Briefing. OBESITY and LABELLING. Key Points. Key Actions. Types of Labelling TOASTIES, PANINIS & WRAPS

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OBESITY and LABELLING July 2016 Briefing Key Points Labelling provides vital information and factual data for the consumer.

level by Regulation (EU) No 1169/2011; it enforces mandatory Back of Pack labelling that must include energy, fat, saturates, carbohydrate, sugars, protein and salt per 100g or 100ml Evidence

can be presented as traffic light labelling, was adopted in the UK and around 75% of businesses use the scheme on their products Voluntary schemes have been criticised for not creating a level

1 OBESITY and LABELLING July 2016 Briefing Key Points Labelling provides vital information and factual data for the consumer. Debate continues about labelling Characteristics which provide the consumer with useful information on which to make informed choices that favour good health Food labelling is regulated at European level by Regulation (EU) No 1169/2011; it enforces mandatory Back of Pack labelling that must include energy, fat, saturates, carbohydrate, sugars, protein and salt per 100g or 100ml Evidence consistently confirms that the traffic light hybrid label is most effective Food labelling appears to impact the food industry and lead to reformulation Voluntary Front of Pack (FoP) labelling, which can be presented as traffic light labelling, was adopted in the UK and around 75% of businesses use the scheme on their products Voluntary schemes have been criticised for not creating a level playing field for businesses. A mandatory scheme would be fairer and more effective Key Actions More consistent application across the retail industry of FoP labelling Improved labelling on added sugar content Improved and consistent nutritional information across the out-of-home sector Types of Labelling On Individual Food and Drink Front of Pack Back of Pack On Menus Calorie Information TOASTIES, PANINIS & WRAPS with chips add 398cal with salad add 71cal Ham & cheese toastie 448cal 4.50 Cheese & tomato toastie 391cal 4.50 Cheese & tomato panini 452cal 4.50 BBQ chicken, bacon & cheese panini 624cal 5.70 Chicken wrap 589cal St Vincent Street Glasgow G2 5RJ info@obesityactionscotland.org

2 Regulations Regulation (EU) No 1169/2011 on the Provision of Food Information sets out how consumers should be provided with food information to allow them to make informed choices. This regulation updates and consolidates EU rules on general food labelling and nutrition labelling 1. The regulation specifies reference intakes (RI) of energy, selected nutrients, vitamins and minerals for adults. The RI: Replacing the Guideline Daily Allowance (GDA), Reference Intake (RI) gives a useful indication of how much energy the average person needs and how a particular nutrient fits into a daily diet. RI for sugar is 90g/day and sugar is defined as all monosaccharides and disaccharides in food excluding polyols (sugar-free sweeteners). It does not differentiate between naturally occurring and added sugars. So far, alcoholic drinks are not included under EU-wide food labelling rules. The Food Information (Scotland) Regulations 2014 set out the requirements for food businesses. The Regulations also establish the enforcement measures for food information law 2. Food Information Law: Any enactment relating to food information as the Scottish Ministers may by regulations specify The Food Standards Agency in 2014 published summary guidelines of these regulations for food operators and enforcement officers. The Food (Scotland) Act 2015 introduced an additional food information requirement for food business operators and established Food Standards Scotland (FSS). Additional Food Information: Information provided by means other than the label Application in the UK Full mandatory (Back of Pack) labelling is required under Regulation (EU) No. 1169/2011 on the Provision of Food Information to Consumers and must include energy, fat, saturates, carbohydrate, sugars, protein and salt. It must be expressed per 100g or 100ml but can also be expressed per portion and/or consumption unit. Other nutrients can be reported only if they are included on the list of voluntary nutrients; these are monounsaturated fatty acids, polyunsaturated fatty acids, polyols, starch, fibre, vitamins or minerals; the list does not include added sugars. FoP labelling, the traffic light system, is voluntary in the UK. EU regulation does not allow a mandatory approach. However, if available, it must be in addition to full mandatory labelling and must meet a set of requirements 4. If placed, FoP labelling must show energy, fat, saturated fat, sugar and salt in either 100g/ml or a product portion. Jane Ellison, the Parliamentary Under-Secretary of State for Health, during a Childhood Obesity Strategy Backbench Business discussion in January 2016, stated that the voluntary FoP nutrition labelling scheme, introduced in 2013, plays a vital part in Government work to encourage healthier eating and reduce levels of obesity and other conditions. 75% of products currently carry voluntary traffic light front of pack labelling 5. In Scotland, a recent review of the Obesity Route Map recognised industry for its contribution to introducing consistent FoP labelling 6. The House of Commons Health Committee commended traffic light labelling but was advised that making it mandatory would require EU legislation. From 1 April 2015: it is an offence for any food business operator who considers that food information law has been contravened, to fail to notify FSS and enforcement authorities have the power to seize or detain food apparently in contravention of food information law. Neither of these new measures currently apply across the rest of the UK 3.

