EU Platform for Action on Diet, Physical Activity and Health

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EU Platform for Action on Diet, Physical Activity and Health UK Presidency Event 21 September 2005 1. The EU Platform for Action on Diet, Physical Activity and Health held its third plenary meeting in London on the morning of 21 September. Following this meeting, the UK Presidency hosted an afternoon event to explore the potential to achieve reductions in population intakes of salt, fats and sugar by reformulating processed foods. 2. Dame Deirdre Hutton (Food Standards Agency Chair) opened the afternoon meeting by emphasising that the key to helping consumers to make healthier choices is practical, realistic proposals and good consumer communication. Dame Deirdre underlined the need for all stakeholders to take shared responsibility for addressing the issue of obesity and to work co-operatively in doing so. In this context, the afternoon session would consider steps that could be taken in one area and might be entered as real commitments under the Platform. 3. Gill Fine (FSA Director of Consumer Choice and Dietary Health) described the work to date of the Department of Health (DH) and the FSA in collaborating with the food industry to achieve salt reductions. Gill set out the scientific and policy context of the work, describing the conclusions of the Scientific Advisory Committee on Nutrition, and the specific targets for salt reduction as set out in the UK Government s White Paper: Choosing Health, and the FSA s Strategic Plan 2005-2010. Gill described the FSA s dual approach to reducing salt intake; combining a consumer education and information programme with product reformulation. The latter has involved meeting with key players and seeking commitments in the form of salt reduction plans from individual companies, which have then been published on the FSA and DH websites to enable effective monitoring. This experience has shown the importance of co-operation between Government and industry, with the importance of Government maintaining pressure while acknowledging the difficulties that exist. 4. Rupert Maitland-Titterton (Heinz) described work to reduce salt in Heinz products. He emphasised the importance of making changes at the right pace moving slowly enough to ensure that consumers did not reject new recipes, but not so slowly that stakeholders begin to doubt the company s commitment. Rupert cited Project Neptune as an example of successful co-operation between the UK industry and its regulator. This crossindustry project had achieved year on year reductions of salt in soups and sauces by developing salt reduction plans that have been audited and

shared with the FSA. Rupert gave examples of some of the significant reductions that have been achieved to Heinz products, which he believed were a direct result of building trust with the FSA. 5. The meeting then broke into three separate workshop groups, to discuss respectively: achieving reductions in fats; achieving reductions in sugars; and achieving reductions by other means including portion size. The conclusions of each group are given below; more detailed summaries of the discussions are provided in the Annex. Achieving reductions in sugars Important to prioritise products for reductions. This could include major contributors to intake, and categories popular with children. Achieving reductions less straightforward than for salt. There are challenges related to suitable substitutes, and the knock-on effects on product recipes. A range of lower sugar choices are currently available, although there is a view that it would be preferable to concentrate on achieving reductions across the board. There was a view that best practice should include not promoting highsugar foods to children. Educating consumer tastes is important. Stepped reductions are possible, as demonstrated by reductions achieved already in a number of products. Achieving reductions in fats A number of examples provided by industry demonstrate that reductions can be achieved. Important to recognise that some product types are inherently fatty and will be more difficult. Reductions in total fat and trans fat/saturated fat are two separate challenges. Total fat is the greater priority, but this should not be at the expense of the overall nutritional balance of the product. Reductions must not compromise product taste. There are issues related to communicating reductions to consumers (and it is important that the regulatory framework allows this). Technological difficulties need to be overcome, as well as the availability and possible costs of alternative ingredients. Large-scale fat reduction policies may have an effect on primary production (e.g., what happens to waste fat). Consumer education (particularly among children) is a vital ingredient.

Best practice should be promoted (including via the Platform database). Regulation could also help to spread best practice. Achieving reductions through other means including portion size The cost of producing smaller portion sizes is the main barrier to manufactures and caterers. It was suggested that a product should be equal value for money regardless of portion size. Retailers should be enabled and encouraged to stock a variety of different portion sizes. The importance of responsible promotions was noted where children are the target audience. There was a need to work towards clearly defined portion sizes by product category. The choices that consumers make are influenced by many factors; cultural change is carried forward by personal knowledge and understanding. Consumers should be enabled to compare between and across food products, through more effective use of on pack labelling, pricing in terms of value for money and appropriate consistent education. 6. A question and answer session then picked up points raised in the workshop group discussions, before ranging more widely. One questioner asked why, if reductions were achievable for salt in the UK, this could not be done for sugar in, for example, breakfast cereals. The answer was that the product would not be the same one, and that a wide range of products was available with different compositions. A point was raised about the use of intense sweeteners, which was one way of reducing sugar intakes. Gradual reductions in sugar levels, in the same manner as for salt, were another. 7. Whilst some speakers were pleased to have had the opportunity to discuss reformulation of products, this was but one aspect of the Platform s activities. Fats, for example, should not be demonised as they had a part in a healthy balanced diet. 8. Dr Jon Bell (FSA Chief Executive), who chaired this session, summarised the main themes raised as: choice the need for more variety; for smaller, less energy-dense portions; and for lower fat versions to be no more expensive than the standard product; promotion placing more emphasis on healthier products (including more fruit and vegetables) and less on bigger portion meals and products;

