1.1 Food security is the ability of individuals to feed themselves and their families with nutritious and affordable food. Household food security is affected by multiple and complex factors including household income, food prices, costs of other essential services such as housing, and a range of other factors that influence these variables. Due to the fluid nature of these factors, individuals’ household food security can change over time.
1.2 The UK has a high degree of food security, built on access to a range of sources including strong domestic production and imports from other countries.
1.3 While there are existing sources of data on UK food security, it is hard to understand the underlying drivers that affect household food security as there is a lack of comprehensive and regular data. There are no existing sources which give us complete, comprehensive information on an annual basis for the UK as a whole.
1.4 HMG has historically used the Office of National Statistics (ONS) Living Costs and Food Survey (LCFS) to inform our analysis in the UK Food Security Assessment. The LCFS is an official statistic which records household spend on all types of goods and services. The most recent findings reported that, of households in the lowest 20% by equivalised income in the UK, 15.2% of spend went on household food in 2017 compared to 10.6% averaged over all households. The proportion of spend on household food has been relatively consistent over the last 10 years.
1.5 The most recent data published by the Food and Agriculture Organization (FAO) of the UN show an improvement in household food security in the UK from 2014-16 to 2016-18. The latest Food Standards Agency (FSA) data for 2018 shows that over 90% of respondents from the Food and You survey in England, Wales and Northern Ireland reported living in moderate to high food secure households.
1.6 The FSA Food and You survey (England Wales, and NI) has included (in its last two surveys) questions from the US Department of Agriculture (USDA) set on this subject. The Department for Work and Pension (DWP) worked with food security experts, the ONS and the Scottish Government to introduce these new questions into the FRS in April 2019. These new questions follow a well-established and internationally recognised methodology, used in the US Module. The first results will be available in spring 2021 and will provide information on household food security, allowing us to investigate drivers and identify the groups most at risk. The ONS has a requirement to measure food security to monitor the UK’s progress on the UN Sustainable Development Goal 2 (Zero Hunger) and will use this data for that purpose.
1.7 Based on the FRS, the Government also publishes an official measure of material deprivation in the UK. This looks at whether parents can afford 21 goods and services, including daily fresh fruit and vegetables for their children. The percentage of children in low income and material deprivation increased to 12% in 2017/2018, but remains lower than in 2010/11.
1.8 Further, the UK Food Security Assessment is a comprehensive analysis of all aspects of food security, including household food security. It has six themes; Global Food Security; Global Resource Sustainability; UK Availability and Access; UK Supply Chain Resilience; Household Food Security; and Consumer Safety and Confidence. It was last published as a whole document in 2010, however it draws on a wide range of national and international indicators, available in the public domain, which are updated with varying frequency. The Assessment looks in depth at key indicators which we monitor on an ongoing basis. This includes analysis on household food security which has used the annually published LCFS data.
1.9 Future work on the UK Food Security Assessment will take into account additional data sources as they become available and the additional data will facilitate improved analysis of households experiencing insecure and insufficient access to safe and nutritious food because of a lack of money or other resources.
1.10 By taking these actions to address the current data limitations in this area, HMG can be confident that any trends or issues are based on robust evidence - we can then consider the need for and the scope of any new strategy. Having a clear and reliable measure of food security will help the government better understand household food security and those groups most at risk.
2.1 Obesity is one of the top public health challenges for this generation. More than a fifth of children are overweight or obese when they start primary school and this rises to around a third by the time they leave. Evidence shows that children who are obese or overweight are increasingly developing type 2 diabetes and liver problems during childhood. They are more likely to experience bullying, low-esteem and a lower quality of life and they are highly likely to go on to become overweight adults at risk of cancer, heart and liver disease . This represents a huge cost to the health and wellbeing of the individual, the NHS and the wider economy.
2.2 Obesity is a complex problem and the causes, notably dietary, are affected by factors including our environment, behaviour, biology, physiology and our society and culture – and importantly, the interaction of these determinants. These factors can impact upon and make it difficult for people to maintain energy balance and a healthy weight.
2.3 The Government published the third chapter of its childhood obesity plan in July as part of “Advancing our health: prevention in the 2020s”. Chapter 3 sets out further measures to help meet our ambition to halve childhood obesity by 2030 and significantly reduce the gap in obesity between children from the most and least deprived areas by 2030. It builds on the real progress we have made since the publication of chapter 1 in 2016 and chapter 2 in 2018.
2.4 Many of the measures set out in the three chapters of the plan will have an impact on tackling obesity across all age groups. These include the soft drinks industry levy, sugar reduction and wider calorie reformulation programme which will improve our eating habits and reduce the amount of sugar we consume.
2.5 The high prevalence of childhood obesity has been decades in the making. It is going to take time to see results. We all have a lot to gain by tackling obesity and it is vital for us all to work together to achieve this, particularly to support parents, especially in the most deprived families and areas, to help their children have the best start in life. Where progress is not being delivered, we will consider what further action can be taken to help us to achieve what no other country in the world has yet achieved: success in tackling childhood obesity.
3.1 There is no specific evidence of how accessibility to healthy food affects populations living in rural or urban areas differently. In rural areas, there may be a slight tendency to use more locally produced foods, such as through farmers markets, and another factor to consider here is the number of fast food outlets in urban areas compared to rural areas.
3.2 In the Rural Statistical Digest where it compares average weekly household expenditure (excluding mortgage payments) as a percentage of disposable income, there is no difference in spend on food and non-alcoholic beverages (8.2%) between rural and urban areas. It is worth noting, however that when this pattern is broken down further to Rural Village and Rural Hamlet/Isolated Dwellings, this percentage declines to 7.9% and 7.5% respectively. This does not indicate how healthy these food choices are.
3.3 Data shows there is a strong association between deprivation and the density of fast food outlets, with more deprived areas having a higher proportion of fast food outlets per head of population than others. Planning has a role to play here; planning can influence the built environment to improve health and reduce obesity and excess weight in local communities. Local planning authorities can support opportunities for communities to access a wide range of healthier food production and consumption choices. Planning policies and supplementary planning documents can, where justified, seek to limit the proliferation of particular uses where evidence demonstrates this is appropriate, for example fast food outlets.
3.4 The Healthy Places programme was set up in 2013 by Public Health England (PHE), in recognition of the fact that where we live (and the homes we live in) has a big impact on our health and wellbeing. The programme supports the development of healthy places and homes with the aim of ensuring that health inequalities are considered and addressed when planning, developing and improving the built environment. The programme includes a specific focus on fast food takeaways, including data on the density of fast food outlets by local authority in England, and outlines the regulatory and other approaches that can be taken at local level.
