier Place-Making at the Town and Country Planning Association

 

Julia Thrift:

If you’re going to take a whole-systems approach to tackling obesity, planning is something that needs to be considered. To make a significant change to the built environment, you need to have built environment professionals involved. At the moment, the concept of the food environment is not something that they are very familiar with.  And so, making it clear that they have a role to play in shaping the food environment, doing that through planning policy, making it clear that supporting good health and reducing health inequalities are important and legitimate parts of planning and should be prioritised in planning policy would be helpful.

 

Baroness Walmsley:

We also heard again and again from experts how important it is not just to ban or discourage the bad, but also to encourage the good.

Emmanuel, youth board member of charity Bite Back.

 

Emmanuel:

One thing that would help is taking junk food out of the spotlight and replacing it and then putting healthier options in the spotlight. People need to know that junk food is not the be all and end all. Because our high streets are flooded with junk, and it is so, so hard to think about anything else when that is all that you see on a regular basis.

We need more youth clubs. We need more community centres. We need more – um - productive ways in which we can engage a younger generation of people. Because as it is at the moment, we only have fast-food shops and takeaway outlets, and that is simply not good enough.

 

Baroness Walmsley:

As well as simply availability, we heard how price is so important to people when choosing foods, so subsidising healthy foods could be effective.

Professor Vogel.

 

Christina Vogel:

We looked at the key elements of the marketing aspects used in stores. We found that point-of-sale signage, so things like shelf tags to prompt you to purchase healthier products, really have very limited effectiveness on its own. Price, particularly targeting the affordability of healthier foods, so through subsidies or rebates, there’s consistent evidence of a positive effect on sales, purchasing and consumption, and that is a reduction or a rebate on healthy products. The greater the reduction in price, the greater the increase in purchasing. And price promotions appear to increase purchases by between 18% and 53%. And there’s the greater magnitude, the closer to 45-53%, is for unhealthy foods rather than healthy foods.

 

Baroness Walmsley:

But some healthy foods don’t need subsidising – just better marketing.

Professor Tim Spector of King’s College London.

 

Tim Spector:

Many cheap products, which are just as nutritionally healthy: most frozen vegetables, frozen peas, spinach, have… as much or sometimes more nutrients than what you would get in a greengrocer. A can of tomatoes has more polyphenols, lycopene than fresh tomatoes, and things like beans, legumes, in cans are extremely nutritious and very cheap. And they just don’t get promoted.

 

Baroness Walmsley:

One other thing that we heard from several experts about was that food manufacturers and retailers of all kinds should have to be upfront about what they’re selling.

Henry Dimbleby.

 

Henry Dimbleby:

Make food companies tell us what they are selling to people. Um, you know, transparency - data transparency is a critical part of the solution. People say that it is very complicated and difficult, but at least being able to see who is selling what, and where in the country, would be a huge advance.

 

Baroness Walmsley:

Even the members of the food industry who spoke to us agreed.

James Mayer of Danone again.

 

James Mayer:

We are a significant food player, but we would really like to see much more transparency and reporting around products, and around the healthiness of products, and targets to be set. Um, and I think in that way, as an industry we can start to move forward. But alongside that we need companies to report in a consistent way. At the moment, people can choose to report or not. If we make it voluntary, we are not going to move, so we need to make it mandatory, ‘cause it kind of levels the playing field and it makes it transparent.

 

Baroness Walmsley:

This applies as much to labels aimed at consumers as to reports for regulators.

Professor Vogel.

 

Christina Vogel:

The labelling rules, legislation, in the UK are weak. Really, they are. There’s strong labelling laws on microbial risk, and food safety, but in terms of nutritional safety, our labelling rules, I would say, are quite weak. We have a voluntary, not mandatory, front-of-pack scheme. The back-of-pack scheme is there, but it is not very well used by consumers. There’s a huge body of evidence to show that  front-of-pack and a more comprehensive, overarching label is more effective, but again it’s not the lever – it is part of  suite of interventions that are required.

 

Baroness Walmsley:

When it comes to labels that are clear and obvious to shoppers, different logos and labelling systems have been researched, and there are several effective ones to choose from.

 

Dr Chris van Tulleken, Associate Professor at University College London, spoke about a particular system, developed in South America, which he thinks would help simplify the regulation system as well.