3 Voluntary Initiatives 1 The Public Health Responsibility Deal (2011) had 4 pledges relating to labelling: A1. Alcohol Labelling: We will ensure that over 80% of products on shelf (by December 2013) will have labels with clear unit content, NHS guidelines and a warning about drinking when pregnant. 101 signatories F1. Out-of-Home Energy (kj/ kcal) Labelling: We will provide energy information for food and non-alcoholic drink for our customers in out of home settings from 1 September 2011 in accordance with the principles for energy labelling agreed by the Responsibility Deal. 45 signatories F7(a). Front of Pack Nutrition Labelling: We will adopt and implement the UK Government s 2013 recommended Front of Pack Labelling Scheme 23 signatories F7(b). Front of Pack Nutrition Labelling: We will promote, and explain to consumers how to use the UK Governments 2013 recommended Front of Pack Nutrition Labelling Scheme. 17 signatories 2 For an up to date list of signatories for each pledge, visit: responsibilitydeal.dh.gov.uk The Supporting Healthy Choices Framework 7 was developed by the Scottish Government and Food Standards Agency and published in With a number of commitments, the following two refer specifically to labelling: Commitment 9: We invite manufacturers and retailers to adopt the UK s recommended format for providing nutrition information on Front of Pack labelling on an ongoing basis. Commitment 10: We invite out-of-home caterers to roll-out energy and, where possible, nutritional information on menus and displays (in print and online) across Scotland on an ongoing basis. Action plans for Supporting Healthy Choices were submitted by only six commercial groups (A G Barr, Aramark, Compass Group, Subway Scotland, Coca Cola, and Eat Balanced), by Scottish Government/FSA Scotland and the Scottish Grocers Federation 8. Effectiveness of Labelling Perceived healthiness of foods was influenced by traffic light labels more than Guideline Daily Amount or a simple healthy choice tick 9 Interpretive (i.e. traffic light labelling) or contextual (i.e. reference daily calorie intake for an adult) labelling may be more effective than numerical nutritional information. The addition of contextual or interpretive nutrition information on restaurant menus assisted consumers in choosing less calories and consuming less calories 10 Labelling Limitations In the context of the UK Childhood Obesity Strategy, the House of Commons Health Committee suggested that labelling alone was unlikely to change the rates of childhood obesity 5. Similarly, in their report Sugar Reduction: Evidence for Action, Public Health England (PHE) claimed that since few people read labels, improved information on labelling would have limited influence 11. Labelling may have different effects in different socio-economic groups 12. It could potentially widen inequalities by having a larger beneficial effect on those who already have healthy preferences 6.

4 To increase the effectiveness of food labelling in disadvantaged populations it was recommended to run mass media campaigns and education initiatives, offer price incentives and define quality standards 13. Awareness and understanding of food labelling in the general population could be improved; in the UK, public awareness campaigns such as Food Standards Scotland s #Lookatthelabel or Change4Life public information TV fillers have tried to address this issue How to Improve Labelling In November 2015 celebrity chef Jamie Oliver presented the UK Government with his recommendations to address childhood obesity in the UK. One of his points was labelling; he asked to make it much clearer and standardised, and to make traffic light labelling mandatory. As witness for the House of Commons Health Committee meeting last October, Jamie Oliver suggested using a labelling system including a graphic representation of the number of teaspoons of sugar (4g) in food and drinks with added sugar. The Committee supported his idea and recommended that the Government invite industry to introduce this labelling voluntarily but make it mandatory if companies fail to adopt it 5. PHE recently launched Sugar Smart, a component of their Change4Life campaign. A free mobile phone app is included which scans bar codes of food and drink products, providing information about the amount of sugar in the scanned product. In this campaign, sugar cubes instead of teaspoons of sugar were used. To date, alcoholic drinks are not included under the new EU-wide food labelling rules. A voluntary energy declaration (per 100ml) can be made on alcoholic drinks without the need to provide a full list of nutrients ( Back of Pack ), which would otherwise be mandatory on pre-packed food. The Royal Society for Public Health, the Royal College of Physicians of Ireland and Local Government Association, are all of the view that alcohol labelling should contain information on calories. In April 2015, European Parliamentary Members voted for calorie labels on alcoholic drinks. The vote was not binding. Customer Attitudes A recent survey of 1440 young adults in Scotland found that nearly half (46%) would welcome calorie information in catering settings and on alcoholic drinks 14. In a survey commissioned by the Chartered Institute of Marketing at the beginning of 2014, 76% of 2,012 UK adults said they understood the traffic light system but the majority answered four out of the five questions on the labelling system incorrectly. Although the majority of respondents (77%) believed that the responsibility for a healthy diet is their own and did not want further government legislation, over half agreed that current nutritional information was difficult to understand and they would take more notice if it was clearer. 59% said that retailers should provide clearer information; and 70% expected manufacturers to do more to explain what is in the products they sell 15. Policy Position Commitments 9 and 10 of The Scottish Government s Supporting Healthy Choices framework invited manufacturers and retailers to adopt the UK s recommended format for providing nutrition information on Front of Pack labelling on an ongoing basis; and out-of-home caterers to roll-out energy and, where possible, nutritional information on menus and displays (in print and online) across Scotland on an ongoing basis 7. Food Standards Scotland encourages all businesses to provide nutrition information on front of pack labels; strongly encourages provision of calorie labelling on menus across both public and private sectors; and expect large catering businesses to provide full nutritional information for consumers (print and on-line)16. The Health Select Committee on the Childhood Obesity Strategy recommended introduction of a labelling system including a graphic representation of the number of teaspoons of sugar (4g) in food and drinks with added sugar 5. The UK Government has indicated a decision relating to child healthy weight will be reached later this year.