3.5 PHE and its partners also developed a toolkit, Encouraging healthier out of home food provision. The toolkit helps local authorities and businesses to provide and promote healthier options for food eaten away from home that reflect the Eatwell guidance and dietary recommendations for children and families.
3.6 The Department for Education (DfE) supports the provision of nutritious food in schools in England to enable pupils to be well nourished, develop healthy eating habits and to concentrate and learn in school. Healthy school food has obvious health benefits and can help to establish healthy eating habits for life, and also helps to improve children’s readiness to learn and their behaviour at school.
3.7 The Government seeks to encourage this through a number of different mechanisms. For example, by providing the legislative framework for the School Food Standards to ensure the provision of healthy school food. The new School Food Standards came into force from January 2015, are mandatory for all maintained schools, and are an explicit requirement in funding agreements for academies and free schools. The standards severely restrict foods high in fat, salt and sugar, including high sugar foods and confectionary and will be updated further next year.
3.8 The Government currently provides free school meals to around 1.3m disadvantaged pupils. To claim a free school meal under the benefits-related criteria, a pupil or their parent must be in receipt of any one of the qualifying benefits. Currently around 15% of the school population are eligible for and claiming a free school meal through this route, with take-up estimated at 89% (based on research conducted in 2013).
3.9 Skipping breakfast has also been shown to lead to poorer overall eating habits and is a recognised contributor to childhood obesity. Research carried out in eight European countries found that children aged 10-12 who skipped breakfast were 80% more likely to be obese. That children learn better when they have eaten breakfast was one of the important arguments of the School Food Plan. In response, the government invested funding to help schools with over 35% of pupils eligible for free school meals to set up self-sustaining breakfast clubs. DfE is now investing up to £26 million in a national breakfast club programme, using funds from Soft Drinks Industry Levy revenues. This money will kick-start or improve breakfast clubs in over 1,700 schools. The focus of these clubs has been to target the most disadvantaged areas of the country to help make sure every child gets the best start in life.
3.10 School holidays can be particular pressure points for some families because of increased costs (such as food and childcare) and reduced incomes (such as loss of a free school meal, reduced working hours etc.). There is a growing body of evidence of a holiday experience gap - with children from disadvantaged families less likely to access organised out-of-school activities; more likely to experience ‘unhealthy holidays’ in terms of nutrition and physical health; and more likely to experience social isolation., The Government is responding to this by investing £9m in summer 2019 in a programme of work in 11 local authority areas to explore ways of supporting children form disadvantaged families to access free holiday activities.
4.1 Where we live has a role to play in tackling childhood obesity and improving diets, whether it is the way our towns and cities are designed to ensure greater active travel or safe physical activity, or how many fast food outlets can operate near schools. Each local authority already has a range of powers to find local solutions to their own level of childhood obesity. But many local authorities are struggling to tackle the complexity of the childhood obesity challenge.
4.2 Challenges vary across local areas, but many local authorities face common issues including: a proliferation of fast food outlets on high streets and near schools; less active travel; limited access to green spaces and physical activity; and unhealthy food marketing dominating many public spaces. These factors create an environment that makes it harder for children and their families to make healthy choices, particularly in some of our most deprived areas.
4.3 The design and use of the built and natural environments, including green infrastructure are major determinants of health and wellbeing. The revised National Planning Policy Framework has a dedicated chapter on ‘Promoting healthy and safe communities’. Planning Practice Guidance has recently been updated to reflect the changes made to the Framework.
4.4 It expects planning policies and decisions to achieve healthy, inclusive and safe places which promote social interaction, are safe and accessible and support healthy lifestyles, especially where this would address identified local health and well-being needs. This can be done through the provision of safe and accessible green infrastructure, sports facilities, local shops, access to healthier food, allotments and layouts that encourage walking and cycling.
4.5 The Government wants to ensure that the places our children live, learn and play are promoting a healthy lifestyle. Through chapter 2 of our childhood obesity plan, we are delivering a Childhood Obesity Trailblazer Programme in partnership with the Local Government Association and PHE, working with local authorities to address childhood obesity at local level. The programme has a focus on inequalities in childhood obesity and is supporting 5 local authorities to take innovative action in their community. It is a priority to encourage and support all local authorities to address this challenge and we will share learning throughout the programme.
4.6 In June, the Department of Health and Social Care (DHSC) announced the 5 successful Childhood Obesity Trailblazer authorities, who together will have access to £1.5 million of funding and support over the next 3 years. The Ministry of Housing, Communities and Local Government (MHCLG) supports this programme and will award the 5 successful authorities £100,000 a year over a 3-year period. They are: Pennine Lancashire Consortium, Birmingham, Bradford, Lewisham and Nottinghamshire. Across the 5 areas, Trailblazer activity will support and create opportunities for future generations, from supporting families and children in the early years through to upskilling adolescents and young adults. Between them, they will test the potential for existing local levers to:
4.7 It is important that the public sector leads by example in creating a healthier food environment on its premises. All central Government departments and their agencies are required to comply with the Government Buying Standards for Food and Catering Services (GBSF), as well as prisons, the armed forces, and the NHS. Schools must follow the school food standards legislation; the school food standards recommend using the nutrition-related standards within the GBSF. The wider public sector is encouraged to apply these standards, including to food and drink offered in vending machines, for example in leisure centres.
4.8 As committed to in chapter 2 of our childhood obesity plan, we have consulted on strengthening the nutrition standards in the GBSF to bring them into line with the latest scientific dietary advice. Once we have had the opportunity to consider the feedback to the consultation, we will publish a response.
4.9 In chapter 3 of the plan we have set out what we can do to support individuals to maintain a healthier weight. This includes a commitment to continue the development of Our Family Health, a digital approach to support families with children aged 4 to 7 years with lifestyle behaviour change. We will work with local authorities to explore how Our Family Health can support families living in some of our most deprived areas with high childhood obesity rates.
4.10 As detailed in question 3, the Government is seeking to promote healthy eating in schools through a number of mechanisms. This includes the School Food Standards, implemented in 2015. Local authorities play an important role in the provision of free school meals, which ensure 1.3m disadvantaged pupils receive a free nutritious meal each day. Most local authorities support the eligibility verification process for schools in their area and have worked hard to increase registration for free school meals over recent years.
4.11 In December 2018 DfE invited organisations (including local authorities) to bid for funding from the Holiday Activities and Food programme to establish Holiday Activity and Food local coordinators in a small number of local authority areas. The coordinator’s role is to fund free holiday club provision for pupils eligible for free school meals and to work with providers to improve the quality, targeting and promotion of this provision. This programme will help show how free provision can be coordinated in different local areas, and it will provide valuable information about what works in supporting this sector.
