Hungry for change: fixing the failures in food Contents

Hungry for change: fixing the failures in food

Chapter 1: Introduction

1.The future configuration, resilience and efficiency of the UK food system is vital for the economy and the health of the nation. Yet, while the agri-food sector as a whole contributes around £121 billion to the UK economy each year17, ill health resulting from poor diets is costing the NHS around £6.1 billion per year and £27 billion to the wider economy.18 The UK farming sector provides important public goods, yet UK agriculture also accounts for over 10% of the UK’s greenhouse gas emissions19, and around 10 million tonnes of food leaving farms is wasted each year.20 A food system that is better for public health and the environment must be created but it will require Government intervention.

2.The term food system is difficult to define. It can be understood as simply describing the ‘food chain’, from farm to fork and comprising agriculture, food production and manufacturing, retail (sale and purchasing of food) and consumer behaviours. There are, however, other important elements that shape food production and consumption, including marketing, regulation and policy. Finally, there are the factors that affect access to that food: price, personal income and circumstances, and even geographical location. We were conscious that the term ‘food system’ is somewhat ambiguous so for the purposes of this inquiry our report has focused on what we produce and how it is produced, and what influences people’s choices and ability to access food.

3.We were told two key things about the food system. First, it is a significant and essential part of the economy and, as such, it could be a powerful lever to improve public health. Second it is failing—failing to deliver for public health, for social equalities and for the environment—it is, at present, ‘unsustainable’. This failure most clearly manifests itself in three key issues: the two seemingly contradictory problems of growing obesity rates, and rising food insecurity; and the damage that is sustained to the environment by the current system of food production.

4.Our witnesses described a food system that is biased towards providing an overabundance of cheap, less healthy food, with adverse consequences for health and the environment. We were told that farmers are trapped in a cycle where there is not enough emphasis or incentive on the need for healthy, environmentally sustainable produce. A significant proportion of food is highly processed by food manufacturers to a point where products contain high levels of energy (calories), salt, sugar and unhealthy types of fat, which contribute to disease risks; and low levels of fruit, vegetables, legumes, whole grains, nuts and seeds, which help to protect against diet-related diseases. Highly processed foods are then aggressively marketed and promoted to the consumer, often at discounted prices. While some responsibility lies with consumers themselves, it is clear that the food system is stacked against the consumer accessing a healthy diet, particularly for those with less choice and limited resources.

5.Our task was to focus on the links between the issues outlined above—food, inequality, public health, and sustainability—to identify where interventions (policy, regulatory or fiscal) might be applied, or reinforced, to tackle the serious health, social and environmental damage that is being inflicted by the current food system. We have brought these themes together under our central line of inquiry: how to ensure a healthy and sustainable diet can be accessed by everyone.

6.We examine these issues in more detail in the following chapters. However, we emphasise at the outset the following conclusions:

(a)The externalities of the current food system—the cost to public health and to the environment—are unsustainable. Without further action and oversight by the Government, “others will always end up paying the true cost of cheap food.”21

(b)The issue of food insecurity is a serious concern, but it should not be viewed as a failure of the food system itself; it is a consequence of poverty and the economic and social failures that sit behind it. Measures to reduce poverty can and should be made elsewhere by the Government. Evidence shows that poverty-driven food insecurity drives people to adopt cheaper and less healthy diets, often with high levels of highly processed foods, resulting in health inequalities that manifest in obesity (particularly in children) and non-communicable diseases. People who have a hard time accessing food have an even harder time accessing healthy food.

(c)In addition, problems accessing healthy food are felt across the population. The whole population is consuming diets that are too high in energy, unhealthy types of fat, salt and added sugar and the health system is shouldering the cost of this. By addressing the dependency on less healthy food in the food system, we can make progress towards more equitable access to healthy food for everyone.

