Ultra-processed Food

Carol Monaghan Excerpts

Wednesday 21st June 2023 Westminster Hall

[Carol Monaghan (Glasgow North West) (SNP)]

I congratulate the hon. Member on securing this important debate. We have a lot of these debates, and one issue with ultra-processed food is that it is ultra-addictive—people want more of it, and we cannot help ourselves—but we do not treat it as we treat other ultra-addictive things like cigarettes and alcohol, although the health implications could be just as serious.

[Suzanne Webb]

I thank the hon. Member for her intervention. Again, we are having the same conversation and I hope to answer her question later in the debate.

Ultra-processed food makes up half of the total purchased dietary energy in the UK. In fact, when it comes to UK children, more than 60% of the calories consumed comes from ultra-processed foods such as frozen pizza or fizzy drinks. All that food is linked to obesity, which causes me great concern. In England, 64% of adults and 40% of 10 to 11-year-olds are either obese or overweight. Those figures are taken from the Dimbleby report. They are staggering.

Figures from 2019-20 show that 1.5 million years of healthy life are lost to diet-related illnesses every year. Tackling obesity costs the NHS about £6.5 billion a year and is the second biggest cause of cancer. To put it starkly, it is a ticking timebomb. Some might say that the ticking has stopped and the bomb has already exploded.

Some 100,000 people have a stroke each year. There are 1.3 million stroke survivors in the UK, thanks to the advances of medicine and medical interventions such as blood pressure tablets, statins and so forth. Children who have high levels of ultra-processed food consumption have been shown to have high levels of cholesterol, increased weight and tooth decay. Obesity has been brought to the fore due to covid. Living with excess weight puts people at greater risk of serious illness or death, with risks growing substantially as body mass index increases.

The cost of all that to the NHS is significant, from prescription drugs and GP and out-patient appointments to the orthopaedic impacts on limbs of weight bearing. Of course, the greatest impact is on NHS hospital admissions. Tackling obesity is one of the greatest long-term health challenges that this country faces. Ultra-processed food is one of the main routes to all obesity issues, because the food is mainly high in fat, salt and sugar. It is marketed aggressively, to the detriment of our health, feeding a growing obesity crisis and feeding our arteries full of fat.

The food supply chain endorses and promotes products that are linked to serious health outcomes, marketing products for which the motivation is profit over health. Certainly at the cheaper end of the market, ultra-processed food does not provide a fully nutritious meal. The marketing and branding of ultra-processed food is relentless. Have we ever seen a high-profile marketing campaign for anything that falls off a tree or comes out of the ground? The answer is no. Instead, we see highly aggressive campaigns selling us the dream of so-called delicious meals. In reality they are highly addictive foods and, without moderating consumption, contribute significantly to poor health outcomes.

I am slightly disappointed that the Government are not proceeding with the plan to ban two-for-one junk food deals. That plan, which has been delayed, would have prevented shops from selling food and drink high in fat, salt and sugar through multi-buy deals. However, at a time when household budgets are under continuing pressure from the global rise in food prices, it would not be right to restrict those options. The principal issue for health outcomes is not so much two-for-one deals anyway; it is the food itself, and we should not lose sight of that. Buying multi-deals does not matter; it is the product itself that matters. That is what we should focus on: trying to eliminate addictive products that are creating poor outcomes for our children.

A good step forward would be an advertising watershed—a 9 pm watershed has been mooted—that would restrict the TV advertising of foods that are high in fat, sugar and salt, not forgetting those online. Current advertising regulations do not go far enough in protecting children from a significant number of unhealthy food adverts. I think that we have all seen the continual adverts for pizzas when we watch family programmes, certainly at the weekend. Those should not be allowed. Half the time, I am moments away from going online to order a couple of those pizzas, but I don’t do that any more.

--- Later in debate ---

[Carol Monaghan]

I thank the hon. Member for being so generous with her time. She says she is not a fan of the nanny state, but we would not market cigarettes and alcohol to children, because we know the harm they do to them. Children are not allowed to buy vaping products, because of the harm they do to them. Yet we have this ticking time bomb. I think she said that 40% of children are overweight. Surely that is a group of people we need to take care of. Maybe adults can make their own choices, but we are talking about children here.