 

Chris van Tulleken:

I would apply black warning-label octagons to harmful foods, and I would use our own pre-existing dietary recommendations. Octagon food is the food you then don’t have in prisons, you don’t have it in hospitals, you don’t have it in schools. You can’t sell or market it to children, it’s not on their ads. In South and Central America, we have good evidence now that the octagons are very well understood, particularly by people with low education or low income levels and that they are shifting purchasing not just to sort of food with fewer octagons but to real food, re-embracing a traditional dietary pattern that everyone agrees is healthy.

 

Baroness Walmsley:

We heard again about the importance of mandating changes.

 

Dr Mathilde Touvier, Head of the Nutritional Epidemiology Research Team at French government research institute, INikita SinclairEric RobinsonM.

 

Mathilde Touvier:

The evidence is here, and also the evidence that this front-of-pack label impacts the quality of the food baskets. Still, this logo is not mandatory in Europe because there is an intensive lobby from the food industry.

 

Baroness Walmsley:

Bringing in a suite of measures like those we’ve heard about already might sound daunting, but other countries have managed exactly these three same aspects together.

Professor Corvalan.

 

Camila Corvalan:

In Chile, we have combined actions that in one aspect informed the consumer by providing a warning label for foods that are unhealthy. Very simple, very concrete that had a strong effect in terms of what people get. So, information - one thing. Restriction to marketing - we need to decrease the desirability. We need not to promote people, things that will become them sick. So strong marketing restrictions, particularly to vulnerable populations – and that includes children.

And then the third aspect is related to affordability access. There is an ongoing discussion about taxing unhealthy foods, but the idea is to link those revenues to a programme that would be deployed through the social development minister for subsidising the access to fruits, vegetables through open markets for the most low-income population.

 

Baroness Walmsley:

So, regulations on labelling, and marketing of unhealthy foods, alongside taxation will help make them less profitable for companies.

 

And on the other hand, promotion and subsidies for fresh and healthy foods will help encourage businesses to grow through providing them.

 

But there is one final big – and important – piece of the picture: children’s diets.

 

Baroness Walmsley:

In the first episode of this podcast we heard how important food is in a child’s earliest months and years.

 

So we asked experts particularly: how can good early-years nutrition be supported?

 

We heard about regulation issues with baby foods that are waiting to be addressed.

 

Vicky Sibson:

The commercial baby food offer is really poorly regulated at the moment, despite a whole host of problems being identified by Public Health England’s evidence review in 2019. So, five years ago.

 

Baroness Walmsley:

Dr Vicky Sibson from First Steps Nutrition Trust

 

Vicky Sibson:

yet there are no compositional regulations for the products on the baby food aisle and there aren’t specific regulations for marketing and labelling. It’s literally a Wild West

 

Baroness Walmsley:

And Professor Vogel told us how the problem goes much further.

 

Christina Vogel:

Parents trust the commercial industry and the commercial companies, because they look… they have the right pictures on them, the right names, and they feel right and parents want to trust to them, and there’s no other sort of more official information as available as that packaging, so I really think that there needs to be much heavier and stronger legislation on infant and toddler foods. They are very high in sugar —not just infant formula and follow-on formula but this whole suite of first infant foods and snack foods for infants.

 

Baroness Walmsley:

So, again, regulation and enforcement of that regulation on commercial infant foods is vital.

 

And then there are nurseries.

 

Dr Sibson again.

Vicky Sibson:

Unlike, um, school food, there are no mandatory standards for the foods and drinks that are served in early years settings—and, and there’s issues with the voluntary standards that do exist being, um, seen as  um, challenging, maybe inappropriate, there’s a lack of awareness. There’s lots of reasons because also because settings have their own resource and implementation challenges.

 

Baroness Walmsley:

As well as introducing mandatory standards to ensure healthy foods are served in early years settings, we heard about some existing programmes that could be built on to help boost healthier eating in young children at home.

 

Vicky Sibson:

The Healthy Start Scheme is a very, very relevant and very important nutrition safety net aimed specifically at the early years from pregnancy to age four.

 

Baroness Walmsley:

Dr Sibson

 

Vicky Sibson:

But this scheme is long overdue improvement. It has so many inadequacies. We’ve got a platform there and a foundation, but it is simply not functioning and with these skyrocketing levels of food insecurity, poverty, obesity and dental caries, it is high time that this is prioritised.

 

Baroness Walmsley:

Charities that do similar things provide the evidence that this can be very effective.

Nikita Sinclair from Impact on Urban Health again.

