Childhood Obesity: A Plan for Action
BDA Policy Statement
Summary
On 18th August 2016 the government published Childhood Obesity: a plan for action1, the long awaited
strategy to tackle the issue of widespread childhood obesity in the UK. The BDA, alongside many other
healthcare bodies and charities, expressed disappointment at the “much diminished” document when it
was published2.
Key policies which were expected to have been included, such as proposals to ban junk food advertising
before the 9pm watershed and regulation of price promotions on unhealthy food, were not included.
Proposals for a Sugar Levy, first outlined by the government in the 2016 Budget, were included, and
welcomed by the BDA in line with our previously stated position3.
The BDA
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Calls on government to strengthen its plan for action to include areas such as regulation of advertising
and price promotions.
Calls on government to better recognise the important role of dietitians, other healthcare professionals
and education programmes can play in preventing and reducing childhood obesity with the plan for
action.
Continues to support the implementation of the Sugar Levy
Encourages industry to reformulate its products rather than campaigning against the Sugar Levy
Analysis
What is missing from the strategy?
The strategy begins by outlining the prevalence of obesity in the UK and the impact this has on the
economy and individual health. However in outlining that “…sustainable change will only be achieved
through the active engagement of schools, communities, families and individuals” the strategy has missed
out one key stakeholder; the food industry. Their involvement is vital in making an impactful change on
our food choices and the environment we live in.
The strategy does not identify the impact of advertising on childhood obesity, namely the advertising of
High Fat, Sugar and Salt (HFSS) foods on TV and through advergaming. There is no restriction imposed
on this. Although the Government has pledged to update the Nutrient Profiling Model which will mean
more stringent rules on coding for high fat, high sugar foods, this will not present enough of a barrier to
stop the advertising of unhealthy foods to children.
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https://www.gov.uk/government/publications/childhood-obesity-a-plan-for-action
https://www.bda.uk.com/news/view?id=133&x[0]=news/list
https://www.bda.uk.com/improvinghealth/healthprofessionals/policystatementSugaryDrinksConsumption
The tax on soft drinks does not go far enough as to restrict the promotion of unhealthy foods in
supermarkets and high street stores. Research indicates that 40% of our purchases are on promotional
goods which tend to be high in fat, sugar and salt. There is no indication in the strategy that there will be
a restriction on the number or percentage of foods high in fat, salt & sugar that can be put on promotion.
Additionally the Government provide no incentive or encouragement for supermarkets or food business to
change the ratio of the promotional food towards healthier foods and drinks such as fruit & vegetables.
Do the elements that are included go far enough?
The tax on soft drinks will be beneficial and the revenue made that will be put towards increasing the
funding for PE and Sport, as well as expanding healthy breakfast clubs is positive and will be beneficial
for schools, providing a healthy start to the school day for children and ensuring they stay active every
day. However, it is important to note in the strategy that the government have given producers and
importers two years to lower the sugar in their drinks so that they will not face the levy if sufficient action
is taken. This implies that little, if any, revenue will be made, and therefore impacts on the funding for
physical activity and breakfast clubs. The BDA would welcome reformulation but also believes the
government needs to ensure funding is available for these activities.
The strategy outlines a programme to be led by PHE to reduce sugar in food products by 20%, targeting
nine main food groups including breakfast cereals, yoghurts, biscuits, cake, and confectionary, morning
goods such as pastries, puddings, ice cream and sweet spreads. Although it states that PHE will be
monitoring the industry to ensure they meet expectations, there is no indication of what sanctions will be
imposed if a company fails to meet the expectations, and the exact details of how the changes will be
made. The government does go as far to explain that alternative levers will be implemented if insufficient
change is made after a review. Nonetheless, the BDA believes this gives less scrupulous producers too
much freedom and prolongs the time it will take for reformulation to be implemented.
The strategy identifies that sugar should not be the only nutrient considered in tackling obesity and
recognises the impact of excessive calories and salt on our weight and health. Despite this, the strategy
does not identify who and how reductions in calories will be monitored and reviewed.
A positive stance from the strategy is the recognition that the public sector should lead by example and
adopt the Government Buying Standards for Food (GBSF) standards, restrict the promotion of unhealthy
food and promote healthy options. The trial in NHS hospitals of behavioural interventions will go towards
supporting workplace interventions.
The government identifies the positive impact of the Healthy Start scheme and supports the continuation
of the scheme in the strategy. However, detail about how Local Authorities will be supported to re-establish
or re-launch the scheme in boroughs is not explained. The strategy fails to recognise why the scheme
may have been unsuccessful in some Boroughs, failing to consider the impact of different demographics,
education and stigma, and the Healthy Start scheme’s obstructive bureaucracy.
The strategy dedicates a lot of focus towards increasing physical activity in schools as well as investing in
active transport, with a £300 million investment in Cycling and Walking Investment Strategy. Yet there is
little information about the support or funding towards educating young people and families about the
importance of a balanced diet and cooking skills. This is vital as evidence from PHE highlights that dietary
risks is the biggest burden of disease in England contributing to Cardiovascular Disease (CVD), diabetes,
neoplasms, urogenital, blood and endocrine diseases (PHE 2016). Supporting and increasing physical
activity is one element to increasing energy expenditure, however does not cover the wide determinants
of obesity namely diet, environment, and education. Additionally, many schools are becoming or
considering becoming academies – although funding will be given to sport programmes these schemes
remain voluntary for schools, so the BDA urges clarity on how schools will be encouraged and supported
to partake in these schemes.
How could and should dietitians be involved in delivering the aims of the strategy?
Enabling healthcare professionals to build on the good work and talk about weight and dietary issues is
one consideration; however the strategy does not identify how healthcare professionals will be supported
to do so. The strategy refers to weight management services and clubs, however fails to acknowledge
that many weight management services are at risk of being decommissioned due to Local Authority funding
cuts and that there are fewer opportunities for health professionals to refer to appropriate services. This
is despite the NICE recommendations on weight management and lifestyle services for overweight and
obese children and adults.
Additionally the strategy comments on reviewing the advice provided by midwives and health visitors to
ensure families get the best and up-to-date advice, but again fails to acknowledge that in some boroughs
these services are being restricted or limited due to a lack of funding to public health services. It also fails
to acknowledge that these professionals will require additional support and training to deliver the best and
most up to date advice. Dietitians are well placed to train and support these professionals, who currently
receive minimal training in nutrition.
Dietitians should be involved in all aspects of the life course from pre-natal right through to later adulthood.
Together with other health professionals, dietitians provide the nutrition expertise required at each life
stage, especially during pregnancy, post pregnancy, in early years, breastfeeding, weaning, start of school,
transitions, and adolescence through to adulthood. Each of these stages has a huge impact on physical
development and mental wellbeing, and can influence the weight of a child through to their adult life, and
also the risk of developing long term diseases such as CVD, diabetes and some cancers. There is no
acknowledgement of dietitians input or help towards this in the strategy, which is very disappointing.
Conclusion
As a whole the BDA does not believe Childhood Obesity: A Plan for Action constitutes a true strategy as
it does not include recommendations for action and lacks prioritisation of activities. It is also insufficiently
stringent and does not impose on industry to make significant change. It does not refer to an executive
summary and does not explain who compiled the strategy. There is no reference to key documents such
as the WHO Ending Childhood Obesity report, Cancer Research report and the Obesity Health Alliance
recommendations.
Published: October 2016
Review Date: October 2017
Written by the BDA Obesity Specialist Group on behalf of the BDA
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