Obesity

Baroness Jenkin of Kennington Excerpts

Wednesday 18th July 2018 Lords Chamber

[Baroness Jenkin of Kennington (Con)]

My Lords, it is an honour and a pleasure not only to have been one of the noble Baroness’s supporters last week, but to be following her now. Like many women in this country, I feel I have been following her for most of my life. The noble Baroness no doubt feels that her younger self—founding Spare Rib aged 21—would have been amazed to see herself here today. Well, I can assure her that my 16 year-old self, in awe of her many achievements, would have been far more astonished at the thought of being here with her today.

The noble Baroness, Lady Boycott, has had an extraordinary and wide-ranging career to date, from 1970s feminist, newspaper editor, writer, farmer to chair of the London Food Board and fearless campaigner on many other issues. As she starts yet another new career, all of these experiences will have given her skills and expertise which will significantly enhance our deliberations, not least in the fields of women’s rights, food and obesity, which we debate today, and I look forward to continuing working with her on many of these vital topics.

My noble friend Lord McColl and I share an office. Tackling obesity has become a shared passion, which we discuss regularly, and I am grateful to him for giving us the opportunity to open up our daily conversation to the Chamber today.

May I start by congratulating the Government on chapter 2 of the childhood obesity plan? As the introduction says,

“Childhood obesity is one of the biggest health problems this country faces”.


It also acknowledges that it is a social justice issue disproportionately affecting children in low-income households in the more deprived areas. The plan makes a good start, and I look forward to the consultation. But I am aware, from the challenges of chairing the Centre for Social Justice’s childhood obesity report Off the Scales last year, that keeping food campaigners and the food industry in the same room is not easy.

Last month, I stumbled across a BBC programme “The Big Crash Diet Experiment”, which took four obese people with serious weight-related health issues—fatty liver disease, heart problems and type 2 diabetes—and, under medical supervision, put them on a nine-week 800-calorie-a-day regime. The presenter, a doctor, was sceptical at the start, like many of us viewers. The programme included interviews with a number of medical experts, including former government obesity adviser Professor Susan Jebb. The results were immediate and dramatic. All four volunteers lost a considerable amount of weight—to the extent that they changed shape before our eyes. Overall, there was 20% less of Father Paul, and his diabetes went into remission; Rebecca lost nearly three stone; Yolande’s liver fat was reduced by a third. I know that ITV has also recently shown a similar programme with similar results.

Curious to know more, I got in touch with Professor Roy Taylor, from Newcastle University, who also featured in the show. He told me that the current position is exciting. It is now accepted by all UK diabetes specialists that type 2 diabetes is a potentially reversible condition. My noble friend the Minister may be aware that the national clinical director for diabetes and Simon Stevens are actively discussing how to roll this out in the NHS. Last month, the American Diabetes Association changed its official position and recognised for the first time that remission of type 2 diabetes was possible.

Changing long-established beliefs about any medical matter takes time, quite rightly. It is 10 years since the publication of the hypothesis of type 2 diabetes being a simple and reversible state, and it is seven years since publication of the proof that real people could actually achieve this. Early next month, Professor Taylor’s paper describing the mechanisms in liver and pancreas as people achieve remission of diabetes will be published in the internationally leading journal Cell Metabolism.

Noble Lords will not be surprised, however, to hear what his research participants report as the greatest barrier to success. They describe very clearly the personal and social difficulties in maintaining reasonable long-term control of food intake in the current obesogenic environment. Although around one-third report no trouble in avoiding weight regain, the majority—like most of us—have to struggle against our food-centred culture: unthinking acceptance of the notion that eating between meals is okay; unregulated fast food production with high added-sugar content and hence lack of feeling full despite significant calorie intake; and the lack of simple, clear labelling of calorie content. He also said that the argument that voluntary regulation by the food industry might help is flawed. The need for action is eloquently illustrated by the simple fact that the average man and average woman are now over 10 kilograms heavier than in 1980. At a current estimated cost to the NHS of £30 billion a year, this cannot continue. I urge my noble friend to act.

Childhood Obesity Strategy

Baroness Jenkin of Kennington Excerpts

Monday 25th June 2018 Lords Chamber

[Lord O'Shaughnessy]

It is always a pleasure to debate issues in this House. This topic is worthy of that debate because there is a huge interest in it in this House.

The noble Baroness is quite right to talk about advertising. It states in the paper:

“Consult, before the end of 2018, on introducing a 9pm watershed on TV advertising of HFSS”—


high in fat, sugar and salt—

“products and similar protection for children viewing adverts online”.

