Obesity: the challenges we face

I would like to begin by thanking the Faculty for inviting me to take part in your annual conference. It is a real honour to speak to you today.

And the sort of conference we need to help spark the ideas that allow us to deal with obesity.

And a wonderful opportunity to visit this wonderful city of Cardiff.

During its 35 years of existence, this Faculty has been one of the custodians of a proud tradition of selfless effort to improve the health of the population. A tradition inspired by the efforts of public health pioneers. Because of this, people are much healthier today.

When is comes to profiling the Welsh greats of the worlds of sports, music and film, most of them need little in the way of introduction. But we should pause to celebrate leading world-class health pioneers, in Wales today.

Those whose work has made such a profound difference to public health in Wales and beyond.

Professor Ron Eccles, of Cardiff University, the world’s leading expert on that most ubiquitous of afflictions – the common cold.

Nobel Prize winner, Professor Sir Martin Evan’s pioneering research into stem cell technology again at Cardiff University.

Professor Ilora Finlay, one of the first “people’s peers” in the House of Lords, who was one of the most outspoken voices in the campaign for a smoking ban.

Thanks to her Private Member’s Bill in 2004, the Welsh Assembly was given the power to ban smoking in pubs, restaurants and shopping centres. Setting Wales ahead of the rest of the UK, who later followed the Welsh example.

But continuing to advance today’s public health agenda will require more than gifted individuals. It’s a much bigger picture.

Indeed much improvement in public health has been achieved by what The Nuffield Institute for Health refers to as “quite interventionist public policies”.

No one person or policy alone is going to solve the problem of childhood obesity or stop the phenomenon of binge drinking. This goes right to the heart of state responsibility verses individual choice.

I know the faculty recognises that and calls for a partnership of all those who contribute to the health of the nation.

This call reflects the fact that we need to have a sophisticated approach where we intervene in many ways and at multiple levels to improve public health.

That’s where I see our role. As Chair of the Food Standards Agency I want us to work in partnership, in co-operation and mutual respect with organisations like The Faculty of Public Health, to improve the safety and quality of the food we eat.

The Food Standards Agency, as an independent voice within government, is a vital part of the jigsaw that goes towards making a healthier nation.

First, I want to talk about some of the challenges that we all face.

We all know that there is an obesity crisis that is growing – the classic ticking time-bomb.

Obesity levels have tripled in England since 1980. And if the current trends continue, by 2050, 60% of men will be obese, 50% of women and a quarter of young people and children.

I know that here in Wales there is a particular problem with teenage girls, who have some of the highest overweight levels in the world.

The cost of this to the UK economy will be almost £50 billion a year.

But how do we make the changes that are necessary to try to turn this around? Changes that are not just about the quality of what we eat but which are cultural – deeply embedded in the way we live our lives.

Generally, the choices we make about what we eat, and what we feed our families, are highly personal. Governments meddle in these food choices at some risk. But also recognise that there is a role for government. To govern the areas that people cannot control as individuals – eg the nature of food supply.

Like many of the big social problems facing government – anti-social behaviour, alcohol abuse, sexual health – the solutions are subtle and often intangible. You can’t order people to eat lettuce. And any choice that requires counter intuitive behaviour today for a better tomorrow is difficult.

But we can help to make healthier eating a positive choice. To help people understand what they need to do and how they can go about doing it.

To motivate people to achieve behaviour change.

And, very importantly to work with industry, as we do at The Food Standards Agency to ensure those choices are easier to make.

One of our primary roles is to give simple, clear comparable information to consumers. But it has to be done in a way that takes account of our increasingly busy lives, while allowing us to make our own decisions.

And we, at the Food Standards Agency, have had some real successes that complement the broader work being carried out by the Welsh Assembly Government, to develop a Public Health Strategic Framework for Wales.

It is vital that we cut down on the amount of salt that is consumed in the UK. Salt has devastating effects on the rates of heart disease in the UK.

The recent FSA salt campaign highlighted that cutting ½ gram of salt from people’s diet can save 3,500 lives a year in the UK. Almost the same number that dies in road crashes each year.

But it’s not just about people cutting salt from their diet.

In the UK, 75% of the salt we consume is already in the food we buy. So we took a ‘push/pull’ approach and worked closely with industry to create both consumer demand and lower salt products from the food industry.

The Food Standards Agency has adopted a three-pronged approach to achieving this:

• First, by encouraging industry to reformulate products, by setting out challenging targets for salt reduction in particular food. Our part of the bargain was that we would promote a change in market demand which we’ve done over the past 2 years
• Second, publicising the dangers of high salt intake, offering advice to consumers, working in partnerships with charities and NGOs to cascade the message into the community. Partnership with organisations, like the Women’s Institute for example
• Third, we revolutionised labelling to influence the environment in which people shop

In short, we worked with the grain of the market to achieve our targets.

