Obesity: Low-fat Diet

Baroness Chisholm of Owlpen Excerpts

Thursday 9th June 2016 Lords Chamber

[Baroness Chisholm of Owlpen (Con)]

I thank my noble friend Lady Jenkin for initiating this important debate, and I congratulate her on having certainly lost weight—and kept it off, which is indeed an achievement. My thanks also go to the noble Baronesses, Lady Miller and Lady Wheeler, and to my noble friend Lord McColl for their valuable contributions. I will pick up on the various points as I go through my speech.

Tackling obesity is indeed an important issue, as my noble friend implied. We know that obesity is a leading cause of serious diseases such as heart disease, type 2 diabetes and some cancers. Furthermore, obesity is a complex issue to which there is no single solution. Eating a healthy diet has a key role to play in helping people lose weight, maintain a healthy weight and thereby reduce the risk of type 2 diabetes and other problems related to obesity.

The noble Baronesses, Lady Miller and Lady Wheeler, suggested that messages are muddling. That is why Public Health England goes to great lengths to ensure that it advises the public clearly and consistently on what constitutes a healthy, balanced diet, basing that advice on broad, robust and objective evidence. It is also why it was so disappointing to see the opinion piece entitled Eat Fat, Cut the Carbs and Avoid Snacking to Reverse Obesity and Type 2 Diabetes. It claims that many of the Government’s dietary recommendations are wrong. However, it fails to provide good evidence. All it has done is confuse the public, and Public Health England has called it “irresponsible”.

To improve diet and reduce obesity levels, our advice remains that people should base meals on starchy carbohydrates, especially whole grains, eat at least five portions of a variety of fruit and vegetables each day, including pulses, as the noble Baroness, Lady Miller, mentioned, and cut back on food and drinks that are high in salt and sugar. That is our Eatwell Guide.

My noble friend Lord McColl and the noble Baroness, Lady Miller, mentioned that eating fat is a good thing. It is extremely important. Our recommendations are that 33% of energy should come from fat. As was also stated by my noble friend and the noble Baroness, the cure for obesity is to eat and drink fewer calories, and that must be remembered.

I underline that Public Health England bases its dietary guidelines on comprehensive reviews carried out by the independent experts who make up the Scientific Advisory Committee on Nutrition. The Eatwell Guide was put together by them and Public Health England, and they consult academia, health charities, public health professionals and representative professional bodies. They also monitor changes in the evidence base and, where sufficient new evidence emerges, will initiate a new review to ensure that the guidance remains current.

Public Health England is taking forward a range of actions to help reshape the environment, to make the healthier choice the easiest choice for people, and to tackle inequalities relating to obesity. Public Health England has a broad plan and is committed to working collaboratively, at a national and local level, to pursue and advance a series of sustained actions to tackle and prevent obesity. Public Health England’s obesity plan is based on a framework that covers community engagement, monitoring progress, supporting delivery and changing the whole culture concerning obesity.

My noble friends Lord McColl and Lady Jenkin pointed out that exercise will not cause someone to lose weight. Exercise is important for lots of reasons, but there is no point going to a class or the gym and then going round the corner for a fizzy drink and a doughnut. It is this sort of culture that needs to change.

My noble friend Lady Jenkin also mentioned the problem of sugar in alcohol. The UK has secured provisions to allow voluntary calorie labelling on alcoholic drinks. This is already being used by Sainsbury’s, the Co-op and Waitrose. The possibility of mandating calorie labelling on alcohol is under discussion at EU level.

Public Health England recognises that weight-management services are an integral part of the public health and health service agenda for tackling obesity. Public Health England is clear that only by taking a whole-system, joined-up approach can we hope to make a difference.

As my noble friend Lady Jenkin stated, sugar is a huge problem. The sugar intake of all population groups in the UK is above current recommendations. We are encouraging a reduction in sugar intake through Change4Life, a social marketing campaign. It provides practical tips to help families reduce their sugar intake, and the sugar app is also a very good idea.

As part of its work, Public Health England is exploring how to support councils and the health service in providing evidence-based weight-management services that work better for people. In particular, Public Health England is collaborating with the Local Government Association and the Association of Directors of Public Health to support councils in developing local, joined-up approaches to tackling obesity. The noble Baroness, Lady Wheeler, mentioned the importance of this and of remembering that those with disabilities have complex nutritional needs. Also, ethnic minorities must not be left behind. This is why Public Health England is concentrating on exploring with the Local Government Association and the Association of Directors of Public Health how to take this down to a local level to decide what is needed in different areas to help those with disabilities and ethnic minorities.

Regarding type 2 diabetes specifically, Public Health England is working with NHS England and Diabetes UK on the development and delivery of Healthier You: the NHS Diabetes Prevention Programme. This year, Healthier You will refer at least 10,000 people to an evidence-based, behaviour-change intervention, funded by NHS England, shown to reduce the risk of type 2 diabetes in those with elevated risk. By 2020, the programme will be made available to up to 100,000 people at risk of type 2 diabetes each year across England. Those referred will receive tailored behavioural support to enable improvements in diet, increases in physical activity and weight loss. Furthermore, Healthier You will link into the NHS Health Check programme, which invites adults between the ages of 40 and 74 for risk awareness assessment and management of the key risk factors leading to premature death and disability in England.

As I mentioned a few minutes ago, obesity is a complex issue. Tackling obesity, particularly in children, is one of the Government’s major priorities and the Government will be launching a childhood obesity strategy next month. The strategy will look at everything that contributes to a child becoming overweight and obese. It will also set out what more can be done by all.

It is critical that we address with young people the obesity issues they face, as we know that it is much more difficult to lose weight later in life. That is why free school meals were introduced in all primary schools and why we have the School Fruit and Vegetable Scheme. I will have to write to the noble Baroness, Lady Miller, on her questions, as I am not up to date on what the Department for Education is doing in relation to cooking in schools and the curriculum.

The soft drinks industry levy announced by the Chancellor in the Budget was the first step in the process regarding sugar intake. The cross-government approach being led by the Department of Health is an exciting one. However, evidence suggests that many of those who have the potential to influence the diet and health of those with whom they come into contact, including childminders, fitness instructors, caterers and those working in care homes, currently receive little or no training in nutrition. Public Health England is working with the Association for Nutrition to devise a competence framework for use in training non-professionals in the catering, fitness and leisure industries in diet, nutrition and health. This is now being used to certify relevant courses. Moreover, the chief executive of NHS England is addressing the presence of unhealthy food and drinks on NHS properties. After all, if those looking after people are not eating healthily, it is not good for any of us. The initiative will encourage NHS staff to lead a much healthier lifestyle.

Eating a healthy, balanced diet plays a crucial role in all our work, but we have choices and we have to take responsibility for them. I thank everybody who has taken part today. If there is anything that I have left out and not mentioned, I will of course write to noble Lords.