25
Examination of witnesses
Andrea Leadsom, Tazeem Bhatia and Natasha Burgon.
Q261 The Chair: Good afternoon, and welcome to this public meeting of the House of Lords Food, Diet and Obesity Committee. We are today holding the 18th evidence session of the committee’s inquiry, exploring the role of foods, such as ultra-processed foods and foods high in fat salt, and sugar, in a healthy diet and in tackling obesity. This is the final week of the committee’s programme of oral evidence before the committee begins to prepare its detailed report to be published later this year.
We are delighted to be joined this afternoon by the right honourable Andrea Leadsom MP, Parliamentary Under-Secretary of State and Minister for Public Health, Start for Life and Primary Care at the Department of Health and Social Care. Minister, you are very welcome. The Minister is joined by two senior officials: Tazeem Bhatia, chief nutritionist, and Natasha Burgon, director of health improvement, at the Department of Health and Social Care. You are also very welcome. Please introduce yourselves the first time you speak.
Today’s meeting is being broadcast, and a written transcript will be taken for publication, which will be sent to you to check for any corrections. I refer to the list of members’ interests, including my own, as published on the committee’s website and as set out in the committee’s first evidence session on 8 February.
After all that, let us start with the questions. I am going to ask the first question, which is: Minister, can you set out the Government’s overarching strategy on enabling people to eat healthily and preventing obesity? Please do this bearing in mind that the committee has heard that every Government since 1992 has missed targets to reduce obesity, despite the publication of 14 strategies and the implementation of around 700 policies. Governments have taken action, but that action has not really been effective. In your view, why is that? What distinguishes the current Government’s approach to preventing obesity? Have lessons been learned?
Andrea Leadsom: Thank you, it is a great pleasure to be here. This is such an important topic and, as the committee will know, obesity costs us around £6.5 billion a year, and something I am very passionate about in particular is the problem of childhood obesity. What we know is that it is much easier to reverse the problem of childhood obesity while you are still young and much harder when you get older. Inevitably, any strategy to tackle obesity and overweight has to be multi-pronged. I hear what you are saying, Lady Walmsley, about the number of different initiatives; nevertheless, it is important to look at measures to make the food we eat more healthy, measures to encourage and educate people to live more healthily—that is, to make more healthy choices—and then really important are measures to regulate the food sector to force it to reduce the fat, sugar and salt, in particular, in the food that we eat.
There are various ways in which we approach this, and we have found through evidence of past policy that combining voluntary with regulatory approaches is the best way to go about it. In fact, we were talking about one such example earlier today: that of ice cream, where the food sector said, “Well, if you reduced sugar in ice cream it wouldn’t taste the same, you couldn’t do it”. But it is part of the voluntary sugar reduction, and sugar in ice cream has been reduced by 7% and nobody has noticed the difference. In my view, that is the big win, where you can actually reformulate the product and nobody really notices the difference.
Lord Colgrain: I declare my interests as in the register. Minister, I am going to ask two supplementary questions together, if I may? Academic analysis suggests that successive government policies on obesity have failed in part because they have relied on changing individual behaviour rather than structural influences, such as food environments. What is your view? Witnesses to this committee, including from industry, have called for tougher regulation of the food industry to reduce unhealthy food consumption and promote healthier food consumption. How will the Government respond to this call?
Andrea Leadsom: It is absolutely right to say that the food environment is crucial in reducing obesity and, as you may well know, the Government have introduced measures such as removing HFSS foods from areas near tills to reduce the pull factor of choosing to eat from there. There is also regulation being brought forward to reduce the advertising on unhealthy foods that appeal particularly to children, and to get rid of the buy one, get one free initiative. Certainly, regulation plays its part. The sugary drinks levy has been incredibly successful in reducing sugar content by around 50%; that is about 46,000 tonnes of sugar removed from sugary drinks. Again, that is all about reformulation.
There is no doubt that the food environment is vital. There is also a lot of work going on in planning, to ensure that planners take into account the need to not allow lots of fast food or unhealthy food restaurants to be grouped around schools, or indeed in one place. Suffice it to say there is a whole cross-government strategy which, as you also question, points out the need for people to make healthier choices. We have universal infant school free lunches and there are school food standards. I am really keen to look more at that and to make sure that that is being properly implemented, perhaps looking at ideas such as a school governor whose job specifically is to look at the quality of food that is on offer in schools. Also, there have been successes, such as with our NHS digital weight app, which actually just recently has reported on assisting something like 30,000 people to lose weight.[1]
Education and the food environment are equally important. Just going back to Start for Life, which is the area I am most passionate about, and the Government’s policy of creating one-stop shop family hubs right around England, there are over 400 of them already, and there is a very large, funded strand of that work that is promoting and supporting breastfeeding and weaning, and helping families who want to make those healthy choices to do so. As we speak, I am looking at commercial baby food and what we can do to provide guidelines, which I think will be published this summer, to reduce the unhealthy content—the sugar and salt—in commercial baby foods. I say again that, of necessity, there is a whole raft of measures both to improve the food environment and to help people make healthier choices.
The Chair: Thank you, there are further questions about some of those issues a little further along today. Can I move to Lord Krebs, please?
