Nanny knows best? Should the Government do more to enforce healthier lifestyle choices?

Our role at the Food Standards Agency is to work with people to ensure that food is as safe as possible both when it is produced and in domestic kitchens.

And to help people to make good decision about what to eat to maintain their health.

How do we do it? We are independent, we base our decisions on the best science and evidence available. And we discuss all our policy decisions in public.

That style of working – and particularly the transparency – has led to high levels of public trust.

88% of the public, in a recent survey, said they believed that what the FSA said was trustworthy.

There are three questions that arise from the title of this session:

• Is there a problem?
• If yes, what is the justification for government intervention?
• And what is the FSA doing?

Let me start with the problem. The statistics about the nation’s poor health and the role food plays in this, really speak for themselves. They cannot be ignored.

Eating a diet that is high in saturated fat and salt, coupled with not taking enough exercise all contribute to the following:

Heart attacks – 275,000 have heart attacks in UK ever year – cause of 1 in 4 deaths in men; 1 in 6 for women.

Strokes – third biggest killer in UK – more than 110,000 people in UK every year.

Diabetes – 2.3 million people are diabetic – will rise to 2.5 m by 2010 (caused by obesity).

Bowel cancer – more than 16,000 people die from bowel cancer every year.

Food related bad health is one of the biggest health challenges we face. Over the last 60 years, the number of people who are severely overweight has risen steadily.

And if the trend continues, by 2050 60% of men will be obese, 50% of women and a quarter of young people and children.

There is a very real danger that today's children will be the first to live shorter lives than their parents and spend more of their years in poor health.

And if we do nothing, by 2050, the cost of to the NHS and the economy will escalate to £50 billion – nearly half the NHS's current annual budget.

It is equally important to remember that while we talk regularly about mortality, levels of long-terms sickness – morbidity – is equally important.

So the answer to the first question is yes, there is a problem.

To turn then to the justification for Government intervention.

In some ways it is easier to justify regulation for food safety – there are processes in the production of food of which the end consumer has no knowledge and no influence and it is right that consumers are properly protected.

But diet? You could say that people should be allowed to eat themselves to death – but:

• the costs are borne by society as a whole
• there is a need for a healthy workforce
• food is more complex – much less obviously understandable
• so there is no one answer.

What We Are Doing?
But 'hard' regulation is probably not the answer for industry and lecturing or hectoring the public does not work.

What can work is education, coupled with clear comparable information and action by industry.

Giving people the information to make choices about the food they buy before they toss it into the shopping trolley.

Working in partnership with industry and finding ways to work together to address these issues.

So – the Food Standards Agency has a 3-pronged nutrition strategy.

• First, we want to encourage the food industry to reformulate so that it produces healthier food.
• Second, to create market demand by educating the public about healthier food.
• Third, front of pack labeling let people see at a glance levels of fat, salt and sugar.

And we have had some great results.

Major projects I would highlight are:

Salt – by working with industry to reformulate products has resulted in a reduction in the people’s average salt intake which has fallen from 9.5g to 8.6, since 2000. This represents a massive 19,700 tonnes of salt per year that has been removed from the UK diet. This is equivalent to the volume of more than 50 community swimming pools.

Studies clearly suggest that a 1g reduction in the average salt intake would prevent at least 7,000 stroke and heart attack deaths a year in the UK.

Saturated Fat – using the same model as our salt work we are starting to work with industry to reformulate and reduce the amount of saturated fat in food.

Saturated fat – intake is 20% higher than recommendations. Our target is to reduce that to below 11% of food energy by the end of 2010. We are working with industry and local authorities to achieve this. We are currently undertaking a consultation.

But there are already specific successes:

• Marks and Spencer 2007 figures showed a 30% reduction in saturated fat in its sandwiches compared with 2005.
• Walkers crisps have reduced the amount of sat fat across almost all its range by 80% since 2004.
• In 2007 Dairy Crest launched 'Cathedral City Lighter' which contains 30% less fat than the standard version.
• Sainsbury’s has launched milk with a 1% fat content, while still retaining the same amount of calcium, protein, minerals and vitamins. It is already hugely popular in the US and Canada, and the supermarket (Sainsbury's) estimates that if UK semi-skimmed consumers were to switch to 1% milk, they could collectively reduce their saturated fat intake by 12,000 tonnes per year.

Front of Pack Labeling – Industry’s universal adoption of front of pack nutrition labeling, which was in the headlines again recently, is testament to this.

Four years ago front of pack nutritional labelling did not exist but consumer research showed that it was needed. FSA research found that Traffic Lights were the most effective in helping consumers make informed decisions.

There has been much debate about the best form of front of pack labelling.

So we are currently undertaking an independent evaluation of the three different approaches, multiple traffic lights, colour-coded GDA (hybrid approach) and GDA alone. This will identify which front of pack labelling approach consumers find most useful.

And the Agency will support whichever scheme comes out as the consumers’ preferred approach.

Food Safety
But the FSA’s role is not just about nutrition. In the UK every year, 500 people die from food poisoning and an estimated 850,000 become ill.

Of course some of this is caused by poor hygiene in domestic kitchens. But the food chain is long and complex. And consumers have no control over it. That’s where the FSA comes in.

Again we are working with industry, improving hygiene standards, to reduce salmonella and campylobacter coming into the food chain before people buy food.

The FSA is an independent evidence-based organisation. We have a network of ten independent scientific advisory committees, with more than 140 independent scientists, to advise us.

That suggests that science is easy and straightforward. It isn’t. It sometimes gives us hints or partial answers. We often have to decide at what point the evidence has accumulated sufficiently for us to take action. This can be before the science is complete.

For example Food colours: some artificial colours have been associated with hyperactivity in some children. So decisions sometimes need to be made about when to act when the science is not complete. People knew, for example, that lemons prevented scurvy long before it was understood why.

Conclusion
To address the title of this meeting 'Nanny Knows Best'. It’s not about nannying it’s about treating people as grown-ups.

Persuasion rather than intervention.

Research shows us that vilifying the extremely fat, for example, doesn't make people change their behaviour.

If you present the message more intelligently - if you explain to parents that many children, regardless of their size, have dangerous levels of salt or fat in their arteries or around their organs, and this may reduce their life expectancy by up to 11 years – then people respond.

We want to enable everyone at every stage of their lives to get the information, encouragement and support they need to be healthy.

From what they see on the television, to what they buy in the local supermarket – to how they travel to and from work or school, to the information and advice they get from health professionals.

So my response to the title is that Nanny has very little to do with it – but where I would make an exception is for children where nannies have a long and honourable history.

The evidence increasingly suggests that children’s eating patterns are laid down very young and that they affect their whole lives.

In this case, intervention seems completely justified whether it is through schools or through helping parents.

I look forward to hearing further comments.