House of Lord Select Committee              Food, Poverty, Health & the Environment              Submission from Birmingham Food Council

Birmingham Food Council CIC – Written evidence (FPO0057)

 

SUMMARY

The supplies of safe, nutritious food are already significantly more expensive than unsafe or adulterated food, or food with low nutritional value. Prices will rise still further owing to threats to the supply network, including those to the global agri-food system. Ensuring urban dwellers, over 80% of the UK population, have sufficient supplies of safe, nutritious food requires inter alia processing of fresh produce and distribution logistics; i.e. what happens in the supply network between the farm gate and plate. With thin, vanishingly small or non-existent profits on fresh produce, commercial pressures will continue being to process more, and limit distribution to some areas. Food insecurity for many will increase unless all these economic challenges are tackled.

Of particular concern to us is the profitability and prevalence of the so-called ‘drug-foods’ (i.e. sugar and sugar substitutes, chocolate, caffeine, alcohol products, and those such as crisps specifically formulated to be more-ish. The over-consumption of these drug-foods generate a considerable public health burden. As these products provide consumers with an easily accessible, cheap, pleasurable means for calorie intake, and they have a long shelf-life, it is not surprising that people living on low budgets are the most affected by diet-related morbidity. It is less well-recognised the production of drug-foods uses up our increasingly stretched natural resources that could be used to produce nutritious food, as well as contributing to packaging disposal challenges. All drug-food products carry standard-rate VAT, unlike nutritious food stuffs which are zero-rated, hence VAT provides us with a precise means to identify not only drug-food products, but also the global corporations manufacturing and promoting them at scale.

We do not think childhood obesity will be tackled successfully unless and until the activities of these corporations manufacturing and promoting drug-foods at scale are curbed, including control of advertising, packaging and product placement, and partnerships and sponsorships with public bodies and research organisations, including universities. This is a significant governance challenge requiring regulation and fiscal measures. Voluntary codes will not work.

The main factor in having a healthy diet is affordability, both at the point of sale and in order to have access to a retail outlet selling healthy foods. Socio-political decision-makers need either raise household income enough so that everyone has access to the food they need, and/or subsidies are put in place and/or means are found for wider provision for mass catering of healthy meals locally, either free at the point of delivery (already possible for school infants, hospital patients and prisoners), or at affordable prices.

We acknowledge many local authorities can and do make some difference to help everyone eat well, despite the drivers of inequalities being out of their direct control. That said, we have particular concern about national and local government partnerships and sponsorships with drug-food companies, and NHS as well as government bodies’ commercial contracts with drug-food vending machine providers.

Although we regret the need for food banks, providers are likely to be able to throw light on spatial, logistical and other organisational elements existing in the current emergency/community food distribution systems that could be put in place at a population level when (and it is when, not if) food shortages and scarcities become more frequent and more spatially widespread due to pressures on the global agri-food network.

We outline four changes at a national level that would help ensure efforts to improve food insecurity and poor diet and its impact are effectively coordinated, implemented and monitored. First, to encourage open, informed discussion of food security matters, rather than the current environment in which many professionals feel unable to talk freely about them. Secondly, to ensure socio-political decision-makers better understand the scale, logistics and contingencies in the UK food supply network. Thirdly, to have more funding to ensure food safety, assurance and integrity and finally, to take up our recommendation to set up a UK Food Security Institute with the specific remits we have outlined.

1              What are the key causes of food insecurity in the UK? Can you outline any significant trends in food insecurity in the UK? To what extent (and why) have these challenges persisted over a number of years?

1.1              Supply side threats and trends

The supplies of safe, nutritious food are already significantly more expensive than unsafe or adulterated food, or food with low nutritional value. Prices will rise still further owing to threats to the supply network. Without socio-political interventions, food insecurity looks set to persist and affect a growing number of UK households.

The main threats to the supply network are:

1.1.1              Global competition for food

Four major interlinked factors affect harvests and their distribution. They are climate change, resource depletion, population pressures and geopolitics.[1] The global competition for safe, nutritious food supplies, already intense, can only increase, inevitably leading to higher prices,[2] thereby affecting more people. Worst case scenarios for the global situation range from frequent shortages and scarcities of some food stuffs, some of which we have already experienced in the UK at a small scale[3] to staple crop failure and subsequent widespread hunger, even famine.