I take that to mean across the board as opposed to those solely aimed at children, which are already subject to world-leading restrictions.

The noble Baroness asked about families. Much of this is about helping families to do the right things. We know how difficult it can be when you are with young children in a shop to resist this, that or the other. You talk about protecting your teeth or eating well, but it is not always obvious what is good for you and what is bad for you. Again, in the paper there is reference to calorie labelling and going much further in terms of restaurants and store promotions. The noble Baroness and her party are always keen to make sure that we can get the most out of Brexit, and going further than the European Union will allow us with food labelling and simple nutrition information is just one of the many opportunities we will enjoy after 2019.

[Baroness Jenkin of Kennington (Con)]

My Lords, my noble friend may be aware that I chaired a commission for the Centre for Social Justice last year, so I welcome the acknowledgement that this issue particularly affects children in the most deprived areas. Can my noble friend give more clarity about the consultation and when it will end? Although I have not read every word in it yet, can he also say whether the Government will look at the “eatwell plate”, which is carb heavy at the moment? I am not sure whether that advice is covered in the paper.

[Lord O'Shaughnessy]

I thank my noble friend for her questions. I salute the work she has done and the leadership she has shown on this issue. As to the content of the consultations, that will depend on when they are launched but it refers in the paper to consulting before the end of 2018 on a number of issues, so that will go through the normal process, I suppose, of a three-month consultation.

I shall look at the issue of the “eatwell plate”. It is worth pointing out that, under the “Schools” heading, there is a desire to update school food standards, reduce sugar consumption, strengthen nutrition standards and the government buying standards for food and catering services. So there is a desire to look at the official guidance that goes out and to make sure that it reflects the best science and enables any institution that is looking after children, families, schools, adults and others to give the best possible nutritional food that they can.

Childhood Obesity: Yoga

Baroness Jenkin of Kennington Excerpts

Thursday 21st June 2018 Lords Chamber

[Lord O’Shaughnessy]

The noble Baroness is quite right to raise that issue. Of course, it is something we are looking at. I also point to the pledge made in the children and young people’s mental health Green Paper to dramatically increase the number of staff on mental health support teams, which are providing not just help for children who are in crisis or having difficulties but well-being skills so that they do not experience those problems in the first place.

[Baroness Jenkin of Kennington (Con)]

My Lords, my noble friend will be aware that I am an enthusiastic advocate of the Daily Mile for schoolchildren. With the terrifying rise in obesity among schoolchildren, I hope it will be included in the updated childhood obesity plan. Can the Minister give us any idea when that plan might be coming?

[Lord O’Shaughnessy]

I am glad that my noble friend has highlighted that. I can confirm that the next chapter of the plan will be coming very shortly. We will be discussing some proposals on the Daily Mile in that plan.

Abortion

Baroness Jenkin of Kennington Excerpts

Wednesday 6th June 2018 Lords Chamber

[Lord O'Shaughnessy]

I agree with the noble Lord that it is and should be a decision for the elected representatives of the people of Northern Ireland. As anyone who watched or read the transcript of the debate in the Commons yesterday will know, there is a profound disagreement about what the implications would be of repealing Sections 58 and 59 of the 1861 Act. If that were brought forward, there would be a discussion in Parliament on the consequences of that and on its interaction with the devolution settlement.

[Baroness Jenkin of Kennington (Con)]

My Lords, following yesterday’s debate in another place, the Minister for Women and Equalities said:

“With authority comes responsibility. Message from NI Secretary of State today: NI should take that responsibility. Message from the House of Commons: if you don’t, we will”.


Does my noble friend agree?

[Lord O'Shaughnessy]

The position of the Government is that this ought to be a decision for the elected representatives of Northern Ireland representing the people of Northern Ireland, which is why we are determined to restore power-sharing agreements and arrangements as soon as possible—so they can make that decision.

Children: Obesity

Baroness Jenkin of Kennington Excerpts

Thursday 10th May 2018 Lords Chamber

[Lord O’Shaughnessy]

I applaud the noble Lord for the work that he is doing. I know he has written to my noble friend Lord Hall about this topic. I think other broadcasters have a role to play as well; we know that broadcasters in the past have had a critical role to play. I remember the Just Say No campaign when I was growing up, as well as campaigns that focused on the prevention of HIV/AIDS. So there is an important role to play here. Broadcasters are not always polite about government actions, but nevertheless we want to support them in their important role in this position.