4.12 The Government will invest £9m in this programme of work in 11 local authority areas. The results of this programme will help show how we coordinate free provision in different areas, and help us decide how best to intervene in the future to explore ways of supporting children from disadvantaged families to access free holiday activities.
4.13 The Government has further implemented a new Healthy Schools Rating Scheme, which provides a way for schools to celebrate the positive actions that they are delivering in terms of healthy living, healthy eating and physical activity. The Scheme will also support schools in identifying further actions that they can take in this area. The voluntary rating scheme, launched in July 2019, is available for both primary and secondary schools. Schools will engage in a self-assessment exercise and will receive their rating based on their responses to questions around food education, compliance with the mandatory school food standards, time spent on PE in school and the promotion of active travel for pupils’ journeys to and from school. We encourage all participating schools to use this scheme to reflect on their future actions, and to share their achievements with parents, pupils and the wider school community.
5.1 This Government remains committed to maintaining a strong welfare safety net, and continues to spend over £95 billion a year on working age welfare benefits for those who need them. Total welfare spending in 2019/20 will be over £220 bn.
5.2 The Government recognises the role that food-aid organisations can play to support vulnerable people in their communities; and has well-established relationships with third-sector bodies to understand their views. The Department for Work and Pensions, for example, meets regularly at both Ministerial and official level with key stakeholders, including the Trussell Trust who operate a network of over 420 food banks across the UK.
5.3 The Trussell Trust publishes biannual statistics on the number of emergency food supplies distributed through their network of food banks; and it has commissioned academics from Heriot-Watt University to carry out a research project, ‘The State of Hunger’, which aims to investigate the drivers of food bank use, including the impact of policy changes on destitution and food insecurity. Full publication of the report is planned for mid-October. The government has no current plans to develop official national statistics on food bank use, or to require individual food banks to keep records, as this would place a significant burden on charitable and voluntary organisations.
5.4 DWP also engages with food banks at a local, operational level and there is long-standing guidance in place which allows staff in Jobcentres to signpost customers in writing to a food bank if all sources of statutory support have been exhausted. However, if a local Jobcentre issues a claimant with a signposting slip, the decision to award a food parcel is that of the food bank. DWP is exploring how a closer working relationship between food banks and Jobcentres can lead to better outcomes for the most vulnerable customers. This may also provide some useful insight of the key issues experienced by food bank users and help to shape future support and policy changes.
6.1 The food and drinks industry have a responsibility to tackle obesity and improve the food and drink we all consume. We have seen many in the industry showing a real willingness to make their food and drink healthier and encourage consumers to make healthier choices and improve their diets. But the challenge to industry to make further substantial progress remains.
6.2 All groups of the population, particularly children, are consuming too much sugar. This increases the risk of excess calorie consumption and weight gain, which, over time, can lead to obesity. With the increasing prevalence of overweight and obesity within the population, it is evident that people are consuming too many calories overall.
6.3 Evidence shows that health inequalities exist in terms of sugar consumption and chronic diseases within the population. The latest National Diet and Nutrition Survey shows that sugar intake for children over the age of 11 years and adults is higher in lower income groups . These groups also have the highest intake of sugary drinks. The National Child Measurement Programme shows that obesity prevalence for children living in the most deprived areas was more than double that of those living in the least deprived areas for both Reception and Year 6. PHE’s National Dental Epidemiology Programme for England 2017 showed that just under a quarter of five-year-olds have tooth decay (23.3%), with children from deprived areas having more than twice the level of decay (34%) than those from the least deprived areas (14%).
6.4 The sugar reduction programme, overseen by PHE, and announced in chapter 1 of the childhood obesity plan, challenges all sectors of the food industry to reduce the level of sugar in foods that contribute the most to children’s intakes (up to the age of 18 years) by 20% by 2020. PHE is also taking forward a calorie reduction programme which challenges the food industry to reduce the number of calories in a range of foods that contribute significantly to children’s calorie intake by 20% by 2024.
6.5 The reduction and reformulation programme is voluntary for industry to take forward. It aims to make foods that contribute the most to sugar and calorie intakes healthier. Reducing sugar and calorie intake has the potential to help reduce inequalities. Free sugars intakes as a percentage of energy decreased with income in adults but not in younger children (under 11 years). Intakes exceeded the maximum recommendation across the range of incomes. It also has substantial public support: a PHE survey found that around 9 in 10 people support the Government working with the food industry to make food healthier. In addition, people believe the greatest responsibility for tackling obesity lies with individuals and families (90%), the food industry (80%) and the Government (72%), underlining a belief in a collective responsibility.
6.6 Data shows that sugar levels in some commercial baby foods and drinks can be very high. We know that 3 in 4 children aged 4 to 18 months have energy intakes that exceed their daily requirements. This figure increases with age following the introduction of solids. Around 9 in 10 children aged 1.5 to 3 years old exceed recommended daily sugar intake levels. Through chapter 3 of the childhood obesity plan we have committed to challenge businesses to improve the nutritional content of commercially available baby food and drinks. PHE will publish guidelines for industry in early 2020.
6.7 Chapter 3 of the childhood obesity plan also sets out our ambition to reduce the population’s salt intakes to 7g per day. Consuming too much salt is associated with high blood pressure, increasing the risk of heart disease and stroke. While our consumption has decreased over the last decade, we are still having too much salt and there is a long way to go. To achieve this, we will publish revised salt reduction targets in 2020 for industry to achieve by mid-2023 and we will report on industry’s progress in 2024. Influencing consumer behaviour through marketing and providing advice, including within the NHS, will also help.
6.8 Evidence from businesses using the front-of-pack colour-coded (‘traffic light’) nutrition labelling scheme, introduced in 2013, suggests that shoppers use the scheme to make healthier choices within categories, for example, ready meals. Businesses also reformulated products according to the traffic light thresholds to make their products healthier.
6.9 We have previously committed in both chapter 1 and chapter 2 of the childhood obesity plan to explore what additional opportunities leaving the European Union presents for front-of-pack food labelling in England. As part of exploring this, in chapter 3 of the plan we announced that we will consult by the end of 2019 on how we can build on the successes of our current front-of-pack nutritional labelling scheme once we have left the European Union. Our consultation will consider the evidence underpinning the many different forms of front-of-pack labelling. It will focus on ensuring that the UK continues to be world-leading in providing UK shoppers with simple nutritional information that they need to make healthier decisions, while taking into account the UK’s ambitions for trade once we have left the European Union.
6.10 Chapter 3 of the plan also commits us to explore how we can improve the marketing and labelling of infant food. This is so that parents and carers have honest and accurate information on the products they feed their babies at this critical stage of life.