1.1.2              Supplying food to people in cities and towns; i.e. between farm gate & and plate

Urban dwellers are acutely vulnerable to food supply disruption owing to population density and distance from agri-food production. Across the UK, 83% of us live in urban areas,[4] over 90% in parts of south east England. Urbanisation is increasingly globally, too. Today, 55% of the worlds population live in urban areas, a figure expected to increase to 68% by 2050.[5]

Calories

Today’s urban dwellers depend on a global network of organisations to grow, store and transport the cereals and seeds they depend on for energy. The weight and bulk of the volume required to supply populations means they are transported by sea, with supply disruptions possible at chokepoints and vulnerabilities along key maritime trade routes.[6] Our dependence on just a few staple crops for our calorie intake increases risks associated with crop pathogens, weather events and pollutants.[7],[8],[9]

Nutrients

Lack of nutrients is health-threatening and has long term impact, but a low-nutrient diet is not an immediate risk to life and, unlike inadequate calorie intake, does not lead to civil unrest. 

Fresh food such as animal products, fruit and vegetables provide us with the nutrients as well as the calories we need. They also need to be consumed or processed within days, some within hours or even minutes to be at their best.[10] It is inevitable therefore that businesses exist to process fresh foods at scale (e.g. canning, freezing, heating, salting, drying, packaging) in order to safely store and transport nutritious supplies into urban areas.[11]

1.1.3              Processing and profit margins

Every level of processing has to add value. This drive for profits, however, can be detrimental; adding ‘value’ may, for example, reduce the nutrient value of the product. This ‘value adding’ incentive can operate with particular perversity when, as is the case, fresh produce all along the supply chain operates at a loss, or with non-existent or wafer-thin profit margins.[12] When margins are so tight, business people have few options. They either leave the sector and make their living elsewhere, or they diversify[13],[14] and/or supply a high value niche market and/or they scale up the business.

Across the world, farmers scrape a living, agricultural subsidies exist in many countries, while wholesalers, distributors and retailers alike operate on tight or vanishing profit margins. We should not be surprised therefore, by our dependence on a few dominant global companies, or by the proliferation of highly processed food and drink products, many with zero or very low nutritional value. Examples of such products are those categorised as ‘drug-foods’.

1.1.4              The profitability and prevalence of drug-foods

What a drug-food is

The term ‘drug-foods’ was first coined by the anthropologist Sidney Mintz[15] for the tropical commodities first brought to Europe by early explorers, namely (cane) sugar, chocolate, caffeine (tea and coffee), rum and tobacco (still classed on the Forbes List as a ‘food’). Our definition subsumes products containing sugar-substitute sweeteners[16],[17] and those, such as crisps, specifically formulated to be ‘moreish’, i.e. to stimulate pleasure responses beyond the natural pleasure of eating,[18],[19],[20],[21] as well as other alcohol products.

The costs of over-consumption on human and planetary health

The health consequences of over-consumption of these drug-foods are obvious to us all and they come at a huge financial and social cost, mostly locally borne, and which include the disposal of drug-food packaging (or recycling though currently much of it can’t be). It is less well-recognised that the production of drug-foods uses up increasingly stretched natural resources, resources that could be used to produce nutritious food.

Drug-food corporations dominate the sector

Manufacturers and promoters of these drug-foods at scale dominate the sector economically, as can be seen from the Forbes 2018 List of the world’s largest food and drink companies.[22]

The price and prevalence of drug-food calories

In many of our poorer wards, the only nearby availability to the calories necessary to sustain life are drug-foods such as confectionery, sweet biscuits, crisps and other savoury snacks and drinks ranging from fizzy pop to alcohol. They’re cheap and more-ish. Moreover, for the retailer, unlike fresh produce sales, the products are a profitable line with a long shelf life. 

A senior supermarket executive wryly summed up the situation to us: We have to sell these products; confectionery subsidises carrots.

VAT: a precise mechanism to identify drug-food companies

The Chief Medical Officer in her 2018 Annual Report,[23] stated Those who shape the environment for health should be held to account . . . Those sectors that damage our health must pay for their harm or subsidise healthier choices.  She is not clear, however, about who those who shape the environment nor those sectors that damage our health are.

