Food: Regulation and Guidance

Baroness Finlay of Llandaff Excerpts

Thursday 7th October 2010 Lords Chamber

[Baroness Finlay of Llandaff]

My Lords, I am also most grateful to the noble Lord, Lord Whitty, for having secured this debate, particularly this week when we have seen the nation’s passions enflamed by concern for the welfare of children. It is apt and welcome that we have an opportunity to focus on one aspect of welfare, which is that good nutrition feeds our children’s life chances.

One concern is that, although we can all grasp the value of financial benefits in determining a child’s outcome, the specific high currency of a nutritious diet is often undervalued and underexposed. It is particularly worrying—I think that we have a moral imperative now to act—that education about nutrition gets through to all sections of society. That has not happened to date, given that invaluable knowledge about healthy eating has tended to be the property of the privileged and the educated and has not reached those whom it needs to reach. The science of nutrition is extensive and complex, but there are, nevertheless, several key messages that must be common knowledge, not privileged knowledge.

The difficulty of acquiring such knowledge is compounded by some of the bogus claims that are made about food and foodstuffs. I was asked recently, “Is plain chocolate good for you?”. That seems such a ludicrous question, but the trouble was that it was asked in all seriousness by someone who was very ill. There was desperation behind that question. I have seen really bogus nutritional advice given to patients. The worst was to a woman with extensive cancer, who had been told by someone with a nutritional adviser label that parsnips would help her body to fight her cancer. As a result, she was eating more than 1 kg of parsnips a day, to the exclusion of everything else in her diet. When I saw her, she had magnesium toxicity as a result. That was a tragic outcome of the desperation that people can feel at times—they are desperate to do anything—because they associate food with the source of life itself.

Of the different aspects of nutrition, I want to focus on intrauterine nutrition, by which I mean the importance of nutrition before birth. There is evidence that the long-term effects of the way that the foetus is nourished carry on throughout the person’s life. In 2002, Sir Derek Wanless’s report to the Department of Health entitled Securing our Future Health: Taking a Long-Term View, identified low birth weight as a pivotal cause of the vicious cycle of poor health. He recognised that the cycle repeats itself from generation to generation and traps communities in poverty and health inequality. The UK now has the highest rate of low birth weight in western Europe. Our message concerning nutrition’s significance from womb to tomb is clearly not resonating sufficiently.

A wealth of medical research and literature corroborates the impact of intrauterine nutrition. In a literature search in preparation for this debate, out of 904 papers listed on the subject, my eye was caught by one paper that examined the emergence of insulin resistance, visceral obesity and glucose intolerance in adult life. Evidence from the Sansom Institute for Health Research indicates that, in the uterus, the foetus adapts to being starved when it is being undernourished by upregulating insulin receptors so that glucose is driven into cells. That does not occur in the skeletal muscle to the same extent, so that organs and the brain are preferentially fed—a very good survival adaptation for the foetus. After birth, there is a general upregulating, so in the growth catch-up that occurs glucose is generally driven into cells. The problem is that, as it is driven in, it is driven into fat cells, so the fat cells get glucose more quickly than muscle and other organ cells can develop. At that point, the foundations of obesity and the metabolic pathways that are associated with it are laid down.

It may seem obvious that obesity is malnutrition, not simply overnutrition, but I think that that is often forgotten. Glucose is essential to our lives. We cannot survive without it, but all of the nutrients that we take in are important. Statistics on child obesity vary, but there is nothing to dispute the information that childhood obesity is rising in the UK. Childhood obesity is unhealthy in terms of biological damage as well as its emotional impact due to stigmatisation and all its other effects.

In our supermarkets, the choice of food and drinks available is now overwhelming. We have to look at the way in which people shop and buy. Following on from the theme taken up by my noble friend Lord Patel, I shall focus on the use of artificial sweeteners, which so often appeal to the young. Another paper that caught my eye was written by Swithers and Davidson at Purdue, who looked at the effects of artificial sweeteners on calorie intake in rats. They did a clever experiment. They fed half the rats with artificial sweeteners and the other half not and they let them run around eating as much as they wanted. They found that the ones that had consumed artificial sweeteners became more obese. It seems that the artificial sweetener affects the whole physiology of the organism, making the animal want to take in more calories, because they are primed to expect a calorie load. I know that that research was on rats—it would be difficult to do it in our population—but it underlines the importance of research and of good knowledge about the problem that we face with this epidemic of obesity.

