Andy Regan: Good afternoon everyone. Thanks for joining us today. My name is Andy Regan. I'm head of Nesta Cymru. For anyone who doesn't know us, Nesta is a research innovation foundation. We use a range of different applied methods to design, test and scale solutions for some of the biggest challenges of our time. Including decarbonizing homes at pace, helping preschool children get the best start in life. And our healthy life mission which we'll focus on today is about halving obesity by 2030. So specifically we today's webinar is going to talk about our development of a policy called the healthy food standard or HFS as one of us will inevitably refer to it as at some point. We're joined by stakeholders from across Wales um folks from local authorities, health boards, public health and government officials. What we hope to do today is tell you about the health food standard policy proposal that we've been working on in some detail for some time, how it differs to previous policies um that have tackled the food environment and how we think it can help tackle obesity in Wales. We're excited that the UK government has incorporated Nesta's healthy food standard into their 10-year health plan. And we're hoping that the next Welsh government uh will support the policy in Wales. So what's the problem it solves? Nesta's analysis suggests that more than a third of adults in Wales were living with obesity in 2022 23 um which is higher than official figures indicated at the time and amongst the highest rates in the UK. Childhood obesity is also higher in Wales than in England and Scotland. And overall that means hundreds of thousands of people in Wales face higher risks of preventable disease, disability and early death. We also know that the economic cost of obesity in Wales runs into the billions. So it's really clear that without decisive action, these harms are going to grow for future generations. So the solution is about systemic change, not policies that only focus on individual people's willpower. And one of the most impactful things we need to do is change the food retail environment so that the healthy choice becomes the easy choice and the healthy food standard is a way to drive that. So, we're going to be joined by two of my colleagues today who'll talk us uh through the the policy. And just like to properly introduce them. First, uh, Sarah Elias is policy adviser in the Nesta Cymru team, working across all three of our missions. Um, with over 15 years of experience across the public and third sectors, Sarah has a strong background in social research and policy development. uh and most recently uh before Nesta working with public health Wales and the future generations commissioner on the implementation of the well-being of future generations act. So Croeso Sara um also joined by Manny Narula who is head of policy delivery in Nesta's healthy life mission team before Nesta Manny's worked as a management consultant at Oliver Wyman and has held policy and strategy roles in the UK government across uh the treasury the cabinet office and the foreign commonwealth and development office. Um, so in a moment I'll hand over to Sara to tell us a little more about the healthy life mission and why it's so important to tackle obesity here in Wales and then to Manny who will talk more into the detail of the healthy food standards policy. Um, we will make sure we have time for some questions uh from you all at the end. So please do submit them throughout using the comments function. Um, and thanks to those of you who sent us some in advance. So without any further ado, hand over to Sarah to start talking us through the context of Wales.