There is a wealth of evidence, however, that one of the sectors is the drug-food sector, and its shaping of the environment for health, whether human or planetary, is hugely damaging.

Through the UK Value Added Tax (VAT) system, however, it is possible to be precise about drug-food corporate vested interests. This tax precisely and systematically identifies both drug-food products and manufacturers,[24] so allowing us, should we wish to do so, to put in place regulation, prohibitions and fiscal measures to curb their activities (see 12.1 below), as we already have against tobacco companies.

2              What are some of the key ways in which diet (including food insecurity) impacts on public health? Has sufficient progress been made on tackling childhood obesity and, if not, why not?

2.1              The impact of diet on public health

The overconsumption of some food products including drug-foods (see 1.1.4 above) generates a considerable public health burden. The spectrum of harm ranges from those that are relatively mild to severe, including death or life-long disability.

The burden includes tangible direct costs to the health, criminal justice and welfare systems, as well as indirect costs such as costs of lost productivity due to absenteeism, unemployment, decreased output or lost working years owing to premature pension or death. Some costs are intangible, including those related to pain and suffering, poor quality of life and emotional distress. The threat of hunger or starvation also has psychological and physiological effects.

2.2              Has sufficient progress been made on tackling childhood obesity and if not, why not?

Sufficient progress has not been made. We put forward these arguments as to why not:

2.2.1              A focus on the food supply system structure

Most of the efforts to tackle obesity focus on demand-side factors, notably seeking to change behaviours. Although the term ‘obesogenic environment’ has entered our parlance, it is rarely used in relation to the food supply system structure. Our analysis suggests a significant reduction in obesity can only be achieved by a focus on curbing drug-food companies.

2.2.2              The economic challenges in curbing the activities of drug-food companies

As stated above (1.1.3), the profitability of drug-food products, unlike that of fresh produce, stretches along the supply chain, from the processing of raw ingredients to vending machines, corner shops and other retail outlets.

Over 50% of the UK household food spend is on drug-foods,[25] and is likely to be an even higher proportion of spend on catering services (about which there is no publicly available data). These foodstuffs are no longer expensive luxuries, occasional treats, but a cheap, easily accessible means to acquire calories whilst also satisfying a more-ish, even addictive pleasure.

The influence of these companies at a global level is indisputable. They also wield great influence and economic power at a local and hyperlocal level, with particular pernicious impact in our more deprived communities.

Moreover, as with smoking, the costs of over-consumption on human and planetary health are not immediately felt, whereas the profits of businesses and associated livelihoods are seen at the point of sale. Political decision-making, dependent as it is on election time-scales, will inevitably discount these longer-term costs.

This state of affairs begs big questions without many answers: How do we support SMEs that make part of their living from drug-food sales? How would planning decisions figure in their economic needs? What mechanisms can national and local government put in place to generate commercially viable profits for healthy agri-food-enterprises?

In summary, countering the power and vested interests of corporations manufacturing and promoting drug-foods is a huge social, political and economic challenge, a challenge that has to be tackled, and tackled far more quickly that our curbing of tobacco company activity.

3              How accessible is healthy food? What factors or barriers affect people’s ability to consume a healthy diet? Do these factors affect living in rural and urban areas differently?

3.1              How accessible is healthy food?

We refer you to the work of Dr Hillary Shaw et al on this matter.[26] Another pertinent question is how accessible is unhealthy food? Drug-foods are for sale in all communities. Moreover, they not only have a long shelf-life, they are easily stored for later consumption in the home.

3.2              What factors or barriers affect people’s ability to consume a healthy diet?

The major factor affecting many people’s ability to have a healthy diet is its affordability, both at the point of sale (POS) and access to POS.

We are not, however, an advocate of seeking ways to reduce the price of healthy foods. Either socio-political decision-makers need to raise household income enough so that everyone has access to the food they need, and/or subsidies are put in place and/or means are found for wider provision for mass catering of healthy meals locally either free at the point of delivery (as in, for example, nurseries, nurseries, schools, colleges, universities, care homes, hospitals and prisons), or at affordable prices.

4              What role can local authorities play in promoting healthy eating in their local populations, especially among children and young people, and those on lower incomes? How effectively are local authorities able to fulfil their responsibilities to improve the health of people living in their areas? Are you aware of any existing local authority or education initiatives that have been particularly successful (for example, schemes around holiday hunger, providing information on healthy eating, or supporting access to sport and exercise)?

