18th August 2016
The governments’ plan was published today outlining its plans to reduce childhood obesity in England over the next 10 years.
Currently in the UK, around one in five 5-year-olds and one in three in 10 year-olds are overweight or obese, with children of all ages being twice as likely to be obese in the most deprived areas compared to the least deprived areas. Half of seven year olds are not meeting the Chief Medical Officer’s target of at least an hour of physical activity daily.
Key features of the plan include:
- A tax on sugar-containing soft drinks from 2018 across the UK (as previously announced) with the levy invested in programmes to reduce obesity (e.g. supporting physical activity and healthy breakfast clubs in schools). This is not a tax on consumers; the levy directly targets the producers and importers of sugar-sweetened soft drinks and companies are not obliged to pass the cost on to consumers. [https://www.gov.uk/government/news/soft-drinks-industry-levy-12-things-you-should-know]
- A reduction in the sugar content of products that contribute to children’s sugar intake by 20% by 2020 (with a 5% reduction in the first year versus 2015 levels), to be achieved via voluntary reformulation, reduction in portion size or shifting purchasing to lower sugar options. This applies to all sectors – retailers, manufacturers and the out of home sector. Initial focus will be on 9 categories: breakfast cereals, yogurt, biscuits, cakes, confectionery, morning goods (e.g. pastries), puddings, ice-cream and sweet spreads but widened to other product categories by 2017 and possibly other nutrients (following SACN’s review on saturated fat).
- Update of the nutrient profile model used to restrict advertising to children.
- A recommitment to the Healthy Start Scheme.
- Incorporation of physical activity into the Healthy Schools rating scheme (see below).
- Advice to be provided to schools on how to access support/resources to encourage children to be healthier, with a new online tool to help them plan for children to be active each day.
- All primary schools to have access to high quality sport and physical activity programmes and opportunities for families to be active and involved in sport as outlined in the Sport England Strategy.
- A Cycling and Walking Investment Strategy which will encourage active transport to school.
- A new healthy rating scheme for primary schools (considered in Ofsted inspections) and an annual competition to encourage good practice.
- A thematic review on obesity, healthy eating and physical activity to be undertaken by Ofsted in 2017.
- An update of the School Food Standards by the Department for Education in light of recent new dietary recommendations (for free sugars and dietary fibre).
- Consideration of sugar labelling on products in light of the UK’s recent exit from the EU.
- Revised menus will be incorporated into voluntary guidelines for early years settings.
- Consideration of ways technology can be used to encourage healthier lifestyles.
- Support training to ensure all those working with families are confident to talk about nutrition and weight management.
The government’s obesity plan has been eagerly awaited as there is no doubt that environmental change to make heathier choices accessible and preferable, to encourage physical activity and to help reduce sedentary behaviour is central to the nation’s battle with obesity. Early childhood is a critical time for obesity prevention and the Foundation welcomes the activities to help early years settings and schools to encourage healthier dietary choices and physical activity habits. We are also pleased that the plan is encouraging participation from all sectors of industry, including the out-of-home sector, which has an important role to play in making healthier food choices available for consumers and in positively promoting these healthier choices.
Opportunities to support healthier eating and physical activity in schools
The Foundation also welcomes the emphasis of increased physical activity in primary schools. To ensure effective and smooth transition, and build on this momentum, this should also be reflected in secondary schools. Importantly, the links between physical activity, health and diet must be emphasised. We would also like to see food and nutrition education included in the plan. All teachers should receive training in relevant aspects of nutrition and have an understanding of the important role they play in supporting the health and wellbeing of children in their care. This should be through initial and continuing professional development. The training should follow the food teaching guidelines developed by government, with BNF, in 2015. In addition, Ofsted inspectors could be given the opportunity to refresh their knowledge and understanding of food and nutrition – supporting their judgements in schools. The BNF would be delighted to work with government on these initiatives.
Sugars reduction as part of a wider strategy to reduce obesity
The plan focusses on sugars intake in light of recent new recommendation to lower free sugars intake to 5% dietary energy. Most people have intakes well above this target, and a key feature of the plan is a target of a 20% sugar reduction by 2020 (including a 5% reduction in year one) in foods and drinks making a substantial contribution to children’s total sugars intake. For a number of reasons, including current legislative constraints, this universal target is likely to be more difficult to achieve for some categories (e.g. low water content foods such as breakfast cereals and confectionery compared to drinks), particularly with the requirement of simultaneous calorie reduction, without which there will be no impact on energy intake. Reductions in portion sizes, alongside reformulation, will therefore be key to achieving the overall target for at least some product categories. An expansion of the plan to consider other energy providing nutrients, particularly saturated fat following the expected publication of SACN’s review in 2017, will be important to ensure that changes support obesity prevention and broader aspects of public health.
Healthy eating is about more than just sugars intake. A healthy, balanced diet, as depicted by the new Eatwell Guide, should be the focus of healthy eating advice in the UK. The new dietary reference value of 5% of energy refers to free sugars specifically, not total sugars; not all forms of sugars are targeted for reduction. In efforts to encourage free sugars (and calorie) reduction, the contribution to essential nutrient intake of foods that provide other forms of sugars (in particular fruits, milk-based products) needs to be considered carefully. This is especially important with regard to teenage girls and young women, for whom there is evidence of a low intake and/or status of a number of essential vitamins and minerals.