Q262 Lord Krebs: Thank you, Lord Chair, and thank you, Minister, for coming to give evidence to us this afternoon. I declare my interests as recorded in the register. My question, which has three parts, builds on what you have just been discussing with Lord Colgrain. You mentioned that many government departments are involved in policies to tackle obesity and improve healthy eating. Perhaps you could tell us how you ensure that there is a coherent approach across departments, because we have heard criticisms that there is not sufficient collaboration.
You have also mentioned measures that have resulted in progress in tackling poor diets and obesity. What is the Government’s assessment of progress against the commitment to halve childhood obesity by 2030, and to reduce the proportion of the population living with diet-related illness?
Again, in the same vein, we have had calls in the evidence for statutory targets on health outcomes, against which the Government would have to report. What is your response to this proposal? So there are three things: collaboration across departments, progress against commitments, and statutory targets and reporting.
Andrea Leadsom: Thank you very much, Lord Krebs. First, working cross-department is absolutely crucial to this. Tackling and resolving and trying to reverse the global rise in obesity levels has shown itself to be very intractable. We know that the Covid pandemic led people to eat more calories, and in many cases less healthy food, during that period of time. It really is essential that we do everything we can cross-government to be able to tackle that.
I would say that possibly the most important cross-departmental link is the levelling-up strategy. We have a levelling-up inter-ministerial group that includes all the departments involved in tackling obesity: the Department for Education, Defra, DLUHC itself, DCMS, obviously the Treasury, my department, and the Food Standards Agency.[2] We are all involved in that inter-ministerial group where we look very specifically at the combination of factors, some of which I just outlined, including planning, the school food standards and advertising to children before the watershed, all which we are now tackling. What the levelling-up inter-ministerial group does particularly is to focus on where prevalence is much greater. As we know, with higher levels of deprivation there is a greater level of living with obesity and overweight, and of course other morbidities.
That takes me on to the second key point, which is the major conditions strategy that we will be publishing this summer. This seeks to look at all the major conditions, including obesity, but also, for example, cardiovascular disease and diabetes, all which are very much linked, with a view to trying to join up—exactly as the committee has already pointed out on a few occasions—the proliferation of initiatives. The major conditions strategy is seeking to join all those together so that we can actually tackle what for an individual is often not just living with obesity, but living with cardiovascular disease, perhaps being a smoker, perhaps living in deprivation, perhaps having other frailties—trying to tackle all those things together.
To your second point specifically, childhood obesity, we have had one little chink of light very recently, which is that the rate of obesity going into primary school has fallen for the first time.[3] I forget exactly what the dates are, but the most recent figures showed a slight reduction in obesity going into primary school. Sadly, this is not following through in primary school, which is why I am a bit of a rottweiler on school food standards, because that could be a key issue to keep those levels of growing obesity down.
Certainly, the Start for Life work to ensure that more families are aware of the benefits of breastfeeding is important. It is a very tricky subject, because of course it is up to every mum whether she wants to breastfeed or not. We know that lots of mums are desperate to breastfeed but feel they do not get the support and the help they need, so they give up. Of course, that has consequences not just for their mental health, for bonding, for all the other health improvements that breast milk can provide to the baby, but for the reduction of the potential for obesity that results from giving your baby too much formula milk, weaning them too early and so on. The support for breastfeeding and weaning will have a marked impact on childhood obesity.
To your question about whether we will halve it, that is absolutely our ambition. All the measures we are taking, both voluntary and compulsory, on things such as advertising, location in store, and getting rid of the buy one, get one free, are absolutely focused on halving childhood obesity by 2030. On statutory targets on health outcomes, I would like to bring Tazeem in here, because as the lead on the science she will want to make the point that actually these are very difficult and there is not one approach that can remedy the situation but multiple approaches, and of course it takes time to see these things bed in. Tazeem, do you want to add anything?
Tazeem Bhatia: Sure. Actually, Lord Krebs, could you just qualify your question: the statutory targets were for whom?
Lord Krebs: On health outcomes. The Minister has mentioned a range of health outcomes that are consequent upon poor diet, including obesity, cardiovascular disease and a whole range of chronic non-communicable diseases. In the end, your aim is to reduce those burdens on the population, which, as the Minister said at the beginning, are costing a huge amount of money and will continue to cost increasing amounts of money. Type 2 diabetes is of course also notable here. It is statutory targets on reporting on those health outcomes. Are you making progress or not? Do you think that is a good idea?
Tazeem Bhatia: Thank you for qualifying and thank you for this opportunity to give evidence. Just to make the declarations that you asked us for, I am the chief nutritionist; my team is responsible for providing the best nutrition science and evidence into the decision-making process. I am a clinician by background, I was a general practitioner, and I am an accredited public health consultant. My only declaration is being a member of the Faculty of Public Health.
In answer to your question, we do have an overarching target within the department already, which is the healthy life expectancy target—to extend that by five years, by 2035. It is an all-encompassing target in terms of the health outcomes, because we want to address those things that are making people sick earlier in life and live longer years in disability, which are the big non-communicable diseases. The risk factors such as diet and obesity, but also alcohol and tobacco use, are the biggies in terms of that life expectancy.
