Childhood Obesity Strategy

Sharon Hodgson Excerpts

Thursday 21st January 2016 Commons Chamber

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I congratulate the hon. Member for Totnes (Dr Wollaston) on proposing and securing this important debate, and she will be pleased to hear that I agreed with almost everything she said. Many here in the Chamber will be aware of my strongly held passion to provide all children with a hot and healthy school meal, especially one that is free. The debate around the Government’s impending childhood obesity strategy, both here in Parliament and in the outside world, has focused on the reformulation of foods that are high in sugar and salt and the introduction of a sugar tax. Although I support those measures, I want quickly to discuss how school food can play a significant role in addressing the obesity crisis facing our children today.

I want to say at the outset—I am sure people are thinking this, if not here then definitely on social media—that I am rather overweight myself and that some may say I should practise what I preach. I do try. But that is why I am so passionate about this agenda: I know how much harder this becomes as you get older. I was allowed to adopt bad habits that are hard to break, and that shows why we need to educate the next generation to do much better.

School food has played a role in public policy for more than 100 years. It was first discussed in this place in 1906 when Fred Jowett, former Member of Parliament for Bradford West, used his maiden speech in the Chamber to launch his campaign to introduce free school meals when compulsory education was being rolled out. That led to the passing of the Education (Provision of Meals) Act 1906, which was originally Jowett’s private Member’s Bill.

Jowett’s campaign was driven by his experience as a member of the Bradford school board, where he witnessed the malnourishment of children who then fell behind their more affluent peers. Here we are, more than 100 years later, and those arguments are still being made today.

[Andrew Gwynne (Denton and Reddish) (Lab)]

I was just thinking the same as my hon. Friend about how far we have come in some respects but not in others. She will be aware of the private Member’s Bill of my right hon. Friend the Member for Birkenhead (Frank Field). Does she support it?

[Mrs Hodgson]

Yes, that private Member’s Bill is an excellent initiative, and should be adopted by the Government and local authorities. It is very simple to share the data that we already have on families who are entitled to benefits, to ensure that the entitlement of their children to the pupil premium is not lost when universal free school meals are rolled out. That is a very important point.

Although we do not always think about obesity in this way, it is a form of malnourishment. What we are seeing today is very similar to what we saw more than 100 years ago, with children lacking the right nutrients to see them living a healthy childhood and growing into healthy adults. That is especially concerning given that today more than one third of children are leaving school overweight or obese.

The school setting is one of the most important interventions in a child’s life; it is where we nurture and educate future generations. Why should we not feed these children so that they are fuelled to receive the best education and life chances possible? That notion was strongly supported by the previous Labour Government, who introduced a raft of measures that addressed the food eaten by children in our schools. They included nutrition-based school food standards that provide children with the proper nutrition to learn, fully costed plans to extend our universal free school meal pilots, and the introduction of healthy, practical cooking on the national curriculum.

Although much, or all, of those measures were scrapped when the coalition Government were formed in 2010, it was very welcome when, in 2013, the school food plan was published, calling for the reinstatement of lots of those measures as well as new and improved measures in our schools to address the health of our children. Those included introducing food-based standards for all schools, training head teachers in the benefits of food and nutrition, improving Ofsted inspections on school food, and the roll-out of universal free school meals for primary school children, when funding was found.

As we know, that funding was found, thanks to David Laws and the right hon. Member for Sheffield, Hallam (Mr Clegg). Fortunately, universal infant free school meals were secured by the Chancellor in the comprehensive spending review. All those measures came out of concerns for the health of our children and the growing obesity crisis, especially given that 57% of children were not eating school lunches. Some were opting to take in packed lunches, only 1% of which met the nutritional standards of a hot lunch, while others were opting to go off site to eat junk food at local takeaways.

As research has found, health problems associated with being overweight or obese cost the NHS more than £5 billion a year, and, with obesity rates continuing to rise for 11 to 15-year-olds, especially in deprived areas, it is now clearer than ever that we need seriously to address childhood obesity.

Giving children a healthy and balanced diet during the school day can only be a positive intervention in helping to address obesity. I cannot stress how strongly I believe that one of the most important interventions to help address health issues in childhood is universal free school meals.