4.1                            Local authorities

We are supposing that local authorities will report to you on what they are doing and could do. We would like to acknowledge that many local authorities can and do make a difference, despite the drivers of inequalities being out of their direct control.

We would like to note, however, that we have particular concern about local authority partnerships and sponsorships with drug-food companies,[27] and their commercial contracts with drug-food vending machine providers on their (and NHS) property. We also refer you to our report on city-level responses to food insecurity.[28]

4.2                            Successful local initiatives

There are many initiatives, as you’d expect in a city the size of Birmingham. Of particular note is the Birmingham Forward Steps initiative,[29] also Holiday Kitchen,[30] also referred to on the Birmingham Forward Steps website.[31]

5              What can be learnt from food banks and other charitable responses to hunger? What role should they play?

5 .1              Current and future role of food banks

Food bank providers will report to you on what they are doing. What they may not mention is what future decision-makers can learn from them when (and it is when, not if) food shortages and scarcities become the new norm for the UK (see 1.1 above). For example, they are likely to be able to throw light on the spatial, logistical and other organisational elements existing in the current emergency/community food distribution systems that future planners and decision-makers could use at a population level.

6              What impact do food production processes (including product formulation, portion size, packaging and labelling) have on consumers’ dietary choices and does this differ across the income groups?

6.1              Impact of food production processes on consumer dietary choices

Others are more able to give you evidence on these important matters.

7              What impact do food outlets (including supermarkets, delivery services, or fast food outlets) have on the average UK diet? How important are factors such as advertising, packaging, or product placement in influencing consumer choice, particularly for those in lower income groups?

7.1                            Impact of food outlets on the average UK diet

Consideration of the average UK diet in relation to the mix of outlet provision in any locality may not be as helpful as other considerations. As an illustration, only 6.54% of household spend is on takeaways. A great deal of concern is expressed against takeaway food outlets, many deemed to be a major factor in the rising burden of obesity. But, given this figure, are they? Or are there some communities where there are a disproportionate number of takeaways and, if so, is their presence related to diet-related disease, such as obesity or cancer risk? If so, are there other factors involved that have a greater or lesser significance?[32]

7.2              Factors such as advertising, packaging and product placement in influencing consumer choice

Corporates will only spend on advertising, packaging and product placement if they made a return on their marketing spend; i.e. they have a huge influence on consumer choice.

It’s worth noting that some drug-food and drink companies own the world’s most valuable brands,[33] spending huge sums to maintain their position.

8              Do you have any comment to make on how the food industry might be encouraged to do more to support or promote healthy and sustainable diets? Is Government regulation an effective driver of change in this respect?

8.1              Voluntary agreements don’t work

We need regulation and other measures by governments to be an effective driver of change. Evidence indicates that voluntary agreements don’t work.[34],[35]

9              To what extent is if possible for the UK to be self-sufficient in producing healthy, affordable food that supports good population health, in a way that is also environmentally sustainable?

9.1              The production of healthy food products

Experts at the Warwick Crop Centre have told us that the UK could be self-sufficient in food, though our diets would be much restricted. A varied, healthy diet depends on the UK having good trading relationships with other countries, hence maintaining efficient trading routes with food suppliers across the world is literally vital to the UK population.[36],[37]

We need to remember, too, that we are a densely populated small group of islands and, as anywhere, the types of agriculture we can have depend on climate, and terrain, as well as professional expertise and labour. How much food we should import is therefore a moot point.[38]

9.2              The production of affordable healthy food products

As said earlier, the price of fresh produce will — and we argue should rise. How fresh produce is made affordable is a socio-political matter, dependent on interventions (see 3.2 above).

9.3              The production of affordable healthy food products + being environmentally sustainable

There are others who can answer questions of environmental sustainability better than we can. What we can say, however, is there is complex balance between feeding a population and doing so sustainably as, for example, with the use of fertilisers[39] and pesticides.[40]

10              Can efforts to improve food production sustainability simultaneously offer solutions to improving food insecurity and dietary health in the UK?

10.1              Sustainability, food insecurity and dietary health

We don’t know the answer to this big question. What we do suggest, however, is that a focus on supply side economics is illuminating.

11              How effective are any current measures operated or assisted by Government, local authorities or others to minimise food waste? What further action is required to minimise food waste?