7.1 Our food environment is constantly evolving and offers a growing range of choices of what to eat and when to eat. This supports a thriving food and drink industry, full of innovation and culinary adventure. Maintaining this choice is important, but it is also important to help children and their parents to navigate this environment and be able to easily identify healthy options.
7.2 The Government is concerned that despite strict restrictions across TV and online, children remain exposed to significant levels of high fat, salt and sugar (HFSS) advertising across the media they enjoy the most. This is a concern as evidence suggests that exposure to HFSS advertising can affect what and when children eat, both in the short term and in the longer term by shaping children’s food preferences from a young age. Over time, eating more than they need can lead to children becoming overweight or obese which is putting their future health at risk.
7.3 We know the location of products within stores can affect what products we buy. HFSS food and drink are more likely to be promoted in key selling locations in stores compared to other products. This can influence our food preferences and purchases, leading us to consume more sugar, fat and calories. For example, end of aisle displays can increase sales of soft drinks by over 50%. Children are even more vulnerable to these promotions. This can then lead to ‘pester power’ and affect what products parents buy. Products that are only meant to be consumed in moderation are displayed prominently in stores and this encourages us to consume more of them on a regular basis. This regular overconsumption can lead to excess weight gain over time fuelling the childhood obesity epidemic.
7.4 Alongside this, there is academic evidence that price promotions in stores are effective at influencing food preferences and purchases. Price promotions appeal to people from all socio-economic groups and although they appear to be mechanisms to help consumers save money, data shows that they increase consumer spending by encouraging people to buy more than they intended to buy in the first place.
7.5 Promotions on food and drink in the UK reached record levels in 2015 and were the highest in Europe, with 40% of the food and drink people purchased being on promotion. Data shows that in store promotions tend to be skewed towards HFSS products as these are more likely to be promoted. Evidence also shows that volume promotions (such as multibuy offers i.e. buy one get one free) cause a greater sales uplift compared to other types of price promotions such as simple price reductions. Volume promotions increase the amount of food and drink people buy by around 20%. Consumers typically do not stockpile these extra purchases to take advantage of the lower price; instead they increase their consumption.
7.6 As part of delivering the key measures outlined in chapter 2 of the childhood obesity plan, we have held consultations on restricting promotions of HFSS products by location and by price, and further advertising restrictions including a 9pm watershed on TV and similar protection online as well as other possible options. The consultations closed recently and received a high level of interest. It is important we take the time to consider the feedback carefully. We will be setting out our responses and next steps as soon as possible.
7.7 The use of licensed characters and celebrities popular with children to promote HFSS products are already subject to restriction as part of the Advertising Codes. Here advertisers must show a due sense of responsibility and are not allowed to use these marketing techniques when directly targeting HFSS product advertisements at pre-school or primary school children. There are no current plans to place a ban on using brand equity and licensed characters, cartoon characters and celebrities to promote HFSS products.
7.8 The National Institute for Health Research Obesity Policy Research Unit, which was established as part of chapter 1 of the childhood obesity plan through £5 million investment over 5 years, will continue to review the evidence base around the effect of marketing and advertising on children, including the use of brand equity and licensed characters, cartoon characters and celebrities to promote HFSS products.
8.1 Encouraging healthy and sustainable diets is a complex issue which the Government cannot tackle alone. Businesses, health professionals, schools, local authorities, families and individuals all have a role to play. We want to see the food industry using their world-leading talents to help all people find the healthier choice the easier choice.
8.2 We have seen some important successes since the publication of chapter 1 of the childhood obesity plan, including over half of all drinks in scope of the soft drinks industry levy being reformulated, the equivalent of removing 45 million kg of sugar every year. Some products in the sugar reduction programme are exceeding their first year targets, for example yoghurts are achieving a 6% reduction in sugar. We have also seen an increasing consumer demand for healthier food and drink as a result of the sugar reduction programme. We are continuing to monitor the impact of the soft drinks industry levy to ensure our approach is informed by the evidence.
8.3 The Government will produce a Food Strategy, shaped by an Independent Review. This review is led by Henry Dimbleby, Defra’s lead Non-Executive Director, and will make recommendations on how the entire food system can optimise its contribution to public health, environmental sustainability and economic wellbeing. The Government intends to respond to the Review’s report with a White Paper within six months of its publication.
8.4 The industry is also exploring opportunities through the Food and Drink Sector Council which represents the entire farm to fork food chain, covering farming, manufacturing, retail, hospitality and logistics. The Sector Council seeks to boost the UK’s productivity, GVA and secure the UK’s position as a global leader in affordable, safe, sustainable and high-quality food and drink through industry-led action and by strengthening partnerships between Government and industry. The Council is supported by a series of working groups including on nutrition and innovation. These look to identify key issues, develop industry led approaches and solutions and strengthen partnership working with Government
9.1 It is worth noting that self-sufficiency is not in itself an indicator of food security. Achieving increased self-sufficiency in indigenous products would not insulate us from shocks to the system – for example, weather and disease can affect the harvests and yields.
9.2 The UK has a high degree of food security, where UK consumers have access to a range of sources of food. UK food supply is highly resilient and built on robust supply chains with access to a range of sources including strong domestic production and imports from other countries. The UK's current production to supply ratio is 75% for indigenous-type foods and 60% for all foods.
9.3 A related measure to production/supply ratio is the origins of domestic consumption. This is a breakdown of where the supply of food consumers actually eat comes from. In 2017, 50% of UK supply was home produced, 30% came from the EU and 20% from the rest of the world. This has remained steady over the last decade and is not low in the context of the past 150 years.
9.4 Horticulture production in the UK provides a valuable part of a healthy diet in the UK through products such as home grown fruits (such as apples, pears, strawberries) and home grown vegetables (cabbage, broccoli, carrots). In England horticulture accounts for 2% of the utilised agricultural area.
9.5 These growers in 2018 ensured that we had 53% of home produced marketed vegetables. Whilst this was down on 2017 figures, this is likely due to the challenging weather conditions faced during 2018 for vegetable growers, highlighting the fragility of vegetable production in the UK. Access to other markets through imports is key to ensure year round supply of the vegetables that are enjoyed by UK consumers.
9.6 UK growers increased the home produced marketed fruit from 16.4% to 16.7% in 2018. Home produced apples are a particular success story, with home produced apples increasing their share of the market to 45% in 2018 from 33% in 2017.
9.7 There is potential that the UK could increase its home produced marketed share and it is likely that the industry would be keen to do this. However, the requirement for imports should not be underestimated, given consumer demand for year round supply. In addition, there are a number of products that cannot be grown on a commercial scale in the UK that would need to be imported, for example bananas and citrus fruits.
