Public health officials are calling on food sellers and manufacturers to cut calories in their products by 20% by 2024, with big businesses that fail to make progress set to be named and shamed.
Public Health England says the ambitious target would slash costs to the NHS by £4.5bn over 25 years and prevent more than 35,000 premature deaths, with another £4.48bn saved in social care costs.
“We have more obese children in England than ever before – we have one in five children arriving in primary school already obese or overweight and one in three leaving primary school obese or overweight,” said Dr Alison Tedstone, chief nutritionist at PHE, adding that more than 60% of adults are also too heavy. “It is the norm now,” she said.
Tedstone said the cost to the NHS was substantial, with £6.6bn spent every year on obesity-related illnesses.
“It is not an attack on overweight folk,” said Duncan Selbie, chief executive of PHE. But, he said, “Britain needs to go on a diet.”
The latest initiative lays down the gauntlet to big businesses, including manufacturers, supermarkets and high street fast-food outlets. “This is about companies that are providing volume into the market,” said Tedstone.
The move builds on the government’s plan for action on childhood obesity, published in 2016, and follows a recent announcement by the agency that parents should limit their children to no more than two 100-calorie snacks a day.
The new strategy outlines 13 food categories, including savoury biscuits, cooking sauces, sandwiches, ready meals and potato products such as crisps and chips. However, foods in the agency’s separate plan to cut the sugar content of products such as chocolate, cakes and breakfast cereals by 20% are not included.
The team say the sugar and calorie reduction efforts, together with the sugary drinks levy that is set to start next month, affect 50% of children’s overall intake of calories.
Tedstone said food producers have a number of options for meeting the target, including reformulating products, promoting healthy options and reducing portion sizes.
She noted that while the new strategy was aimed at tackling childhood obesity, it would help adults too. “Our children don’t eat special children’s food,” she said. “We buy the same food for our entire family.”
She said PHE would produce guidance for specific categories of products by 2019 for the whole food industry to follow, and report regularly on what steps are being taken by major companies.
“PHE will advise government if progress isn’t being made,” said Tedstone, noting that the government might invoke “other levers” in that case. Selbie added: “There will be complete transparency and published progress or not, by category, by company, by products.”
According to recent figures, more than a third of children in the final year of primary school in England were obese or overweight, with poorer children more likely to be heavy than their wealthier peers.
The new report notes that children are overeating, revealing that overweight and obese boys consume up to 500 excess calories a day while girls who are overweight or obese consume up to 290 excess calories a day. On average, adults were found to consume about 200 calories beyond what is necessary a day.
“500 calories is an extra meal a day – it is a lot,” said Tedstone, adding that the figures were a conservative estimate, since weight does not remain stable with age. “We know that people tend to underestimate the amount of calories they are consuming, and that is a particular problem for obese and overweight people,” she said.
PHE has also said it is extending its “One You” campaign, which encourages individuals to make healthy lifestyle choices, urging adults to be more conscious of the calories in their food.
It suggests adults try to limit the calories of their three main meals to 400 for breakfast and 600 each for lunch and dinner. Selbie noted that the remaining calories of the daily guidelines – 2,000 for women and 2,500 for men – are likely to be made up of snacks and drinks.
Tedstone said major companies including McDonald’s, Subway, Boots and Starbucks were planning to signpost foods using the approach in a bid to help individuals pick products with the desired calorie content.
The new announcements follow PHE’s actions on sugar and on salt – although campaigners noted last year that few foods were on track to meet salt targets – and the government’s own sugary drinks levy.
However the government has been criticised for failing to restrict TV advertisements of junk food to after 9pm.
Susan Jebb, professor of diet and population health at the University of Oxford, supported the latest move by PHE, but said smaller portion sizes were likely to be the most common solution used by the industry and that transparent and rigorous tracking of progress was crucial. While she welcomed raising calorie-awareness, she noted that the recommendation to eat a total of 1,600 calories for main meals was well below daily levels and assumed people were snacking. “Maybe it is better to have a slightly bigger meal and not to snack,” she said.
Professor Francesco Rubino, chair of metabolic and bariatric surgery at King’s College London, said it was positive both that the strategy recognised that action was needed on a national, not just individual, level and that the food industry was engaged.
But he said it was not yet clear that the obesity epidemic is due to calories alone, noting that other chemicals in modern food might be involved and that calorie restriction was most helpful for prevention of obesity.
Another potential problem, said Rubino, is what substances the food industry might use to reduce calories in products: “If you ask the food industry to change their products to reduce calories, you don’t know exactly how they will accomplish that.”