[Suzanne Webb]

I thank the hon. Member for that powerful intervention. I believe that before we get into nanny statedom, those manufacturers need to step up and wake up to what they are selling. They are peddling a false dream. This is not about wrestling with one’s conscience; they need to think about the impact of what they are selling to people. That is what they have to face up to first. I believe I am coming on to that further on in my speech.

We have talked about misleading health claims. Children are regularly exposed to products that extol their own virtues but are in fact the opposite: rich in saturated fats, trans fatty acids, added sugar and salt. If a manufacturer were to put labelling telling us that that was what was in their product, I do not think any of us would go out and buy it. We are being sold something completely different from what is actually in the product.

We should not forget emulsifiers, which hold ultra-processed foods together and improve appearance and texture. In other words, emulsifiers make a product taste and look like the food we want it to be. There is growing evidence of their impact on an increased risk of cancer—notably breast cancer—and cardiovascular diseases. Meanwhile, aspartame—I do not know how to pronounce it—is the most controversial ultra-processed food; a sweetener 200 times sweeter than sugar. When I gave up smoking, I used fizzy drinks to help me through that process. Hon. Members will guess that I am now near enough addicted to those fizzy drinks.

[Carol Monaghan]

It is a horrible sweetener.

[Suzanne Webb]

It is, hence my sparkling water, which I was rushing out for. In May 2023, the World Health Organisation said it was concerned about the long-term use of aspartame as it increased the risk of type 2 diabetes, heart diseases and mortality, although the UK’s Food Standards Agency has accepted that it is safe.

Much of this food is our everyday pleasure, so I am not advocating that we tell people what to eat and not to eat. I am hugely conscious of the cost of living pressures and the ways that people are trying to make changes and save money. Consumed in isolation and moderation, this food is fine. The problem is when it takes over our lives—and it has.

The key challenge is to get supermarkets to put healthy products on multi-buys, encourage a promotional spend shift to healthier food products and focus on making food more affordable. Promotional deals are easy ways to make profit for the supermarkets, peddling products that, to them, are low cost but high margin, and have no nutritional value. There is no doubt that modern living and work patterns mean that we find it difficult to find time to cook unprocessed foods instead of purchasing ultra-processed foods, as they are quicker to cook, ready to eat and cheaper. I do not think that there is anyone here who has not left Westminster on a Wednesday night and probably just picked up a ready meal because it is the quicker and easiest thing to do.

I am pleased to have read that the Scientific Advisory Committee on Nutrition, which provides recommendations on dietary guidelines, is carrying out a scoping review of the evidence on processed foods and health. It aims to publish its initial assessment in the summer of 2023. TV medic Dr Chris van Tulleken has also been vociferous on ultra-processed foods, and long may that continue. The facts are there. It is a serious crisis when one in three children are obese by the time they leave primary school.

I want to see the private sector lead by example, with manufacturers stepping up, taking responsibility and stopping packaging and promotional techniques that lure customers towards ultra-processed food with no nutritional value. We need to address the potential loopholes and displacement from marketing regulation of food that is higher in fat, sugar and salt when selling the dream of a 100% beef burger when, in fact, it is not. Regulators need to focus more on how the processing of food impacts our health outcomes. Will the Minister consider introducing the important advertising watershed sooner rather than later? We cannot afford to delay. The obesity figures speak for themselves; the cost to the NHS speaks for itself. Also on my wish list is considering introducing a reduction target to keep focused on ensuring that ultra-processed food consumption levels in the UK are at a healthier level.

I am deeply concerned about the impact that such food is having on health outcomes and the impact on the NHS. We need to continue the debate, as the simple fact is that 64% of adults in England and 40% of 10 to 11-year-olds are either obese or overweight. That is staggering. To me, we are not far off from the time for urgent intervention like we had in the cigarette industry. An article was written on Monday, independent of my securing this debate, in which I read someone saying very similar things. The obesity crisis is truly shocking and cannot be ignored. The role of ultra-processed foods in that is significant, as is the role of the food supply chain. The food supply chain needs to step up and play its part in the fight against obesity before the Government need to intervene and start to tackle the ultra-processed foods like they did with tobacco— to basically get in there. The Government will have to intervene at some point if the industry do not get a grip.