7.Continuing with business as usual does not make economic sense. It will lead to greater costs to the public purse through an excess burden on the health system from preventable non-communicable diseases and through increasing environmental degradation. We should aim to ensure the food system provides safe, healthy and affordable food, that is built upon a resilient and sustainable agricultural system, at the same time as being economically viable. Our recommendations are aimed at driving changes to the food system to enable more people to access the food which will keep the population healthy and reduce the burden on the NHS, economy and the environment.

8.Finally, we know that the outbreak of COVID-19 is having, and may continue to have, a very significant impact on the economy and the health of the nation. When the lockdown measures were first introduced, we had almost concluded our evidence gathering, but were forced to cancel three evidence sessions. While we did not have time to take formal evidence on the impact on the food system of the crisis, we have, where possible, reflected the most recent data, generated during the pandemic, on the areas covered by our inquiry. We note that a significant amount of scrutiny work is underway across Parliament on the impact of COVID-19 including an inquiry into COVID-19 and food supply being conducted by the House of Commons Environment, Food and Rural Affairs Committee.

9.While we acknowledge that the Government is at the moment, rightly, focused on its response to COVID-19, our inquiry highlighted some serious, systemic problems with the food system, problems that the COVID-19 crisis only serves to underscore. Many people were already struggling to access a healthy diet, and the current crisis will worsen that situation, as more people face unemployment, uncertainty and the effects of ill health. It is, as the Food Foundation has stated: “A crisis on a crisis.”22

The inquiry and the Committee’s work

10.The Committee was first appointed by the House of Lords on 13 June 2019 to: “Consider the links between inequality, public health and food sustainability.” This followed a recommendation from the House of Lords Liaison Committee that such a Committee be established. The Committee was originally set up with a requirement that it should report by 31 March 2020.

11.The Committee met for the first time on 25 June 2019. On 24 July 2019 we published our call for evidence, which is reprinted in Appendix 3.

12.The Committee’s original work programme included taking evidence during around 20 evidence sessions spread over 14 meetings, concluding on 10 December 2019, and agreeing the report by the end of March 2020. Our programme was disrupted by three subsequent events. The prorogation on 10 September 2019 meant the Committee was dissolved. As the ruling by the Supreme Court meant that the prorogation was not lawful, the Committee was able to continue without being reappointed. Prorogation on 6 October, however, meant the Committee was dissolved again and was reappointed on 22 October 2019. After meeting only twice more, the Committee was yet again dissolved for the general election, and was not reappointed until 22 January 2020. The order reappointing the Committee required us to report by 23 June 2020.

13.Over the course of our inquiry, we received 105 submissions of written evidence and heard from 44 witnesses in 17 oral evidence sessions. We are very grateful to all those who took the time to provide us with evidence. A list of those who gave us written and oral evidence is included in Appendix 2, and is available on our website.

14.It was of vital importance that we heard from people with lived experience of food insecurity, and from those who are working ‘on the ground’ to tackle the issues the inquiry was set up to consider. We had planned, with the help of Sustain: the alliance for better food and farming, and Church Action on Poverty, an engagement session with people who have experienced food insecurity on 17 March 2020. Due to the growing concerns around the coronavirus, this event was cancelled. We were able instead to arrange phone calls between the individuals with whom we had planned to meet and the secretariat of the Committee. A note containing a summary of these conversations has been included in the report in Appendix 5. We thank Sustain and Church Action on Poverty for their support with this process and to the individuals who took the time to share their experiences with us.

15.The Committee also had a visit to Leeds planned for 18 March 2020, which again had to be cancelled. This was to include a visit to the Compton Centre, one of the Council’s Community Hub sites, Neruka’s Soup Kitchen, which provides meal provision for people in need of food, and CATCH, a community café and Healthy Holiday’s Programme Leader. We are grateful to Emma Strachan and Nick Hart of Leeds Council who helped to plan the visit. Information and insights that Leeds Council and its local partners wanted to share with us were instead submitted as written evidence and are listed in Appendix 6.

16.Policies relating to food are largely devolved in the United Kingdom. Consequently, much of the evidence we received and the corresponding conclusions and recommendations we have drawn focus on the situation in England.

