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Scientists comment on a report by the House of Lords Food Diet and Obesity Committee.
Prof Martin Warren, Interim Director, Quadram Institute, said:
“We welcome the House of Lords’ Food, Diet and Obesity Committee report. As the report highlights, food, diet and obesity are not only a public health crisis but also a major economic problem. Poor diet and health are not only hampering the life chances of many, but also costing the NHS and the wider economy billions of pounds every year.
“Over recent decades we have seen the proliferation of energy dense food which is lacking in key nutrients. As a nation, we need to focus on producing and consuming nutrient dense food. We welcome the recommendation that more research is needed into the mechanisms by which different foods (UPF or otherwise) influence health.”
Dr Hilda Mulrooney, Reader in Nutrition & Health, London Metropolitan University, said:
“I think based on what I have read the press release gives a broad outline of the recommendations of the report. The report was informed by consultation with a wide range of stakeholders including scientists, academics, researchers and representatives from the food industry as well as the third sector. It recommends a comprehensive strategy, underpinned by law. A key criticism is of the failure of successive governments to take mandatory action to address the food system, relying instead on personal individual responsibility. Mandatory action has been shown to be markedly more successful than voluntary action when taken (e.g. the Soft Drinks Industry Levy vs. sugar reformulation of foods marketed to children), but there has been political reluctance to acknowledge this. From the perspective of industry, mandatory action also imposes a level playing field.
“The current food system is far from ideal with a small number of large organisations having high levels of influence, including potentially over policy through lobbying and other activities. The risk of undue and opaque influence is of concern particularly in the food industry where large profits can be made – everyone has to eat, so everyone has to procure food. The issue of conflicts of interest or their potential is a reasonable and genuine concern although what constitutes a conflict of interest is not always clear. Demonisation of reputable scientists, academics and clinicians on the basis of former or current involvement with the food industry is unfair and fails to acknowledge other potential conflicts of interest, such as ideological or other biases. While policy making should be protected, it is unclear how the proposal to exclude food businesses with more than a specified proportion of their sales derived from unhealthy foods from discussions of future food policy would work in practice. The bottom line of any industry is to make profits; adopting a ‘polluter pays’ principle might make unhealthy food production, marketing, advertising and sales less profitable and therefore help drive healthful action.
“There is a need for independent oversight of action to address the food system, with regular reports to and responses from government. A cross-departmental approach, recognising health in all policies, is also needed. Both are currently lacking.
“The substantial overlap between unhealthy foods (HFSS – high in fat, salt and sugar) and UPFs means that current UK healthy eating guidance (the Eatwell Guide) in practice already advocates against over-consumption of many UPFs. Research suggests an association between high intakes of UPFs and increased risks of ill-health, but causality has not been established and potential mechanisms not yet identified. It makes sense to continue to encourage consumption of whole foods, minimising intakes of HFSS foods. However, this will be more difficult for those on low incomes to achieve, given the higher cost of healthier foods. Without addressing this through greater support (e.g. free school meals, Healthy Start), there is potential to inadvertently increase health inequalities. Identifying which UPFs may be problematic is needed, while recognising that the system usually used to classify them (NOVA) does not take their nutrient content into account, only their degree of processing.”
Prof Susan Jebb, Chair of the Food Standards Agency, said:
“The FSA welcomes the Committee’s comprehensive report. As an independent body, set up to safeguard public health and protect consumers in relation to food, we wholeheartedly share the sentiment of this report on the need to transform our food system to enable people to live longer, healthier lives. This in turn will reduce the pressures on the NHS and boost economic growth.
“The proposals that the FSA should take on additional responsibilities for the oversight and regulation of the food system are for the Government to consider.
“From our experience as a regulator, we agree it is important that any targets or requirements on businesses are accompanied by effective monitoring and enforcement to drive positive changes.
“There is much in this report that warrants detailed consideration and we look forward to discussing these proposals with the Government.”
Prof Tom Sanders, Professor emeritus of Nutrition and Dietetics, King’s College London, said:
“This report highlights the importance of preventing obesity. It arguably suggests that poor diet is second only to smoking to years of life lost (alcohol and drug misuse are probably more important and alcohol intake which has risen greatly in adults contributes to obesity). The report recognises the impact of new drug treatments of obesity that help patients comply with diets that contain fewer calories. It correctly focuses on prevention of obesity and the lifestyle changes that are needed. However, the report conflates unhealthy diets with excessive calorie intake. It is an excessive calorie intake not the mix of nutrients that cause obesity.
