I met a councillor at a recent food and farming event and she asked me why the government doesn’t have a plan to fix the food system. It’s a good question, one we should all be concerned with. Civil servants and food policy wonks will tell you there isn’t the political will, that the government largely leaves the job of feeding people to the big food corporations, and that the disconnect between government departments makes leadership and oversight of the food system difficult.
But should we accept this given our public health crisis? England has one of the highest rates of obesity among high-income nations, driven primarily by unhealthy diets. In fact, we have one of the most ultra-processed diets in Europe. In Brighton where I work, only 38% of adults in the city consume five or more portions or fruit and vegetables per day and one in three 11-year-olds are obese or overweight (up to two out of three in some schools).
The high cost of poor diets
Obesity costs the NHS around £6.5 billion a year and is the second biggest preventable cause of cancer, after smoking. A recent study showed that one in five young adults had fat accumulation within the liver and 1,206 children in England are receiving care for type 2 diabetes – a disease not seen in children 25 years ago.
There is a mass of evidence correlating diets high in ultra-processed foods with poor health. But despite this evidence, 7 in 10 parents say it’s getting harder to ensure children are eating healthily. The sad truth is it is cheaper to feed your kids with a frozen pizza than cook from scratch with fresh ingredients.
There is a lot of buzz around the recent House of Lords report, ‘Recipe for health: a plan to fix our broken food system’. I was struck by the comments of Baroness Walmsley, Chair of the Food, Diet and Obesity Committee. She said: “Over the last 30 years successive governments have failed to reduce obesity rates, despite hundreds of policy initiatives. This failure is largely due to policies that focused on personal choice and responsibility out of misguided fears of the ‘nanny state’.” Walmsley urged the government and the food industry to “take responsibility for what has gone wrong and take urgent steps to put it right.”
In the report, Kristin Bash, Chair of the Food Special Interest Group at the Faculty of Public Health, said that the policy focus on individual responsibility over intervention “is like saying that we should all have responsibility for driving our cars safely, but ignoring the influence and purpose of traffic regulations and speed limits.”
Dr Chris van Tulleken, TV presenter and author of the book Ultra Processed People, agreed that the argument in favour of personal responsibility “is morally, economically, socially, politically and scientifically dead and buried.”
We need better food environments
We live in increasingly ‘obesogenic’ environments, and it’s not hard to guess what that means. The number of fast-food outlets in towns and cities has soared and, thanks to the plethora of food delivery companies, we no longer need to leave our chair to be able to eat food loaded with fat, sugar, salt – and ingredients that don’t even count as food.
While developing Brighton and Hove’s Food Strategy Action Plan, I was interested to discover that we have seven neighbourhoods in the top 20% of places in England with food ‘desert’ characteristics – a mixture of low incomes, poor access to transport, and a limited number of food retailers providing fresh produce and healthy groceries for affordable prices. It’s sobering to think there are any food deserts in a city that prides itself on its gastronomy.
Food is big business – we all have to eat. But food that is bad for us comes with higher profit margins, so where is the incentive for businesses to make food healthier? The obvious answer is regulation. According to the Recipe for Change coalition, an industry salt and sugar reformulation tax could prevent up to two million cases of chronic disease, including diabetes, cardio-vascular disease and some cases of cancer over the next 25 years.
Although many leading retailers and a growing number of food and drinks companies are increasingly backing smart regulation, food corporations have used a toolbox of tactics to resist it, from lobbying ministers and financing political parties to challenging regulations in court and exploiting legal loopholes. If that doesn’t work, they can always fund campaigns to shape public opinion, arguing that regulation would wreck the economy or take away our choices.
Junk food advertising promotes unhealthy options
We know that advertising works. It’s why businesses spend eyewatering sums on it. Fifty years on, I can still recall the force and persistence with which I begged my mum to buy Klondike Pete’s Golden Nuggets breakfast cereal, which came with the irresistible promise of a Flikka motion card inside. But try as I might, I can’t recollect any TV advert seducing me to buy a bunch of carrots. A third of the total food and drink marketing spend in the UK is channelled towards unhealthy products compared to just 1% used to advertise fruit and vegetables.
Politicians may fret about ‘nanny statism’, but people do want government intervention to improve the food system, as the Food, Farming and Countryside Commission discovered through their Food Conversation. The much called for ban on junk food TV adverts before the 9pm watershed will finally come into force from 1 October 2025. No doubt this will help protect children to some extent, but they will still be bombarded by junk food adverts in the street, on public transport or online where they spend much of their time.
Can we be hopeful for change?
After commissioning the National Food Strategy, the Conservative government failed to implement most of its recommendations. But with Labour, there are signs of mood change. The dire situation facing the NHS, as laid out in the recent Darzi Review, has led to calls for a more preventative health policy. And the Prime Minister himself is reported to be concerned at “the declining physical and mental health of our children”.
The Labour government has at least committed to rolling out free breakfasts in primary schools from April 2025 and to ban sales of energy drinks to children under 16. It’s a start. But to ensure breakfast clubs are healthy, there need to be standards and provisions to implement them to avoid replicating the beige, carbohydrate laden, largely outsourced school meals.
The food industry is a hard nut to crack. But as Labour said in its manifesto for the NHS, “Prevention will always be better, and cheaper, than a cure”. Let’s hope they will be bold. It was never enough just to clap for our NHS, we must push our government to tackle the food system that is choking it.
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