The UK Government needs a plan to fix our broken food system and turn the tide on the public health emergency

November 7, 2024

Rather than blaming individuals for ‘lifestyle choices’, we need to regulate the food industry, argues Frank Hansen.

Of course we’d all like to see reform/abolition of the House of Lords and the establishment of a democratic system. However, one of the ironies of the UK’s system of bourgeois/feudal “democracy” is that on a few occasions the House of Lords may actually come up with proposals which are better researched and much more progressive than the elected Government. In fact, the headline above is the key conclusion from a report, published last month, by the House of Lords Food, Diet and Obesity Committee.

The report, ‘Recipe for health: a plan to fix our broken food system’, finds that obesity and diet-related disease are a public health emergency that afflicts millions and costs society billions each year in healthcare costs and lost productivity. It demands that the Government should develop a comprehensive, integrated long-term strategy to fix our food system, underpinned by a new legislative framework. It is a report that Labour Party members should welcome and demand that the Government implements.

The Committee was formed in response to the steady increase in obesity, type 2 diabetes and other chronic diet-related conditions. For instance, in the UK, two-thirds of us are overweight, and one-third have obesity. Diet-related conditions are an epidemic, cutting millions of lives short. According to leading nutritionist Professor Tim Spector, who submitted evidence: “One of the main drivers of this increase in ill health is the increase in consumption of industrial, ultra-processed foods (UPFs).

“Large-scale studies show that people who eat the most UPFs have an increased risk of type 2 diabetes, obesity, high blood pressure, depression, heart disease, and unhealthy levels of blood fats. We also have evidence from tightly controlled clinical trials that UPFs are linked to increased energy intake – around 500 extra calories per day, coupled with increased hunger.

“Over recent decades, food manufacturers have become experts at producing easy-to-eat, delicious food-like substances that lack beneficial nutrients. With no fibre but masses of sugar, saturated fat and additives, these products play a pivotal role in the health crisis we are currently navigating. The food industry, which only cares about profits, has free rein to create and market these hyper-palatable products that are making us sick. When it comes to UPFs, the UK has some of the weakest standards in Europe. Currently, 60% of the calories we consume in the UK comes from UPFs.”

Health Minister Wes Streeting may recognise the problem, but his ‘solution’ is far from comprehensive, let alone integrated. He appears less concerned about the health of the millions who suffer from diet-related, metabolic health problems and more concerned with productivity and getting ‘obese people’ back to work. No mention of the food industry and its role in the crisis, certainly no mention of regulation.

Apparently his focus, which must be music to the ears of Big Pharma, is to give ‘weight-loss’ jabs, based on the latest generation of drugs, to unemployed people to “help them get back to work”. On the day that Starmer hosted an international investment summit, the Government announced a £279m investment from Lilly, the world’s largest pharmaceutical company to undertake trials in the UK. Streeting added: “The reforms this Government will put in place will open up the NHS to work much more closely with life sciences to develop new, more effective treatments.” Where have we heard that before?!

Unlike the Tories, who shunned ‘nanny state’ intervention, Labour at least recognises that something has to be done to address what is now a national health emergency. But is this the right approach? These are new drugs and the long-term effects are unclear. They are very profitable and costs are high, partly due to rising demand as people seek them out as a ‘quick hack’ for cosmetic as well as health reasons. Do they supply a sustainable solution to weight problems, or do people have to come back to them time and time again?

After all, Big Pharma doesn’t tend to make its monopoly profits from drugs that are ‘one off’ and ‘cure’ people, but from drugs that alleviate symptoms and deliver a long term income stream. There are also ethical issues. Dr Dolly van Tulleken of Cambridge University points out “there are serious financial and efficacy considerations… such as measuring people based on their potential economic value, rather than primarily on their health needs.”

Using these type of drugs may well be part of a more integrated approach, particularly for people who have suffered serious weight-related issues. Currently, the NHS uses bariatric surgery – an operation that makes changes to the digestive system and physically restricts overeating. It is intended for people who need to lose weight, but have not been able to do so through other means. It has proved effective, but is difficult to access on the NHS and has obvious side effects.