[Helen Whately (Faversham and Mid Kent) (Con)]

The hon. Lady mentioned that children are consuming junk food from outlets near schools. Does she believe that councils should have powers, as part of planning guidance, to take action on junk food outlets being so close to schools?

[Mrs Hodgson]

Yes, I do. I really welcome that intervention, because it not only makes the point, but stresses it very strongly. Some councils are very good and introduce byelaws to ensure that burger vans cannot pull up outside a school, and that, if there is already a number of takeaway shops nearby, no more can open. Matters such as that need to be addressed by councils.

The pilots introduced by the previous Labour Government in Durham and Newham to look into the benefits of universal free school meals found many benefits to a child’s health, and research continues now that we have universal infant school meals. The pilots in Durham and Newham found a 23% uptake in vegetable consumption at lunchtime and a steep decline in the typical unhealthy packed lunch foods. For example, there was a 16% decline in soft drinks and an 18% decline in crisps. Those are all-important figures that the Government should remember, and both the Department of Health and Department for Education should look further into how best they can use the vehicle of universal free school meals to help improve children’s health.

Although universal free school meals are protected in the Government’s comprehensive spending review—this followed a concerted campaign by school food campaigners, myself and others in the House—there is another area that the Government must consider when looking to improve the health of our children: holiday hunger. Children are in school for just 190 days of the year, and the rest—a total of 170 days—is totally down to their parents. Some may say that that is how it should be and that when we lock the school gates for the holidays it is none of our business what children eat, whether they eat or what they get up to. None the less, with the growing use of food banks in school holidays and the reports that children return from the longer school holidays noticeably thinner and unhealthier, the issue is one that we can no longer ignore.

If there is a push for better food provision in our schools, then we need to be doing much more during the holidays so as not to undo the hard work that goes into improving the life chances of children during term time. That is why the school food all-party group, which I chair, has established a holiday hunger task group, which last year launched its “Filling the Holiday Gap” guidelines to provide organisations and local authorities wishing to provide food during holidays with the resources to offer healthy and nutritious food. Late last year, it published its update report, which called for action to be taken by the Government.

When the Government’s childhood obesity strategy is published, I hope that there will be significant mention of the benefits that school food, especially universal free school meals, can have on a child’s health, and of how it can be used to address the growing childhood obesity crisis. There is evidence out there to support using universal free school meal provision to its fullest, instead of squandering its potential, to improve the health of our children.

This is a moment when the Government can really make a difference to children’s lives and I hope that all options and avenues will be pursued so that children are given the healthy food that they need to fuel their education and to make them as healthy a version of themselves as possible so that they grow into fit and healthy adults.

--- Later in debate ---

[Alison Thewliss (Glasgow Central) (SNP)]

I am glad to be able to speak in this debate and hope that what I say will provide a different kind of insight into the debate on childhood obesity.

I am a great enthusiast for breastfeeding. Breast milk has many exceptional qualities, the most obvious being that it is exactly the right thing for infants to be eating. In the beginning, there is the double cream of breast milk, colostrum, which appears before a baby is even born in preparation for those first feeds. The milk that comes thereafter changes and adapts over time as the baby’s needs change. Breast milk has everything that a baby needs and, taken directly from source, it has the advantage of being at the correct temperature. It is easily absorbed by the infant gut. It is a miracle of nature.

What breastfeeding contributes to this debate is the impact that it can have on reducing childhood obesity. An excellent study was pulled together by UNICEF a few years ago called, “Preventing disease and saving resources: the potential contribution of increasing breastfeeding rates in the UK”. The report analysed data from many studies to ensure that there was a sound scientific basis for the claims that it made. Although I accept that giving precise figures and modelling on this is difficult, the UNICEF report estimates that:

“A modest increase in breastfeeding rates could result in a reduction in childhood obesity by circa 5%. If this was the case, the number of obese young children would fall by approximately 16,300, and annual health-care expenditures would reduce by circa £1.63 million.”

That would be no mean contribution. Breastfeeding starts babies off on the right track and, with the accompanying health benefits, such an increase could result in a generation of healthier babies and young people.

The Government should bear that in mind and ensure that services to promote, protect and support breastfeeding are well maintained. This is too important to be left to the good will of the wonderful network of voluntary organisations across the country. It needs to be an identified priority of this Government. The newly formed all-party parliamentary group on infant feeding and inequalities, which I established this week with colleagues from across the House, aims to examine the matter further. We will consider the issues of inequality, because there are multiple deprivation issues, with lower rates of breastfeeding in deprived communities.