--- Later in debate ---

[Jo Gideon (Stoke-on-Trent Central) (Con)]

I thank my hon. Friend the Member for Stourbridge (Suzanne Webb) for securing this important debate on a subject that is really close to my heart.

Most people are now aware of the health impacts of HFSS diets, yet it is increasingly clear that the primary cause of diet-related disease is not a diet that is high in fat, salt and sugar, but rather one that is high in UPF. However, as has been said, I wonder how many people know what UPF is and what it stands for, even though it represents 60% of the average UK diet.

To put it simply, if a food is wrapped in plastic, has at least one ingredient that we would not usually find in a standard home kitchen, or has a health claim on the packet, it is likely to be UPF. Much of it will be familiar as junk food, but there are also plenty of organic, free-range and “ethical” ultra-processed foods that might be sold as healthy, nutritious, or useful for weight loss.

Home-made chips, lasagne and cake are not the same as their UPF equivalents. The processing is what is important—so we do not have to all give up cake, as long as we make it ourselves. When we think about food processing, most of us think about the physical and chemical things done to food, but the definition of ultra-processing includes its purpose: to create profitable, convenient, hyper-palatable products. Those indirect processes—marketing, legal challenges and lobbying—all make the issue of how to tackle the health impacts of ultra-processed foods more complicated.

The evidence on ultra-processed food is robust. It is not just a couple of trials; hundreds of papers and high-quality data show the wide-ranging health impacts. Many people are unaware of how artificial the designs of ultra-processed foods are. They typically contain little, if any, whole food. The food’s structure is destroyed by industrial processing, meaning that UPFs are usually soft. They are therefore easy to eat quickly, which means that people eat far more calories per minute and do not feel full until long after they have finished eating. UPFs contain drastically reduced levels of phytochemicals, which are essential for dietary health and cannot be replaced through supplementation. There are also extensive environmental effects. The monocultural food system necessary for the production of UPFs is a leading cause of declining biodiversity and the second-largest contributor to global emissions.

If they are so bad for us, why do we eat them? Highly processed foods are on average three times cheaper per calorie than healthier foods. People from households with lower financial security or food security report consuming fewer fruit and vegetables, less fish and more sugar-sweetened soft drinks than those who are more financially secure.

The rise of UPFs is an emergent property of today’s commercialised and commodified food systems. Many people feel food systems have become more profit driven, with natural and fresh food less accessible. For example, buy-one-get-one-free offers in supermarkets often tempt us to buy more but, in 2015, supermarket promotions in Britain were the highest in Europe, with around 40% of our food expenditure going on promoted products.

Lord Hague recently wrote a fabulous article that argued that it now seems extraordinary to us that tens of millions of people used to smoke cigarettes without realising the serious harm they could cause. I suspect that when people look back a few decades from now, they will have a similar sense of incredulity about the food we eat.

One in 20 UK cancer cases is down to excess weight, which is the second largest preventable cause of cancer after smoking. Diet-related disease is the leading cause of early mortality, with the primary cause being high-UPF diets. Two in five children in England face ill health as a result of the food they eat. Those children are five times more likely to develop serious and life-limiting diet-related conditions in adulthood.

We must re-design our food system to put health first. That our diets should be made up mainly of real food seems simple. Individual responsibility is important but, to facilitate it, we must ensure that as many children as possible finish school with the knowledge and ability to cook healthy and nutritious food for themselves. I am arguing for a proactive approach to public health that equips people with the tools and information they need to make informed, healthier choices. We must also increase the powers of local authorities to empower their communities to address their unique health challenges by, for example, tackling the flood of unhealthy food and drink advertising in outdoor areas, especially near areas where children congregate.

The levy on sugar and soft drinks has been an enormous success. The sugar removed from the national diet as a result is estimated to be equivalent to the weight of 4,000 double-decker buses, without leading to a fall in sales. Fiscal measures can incentivise—

[Carol Monaghan]

I am sorry to interrupt the hon. Lady’s flow. Sugar may have been removed from soft drinks, but other things have gone in. We have already heard about aspartame, which is a particularly horrible sweetener. We know that the levy has taken a huge amount of sugar out, but it has not had any impact on obesity, particularly childhood obesity, so maybe we need to look at other things too.