And we have been had much success. We worked with some of our big food producers such as Heinz, Kelloggs and Nestle to produce food with lower levels of salt in them.

And with organisations, who also work closely with The Faculty of Public Heath - Age Concern, The British Diabetic Association, The British Heart Foundation, The National Federation of Women’s Institute - to get across the lower-salt message.

And we now have clear signs that we are reversing the rising trend in salt consumption:

• There has been a 58% increase in number of people claiming to check labels for salt
• And there has been a half a gram fall in salt consumption to 9g a day by 2006
• Further results are due to be published later in the summer and we will be looking at further revisions to targets for food manufacturers. Currently our target is for a reduction to 6g by 2010

Let me return to the third leg of that strategy – labelling. We have also pioneered traffic light labelling on food to help people make decisions about healthier food as they shop. To help them in those quick, at-a-glance decisions as food is tossed into the shopping trolley.

Consumers can see at-a-glance whether a product is high, medium or low in key nutrients: fat, saturated fat, sugars and salt.

Red means high, amber medium and green low. The more greens on a label, the healthier the choice. A very easy visual aid that we continue to promote across the UK – bilingually in Wales.

Traffic light labelling helps consumers compare products and provide an incentive for industry. By reformulating their products they can work towards more greens and ambers and fewer reds.

And I know that here in Wales, you should have your first Welsh food manufacturer or processor adopting traffic lights by the end of the year.

Some manufacturers are using other Guideline Daily Amounts schemes and independent research is being undertaken to see what works best for consumers – what aspects of what scheme best help them to make healthier choices.

We know that the types of food children choose – not just which brands – are affected by advertising.

This was confirmed in a review by Professor Gerard Hastings, commissioned by the Food Standards Agency in 2003.

Indeed, it is important to underline that all the work of the FSA is underpinned by evidence. We have a network of independent expert advisory committees, with 140 independent scientists, to advise us. And a research budget of £25 million.

We are the biggest commissioner of nutritional research in the UK. But still we have to admit there is much that we don’t know. Much work we still have to do.

All the work we do: influencing people, products and the environment where people make their food choices in underpinned by the best available science.

Following the Hastings Review, we launched a national debate on ‘Defusing the Diet Timebomb: food promotion and children’.

This work on nutrient profiling led to tougher rules on TV advertising, through work with Ofcom, to control the advertising to children of foods high in fats, salt and sugars.

In addition to this, the FSA carried out some research into concerns that children were being affected by artificial colours in food and drink.

Scientists at Southampton University found that certain mixtures of artificial colours, together with the preservative sodium benzoate, are associated with an increase in hyperactivity in some children.

Because these additives give colour but nothing else we believe it is sensible, in the light of these findings, to remove them over time from children’s food and drink products.

Therefore, we have advised the Government that there should be voluntary action to remove specific artificial colours from food and drink by 2009. In addition there should be action to phase them out in the European Union.

But what are our next challenges?

We all know that we have to reduce the UK’s intake of saturated fat. To replace it with unsaturated fat such as vegetable oils.

So we need to get the message across to consumers but again, learning from our previous campaigns, we will need to work with industry and NGOs. It is early days for us on this campaign. We will soon be setting targets and we hope to develop partnerships across industry to reduce saturated fat levels and educate the nation’s taste buds as has happened with salt.

Where a product can’t be reformulated, we will be encouraging portion size reduction. Healthier eating becomes easier if the tempting treats come in smaller packets.

We all know that making healthier eating easier is a challenge.

The Government’s Obesity strategy, launched earlier this year, gives a roadmap for how we can – together - begin to tackle this growing crisis.

It recognises that successfully maintaining a healthy weight and eating well must be the responsibility of individuals first.

But we all recognise how difficult it is for individuals and we know that we have to help.

Equally, we know that it’s difficult to find the right help – there is not too much evidence of successful interventions around the world. Fern’s gastric banding is not a panacea.

But we have to try. To rise to these challenges.

Government has a role in alerting people to the risk. And using its influence to make the environment we live in more conducive to healthier eating.

This dovetails with my role at the Food Standards Agency, in promoting healthier food choices.

Helping people to make those sometimes difficult decisions – for a range of reasons – to reduce foods that are high in fat, sugar and salt.

And to make positive changes in their lives.

But with organisations like you - The Faculty of Public Health - industry, Government and the public working in partnership, I believe that we can do it.

That we can make a real difference together to the health of the nation.