 

Nikita Sinclair:

I would like to shine a light on Alexandra Rose Charity. They as an organisation provide vouchers for fruit and veg to, um, families living on low incomes with young children. And those vouchers specifically are used in local food markets and greengrocers. So it is a fantastic example of how we create a really positive incentive for a local food economy. I was actually with a parent the other day who was telling me about how her daughter is now obsessed with fruit and veg. She loves going to the market, she loves picking all the variety, all the colour and it’s something they simply wouldn’t have been able to afford it before.

 

Baroness Walmsley:

And the charity has done an evaluation.

Nikita Sinclair:

Families who start the programme, about 7% of children are having their five a day. Six months in, 64% are having their five-a-day.

 

Baroness Walmsley:

So, more needs to be done to help low-income families with young children access healthy food.

 

But once children go to school, there are government standards on what food is served in meals – but are they effective?

 

Baroness Walmsley:

School food is a vital opportunity to improve children’s diets because it makes up about 30% of their daily energy intake.

 

But we heard about issues with the national food standards.

Naomi Duncan, Chief Executive of Chefs in Schools

 

Naomi Duncan:

We need to really beef up, freshen up and enforce the school food standards. We’re 10 years on from the School Food Plan, the standards have never been updated, and in secondary schools, it is incredibly easy to create a product and label it as “suitable for schools”. We still have prepacked products being sold to secondary schools: things like yoghurts and snacks and things which are being sold under the banner that they are school-food compliant, as though that’s a halo that means, because they are not against the standards, they are therefore good for us. So things like biscuits, Mini Cheddars and muffins, all packaged up and available for sale.

 

Baroness Walmsley:

One issue is that funding doesn’t match the ambition.

Anita Brown, National Chair of the Local Authority Caterers Association.

 

Anita Brown:

The amount of oily fish that we have to put on every week - at the moment, that is beyond the money that we are getting in. Because we get £2.53 for an allocation for a free school meal, where our neighbouring nations get in excess of £3. So, not every local authority can manage that, to meet those standards to that level because of the food cost and the cost of living crisis that we are all in.

 

Baroness Walmsley:

According to the Institute for Fiscal Studies, the funding per meal for free school meals was 16% lower in real terms in 2023 than in 2014.

But we did hear of local innovations which could be learned from. Naomi Duncan again.

 

Naomi Duncan:

Regulation alone isn’t enough. We also have to set the tone that what we feed kids in school is important, and that the food and the food education kids receive in school can be a really big part of the solution. Part of that is, I think, on funding. I will say that in some of the schools that we work with, they are managing to break even with the funding they have at the moment, and they’ve done that by encouraging 100% participation. They’ve phased out packed lunches entirely. And when they’re trying to, er, reduce the cost burden for some parents who cannot afford to pay, the chefs who are running the kitchen are baking bread and selling it to other parents, making fermented hot sauces, and they’re being creative in how they’re doing that. But, in reality, it is incumbent, I think, on government to make sure that there’s enough funding available to put a decent meal on every plate.

 

Baroness Walmsley:

Naomi Duncan stressed the importance, in her view, of ensuring all children get a healthy school meal.

 

Naomi Duncan:

If, if, you want a single, effective strategy, then every single child eating a hot meal, not a grab and go meal, but a decent, full-balanced meal in school every day, family-dining style. I’ve seen it done in secondary schools really effectively. That is the best way. Then you know, for your money, that the child is getting a nutritious meal and they’re not going to do what a lot of kids in secondary school do, which even when there is a closed-gate policy, they’ll come in, buy a couple of slices of pizza and a chocolate Yazoo at breaktime, and then they’ll wait until the end of the day to go to the chicken shop. And again, if you go outside any school at 3.30 pm, you will find all the kids in the chicken shop that’s five minutes down the road.

 

Baroness Walmsley:

Some experts argued that school meals should be made free for all. Georgie Branch from charity School Food Matters

 

Georgie Branch:

The national universal infant free school meal scheme, for example, that’s has been rolled out in England since 2014, has been shown to reduce obesity rates among children in their first year in primary schools. There’s also more recent evidence, published last month of the universal free school meals for children up to the age of 11, which was rolled out in several local authorities in London, which also shows that it reduces the proportion of reception-age children living with obesity by between 7 to 11%, and also reduces the proportion of year 6 children living with obesity by around 2 to 5%.

 

Baroness Walmsley:

Again, some local schemes are worth looking at and learning from.

Nikita Sinclair.