Could we move to particular targets on health outcomes? You potentially already have those in the public health outcomes framework and in the NHS outcomes framework, where the public health system is reporting against specific health outcomes. Maybe we could consider making those higher profile with regard to the department, but the healthy life expectancy one is all-encompassing of them and a very difficult one to meet—very ambitious and stretching.
Q263 Baroness Jenkin of Kennington: Thank you, Minister, for being with us today. I declare my interests as set out in the register. Moving on to the food industry, we have had quite a lot of discussion about it but, sadly, not so much from it, because some did not want to come. What role, if any, should the food industry play in the formulation of the Government’s policy in tackling obesity?
My second question is that we have heard concerns that the food industry exerts disproportionate influence over the Government. Witnesses have argued that there should be strict guidelines for engagements between the food industry and government, and that all meetings should be transparent. I wonder whether you agree with that.
Andrea Leadsom: Thank you very much. In my other role, I am the Bill Minister for the smoking and vaping Bill, and a lot of people say, “Well, you don’t talk to the smoking and vaping industry at all, so why do you talk to the food industry?” My answer to that is that, of course, we all need to eat. Therefore, to not engage with the food industry, we lose out on the potential knowledge and expertise and doability, whereas in the context of the smoking and vaping sector it would be much better for the world if they just completely ceased to exist. The same is not true with the food industry. That is the background to this because I was considering how I would approach such a question.
However, I completely agree with you that there is a very clear conflict of interest. In fact, when I was first in the post—I came into this job in November last year—within only a few weeks I attended my first food data transparency task force, which is a voluntary group of supermarkets, manufacturers and the big takeaway companies, the big Deliveroo-style companies. What was very interesting there was that the attendees were all their senior nutritionists, and all were absolutely committed to the idea of reducing fat, sugar and salt, of healthier eating, of more labelling, and so on. But the one ask they all had was that there needed to be a level playing field; it is very difficult if everything is done voluntarily. They all welcomed the sugary drinks levy because it created a level playing field, and they all acted together.
I have already given the example of ice cream, so have illustrated how actually sometimes doability is something that the food manufacturing sector is best placed to be able to respond to. Certainly, when it comes to us looking at what policies we want to implement, ironically, the food sector is asking us to regulate, not to leave it voluntary in many cases. What you have in the food sector are different parts; it also has its scientific expertise and its advisers on the proper formulation of foods. But, ultimately, we all need to eat, so to not engage with it would be a mistake. However, I know that there are very clear Chinese walls and guidelines, and perhaps you could set those out for us, Tazeem.
Tazeem Bhatia: Yes. Would you like me to move on to the question around dietary guidelines and industry involvement that you also shared?
The Chair: Yes. The main thing that witnesses have wanted to do is draw a line between policy development, which should not, in their view, be affected by interests of industry, and the implementation and practicability—the doability, as you just said, Minister—of implementing those policies. That is the difference that they have been highlighting.
Tazeem Bhatia: I can reassure you that for the nutrient profiling model, if we take that as an example, it is a tool to help underpin the SACN recommendations into policy. When we were updating that as a result of the 2015 Carbohydrates and Health Report that you heard about last week, PHE undertook an evidence review and came up with a list of policy options. In that, it said you need a clear indication of what is high sugar and the NPM is the best way—or the existing way—to do that. We set up an expert working group of academics and a few relevant NGO nutrition experts. They all had to declare interests at the start of it in the same way as the SACN process. They advised us in terms of the modelling that we did, the validation processes and such like.
We then had a separate reference group that was a wider group of academics, NGOs and industry, and that was a lot more about feasibility and implementation. They had experience of using the nutrient profiling model from 2004 and 2005. It was essentially about what the challenges would be with the updated model, and then we consulted on the draft model. That is the sort of process we would use to get industry input and feedback where it is appropriate.
The Chair: The thing that has really brought this to light was the pushback from industry when the Government legislated in 2022 to ban the advertising of unhealthy foods in certain situations. That has now been postponed for nearly three years, actually, from when it was first legislated. There did not appear to have been transparency about the meetings between Ministers and certain industry lobbyists at that time. That is what has brought about this concern about which we are asking.
Andrea Leadsom: That is entirely understandable. Again, when I came into this role in November, I reviewed that and asked the question, “Could we bring it forward?” But very clearly, the issue was that of proper consultation and proper implementation, so the advice came back, “No, it needs to be 2025”. But I then wrote to all the big supermarkets, asking them to not wait for the regulation, but to get rid of their buy one, get one free; obviously, they had already moved things away from the till. Actually, to their credit, they pretty much all have, have they not?
Natasha Burgon: There are certainly a few that have implemented it voluntarily. It might be worth also saying, just in answer to your question, that in the Department of Health and Social Care we certainly try to adhere to the WHO principles on safeguarding against possible conflicts in nutritional programmes. That includes being transparent and making sure that we are monitoring industry and publishing that. The Minister referenced the Food Data Transparency Partnership: the minutes of those meetings—everything—are published on GOV.UK in the interests of full transparency.