9.8 The Government recognises the scope to further improve productivity in the agriculture sector. Industry is well placed to consider and implement farm efficiencies. To improve UK productivity, our priority is a productive, competitive farming sector supporting farmers to provide more home-grown, healthy produce made to high environmental and animal welfare standards. We will develop policies to support farmers to improve productivity sustainably and in a way that also improves our air, water, soil, and biodiversity, whilst also tackling climate change.
9.9 We are facing a new technological revolution which presents huge opportunities driven by advances in AI, big data and robotics to increase productivity as well as improve soil health, animal welfare, nutrition, and resilience to pests and disease. Research and development (R&D) and technological innovation is key if we are to compete globally. It can unlock the potential of farming by improving productivity. By pioneering the use of more innovative and efficient farming techniques we can also use our resources more sustainably and reduce environmental impact.
9.10 The UK has world-leading and world-renowned institutes and universities, dynamic and forward-thinking farmers and impressive entrepreneurs whose “disrupter” approaches put us in a good position to lead the way.
9.11 The Government is building on the 2013 £160million Agri-Tech Strategy investment which unlocked a new phase of agri-tech development, with support for innovative R&D to increase agricultural productivity and reduce environmental impacts from food production. The Industrial Strategy Clean Growth challenge is supporting programmes to stimulate the development, manufacture and use of low carbon technologies, systems and services. The £90M ‘Transforming Food Production’ Challenge Fund is one of these programmes and is focused on precision agriculture. Its objectives are to improve the productivity of the sector by transforming agriculture, meeting the needs of a growing population, providing cleaner systems for agriculture, reducing those costs associated with, and through, reducing use of carbon-based inputs as well as generating GVA opportunities for those businesses producing precision technologies and services. In doing so, the programme also aims to support the industry to reduce waste and to move towards net-zero emissions. These industry-led proposals will address end user needs and ensure that new and exciting innovations are commercially viable.
9.12 The Government’s new Environmental Land Management (ELM) scheme is the cornerstone of our new agricultural policy. Founded on the principle of “public money for public goods”, ELM is intended to provide a powerful vehicle for achieving the goals of the 25 Year Environment Plan and commitment to net zero carbon, while supporting our rural economy. Land managers will be paid for delivering the following public environmental goods set out in the 25 Year Environment Plan: clean air; clean and plentiful water; thriving plants and wildlife; protection from and mitigation of environmental hazards; beauty, heritage and engagement; mitigation of and adaptation to climate change. We are working closely with a range of environmental and agricultural stakeholders to collaboratively design the new scheme, and promote the important role of the agricultural community in delivering environmental public goods.
9.13 Leaving the EU provides an opportunity to develop new ambitious R&D proposals as part of our new policy for agriculture, which will boost sustainable innovation in agriculture and build on existing programmes to develop new technologies that could offer step changes in production efficiency. During the transition, we also intend to support farmers to invest in equipment, technology and infrastructure to help to improve their productivity, as well as deliver environmental benefits. These activities will encourage uptake of precision techniques and practices which could contribute to achieving the net zero carbon target.
9.14 Improvements in agricultural practice mean that we are producing pork with 36% less emissions compared to 1990. Efficiency gains in dairy farming mean that we are now producing 9% more milk than we were in 2000 with 18% fewer cows, and 7% less greenhouse gas emissions.
9.15 Defra takes a key role in supporting emissions reduction by providing scientific advice and evidence. This includes long term breeding work to develop more efficient crops and livestock, as well as research on more efficient feeding strategies for livestock. In 2018, Defra commissioned research with Scotland’s Rural College into greenhouse gas mitigation options in agriculture, addressing existing knowledge gaps.
10.1 Food security and poor dietary health have multiple and complex causes and we have set out in the response to Question 1 the work underway to better understand the causes of food security. Farming productivity plays a role in terms of ensuring a productive sector that is able to provide healthy homegrown produce to consumers. But alongside this we need to ensure that there is demand for these products from consumers. Where that demand exists and increases we need to ensure our domestic sector is able to capitalise on this increased demand.
10.2 Improvements to environmentally sustainable farming productivity can improve the amount of food and other crops produced from land and help to ensure a competitive, profitable farming sector. The UK government is supporting improvements to farming productivity, for example through Countryside Productivity grants and support for innovation and R&D.
10.3 Technological innovation can unlock the potential of farming by improving productivity and tackling problems such as pests and disease. Innovation and science is key to this, and the UK has a world class science base to draw on. For example, Defra is currently supporting work seeking to develop Integrated Pest Management (IPM) of root-feeding fly larvae infesting outdoor vegetable crops. A better understanding of pest and natural enemy phenology, together with refinement of existing monitoring and forecasting approaches, can lead to development of novel methods of control, so reducing the reliance upon agrochemicals. Furthermore, our Crop Genetic Improvement networks are improving crop resilience to pests and diseases to help reduce reliance on agrochemical inputs.
10.4 Crop disease and pest management is just one example of an issue which raises a number of challenges and which innovative technology can help to tackle. Defra is further developing an innovation R&D package to boost sustainable productivity in agriculture as we leave the EU’s Common Agricultural Policy (CAP). The package will provide industry co-funded opportunities to develop new technologies that could offer step changes in production efficiency.
10.5 Through these new R&D funding schemes we will facilitate enhanced collaboration, and pioneer the use of more innovative and efficient farming techniques, such as automation. We will support farmers to work in partnership with our leading research organisations to carry out research projects and to trial new approaches.
10.6 As we noted in the response to question 9, the agriculture sector is one of the big beneficiaries from the Industrial Strategy, with a £90 million public investment in “Transforming Food Production”, which aims to support the development and use of precision agricultural technologies that boost the efficiency and productivity of UK agricultural systems
10.7 Through the Transforming Food Production programme, £90M will be invested over four years to support the rapid development and adoption of novel advanced precision agricultural technologies and solutions that will enable optimum use of resources (e.g. water, nutrients, crop protection products, antibiotics) and more effective decision making.
10.8 An increase in productivity through initiatives such as the above could lead to the increase in horticulture production in the UK, which provides a valuable part of a healthy diet through products such as home grown fruits and vegetables.
10.9 Improvements to production will enable a greater supply of sustainable, healthier food choices. However, demand for these products needs to match supply. The Government advocates a healthy balanced diet, based on the nutritional food model the Eatwell Guide. The Guide depicts a diet that is based on fruit, vegetables and higher fibre starchy carbohydrates. The Carbon Trust conducted a sustainability assessment of the Eatwell Guide when it was launched in 2016. The analysis shows an appreciably lower environmental impact than the current UK diet. A study looking at the cost of achieving a diet in line with the Eatwell Guide concluded that although achieving this would require large changes to the current average diet; these changes would not lead to significant changes in the price of the diet.