What is less well known about infant formula is the specific contents of that product. It takes a complex chemical process to produce formula that involves either dry blending or wet mixing and spray drying, in which cow’s milk is treated with added lactose or other carbohydrates, vegetable and other oils, vitamins and minerals. According to the First Steps Nutrition Trust, the current regulations require infant formula and follow-on formula to have an energy content of between 60 kcal and 70 kcal per 100 ml. Those figures are based on the energy content of breast milk, but, as I mentioned earlier, breast milk composition changes in response to the baby as it grows. Breast milk also has more unsaturated fats than cow’s milk and the fats in infant formula tend to come from the vegetable oil. If anyone has an interest in finding out more about this, I recommend that they seek out the “Infant milks in the UK” report that is produced by the First Steps Nutrition Trust. The level of detail is fascinating.

There are differences between the growth curves of breastfed and formula-fed babies, with the formula-fed babies gaining more weight in the first year. Some studies suggest that that may, in part, contribute to childhood obesity. Pressure is also put on mothers to ensure that their baby is gaining the correct amount of weight. We should consider how formula milk is delivered. I have heard many people describe how many millilitres of formula their baby has drunk at any given time, comparing and contrasting this with others. There is an expectation of how much is normal.

There is a risk in the making up of formula milk, because one must ensure that the correct dosage of powder is dissolved in the water. If this is not done accurately, there is a risk of babies being overfed or, indeed, underfed. The risk of that is far lower for breastfed babies, although I admit that I could only really tell how much breast milk my babies had by the amount that they both threw up all over me. There is not really any other way of telling.

[Mrs Hodgson]

I agree with everything the hon. Lady has said so far. As she knows, I took part in the debate that she led in Westminster Hall on this issue. The point that she is making is very important. I was an evangelical breastfeeder myself and still encourage everyone to do it in every which way they can. She makes the point that breastfed babies feed on demand, so they take as much or as little as they need, whereas when babies are bottle fed, there is an obsession with whether they have taken half a bottle, 8 ml or whatever. Parents inadvertently force-feed their baby the amount they think they should have, rather than what the baby needs, so babies get used to being full. As we all know, that is not necessarily good and can lead to the bad habits in adulthood that I spoke about earlier.

[Alison Thewliss]

I absolutely agree with what my good friend says. Bottle feeding tends to be at a set time—“Is it time for the baby’s feed yet?”—rather than when the baby actually needs to be fed, whereas breastfed babies are fed little and often on demand, which is a slightly better habit to get into.

There is also a beneficial effect on breastfeeding mothers. As well as reducing the risk of cancer and diabetes, breastfeeding burns calories and helps to get mothers back to their pre-maternity weight—for me the prospect of burning an extra 400 to 500 calories just by breastfeeding my baby was very attractive, and it certainly helped me to fit back into the clothes that I wore before I had my children, both of whom were breastfed for two years.

I was interested in the findings of the Select Committee report, and I particularly note the points about marketing and sugar content in foods. I was a wee bit disappointed that it does not contain much discussion on baby foods and toddler milks, as there are significant issues in that area regarding the advertising and the content of the products. In evidence to the Committee, Dr Colin Michie of the Royal College of Paediatrics and Child Health stated:

“Follow-on formulas are not necessary for human beings, but it would not seem so if you watch television. The problem is we are all very convinced by the stories. There are other issues that have parallels for what was said earlier in that the milk companies sponsor education, training, events and an awful lot of professional activities, which again does exactly, to our minds, what we heard it does to infants’ minds: when we see brand names, we equate certain things with them. It is an insidious business that we know enough of to be very wary of.”

The artificial creation of a market for follow-on or toddler milks is of some concern, because those products are not subject to the same level of scrutiny as formulas for very young babies. Research gathered by the First Steps Nutrition Trust suggests that

“Growing-up milks and toddler milks contain almost twice as much sugar per 100 ml as cow’s milk, and some Aptamil and Cow & Gate growing-up milks and all SMA growing-up milks contain vanilla flavouring. It is unclear whether repeated exposure to sweet drinks in infancy and toddlerhood might contribute to the development of a preference for sweet drinks in later life.”