Q264 Baroness Boycott: I declare my interests and thank you all very much for coming before the committee. One of the things that we have heard has been that a lot of the largest food and drink manufacturers derive most of their sales from unhealthy products. Indeed, there was a story in the FT last year saying that, I think, 68% of Nestlé products would not be authorised as healthy to eat. A lot of witnesses have said that we need to have targets for businesses to meet for healthy food, which seems entirely reasonable. I want to know what your position is on that.
My second question is on the same line: a lot of the goals of industry seem to be more aligned with making money rather than making people eat healthily; in other words, making them buy more. What strategies are the Government considering to try to help achieve a closer alignment of the goals of industry with those of public health? Certainly, some stuff we have heard makes it seem like those two things are often incompatible.
Andrea Leadsom: Yes, these are absolutely critical questions. Of course, we have already talked about the sugary drinks levy, which has reduced the amount of sugar in drinks by up to 50%. We also have the voluntary reduction in sugar and salt, which has actually had some quite positive results; for example, a reduction of up to 15% of sugar in children’s cereals. A study commissioned by the department shows that all of us in the UK are now taking in a smaller amount of salt every day than we have been, so the salt reductions are evidenced in all our bodies, which is a good thing.
It is a mixture of voluntary and regulatory change. Obviously, when the advertising regulations come in, that will promote healthier food advertising by companies, because all those foods that are on the list of unhealthy products will not be able to be advertised ahead of the watershed, or at all in paid advertising online. What that will mean is companies that want to promote alternatives will be forced to formulate those alternatives to be able to advertise them. That push factor will make a difference in terms of the incentives of companies.
Just in the last couple of weeks I have been looking at the RAG rating—red for fat, amber for sugar, green for salt or whatever it might be—and whether in fact we could look at a single rating instead. As the committee may know, there has been a consultation carried out on that, and I am urging the department to report on that sooner rather than later because that enables people to have better information on the food that they are eating. What we have also found with companies that have been obliged to report calorie labelling is that, miraculously, the calorie content has come down because they obviously do not want to be showing the incredible number of calories in their food. So there are a number of ways to force better activity without necessarily regulating in every instance.
Natasha Burgon: Minister, I would add to that the work that we are doing under the Food Data Transparency Partnership, where the core objective of that group is to get to a common set of health metrics that we and the industry agree with, and then get the whole food industry to report against them. Doing that work in tandem with industry enables us to uncover where industry may or may not want to game the metrics, and make sure that industry is measured against a common set. You mentioned the Nestlé figures: sometimes it is difficult to compare apples with apples, and that is what we are trying to do through that partnership.
Tazeem Bhatia: I can probably just add to that: that is all sectors of industry, including the out-of-home, for which there is very little information and very little data. We have always struggled to look at the nutrition and sales component of, and drive change in, that sector.
Q265 The Chair: Thank you very much indeed. The next question is from Baroness Browning, who is joining us virtually. Lady Browning, can you hear us? I think not, so I will ask the question, which is about ultra-processed food.
In 2023, the Scientific Advisory Committee on Nutrition’s statement on processed foods and health found that systematic reviews, “consistently reported that increased consumption of (ultra-) processed foods was associated with increased risks of adverse health outcomes”. Some witnesses to the committee have suggested that the Government should issue guidelines warning people against the consumption of ultra-processed foods. What is your position on that, Minister?
Andrea Leadsom: This is a tricky area, because it is a bit of a chicken and egg situation. The problem is that we do not know whether it is ultra-processed foods themselves that are the danger, or whether the danger is that so many foods high in fat, sugar and salt are themselves ultra processed. We have not yet got to the bottom of this question. There is a big call for evidence, and we are trying to commission research on the subject. That is why I say it is a bit of a chicken and egg situation.
For example, a sliced loaf of wholemeal bread would count as an ultra-processed food, whereas butter would be a very unprocessed food. So, without more evidence or nuance, it is very hard to say, finally, whether ultra-processed foods are a bad thing in themselves, or whether it is because of the content of most of them.
We were looking just recently at what other countries do on this issue. I am aware, for example, that Canada recommends that people should eat fewer ultra-processed foods, but does not necessarily give very clear guidelines, such as a single colour-coded, “This is a red, do not eat this except for a treat”, versus, “This is a green, eat lots of this”. Therein lies the problem, and the Scientific Advisory Committee on Nutrition is looking at this very point. I think that the CMO is trying to commission advice right now, is that correct?
Tazeem Bhatia: Yes. To add to that, as you said, the Scientific Advisory Committee that you heard from last week absolutely agrees with you. The association between processed foods and poor health outcomes is really concerning and does need looking into. As the Minister says, the CMO has convened round tables with funding bodies to move forward on that evidence base.
In answer to your question, it is tricky because the Nova 4 classification is very, very broad. So, as the Minister said, there are many foods in the UPF category that we already advise the public to consume less of; they are outside of the Eatwell Guide image because of their nutritional content. Then there are other things, as the Minister said, such as wholemeal sliced bread, fortified flours and fortified cereals, which are part of our advice for a healthier diet. They would all come under Nova 4, and we would be saying, “Eat less of these”. We do not know what the unintended consequence might be of asking people to consume a lot less of these foods.