Sarah Elias: Um diolch Andy. Um so I'm Sara. I'm the policy advisor um at Nesta as Andy mentioned. Um but today I want to talk about uh our focus um on health. Um so I wanted to start with kind of considering why does Nesta focus on health? Um and then within that why do we focus on obesity? Um, so the main reason we care about health is simply because kind of our health is getting worse and it's not from lack of trying to have really good implementation. So we've got some really great ambition in Wales. We've got um creating a healthier Wales as a key component of our well-being goals and we have a healthy weight healthy Wales strategy in Wales. But still our trajectory doesn't look good and and we've got a widening gap in life expectancy between the most and least deprived areas. So we care very much about health and if we care about health then we really need to be thinking about not just about treating health but how do we stop people from getting ill. So we need to care about prevention. We can't just keep putting money into the NHS to deal with that sickness and we need to think about what are the root causes of that ill health and what can we do um to tackle those and reduce the demand. So if we look at prevention there's two really big drivers of ill health and those are smoking and what we eat. And when Wales um was looking at smoking it was really brave. So Wales was one of the first UK nations um to ban smoking in enclosed public spaces and since then has introduced kind of additional measures then over time to reduce the number of smoking. Not just one big bang policy but a series of policies and support packages that work together um to create an impact and it really did create an impact. So adult smoking rates have reduced from around 24% in 2007 to 13%. Um and if we skip to slide three, sorry, there we go. Um we can't we can't take the same approach to um food. So food it is trickier. We can't just stop um eating, but excess weight is one of the main contributors of poor health and reduced quality of life in Wales. So an our analysis suggests that a third of adults in Wales are living with obesity. and and as Andy mentioned that's the highest rate um in the UK. So we need to be just as brave and just as radical about thinking how do we tackle the issue of obesity. So Nesta's ambition um is to halve obesity rates which does sound uh very ambitious but what it means in in reality is bringing back those levels to the same levels we saw in the 1990s. So we we know it's ambitious but we think reducing obesity is really urgent and we think it is achievable. Um so if we skip to the next slide. Um and we don't think it's an issue that we can ignore. Um not just because it has an impact on ill health and inequalities but it also has a huge impact on our economy in Wales. According to research conducted by Nesta and Frontier Economics, the cost of obesity in Wales's economy and wider society is equivalent to around 5.2 billion in 2025. And this number is growing each year. So this includes approximately 470 million in direct NHS spending alongside wider societal costs then from reduced quality of life and costs associated with paid and unpaid social care. So really kind of we we can't ignore this. So a smart investment in Wales would be to tackle obesity. Next slide. Um but that got us thinking kind of where to start and how can we reduce obesity in Wales. So we broadly know as a lot of you kind of will know that um we know need what needs to happen on average to halve obesity prevalence across the population people living with excess weight need to reduce their average daily calorie intake by around 8.5% which is about 216 calories. Um if those numbers still don't make sense it's roughly the equivalent of a single slice of medium pepperoni pizza. But that needs to be a consistent and long-term reduction, not a just a kind of a one-off. And there's no shortage of ideas about kind of how we can do this. So, we've had numerous policies that governments have implemented um here in the UK and in other countries as well. But what we don't really have is a way of really looking and understanding which of those policies works. How do we compare the policies and decide kind of where we put our limited resources? Um, and this isn't um this isn't just an issue for obesity. There's a lot of public health issues where they kind of uh take place in such complex environments that it's really hard to compare against each other. Um, so this is the challenge that the Nesta team wanted to um to tackle. So we created something called the blueprint um for tackling obesity. So what we did was we created a panel of 16 academics who identified 30 key obesity policies. They screened more than 3,000 studies for the best evidence evidence and then modeled those estimates of the impact um on obesity rates across the population. We then had some health economists estimate the five-year costs and benefits of those policies. Um and those insights are now available to look at in an interactive tool. Um and I do um suggest that people do go and have a look at what those are. So what did we find? We found that the interventions with the highest impact but also had the low cost to government were those that tackled the food environment. So moving away from personal responsibility and agency and more around kind of how do we implement those in the surrounding environment and that's not really too surprising when we think the majority of the food that we buy in the UK comes from supermarkets. It's where 80% of calories come from and if we look at that across the nations there isn't a huge variability in that. Um, and then if we think about the 80%, 11 key businesses make up the majority of that 80%. Um, and you'll see from the list on the screen kind of, uh, tackling the food environment isn't a new idea. We've had retail policies in the past. Um, so most recently in Wales, we had the food promotion and presentation regulations. Um, but these are tricky and kind of going against industry is difficult. So when we try to introduce these sorts of bans and restrictions, what typically happens is that industry will often look for a way to move around these regulations. Um so for example, in January, the UK government implemented the kind of long-awaited restrictions on advertising of less healthy food and drink. So the ban on paid pre-watershed TV and online advertising was billed as quite a landmark uh change for public health. Um but what our new kind of report looks at and is confirmed and it's available online is that these restrictions really fall short of the original ambition of that policy. The analysis details how delay dilution and industry influence really weaken those rules that are now in place. And we think that only around 1% of food and drink advertising spend um will actually be affected once the expected shifts to unregulated channels are taken into account. So these bans and regulations often kind of lead to loopholes um and industry looking for a way around them. And that made us then think about kind of introducing um healthiness targets which are a different approach to restrictions and bans. So essentially we wanted to know how can we incentivize businesses to think about health as well as their profit. How can they make small changes to the food environment that leads to long-term trends in less calories consumed? And how can we make everything just a little bit healthier? So we're not radically changing anything. We're not asking people to swap their angel cakes for carrots sticks. Um, but maybe rather than an angel cake, a healthier cherry cake um would help bring that calorie intake down. And that's what we're looking for because that leads to kind of a more longlasting impact. Um, I'll let Manny go into kind of the actual details of the policy, but in essence, it's a way to create a healthier shopping baskets. So by moving towards outcome-based incentives, we can stop kind of the micromanaging of shelves and instead really reward supermarkets for the one thing that we actually care about, which is the health of the food that they sell. So we want to align their profits with our progress. And by implementing outcome-based incentives, we can make health a core KPI for those supermarkets that supply 80% of our calorie intake. Have we next slide? There you go. Um, and I think the policy landscape in Wales kind of really lends itself to this. We've already got kind of um healthy weight, healthy Wales strategy that recognizes the role of our food environment in our ability to make those healthy decisions. We've got the future generation act which provides us with a legal duty to make decisions that do contribute to a healthier Wales and and also kind of act in a preventative manner. Um so what makes Nesta's approach different um is that kind of focus on outcomes not just the obstacles. Instead of telling supermarkets how to sell, we're really interested in what they sell and kind of closing those loopholes um and making supermarkets really part of the solution. Um I will hand over to Manny now who can describe in um a lot more detail around the actual details of the policy um and how it could be implemented.

