Food, Diet and Obesity Committee Report

Lord Krebs Excerpts

Friday 28th March 2025 Lords Chamber

[Lord Krebs (CB)]

My Lords, I join other noble Lords in thanking the noble Baroness, Lady Walmsley, for being an excellent chair of this Select Committee inquiry and for her outstanding introduction to this debate. I also express thanks to our specialist adviser, Professor Martin White from Cambridge University, who kept us on the straight and narrow, as well as our clerk and policy analyst.

I declare two interests. First, I am the chair of the World Cancer Research Fund’s global expert panel, which reviews the scientific evidence for links between diet, obesity and cancer risk. Secondly, I am a scientific adviser to Marks & Spencer.

Like the noble Baroness, Lady Walmsley, I am puzzled. The Government agree with our diagnosis of the problem. They say in their response to our report that people are eating too much calorie-dense, highly palatable food, commonly known as HFSS—high in fat, salt and sugar, or junk food for short—and, as a result, obesity rates have rocketed in recent decades. They go on to say that this rise in obesity has adverse effects on health, well-being and the economy. They also say there is a need to reshape the food environment, which has been an important causal factor for the rise in obesity.

Having read these introductory paragraphs of the Government’s response, I was ready to enjoy learning that, having agreed with our diagnosis, they also agree with our proposed solutions. These solutions were based on many months of hard graft and more than 1,000 pages of written evidence from experts. Instead, the Government, as we have already heard, rejected nearly all our recommendations, as indeed they rejected the recommendations of the inquiry I chaired a few years ago on food poverty, health and the environment. There were—as the noble Baroness, Lady Walmsley, mentioned—some honourable exceptions. These included the policies inherited from the previous Government on restrictions on the promotion and advertising of junk food, as well as the welcome uprating of the soft drinks industry levy announced in the Autumn Budget. Apart from those two, we got some rather vague hand-waving about the health mission of prevention instead of treatment and the new Defra-led food strategy.

For nearly all our recommendations, we got answers such as, “It’s all terribly complicated. We will review, consider and consult. We have to carefully consider the balance between voluntary and mandatory measures”. This is, to say the least, disappointing. There has been plenty of review, including in our inquiry, and there is no need for further paralysis by analysis. There is no need to further consider the balance of voluntary and mandatory measures. Simply read paragraph 62 of our report, where we refer to research from Cambridge University showing that about 700 policies to tackle obesity have failed because they were based on individual responsibility and voluntary measures. Does the Minister disagree with the conclusions of this Cambridge University research? If so, why?

Perhaps the Government might look at the lessons learned from smoking. In the middle of the last century, over 80% of adult males and over 40% of adult females smoked. Today, under 12% of adults smoke. This dramatic shift has not been driven by voluntary measures and individual responsibility; it has come about through a combination of legislation, taxation and education. The Tobacco and Vapes Bill, announced this week, will further tighten the regulatory screw. I know there are important differences between smoking and overeating, but both have major impacts on public health, so why not apply a similar logic to both problems? Given that they have not accepted our recipe for change, what is the Government’s plan? I could go on at great length, but a simple, straightforward answer to this question would be most welcome.

However, before I finish, I want to say a few words about ultra-processed food. As the noble Lord, Lord Brooke of Alverthorpe, mentioned, there were some disagreements in our committee, and our chair handled those disagreements very skilfully. One of them was about whether UPF—ultra-processed food—is dangerous, or whether it is largely a red herring. The committee was divided on this, and I was on the red herring end of the spectrum. Why? There are three reasons. First, as Chris van Tulleken and others told us, UPF is not suitable as a policy tool, not least because experts often disagree when they try to apply it to individual foods. In one study we were referred to, a panel of experts agreed on only four out of 231 foods they were asked to classify as UPF or not. Secondly, there is no convincing scientific evidence to show that processing, as opposed to the content of food, is harmful to human health—of course, that evidence base may change. Thirdly, most UPF is also HFSS. The foods that are deemed to be UPF but not HFSS, according to some experts, include things such as oat milk, vegan sausages, wholemeal bread from the supermarket and pre-packed cooked vegetables. Do we really want to suggest to the public that these foods are dangerous to eat? No, let us concentrate on HFSS, where the evidence for harm is robust and the definition is already used in regulation.

Bread and Flour Regulations 1998

Lord Krebs Excerpts

Wednesday 11th December 2024 Lords Chamber

[Baroness Merron (Lab)]

The addition of folic acid is to non-wholemeal products. Flour is not just used in baking but is in all sorts of other products. That is part of the reason for it being a 24-month transition, and of course industry can act quicker than that. The reason that it is in non-wholemeal flour is that wholemeal is already a higher source of folate. In respect of chapattis, all products will be considered. I should add that some of the transition time is due to the labelling changes that will be required. We are not stopping industry acting quicker, but we are being realistic about how long it will take.

[Lord Krebs (CB)]

My Lords, I congratulate the Government on introducing this legislation and the noble Lord, Lord Rooker, on his tenacity. However, I would like to ask about another vitamin. We know that between one in five and one in six people in the country have low vitamin D levels; the previous Government had a consultation on this back in 2022. Will the Minister update us on what the Government’s policies will be to try to address the issue of low vitamin D levels?