5 REFERENCES 1. The European Parliament and the Council. Regulation (EU) no 1169/2011 of the European Parliament and of the Council of 25 October 2011 on the provision of food information to consumers, amending regulations (EC) no 1924/2006 and (EC) no 1925/2006 of the European Parliament and of the Council, and repealing commission directive 87/250/EEC, council directive 90/496/EEC, commission directive 1999/10/EC, directive 2000/13/EC of the European Parliament and of the Council, commission directives 2002/67/EC and 2008/5/EC and commission regulation (EC) no 608/2004. Official Journal of the European Union. 2011; 304: The Food Information (Scotland) Regulations 2014 no The Food (Scotland) Act Department of Health, Food Standards Agency, British Retail Consortium. Guide to creating a front of pack (FoP) nutrition label for pre-packed products sold through retail outlets The House of Commons Health Committee. Childhood obesity - brave and bold action. First report of session ; HC Kerr A. ScotPHN Scottish public health obesity special interest group review of the obesity route map (ORM) Scottish Government. Supporting healthy choices. A framework for voluntary action. An invitation to the food industry to work in partnership with government in Scotland Scottish Government. Supporting healthy choices: Supporting statements & action plans. Living/Food-ealth/supportinghealthierchoices/ SHCSupportingMaterial. Updated Accessed 06/12, Borgmeier I, Westenhoefer J. Impact of different food label formats in healthiness evaluation and food choice of consumers: A randomizedcontrolled study. BMC Public Health. 2009; 9(184). 10. Sinclair SE, Cooper M, Mansfield ED. The influence of menu labelling on calories selected or consumed: A systematic review and metaanalysis. Journal of the Academy of Nutrition and Dietetics. 2014; 114: Tedstone A, Targett V, Allen R. Sugar reduction. The evidence for action Crockett RA, Jebb SA, Hankins M, Marteau TM. The impact of nutritional labels and socioeconomic status in energy intake. An experimental field study. Appetite. 2014; 81: Afshin A, Penalvo J, Del Gobbo L, et al. CVD prevention through policy: A review of mass media, food/menu labelling, taxation/subsidies, built environment, school procurement, worksite wellness, and marketing standards to improve diet. Current Cardiological Reports. 2015; 17: Nikolau CK, Lean MEJ, Hankey CR. Calorielabelling in catering outlets: Acceptability and impacts on food sales. Preventive Medicine. 2014; 67: The Chartered Institute of Marketing. Consumer confusion over food labelling. co.uk/news/2014/03/25/consumer-confusionover-food-labelling/. Updated March 25, 2014, 12:01 p.m. Accessed 03/03, Food Standards Scotland. Diet and nutrition: Proposals for setting the direction for the Scottish diet. Paper for the board meeting 20 January ; FSS 16/01/04. Obesity Action Scotland was established mid-2015 to provide clinical leadership and independent advocacy on preventing and reducing overweight and obesity in Scotland. Our main aims: To raise awareness and understanding of what drives obesity and the health problems associated with obesity and overweight with health practitioners, policy makers and the public To evaluate current research and identify strategies to prevent obesity and overweight based on the best available evidence To work with key organisations in Scotland, the rest of the UK and worldwide, to promote healthy weight and wellbeing Overseeing our work is the Steering Group whose membership spans various disciplines involved in preventing and tackling obesity and its consequences: clinicians, public health experts, epidemiologists, nutritionists and dieticians, GPs and weight management experts. There are four members of staff. Royal College of Physicians and Surgeons St Vincent Street Glasgow G2 5RJ Further copies can be downloaded from our website

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