11.1 In the UK an estimated 10.2 million tonnes of food and drink are wasted annually after the farm gate, worth around £20 billion. The UK has long recognised the need to tackle food waste, and is an international leader on the issue. Since 2007, we have approached the problem from numerous angles, including through a series of voluntary agreements that have reduced per capita food waste by 14%.
11.2 The Waste and Resources Action Programme (WRAP), supported by Defra, launched the Courtauld Commitment 2025 in March 2016. This is an ambitious voluntary agreement that brings together organisations across the food system – from producer to consumer – to make food and drink production and consumption more sustainable. The main target is a 20% per capita reduction in food and drink waste arising in the UK.
11.3 We are also fully committed to meeting the UN Sustainable Development Goal 12.3 target, which seeks to halve global food waste at consumer and retail levels by 2030.
11.4 Our determination to cut food waste has not been matched by progress, which in recent years has plateaued. A new approach was outlined in the Resources and Waste Strategy, published in December 2018.
11.5 The Government‘s Resources and Waste Strategy sets out a new approach to address food waste from farm to fork. The food waste chapter sets out how the government will:
11.6 In October 2018, the Secretary of State announced a £15m fund for 2019/20 to support the further redistribution of surplus food and reduce food waste. Over £4 million of the £15m fund has already been awarded. WRAP has also launched further grant opportunities for redistributors to bid for infrastructure projects that will help address barriers in the sector to reduce food waste, with further projects currently being scoped.
11.7 Philanthropist Ben Elliot, has been appointed as the UK Governments Food Surplus and Waste Champion and tasked with setting an ambitious direction to cut food waste from all sources, by working with businesses and other stakeholders from across retail, food manufacture, hospitality and food services.
11.8 The Step up to the Plate event was held on the 13 May 2019, hosted by Ben Elliot at the V&A, to raise the profile of food waste. Attendees were asked to sign the Step up to the Plate Pledge. The Pledge commitments are a mix of actions for organisations and individuals: to measure food waste and set reduction targets, to support reducing citizen food waste and to act as a leader to reduce other peoples and their own food waste.
11.9 Through the Pledge, signatories have agreed to support a week of action, the Food Conversation Week, planned for November 2019. The Food Conversation Week will focus on citizen food waste, facilitated through partner work with Pledge signatories, Defra and WRAP announcements and media amplification of the issue.
12.1 The Government needs to take a balanced approach to improving diets, considering the steps we can take to create a fair food environment that does not drive excess consumption and which makes the healthy choice the easy choice; whilst ensuring parents are able to choose what food they feed their families and have access to affordable healthy food options.
12.2 There have been some important successes since the publication of chapter 1 of the childhood obesity plan, including over half of all drinks in scope of the soft drinks industry levy being reformulated, the equivalent of removing 45 million kg of sugar every year. Some products in the sugar reduction programme are exceeding their first year targets, for example yoghurts are achieving a 6% reduction in sugar, and significant investments are being made in schools to promote physical activity and healthy eating.
12.3 As part of delivering key measures outlined in chapter 2 of the childhood obesity plan, DHSC have held consultations on ending the sale of energy drinks to children, calorie labelling in the out-of-home sector, restricting promotions of fatty and sugary foods by location and by price, further advertising restrictions including a 9pm watershed on TV and similar protection online, and Government Buying Standards for Food and Catering Services. The Government has received a high level of responses to the consultations and it is important we take the time to consider them carefully; it will be setting out its responses and next steps as soon as possible.
12.4 Public food procurement covers the purchase of food and the purchase of catering services (covering aspects such as staff and facilities) by the public sector. This broadly covers sectors such as hospitals, care homes, schools, prisons and defence as well as catering facilities in Government Departments and their Agencies.
12.5 The public food procurement landscape is complex and the Government will have varying levels of direct influence. There are a multitude of businesses operating and menu creation is often dictated by caterers, customer demand or requirements and budgets. Whilst the Government does not specify diets, current public procurement policy does aim to encourage more balanced diets via guidance documents. For example nutritional standards based on PHE guidance for intake levels of salt, saturated fat and portions of fruit, vegetables and fish.
12.6 In relation to the use of public procurement to improve dietary behaviours, there is the potential for the Government to consider stronger policy tools to encourage behaviour change, such as prescriptive regulation outlining menus options. However changes to current rules needs careful consideration, as hospital patients, primary school children and army personnel will have very different nutritional requirements. There is also the issue of commercial viability of catering operations if menus do not match customer demand. For example, if canteens replace chips with boiled potatoes to reduce salt and fat intake, staff and visitors could purchase chips from external vendors, potentially resulting in food wastage and loss of profit.
12.7 However, despite these difficulties, the Government is taking steps to use public procurement to effect dietary change. The Government Buying Standards for Food and Catering Services (GBSF) were introduced in 2011 as a means of meeting the Greening Government Commitments when buying and providing food and catering services. The wider public sector is encouraged to apply these standards, including to food and drink offered in vending machines. PHE actively encourages and supports the adoption of GBSF as a baseline standard across the wider public sector and beyond. This enables healthier more sustainable food and drink options to be made available across a range of settings (for example in healthcare settings and in leisure centre vending machines).
12.8 Healthy diets are partly established by accessing healthy school food, as this can help form healthy eating habits for life. DfE has already done a lot to improve school food: many school canteens are unrecognisable from those 20 to 30 years ago. The School Food Plan, published in July 2013, has helped bring about whole school improvements in food; and the School Food Standards have been widely welcomed.
12.9 Cooking and nutrition is included in the curriculum as part of design and technology and is compulsory in maintained schools from Key Stages 1 to 3. We have also introduced a new food preparation and nutrition GCSE for those Key Stage 4 pupils interested in studying this subject further. Health education will be compulsory in all state-funded schools from September 2020. As part of this, pupils will be taught the benefits of an active and healthy lifestyle.
12.10 £100m of revenue generated from the Soft Drinks Industry Levy is being used for the Healthy Pupils Capital Fund (HPCF). This one-year fund is intended to improve children’s and young people’s physical and mental health by enhancing access to facilities for physical activity, healthy eating, mental health and wellbeing and medical conditions. These facilities include kitchens, dining facilities, changing rooms, playgrounds and sports facilities.
12.11 DfE’s Holiday Activity and Food programme aims to ensure that disadvantaged children can access healthy food outside of school times and that they remain active throughout the holidays. Clubs in the programme are required to meet a minimum set of standards, including that: the food they offer meets School Food Standards; the programme includes an element of nutritional education each day; and they provide activities which meet the current physical activity guidelines. By participating in this programme, it is hoped that children attending will eat more healthily and be more active over the summer holidays, and that they will gain greater knowledge of health and nutrition. DfE’s evaluation of this programme will help shape how we coordinate free provision in different areas, and help us decide how best to intervene in the future.