“The report correctly points to the failure of successive administrations to tackle obesity with effective policies but then goes on to suggest more stringent enforcement of the same policies (cut salt, fat and sugar) that have not worked. Even the much vaunted soft drinks levy had not reduced the volume of full sugar beverages according to the government’s own statistics published in September.
“The report focuses on the food industry as the villain. It suggest a new tax on salt. While there are good reasons to reduce salt intake because of its effects on blood pressure, it has nothing to do with obesity.
“It calls for further controls on the advertising of unhealthy food but seems to have forgotten the elephant in the room which is portion size. Portion sizes have been getting larger over the past twenty years and this is especially true of ready prepared and takeaway meals.”
Dr Katie Dalrymple, Lecturer in Nutritional Sciences, King’s College London, said:
“The obesity epidemic presents a major public health challenge across all stages of the life course. Without effective, evidence-based interventions, we are unlikely to see a reduction in obesity rates within our lifetime. Children and young people are particularly at risk of developing obesity. This report highlights the importance of maternal preconception health, as well as the crucial role of infant and early childhood diets in shaping longer term food choices. Early years settings and primary schools also provide an opportunity to support children in accessing healthy food options. The report has synthesized the current literature and offers several recommendations for future policies; I hope the suggestions lead to immediate, tangible, and effective interventions during this critical stage of the life course.”
Dr Aisling Daly, Lecturer in Nutrition, Oxford Brookes University, said:
“From the report summary and the details in the press release, I have the following minor comments.
“I find it a good approach to (finally) move away from focussing on personal choice and education about healthy eating, recognising that is it more important to address the food system and food environment to improve the quality of diet and health in the population and population sub groups. It is impossible for people to make health-promoting food choices when the foods available for them to access or choose from are not health-promoting themselves.
“Although welcomed, approaches for food reformulation and banning advertising may be challenging given the conflict between food businesses’ need for profit over improving population health.
“One key aspect which is highly welcomed in both the research and public health/health promotion communities relates to point 5 on commissioning research on UPFs, specifically addressing the limitations of the NOVA classification, which is widely used and widely criticised for not differentiating between “health supporting” and “health damaging” HFSS foods. Commissioning research to develop or agree on a more suitable method for classifying UPFs and therefore analysing their impact on health will be a very welcome approach. Otherwise the research being conducted will not be as useful to the population and to food industry as it could be to drive change.”
Dr Nerys Astbury, Associate Professor – Diet & Obesity, Nuffield Department of Primary Health Care Sciences, University of Oxford, said:
“The House of Lords report concludes that obesity and diet-related disease are a public health emergency. Whilst it’s great to have this acknowledged publicly by such a high-profile report, many, including those of us who work on diet and obesity research believe that this is already well established. However, what is needed are immediate, specific, and measurable actions which have the potential to reduce obesity and diet related disease rates which contribute to ill health and have significant impact on the wider economy.
“The report highlights that between 1992 and 2020, almost 700 policies were proposed by successive governments to tackle obesity in England. Yet the prevalence of obesity continues to rise, as do the rates of many diseases associated with obesity including type 2 diabetes, cardiovascular disease, and certain obesity-related cancers.
“Whilst the report goes some way to suggest several key actions which have the potential to help reduce obesity rates and prevent other diet related diseases, time and political will are needed to envisage these changes. Some of these policies suggested may be unpopular, and there will likely be resistance to making some of these changes, particularly from the food industry who try to resist policies which could impact their profit margins.”
Prof Alex Johnstone, Theme Lead for Nutrition, Obesity and Disease at the Rowett Institute, University of Aberdeen, said:
“I welcome this report from the House Of Lords and the ethos to support preventative strategies as part of healthy weight management in the UK. Our own research on Transforming the UK Food System (TUKFS), funded by UKRI, on food insecurity and obesity, with focus on the retail food sector, supports the priority actions identified, which include strengthening policy and mandatory reporting. As an academic, I particularly welcome opportunity for future funding for more mechanistic research on ultra processed foods impact on health. The food system is complex and encompasses farm to fork, and we should not miss the lived experience of those with obesity. These measures are only the first step to move towards access to healthy and sustainable food for all to reduce the dietary health inequalities in the UK.