So one of the research recommendations is that we narrow down that classification, work out what components are of concern and break it down into food groups; there is good research such as the Cordova paper that is starting to do that. Our national diet and nutrition survey has also been updated, and it will look at exposure to processed foods as well so we can do those studies with a big data set.
Just coming away from the question, it is also important to note that the ultra-processed food debate does not look at what we eat through takeaways, deliveries, fast food, and outside the home, and that is a quarter of the calories we consume. We know those foods are high in energy, saturated fat and salt, and we should not lose sight of such a big driver of calorie consumption.
The Chair: It is most certainly true that there is a big overlap between HFSS and ultra-processed foods, but the question was not about regulation, which might be quite difficult at the present stage of knowledge, but about guidance. There is a big awareness out there among the public about ultra-processed food being calorie-dense and hyper-palatable and all that, and we get the impression that the public are crying out for some help and guidance from the Government.
Andrea Leadsom: Is it your sense that the public are crying out for help and guidance on ultra-processed foods, or on what is healthy to eat and what is unhealthy to eat? The sense I have as a constituency MP is that people who are overweight or struggling with obesity want to be given a route to losing weight. To be told, “Don’t eat ultra-processed foods” is not necessarily exactly what they are looking to hear. In fact, one of the steps we have taken, which I am very pleased to say has had early results, is a digital weight loss app, which has enabled 30,000 people so far—I think it is 30,000—to lose weight sustainably.[4]
There are various different ways to indicate to members of the public whether something is healthy or less healthy, such as calorie labelling, RAG rating or a single code. It is just not clear to me that saying, “Don’t eat ultra-processed foods” will necessarily give people exactly what they are looking for, particularly when there are concerns over whether that might inadvertently get them thinking, “Right, well, I’ll have the Big Mac, but I’ll leave the wholemeal sliced loaf”. That is where the lack of clarity could be worrying.
The Chair: I see. Can we move to the Earl of Caithness, please?
Earl of Caithness: To be honest, Minister, I am afraid I find that rather depressing. There is so much evidence about ultra-processed food, and you are not prepared even to take a precautionary principle action to help the growing tide of people who want something done about it. High fat, sugar and salt does not ring with people. Ultra-processed food does ring with people in a big way, and we have an amazing opportunity now to do something about it. SACN has been very clear on this. I find it very depressing that my Government are taking this rather negative attitude.
SACN also recommended further research on the relationship between ultra-processed food and health outcomes. What action are you taking on that? More widely, can you set out how you review dietary guidelines and government policy on nutritional and energy intake?
Andrea Leadsom: First, I entirely refute your view that the Government have a negative attitude. That was not what I, or my colleague, were expressing at all. What we are saying is simply that more research is needed to avoid the unintended consequences of drawing a conclusion without final evidence. It is right that the Department for Health and Social Care and the Chief Medical Officer and SACN commission more research.[5] That is exactly what we are doing, and my colleague Tazeem has just presented to the committee that there is a call for evidence. We are looking at whether UKRI would pick this up and provide evidence. There is already a call for evidence among all the research organisations that the Chief Medical Officer and SACN are involved with. So, I do not agree that there is nothing going on, nor do I agree that we are not acknowledging that there is a problem. We very much are.
To your point about what we are doing on labelling and advice for people on what they are eating, I have also set that out. At the moment, we are reviewing whether there should be a single indicator of whether something is a positive and healthy choice to make. We are certainly looking at how to incorporate calorie counting and health rating or RAG ratings on out-of-home foods, which, as has already been discussed, account for a significant amount of some families’ calorie intake.
We know that the portion size, calorie content, sugar, fat and salt content of out-of-home foods are extremely high, so we are looking at what can be done in that particular sector. As we know, there have already been measures taken to ensure that there is calorie labelling on restaurant menus, food packaging and so on.
I can tell that you are very upset, so would you like to ask me another question? I am obviously not making you happy.
Earl of Caithness: No, at the moment I am just listening, Minister.
Andrea Leadsom: Well, you are listening in a very disgruntled way, so if there is another question you would like to ask me, then do. I feel I am trying to answer your question as openly as I possibly can.
Earl of Caithness: Yes, you are doing lots of research, and you are commissioning reports. That is not taking action.
Andrea Leadsom: No, I was just explaining the action we have taken. Going back to the beginning, we have the food data transparency task force, and we are working with that group to look at reformulating. It would be a big win if we could emulate what happened with the sugary drinks levy, which effectively has reduced sugar content by 50%, and yet nobody is clamouring that their Coke does not taste very sweet any more.
As we have discussed, the extent to which we can reformulate products requires that we work with the food industry to look at the doability, to see that you can still have a ready-made meal with a lower calorie content and lower fat, sugar and salt, and yet it can still be something that you might enjoy. Likewise, we are looking at how we can do that with the out-of-home sector.
SACN is also looking at the commissioning of final data on the issue of ultra-processed foods,[6] but we are absolutely taking action on foods with high fat, sugar and salt. I have already gone through our measures on reversing childhood obesity and on labelling. I am happy to repeat them if anything was not clear.