[Baroness Jenkin of Kennington (Con)]

My Lords, for noble Lords who may be confused, there are two different Questions in the name of the noble Lord, Lord Brooke, on the two different Order Papers—and I am delighted that the Minister has responded to the one in House of Lords Business. On a daily basis we seem to be getting reports that further prove that there is going to be a generation of children who die ahead of their parents because of the scourge of childhood obesity. The BBC is to be congratulated on commissioning Hugh Fearnley-Whittingstall’s latest campaigning series, which culminated last night in a rather uncomfortable episode for the Government. When the childhood obesity strategy was published, we were told it was the first part of a conversation. Is the Minister able to tell us when we might hear the second part?

[Lord O’Shaughnessy]

My Lords, for the avoidance of doubt, I thank my noble friend for pointing out that we are talking about obesity rather than the NHS constitution—which is just as well because I had not prepared for that. She has been steadfast in campaigning on this issue. We know that the problem presents some uncomfortable truths. The Government have taken some significant actions in this area, such as the soft drinks levy, but we have always said that we will not rest if we do not think they are having the impact that we want them to. There is emerging evidence that we need to go further. I cannot give my noble friend a date on further action but I can tell her that this is the subject of most serious consideration at the centre of government.

Children: Obesity

Baroness Jenkin of Kennington Excerpts

Thursday 19th April 2018 Lords Chamber

Asked by

[Baroness Jenkin of Kennington]

To ask Her Majesty’s Government what action they are planning to reduce childhood obesity.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord O’Shaughnessy) (Con)]

My Lords, the Government’s childhood obesity plan, launched in August 2016, focuses on the areas that are likely to have the biggest impact on preventing childhood obesity. All reports and data on progress in delivering our plan will be published and open to scrutiny. We will use this to determine whether sufficient progress has been made and whether alternative levers need to be considered.

[Baroness Jenkin of Kennington (Con)]

My Lords, I am well aware that we had a pretty comprehensive trot around the issue earlier this week but I did not have the opportunity to raise with the Minister the issue of the Daily Mile, an initiative started some six years ago in a small Scottish primary school where children were encouraged to run for 15 minutes a day, which turns out to be a mile. Since then the initiative has proliferated and now over 3,300 schools are participating. It has been independently evaluated and proven to show a massive improvement in health, well-being and academic attainment. The Scottish and Welsh Governments have written to every single primary school encouraging them to participate. Would the Minister please consider doing the same here?

[Lord O’Shaughnessy]

Following the debate that we had the other day, I looked up the Daily Mile online. It is now in 2,000 schools across the UK. My right honourable friend the Secretary of State has described it as an excellent initiative, which indeed it looks like. It certainly seems to develop good habits of physical and mental health. Writing to schools is of course a matter for the Department for Education, but I will certainly speak to my colleagues in that department to encourage schools to take this up. In the spirit of the debate of the noble Baroness, Lady Walmsley, I think it would be better to end with a quote from William at Woodfield Primary School in Wigan, who said that the Daily Mile,

“helps you with your maths, English, and you get faster each time, which makes you healthier”.

What more could you want?

Children and Young People: Obesity

Baroness Jenkin of Kennington Excerpts

Tuesday 17th April 2018 Lords Chamber

[Lord McColl of Dulwich (Con)]

My Lords, I thank the noble Baroness, Lady Walmsley, for initiating this important debate. I do not need to repeat all the figures that she has so ably put forward. However, I shall ask a question: how on earth did we get into this mess in the first place? It is the worst epidemic for 100 years.

Now, many of us have managed to stay the same weight for 100 years—

[Baroness Jenkin of Kennington (Con)]

Not that many!

[Lord McColl of Dulwich]

I will not say “Speak for yourself”, but there are a lot of people who have managed to stay the same weight.

The question is: how did they do it? They simply respected the various mechanisms that exist in the body for keeping the weight constant. What are they? They are very intriguing. One is to eat food that you have to chew. When you chew, the chewing muscles produce impulses that go to the brain telling it that you have had enough to eat. If that does not work and there is fat in the meal, when the fat goes through the stomach into the duodenum it releases a hormone that stops the stomach moving any further. We get a feeling of being full, so we stop eating. It is a very nice mechanism. Then, when the fat has been emulsified by the bile, the whole thing moves on and the stomach starts to move again.