The problem for the Government is that they have to communicate risk in a proportionate and sensible manner. I am sure that the noble Lord, Lord Whitty, knows better than most of us the difficulty of trying to communicate risk to the public, allowing people to be risk intelligent while not creating food scares. We all remember the food scare in 1988 about eggs and egg production. Egg production plummeted following the statement that it was infected with salmonella. The risk was minute—less than 200 million to one—but that warning will always be remembered in relation to public statements. Indeed, in my own household, egg consumption at breakfast went from high to zero—not my doing, but because of other members of the family.

Nutritional outcome in our society is inextricably linked to socio-economic outcome. Sir Michael Marmot’s review, Fair Society, Healthy Lives, conducted in 2008, although published only recently, shows clearly the importance of nutrition from the moment of conception, from when we can nourish and nurture every child’s health and opportunity. Sir Michael reports that,

“the foundations for virtually every aspect of human development ... are laid in early childhood. What happens during these early years (starting in the womb) has lifelong effects on many aspects of health and well-being”.

The Food Standards Agency certainly tries hard to communicate accurate information. I was interested in tartrazine, that yellow colouring in food, which fortunately fell out of favour some years ago. However, we have not banned it. In 2008, it was recommended that tartrazine should not be included, as a result of awareness that it is allergenic, is associated with behavioural problems in children and has been implicated in malignancy of the thyroid. The Food Standards Agency called for a voluntary phasing-out of tartrazine along with five other colourings and duly reported the link with hyperactivity. By then, tartrazine had already been banned in Norway, Austria and Germany, but an EU directive overturned that ban in the same year. We are left without it being banned; it is simply recommended against.

The information on the FSA website is helpful. It states that, if you have a child with hyperactivity, you should consider avoiding giving them certain artificial colourings, because this might help to improve their behaviour. It lists six colourings, which have absolutely no nutritional value. However, there is a problem. The colourings are listed either by name or by E number. I am sure that none of us can remember our PIN codes let alone the E numbers for six different food additives when we go shopping for children. These six have to carry a label saying that they may have an adverse effect on activity and attention in children, but it is impossible to read all the print on all the labels—we probably end up just reading the main name. Those who have difficulty with literacy may not be able to assimilate the information in a meaningful way.

Another problem with this brightly coloured food is that children become acclimatised to the notion that food should be brightly coloured; they begin to think that if it does not have food additives it looks dull and unexciting. In that way, we begin to condition the next generation to believe that food that is not psychedelically coloured is of less worth, particularly if the people who are responsible for their care are buying this food for them.

We should not forget the mantra “Every Child Matters”, which is associated with the previous Government, or the importance of education. They touch the humanity of every individual. They are universal sentiments, which cut across all political lines. They point to universal education about the value and importance of nutrition, which is a fundamental contributor to affording equal opportunity and outcome for all. If we do not teach children how food grows, how to shop, how to cook, how to sit at table with others and how to eat well, it is hardly surprising that the cycle of malnutrition continues. If we do not have clear information for the public, put across in a sensible way, it will become increasingly difficult for well meaning parents to know how to shop appropriately for children. People need to be able to avoid being misled by the sensationalist headlines that appear so often in the press and skew shopping habits. It is interesting to talk to shopkeepers, who will sometimes say, “I don’t know why we’ve had a run on such and such this week”. The reason is that the product has probably been associated with a headline or a magazine article.

I suggest to the Government that they consider, in all that they do, the importance of communicating accurately and with sound information, to help people to understand risk. If we do not improve the nutrition of our nation, particularly for women about to conceive and in pregnancy, we will harvest the downside for many generations.