Childhood obesity-brave and bold action Contents

Conclusions and recommendations

Our recommendations for action

1.In our view, the evidence is sufficiently strong to justify introducing all the policies we recommend. Rather than wait for further evidence to follow from international experience, we urge the Government to be bold in implementing policy, with the assurance of rigorous evaluation and sunset clauses if found to be ineffective. (Paragraph 27)

2.We call on the Government to work with the devolved administrations on the implementation of our recommendations, for the benefit of children across the UK. (Paragraph 28)

Price promotions

3.We endorse Public Health England’s recommendation that measures should be taken to reduce and rebalance the number and type of promotions in all retail outlets, including restaurants, cafes and takeaways. In our view this should not be limited to products which are high in sugar, but also those high in salt and fat. Voluntary controls are unlikely to work in this area and the Government should introduce mandatory controls. Measures should be designed to reduce the overall number of promotions of unhealthy foods and drinks. They should be as comprehensive as possible, and should be carefully designed to take account of possible unintended consequences, including the introduction of compensatory promotional activity of other unhealthy foods and drinks. (Paragraph 41)

Placement of food and drink within the retail environment

4.We endorse Public Health England’s case for removing confectionery or other less healthy foods from the ends of aisles and checkouts. We recommend an outright ban on these practices and call on retailers to end the promotion of high calorie discounted products as impulse buys at the point of non-food sales. (Paragraph 44)

Restrictions on advertising to children

5.We endorse Public Health England’s recommendation of broader and deeper controls on advertising and marketing to children, including extending current restrictions to the full range of programmes that children are likely to watch, as opposed to limiting them just to children’s specific programming. In our view, a logical way to do this would be by restricting all advertising of high fat, salt and sugar foods and drinks to after the 9pm watershed. (Paragraph 53)

6.We also endorse Public Health England’s recommendation of extending current restrictions on advertising to apply across all other forms of broadcast media, social media and advertising, including in cinemas, on posters, in print, online and advergames. In our view this should be implemented without delay, and the scope of the CAP’s forthcoming consultation should not be on whether it should be done, but on how it should be implemented following clear direction from the Government within the childhood obesity strategy. (Paragraph 54)

7.We further support Public Health England’s call to tighten loopholes around the use of non-licensed cartoon characters and celebrities in children’s advertising, and its call to reform the current nutrient profiling system which means that a breakfast cereal which is 22.5% sugar does not fall within the current definitions of a high fat, salt or sugar food, and can therefore be directly advertised to children. (Paragraph 55)

Reformulation and portion size

8.We endorse PHE’s recommendation of “a broad, structured and transparently monitored programme of gradual sugar reduction in everyday food and drink products.” There are arguments both for and against the use of artificial sweeteners in a sugar reformulation programme. We recommend that the Government’s sugar reformulation programme should aim to reduce levels of overall sweetness, but such a programme could also include the use of artificial sweeteners where possible, given the potential to achieve reductions in sugar consumption more quickly through their use. (Paragraph 64)

9.We recommend that the sugar reformulation programme should be strongly led from the centre of Government and transparently and regularly monitored. A voluntary approach should be adopted with the clear proviso that if the industry does not respond comprehensively and swiftly to voluntary sugar reduction targets then regulatory action will quickly follow. Industry needs a level playing field in order to reformulate products in a way which improves health without advantaging those businesses which fail to act responsibly. (Paragraph 65)

10.The Government should also introduce a parallel programme of reformulation to reduce the overall calorie content of food, including reducing the levels of fats. (Paragraph 66)

11.We agree with Public Health England that a cap on portion sizes for relevant foods and drinks in both the retail and entertainment sectors is a clear way of reducing both sugar and calorie intake, and we recommend that caps on portion sizes linked to the calorie content of certain foods and drinks should be introduced. As with the reformulation programme, action to introduce portion caps should be should be strongly led from the centre of Government and transparently and regularly monitored. A voluntary approach should be adopted with the clear proviso that if the industry does not respond comprehensively and swiftly then regulatory action will quickly follow, to ensure industry has a level playing field. (Paragraph 71)

A tax on full sugar soft drinks

12.We support Public Health England’s recommendation for a tax on full sugar soft drinks, and recommend that it be introduced at a rate of 20% to maximise its impact on purchasing and help to change behaviour. (Paragraph 87)

13.We consider that a tax on full sugar soft drinks is a proportionate policy response and also sends a clear message to parents and their children about the importance of reducing sugar consumption. (Paragraph 88)

14.There is compelling evidence of the disproportionate harm to disadvantaged children from high sugar products which can no longer be ignored. Nonetheless, given the concerns that the income raised by a tax could come disproportionately from lower income families, there is a strong case that those families should also derive the most benefit. A sugary drinks tax should act as a child health levy, with all proceeds directed to measures to improve children’s health. Those measures should be especially targeted to help the children who are at the greatest risk of harm from obesity. (Paragraph 90)