“The consultation was wide ranging and actively sought evidence from a wide range of food system stakeholders. I submitted written evidence, both as an individual academic https://committees.parliament.uk/writtenevidence/130634/pdf/as and as part of a UKRI Transforming UK Food Systems research team https://committees.parliament.uk/writtenevidence/130616/pdf/. This process was extensive; the report is transparent, with transcripts of oral evidence also provided. The report does appear to be evidence based, with a balance of actions which also identify knowledge gaps, for example, more funding for more research on UPF, where the evidence is less clear. The actions prioritise changing our food system, or food environment, which is welcome. I would have liked to see more mention of the lived experience from people living with obesity being cited as evidence, and more direct actions on reducing food insecurity for people living with obesity. I would have also liked to see some evidence on how we communicate about overweight and obesity, there is evidence on changing the narrative from body weight to a healthy weight (https://publichealthscotland.scot/news/2023/march/improving-how-we-communicate-about-health-and-obesity-in-scotland/).”
‘House of Lords Food, Diet and Obesity Committee Report of Session 2024-25, Recipe for health: a plan to fix our broken food system’ was published at 00:01 UK time on Thursday 24 October 2024.
The SMC submitted evidence to this Inquiry: https://committees.parliament.uk/writtenevidence/129356/pdf/
Declared interests
Prof Martin Warren:
The Quadram Institute is a UK science national capability strategically funded by the Biotechnology and Biological Sciences Research Council, and also receives funding from other government agencies, national and international charities, and limited funding from industry (six per cent of total funding in 2022/23 came from industry).
Martin’s not got any interests to declare.
Dr Hilda Mulrooney: “I am a committee member of the British Dietetic Association Obesity Group; a committee member of the European Specialist Dietitians Network (Obesity) and a member of the Obesity Management collaborative. I am Council Member for Public Health of the Nutrition Society. All of these positions are voluntary and unpaid.”
Prof Susan Jebb:
The FSA works in partnership with stakeholders and one of our guiding principles is to make it easier for businesses to meet their obligations and do the right thing for consumers, but we also have statutory powers which include the power to issue guidance on control of foodborne disease, and the power to gather and publish information about the food system in support of our objectives, and to publish our own advice. We also have specific powers as a regulator, to enforce food controls directly with some businesses and to oversee the enforcement of them by local authorities.
Prof Tom Sanders: “Member of the Science Committee British Nutrition Foundation. Honorary Nutritional Director HEART UK.
Before my retirement from King’s College London in 2014, I acted as a consultant to many companies and organisations involved in the manufacture of what are now designated ultraprocessed foods.
I used to be a consultant to the Breakfast Cereals Advisory Board of the Food and Drink Federation.
I used to be a consultant for aspartame more than a decade ago.
When I was doing research at King’ College London, the following applied: Tom does not hold any grants or have any consultancies with companies involved in the production or marketing of sugar-sweetened drinks. In reference to previous funding to Tom’s institution: £4.5 million was donated to King’s College London by Tate & Lyle in 2006; this funding finished in 2011. This money was given to the College and was in recognition of the discovery of the artificial sweetener sucralose by Prof Hough at the Queen Elizabeth College (QEC), which merged with King’s College London. The Tate & Lyle grant paid for the Clinical Research Centre at St Thomas’ that is run by the Guy’s & St Thomas’ Trust, it was not used to fund research on sugar. Tate & Lyle sold their sugar interests to American Sugar so the brand Tate & Lyle still exists but it is no longer linked to the company Tate & Lyle PLC, which gave the money to King’s College London in 2006.”
Dr Aisling Daly: “I have no conflicts of interest to declare. I am a registered nutritionist with the Association for Nutrition and work as a lecturer in nutrition at Oxford Brookes University.”
Dr Nerys Astbury: “No conflicts.”
Prof Alex Johnstone: “Current Association for the Study of Obesity Scotland Chair (https://aso.org.uk/scotlandand), has a voluntary position with the British Nutrition Foundation Advisory Group (https://www.nutrition.org.uk/news/prof-alex-johnstone-to-join-british-nutrition-foundation-advisory-committee/). She leads a TUKFS- Transforming UK Food System- FIO Food grant (Food Insecurity in people living with obesity, https://www.abdn.ac.uk/rowett/research/fio-food/index.php).”
Dr Katie Dalrymple: “I have a COI, I worked for Danone Nutricia for 4 years from 2012-2016. This is on my bio on the KCL website: https://www.kcl.ac.uk/people/kathryn-dalrymple.”