17.Inevitably, given the breadth and complexity of the issues involved, our reporting deadline of 23 June, and the considerable disruption to our timetable, it has not been possible to go into great depth in all the policy areas that impact on how we access food. Similarly, it was not possible to examine all aspects of the food system in granular detail. Instead, we have focused on those policy areas which seemed to be of principal concern, the areas that require the most urgent change and where we think intervention could help to achieve the greatest impact.

18.On 27 June 2019, the then Secretary of State for Environment, Food and Rural Affairs, the Rt. Hon. Michael Gove MP, commissioned Henry Dimbleby to conduct an independent review to help the Government create a National Food Strategy. The Government committed to responding with a White Paper six months after the review is published. The National Food Strategy review is ongoing, and we want to express our gratitude to Henry Dimbleby for providing evidence to us. The National Food Strategy review will doubtless contribute towards tackling many of the issues identified over the course of our inquiry, and we hope our recommendations will complement its work.

19.We are grateful to our two Specialist Advisers: Professor Elizabeth Robinson, Head of Applied Economics and Marketing at the School of Agriculture, Policy and Development at the University of Reading; and Professor Martin White, Professor of Population Health Research in the Centre for Diet and Activity Research and MRC Epidemiology Unit, at the University of Cambridge. Their expertise has greatly assisted our deliberations during the course of this inquiry.

Box 1: A note on definitions

For the purposes of this report, we use the following terms and definitions:

  • Food system. This term comprises: agriculture and horticulture; food manufacturing; food retail; the food environment, and the interaction of all of these elements with each other and consumers.
  • Food environment. In the report, this term is used to describe the factors that impact on individual’s food choices. It includes, but is not limited to, the physical presence of different types of food outlets and the physical layout of outlets, the marketing and advertising of foods and nutritional information.
  • Food insecurity. The FAO defines food insecurity as “limited access to food, at the level of individuals or households, due to lack of money or other resources.”23 We also note the definition used by the Food Foundation and the UK’s Low Income Diet and Nutrition Survey, 2007: “limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways (e.g. without resorting to emergency food supplies, scavenging, stealing or other coping strategies).”24
  • ‘Food security’ refers to a household or an individual’s ability to access food. In the report, that is distinct from discussions on the resilience and continuity of the food supply.
  • ‘Healthy diet’. This term is generally understood to mean a diet that is high in fruits, vegetables, legumes, nuts, seeds and whole grains and low in unhealthy types of fat25 , salt and unrefined carbohydrates (e.g. added sugars). A healthy diet also contains sufficient, but not excessive energy (calories) and is low in foods that are ‘energy dense’ (i.e. foods that have a large number of calories per serving). In the UK, government recommendations for a healthy and sustainable diet are set out in the Eatwell Guide.26 An ‘unhealthy diet’ is generally understood to be one that does not adhere to the properties set out above.
  • ‘Less healthy food’. This term is generally understood to mean foods that are high in unhealthy types of fat, salt or added sugar, and is used to describe foods that are low in fruits, vegetables, legumes, nuts, seeds and whole grains. The terms also covers foods that are ‘energy dense’, foods that have a large number of calories per serving.
  • ‘Highly processed foods.’ The report also includes reference to ‘highly processed’ foods. These are foods that are created by a series of industrial techniques and processes. The Food and Agriculture Organisation (FAO) of the United Nations states that foods which have been highly processed (it uses the term ‘ultra-processed’) are: “energy-dense, high in unhealthy types of fat, refined starches, free sugars and salt, and poor sources of protein, dietary fibre and micronutrients and are made to be hyper-palatable and attractive, with long shelf-life, and able to be consumed anywhere, any time.”27
  • HFSS foods. The Childhood Obesity Plan refers to ‘HFSS’ foods, which it defines as products that are high in fat, sugar and salt.28 The Department of Health and Social Care (DHSC), through its Standing Advisory Committee on Nutrition (SACN) developed its Nutrient Profiling Model (NPM) to define which foods are classified as HFSS. The NPM classification system was used to classify foods in the Ofcom regulation of the TV advertising of foods to children (2007) and has been proposed as the basis for classifying foods subject to further regulations in the Government’s Childhood Obesity Plan. The NPM was updated in 2018, and the new version published, but it is yet to be implemented for new policies.29

