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Healthy, easy, affordable and attractive food: how to improve Scotland’s health

The latest research from Nesta’s healthy life team confirms that we desperately need to act to improve Scotland’s health – but it also highlights solutions that are achievable and within reach if we work to tackle the obesity crisis.

Analysis from Frontier Economics, commissioned by Nesta, calculates the annual cost of obesity in Scotland is £5.3bn. A significant amount in cold financial terms but beyond the headline figure, lies an enormous human cost in terms of our health.

The vast majority of that figure – £4.1bn of the total – is in value lost by people in Scotland through reduced quality of life and shortened lives. The monetary figure is a calculation of quality-adjusted life years and means the equivalent of more than 58,000 years of healthy life are lost each year to obesity in Scotland. Obesity is now the leading cause of death in Scotland.

What’s more, the pain of this ill health is not felt evenly. A greater share of this cost burden of obesity in Scotland is borne by those living in the areas of highest deprivation, further exacerbating already deep health inequalities.

The remaining costs include £776m annual cost to the NHS, £246m in informal and formal social care costs and £213m wider economic costs related to employment and lost productivity.

When the cost is this high, it is clear that swift and committed action is long overdue.

And it can be done. Further research published by Nesta and the Behavioural Insights Team uses population-level calorie reduction as a gauge for reducing obesity prevalence. It shows that if an on-average reduction of 188 kcal per day could be supported for all adults across the population it would be enough to halve the prevalence of obesity over as little as three years if the reduction is sustained. For adults living with some level of excess weight, it would require a little more and would need an average reduction of 230 kcal per day to be supported.

In Scotland, most of us (more than two-thirds of the adult population) fall into the latter category of living with excess weight. Another bleak statistic that points to decades of failed policy aimed at addressing the issue.

How we are trying to reduce obesity needs to change. We must focus on stemming the tide of unhealthy food that floods our shop aisles, restaurants, workplaces and schools and look seriously at the role of advertising, deals and product displays.

Policies in Scotland such as the Good Food Nation Act and the Eating Out Eating Well Framework are positive steps in the right direction but will not be enough to reverse decades of ineffective policy, widespread marketing by the food industry and increasing levels of poverty, all of which contribute to our current obesity crisis.

We need to face up to the substantial role played in our worsening obesity crisis by how our food is made, marketed and sold and the difficulties faced by many of us in accessing – and affording – healthier food options.

Delays by the Scottish Government on restricting the promotion of unhealthy food and the introduction of calorie labelling are disappointing given the severity of the crisis and high cost being paid by us all. Governments, in Holyrood and Westminster, need to go much further faster including putting pressure on industries across our food systems to improve the way they operate.

Industry has many levers it can pull to improve the healthfulness of the food we eat. It is possible for this to be done in a way that is sympathetic to their commercial needs, as the Soft Drink Industry Levy has shown. However, the food industry needs to acknowledge the significant role it plays in this health crisis and take responsibility for being part of the solution. Ideally, industry should do so through voluntary action, mitigating the need for increased legislation – but if not, government must step in.

The biggest influence on our diet are the environments we live, work and socialise in and there is no single way to make the significant and urgent change we need to make them healthier.

Instead it will need layers of policies and initiatives that address different facets of our food environments. Approaches such as reformulating some food products that are particularly high in fat, salt and sugar so they taste just as good but don’t harm our health could have significant positive effects on obesity.

Promotion of unhealthy food is driving increased consumption and recent research has shown that a third of all volume promotions in our supermarkets are for foods high in fat, salt and sugar. This leads to us buying 20% more than we would otherwise. We need to limit these promotions and instead make healthier food cheaper and more accessible for everyone.

Research suggests introducing calorie labelling on menus can act as a catalyst for businesses to reduce the amount of calories in their dishes, providing healthier menus for customers.

We need a raft of these kinds of measures that make healthier food options easy, cheap and attractive, whether we are shopping for groceries or grabbing dinner while out and about.

The cost of obesity in Scotland is higher than we should ever have to pay – especially when we are paying with our health and our happinesses. It is time for a firm commitment and collective action across the UK and Scottish Governments, industry and society to make healthier food environments a national priority.


Frances Bain

Frances Bain

Frances Bain

Mission Manager (Scotland), healthy life mission

Frances is Nesta’s mission manager for Scotland working on the healthy life mission and based with the Scotland team in Edinburgh.

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