What is BNF doing?
BNF is involved in a number of activities that directly relate to many of the initiatives outlined in the obesity plan.
Helping the out of home sector provide healthier choices
To improve awareness and knowledge of healthier eating amongst catering staff, BNF has developed Catering for health - an online training course aimed at providing caterers and food service providers with the knowledge and skills to be able to offer healthier menus. This is currently being updated to encompass the new Eatwell Guide, and the recommendations stemming from the SACN Carbohydrates and Health report and will be available in early September 2016.
Helping food businesses keep abreast of developments in nutrition
The Foundation has also developed a number of online courses to support those in industry keep up to date with nutrition-related issues. These include basic and more advanced nutrition courses as well as those focussing on specific topics (e.g. food labelling and regulation).
Supporting early years settings
BNF is involved in a number of initiatives to help parents and carers to provide healthier foods/drinks for the under 5s. These include:
- Complementary feeding and obesity
We have developed an online training course for health professionals, Complementary feeding and obesity, that looks at the factors in complementary feeding (also commonly known as weaning) that may influence obesity in childhood.
- A portion size guide: 5532
To help parents and carers know what types of foods toddlers should be eating and in what amounts, we developed the 5532 model for toddlers aged 1-3 years. This is designed to help parents and carers choose a healthy, varied diet for their child.
- EYN Partnership
BNF is a partner in the new community interest company Early Years Nutrition Partnership which aims to improve the future outcomes for young children by setting a standard for nutrition practice in early years settings. Unique and central to the EYN Partnership is the provision of ‘hands-on’ help for early years settings, delivered by a network of registered nutrition professionals (Registered Nutritionists and Registered Dietitians) specialising in the early years. These nutrition professionals work alongside settings to improve their nutrition practice, supporting them on their journey to improve and enhance their whole setting approach to nutrition practice. The support provided by the local nutrition professional is tailored and nuanced towards the demographic of each particular setting and the community in which it operates, in recognition of the fact that each early years setting is different and is likely to face different challenges.
As part of the EYN Partnership programme, early years settings can seek accreditation with the EYN Partnership Quality Mark, demonstrating a ‘whole setting’ approach to good nutrition practice. The programme will further upskill early years practitioners by providing them with the opportunity to study for a Level 3 CACHE award in nutrition and hydration in the early years, or a Level 2 award for early years caterers. The EYN Partnership is committed to building a working model that will support those settings with the highest social deprivation needs, with an ambition that at least 10% of the settings registered will benefit from subsidised access.
Enabling health professionals to support families
BNF recognises the enormous potential of health professionals to make every contact count with children, their families and adults to facilitate their ability to achieve and maintain a healthy weight. As well as running eseminars, we have developed a number of evidence-based online training programmes for health professionals (e.g. midwives, health visitors, nurses) to strengthen their knowledge and confidence when talking to their clients about diet or weight issues.
BNF online training is available on https://www.nutrition.org.uk/online-training.html
Working with schools
BNF plays an important role in this area, delivering teacher training events across the UK. In 2015, we launched a professional development programme and already have over 1,300 teachers registered to improve their food and nutrition knowledge. We also have an ambition to provide the opportunity for online nutrition training for primary and secondary school teachers in 2017.
The Foundation's education programme, Food - a fact of life, established over 20 years ago, provides a range of free, curriculum compliant resources to support busy teachers. Our work with teachers has shown that this resource can have an important role in the teaching and learning of food and nutrition teaching in primary schools (Schneider & Theobald 2016).
In addition, BNF’s Healthy Eating Week, which in 2016 worked with over 6,800 schools (representing over 3.2 million children), has the potential to enable schools to showcase how they promote and support the health and wellbeing of their children. Teacher feedback indicates that they believe that the Week helps to raise the profile of healthy eating and demonstrate the importance of physical activity (Ballam 2016).
In support of the government’s childhood obesity plan, the Foundation has a number of proven resources and initiatives that will support schools on their journey. These include:
- Core competences (PHE 2014) https://www.nutrition.org.uk/foodinschools/competences/competences.html
- Food teaching in primary schools: knowledge and skills (PHE/DfE 2015) https://www.gov.uk/government/publications/food-teaching-in-primary-schools-knowledge-and-skills-framework
- Food teaching in secondary schools: knowledge and skills (PHE/DfE 2015) https://www.gov.uk/government/publications/food-teaching-in-secondary-schools-knowledge-and-skills-framework
- Development and evaluation of food and nutrition teaching kits for teachers of primary schoolchildren http://onlinelibrary.wiley.com/doi/10.1111/nbu.12189/full
- British Nutrition Foundation Healthy Eating Week 2016 http://onlinelibrary.wiley.com/doi/10.1111/nbu.12227/full
Ballam R (2016) British Nutrition Foundation Healthy Eating Week 2016. Nutrition Bulletin 41: 283–289
Scheider E & Theobald C (2016) Development and evaluation of food and nutrition teaching kits for teachers of primary schoolchildren. Nutrition Bulletin 41: 55–66