The Chair: Thank you. Can I move to Lord Brooke now, please, for the next question?
Q266 Lord Brooke of Alverthorpe: Good afternoon, Minister and colleagues. My interest is in reformulation and healthy alternatives to sugar, which are not greatly pursued. Minister, you have given us a fair outline on the progress made with salt, and we have made progress with fat. Regarding sugar, you have trumpeted several times the advances we have made with the levy, and I congratulate you on doing that. Where I take issue with you is that it was back in 2018. Why have we not moved forward since?
Andrea Leadsom: That is a very good question. The policy has been to consider ways to reformulate food through co-design with the food sector. I have specific statistics somewhere, if I could find them, on the results of that so far; for example, 15% sugar reduction in children’s foods such as breakfast cereals. We have also seen reductions in many other different foods through the food industry’s voluntary scheme.
Lord Brooke of Alverthorpe: Can you tell us what work you are doing now, and when you expect to see a change in the results coming from that work?
Andrea Leadsom: The advertising regulations coming in 2025 will make a significant difference, because all the evidence points to the fact that children clamour for those foods that they see advertised. TV programmes and online programmes that children are attracted to have a prevalence of adverts for unhealthy foods, so that will make a big difference.
We have already seen that taking away particular unhealthy foods from the tills has made a difference to children’s consumption of them. In addition, through the family hubs we have all the measures that I have already outlined that help families at a very teachable moment when they are expecting a baby—not just about the choice of breast milk or infant formula but on the importance of weaning and a healthy diet for all the family. Early results demonstrate that, when early years professionals work with families who are expecting a baby, the whole family changes a lot of things, including reducing smoking, or ideally giving it up, reducing alcohol consumption, and eating more healthily. So we have taken a lot of measures, and it is very difficult to point specifically to one killer intervention.
Lord Brooke of Alverthorpe: You were specifically pointing to the great success of it, yet we have not taken it further forward. I concede that a multitude of different approaches is required, but if you have a very successful one, why not repeat it?
Andrea Leadsom: As I have just said, it is because we all need to eat, and as well as reducing sugar, fat and salt in food consumption, the reformulation requires that it still be enjoyable and desirable to the consumer and thus saleable. That is why it is very difficult for the Government to say simply, “Right, you have to cut the fat content by 30%”, because that may make something unviable.
For that reason, government policy has been to work with the food sector to really focus on reformulation in a way that enables people to still enjoy the foods they want to eat. At the same time, there has been a constant drumbeat of targeted public health messaging about the importance of a healthy diet. The Eatwell Guide is promoted through all of primary health, through schools, and through school food standards.
So on the manufacturing side there is the attempt to reduce unhealthy products through the voluntary scheme, and on the consumption side, where we are able to educate, inform or, in the case of children, provide better food, then that is what the Government have done. You will be aware of the Healthy Start scheme, the fruit and vegetable schemes, the Nursery Milk Scheme that get children off to a good healthy start. It is very early to crow about it but, as I say, we have seen a slight reduction in the number of children starting primary school with obesity and overweight.
The Chair: Is it not true that the SDIL was actually mandatory and industry responded extremely quickly by reformulating, and yet when Henry Dimbleby proposed that the same strategy was spread more widely across other foods in the national food strategy, the Government did not accept that recommendation? Is there any plan to do that?
Andrea Leadsom: As I have just explained at length, the conclusion drawn by the Government was that sugary drinks are very different from food, and therefore it is difficult when you are formulating food to just set out targets that may or may not make that food saleable and appealing. I have not seen that advice personally, but perhaps, Tazeem, you would like to explain further.
Tazeem Bhatia: Yes, as you have set out, it has been easier to take sugar out of drinks, and we already had alternatives on the market when the Chancellor announced that policy, so the direction of travel was clear. The voluntary programmes have started to demonstrate what is possible in food, which is much more technically difficult and does take longer.
We have now given the industry a target of the end of 2025 to meet the sugar calorie reduction ambition, with a clear mandate that, if we have not seen any progress—it has been given a lot of time to get there, as you say—further levers will be considered.
The Chair: We have heard from industry that it has to be done incrementally so that it is tolerated by the consumer, but it can be done. Lord Colgrain, do you have a question?
Lord Colgrain: I am really just following up on the point you have just made. We have been rather depressed by consistently hearing that, if there is an issue it should go out to consultation, which just kicks the can down the road and means that nothing gets done. What we want to hear is government saying, “You will do this”. Last week we had young people giving us evidence, and we said to them, “If the food industry is told to do something, how long will it take them to do it?” They said, “No time at all. If their back is against the wall they will do it”.
So we are saying to you, the Government, can you please put yourself in a position where you are going to get something done, and not allow endless further consultation? That is, perhaps, the point my noble friend was making as well.
The Chair: Minister, you mentioned that the Food Data Transparency Partnership, a working group, is trying to develop consistent metrics by which companies can report on the healthiness of their sales. We have not heard when that group is going to report, and we think it could be extremely important. Industry needs consistent metrics before it can report. Do you know when that is going to happen?
