Ultra-processed Food

Maggie Throup Excerpts

Wednesday 21st June 2023 Westminster Hall

[Maggie Throup (Erewash) (Con)]

It is a pleasure to serve under your chairmanship, Dr Huq. I could not miss the opportunity to progress my argument about the importance of tackling obesity, and today’s debate, which was so aptly brought to this Chamber by my hon. Friend the Member for Stourbridge (Suzanne Webb), provides just that opportunity to discuss the ultra-processed food that has an impact on everybody’s diets.

I welcome the premise that if we want a wealthy nation, we need a healthy nation, as I am sure everybody in this room would agree. Obesity and related conditions, such as type 2 diabetes, are the most prominent health impacts of poor diets, which are driven by high levels of consumption of products that are highly processed and contain unhealthy levels of fat, salt and sugar. The term “ultra-processed foods” comes from the NOVA food classification system, which was originally developed by researchers in Brazil. Ultra-processed foods typically have five or more ingredients and, as we have heard, tend to include many additives and ingredients that are not typically used in home cooking, such as preservatives, emulsifiers, sweeteners, and artificial colours and flavours. Such foods generally have a long shelf life. This is how I define the term: if there is a word that someone cannot pronounce when they look at the contents list on a package, the food is ultra-processed.

The vast majority of ultra-processed foods are high in fat, salt and sugar—HFSS, which is the well-established term to refer to foods that negatively impact on people’s health. It has been known for decades that products high in fat, salt and sugar have a negative impact on the health of the nation, and the nutrient profiling model underpins the existing and planned legislation to improve the food system. That includes now-delayed measures to protect children from seeing junk food adverts on TV and online, and to prevent two-for-one offers. My plea to the Minister today is: can we look at the timescales again? They are far too distant in the future and, as I say, the health and wealth of our nation is far too important.

A recent report by the Obesity Health Alliance argued that obesity is the new smoking. That comparison was reinforced by the announcement of £40 million to pilot ways to make the newest and most effective obesity drugs accessible for eligible patients. There is acceptance that obesity is a disease and should be treated with drugs, in the same way that lung disease is treated with drugs. Following that argument through, immense effort has gone into stopping smoking measures and reducing exposure to cigarettes, so immense effort should now be put into reducing everyone’s exposure to foods that are more likely to cause obesity—that is, ultra-processed foods.

The health and economic impacts of obesity are devastating. Obesity is a force multiplier on fatty liver disease, cardiovascular disease, stroke, type 2 diabetes and cancer, which puts ever-increasing pressure on the NHS. The combined cost of obesity to the Treasury—that is, through the NHS, the Department for Work and Pensions and the economy as a whole—is predicted to reach £58 billion a year, and I fear that that is probably a very conservative projection. Those who are obese cost the NHS twice as much as those who are not, and it has been estimated that those who are obese take four extra sick days a year, which equates to 37 million sick days across the UK working population. Those stats are clearly very concerning, and there needs to be a collective effort to tackle this widespread problem. If action is not taken now, we will embed ill health and low productivity in generations to come.

A few weeks ago, BBC’s “Panorama” highlighted just how harmful ultra-processed foods are and how they contribute massively to diet-related ill health. However, as we have heard, they are among the most profitable foods that companies can make. This may sound unlikely, but there is willingness among food manufacturers to reformulate their products. However, they want a level playing field. We have a proven model in the soft drinks industry levy, so let us use that as a basis for the reformulation of ultra-processed food and provide manufacturers with a level playing field, because no company is willing to step out of line and lead the way. If consumption of ultra-processed food continues at the current rate and the obesity rate continues to rise, our nation will be economically poorer and very unhealthy.

I will be bold and state my belief that this country is addicted to ultra-processed foods, similar to the way it was addicted to smoking in past decades. We tackled smoking addiction by intervention; it is now time to tackle ultra-processed food addiction by intervention, too.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)]

It is a pleasure to serve under your chairmanship, Dr Huq. I am particularly grateful to my hon. Friend the Member for Stourbridge (Suzanne Webb) for securing this debate, which is timely and deals with an incredibly important issue, which I am very interested in. I recently met Dr Van Tulleken and the Scientific Advisory Committee on Nutrition, and we are working on this at pace, so I welcome the debate.

One of the great challenges with ultra-processed food is defining what it is. The most commonly used definition, as we have heard, is the NOVA definition, which includes foods that are clearly less healthy, such as sugary drinks, confectionery, salty snacks, cakes and other products that are high in calories, saturated fat, salt and sugar. A diet high in those things increases the risk of excess weight gain and obesity. We are committed to tackling obesity, and have a programme of measures to do that. We have introduced calorie labelling in cafés and restaurants, and since last October we have introduced location restrictions on less healthy foods to reduce pester power. An advertising watershed will be introduced in 2025. That requires numerous steps, and we are taking them.

For children and young people, we are spending £150 million a year on healthy food schemes, such as school fruit and veg and nursery milk, through our Healthy Start scheme. We are also putting in £330 million a year for school sport and the PE premium. In addition, there is a £300-million youth investment fund in facilities to encourage an active lifestyle, and we are spending about £20 million a year on the national child measurement programme, which aims to nip problems in the bud. Only a few weeks ago, the Prime Minister made an announcement on funding a £40-million start in the use of new weight loss drugs for those living with obesity.