13.1 The UK’s main public sector funders of food-related research work together to coordinate research and innovation on Food Security through the multi-agency Global Food Security Programme (GFS). Research coordination through the GFS is a key part of informing UK activity at an international level through participation in European Joint Programming Initiatives, such as that for Agriculture, Food Security and Climate Change (JPI-FACCE). Partners and affiliates of the GFS programme include government departments and Research Councils.
13.2 The GFS programme strives to meet the global challenge of providing the world’s growing population with access to environmentally, economically and socially sustainable, safe, affordable and nutritious diets. As part of this, GFS administer a 5 year £14.5M research programme focussing on three overlapping themes:
13.3 The most recent UK Food Security Assessment was published in 2009. This describes the framework and indicators the Government uses to analyse food security in the UK. The assessment is currently being updated.
13.4 The FSA’s Food and You survey reported in 2017 on food security in England, Wales and Northern Ireland. This indicated the majority of respondents (79%) lived in highly food secure households (13% marginally insecure, and 8% food insecure). However there was substantial variability across groups. For example, 23% of those in lowest income quartile households lived in food insecure households, compared to 3% in the highest quartile.
13.5 Evidence underpinning the global links between food, health and sustainability is described in the EAT-Lancet Commission which reported in 2019. The report recognises the global human health burden associated with unhealthy diets, and the sustainability challenges associated with food production.
13.6 Research on poverty, food security, health inequalities and the sustainability of food production and the links between them is a cross-government agenda. DHSC invests in high quality research to improve health through the National Institute for Health Research (NIHR). This research includes the broad area of food policy, such as:
13.7 Public Health Research programme. The programme is concerned with improving public health and reducing health inequalities and it serves stakeholders including national and local decision-makers. An example of a relevant study is a rapid review that was published in November 2018 ‘Child food insecurity in the UK: evidence on its extent, nature and effects and what can be done to address it’. The report suggests an urgent requirement for the development of a reliable instrument to measure and monitor child food security in the UK and for well-designed interventions or programmes to tackle child food security issues.
13.8 Policy Research Programme (PRP). The programme supports the Secretary of State for Health and Social Care, Ministers and Senior Officials in the department and its Arm’s Length Bodies. The PRP funds a series of Policy Research Units (PRUs) which are consortia, typically based in universities, with experts in priority policy topics.
13.9 The Obesity PRU, established in 2017, is building the evidence base to help reduce the prevalence and burden of obesity and has several work strands. A particularly relevant area is exploring opportunities to reduce inequalities in obesity through supportive food provisioning environments. An abstract on provisioning in areas of deprivation concludes “Attempts to address obesity through altering food environments must take into account the contexts and expectations of individuals as they enter into those environments. It is critical to focus policies and interventions so that peoples’ broader needs are met, while also increasing the physical, financial, and cultural accessibility of more nutritious foods”.
13.10 The Public Health PRU (founded in 2005 as the Public Health Research Consortium) aims to strengthen the evidence base for interventions to improve health, with a strong emphasis on tackling socioeconomic inequalities in health. An example of a relevant study is an investigation of the clustering and co-occurrence of multiple risk behaviours including diet, published in 2016. The study found potential for intervening at the social or environmental level due to the strong association with socio-economic status and clustering of different risk behaviours.
13.11 School for Public Health Research. The School Public Health Research (SPHR) was established in April 2012 and is a partnership between eight leading academic centres with excellence in applied public health. The SPHR aims to support practitioners and policy makers to engage with research, and actively seek out high quality research evidence to inform their decisions, and its work includes food and inequalities. One of the current themes of the School’s research programme is ‘Efficient and equitable public health systems’, and a relevant component of this theme is ‘Shaping a healthier food environment’. Work is underway to consider, for example, how local authorities and the public can use existing policy levers more effectively to form a healthier food environment.
13.12 Other. The NIHR has also contributed funding to support other research initiatives that have carried out relevant research relating to the topics of the inquiry e.g. the UKCRC Centres of Excellence in Public Health, including:
13.13 The Government’s National Food Strategy includes an independent review, which will consider how the UK’s food sector currently operates, and will set out the options for adjusting government policies to achieve the objectives of the strategy. This review will be evidence based, and includes a Call for Evidence, launched on 17 August. The strategy will carry out an integrated analysis of our food system, looking across the issues of food security, climate change and health to develop a series of recommendations for Government. The strategy is outlined in more detail in question 15.
14.1 As members of the Global Food Security programme, public funders work both nationally and with other countries to build international collaborations and knowledge exchange opportunities to address food policy challenges.
14.2 With its recognised strength in world class science, innovation and interdisciplinary research, the UK is well placed to be the global partner of choice. This will create new opportunities for international trade and enable inward investment through collaborative, interdisciplinary research and development.
14.3 International partnerships include the Sustainable International Temperate Agriculture Network, The Global Research Alliance on Agricultural Greenhouse Gases, partnerships with China, Canada and India; as well as collaboration with European countries via European Commission programmes such as Horizon 2020 and the Joint Programming Initiatives on ‘Agriculture, Food Security and Climate Change’ (FACCE-JPI) and ‘A Healthy Diet For A Healthy Life’.
14.4 The Environmental Audit Committee published the report ‘Sustainable Development Goals [SDG] in the UK follow-up: Hunger, malnutrition and food insecurity in the UK’ on 8 January. This reviews progress towards achieving the Sustainable Development Goals.
14.5 As well as participating in international programmes, the Government is learning from initiatives that work in other countries. For example, Amsterdam’s Healthy Weight Programme is aiming to end its obesity epidemic through a radical and wide-reaching programme. The programme appears to be succeeding by hitting multiple targets at the same time – from promoting tap water to after-school activities. Between 2012 and 2015 the number of overweight and obese children (aged 2 to 18) dropped by 12%, the biggest fall was amongst the lowest socio-economic groups. In absolute terms there are 2,500 fewer overweight or obese children between 2012-2015. We want to make sure that all local authorities are empowered and confident in finding what works for them, whilst learning from local authorities both here and international examples such as Amsterdam that are tackling the problem.
14.6 Through chapter 2 of our childhood obesity plan, we are delivering a Childhood Obesity Trailblazer Programme in partnership with the Local Government Association and Public Health England, working with local authorities to address childhood obesity at local level.
14.7 The Independent Review into the National Food Strategy launched its Call for Evidence on 17 August 2019 and will run until 25 October 2019. The Independent Review will be examining best practice in other countries and the Call for Evidence asks for examples of what works well in other countries and could be replicated in the UK . The Strategy is detailed further in question 15.