Manny Narula: Sure. and um Croeso and uh it's great to join you all today to talk about such an important topic. So thank you for the next slide. Um you know I won't go into the context which I think both Andy and and Sara have covered so skillfully. Um I think here what I basically say was a real positive that the government introduced um the world's first healthy food standard uh through the announcement in the 10-year health plan from last summer. Um and sort of essentially what this policy would aim to do is to mandate all large food businesses to report on the healthiness of their sales. um and then therefore set health targets for these businesses to meet. Um this was built on Nesta's proposals to set health targets for supermarkets which we published in 2024. And so here on Nesta showed that such targets on the largest 11 retailers um could reduce obesity rates by as much as 20%. If we go to the next slide. So why are we considering this policy and why is actually something that the government has introduced and sort of as Sarah was saying you know the goal of this policy is not to radically change someone's diet overnight. It's about small sustained shifts to achieve you know the intended obesity reduction. So here you know the approach is to maintain food enjoyment and affordability whilst reducing daily calorie intake. So I think what this means in terms of design, it is crucial that the policy is mandatory to shift incentives for large businesses towards healthier products and those sales and sort of you know we've seen from international case studies that if you just introduce voluntary action that businesses don't typically comply and sort of as Sarah was saying that you know supermarkets are sort of key part of the puzzle given sort of they they comprise sort of over 80% of the calories consumed among the public. next slide. So in terms of the what I think here what we are saying and sort of as sort of is outlined in our proposals as opposed to something that sort of is official government policy is that sort of we recommend that sort of transparent reporting is based on the nutrient profiling model or you may hear as NPM which sort of we think provides as holistic score as possible for the nutritional quality of food and you know we think that this would be advantageous because it's already something established across the food sector and also in law. Um and sort of here our recommendations would be to set targets based on this reporting as provided by food businesses and in a way that sort of aligned at the current best performance of health overall standards. If we go to the next slide and sort of as Sara was saying that you know this policy is unique in the sense that it is outcome based and sort of what it aims to do is sort of give businesses maximum flexibility to meet targets using their existing commercial tools rather than you know them being told by the government on exactly how they should run their operations. So because of that we think this is low cost to implement and shouldn't increase costs for consumers. Um and of course to ensure this policy drives meaningful change among businesses our view is that this policy must be backed by an enforcement regime that can issue strong penalties for businesses that do not comply with these standards. And if we go to the next slide. So what next? So of course the the overall timelines will be set by the UK government and sort of here what we do know through parliamentary questions and responses from the government um that they are working towards um a spring public consultation. So I think what this means is that we're expecting a consultation shortly and therefore is essential that the UK government moves quickly and pragmatically working collaboratively with the Welsh and other devolved governments to introduce both mandatory reporting and targets before the end of the current UK parliament and you know fundamentally ensuring that we're able to realize the health benefits for the public. I'll pause there and head back. Thanks.

Andy Regan: Thanks Manny and and thanks Sara um for talking us through that. So we'll have a bit of a discussion now between the three of us but please do start uh popping your questions for Manny and Sara into the chat about um any aspect of the policy. Um so Sara I think we start with some sort of small P politics. Um, often in Welsh policy, there's quite rightly a desire for a made in Wales solution. Um, always be one of the first to kind of advocate for that myself. Um, rather than aligning or kind of piggybacking, um, sometimes said negatively on a on a policy that's being driven by the UK government. But on the healthy food standard, um, policy development and legislation, as Manny said, is is kind of underway in Westminster. So there is an opportunity to align with that and have a a UK-wide standard. So I guess what what would we say to anybody sort of tempted to say that Wales shouldn't jump on that bandwagon but should develop its own policy on large food retailers perhaps starting from scratch. What would we what would we say to that?