11.1              Food waste

Others, for example WRAP,[41] are better able to answer this question.

12              A Public Health England report has concluded that “considerable and largely unprecedented” dietary shifts are required to meet Government guidance on healthy diets. What policy approaches (for example, fiscal or regulatory measures, voluntary guidelines, or attempts to change individual or population behaviour through information and education) would most effectively enable this? What role could public procurement play in improving dietary behaviours?

12.1              Policy approaches

An effective start would be the following: For food and drink products upon which VAT is levied, advertising and product placement should be prohibited and, as with cigarette products, strict controls are placed on branding and package design. We also suggest that corporations making and promoting any food and drink products upon which VAT is levied are prohibited from sponsorship and/or partnerships (including commercial partnerships such as vending machines) with national and local government bodies, nurseries, schools, colleges, universities, research organisations and the NHS.

12.2              Role of public procurement

Public procurement can have a direct impact (as for example, in school meal provision) and an indirect impact being exemplar providers and, if they buy locally and providing they don’t squeeze profit margins, they can have a beneficial impact on the local area.

13              Has sufficient research been conducted to provide a robust analysis of the links between food poverty, food insecurity, health inequalities and the sustainability of food production? How well is existing research on the impact of existing food policy used to inform decision-making

13.1              Sufficient research on food poverty, food insecurity, health inequalities & sustainability

These links are known. And there’s always a need for more research, both to challenge the validity of existing findings and to reflect changes in both the food network and in society. Nonetheless, our judgement is that the lack of action isn’t a research challenge, but a governance challenge.[42]

13.2              Existing food policy and its use to inform decision-making

We are not aware that the UK has a food policy.

14                            What can the UK learn from food policy in other countries? Are there examples of strategies which have improved access and affordability of healthy, sustainable food across income groups?

14.1              Learning from food policies in other countries

We refer you to Designing Urban Food Policies: Concepts and approaches, in particular to the conclusion by Nicolas Bricas which provides a useful summary.[43]

14.2              Examples of strategies that have improved access and affordability of healthy sustainable food across income groups

None that we know of.

15              Are there any additional changes at a national level that would help to ensure efforts to improve food insecurity and poor diet, and its impact on public health and the environment, are effectively coordinated, implemented and monitored?

15.1              Encouraging open, informed discussion

We are deeply concerned that many people with professional expertise in the public sector and our universities feel unable to talk freely about food security matters in fear of losing their job and/or losing promotion opportunities and/or funding of projects.

This is a regrettable situation at the best of times and against the national interest at all times, perhaps particularly so given the huge challenges we’re facing, and the big impacts they will have upon us all too soon — and, too, that few outside the sector or relevant research bodies, understand food supply matters (see 15.2).

15.2              Education about the scale, logistics and contingencies in the UK food supply network

Few outside the food supply businesses have a realistic grasp of the scale, logistics and the contingencies involved in growing and delivering food to a population.[44] Furthermore, perhaps because it’s 65 years since food rationing ended, most people, including many politicians, are complacent about the possibility of shortages or scarcities.[45]

As a result, some crucial socio-political decision-making about the food sector is of dubious value or even non-existent.[46]

15.3              More funding to ensure food safety, assurance and integrity

The UK food system is currently one of the safest in the world. Yet food-borne illness affects millions of us every year. In 2014, the Food Standards Agency (FSA) reported 1M cases of food poisoning the previous year and, of these cases, 20,000 people were hospitalised and 500 died.[47]

Pressures on local authority budgets have resulted in a chronic decline in the number of enforcement professionals, with a continuing decline in the number of laboratories and their capabilities.[48] This translates into few inspections and falling numbers of samples to test compliance with food hygiene and food standard requirements.[49]

The UK is thus becoming increasingly vulnerable to attack, whether through local authorities not directing adequate resources to discharge their responsibilities, unscrupulous food businesses or organised criminals making a fast buck while using our lives as collateral damage or, in the case of the terrorist, disrupting our social order.

