Health Improvement and Food Production

Baroness Bennett of Manor Castle Excerpts

Thursday 7th July 2022 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, I thank the noble Baroness, Lady Walmsley, for securing this debate and her excellent introduction. I particularly thank her for focusing on the work of Bite Back, which is a powerful demonstration of how the whole process of governance needs to listen much more to young people, who are getting more engaged in politics and political campaigning. We need to think about how we can get that to have more influence on decision-making.

It is a great pleasure to follow the noble Baroness, Lady Jenkin of Kennington. Your Lordships’ House will probably think she and I are entirely co-ordinating this because my speech focuses on exactly the same theme as hers—ultra-processed food—but, in practice, we have not exchanged a word in any form.

The practical reality is that there is a reason for this and a reason why we can see two opposite sides of the House arriving at the same point: this Government are failing to catch up with the science and the reality of what is increasingly happening around the world. The focus on foods that are high in fat, sugar and salt is simply not adequate to capture the reality of ultra-processed foods, as identified by what is known as the NOVA classification system.

Of course, the Government often like to talk about how they are world-leading. Well, they have some catching up to do with the Welsh and Brazilian Governments and other Governments around the world. Indeed, in researching this speech, I noted that the next set of dietary guidelines for Americans, for 2025 to 2030—they are now being drawn up—are expected to contain a new emphasis on the damage done to health by ultra-processed foods. So the Government have a small window here at least to catch up with the Americans; they could be doing so.

The extra theme that I want to introduce into my speech, in addition to what the noble Baroness, Lady Jenkin, said, is the impact of economic and regional inequality. This should be feeding into the Government’s levelling-up agenda. The disparities in our deeply unequal society, where levels of inequality are speeding past the Edwardian and heading back towards the Victorian—another time when we were very concerned about the impact of food on the health of the nation—are really having an impact. If we look at some of the people who are the most deprived, according to research by the Social Market Foundation and Kellogg’s from 2018, 1.2 million people live in food deserts. Research by Dr Megan Blake, from the geography department at the University of Sheffield, points out that living in a food desert

“can mean having to carry … food shopping a long distance, a struggle that many older people living in food deserts experience.”

I would go further than that. If we think about people with disabilities, who are one in five of the working-age population, or people caring for young children, carrying food long distances will tend to bias them towards ultra-processed food, which is lighter because it contains less liquid than fresh food. In that study, 41% of respondents did not have a car, but there is also the problem of financial barriers—something that we know is becoming more of an issue with the cost of living crisis. The latest ONS data from March 2022 showed that nearly a quarter of adults reported that it is difficult or very difficult to pay their household bills.

It is also worth thinking about the fact that people debating this issue often talk about choice. However, the type of food that we have access to and eat affects us in many ways, both obviously and subtly. When people have access to fresh produce, they can readily select the ingredients for the meals they want to prepare, whereas people relying on ultra-processed food, ready meals and takeaways are under the manufacturers’ control. Those who talk about choice need to look at who is in control in this relationship.

There have been detailed studies on this issue. A recent Japanese study showed that children who frequently eat instant food have significantly higher rates of inadequate nutrient intake and excess nutrient intake, while children who eat more take-out food had significantly higher levels of inadequate nutrient intake. Another study from Luxembourg showed that:

“On controlling for age, sex, socio-economic status and lifestyle factors, daily consumption of ready-made meals was found to be associated with higher energy intake and with poor compliance with national nutritional”


standards. A study by the American Journal of Clinical Nutrition in the past month showed that children aged three to five who ate more ultra-processed foods had lower locomotive skills, while children aged 12 to 15, again eating more ultra-processed foods, had higher levels of obesity.

Beyond the macronutrient considerations, it is worth thinking about what impact the consumption of ultra-processed food has on the human microbiome—something that we are increasingly coming to understand is crucial for physical and mental health. As Dr Rodney Dietert points out in his book The Human Super-Organism, many additives that are now common in our foods have been shown to dramatically alter the human gut microbiome, often leading to inflammation and disease. One example that he cites is the emulsifiers polysorbate 80 and carboxymethylcellulose, which show effects such as thinning the mucus layer and increasing inflammation, eventually leading to inflammation-driven disease in mice. A US National Institutes of Health report in 2015 shows that common food emulsifiers disrupt the gut microbiome and provide pathways to non-communicable disease, including inflammation-driven obesity.