Sarah Elias: Yeah. Um and the same kind of I completely understand and respect the impulse to always want to have a kind of made in Wales solution. Um and that kind of that and that that is there for a good reason. We've got really unique legislation here that gives us a mandate to think longer term, more holistically. Um and we've also we we've been the first movers um in a many of instance and thinking kind of smoking, organ donation, carrier bags. We've been the first for a lot. So that desire to craft something that fits not only kind of our policy landscape but also the specific health profile, the the kind of the the the retail landscape, all that those things that make Welsh kind of Wales Welsh um is something that is totally understandable. Um saying that I think kind of what we need to think about is the scale of the problem. Um and consider kind of which path leads to the biggest impact for the people of Wales. Um and we need kind of then thinking about that we need to think of the speed of the impact and our collective bargaining. I think those are two really important things when we think about implementing this policy. So acting quickly I think um to introduce it would help ensure people across Wales can benefit sooner and kind of these are really big potential kind of um wins for the people of Wales. It's a potential 20% reduction in obesity prevalence which means people can live longer, people can live healthier. We can see a positive impact on our economy and a reduced stress on the NHS. So I think um weighing that up against anything that we think how how much more could we do um if we delayed it by um by having a a kind of made in Wales policy. Is it worth um the impact that it could have on delaying? So I think that that pace and impact needs to be considered. Um and there's a really kind of important opportunity coming up where Wales can get in on this early. This isn't kind of a fully designed policy that's ready to go. Westminster are consulting on it. There's opportunity for intergovernmental working. Um the elections in Scotland or Wales uh do make that a bit tricky at the moment, but it's it's there's no reason why a new government couldn't pick this up as soon as they land. Um and so there's that window of opportunity to make sure kind of what Wales wants to get out of the policy is integrated into how it's designed from the beginning. Um and the other point on kind of um collective bargaining um this is a is a policy that will impact on how industry works and there's been support from retail industry but there will be some difficult decisions and there's a certain amount of strength to all the nations working together to create a kind of a unified approach um to that bargaining and rather than asking for kind of um similar but slightly different policies in different countries um and that might kind of risk eroding or reducing um that support from industry. So thinking kind of what is the best way um that we can make use of our power. Um and my third point is also about capacity. Sorry, I've got three points on this one. Um, so as I mentioned, um, kind of when we think about smoking, that wasn't one policy that, um, that fixed the problem and we're not going to have one policy that brings us back to obesity levels that are similar to the 1990s. So by working together kind of that releases some capacity in Wales to think of actually some of the the other pieces of the problem kind of the wider systems issues that we also need to tackle. It gives us more capacity to focus on those. We do have limited capacity. we can't do everything and we really need to focus on where we can have our biggest impact.

Andy Regan: Great. Thanks, Sara. Um, so we've kind of had an overview on the the what um but sort of digging into more about the Welsh context and the the where obviously we aren't implementing policy in a vacuum. We're implementing it in a country with a specific mandate to tackle inequality amongst other things. And I've already see a couple of questions coming through in the discussion around uh qualities on this. So there's there's talk about Wales being a Marmot nation for health. So be helpful Sarah perhaps if you could summarize what that means for anybody who's unfamiliar with the term and then how we kind of think about healthy food standards um in terms of avoiding one of the Marmot concepts I think of lifestyle drift where we start talking about social causes but then end up just blaming individuals for their food choices. How how does it fit in with that with that thinking?

Sarah Elias: Yeah. So, in terms of um becoming a Marmot nation um so I think that commitment from Wales is a real commitment to tackling health inequalities and improving kind of population health um for everyone. Um and what it involves is implementing um policies based on eight Marmot principles. um things like fair employment, early childhood and investment and healthy communities to bridge that gap between life expectancy between the social groups. So those eight Marmot principles really think about and tie in the importance of the um social determinants of health and how we can bake those into policies um to tackle health inequalities. Um and I think the healthy food standard fits nicely into these principles specifically the one around creating a healthy standard for everybody. Um so when Nesta was developing this policy it was um it was really important for us that it didn't increase the cost of food to consumers because I think especially kind of these days with cost of living um that is a really important issue for us. So to help us answer the question, we commissioned an independent economic assessment that suggests that um it's unlikely that this will happen due to the relatively low implementation costs for large food retailers. Um we've also done some work to look at um kind of uh the healthiness scores of large retailers and what we found is there isn't a strong link between a retailer's health score and the average cost of this basket. So since the budget kind of supermarkets aren't at an unhealthier kind of starting point compared to the high-end retailers, we expect the policy to lift healthy standards equally across the board. Um and lower income shoppers should be shouldn't be left behind in that. They should be kind of raising all the standards across the board. Um and that's really important to us because that that kind of lifestyle drift happens when kind of healthy choices require more effort, more money, more willpower. Um and to stop that, we need to make sure that kind of healthy choices are easy and they're affordable for everyone. Um and that is one of one of the core kind of um approach that Nesta takes to tackling obesity is that it is population um level um so we're looking for impact for everyone.