15.4              A UK Food Security Institute

As a result of our horizon scanning project last year, we recommended that the Government should set up an independent Food Security Institute led by senior members of the MoD and/or intelligence community, with funding over the next 25 years and a specific remit which we outlined in our project report Back from the future.[50]

 


Birmingham Food Council CIC


12th September 2019

12th September 2019                            page 13/13


[1]              Birmingham Food Council (2019) Global Risks to UK Food Supplies

[2]              See this video interview on the topic with Parveen Mehta, Operations Director at Minor Weir and Willis: https://youtu.be/kOR-op8Igxg

[3]              As, for example, shortages and scarcities of some vegetable crops after poor weather in southern Spain affected harvests in early 2017.

[4]              United Kingdom: Degree of urbanization from 2007 to 2017. Statistica

[5]              United Nations Population Division World Urbanization Prospects, 2018 Revision: https://www.un.org/development/desa/publications/2018-revision-of-world-urbanization-prospects.html

[6]               https://www.chathamhouse.org/about/structure/eer-department/vulnerabilities-and-choke-points-global-food-trade-project

[7]               Lloyds of London (2015) Food system shock: The insurance impacts of acute disruption to global food supply.

[8]              Birmingham Food Council (2019) Global Risks to UK Food Supplies, page 3

[9]               Birmingham Food Council (2018) Back from the future: Horizon Scanning Project Report, pp2-3

[10]              Nutrient loss for most fruit and vegetables begins immediately after harvesting. See this review of the literature on this topic from Emeritus Professor Diane M Barrett: http://www.fruitandvegetable.ucdavis.edu/files/197179.pdf

[11]              Wholesalers have strong incentives to get undamaged fresh produce into supermarkets. If a customer returns a bruised or damaged fruit or vegetable at the counter, the wholesaler will be fined many times the value of the item, sometimes as much as £20 or £30, cutting into already thin profit margins. This system has, however, led to highly sophisticated storage, packaging and just-in-time logistics systems.

[12]              We’ve been told 0-2.5% in personal communication with senior executives from both a large wholesaler and a supermarket. As for pre-harvest margins, they can be less than zero, hence agricultural subsidies.

[13]              Its in the business interests of, say, a fruit wholesaler to slice and package fresh fruit into small containers — it lasts longer than the product itself, there are fewer recalls and the margins are much higher.

[14]               As Simon Beckett of Becketts Farm, Wythall just south of Birmingham. On Farming Today (31/03/18), he described his 80-year old family farm of 1000 acres, worth £1500/acre, now has a conference centre, a farm shop, a restaurant, a petting farm, a cookery school. Their butchery counter makes double the money of their £15M capital under primary production of “anything that can go up into the mouth of a combine harvester”.

[15]              Mintz, Sidney W Sweetness and Power: The place of sugar in modern history p99-100. Penguin 1986.

[16]              Yang, Qing Gaining weight by “going diet”? Artificial sweeteners and the neurobiology of sugar cravings. Journal of Biology and Medicine 2010; 83:101-108.

[17]              Cabral, TM, Pereira, MGB, Falchione, AEZ, de Sá, DAR, Correa, L, da Maia Fernandes D, de Sá, LBP and Arbex, A K Artificial Sweeteners as a Cause of Obesity: Weight Gain Mechanisms and Current Evidence. 2018; Health, 10, 700-717

[18]               DiFeliceantonio AG, Coppin, Rigoux L, Thanarajah SE, Dagher A, Tittgemeyer M, Small DM (2018) Supra-Addictive Effects of Combining Fat and Carbohydrate on Food Reward. Cell Metabolism, Vol 28 Issue 1 pp33-44. E3

[19]              Hoch T, Kreitz S, Gaffling S, Pischetsrieder M, Hess A, Manganese-Enhanced Magnetic Resonance Imaging for Mapping of Whole Brain Activity Patterns Associated with the Intake of Snack Food in Ad Libitum Fed Rats. PLoS ONE 2013; 8(2): e55354. https://doi.org/10.1371/journal.pone.0055354

[20]              Institute of Physics Report (2016) The Health of Physics in UK Food Manufacturing (www.iop.org/publications/iop/2016/page_68332.html

[21]              Bows John (2016) Where’s the physics in making the humble potato crisp that we all know and love? (www.iopblog.org/physics-in-food-and-drink-manufacturing-case-study-crisps/

[22]              Forbes (2018) https://www.forbes.com/sites/maggiemcgrath/2018/06/06/worlds-largest-food-and-beverage-companies-2018-anheuser-busch-nestle-and -pepsi-top-the-list/#651471a11b08.