At the end of food rationing the food industry was presented with a problem. It wanted to increase the amount of food that people ate, because we were all eating just the right amount—food rationing had sorted that one out. How was it to persuade people to eat more? The simple solution is to sabotage these beautiful mechanisms for keeping the weight constant. How did the industry do that? It demonised fat and got some unscrupulous members of the academic world to produce research that just happened to confirm its view that fat was the wrong thing. Then President Eisenhower had a heart attack and they found that what blocked his arteries was atheroma. As noble Lords will know from their Greek studies, atheroma is a Greek word meaning porridge. It might be Greek porridge, but it is not Scottish porridge, that is for sure. In fact it is not porridge at all: it is a cholesterol, fatty material. So they blamed that. Fat was demonised, so we had a low-fat diet.

The problem then was where to get the calories from, so they filled the diet up with carbohydrates. A low-fat, high-carbohydrate diet is tasteless because fat gives us a nice flavour. The food industry then faced the problem of how to get people to eat this terrible stuff. The answer is to pour in sugar. That makes it palatable. So was born the obesity epidemic: a low-fat, high-carbohydrate, high-sugar diet.

Then, just to make things worse, NICE said that all the calories we eat are expended on exercise. That was not true either: only a fraction of the calories we eat go on exercise. In fact, it is about a quarter. This idea that exercise is the answer to obesity led to hundreds of thousands of people pounding the pavements and roads wearing out their joints, so you had more and more joint replacements for the hip and knee. So the nonsense continued. Of course exercise is very important to general well-being and health, but not in terms of controlling weight. Then we insulted the children by calling them couch potatoes. Inactivity does not lead to obesity. Obesity leads to inactivity, but that is a different matter.

What is the answer? It is that we need an all-out campaign involving every man, woman and child, every institution, school, university and government department to try to reduce the obesity epidemic. When we were taking evidence from the experts in a recent Select Committee, we were told that all-out campaigns do not work. I pointed out that the AIDS campaign did. One of these experts said, “No it didn’t”, which surprised the Lord Speaker, Norman Fowler, because it was his campaign. It worked because he was absolutely honest and did not bother with anything politically correct. He said it as it was: “Don’t die of AIDS”; AIDS is lethal. So the campaign was successful. That is what we now need, because we owe it to our children. The obesity epidemic is killing millions and costing billions. The cure is free: eat less.

--- Later in debate ---

[Baroness Jenkin of Kennington]

My Lords, some 18 months ago I was asked by the Centre for Social Justice to chair its working group, which last December produced a report entitled Off the Scales: Tackling England’s Childhood Obesity Crisis. I urge noble Lords who are interested to take a look at that report, or at least its summary and recommendations. I for one would have liked to go further but the stresses between representatives of the food industry and food campaigners on the committee proved challenging, to say the least.

The topic might not seem a natural fit for the Centre for Social Justice but, as other noble Lords have mentioned, it is clearly a matter of social justice. By the age of five, children in poverty are twice as likely to be obese as their least deprived peers and by the age of 11 they are three times as likely. Children living in poverty are more likely not only to be obese but to experience a combination of acute social problems over their lifetime. Other identified barriers to families in deprived areas living a healthy life—in practice, healthy behaviours—include being more likely to live in an area with more takeaway and fast-food outlets, more likely to live in poor, unsuitable or overcrowded housing, and more likely to experience a combination of family breakdown, stress, mental health issues and financial problems. They are more likely to be judged and negatively influenced by social disapproval of their deprivation and obesity. These conditions make it challenging for families in poverty to practise healthy behaviours and difficult for policymakers to know where to begin, especially when education and awareness are not enough.

Since we started working on the report, further evidence and a plethora of similar reports have emerged on a regular basis. This includes one reported today from the University of Warwick about lack of sleep leading to obesity, as my noble friend Lady Neville-Rolfe mentioned. Not only is our children’s health at serious risk but our health service and our country is, too.

No child wants to be fat. I was a chubby child and a plump adult until I lost 28 pounds around seven years ago—and having put half of that back on again, I know just how difficult it is to lose weight and keep it off. I came to this subject and report not as an expert, but as a lay person who simply could not stand by and let things get any worse. We all know that living in an obesogenic society means that it is hard for most of us to resist temptation and maintain a healthy weight but it is especially hard for those living in poverty, whose choices are limited by circumstance.

During the process of writing our report, we came to understand how it is that no country around the world has been able to reverse its obesity trend on a national scale, although I urge the Government to look carefully at the work being done in Amsterdam through a city-wide, whole-systems programme that has kids weighed regularly and tested for balance and agility. I have visited the programme, and I think the Health Select Committee in the other place is going in the next few weeks. It is early days but, thanks to the deputy mayor’s political commitment, the city’s numbers are improving, showing a 12% drop in obesity over a three-year period and even more in the poorer areas. The case study of the Amsterdam healthy weight programme demonstrates the power that political leadership can have in bringing people together, seeking change and driving it through.