Andy Regan: Great. Thanks Sara. So Manny, another question for you about the the context here. So Wales has a distinct sort of food retail landscape. Um market share slightly different. um and have high density rural areas and lots of kind of rural food deserts and top-up shopping from supermarkets in smaller convenience hubs. So, have we been thinking about how uh we ensure the standard doesn't inadvertently penalize certain retailers or in our kind of most remote or deprived communities?

Manny Narula: Sure. and you know, it's an interesting question, one that I think we come across a fair amount. I think sort of here I think it also comes back down to the policy design and sort of here it aims to focus on the what not the how. So what this means is that food businesses have flexibility to choose how they want to meet these targets. So essentially what this means is that this policy can apply to Wales's own landscape and allows businesses to pull appropriate levers that recognize the nuances of its own markets. Um but you know I think what's an interesting point here is that you know we see that sort of Wales typically being close to great Britain figures in terms of the calories that are consumed from the largest retailers. So we would expect to see that the policy would have a sort of similarly sizable impact on obesity rates sort of across Great Britain as it would you know for um the nation itself. And I think what also is important here is that the policy will only be designed to cover large food businesses which will ensure that you know the impact is sort of shielded for sort of smaller and more rural uh companies.

Andy Regan: Great. Thanks Manny. I mean, it's one of the the strengths that we've argued about the policy is that it isn't intended to be uh prescriptive in and micromanaging how retailers meet it. And that makes sense because, you know, the way that a retailer that mostly sells fresh food versus mostly selling frozen food, for example, will have to take different approaches and they they understand their business and their customers best. But for the benefit of anyone listening who's kind of curious about what just curious to know like what are the sorts of approaches that we anticipate retailers might take uh to achieving the standard within their stores like what's in their toolbox to get this done.

Manny Narula: Yeah. Yeah. And and sort of you know the great thing about this policy is and you know something in the title here is that you know it is outcome based which means that sort of business have a freedom to use existing commercial tools to meet the health targets which are set and sort of here you know there are uh quite a few options which are available um and you know these include some of the more established ones like recipe reformulations, adjusting store placements as well as sort of changing promotional strategies. But of course, you know, these are ones that are more established and you know, it is down to the business themselves about exactly how they want to do this, but sort of these are sort of generally the sort of more established ways to deliver that.

Andy Regan: Thanks. One more question which I'll I'll put to to both of you and then we'll start bringing in some of the questions that are coming through from the audience. So basically if we get this right and we look back 10 years from now through the lens of the well-being of future generations act what's the single biggest shift we will see in the health of a child growing up in Merthyr Tydfil or or Wrexham today? Manny perhaps come to you first.

Manny Narula: Yeah sure. Um and and you know I think to put it quite simply we want every child growing up in the country to be fed nutritious affordable meals with their parents having access to healthier and more affordable food in the places that they shop and also in the chains that they eat out. So you know here we believe that sort of the healthy food standard will be central to sort of help with achieving this and sort of ensuring that kids lead a happier and healthy childhood.

Andy Regan: Great. And Sarah, what's your thoughts on that?

Sarah Elias: Um I think I would um so I've got two young ones. I would love them to grow up um where kind of the the food environment kind of has changed and that their kind of baseline for sweet or salty flavors is much lower. You can definitely tell when you're in America and you kind of taste the food um and you can taste the sweetness and saltiness in them. and to bring it down to kind of a lower baseline so that actually their enjoyment of all food isn't um out of kilter and the kind of fruits and vegetables um are just as appealing to them as other products that are available. Um so actually kind of and and the overall kind of thing that we want is their enjoyment of food that surrounds them doesn't impact negatively on their health but also their lifestyle because we need to keep fit. need exercise, kind of our overall health needs all these different elements to be kind of aligned and I think really fixing our food environment is a key element of that.

