The UK is in the midst of an unprecedented health crisis.
Obesity costs the UK an estimated £54bn every year and is one of the top risk factors for ill health and premature death. The nation’s health service is already under major strain. But if we can bring down obesity rates, then we can prevent weight-related health issues before they have the chance to become a problem. To achieve that goal, we need bold and ambitious action.
Last week, Nesta launched two reports about the obesity crisis in the UK. The first revealed that – based on data modelling and existing nutritional research – it’s possible to halve obesity by 2030 by cutting just 216 calories from the daily diets of people who are overweight or obese.
The second demonstrated that a 10% reduction in the calorie content of 10 everyday food items (shown below) could shave off 38 of those 216 excess calories we’re consuming each day.
The message is clear: small changes have the potential to make a big difference to curbing obesity.
These findings have generated some strong reactions. Critical feedback highlights the small scale of calorie reduction relative to the effort (one commenter said they’d lost 38 calories through rolling their eyes), as well as the potential implications for taste.
Some commentators took issue with the impact and evidence underpinning reformulation, arguing that reformulation will simply lead consumers to find their calories elsewhere.
A systematic review of the evidence suggests the contrary, that people who consume less calorie dense foods do not fully compensate by eating more. The same is true of foods reformulated to contain sweetener rather than sugar – in fact, the research suggests that reformulation leads to a significant reduction in body weight.
As an alternative to government and industry taking action, critics appeal to personal responsibility as a strategy for tackling obesity. In a spirited contribution to CapX, Christopher Snowdon argues: ‘If people are worried about their weight [they should] avoid cakes and chocolate bars altogether’.
The problem is that relying on individual agency alone does not work. Over the past 30 years, we have seen 689 government policies targeted at obesity, but the research suggests that they had little impact. This is, researchers contend, because the majority of UK policy-making has placed high demands on the individual, overlooking the wider systemic issues at play.
Consumers in the UK are flooded with unhealthy options – calorific foods are highly marketed and are often amongst the cheapest, quickest and most readily available. As a result, obesity rates have doubled since the early 90s and they’re continuing to climb; there are 35 million overweight and obese people in this country and it’s naïve to think that public health initiatives based only around individual willpower will bring those numbers down.
Our research clearly shows the extent to which our daily diets are saturated by calorie-dense discretionary products, such as chocolate, cakes and pastries. Finding ways to reduce the calories within these products, while maintaining taste, could lead to imperceptible changes in calorie consumption.
The easiest way to help people change their dietary habits is to adopt a ‘producer pays’ model. This means that the problem – in this case, the proliferation of highly calorific foods – is addressed at the source by industry rather than by the end consumer, who as a consequence finds it easier to make healthier choices. If we want to see health improvements at the population level, then we need to change the food environment, and that calls for action from the top.
To cut down on excess calories, the government and industry must take action in tandem and on a number of fronts. There’s no single initiative that will get us all the way there.
We need to improve access to healthy food outlets; we must tackle aggressive marketing techniques that encourage over-consumption of calorie dense foods; we can look at portion sizes, labelling transparency, and we can also push for reformulation to bring down the calorie content of key foods without affecting taste, price or quality.
It’s fair and reasonable to question the scale of impact here. Indeed, 38 calories isn’t a lot, but if we’re all dropping 38 calories a day, that equates to one billion calories at the population level – and that is exactly the kind of scale we should be aiming for. Millions of people dropping 38 calories a day has a far greater impact on national obesity rates than a limited number of individuals counting calories. Indeed, our calculations – based on government cost estimates – suggest that this change could result in a potential saving of around £23 billion to the NHS over the next 25 years. As part of a blended approach that encompasses action on advertising, portion sizing and improved access to healthy options, reformulation can absolutely make a difference.
But what of the impact on taste? How are companies supposed to take calories out of a wide range of products without consumers noticing?
To pit flavour against calories is a false dichotomy. Industry is constantly reformulating the food we consume, and most of the time those changes go entirely unnoticed. There are minor differences in the calorie content of many foods sold in the UK versus their European and North American counterparts – for instance, a tub of branded ice cream contains 1,159 calories in the UK compared with 825 calories in the USA, but most consumers wouldn’t notice a difference. Advances in technology are helping companies reduce sugar and fat by up to 75% without affecting taste or texture.
Nesta is calling for clear, mandated targets on calorie reduction alongside fiscal incentives to support industry to reformulate. We’re also recommending the introduction of a new institution with statutory powers to design, set and monitor targets for calorie reduction by manufacturers, so that producers are held accountable to a shared set of standards. This must all be underpinned by legally-mandated data collection and reporting on how businesses are performing, something the Food Data Transparency Partnership (as announced in the 2022 Food Strategy) ought to address.
The viability of this approach has already been tested in practice by the soft drinks levy – an initiative which clearly demonstrated how reformulation can create meaningful health improvements without either increasing cost to the consumer or compromising on taste or industry profits. Introduced in 2018, the so-called ‘sugar tax’ led to a 35% reduction in the sugar content of soft drinks, and at the same time sales increased by 10.2%.
Critics are right to point out the impact of such initiatives on businesses. For too long, the food industry has been subject to constant chopping and changing in health policy, forced to respond to new interventions with each successive government. That’s why government and public health professionals need to work alongside industry to introduce a range of policies that target different facets of the problem.
Our reports show that, as part of a multi-pronged approach to tackling obesity, reformulation has the potential to improve the nation’s health; it also outlines timelines, strategies and next steps to help us get there.
When it comes to improving health by reducing obesity, reformulation is no ‘magic bullet’ – but it is an important part of the solution. Lecturing the public on what to eat doesn’t work. The best path to halving obesity in the UK is to follow the evidence regarding public health policy.