information and education this is being taken forward on salt and in other areas, and it was necessary to reach young people; and co-operation this was a key driver. Industry had shown itself keen to share its knowledge and technology. It was important to identify common goals and work toward them. There were roles here for government authorities and the industry. 9. Closing the afternoon, Robert Madelin (Director General, DG SANCO) thanked the Department of Health and the FSA for allowing Platform members the opportunity to brainstorm an area not discussed so far within the Platform. Reducing salt intakes was a challenge facing all EU governments and industries, and co-operation appeared to be a major contributor to potential success. Leadership did not always have to come from the authorities but from industry too. Mr Madelin thanked participants, and especially the industry for its active engagement. Food Standards Agency - Nutrition Division October 2005

Annex 1 Outcomes of the Workshop Sessions Achieving Reductions in Sugars The working group began with two presentations. 1. Karen Cunningham (Coca Cola) Coca Cola s response to the healthy eating agenda incorporated a broadening of their drinks portfolio. In the EU they had 130 brands and 49 of these had few or no calories. 39% of brands in Belgium and 42% in UK fell into this category. Diet Coke, launched in 1982, is now their biggest selling drink in the world. There had been a 10% lowering of average calorie content of drinks sold by Coca Cola, the company is also promoting no added sugar and or zero calorie drinks (e.g., Fanta Z). There are barriers to consumers switching from regular to diet, e.g. term diet does not appeal to men. For consumers, taste is king. This was demonstrated when a new healthy drink for children did not sell well because of taste. Consumer acceptance of artificial (intense) sweeteners is a key issue. Recognise that there is a media image problem with intense sweeteners, so more needs to be done to explain science and safety assessments. 2. Toine Hulshot - Kelloggs Kelloggs offers a wide choice of breakfast cereals with differing levels of sugar ranging from very low to quite high. Additional nutritional labelling is used to show the contribution to guideline daily amounts. Taste is king, and consumers notice small changes. The consumer must like the product, or the product must offer a specific health benefit to compensate for a taste the consumer likes less. Cannot compare cereals with drinks as there are different technical considerations. Innovation is much more important if big steps are to be made in reformulation of breakfast cereals Calories will stay the same if sugar is replaced by starch or protein and will actually increase if fat used Points made during discussion Suggested that action should focus on foods that make a major contribution in the diet, and products popular with children, as the problem

is building up for future generations. Need to use innovation to push healthier products Although companies have achieved salt reductions, sugar raises separate issues. For example, it is very difficult to replace on a weight-for-weight basis, and direct substitution can affect energy density. Above all, reformulation must be based on sound science. It was pointed out that a wide range of substitute ingredients is available to food technologists. Concerns do exist about some substitutes; as well as technical feasibility, safety is crucial. In this context it was noted that the long term safety of aspartame has been established; it is probably the most studied additive in the world. There is already a range of reduced calorie foods available, and there is clearly a market for low sugar options: Kelloggs have low sugar Frosties (9g versus 11g per portion). Oasis has reduced sugar levels in their drinks in much the same way as Heinz achieved with salt. There was a view that it would be preferable simply to market the lower sugar versions, rather than a range. The view was expressed that best practice should include not promoting to children as this encourages consumption in future years. There was also support for increasing promotional expenditure on lower sugar options, and providing further incentives through price. Although taste may be king, there remains a real need to educate consumers: it is possible to implement stepped reductions in much the same way as salt, although it is important to ensure that steps are not too large as sales are likely to suffer.