Andy Regan: Great. Definitely agree. Okay, so let's start to um bring in some of the questions from the from the chat. So we'll start with one by Xanth Bevis name right. So Xanth is asking about enforcement of the targets and how we envisage that working and uh saying please confirm where we're getting the definition of the standard from. So Manny you you've talked about NPM scores. It might be helpful just to elaborate on what those mean. But Xanth also also has another question which I think is is perfectly reasonable and I'll answer it which is how is Nesta funded? Um perfectly reasonable to want to understand who's who's sort of pushing this and Nesta is a is a charity and we're funded by an endowment. So we were created by the national lottery just over 20 years ago. Um and endowment funding means essentially we have a pot of money which generates our operating budget year to year. So we don't have like we you know we will do some funded work but we are largely funding our own work and therefore quite independent of both government and businesses and and any other external interests. It puts us in quite a quite a privileged position to be able to directly kind of set our own priorities and fund our own work. um which is why we've chosen to focus on specific missions to show what we're actually doing with that privilege position. So that's how Nesta's funded and hope that's helpful to understand. Um but yeah, Manny perhaps you could pick up Xanth's points on enforcement and how we're defining the standard.

Manny Narula: Yeah, sure. And sort of in terms of the uh definition, I think it is quite important to say that sort of you know we are uh based this on our recommendations that we put forward in the healthy targets for supermarket work that we published um so just under two years ago and sort of there is sort of the information that we have that we use to sort of inform our recommendations for this standard itself. So I think here it's quite important to say that this is our current position and our recommendations as opposed to um this being sort of you know the detail that's been put forward by the government because obviously you know given this is an announcement from the government it is now in in in their hands about exactly what this looks like. Um so I think this um was an opportunity more to sort of to to share our thoughts and sort of to to help contribute to the wider discussion as the sort of policy gets finalized over the next few months. Um and sort of just going to the point around enforcement I think you know it's a very important one and I think here what we are are are keen to see and you know this is something that will would have to come out in the consultation um is that there to be an established authority um that is able to oversee uh the uh introduction and enforcement of the policy and one that has sort of statutory powers to sort of enforce compliance both in terms of mandatory reporting but also from mandatory um targets. And of course you know as is always the case with um the regulation of a sector we you know something that we need to ensure is sort of both effective but also proportionate for um the business and scope but but then also for um the capacity and capabilities of sort of the government and the statutory authority. Um I'll keep it to that.

Andy Regan: That's okay. Yeah makes that makes sense. And so we've had another question about um GLP-1s. So you know weight loss drugs that are available under various different different brands. Uh question from Jennifer McConnell. Um pointing out that they will impact on obesity data and obesity rates but not going to negate the overall importance of still eating more vegetables for fiber and more nutritious food. Um so yeah whether we can kind of account for this within the healthy food standard and and how we see the sort of interaction between that and um you know greater uptake of of weight loss drugs. Um Sara put that to you I think

Sarah Elias: um yeah I think there's there's kind of two different elements. The one is kind of how how the GLP-1s kind of fit into the bigger picture about um on tackling obesity. Um I think uh this is incredible and kind of used in the right way I think has uh so much potential. Um but I think what's key for us to consider is um that they are a treatment. They are not prevention. Um so if we're if we're looking for kind of long-term impact um then we need to we need to be focusing on that prevention space. um for some cases um then it it might be very suitable for those people on the higher end um of uh their BMIs then that might um support them and kind of the the Welsh obesity um pathway has kind of support around them not just providing drugs as a solution but I think there's also and kind of what maybe um I think the question was from Jennifer um you're referring to is the impact that that is having on uh shoppers anyway and uh shopping habits. So I think in terms of um how the market is responding to people wanting to change. So we've seen kind of Marks and Spencers introduce new products that are uh nutrient-dense. Um uh I can't remember the specific term that they use but how that will change the market and I think it's something to keep an eye on. um it'll be interesting and I think one of the things we can't do at the moment because we don't have this mandatory reporting is to track things like that but actually if this um if this piece of legislation came into place we would have a better ability to track what is being sold where is it being sold um and to have a better understanding of how drugs like GLP-1 then do influence on the nutrients that are being sold not just kind of surveys on individual consumer behaviors

Andy Regan: Thanks. Sorry, Manny. Did you want to comment on this one as well?

Manny Narula: Yeah, sure. And the point that I'd add to that is sort of um in terms of the actual policy itself. So our sort of recommendation is that it is measured through the nutrient profiling model. So NPM, which we consider is the sort of most holistic um measure of food nutrition. Um and sort of here, you know, it's able to sort of take account of both sort of good nutrients, so things like fruit, vegetables, nuts, fiber, protein, but then also is able to sort of compare that against sort of some of the ones that are sort of more harmful um as well. I think sort of this sort of holistic account will ensure that it sort of captures all these sort of um dynamics and interactions which I think sort of ensures that it's sort of as holistic and comprehensive a policy as possible.