These are issues that the Government have been told about, and of course they have to cite the excellent Dimbleby review of the national food strategy. This picks up the point from the noble Baroness, Lady Walmsley, that we are talking about not just human health but the health of nature. An agricultural system focused on producing commodities to put into this ultra-processed food has terrible impacts. As the Dasgupta review—another government report—said,

“the agricultural system has completely wiped out the natural system”.

So the food that we are producing causes enormous damage to both the environment and human health. Mr Dimbleby referred to “the junk food cycle”, saying:

“We will not be able to educate our way out of that feedback loop. It needs strong government intervention on commercial interests.”


Because the Motion focuses on food production, I want to pick up and focus on the point that farmers produce what the system has forced them to produce. We know that farmers are getting only about 8p in the pound of the cost of food. This is a situation where the Government urgently need to act to provide different options and different kinds of food system that provide a good living for farmers while ensuring healthy food for people.

The noble Baroness, Lady Walmsley, referred to the crucial and final government decision to introduce a land-use strategy. I propose, as I proposed during the passage of the Agriculture Act a couple of years ago, that it needs to focus on how we use land for food production for the best possible nutrient production per hectare, which without a doubt would mean huge amounts more vegetable and fruit production and much less grain and oil—which, incidentally, is what is recommended in the recent Sustainable Food Trust report, Feeding Britain. I urge the Minister to speak to his colleague, the noble Lord, Lord Benyon, who I know was at the launch of that report, which looks at the intersection of food production and health. I know that may not seem to fall within the remit of the Minister’s department, but it is something that he really should take a look at.

Of course, not all food has to be produced by farmers and growers—people operating commercially. We are seeing the NHS increasingly focus on green prescribing and looking at how people can be given access to healthy food but, even better, how people can grow healthy food for themselves. I will focus here on the work of the excellent Incredible Edible, founded in Todmorden but now a movement around the world. Let us see our green spaces producing food that is accessible and free to all. That is one way in which we can grow a much healthier diet.

When the Government talk about innovation in the food system, they like to focus on things such as gene editing—people in labs with test tubes. Some of the finest, most important and leading innovation is the kind of social, economic innovation that looks at how to produce food in different ways. When thinking about how we help farmers, growers and communities to produce that healthy food—we have been working on the infrastructure Bill—what could be a better addition to the UK’s infrastructure than an excellent system of research, support and advice, working with farmers and growers to produce a healthier food system? It would also need to focus on distribution systems—the ways in which food reaches people.

My final thought is on how often this debate drifts back into, “We can’t have a nanny state; people make choices for themselves.” Marie Antoinette was castigated for saying, “Let them eat cake.” What we have is far worse. The supermarkets, the multinational food companies, seed and chemical manufacturing, and fast food companies control what we eat, saying, “Let them eat extruded, moulded, milled, additive-rich food with added sugars, starches, fats and artificial colours, flavours and stabilisers. Let them eat this ultra-processed pap.” Indeed, people are not being given any choice but to eat this ultra-processed pap.

--- Later in debate ---

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

My Lords, I also congratulate the noble Baroness, Lady Walmsley, on securing this debate. I am also grateful to all noble Lords for their considered and thoughtful contributions. It is a self-evident truth that we all need food to survive. However, as with many things in life, it is not enough simply to restate this. As noble Lords have rightly said, there are many factors to be considered. How is the food produced? Is it done sustainably? How affordable is it, and what is its impact on our health?

We know that access to good-quality, healthy food is essential to achieving our ambition to halve childhood obesity by 2030, to reduce the gap in healthy life expectancy and to reduce the number of people living with diet and weight-related illnesses. The Government are committed to supporting the production and availability of good food to help improve the nation’s health.

As noble Lords have referred to, our recently published food strategy puts food security at the heart of our vision for the food sector. Our aim is to maintain broadly the current level of food that we produce domestically and to boost production in sectors where there are the largest opportunities. It sets out our ambitions to create a sustainable and accessible food system, with quality products that support healthier and homegrown diets for all. Our farming reforms are designed to support farmers to produce food sustainably and productively and in a more environmentally friendly way, from which we will all benefit. I am sure we all want to see a sustainable and healthy food system, from farm to fork and catch to plate, seizing the opportunities before us and levelling up every part of the country so that everyone, wherever they live and whatever their background, has access to nutritious and healthier food.