[23]              https://www.gov.uk/government/publications/chief-medical-officer-annual-report-2018-better-health-within-reach, Chapter 1, p15

[24]              Birmingham Food Council (2019) How the UK VAT system identifies vested interests costing us and the earth

[25]              Birmingham Food Council (2019) What does this food sector balance sheet tell us?

[26]              http://www.fooddeserts.org/

[27]              See: Birmingham Food Council (2015) Coca Cola and its effects on us and the city, pp 6-7. In fairness to the current City Council, although the commercial relationships with Coca Cola and Mondelez outlined in this report are still extant, there are some indications that they will not be renewed. It’s worth noting that some of corporate current pracrtices are or will be banned under EU law: https://ec.europa.eu/jrc/en/health-knowledge-gateway/promotion-prevention/other-policies/marketing

[28]              Birmingham Food Council (2015) Food insecurity in Birmingham — a city level response.

[29] Birmingham Forward Steps: Delivering early years health and wellbeing for children aged 0-5.

[30]              Public Health England (2017)  Public Health Briefing: Holiday Kitchen and Public Health Outcomes.

[31]              https://bhamforwardsteps.co.uk/holiday-kitchen/

[32] Birmingham Food Council (2019) What does this food sector balance sheet tell us?, note 11.

[33]              Forbes 2019 ranking: The world's most valuable brands

[34]               The RSPB carried out research across sectors and across the world. We took from their work what was relevant to the food sector in this report:
Birmingham Food Council (2015) What works: Regulation or voluntary schemes in the food sector

[35]              See also Lacy-Nicols  Jennifer, Scrinis Gyorgy, Carey Rachel (2019) The politics of voluntary self-regulation: insights from the development and promotion of the Australian Beverages Council’s Commitment. Public Health Nutrition

[36]              British Retail Consortium submission to the House of Commons Select Committee on the Environment, Farming, Rural Affairs stated their members had reported 79% food supplies coming from the EU:  https://publications.parliament.uk/pa/cm201719/cmpublic/taxation/memo/tctb06.pdf

[37]              House of Lords European Union Committee (May 2018) Brexit: food prices and availability. https://publications.parliament.uk/pa/ld201719/ldselect/ldeucom/129/129.pdf

[38]              See for example, this report of a Morrisons funded project led by Professor Tim Benton: British Food: What role should UK producers have in feeding the UK?

[39] Birmingham Food Council (2019) Global Risks to UK Food Supplies, page 7

[40] Ibid, p 9

[41] http://www.wrap.org.uk/food-drink

[42]              Birmingham Food Council (2018) Food system dynamics: Part III - Vested interests gives an account of how we came to this judgement after conversation with Prof Sir Andy Haines a paper he co-authored: Future Earth—linking research on health and environmental sustainability.

[43]              Designing Urban Food Policies: Concepts and approaches Springer, 2019.

[44]              As illustration, the UK population requires 132,800,000,000 kcal/day to include 332,000,000 portions of fruit and vegetables, assuming the UK population to be 66.4M people, calorie requirement at 2K/day/per person each following Public Health England advice to eat 5-a-day.

[45]              As illustrated by Lord Bilimoria in the House of Lords debate on Brexit: Food prices and availability on 25th April 2019, Hansard columns 759-62.

[46]              For example, there is no up-to-date West Midlands Risk Register and Resilience Plan. The currently published one (2014) states on p17: There are no realistic scenarios within the UK which would lead to a shortage of food supplies: http://foi.west-midlands.police.uk/wp-content/uploads/2014/05/Risk-Register-2014.pdf

[47]              We can no longer find the relevant document for these figures on the FSA website. They are, however, reported on the LeighDay website here: https://www.leighday.co.uk/News/2014/June-2014/Food-Standards-Agency-publishes-latest-figures-on

[48]              For a map of where the laboratories are, see http://www.publicanalyst.com/about_us/the_laboratories/

[49]              Birmingham Food Council (2018) Towards a Birmingham Food Strategy contains three recommendations to improve food safety in the city, applicable to other local authorities. We also made suggested actions for London, where the local government structure is different, on page 6 of Our Response to the draft London Food Strategy (2018)

[50]              Birmingham Food Council (2018) Back from the future: Horizon scanning project report