Andy Regan: I think um so related to that Alona Johnson um in the chat asked a couple of questions essentially around loopholes um in terms of what is measured and the reach of what is measured the the capacity for enforcement and I think if I'm if I'm understanding her question correctly like the essence of it is about gamification like you know is there a way of retailers sort of meeting the standard without in fact achieving the the goal of the standard. So how how have we been thinking about that in the in the detailed thinking we've been doing and

Manny Narula: of you know I think sort of first say that sort of this will be fundamentally a matter for government in terms of finalizing the policy design and ensuring that it's robust and as well that can be sort of implemented in a way in which it sort of has robust coverage of um the businesses but also can therefore be enforced in a way in which sort of a statutory authority um can oversee sort of both the reporting that is submitted by businesses but then also sort of um able to sort of ensure that you know businesses can report back on sort of them hitting targets um as as well. So I think it is sort of something that's down to government in terms of how to take it forward. I think sort of what I will say and I think goes back to the point I was making around the NPM is that sort of our recommendation is that sort of this is sales weighted that it sort of captures sort of the amounts of different products which are sold which will fundamentally inhibit a lot of these gaming scenarios because you know you can't then sort of um artificially say that you're you're you're you're you're you're selling all these different products when it's actually sort of um based on the sales and sort of this data is therefore then reported to the statutory authority.

Andy Regan: Thanks Manny. Um I'll I'll go to a question that was actually submitted in advance. Um so apologies I don't know who submitted it. I didn't have the name but thanks for sending it in. Um, someone just asking generally about the views on kind of integrating health and exercise alongside healthy eating. So maybe Sara for you like how how have we kind of thinking about that within our overall analysis of of different approaches to tackling obesity?

Sarah Elias: Yeah. Um, so exercise programs were part of the policies that were included in the blueprint work. Um so we were able to kind of look at them um along with other policies as well around what is their impact when we're trying to reduce obesity. Um compared to to kind of healthiness targets that they have a reduced impact on obesity. Um that isn't to say they're not worth doing. And I think kind of what we did find was although they don't have the same sort of impact when we're trying to reduce obesity, they are very important in terms of um maintaining a healthy weight um and also increasing um our general health and cardiovascular health. There's also a lot of social elements to kind of exercise programs that um and the kind of the the benefits that um the social interaction can also have on um health is also really important. So whilst it may not be and this is in consideration as well of the scale of the issue in Wales kind of highest obesity levels the impact on um people's ability to live kind of happy healthy lives um that cost on the NHS the cost to our own economy if we are thinking about an obesity strategy um it shouldn't be kind of the core driver of that obesity strategy but it is a really important element of it in the kind of the longer term and we do have kind of in in the well-being act we've got that focus on we do need to think about the longer term. So definitely not one to ignore. Um but if we're specifically thinking about obesity and how to reduce obesity at a population level um possibly not the most impactful thing that we could be doing with our limited resources.

Andy Regan: Yeah, definitely part of the mix though. Um I'm going to take us on a a slight detour through um an interesting question from Joe Rossa. Um we we talked earlier about the Marmot nation in a Welsh context. Joe's asking whether it's kind of practically and and politically possible um given so much demand from waiting lists, health and social care being such a huge part of the Welsh government's budget already, more than half of it. um arguing that focusing on prevention inherently comes at the cost of frontline services and whether we and I don't know who he means by by we but could be anyone like is anyone willing to have that argument about that tradeoff sara you've got some thoughts on this.

Sarah Elias: Yeah, I think given the reality the scale of the issue I don't think it's something that we can ignore. we simply can't keep putting money into the kind of um health budgets um and and kind of the social care once you add that into it. Um those budgets are huge. I think we have to think about how we can do that shift. Um they're not sometimes um it's the way we do things. They they don't have to be as costly um as the NHS. So kind of shifting that um prevention over to that budget over to prevention kind of over time looking for those big impact low cost policies to begin with to help start shift making that shift. Um I don't think we've got a choice because otherwise kind of our we won't be able to pay for kind of education or these other areas that are losing ground because we're having to put more and money more and more money into kind of a health and social care. um we can't afford not to not to ignore prevention.