[Jo Gideon]

I entirely agree with the hon. Lady. If I had my way, fizzy drinks would be banned from all schools and would be hugely discouraged wherever they are sold, but at least the money raised from that tax helps to educate people that we need to look at what we are drinking and eating.

I will not take up more time, but I want to make the case that we have good reason to look closely at the food that finds its way on to the nation’s plates, and we should take ways to tackle the health impacts of ultra-processed foods seriously, renew our commitment to halving childhood obesity by 2030, reduce diet-related inequality and create a long-term shift in our food culture.

--- Later in debate ---

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

It is a pleasure to serve under your chairmanship today, Dr Huq. As many Members know, the subject of food and nutrition is close to my heart, and not just because I enjoy eating good food. I chair the all-party parliamentary food and health forum, which is discussing holding a joint meeting with the all-party parliamentary group on obesity on this very subject. I am therefore really grateful to the hon. Member for Stourbridge (Suzanne Webb) for securing the debate. I know that the Minister’s closing remarks will be of interest to the Members here, to people throughout the nations, and to both all-party groups.

There can be no doubt that ultra-processed foods have created a looming health crisis that has cost implications for the future of our public services, particularly our NHS. With more than half the calories consumed by the average person in the UK coming from ultra-processed foods, and with research from The BMJ linking these foods to early death and poor health, we really cannot afford to be complacent.

As we have heard, ultra-processed foods usually contain ingredients that people would not add when cooking food themselves. Many would not recognise the names of these ingredients, many of which are chemicals, colourings, sweeteners and preservatives. Research suggests that these additives could be responsible for other negative health effects, with several studies showing links between larger amounts of ultra-processed foods and cardiovascular disease and death, and the more of them a person eats, the greater the risk. The words of Professor Tim Spector, professor of epidemiology at King’s College London, are alarming. He said:

“In the last decade, the evidence has been slowly growing that ultra-processed food is harmful for us in ways we hadn’t thought. We’re talking about a whole variety of cancers, heart disease, strokes, dementia”.

Let that sink in. Quite frightening.

Buying processed foods can lead to people eating excess amounts of sugar, salt and fat, often unaware of how much has been added to the foods they are buying and eating. Scotland, as I mentioned a couple of weeks ago, has the highest obesity levels in the OECD countries, so we have a bit of work to do. Public Health Scotland found that children from the most deprived backgrounds were almost three times as likely to be at risk of obesity as those from the least deprived. According to the Scottish health survey, in 2021 two thirds of adults were overweight, similar to or marginally higher than the rates recorded every year since 2008. We are not making much progress in tackling the issue. Men have consistently shown higher prevalence of being overweight than women each year since 2008. One third of children are overweight, and I have no doubt that diet, and overprocessed foods in particular, is a major factor.

I want the UK Government to implement a sustainable food strategy that targets products that are high in sugar and ultra-processed foods. Our colleagues in Holyrood published the Good Food Nation Bill and passed it unanimously, enshrining in law the Scottish Government’s commitment to Scotland being a good food nation, where people in every walk of life take pride and pleasure in and benefit from the food they produce, buy, cook, serve and eat each day.

Education and consumer knowledge are important tools in the fight against ultra-processed foods, but accessibility and price are also key. A few weeks ago, in another debate, I pointed out that for many living in poverty, eating healthy food is a secondary consideration to eating at all. Access to healthy food should be a right, not a privilege.

[Carol Monaghan]

We have talked a lot about children, and there are a few issues there. Children who are obese are less able to exercise, which continues the cycle, and of course this is made more difficult in areas of deprivation. Some Members know that I coach gymnastics locally. We see children, some of them very young, who struggle to exercise because they are overweight. We need serious action.

[Martyn Day]

I thank my hon. Friend for making that point. I agree entirely; the only thing I would add is that not only is it important for children to exercise, but when they do they develop habits that stay with them for their lifetime. We have to crack the children issue at an early age.

On a positive footnote—I will get hell for this when I get home—I am pleased to say that our household contains a 19-year-old who has much healthier eating habits than I had as a 19-year-old male, all those decades ago. If I ask him before going to the shops what he would like, I am invariably told, “Raspberries, strawberries and grapes,” whereas I would have asked for chocolate bars and cans of fizzy juice.

[Carol Monaghan]

They are expensive.