15.The sugary drinks tax should be designed and introduced alongside an evaluation of its effectiveness. This should include specific consideration of its financial as well as health impact on different socio-economic groups. We also recommend a sunset clause so that if it becomes clear that it is not effective it can be withdrawn. (Paragraph 91)

16.A sugary drinks tax is an essential part of a wider package of measures to tackle childhood obesity. We believe that measures to tackle childhood obesity should be introduced as swiftly as possible. A tax on full sugar soft drinks is a clearly defined policy recommendation that can be simply and swiftly implemented. (Paragraphs 92 and 93)


17.In our view, a labelling system showing teaspoons of sugar (where a teaspoon is defined as 4 grams) provides a clear and compelling visual representation of the amount of sugar in a particular product. A labelling system of this kind should be applied to a single-serving portions of foods and drinks with added sugar, to aid parents reducing their children’s sugar consumption to recommended levels, as some 500ml bottles of soft drinks contain nearly triple a young child’s recommended daily amount of sugar in a single bottle. The Government should offer manufacturers the chance to introduce this labelling voluntarily, but should be clear that it will be pursuing the introduction of labelling on a mandatory basis if companies do not adopt the voluntary scheme. (Paragraph 100)

Education and information

18.We accept the conclusions of Public Health England that health information and education campaigns would be insufficient on their own to tackle childhood obesity. In light of their potential to widen health inequalities, rather than narrow them, the government should not take the easy option of relying on health education campaigns to solve this problem. Whilst education is of course important to public understanding of the causes and consequences of childhood obesity as well as how to prevent and tackle the problem at an individual level, health education should form only one part of a far more ambitious approach. (Paragraph 106)

Nutrition standards in schools

19.We recommend that clear nutritional guidelines should be published, setting out food standards recommended for packed lunches as well as food supplied by schools. We heard that lunch box food standards would be a valuable tool where teachers need to have conversations with parents about improving their children’s diet. Furthermore, while the introduction of school food standards is to be welcomed, it is an anomaly that they do not apply to free schools or academies. The aim of the childhood obesity strategy should be to improve the health of all children, so we recommend that school food standards should apply to all schools in both the state and private sector. (Paragraph 111)

Local authorities and the wider public sector

20.A simple way to boost local authorities’ effectiveness in this area would be change planning legislation to simplify the processes for limiting the proliferation of unhealthy food outlets in local areas, which we have heard can be time-consuming and difficult. We recommend that this change should be made. In particular, health should be included as a material planning consideration. (Paragraph 116)

21.We endorse Public Health England’s recommendation that clear national standards for healthy foods should be adopted, implemented and monitored across the public sector, including national and local government and the NHS. (Paragraph 119)

Early intervention driven by the National Child Measurement Programme

22.As part of its strategy to tackle childhood obesity, the Government must protect funding for the National Child Measurement Programme, and should evaluate the benefit of extending measurements to younger children, given that over 20% of children are overweight or obese by the time they reach primary school. (Paragraph 126)

23.The National Child Measurement Programme also provides stark evidence of the distribution of childhood obesity—put simply, the problem is twice as bad amongst the most deprived children. Revenue raised by a sugary drinks tax could and should be targeted to deliver the most help to communities where children are most severely affected by childhood obesity, and should be transparently allocated for the purpose of improving children’s health. (Paragraph 127)

24.We recognise that further research is needed into interventions to help overweight and obese children, and recommend that projects funded through a sugary drinks tax should be carefully evaluated for their effectiveness. (Paragraph 128)

Calorie reduction

25.Sugar is not the sole contributor to excess calories and increasing BMI, and in formulating a childhood obesity strategy the Government will need to adopt a broader approach than the PHE report, and should consider calorie intake as a whole. Whilst interventions to reduce calorie intake are likely to benefit all ages, we urge the Government to ensure that the strategy includes measures targeted to deliver the most benefit to children and young people and especially those at greatest risk. (Paragraph 17)

The role of physical activity

26.We reiterate and endorse the findings of our predecessor’s inquiry that exercise has enormous benefits for children’s health and wellbeing irrespective of their weight. We call on the Government to increase provision for physical activity in childhood and consider this an important part of a strategy to tackle obesity. We urge the Government, however, not to lose sight of the clear evidence that measures to improve the food environment to reduce calorie intake must lie at the heart of a successful strategy, as these measures are likely to have a greater overall impact on childhood obesity levels. (Paragraph 20)

© Parliamentary copyright 2015

Prepared 27 November 2015