Andy Regan: You agree. Um but certainly not a not a straightforward one politically to to look at. Um going to take another one that's been submitted. Um probably do have time for some more, but I think many of the ones so far are covering things we've already uh covered. So if you've got if you've got a question, please do ping it in now while I ask uh the next one. Otherwise, may bring us to a close. Um so we've had a question from Baroness Jones Whitchurch is asking um how could we make adherence to or even exceeding the healthy food standard uh be seen as a reputational issue for the bigger food retailers you know could we could we spin this into a sort of positive or or negative kind of reputational incentive for them um what do you think about that one Manny is that is that part of the thought process

Manny Narula: yeah and it's an interesting question and I think it's sort of it is something that definitely need to be factored into the policy design and sort of the government sort of finalizes its plans you know as part of the consultation process and I think sort of here goes back to the point around designing in enforcement in a way in which sort of encourages that accountability uh for all the sort of large businesses which are in scope Um and then also sets sort of targets in in a way in which sort of lifts up the standards of across other businesses um and therefore is communicated also in a way in which sort of encourages compliance um as well across um all food businesses that are sort of in scope. So I think here it's it it's sort of you know both the sort of um point around the design overall of the policy but then also you know how we implement and enforce in a way which sort of encourages these behaviors.

Andy Regan: Great. Thanks Manny. So I've not seen that any other um questions have have come through. So I guess the final question there which perhaps is slightly builds on a a comment that Suzanne Cass has put in the chat about um just the levels of support amongst the public for action to tackle obesity like generally speaking it's something people understand um you nanny state is often raised in these sorts of discussions but I understand you know we've done some work internally kind of gauging people's reactions to to this policy and to the you know just generally to action on on tackling obesity. If you were sort of um trying to make the case to a politician from any party about why including this in in their manifesto for the for the Senate elections is is likely to kind of have public support like what what's the case we might make to a politician considering um including it in their manifesto or their program for government or perhaps start with you Sara. Why is this good politics as well as good policy?

Sarah Elias: Um I think we've seen and this is across um work that we've done with more in common where we worked with them across the nations um on some um public opinion work um and I think work from public health Wales in their time to talk surveys. People want to take action against these big supermarkets. They see the big supermarkets as part of the problem. People recognize it. I think um so I just looked up the figures quickly as you were talking about but 78% in our work with more in common recognize that supermarkets have a significant influence over their diets. Um and I think kind of people do understand the strain on the NHS and that something needs to change and kind of making that link between kind of um how healthy the food is that we are being sold. Um that's not the decisions we're making about what to eat. when kind of sometimes those decisions are just taken away from us. It's simply what's available on what's on offer. Um the government needs to stand up for people and to make sure kind of that people are offered choices that are affordable, that they're healthy so that they can look after themselves. Um because people do want to lose weight, people do want to be healthy. we need to create that environment. Um and it's up to kind of some would say our politicians to help create that um environment that we want so that we can have kind of those healthier, happier lives.

Andy Regan: Thanks. Sorry, Manny. Do you want to add anything to

Manny Narula: Yeah, sure. And then you know as someone who's sort of well worked in the UK government having come from sort of you know both the treasury and like you know the public spending space I think so this is good politics in the sense that you know we're obviously living in a sort of a very challenging economic context given this geopolitical environment and you know there's a push across government of course of you know sort of tightening spending um and and you know so here I think this really presents opportunity and a policy where actually it's low cost for both um for businesses but then also for the government to implement um but then also at the same time you're able to sort of see potentially huge benefits in terms of the impact you can have on obesity rates and terms of it impact on public health overall. So I think in in terms of that I think it's it's got a serious potential in terms of having an impact.

Andy Regan: Agree. Well, thanks both for um talking us through the policy and the context in Wales today. Um and thanks to everybody for joining and for submitting the questions. I think um you know if I could summarize from the last bit like there's there's clearly lots of very good well-evidenced tangible in some cases quite low cost policies available to governments to tackle obesity uh and all the evidence that that we have and that Suzanne has shared in the chat and I can see Simon from Obesity Alliance Cymru has just shared some evidence as well. I think there's perhaps um a perception that it's it it may be harder than it in fact is in terms of public support for these sorts of measures. I think um if you what the public wants is the government to do things that work uh and do them now. And I think this is an opportunity to do exactly that for the next Welsh government. So hopefully some folks on the call um are in a position to take that forward if um if they or people they work with are involved in the next Welsh government. Um so yeah, thanks everyone for your time today. Um as we said, you will get the um the slides from the presentations in your inbox afterwards. Uh Rory has kindly put a link in the chat to sign up for Nesta's newsletter. We have a Nesta Cymru newsletter that you can sign up for. So please do keep in touch and look out for our future events and thanks very much for joining us today.