National Food Strategy: urgent and robust government support is needed.
Dear Editor
The Institute of Health Promotion and Education welcomes the publication of the National Food Strategy report.(1,2) This ambitious 289-page publication quite rightly includes sections on food production, education, marketing and supporting those on low incomes. It also suggests actions in key settings - schools, hospitals, prisons and local communities. We hope that the government will carefully consider its recommendations and quickly launch a well-funded strategy that is robust enough to tackle the obesity epidemic.
Over recent years we have consistently argued for a comprehensive strategy,(3,4) but as obesity is one of our most pressing public health problems, we urge the government to act immediately in five key areas:
I) Make reducing obesity a government priority.(3,4)
II) Provide appropriate funding for Directors of Public Health.(5,6)
III) Support schools in relation to the formal curriculum, catering and physical activity.(7-12)
IV) Provide healthy options in hospitals for patients, staff and visitors.(8,12-14)
V) Increase physical activity opportunities.(15,16)
Although there is a pressing need for national government support and action, there is also a vital role for local Directors of Public Health to play.(5,6) Directors will need increased and sustainable funding so that they can encourage action in different settings and develop local evidence-based strategies. Schools, hospitals, primary care, local companies and the media all need to be involved. Key roles for directors and their teams will include coordination, training professionals, empowering communities and galvanising people into action.
Schools are an essential setting for the promotion of health and the development of health literacy in young people.(7,9) The report suggests schools should be encouraged to adopt a whole school approach, however food should not just be another health topic. It is shame that such an approach is no longer part of a National Healthy Schools Programme discontinued by the Government in 2010. The recently published Health Education food choices, physical activity and balanced lifestyles mapping guidance from the PSHE Association goes some way in helping children and young people develop the knowledge and skills to make healthy choices.(17)
Looking back at the recent past, governments have taken a fragmented approach to tackling obesity and often focused solely on trying to promote individual behaviour change. There has been less action on obesogenic environments that undermine the adoption of healthy eating and hinder the ability to be physically active.
This current government has indicated that it will carefully consider the report and respond with a white paper within six months, setting out priorities for the food system. However, with rates of obesity in England being high and rising, we believe that the action should be sooner.
It is important to note that the National Food Strategy report builds on the wealth of research, authoritative reports and parliamentary inquiries that have called for urgent action.(8, 18-28) Moreover in developing the report the authors took advice form a wide range of academics and other experts from agriculture, industry and voluntary groups. We strongly believe that the government should quickly respond to this report with a comprehensive long-term strategy that is adequately funded and robustly supported.
References
1) Iacobucci G. Food strategy calls for tax on sugar and salt and for GPs to prescribe fruit and vegetables. BMJ 2021;374:n1807 https://www.bmj.com/content/374/bmj.n1807
7) Lloyd J. Improving health outcomes and health literacy for children and
young people through Personal, Social and Health Education in schools.
Paper presented at the 17th EUSUHM Congress. 27 June 2013. Royal College
of General Practitioners. London.
8) BMA Food for thought: promoting healthy diets among children and young people. London: BMA 2015.
11) Watson MC, Lloyd J. Creating health promoting schools will improve population health and help reduce inequalities. BMJ 2021;373:n1290 https://www.bmj.com/content/373/bmj.n1290
12) Baybutt M, Kokko S, eds.A handbook on settings-based health promotion.
Springer, 2021, (forthcoming).
21) World Health Organization. Prioritizing areas for action in the field of population-based prevention of childhood obesity. A set of tools for Member states to determine and identify priority areas for action. Geneva: World Health Organization 2012. https://apps.who.int/iris/handle/10665/80147
26) Loopstra R, Reeves A, Tarasuk V. The rise of hunger among low-income households: an analysis of the risks of food insecurity between 2004 and 2016 in a population-based study of UK adults. J Epidemiol Community Health. 2019 Jul;73(7):668-673. doi: 10.1136/jech-2018-211194. Epub 2019 Apr 29. PMID: 31036607. https://jech.bmj.com/content/73/7/668.long
Rapid Response:
National Food Strategy: urgent and robust government support is needed.