Andrea Leadsom: What I can say is that I met it for the first time within a couple of weeks of coming into the job. The next meeting is in July, which I shall also attend. For me, at that point it will be a case of, “Right, you’ve had your chance to come up to the table, and either you have, or you haven’t”. So, that will be a very important meeting.
The Chair: Indeed. Baroness Goudie.
Baroness Goudie: Good afternoon, Minister and colleagues. I would like to declare my interests as stated in the register of interests.
Witnesses, including from the industry, have suggested that mandatory reporting would be more effective. Do you agree? Further, in 2018, Public Health England developed a revised nutrient profiling model to reflect the latest guidance on free sugars. What would have increased the proportion of high-sugar products subject to the regulation, and why was the proposed new model never implemented? Are there any other plans for further implementation?
Andrea Leadsom: I am afraid I cannot speak to a decision that was taken some time ago. Tazeem or Natasha, can you answer that?
Tazeem Bhatia: Maybe Natasha is best placed to talk about the use of the nutrient profiling model. I explained earlier how the review process worked.
Natasha Burgon: In terms of the specific timeframe that you are talking about, we deliberately chose to use the existing NPM for our regulations because it was finalised and ready and accepted. At the time, we thought that if we waited for the outcome of that review it would delay things further and we would miss the boat in terms of the primary legislation. We now have the review, and there are still steps to be taken, but it is an area that we are looking to update as soon as we can.
On the mandatory reporting side, we are working with the Food Data Transparency Partnership in a voluntary way, and there are huge benefits to that approach. We are trying to ensure that everybody comes to the table because they want to create a consensus. That is really getting us somewhere and gives us, at least, a starting point to build on.
The Chair: We asked because we heard from the chair of SACN that he felt that if the reviewed criteria had been put into operation it would have brought more products into the regulation on free sugars, but that has not happened, which is unfortunate.
Natasha Burgon: At the time of doing the regulating it was not quite ready, so that was not the right time. It is something we should look at going forward.
The Chair: Maybe you could send in something else on that to update us as to where you are just now.
Q267 Baroness Boycott: We have touched on this a bit throughout, but I would like to dwell on the whole business of advertising unhealthy food. We have heard from some witnesses that they think all adverts for unhealthy food should be banned. I would like to know your opinion on that.
Also, I know you have answered some questions from the Chair, but could I possibly probe a little more into the delays to the 9 pm watershed? You came back saying we needed more consultation on this, but the person who did all that for Cameron’s Government is a Member of the House of Lords, so I know how much consultation was done. I cannot see why you would need more. Can you shed light on why it has been delayed?
I would also like to ask what you are doing about paid-for HFSS advertising online. Products such as Prime energy drinks exist entirely as online products. They contain 20 teaspoons of sugar and are targeted at children as young as five.
Andrea Leadsom: First, I absolutely share your concern, and the committee’s concern, about advertising. In terms of the statutory instrument, when I came into this role I asked whether we could bring it forward earlier, and we could not.
Baroness Boycott: Why?
Andrea Leadsom: We would have had to withdraw the statutory instrument with another statutory instrument, and then we would have had to re-lay it.
Natasha Burgon: There were a few technical things. We have to respond to the consultation that we did. That has been quite a lengthy process. We needed to finalise the statutory instrument, draft the guidance and appoint the regulator, so there were quite a lot of steps to go through.
Baroness Boycott: Can you say, in front of this committee, whether the delay had anything to do with pressure from the food industry, and, indeed, the commercial television and media industry?
Natasha Burgon: Not from my perspective. The delay was for practical reasons, as I have set out. We had a consultation and there were a number of responses—
Baroness Boycott: Yet Sadiq Khan was able to cancel all advertising of junk food on TfL adverts on the street with a click of the fingers. Was that a weird thing to do?
Natasha Burgon: All I can speak to is the steps that we have had to go through as government in following the legislation set out in the primary vehicle. We have had to review all the consultation responses, and we are looking to publish that review as soon as possible. As the Minister said, she is really pushing us to make sure that timeline is kept to, but there are also a number of practical steps—including the guidelines and finalising the instrument itself—that we have had to go through, and that has been the driver for pushing the timeline.
Baroness Boycott: I find that a really gobsmacking answer, given that this has been debated now for nearly seven years. I find it quite extraordinary that we still seem to be there, and these advertisements are still allowed.
I know we are running out of time, so I am going to get my second question in here. Could you comment on the implementation of the 2022 restrictions on the placement promotions for unhealthy foods, which has not been consistent or equitable?
Natasha Burgon: I am sorry, what do you mean it has not been consistent?
Baroness Boycott: Whereabouts you can place foods within supermarkets—
The Chair: Food placement near the tills and so on—it has not been consistent, it has not been monitored and enforced.
Andrea Leadsom: I am not aware of that.
Natasha Burgon: In terms of an enforcement issue—
Baroness Boycott: Sorry, but that was a very big plank of one of the many, whatever it is, 187 obesity strategies that we have had.
Andrea Leadsom: No, no, no, of course I am aware of the regulation, what I am not aware of is you said it has not been—what?
Baroness Boycott: It has not been enforced.
Andrea Leadsom: It has not been implemented.
