Childhood obesity: time for more comprehensive regulation of the food industry

Childhood obesity continues to rise in the UK. Currently one in ten children are obese at the start of primary school, and one in six are obese by the end of it. Furthermore, severe obesity is becoming more common, with nearly four per cent of children aged 11 years falling into this category. Of additional concern are the higher levels of childhood obesity seen in more socioeconomically disadvantaged children, which significantly contributes to the health inequalities that are present in the UK.

In August 2016, post Brexit and during Parliamentary recess, the Government launched a national action plan to tackle childhood obesity. This was widely criticised as inadequate and lacking in legislative approaches, especially with respect to regulation of the food industry. Instead, the focus was on encouraging companies to voluntarily take action and work towards reducing the sugar in products consumed by children. A target of a 20 per cent reduction by 2020 was set, with a five per cent reduction in the first year. This governmental approach of voluntary action was particularly disappointing given the failure of the public health responsibility deal, introduced in 2011, which aimed to foster partnership with the food and drinks industries by encouraging them to voluntarily pledge to improve the health of the public through a variety of measures.

The one regulatory approach included in the Government’s childhood obesity action plan was the soft drinks industry levy,or the so-called ‘sugar tax’, subsequently introduced in April 2018. Companies manufacturing soft drinks with added sugar have to pay a levy, and there is a higher rate for drinks with higher levels of added sugar. Although it is early days, the levy appears to be having a positive impact, with companies reformulating soft drinks and substantially reducing their sugar content. Perhaps of note though, is that two iconic soft drinks that are distributed globally - classic Coca-Cola and full sugar Pepsi - have not been reformulated and so are subject to the higher levy, which has resulted in price increases for consumers.

In comparison to the relative success of the soft drinks industry levy, the programme of voluntary reformulation of sugar-containing foods has proved disappointing, with only a two per cent reduction in added sugar in the first year; a significant shortfall from the target of five per cent. This may, of course, improve as further time passes but given the evidence to date, we would be naïve to think that this voluntary approach will match the changes that could be achieved by regulation. At risk of stating the obvious, the key driver for food companies producing unhealthy foods is profit, and not the health of the public, and there is plenty of evidence to show that multinational companies seek to work around public health policy to preserve their profit margins.

Food industry regulation as a way of tackling childhood obesity presents a huge opportunity. Food reformulation is only one area where legislation could be applied. Other areas where legislative approaches could have a real impact are agricultural policy, food marketing and pricing, broadcast and non-broadcast advertising, and sponsorship. The Health and Social Care Parliamentary Committee Inquiry into childhood obesity took place in May this year, ahead of the Government’s planned publication of a refreshed childhood obesity action plan this summer. Encouragingly, the Parliamentary Committee recommend advertising and food promotion restrictions, and greater powers for Local Authorities to control the proliferation of fast food outlets and billboard advertising, as well as calling for the soft drinks industry levy to be applied to milk-based drinks.

It is heartening to see these legislative recommendations, but what now remains to be seen is whether the Government will face up to the food industry and see these recommendations through in the updated action plan. If they do so, we may see a much greater impact on the diets of our children, and that can only be a good thing.

Dr Miranda Pallan,

Senior Clinical Lecturer in Public Health at the University of Birmingham's Institute of Applied Health Research