Dear Editor
The Institute of Health Promotion and Education welcomes the publication of the National Food Strategy report.(1,2) This ambitious 289-page publication quite rightly includes sections on food production, education, marketing and supporting those on low incomes. It also suggests actions in key settings - schools, hospitals, prisons and local communities. We hope that the government will carefully consider its recommendations and quickly launch a well-funded strategy that is robust enough to tackle the obesity epidemic.
Over recent years we have consistently argued for a comprehensive strategy,(3,4) but as obesity is one of our most pressing public health problems, we urge the government to act immediately in five key areas:
I) Make reducing obesity a government priority.(3,4)
II) Provide appropriate funding for Directors of Public Health.(5,6)
III) Support schools in relation to the formal curriculum, catering and physical activity.(7-12)
IV) Provide healthy options in hospitals for patients, staff and visitors.(8,12-14)
V) Increase physical activity opportunities.(15,16)
Although there is a pressing need for national government support and action, there is also a vital role for local Directors of Public Health to play.(5,6) Directors will need increased and sustainable funding so that they can encourage action in different settings and develop local evidence-based strategies. Schools, hospitals, primary care, local companies and the media all need to be involved. Key roles for directors and their teams will include coordination, training professionals, empowering communities and galvanising people into action.
Schools are an essential setting for the promotion of health and the development of health literacy in young people.(7,9) The report suggests schools should be encouraged to adopt a whole school approach, however food should not just be another health topic. It is shame that such an approach is no longer part of a National Healthy Schools Programme discontinued by the Government in 2010. The recently published Health Education food choices, physical activity and balanced lifestyles mapping guidance from the PSHE Association goes some way in helping children and young people develop the knowledge and skills to make healthy choices.(17)
Looking back at the recent past, governments have taken a fragmented approach to tackling obesity and often focused solely on trying to promote individual behaviour change. There has been less action on obesogenic environments that undermine the adoption of healthy eating and hinder the ability to be physically active.
This current government has indicated that it will carefully consider the report and respond with a white paper within six months, setting out priorities for the food system. However, with rates of obesity in England being high and rising, we believe that the action should be sooner.
It is important to note that the National Food Strategy report builds on the wealth of research, authoritative reports and parliamentary inquiries that have called for urgent action.(8, 18-28) Moreover in developing the report the authors took advice form a wide range of academics and other experts from agriculture, industry and voluntary groups. We strongly believe that the government should quickly respond to this report with a comprehensive long-term strategy that is adequately funded and robustly supported.
References
1) Iacobucci G. Food strategy calls for tax on sugar and salt and for GPs to prescribe fruit and vegetables. BMJ 2021;374:n1807
https://www.bmj.com/content/374/bmj.n1807
2) The National Food Strategy. The plan. July 2021.
https://www.nationalfoodstrategy.org/
3) Watson MC, Lloyd J. Taxing sugar should be just one element of a multifaceted campaign. BMJ 2015;351:h4388.
https://www.bmj.com/content/351/bmj.h4388
4) Watson MC, Lloyd J. Obesity epidemic: bold and decisive action needed. BMJ 2019;367:l6396
https://www.bmj.com/content/367/bmj.l6396.full
5) BMA. Funding for ill-health prevention and public health in the UK. May 2017.
6) Watson MC, Thompson S. Government must get serious about prevention.
BMJ 2018;360:k1279. doi: 10.1136/bmj.k1279 pmid: 29588283
https://www.bmj.com/content/360/bmj.k1279.long
7) Lloyd J. Improving health outcomes and health literacy for children and
young people through Personal, Social and Health Education in schools.
Paper presented at the 17th EUSUHM Congress. 27 June 2013. Royal College
of General Practitioners. London.
8) BMA Food for thought: promoting healthy diets among children and young people. London: BMA 2015.
9) Lloyd J, Watson MC. Institute of Health Promotion and Education position
statement: personal, social, and health education. Institute of Health
Promotion and Education. 2019.
https://ihpe.org.uk/wp-content/uploads/2020/02/PSHE-Position-Paper-Octob...
10) Cheater S. Health promoting schools—back to the future! Int J Health Promot
Educ 2019;57:355-7. doi: 10.1080/14635240.2019.1665926
https://www.tandfonline.com/doi/abs/10.1080/14635240.2019.1665926?journa...