However, drugs and surgery should be seen as a last resort not a quick fix for everybody. After all, two-thirds of adults are overweight and an increasing number of children and young people are now affected by diet-related illnesses, including Type 2 Diabetes. Given these numbers, a national integrated approach is needed – currently specialist weight management services only treat 49,000 people a year. A more natural programme of healthy eating could help ease the problem – but we need to define exactly what is ‘healthy’. 

The problem with Wes Streeting’s approach is that he doesn’t really identify the causes of the health crisis, but deals only with quick fixes to tackle its effects. He says that despite the new drugs, individuals still need to remain responsible for taking “healthy living more seriously” as the “NHS can’t be expected to always pick up the tab for unhealthy lifestyles.”

In effect, he blames individuals and the victims for – ‘unhealthy lifestyles’, rather than addressing the real causes – the food we eat, the way it has been industrialised and processed over the past 50 years and the lack of regulation and information over the way it is produced, sold and advertised. This is what has been driving ‘unhealthy lifestyles’, making it very difficult for consumers to make sensible decisions, while delivering excess profits to big food companies, not just in the UK but globally.

In contrast, the House of Lords’ report addresses some of the real causes of the crisis, particularly Government failure to regulate the food industry and its effect on our health.

It notes that “there has been an utter failure to tackle this crisis. Between 1992 and 2020, successive governments proposed nearly 700 wide-ranging policies to tackle obesity in England, but obesity rates have continued to rise. The food industry has strong incentives to produce and sell highly profitable unhealthy products. Voluntary efforts to promote healthier food have failed. Mandatory regulation has to be introduced.”

The report identifies key issues, including the preponderance of sugar, chemicals and UPFs in the food chain and calls for regulation and further research. The proposals may not cover everything, but they provide a solid programme of action with which to start.

The Labour Government needs to have the courage to regulate the food industry, no matter how difficult. If it is done in the right way and combined with community initiatives, involving councils, schools, voluntary groups and local health services, then millions of people will benefit. 

We should lobby for the main recommendations of the report to be adopted by the Government. These are:

• Make large food businesses report on the healthiness of their sales and exclude businesses that derive more than a defined share of sales from less healthy products from any discussions on the formation of policy on food, diet and obesity prevention.
• Give the Food Standards Agency (FSA) independent oversight of the food system.
• Introduce a salt and sugar reformulation tax on food manufacturers, building on the success of the Soft Drinks Industry Levy. The Government should consider how to use the revenue to make healthier food cheaper, particularly for people living with food insecurity.
• Ban the advertising of less healthy food across all media by the end of this Parliament, following the planned 9pm watershed and a ban on paid-for online advertising in October 2025.
• Commission further research into the links between ultra-processed foods (UPFs) and adverse health outcomes and review dietary guidelines to reflect any new evidence. The rapidly growing body of epidemiological evidence showing correlation between consumption of UPFs and poor health outcomes is alarming. Beyond energy and nutrient content, causal links between other properties of UPFs and poor health outcomes have not at the present time been clearly demonstrated. To understand any links, more research is needed.
• Immediately develop an ambitious strategy for maternal and infant nutrition and drive up compliance with the school food standards. This will help break the vicious cycle by which children living with obesity are five times more likely to become adults with obesity.
• Enable auto-enrolment for Healthy Start and free school meals and review the costs and benefits to public health of increasing funding and widening eligibility for both schemes. This is essential to help families living in poverty afford healthy food and to begin closing the gaping inequalities in unhealthy diets and obesity rates.

The main issue that the food industry will resist is the one that will most affect their profits – the regulation of UPFs. At least the Committee has opened up the debate on these, which it describes as “alarming” and called for more research. There is a growing community of scientists and practitioners who are more than willing to accept this challenge. There is also state-of-the-art guidance on healthy eating from Tim Spector’s ZOE organisation and others, which can be accessed free of charge (but not participation) in their app-based programme.

  Frank Hansen is a former Councillor in the London Borough of Brent.

Image: https://www.freemalaysiatoday.com/category/leisure/2024/05/28/study-links-ultra-processed-foods-to-higher-risk-of-early-death/ Licence: Attribution 4.0 International CC BY 4.0