The British Nutrition Foundation responds to the National Food Strategy

15th July 2021

Part 2 of the National Food Strategy, led by Henry Dimbleby, has been published today and contains recommendations to address the major issues facing the food system: climate change, biodiversity loss, land use, diet-related disease, health inequality, food security and trade. The report takes an in-depth look at our food systems, how these are currently harming both health and the environment and makes a number of recommendations on how this situation could be tackled. These recommendations will be considered by Government, who will decide how to take them forward.

Professor Judy Buttriss, Director General of the British Nutrition Foundation said: “We support the ambition of the report to improve health, protect our environment and build a better future for generations to come. We also support the need to look more holistically at the interrelationships between our food system, nutrition and health.”

Making healthier choices easier

The report highlights that it is not enough to simply provide people with information and then leave the rest to individual willpower. Our environment provides easy access to calorie dense, palatable and affordable foods, making it challenging to follow a healthy dietary pattern, especially for those on low incomes.

We need major changes to our food environment to make the healthy choice the easiest choice and to support people in making the changes that we know can benefit health. Obesity stigma is not mentioned in the report, but we also need to change the narrative to shift the responsibility from being solely on individuals living with obesity and to challenge the stigma that is both damaging to those who experience it and counterproductive in terms of encouraging healthier lifestyles. It is important that advice on diet and health is not accompanied by moral judgement but is about supporting people across the population and reducing inequalities.

A holistic approach to diet and sustainability

We are pleased that the report emphasises the importance of bringing together environmental sustainability, diet quality and health as part of a joined-up food systems approach. The British Nutrition Foundation’s ultimate aim as a charity is to help make healthy, sustainable diets accessible to all - regardless of age, time, skill or income. However, we know that current average diets in the UK are a long way from meeting existing nutrition and food-based recommendations. We would agree with the sentiments in the report that multiple interventions will be needed to help make healthier choices easier for people across the population, not least tackling the economic inequalities that the report shows have a stark impact on diet-related health conditions.

The report sets out recommendations for substantial changes needed to diets over the next 10 years in order to meet existing Government targets on health, climate and nature. These include a 25% reduction in consumption of high fat, salt and/or sugar (HFSS) foods. There is consensus about the need to reduce HFSS foods, but an understanding of the most effective way to do this is unclear.  Reformulation does not always require individual behaviour change and the report highlights the importance of this strategy going forward to reduce the sugar and salt content of foods (and further suggests reformulation tax on sugar and salt to encourage manufacturers to produce foods lower in these nutrients). But we would have expected to see greater recognition within the recommendations of strategies to encourage intake across all population subgroups of nutrients that we are short of in UK diets – particularly fibre.

Alongside making healthier choices easier, food science and innovation are key to supporting the changes needed to make diets healthier and more sustainable. The report recommends an investment of £1bn in research into more productive fruit and vegetable growing, and the identification and promotion of plant-derived protein and other alternative proteins. We welcome the recognition of the need for science and innovation and would highlight that it is vital that the food industry and research scientists work together to bring the greatest possible benefits to society. But we note that in discussing a ‘protein transition’ linked to reducing meat intake the report focuses only on protein and neglects to consider the many other nutrients that are essential for health and provided in bioavailable form by meat and other animal sources of protein. This needs to be integrated as an important consideration.

The report notes that whilst most people already achieve the recommendation to consume 70g or less of red and processed meat per day, a third eat more, and the report estimates that national meat consumption would fall by at least 15% and red and processed meat consumption by at least 27% if everyone complied with this advice. However, the report states that meat consumption will need to be reduced by 30% to meet targets related to climate change and that consumption of fibre and fruit/vegetables will need to increase by 50% and 30% respectively to meet health related goals. These changes to fruit, vegetable and fibre consumption reflect the need to meet current 5 A DAY and fibre recommendations but will be challenging (major sources of fibre being wholegrain cereals, vegetables, pulses and, to a lesser extent, fruit).