I do not underestimate the political courage needed to make that change and to take on many vested interests, but although childhood obesity is a complex and contentious issue, it is not impossible to address. Many key steps have already been taken. The childhood obesity plan is a welcome start to the conversation, and much good work is already being done across England by local authorities, charities, NGOs and universities among others. However, the system is fragmented. Without a joined-up approach, these efforts are at risk of being eclipsed by the growing scale of the epidemic. It requires robust and persuasive political leadership, cross-party and cross-sector commitment, a long-term vision, a whole-systems and targeted approach and consistent monitoring and evaluation.

I am lucky enough to spend many of my weekends with two great-nephews aged two and four. They run everywhere. Children are designed to run. You do not see small children walking. I would like to have the opportunity to talk about the daily mile, which fits in with what the noble Baroness, Lady Grey-Thompson, and the noble Lord, Lord Addington, were talking about, but time is short. Today you are sadly more likely to see children strapped into buggies for hours on end, in front of a tablet with a bottle of sugary, teeth-rotting juice and a sausage roll—sometimes called a Greggs dummy—to keep them quiet. The average child eats its own weight in sugar every year. Those kids simply do not stand a chance.

People think that being overweight is an abnormal response to a normal environment. That is not true at all. It is a normal response to an abnormal environment. Political will is needed to effect the change we so desperately need. I urge the Government to be bold, and I look forward to the Minister saying, “We can, and we must, end childhood obesity”. We really have no other choice.

Abortion: Misoprostol

Baroness Jenkin of Kennington Excerpts

Tuesday 20th March 2018 Lords Chamber

[Lord O'Shaughnessy]

No, I do not think it proves that. The fact that illegal drugs of all kinds are being bought online, whether they are illegal drugs or prescription drugs bought illegally, is a feature of modern life. Rates of abortion in the under-18s are falling, as is the teenage pregnancy and conception rate. Those are separate issues.

[Baroness Jenkin of Kennington (Con)]

My Lords, is my noble friend aware that, as well as in Scotland, the home use of misoprostol is common practice in the United States, Canada and multiple other European countries?

[Lord O'Shaughnessy]

Yes, I am aware of that. As I said, those countries operate under a different legal framework from ours.

National Child Obesity Strategy

Baroness Jenkin of Kennington Excerpts

Monday 26th February 2018 Lords Chamber

[Lord O’Shaughnessy]

We are making good progress in reformulation and in reducing sugar in drinks, which I have talked about, and in other foods. However, we have to look at the impact. We will look at that and if progress is not made—let us face it, obesity levels are unfortunately continuing to increase—clearly other actions will have to be taken.

[Baroness Jenkin of Kennington (Con)]

My Lords, last year I chaired the Centre for Social Justice’s childhood obesity report. Until then, I had not appreciated how challenging and complicated it is, not least to keep representatives from the food industry and food campaigners in the same room. Amsterdam’s healthy weight programme has helped to reduce childhood obesity by 12% since its launch in 2012. Will my noble friend confirm that the Government are studying carefully how that reduction has been achieved?

[Lord O’Shaughnessy]

I thank my noble friend for that and applaud the work that she has done in this area. The Amsterdam effect seems significant and is an area we are looking at as we consider further actions in future.

Dental Health: Children

Baroness Jenkin of Kennington Excerpts

Tuesday 7th June 2016 Lords Chamber

[Lord Prior of Brampton]

Schools clearly have an important role to play. Interestingly, in Bradford the Building Brighter Smiles programme involves not just a community-based fluoride varnishing application but also supervised tooth-brushing in schools and nurseries. I am sure that that has a very important role to play.

[Baroness Jenkin of Kennington (Con)]

My Lords, the number one reason for primary school children to be admitted to hospital is for multiple tooth extraction as a result of poor diet and the other things that have been mentioned. These are children who generally do not drink water; they drink juice and fizzy drinks. Can my noble friend please confirm that the Government will give this a priority in the obesity strategy later this summer?

[Lord Prior of Brampton]

My noble friend will be aware that a part—only a part—of the obesity strategy includes a levy on fizzy drinks. That will be a levy on the manufacturer not the consumer. That is a very important part of trying to improve the diet of young children.