We all know that the food we consume plays a role in our overall health. Covid-19 highlights the risks of poor diet and obesity, driving home the importance of better diets and maintaining a healthy weight. As noble Lords have referred to, the Eatwell Guide outlines the Government’s advice on a healthy, balanced diet. It shows the proportions in which different types of food are needed to have a well-balanced and healthy diet, to help meet nutrient requirements and reduce the risk of chronic disease. We know that too many of us are eating too many calories, too much salt and saturated fat and too many large portions, and are snacking too frequently.

While some parts of the food and drink industry are leading the way, by reformulating products or reducing portion sizes, and I think we should pay credit to those parts of the industry that have done so and sometimes met targets in advance of target dates, the challenge to go further remains.

We know that obesity does not develop overnight. When you look at the behavioural contributions, it builds over time through frequent excessive calorie consumption and insufficient physical activity. It is not the stereotype of Billy Bunter stuffing his face with 75 cream cakes. Even eating small amounts of excess calories over time can add up for both adults and children. It catches up with many people over time.

As noble Lords have rightly said, obesity is associated with reduced healthy life expectancy. It is a leading cause of serious non-communicable diseases, such as type 2 diabetes and heart disease, and it is often associated with poorer mental health. We also know now that it increases the risk of serious illness and death from Covid-19.

Helping people to achieve and maintain a healthy weight and a heathier diet is one of the most important things we can do to improve our nation’s health. We all have a role to play in meeting this challenge: government, industry, the health service and many other partners across the country. As a government, we can play our role in enabling healthier food choices by making a greater range of healthier food more accessible; by empowering people with more information to make informed decisions about the foods that they eat; and by incentivising healthier behaviours.

As noble Lords have acknowledged, the food industry supplies most of the food and drink that we consume. Therefore, it plays a critical role in supporting the aims that we want to see, such as selling healthier food and drink. Through our reduction and reformulation programmes, we are working with the food industry to encourage it to make everyday food and drink lower in sugar, salt and calories. The programme applies across all sectors of the food industry: retailers, manufacturers, restaurants, cafés, pubs, takeaways and delivered food. We have seen some progress since the publication of chapter one of the childhood obesity plan in 2016, with the average sugar content of breakfast cereals and yoghurts decreasing by 13%, and drinks subject to the soft drinks levy decreasing by 44% between 2015 and 2019. These statistics are very welcome, but we know there is more to be done.

However, we also need to be careful about the unintended consequences. As an example, when the sugar content of Irn-Bru was reduced, customers complained about the taste. How did the company respond? By claiming to rediscover an old recipe from 1901, which contained even more sugar. It was a huge hit with Irn-Bru drinkers. How do we address these unintended consequences?

[Baroness Bennett of Manor Castle (GP)]

I thank the Minister for giving way. He referred to “everyday food and drink” and the formulation thereof. Will he acknowledge that, if we are talking about everyday foods, we should not be talking about formulation? You do not talk in that way about fruit and vegetables, and unprocessed food.

[Lord Kamall (Con)]

The noble Baroness makes an important point, but we have to recognise the reality: not where we want to get to, but where we are at the moment. People do eat food that will need to be reformulated if we want to make it healthier. Of course, we know that fruit and vegetables are healthy, but not everyone, as we help them transition, will eat fruit and vegetables, or make stuff from the raw products. They will buy products in supermarkets, and therefore if they are buying them, we have to make sure that they are healthier and reformulated. We do not yet live in that ideal world where everyone buys fruit and vegetables, and cooks everything for themselves.

Given that, we also need new regulations on out-of-home calorie labelling. As we know, many people go to restaurants, buy takeaways or have their food delivered. It is important that we have calorie labelling for food sold in large businesses, including restaurants, cafés and takeaways, which came into force on 6 April 2022. As noble Lords are aware, there will be further legislation, on restricting the promotion and advertising of products high in fat, salt and sugar, which will come into effect in the next few years. I know that many noble Lords disagreed with the Government’s views on delaying some of those measures. We will continue to have the end-of-aisle promotion on the target date, but others, such as “buy one, get one free”, are delayed because of the trade-off with the cost of living crisis, but will come. It is delayed, but we have set target dates.

Once again, we have to be open—