17 Department for Environment, Food and Rural Affairs, National Statistics: Food Statistics in your pocket Summary’ (updated 30 March) : https://www.gov.uk/government/publications/food-statistics-pocketbook/food-statistics-in-your-pocket-summary#gross-value-added-of-the-uk-agri-food-sector-2018 [accessed 30 June 2020]

18 Public Health England, ‘Health Matters: obesity and the food environment’, (31 March 2017): https://www.gov.uk/government/publications/health-matters-obesity-and-the-food-environment/health-matters-obesity-and-the-food-environment--2 [accessed 30 June 2020]

19 Department for Business, Energy and Industrial Strategy, 2018 UK Greenhouse Gas Emissions, Final Figures (4 February 2020) p 12: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/862887/2018_Final_greenhouse_gas_emissions_statistical_release.pdf [accessed 30 June 2020]

20 Committee on Climate Change, Net Zero The UK’s contribution to stopping global warming (2 May 2019) p 188: https://www.theccc.org.uk/wp-content/uploads/2019/05/Net-Zero-The-UKs-contribution-to-stopping-global-warming.pdf [accessed 30 June 2020]

21 Written evidence from the Food Ethics Council (ZFP0054)

22 The Food Foundation, Covid-19: latest impact on food, (March 2020): https://foodfoundation.org.uk/covid-19-latest-impact-on-food/ [accessed 30 June 2020]

23 FAO, IFAD, WFP and WHO, The State of Food Security and Nutrition in the World, (2017), p 96: http://www.fao.org/3/a-i7695e.pdf [accessed 29 June 2020]

24 The Food Foundation, Too poor to eat: Food insecurity in the UK (May 2016) p 3: https://enuf.org.uk/resources/too-poor-eat-food-insecurity-uk [accessed 30 June 2020]

25 All fats are energy dense, so should be eaten in moderation, but some fats are healthier than others, being essential for bodily functions (e.g. absorption of some vitamins, production of some hormones, development of cell membranes).

Healthier fats include polyunsaturated fats (e.g. pure vegetable oils, fish oils), monounsaturated fats (e.g. from some fruits, nuts and seeds, such as olive oil, peanut oil) and saturated fats derived from dairy products. Unhealthy fats include industrially processed fats (e.g. ‘transfats’—now banned in the UK), and saturated fats from animal sources (e.g. red and processed meats): Jason Wu, Renata Micha, & Dariush Mozaffarian, ‘Dietary fats and cardiometabolic disease: mechanisms and effects on risk factors and outcomes’,. National Reviews of Cardiology, 16, 581–601 (2019) doi: 10.1038/s41569-019-0206-1: https://pubmed.ncbi.nlm.nih.gov/31097791/ [accessed 30 June 2020]

26 NHS, The Eatwell Guide: https://www.nhs.uk/live-well/eat-well/the-eatwell-guide/ [accessed 30 June 2020]

27 Carlos Monteiro, Geoffrey Cannon, Jean-Claude Moubarac, Renata Levy, Maria Louzada and Patricia Jaime,. ‘The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing’,. Public Health Nutrition. 2018;21(1):5–17. doi:10.1017/S1368980017000234: https://pubmed.ncbi.nlm.nih.gov/28322183/.[accessed 30 June 2020]

28 HM Government, Childhood obesity: a plan for action, Chapter 2 (June 2018): https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/718903/childhood-obesity-a-plan-for-action-chapter-2.pdf [accessed 30 June 2020]

29 Public Health England, Annex A The 2018 review of the UK Nutrient Profiling Model (March 2018) p 9: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/694145/Annex__A_the_2018_review_of_the_UK_nutrient_profiling_model.pdf [accessed 30 June 2020]




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