11) Watson MC, Lloyd J. Creating health promoting schools will improve population health and help reduce inequalities. BMJ 2021;373:n1290
https://www.bmj.com/content/373/bmj.n1290
12) Baybutt M, Kokko S, eds.A handbook on settings-based health promotion.
Springer, 2021, (forthcoming).
13) Watson MC, Lloyd J. It’s time to ban junk food on hospital premises. British Medical Journal Rapid Response, 1 July 2013.
https://www.bmj.com/content/346/bmj.f3932/rr/652126
14) Holmes J. Tackling obesity. The role of the NHS in a whole-system approach. London, Kings Fund 2021.
https://www.kingsfund.org.uk/publications/tackling-obesity-nhs
15) Academy of Medical Royal Colleges. Exercise: the miracle cure and the role of the doctor in promoting it. London: Academy of Medical Royal Colleges, 2015.
https://www.aomrc.org.uk/reports-guidance/exercise-the-miracle-cure-0215/
16) Watson MC, Lloyd J. Seismic shift in policy needed to increase physical
Activity. BMJ 2015;350:h3486
https://www.bmj.com/content/350/bmj.h3486
17) PSHE Association. Health Education: food choices, physical activity & balanced lifestyles mapping guidance. London: PSHE Association, 2021.
https://www.pshe-association.org.uk/curriculum-and-resources/resources/h...
18) Lobstein T, Baur L, Uauy R. Obesity in children and young people: a crisis in public health. Obesity Reviews, 2004, 5(Suppl 1):4–104.
https://onlinelibrary.wiley.com/doi/full/10.1111/j.1467-789X.2004.00133....
19) Foresight. Tackling Obesities: Future Choices – Project Report. Government Office for Science: London, 2007.
https://www.gov.uk/government/collections/tackling-obesities-future-choices
20) World Health Organization. Population-based approaches to Childhood Obesity Prevention. Geneva: World Health Organization, 2012.
https://www.who.int/dietphysicalactivity/childhood/WHO_new_childhoodobes...
21) World Health Organization. Prioritizing areas for action in the field of population-based prevention of childhood obesity. A set of tools for Member states to determine and identify priority areas for action. Geneva: World Health Organization 2012.
https://apps.who.int/iris/handle/10665/80147
22) Academy of Medical Royal Colleges. Measuring Up: The Medical Profession’s Prescription for the Nations Obesity Crisis. London: Academy of Medical Royal Colleges, 2013.
https://www.aomrc.org.uk/reports-guidance/measuring-up-0213/
23) World Health Organization. Fiscal Policies for Diet and Prevention of Noncommunicable Diseases. Geneva: World Health Organization, 2016.
https://www.who.int/docs/default-source/obesity/fiscal-policies-for-diet...
24) House of Commons Health Committee. Childhood obesity: follow-up. 27 Mar 2017.
https://publications.parliament.uk/pa/cm201617/cmselect/cmhealth/928/928...
25) World Health Organization. Report of the Commission on Ending Childhood Obesity: implementation plan. Report by the Secretariat for the 140th Session of the WHO Executive Board. Geneva: World Health Organization, 2017.
https://apps.who.int/iris/bitstream/handle/10665/259349/WHO-NMH-PND-ECHO...
26) Loopstra R, Reeves A, Tarasuk V. The rise of hunger among low-income households: an analysis of the risks of food insecurity between 2004 and 2016 in a population-based study of UK adults. J Epidemiol Community Health. 2019 Jul;73(7):668-673. doi: 10.1136/jech-2018-211194. Epub 2019 Apr 29. PMID: 31036607.
https://jech.bmj.com/content/73/7/668.long
27) Davies S. Time to Solve Childhood Obesity. London: Department of Health Social Care, 2019.
https://www.gov.uk/government/publications/time-to-solve-childhood-obesi...
28) Health and Social Care Committee. Childhood obesity follow-up inquiry launched 16 September 2019 [accessed 18/7/2021]
https://committees.parliament.uk/committee/81/health-and-social-care-com...
Competing interests: No competing interests