We know that healthy dietary patterns provide significant benefits for our health but it is also clear that we need to change the way we produce and consume food in order to make our food system more environmentally sustainable. While there is still a lot we don’t know about exactly what a healthy and sustainable diet looks like, there are many changes we can make that can benefit both health and the planet. These include eating a plant-rich diet with more wholegrains, vegetables, fruits, nuts and pulses, varying our intake of protein-rich foods to include more plant-based sources, and reducing food waste.

Increasing access to healthier foods

A number of the report’s recommendations relate to increasing access to healthier foods, particularly for those on low incomes. This includes extending access to free school meals, expanding the healthy start scheme and the ‘Community Eatwell’ programme, where GPs would be able to prescribe fresh fruit and vegetables to those suffering from poor diets or food insecurity. We welcome this positive focus on not only cutting back on nutrients such as sugar and salt, but also emphasising what we need to eat more of. While fruit and vegetables are clearly important to include, we would encourage including a broader range of plant foods including wholegrains and pulses to provide a balance of nutrients and variety across the diet.

The report focuses heavily on the adverse outcomes associated with obesity, but it is important to remember that whilst overweight and obesity are key public health concerns, health is much more than just our body weight. The current UK diet falls short in terms of meeting recommendations such as adequate fibre and fruit and vegetable intakes, and intakes of some essential vitamins and minerals are low in some age groups. A healthy balanced diet supports all the systems of the body including our immune, cardiovascular and nervous systems, helps to maintain healthy bones and muscles and supports a healthy gut. While the report highlights that physical activity alone does not usually deliver weight loss, there is evidence that activity combined with dietary changes can be more effective than diet alone for weight control and that physical activity can have significant benefits for physical and mental health and reduction of disease risk.

More and better food and nutrition education in our schools

Roy Ballam, Managing Director and Head of at the British Nutrition Foundation said: “We welcome the inclusion and support for more and better food and nutrition education in our schools and are pleased to see food education highlighted throughout this report. We agree that food and nutrition should be taken seriously – the British Nutrition Foundation always has”.

In relation to the 5 key areas of recommendation 3 in the report, Launch a new Eat and learn initiative for schools, we would highlight the following points:

1. Curriculum changes

 a. Sensory education for early years – we support food and nutrition education for nursery and reception classes. We believe that they can actively take part in a range of learning – about health, cooking and food provenance. We already provide support online, and have been involved in research projects looking at increasing fruit and vegetable consumption in this age phase.

b. Reinstate A-level - We fully support the recommendation to reinstate food and nutrition at A-level. We have been vocal in our support for this to happen. More recently, we undertook research with the Food Teachers Centre, which indicated that as a consequence of the removal, there is less food and nutrition teaching, less funding, a decline in status, and an issue with staffing capacity. A new food and nutrition A-level should be robust, and fully embrace nutrition, food science and sustainability – engaging with young people, universities and employers.

c. Review other qualifications - We welcome a review of qualifications, ensuring good progression from GCSE into higher education and future careers.

2. Accreditation - While we support this recommendation in principle, funding to participate in these types of accreditation schemes should not be a barrier for schools. There are many good Healthy Schools schemes in operation.

3. Inspection - We support Ofsted undertaking a review of food and nutrition in schools – primary, middle, secondary and special. We also believe that Ofsted needs to have staff who have the necessary skills, knowledge and understanding. While it is about high quality teaching and learning, subject content matters. We would welcome the opportunity to support Ofsted staff in this matter.

4. Funding - We fully support the recommendation that the government pays for ingredients that children use. The British Nutrition Foundation recommended this in the Food Education Learning Landscape report (2017, page 72).

5. Recruitment - We fully agree that a recruitment drive is required for new food and nutrition teachers in our secondary schools. The most recent DfE school workplace review indicates that since 2015/16, the number of these teachers has reduced by 678 equivalent to over 15% of the workforce.

The British Nutrition Foundation also recommends that those training to become primary school teachers also receive food and nutrition training and support in their training year.

More generally, we have always supported the Whole School Approach – and provide support and advice on our education website.

There are many organisations, such as the British Nutrition Foundation, that already provide a range of resources, training and experiences to schools. Therefore, it will be important that these organisations work with government to support, promote and stimulate food and nutrition education even further.