[Baroness Merron (Lab)]

I will be glad to look into that and to update the noble Lord and your Lordships’ House on the matter.

Diets: Fat

Lord Krebs Excerpts

Thursday 31st October 2024 Grand Committee

[Lord Krebs (CB)]

My Lords, I declare my interests as recorded in the register, in particular my work with the World Cancer Research Fund and the fact that I am a scientific adviser to Marks & Spencer. Like the noble Lord, Lord Brooke of Alverthorpe, I was a member of the Select Committee which reported last week on diet and obesity. I congratulate the noble Lord, Lord McColl of Dulwich, on securing this debate and his introduction to it.

The idea that eating a diet with plenty of fat suppresses appetite is not new. About 50 years ago, Dr Richard Mackarness published a book entitled Eat Fat and Grow Slim. However, like so many other dietary fashions, this one ran into the sands of evidence. I will mention just one study: a double-blind randomised control trial published in the journal Nutrients in 2018. The participants—older, healthy males—were offered one of three calorie-controlled drink supplements containing different amounts of fat, protein and carbohydrate, or a control drink containing virtually no calories. The results showed that adding fat to the supplements raised levels of the gut hormone cholecystokinin, to which the noble Lord, Lord McColl, referred, but did not suppress energy intake from a subsequent buffet meal with ad libitum food. The evidence does not support the idea that eating more fat suppresses appetite.

The National Diet and Nutrition Survey shows that the population-average intake of fat is close to the recommended guideline of 35% of daily energy intake. However, the intake of saturated fat is above the guideline of 11% of daily energy intake. Saturated fat, in particular animal fat rather than fat from dairy produce, is associated with an increased risk of cardiovascular disease and stroke. Therefore, dietary advice is, correctly, to consume less saturated fat, but not because of its contribution to obesity.

Turning to obesity, I will make three points. First, the best way to tackle the obesity crisis is to prevent people putting on excess weight in the first place. This is most effectively achieved, as the noble Lord, Lord McColl, said, by reducing calorie intake rather than by trying to burn it off with exercise—if you try to burn off the calories from one energy drink, you will find out how tough it is.

Secondly, the dramatic rise in obesity during the past 30 years has been driven largely by the increased availability of cheap, highly palatable, calorie-dense food, known colloquially as “junk food”. The report of the Food, Diet and Obesity Committee published last week recommends a raft of policies to deal with this challenge. The overarching theme is that there should be a switch from the 700 or so failed policies based on individual choice to policies based on regulation of the junk food industry and the junk food environment. Does the Minister agree with that general proposition?

Thirdly, it might be tempting to see effective weight-loss drugs such as Wegovy and Ozempic as a “get out of jail free” card. They will have an important role, but they are not the answer to treating the millions of obese people in this country and a much larger number around the world. At the moment they are very expensive, although it is possible, with many drugs in development, that the price will come down. More importantly, they require a lifelong commitment: it is not just about taking the drug for a few weeks; it is about taking it for ever. Recent data from the United States, where one in eight people has tried a weight-loss drug, show that two out of every three obese people give up taking the drug within a year and then regain the weight they have lost.

The Government have said they want to shift from treatment to prevention as one of the three pillars of reforming the NHS. Can the Minister explain to us in broad terms how she envisages this shift from treatment to prevention being applied to diet and obesity, the second-biggest avoidable risk of ill health? In this context, I want to cite one example and ask the Minister to comment on it. My local sports centre, owned by Oxford City Council and which I visit regularly, has an entrance packed with junk food—sugary drinks, ice creams, doughnuts, the lot. Does the Minister think that that is an appropriate way for a local council to run a fitness centre?

Bread and Flour Regulations 1998

Lord Krebs Excerpts

Wednesday 11th September 2024 Lords Chamber

[Baroness Merron (Lab)]

I assure the noble Baroness that that has already happened. As I am sure your Lordships’ House is aware, the proposal is to add 250 micrograms of folic acid per 100 grams of non-wholemeal wheat flour. I emphasise that this fortification would be in addition to the foods that are already voluntarily fortified, such as a wide variety of breakfast cereals, so we are not talking about just bread. The feeling among the experts, to whom we listen, and the committees to which the noble Baroness referred is that this is the right level at which we can provide reassurance, and so this is where we are focusing our efforts.

[Lord Krebs (CB)]

My Lords, I am delighted to hear that the Minister has confirmed that folate fortification of bread flour will proceed. However, I want to ask her about members of our population who do not eat white bread flour because, for example, they are coeliacs or gluten intolerant, or because they come from ethnic groups who get their main carbohydrate intake from other sources such as rice. In the United States, rice, maize and flour are all fortified with folate and have been since 1998.

[Baroness Merron (Lab)]

The noble Lord raises an extremely good point. Before we speak about the groups to which the noble Lord referred, I want to point out that fortification will not be enough in any case. We need to continue our encouragement for women to take daily folic acid supplements before conception and in the first 12 weeks of pregnancy, because doing so can prevent up to seven out of 10 cases of neural tube defects—I want to emphasise that. I will take on board the noble Lord’s very important point and ensure that it is part of our considerations.