[Maggie Throup]

Are the Government still committed to halving child obesity by 2030?

[Neil O'Brien]

Yes. We are working with food businesses and we have set out direct measures to further progress reformulation, which is crucial to helping people to make healthy choices. The soft drinks industry levy decreased the amount of sugar in soft drinks by 46% between 2015 and 2020, and the voluntary sugar reduction programme has delivered a nearly 15% reduction in average sugar levels in breakfast cereals and a 13.5% reduction in yoghurts and fromage frais. Together, these policies are expected to accrue health benefits of about £60 billion, producing savings for the NHS.

Although a significant amount of work has been published, there is no universally agreed definition of ultra-processed food; nor is there an evidenced position. We do have definitions of products that are high in fat, salt and sugar, and that is the basis on which we regulate and control those foods. The Scientific Advisory Committee on Nutrition provides the Government with robust, independent advice on the science and the underpinning evidence base. SACN is clear that there is evidence that a diet high in calories, fat, salt and sugar is bad for people’s health. The question then is what ultra-processing adds to that impact. Is it something about the ease of eating these foods, or what it does to someone’s physiology? Are the products in some way addictive, or is it something else entirely?

Some people say, “Why don’t you just adopt the NOVA definition?” but the breadth of the NOVA definition is such that it includes foods that our current dietary guidelines encourage as part of a healthier diet. Shop-bought wholemeal bread, baked beans, or wholegrain breakfast cereals such as bran flakes and Weetabix would be captured by it, so clearly there is work to do to reach the right definition. Some of the foods that I have mentioned can make a positive contribution to nutrient intakes: for example, fortified breakfast cereals or bread and pasta made from fortified wheat flours are the largest source of dietary iron in all age and sex groups and provide, on average, between a third to a half of our calcium intake.

Defining the problem is not completely straightforward. To make progress so that we can start to regulate or do anything else, we need to have a clear definition. However, even though how to define these things is not totally obvious, that does not mean that there is not a problem, that we will not take action, or that we cannot find a solution. We all know it when we see it—I particularly admired the definition of my hon. Friend the Member for Erewash (Maggie Throup) that having an unpronounce-able ingredient is a pretty good sign—but we need to be precise and follow the scientific evidence.

That is why SACN is carrying out the scoping review of the evidence on processed foods and health, which includes reviewing existing processed food classifications and the ability to apply NOVA to UK diets and our national diet and nutrition survey. SACN aims to publish its initial assessment this summer, so we are moving quickly. We are also in touch with other countries in the same position, and I know that France and Canada are doing similar work. As part of the review, SACN will consider whether there is sufficient evidence to undertake a full risk assessment. Only after an in-depth risk assessment and the identification of robust supporting evidence would we consider updates to Government dietary advice.

The Eatwell Guide, which most Members present will know about, summarises dietary recommendations and shows how much of what we eat overall should come from different food groups to achieve a healthy, balanced diet. It recommends that we consume less often, and in smaller amounts, food and drinks that are high in saturated fat, salt or free sugars. Foods such as crisps, biscuits, cakes, ice cream and sugary drinks are all shown outside the main Eatwell Guide image to highlight that they are not necessary. Those foods also meet the NOVA definition of ultra-processed foods.

The Eatwell Guide and associated messaging is promoted through a range of channels, including the NHS and gov.uk websites, and the Government’s national social marketing campaigns, such as Better Health. We know from our national diet and nutrition survey that most people in the UK are not meeting the dietary recommendations depicted in the Eatwell Guide. Aligning diets more closely with existing dietary recommendations will deliver considerable population health benefits and healthcare savings.

Obviously, one of the things that we are doing to achieve those benefits is supporting people with the cost of living so that they can afford to do it. Support for the cost of living, which we have provided through both energy price support and direct measures for poorer households, has been worth £3,300 for the average household over last year and this year—one of the most generous support packages anywhere in Europe. We are absolutely conscious of the challenges around the cost of food at the moment, caused by the Russian invasion of Ukraine.

Even as we focus on the cost of living, we are still very much focused on obesity, because it accounts for a significant cost to the NHS and the economy. That is what we are doing with our existing programme on obesity and healthy eating. We know that there is more to do, and we will do more. Our major conditions strategy has a call for evidence that runs until 27 June, seeking people’s views on how the healthcare system can support people to lead healthier lives, including supporting them to achieve and maintain a healthy weight. We know that diet has an important impact on health. My hon. Friend the Member for Stourbridge has raised important concerns about ultra-processed foods, which we are looking at.

Our existing policies support less consumption of many of the foods that would be classified as ultra-processed because they are high in fat, salt and sugar. We know that they are a problem, and that is why we regulate in the way we do. It is vital that we take a considered and robust approach to the emerging evidence on what ultra-processing is doing. That is what we are doing, and we will not hesitate to take action if the evidence suggests that it is needed.