Achieving Reductions in Fats Scene setting talks were provided by Stephen Kehoe (Pepsico), Harry Jongeneelen (Unilever) and Jean Claude Martine (Bunge). Stephen outlined the measures that had been taken to reduce saturated fat levels in Walkers/Lays crisps, identifying that significant reductions had been achieved by changing the oils used for frying the products. Harry explained what Unilever had been doing and how, through a nutrition enhancement programme, they had been able to make reductions in fats (and specifically trans and saturated fats) in a range of products such as margarines, ice creams, soups and sauces. Jean Claude highlighted that within the EU there are different markets, with different consumers and habits. As such, it is important to consider whether reformulation to reduce fats would be relevant in all countries. Overall there is a positive message that for some products it is possible to reformulate to achieve reductions in fats. There are two challenges, total fat and trans/saturated fats, and it was recognised that any reduction should not be compensated for by significant increases in other ingredients. However, there are hurdles to reformulation, including that for some products there is a need to develop new technology/new processes to be able to achieve a reduction without compromising consumer acceptability. This can require substantial investment by a company, which would obviously be harder for SMEs to finance. However, it was noted that these new technologies/processes are generally made widely available so other companies making similar products would have access to them. The point was made that there are long-term implications for the market when considering the reformulation of products. Especially if this was done on a large scale. For example, whilst there are better oils with which to fry crisps, there may not be a sufficient supply at the moment to allow all companies to use it. If fats are removed from foods where do they go? There are costs associated with disposal, and who would be paying? It was also recognised that some products, such as cheese, are inherently fatty and that the scope for reduction of these can be quite limited. That said, by offering a range of options, by not compromising taste, and by making use of marketing it is possible to persuade the consumer to take the healthier option, e.g. as with Kraft Philadelphia Cheese where it is the light and extralight versions that are the big sellers.

Targeting which products to reformulate was important, the comment being that perhaps it should be the staples in a diet where the effort is made rather than those foods which we consume less of. It was also emphasised that regardless of what changes were made with reformulation they had to be acceptable to the consumer and that for the industry this was the main concern. It was happy to change products to offer the consumer choice, although there was a need to ensure that the regulatory environment did not prevent the consumer being told about the changes. For example, the implications of the Nutrition and Health Claims legislation needed to be considered as would some of the compositional standards. General points made included the importance of education, the fact that children (and hence the products they eat most) should be a priority, and that perhaps there might be a role for regulation in spreading best/good practice. In respect of the latter point, the importance was emphasised of putting actions on reformulation forward for the Platform database.

Achieving Reductions Through Other Means Including Portion Size Scene setting comments were made by Gerd Harzer (Kraft foods), Janet Aylott (Nestle), and Roberto Menta (Ferrero Rocher). The following points were made: Kraft Foods: best practice should include: consumer information - additional on pack labelling (e.g., calories per bar of chocolate); advertising; and nutrition education in schools; portion size extending range of sizes offered; and producing packaging that can be resealed; recipe reformulation producing lower calorie product varieties. Nestle: Needs of retailers must be addressed, as some will not stock smaller portions or some product varieties. Front of pack labelling giving calories per chocolate bar will enable consumers to make product comparisons. More detailed labelling information on pack will help to educate consumers, and can be followed up with information provided instore and on websites. Ferrero Rocher: Discussion on the effect of snacking and portion size on obesity. Overview of some of the evidence regarding snacking and the contribution of certain snacks to total calorie intake. A general discussion followed, during which the following points were made: Reformulation of food products is currently being explored by the UK Government, however portion sizes is another area the needs further investigation. It was noted that the US has clear definitions for portion sizes. It was noted that there is a clear scientific evidence base supporting the relationship between energy intake, energy density of foods and portion size. One of the best ways to reduce energy intake is to reduce the energy density of food potentially through reformulation of food products. It was recognised that portion size as a means of reducing energy intake is effective and an important and appropriate area to consider. Participants noted that reformulation of certain products has already begun. However it was also recognised that reformulation is not always possible or could compromise the taste and quality of a product (e.g., mayonnaise and confectionery). For this reason it was felt that it may be more appropriate to regulate service size of products. Industry representatives pointed to the amount of customer research that was needed before existing products can be changed. It was also noted that considerable financial investment was often needed to accommodate a decrease in portion size, as production lines would need to be amended and products would need to be repackaged and rebranded. Concerns were expressed regarding the potential reaction of consumers to smaller portion sizes and the need to balance this with consumer expectations of

current products. Participants felt this should involve raising consumer awareness to reductions in portion sizes and enabling retailers to provide choice. The importance of addressing the energy density and portion sizes of food consumed outside the home was highlighted. There is data that this sector provides 14-15% of total food consumed but 40% of the calorie intake. The importance of price in public procurement contracts was noted, and that plans to reduce energy density or portion sizes by manufactures or caterers would nee to honour existing contracts. It was highlighted that portion sizes differed in contract verses restaurant catering and that these two sub-sectors must therefore be considered separately. It was noted ingredients costs are relatively small compared to costs from labour, transport and packaging. The idea of product substitution, adding more fruit and vegetables to ready meals for example, was explored. Linking nutrition education provided in school with family life was an area that participants felt should also be further considered.