 

Nikita Sinclair:

So Southwark Council, for over a decade, has been funding universal primary free school meals. In the last year, they have extended free school meal eligibility to children on universal credit in secondary schools, and we’ve been working with them on a school food transformation programme where they have hired a school food improvement officer and they’re looking at a range of mechanisms to drive up the quality of school food in Southwark. So that includes training for school business managers to really signal that they have an important role to play in school food and making sure that it is healthy, um, supporting schools with procurement so that they have access to the skills and expertise to make sure that what they’re kind of procuring in school food is actually healthy, because it can be a real challenge for schools where their expertise is not in this area. And most importantly, they’re thinking about monitoring and accountability to ensure that standards are met.

 

Baroness Walmsley:

Experts told us that this approach of prioritising the poorest was vital, and there is evidence that it helps. Recent research we saw suggests that even subsidizing provision for children just above the eligibility threshold – if you can’t make free meals universal – can have beneficial effects. And that it would be a vital start.

Henry Dimbleby spoke for many we heard from.

 

Henry Dimbleby:

The cut-off for free school meals—which then comes with it holiday support, also comes with it Healthy Start, early years vouchers and stuff—is just way too low. It is £7,400 pre-benefit household income. It’s insane it hasn’t changed for ages.

 

Baroness Walmsley:

School meals, then, provide a real opportunity to set young people’s diets on a healthy track. And there are great examples of local schemes doing just that, with promising results, that could be learned from.

But overall, the experts we heard from kept reminding us, the government needs to have a joined-up strategy for tackling our dietary health.

Anna Taylor.

 

Anna Taylor:

We’ve got a very undeveloped policy process, I would argue, focused on how we improve access to nutritious foods for people. We have a little programme, Healthy Start, which provides vouchers for very low-income mums. We have free school meals for some disadvantaged children. But really thinking seriously about how do we actually enable businesses to thrive, which are actually selling great fruit and veg in our communities at a reasonable price, linking perhaps to local production where that’s possible. Those kinds of things and that policy thinking is very undeveloped. And if you talk to Defra, who are in charge of food, about those issues, they say ‘well, we’re not really interested in consumption and diet; we are interested in production and food companies’. It’s sort of a complete disconnect.

 

Baroness Walmsley:

Professor Jebb agreed:

 

Susan Jebb:

I just don’t see that any Government is going to be able to, in a way, to get through this on the basis of individual, um, initiatives. And so I want to go back to something, and that is the need to sort of step up a level and try to initiate system-level, um, change. I think what policymakers need to do, and government, is to set out the sort of food system we want and then hold industry to account for delivering that. Government needs to, set out a new concordat with the food industry and the licence by which it operates. Regulation’s not a threat to businesses; it’s actually a vital support for responsible businesses. I think that is why more and more business leaders, even, are calling on the Government to take that leadership position and to be able to frame the environment in which they operate so that they can actually start to deliver the outcomes that we so badly need.

 

Baroness Walmsley:

And any strategy needs to be based on the evidence we have now, whilst also being designed to incorporate new evidence as it comes in.

Andrew Opie from the British Retail Consortium.

 

Andrew Opie:

One of the problems with the obesity strategy is that interventions are put in without evidence to follow up to see what works best so that you dial it up or you dial it down in terms as part of an overall strategy. The Government need to properly resource its public health strategy to ensure that data can be actually acted upon to tweak it if necessary.

 

Baroness Walmsley:

And the public would welcome government intervention.

Rob Percival.

 

Rob Percival:

I’d like to emphasise that there is a public mandate for really bold regulatory action. I think part of the reason Government has backed down previously is because they have been worried about a kickback from the press. So we need to get those policies over the line and recognise that there is a public mandate. It’s been found by the national food strategy. It’s been found by the citizen assemblies in the climate space. You can be confident that if you put forward regulatory proposals, the public will be behind you.

 

Baroness Walmsley:

As a Committee, we have published a report based on the evidence that we heard, and that people submitted to us in writing. And we have made a list of specific recommendations to the government as a result.

 

You can find our report, called Recipe for Health: a plan to fix our broken food system, online.

 

It contains more detail about all the issues covered in these podcasts, our formal recommendations to government, and our thinking behind them.

 

We think it sets out how radical change can be achieved. And the government should respond formally by the end of January 2025.

 

And I’ll leave you with Henry Dimbleby:

 

Henry Dimbleby:

I do think, if we are to win this fight, we have to believe in a future where we will look back at today and we think, wow, that was the time when we ate all that stuff! That was a bit weird. And I think that we need to maintain the belief that this kind of cultural fatalism, that culture cannot be changed, is both wrong—there are all sorts of examples of cultures being changed over time—and completely defeatist. So we need to fight that tooth and nail to get this to change.