#IGObesity16. Professor Graham MacGregor Chairman Action on Sugar

Transcription

1 #IGObesity16 Professor Graham MacGregor Chairman Action on Sugar

2 Unhealthy Food The Biggest Cause of Death in the UK Graham MacGregor Professor of Cardiovascular Medicine Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK

3 Disease burden attributed to risk factors - England Unhealthy diet Unsafe water, sanitation, and handwashing Disability-adjusted life-years (DALYs, %) Newton et al. Lancet 2015;386:2257

4 Processed foods and soft drinks Sugar Fat (saturated) Salt Calorie Dental caries Obesity Type 2 Diabetes Cancer Cholesterol Heart disease Stroke Blood Pressure

5 Hidden Salt in food e.g. processed, fast, takeaway, restaurant food Food industry slowly reduce - No rejection by public Fantastic for Public Health Very little cost BP No need to change diet

6 CASH Strategy for Reducing Salt in UK Source Salt intake g/day Reduction needed Target intake g/day Table/Cooking (15%) 1.4 g 40% reduction 0.9 g Natural (5%) 0.5 g No reduction 0.5 g Food industry (80%) 7.6 g 40% reduction 4.6 g Total 9.5 g Target 6.0 g The food industry needs to slowly reduce salt content of all foods by 40% over the next 5 years by setting target for each food category

7

8 Incremental reformulation (Example from UK) Progressive salt reduction targets have been set, i.e. 2005, 2008, 2014 for over 80 categories of food Gradual reduction, 10-20% a year. No rejection by public, i.e. progressive gradual reformulation Initial voluntary system worked, but has now failed. Essential to have mandated or regulated targets

9 Salt Intake, BP and CVD Mortality in England Deaths per 100,000 per year *** IHD 100 *** Stroke Blood pressure (mmhg) *** * P<0.05 *** P< *** Salt intake (g/d) (from 24h UNa) * He et al. BMJ Open 2014; 4:e004549

10 Countries with regulated salt targets South Africa (29 out od 30 companies preferred regulation) Chile Argentina Brazil Bulgaria Greece Paraguay Portugal

11 Why are we getting so fat? A Big Mac, large chips and coca cola 11 bananas or 18 oranges or half a marathon

12 Food/soft drink industry Calorie-dense Cheap Profitable Transient satiation/ fullness Brilliant marketing Any time Everywhere Eat more Calorie intake Obesity/type 2 diabetes

13 Portion size increase over time

14 Relentless pressure on consumers Unhealthy foods/soft drinks are available Any time Everywhere Brilliant marketing + advertising (particularly to children) Very cheap

15 Who is responsible? Public Government Food industry Food industry must reduce salt, fat & sugar content of foods

16 What can we do? Tax - High salt, sugar, fat foods Subsidise healthy food, e.g. fruit & veg Ban unhealthy food advertising Restrict availability Reduce portion size Reformulation

17 What is practical? Big food very powerful Biggest industry & employer Strong ties to & influence on government Some similarities to tobacco (50 yrs)

18 Sugar: Spinning a web of influence

19 Obesity plan by AoS 1. Incremental reduction* Sugar (free) 50% Fat (Sat) 20% in 5 yrs 100 Kcal 100 Kcal 2. Only healthy foods to be promoted and/or advertised* Kcal 3. 20% sugar duty soft drinks & confectionery 4. All public sector food must meet strict guidelines* 5. Uniform colour-coded labelling* *Enforced by independent nutrition agency eg FSA

20

21 May s Pathetic Obesity Plan Tax on sugar-sweetened drinks, but no coherent plan to reformulate (unlikely to be passed by parliament) 20% voluntary reformulation only for some products that contain sugar No restrictions on marketing or promotion Ultimately our need to eat Complete betrayal of her Downing street pledge

22 Incremental reformulation Industry must have Level playing field Gradual reduction with incremental targets Technical knowledge & support Transparent reporting & analysis

23 Voluntary Regulation/legislation Set up quicker Needs continuous media pressure Acceptable to government Only results in small reductions Initially slower No need for media pressure Party in power may change Big reduction industry needs mandated or regulated targets

24 Industry feedback to AoS Supermarkets & many branded companies want mandatory targets. Fed up with some companies pretending to make reductions, but not CEO Sainsbury s: We need compulsory and measured targets for the reduction of sugar (& saturated fat). Nothing less will work... the government should have used this opportunity to create a level playing field make traffic-light labelling compulsory, whether you are buying food and drink from a shop, a restaurant or as a takeaway. BRC disappointed only propose voluntary reductions because some manufacturers will try to take advantage by retaining more sugar in their food products. previous experience with salt reduction has proven this to be the case.

25 Incremental sugar targets like salt Sugar-sweetened soft drinks immediately Foods with added sugar (No replacement. Solid foods portion size or polyols, insoluble fibre) Incremental targets, i.e. 10% reduction per year (50% reduction within 5 yrs) Reduce artificial sweeteners, i.e. sweetness This will calorie intake by >100 Kcal/d

26 Incremental fat targets like salt Fat: the major calorie contributor in processed foods Easier to reduce as complex carbohydrates or vegetables can be substituted (fat 2.5 x calorie/g) Sat fat LDL cholesterol, the major cause of atheroma. focus sat fat, e.g. palm oil Incremental targets, i.e. 4% reduction per year (20% reduction within 5 yrs) This will calorie intake by >100 Kcal/d

27 Other actions Prevent relentless pressure on consumers particularly children to eat unhealthy food a) only allow marketing of healthy food b) reduce portion size & availability c) escalating tax on all sugar-sweetened drinks & confectionery UK nutrition to independent agency, e.g. FSA (i.e. free from politicians)

28 Summary Reduction in calorie intake per person per day Sugar Fat >100 Kcal >100 Kcal Other Kcal ( marketing, tax, etc) Total >250 Kcal This will prevent obesity & type 2 diabetes

29 Reformulation of unhealthy food e.g. processed, fast, takeaway, restaurant food Food industry slowly reduce salt, sugar & fat - No rejection by public Fantastic for Public Health Very little cost BP, obesity & cholesterol No need to change diet