15.1 Defra recognises that we face a number of challenges across the food system, including food security, health and climate change. The UK food supply and food security faces multiple challenges, including the impacts of intensive farming, population growth, mass migration, re-emerging trade barriers and health dangers from anti-microbial resistance. Furthermore, obesity is a big issue in England. Nearly two-thirds of adults (63%) in England were classed as being overweight (a body mass index of over 25) or obese (a BMI of over 30) in 2015. The proportion who were categorised as obese increased from 13.2% of men in 1993 to 26.9% in 2015 and from 16.4% of women in 1993 to 26.8% in 2015. The rate of increase has slowed down since 2001, although the trend is still upwards. Obesity is particularly an issue for poorer communities and young people.
15.2 In response to these challenges, Defra has commissioned its lead Non-Executive Director, Henry Dimbleby, to lead an Independent Review to develop a series of recommendations that will help shape a National Food Strategy.
15.3 The National Food Strategy will cover the entire food chain from field to fork, building on work already underway in the Agriculture Bill, the Environment Bill, the Fisheries Bill and the Childhood Obesity plan. The scope will be England, but the strategy will consider our relationships with the devolved administrations, the European Union and our other trading partners. It will focus on five policy pillars: health, environment, food security, agriculture, and the economy. Its aim is to help ensure that our food system delivers healthy and affordable food and is built upon a resilient and sustainable agriculture sector. The review is working across Government with all major departments involved.
15.4 The objectives of the Strategy is to create a food system that:
15.5 The Independent Review has launched a Call for Evidence on 17 August 2019, due to close 25 October 2019. It will publish an interim report by end of 2019, with its final review due to be published in summer 2020. The Government has committed to publishing a White Paper in response within six months of the review being published.
15.6 DHSC published the third chapter of the childhood obesity plan in July as part of “Advancing our health: prevention in the 2020s”. Chapter 3 sets out further measures to help meet our ambition to halve childhood obesity by 2030 and significantly reduce the gap in obesity between children from the most and least deprived areas by 2030 including bold action on infant feeding, clear nutrition labelling, food reformulation to improve the nutritional content of infant foods, and support for individuals to achieve and maintain a healthier weight.
15.7 Taken together, the actions in chapter 3 alongside the ones we already have in place, are world-leading. However, we remain committed to reviewing what more can be done to make sure we meet our ambition of halving childhood obesity by 2030 and will continue to monitor progress and emerging evidence carefully.
15.8 As part of this process, the Secretary of State for Health and Social Care has commissioned the Chief Medical Officer (CMO) to undertake an independent review that should set out what more the Government will need to do to meet its 2030 target. To that end the CMO will produce written advice and recommendations on further measures to reduce the rate of childhood obesity in England. The independent report – which is not government policy – will then be considered by the Government.
18 September 2019
 For 2016/17 % of farm businesses which are processing/retailing farm produce in Severely Disadvantaged Areas are 5%, as opposed to non-SDAs which are 9%
Defra, (2019), Statistical Digest of Rural England, pg 142. Accessed at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/818295/07_Statistical_Digest_of_Rural_England_2019_July_edition.pdf
 A list of references for the evidence on how food affects behaviour, attainment and health is provided in the Annex C of the School Food Plan
 Full details of permitted food groups is available in the School Food Standards, a summary of the standards and a practical guide are available from the School Food Plan website
 Vik, F. N., Bjørnarå, H. G., Øverby, N. C., Lien, N., Androutsos, O., Maes, L., Jan, N., Kovacs, E., Moreno, L. A., Dössegger, A., Manios, Y., Brug , J., and Bere, E., 2012. Associations between eating meals, watching TV while eating meals and weight status among children, ages 10–12 years in eight European countries: the ENERGY cross-sectional study. International Journal of Behavioral Nutrition and Physical Activity, 10, 58. http://ijbnpa.biomedcentral.com/articles/10.1186/1479-5868-10-58#Tab2
 The Sutton Trust, 2014. Extra-curricular Inequality Research Brief; Cullinane and Montacute, 2017. Life Lessons: Improving essential life skills for young people, The Sutton Trust
 Kellogg’s, 2015; Mann, S., Wade., M., Sandercock, G., and Beedie, C. (2017). The impact of summer holidays and school deprivation index upon cardiorespiratory levels in primary school children. Presented at European College of Sports Science, Essen, Germany
 Gill and Sharma, 2004. Food poverty in the school holidays, Barnardos
 Kellogg's Foundation, 2015. Isolation and Hunger: the reality of the school holidays for struggling famil, s, s.l.: Kellogg's
 The Trussell Trust. (2019). The State of Hunger Introduction to a Study of Poverty and Food Insecurity in the UK. Available at: https://www.trusselltrust.org/wp-content/uploads/sites/2/2019/06/SoH-Interim-Report-Final-2.pdf [accessed 22 Aug 2019]
 Meat products, pizza, food on the go, crisps and savoury snacks, potato products, cooking sauces and pastes, table sauces and dressings, pasta, rice and noodles, ready meals, prepared dips and salads and processed fish, poultry and red meat and pork, and meat alternatives
 ‘Free sugars’ comprises all monosaccharides* and disaccharides* added to foods by the manufacturer, cook or consumer, plus sugars naturally present in honey, syrups and unsweetened fruit juices. Under this definition lactose (the sugar in milk) when naturally present in milk and milk products and the sugars contained within the cellular structure of foods (particularly fruits and vegetables) are excluded.
*Monosaccharides are single sugar units (glucose and fructose) and disaccharides are two single units joined together (sucrose).
 PHE survey: https://www.gov.uk/government/news/overwhelming-public-support-for-sugar-and-calorie-reduction; and Ipsos Mori survey: https://www.ipsos.com/ipsos-mori/en-uk/public-perceptions-and-awareness-public-health-englands-reduction-programmes
 Cairns G, Angus K, Hastings G. (2009).The extent, nature and effects of food promotion to children: a review of the evidence to December 2008. World Health Organization, WHO Press
 Sales impact of displaying alcoholic and non-alcoholic beverages in end-of-aisle locations: An observational study, Nakamura et al, Social Science & Medicine 2014
 Chandon P, Wansink B. 2002. When are stockpiled products consumed faster? A convenience-salience framework of post-purchase consumption incidence and quantity. J. Mark. Res. 39:321–35
 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/770704/consultation-on-restricting-price-promotions-of-HFSS-products.pdf, pg. 6
 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/770704/consultation-on-restricting-price-promotions-of-HFSS-products.pdf, pg. 6
 Willett et al, 2019. Food in the Anthropocene: the EAT-Lancet Commission on healthy diets from sustainable food systems. The Lancet. 393 447-492 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31788-4/fulltext