Baroness Boycott: How do you implement it? Do you feel it is well implemented and do you feel it is fairly implemented?
Natasha Burgon: Enforcement is through local authorities, either through trading standards or environmental health officers, so it is on them to enforce the regulations. They are the law so we would certainly hope that they are enforced, and funding is made available to support that enforcement.
The other bit that I would add is that we have built a five-year evaluation into the regulations, so we will review implementation as we go and any changes that need to be made as a result.
Baroness Boycott: I have one final question. I was in a gas station on Friday night, coming off the M3 on to the A303. There was a full stand between the two checkouts of a drink called Monster, which is targeted at children, with nine different patterns on the bottles. We had a young person in here last week saying how this is marketed at schoolkids. It has 19 spoons of sugar in it and costs £2.50, and the marketing for it is obviously uncontrolled. Do you do anything about things such as that? Do they even cross your desk?
Andrea Leadsom: Absolutely. I am sick and tired of the deliberate promotion of things such as that to children. It is absolutely disgraceful. But, equally, you will understand that regulation is the law, and the law must then be enforced and implemented at a local level. The regulation that was put in place removes certain products from areas near the till, but of course, businesses will always seek loopholes, and that is the incredible frustration.
In terms of your specific example, I cannot answer that but suffice it to say that I will do everything possible to ensure that businesses do uphold what is clearly intended.
Baroness Boycott: In all the months of this inquiry, I personally have not heard of anyone actually being fined or in any way challenged about such behaviour.
I am sorry, Chair, I know I have used up enough time.
The Chair: Thank you. The young man who gave us evidence last week, Minister, said that this can should not be labelled as an energy drink, it should be labelled as a can full of sugar. That was his view. So I hope, Minister, that if we make recommendations to improve that situation, you may perhaps welcome them.
Can I move to Lord Krebs now, please?
Lord Krebs: Thank you, Lord Chair. I will try to be brief but just to follow up on Baroness Boycott’s question, if you look back at one of our earlier evidence sessions you will see a very clear set of evidence as to why the restrictions on placement in supermarkets are not being followed and that companies have found ways around it.
My question relates to labelling. Minister, you have talked about front-of-pack nutrition labelling, and you have said there have been discussions about adopting something more akin to the French Nutri-Score system, which is a single colour-coded system representing the nutrient profiling model, as opposed to the multiple traffic light system we have at the moment.
The question I want to put to you is: what we have at the moment is voluntary but should it be mandatory? There was a 2020 consultation on front-of-pack labelling and, as we understand it, there has not been any government response yet. Why is that? Some witnesses have argued that there should be health warning labels on food packaging. What do you think about that?
Andrea Leadsom: I completely agree with your point that we need to get our consultation response up. We need to do that urgently. As I say, I have been looking at whether a RAG rating is better than a single Nutri-Score-style indicator that this is bad for you or good for you. Intuitively, it seems to me that a single score would be better than a RAG rating. If it is red for one thing, amber for something else and green for something else, then should I eat it or not? A single rating would be much clearer.
However, it makes sense to do the analysis of what that would tell you. If people start using a single code to plan their daily meals, you do not want it to inadvertently cause them to be short of one particular food type or another. That is why there is a lot of thought going into front-of-pack labelling. I certainly agree it should be mandatory and that we should have it on out-of-home products as well. Anecdotally—there are a lot of anecdotes flying around the room—when you look at restaurant menus now, miraculously you do not see the 2,300-calorie figures that you used to see, so either they are not telling you the truth or they have managed to reformulate or are just serving up less. Labelling can be a big tool in persuading the food sector to reduce the calories and content of their food to more healthy ingredients.
Lord Krebs: The key thing that I would take from that is that you are in favour of mandatory front-of-pack labelling, whether that is a Nutri-Score or a multiple traffic light system.
Andrea Leadsom: I am, yes.
Lord Krebs: You just mentioned portion sizes in restaurants: would you want to include mandatory labelling in relation to portion size of products in the retail sector?
Andrea Leadsom: I do not have such a strong view on that because if, for example, a salad gives you the calorific content per 100 grams and per portion size, they tend to go hand in hand. I have not given it much thought but, as I sit here now, I guess it would make sense to do that too.
Tazeem Bhatia: Coming back to your question on warning labels, alongside the consultation we had research that was looking at different labelling types, with 4,500 participants in the UK. The Nutri-Score and the multiple traffic light performed best. Warning labels did not perform particularly well, so that would be an answer to that question.
In terms of standardising recommended portion sizes, I get the premise that portion sizes have grown over the years and we are consuming too many calories, particularly out of home, where, again, portion sizes are double. The traffic light system already includes portion size in it, so you get the nutrient information per serving on the pack. But, again, that is only packaged food, not out of home.
We have looked in the past at standardising portion sizes, with the purpose of providing consumers with that sort of clarity about how much they should be eating of one food group or another to achieve a balanced diet. It is actually very challenging because when you think about the adult population, a small, older woman will perhaps not need the same amount as a young man who is training at the gym every day. How many different ways do you cut the population? If you do not want to cut it up into lots of different sizes, then you give a large range, which loses the purpose of clarity about the s