It is important to take cognisance of that and consider the issue as part of the obesity strategy.

--- Later in debate ---

[Mrs Flick Drummond (Portsmouth South) (Con)]

I am delighted to follow the hon. Member for Glasgow Central (Alison Thewliss), who has established the fantastic all-party group on infant feeding and inequalities. I am looking forward to being part of that as it progresses, and I thank her for setting it up.

The chief executive of NHS England describes obesity as “the new smoking”, and in many ways he is right. Obesity leads to a multitude of health complications, ranging from lack of mobility to cancer. There are also many hidden health risks for people who are obese or severely overweight. Obesity can lead to a lack of self-worth or depression, and it can affect relationships and careers. Because of the growing obesity problem, and the very serious threat to our children’s futures, I am happy that this debate is taking place, and I congratulate my hon. Friend the Member for Totnes (Dr Wollaston) on securing it.

In my constituency of Portsmouth South, 20% of children and 25% of adults are obese, which is above the average for England. In other ways, obesity is unlike smoking—there is no “vaping” technology for people who struggle to maintain a healthy diet. We know that fast food is an immediate satisfaction, whereas healthy food can take longer to prepare. I am concerned, however, that some studies suggest that healthy food is more expensive than the fast and unhealthy food that we see on offer every day, or positioned conveniently at supermarket checkouts.

I am particularly concerned by a fairly recent report by the University of Cambridge, which found that healthy food was three times more expensive than unhealthy food. I would dispute that. It is perfectly possible to eat healthily on a low budget. As Baroness Jenkin from the other place has shown, someone can live healthily on £1 a day, and I know from my own busy household that it is possible to live healthily on a very small budget. At the local food bank where I volunteered before the election we handed out healthy recipes for the food that was provided, which should have lasted people for three days. I am sure that I do not need to repeat what that issue means for those living in deprived areas, except to say that in my constituency of Portsmouth South, where deprivation is higher than the English average, the challenge to encourage people to eat healthy food is even greater.

The whole House will agree that today our nation’s children are more susceptible and at risk of becoming obese. Children do not control their diets—it is the parents who do the weekly shop—and we would never blame a child for their poor dietary choices. Children who develop obesity at a young age are at risk of developing lifelong conditions, some of which are also life-limiting; as we have heard, cases of diabetes are increasing. During childhood, people develop habits that can last the rest of their lives. A lot of facts have been flying around in this debate, and although I understand the financial burden that a growing obesity problem poses for our NHS, the human cost cannot be quantified.

The solution to this problem is not simply more money. As other Members have said, it requires the energy and commitment of central and local government, health organisations, and our local charities, to educate the population on how to live on a low wage. I am really pleased that the Roberts Centre in my constituency is a family-focused charity. It offers a range of services offering support and assistance, including making healthier lifestyle choices, to some of the most disadvantaged families in the city.

[Mrs Hodgson]

On the hon. Lady’s point about living healthily on a low wage, I take on board that it is very possible to make healthy food very cheaply, but people need the skills and knowledge to be able do that. I wonder whether she will say a bit more about that. The School Food Plan says that education should start with children learning the skills they need to be able to look after themselves as adults.

[Mrs Drummond]

That is exactly what I was going to come on to, so I thank the hon. Lady very much indeed.

Last week, I met Home Start, a national family charity with a strong presence in Portsmouth. It has an army of volunteers who offer unconditional help and support to all families who need help in getting it right, and show them how to cook healthily. There is, however, a major role for our schools in tackling obesity. The school where I am a governor, Milton Park primary, is taking the lead locally in educating children about healthier choices. The cooks at the school have won awards and I can recommend their so-called “chocolate muffins,” which in fact are made of beetroot.

I would like to see cooking classes become mandatory in schools. I know it would be difficult to re-establish kitchens, but the rewards would be worth it. I see that as the only way to prevent future generations from continuing poor eating habits. The only way to do that is by teaching them how to cook healthily and how to budget. Like some of my colleagues, I was against a sugar tax to start with. If we can use the sugar tax to fund cooking classes in schools, however, then I am all for it.

In Portsmouth, there are a number of charitable organisations actively engaging with the community to help to tackle obesity through a more active lifestyle. Affiliated with Portsmouth football club, Pompey in the Community provides education and opportunities for children in the city.