DoH Press Release, 16 November 2004

LABELLING - Action to enable people to make healthy choices : White Paper sets out new moves on smoking, obesity and sexual health

Health Secretary John Reid today published Choosing Health – the Government’s White Paper on improving public health in England.

The document aims to make it easier for people to change their lifestyle so they eat more healthily, exercise more and smoke less. It also sets out moves to improve sexual health, encourage sensible drinking and improve mental well-being.

John Reid said:

‘It is clear we need to do more as a society to improve people’s health. Having defeated many deadly infectious diseases, we now face the challenge of avoidable ill-health caused by poor diet, lack of exercise and smoking.

‘These are challenges for all of us to address in our lifestyles – making our own choices about what to eat, how often to exercise and whether we smoke, drink too much, take drugs or engage in risky sexual activity.

‘People make their own choices about health, but they have made plain in our consultation that they want the information, advice and support in making their own choices so, we need to ensure that people have the information they require to make properly informed choices; and that they are presented with genuine opportunities and the practical support to make healthy choices.

‘We have listened to the public about what they want and looked hard at the evidence of what is effective. There is a role for everyone in this – individuals, communities, employers, parents, schools, the hospitality, food and leisure industries, and of course the NHS and local government.

‘This Government’s role is to help ensure society moves in the right direction – by providing clear information for individuals, working with industry to deliver real progress and where necessary taking decisive action to ensure healthy choices are available to all.’

New measures in the White Paper include:

• Radical action to increase the number of smoke-free workplaces
• Curbs on the promotion of unhealthy foods to children
• Clear, unambiguous labelling of the nutritional content of food
• NHS Health Trainers to provide advice to individuals on how to improve their lifestyle
• A wide range of measures to tackle social and geographical inequalities in health
  

To download a copy of the White Paper, go to White Paper

The following are some extracts from the White Paper which relate to Food Law issues

CHAPTER 2 : Health in the consumer society

BETTER INFORMATION TO SUPPORT HEALTHY CHOICES IN A CONSUMER SOCIETY

18. Success in developing demand for health is not enough on its own; people need to be able to mak e informed choices about what action to take. Clear information that people trust

19. Information about health will always be available from a range of different sources. The Government's role is to help information providers give factual information that is up to date and accurate.

20. The Department of Health is already working with providers of information on healthcare to:

• add the NHS brand and other brands, such as 5 A DAY, to highquality health information resources; and
• help distribute them – for example, working with the Coalition for Cancer and through other campaigns.

21. The most successful campaigns have been those that reach people through a number of sources that actively and consistently promote health. We will build on this by:

• funding specific campaigns through nongovernmental organisations like the British Heart Foundation, Cancer Research UK and Age Concern;
• encouraging industry involvement – through use of consistent messages on health like 5 A DAY in supermarkets and on food packaging – to reach people when they are making choices;
• working with the sports and recreational activity sectors to deliver positive, innovative messages about healthy lifestyles through, for example, football, walking, cycling and fitness centres; linking into activity in communities, schools and workplaces to make messages relevant to different people’s lives – as set out in chapters 3, 4 and 6.

Information on food content

22. Food is a prime example of an area where there needs to be clear and consistent information to help people make healthy choices. A lot of information is provided on packaged and processed foods. Many people already understand the importance of thinking about how much salt, fat and sugar they eat. But lists expressed in terms that few of us can understand are not enough. What we need to know is where a particular food fits in a healthy balanced diet so that we can make informed choices.

23. We will press vigorously for progress before and during the UK presidency of the EU in 2005 to simplify nutrition labelling and make it mandatory on packaged foods. Nutritional criteria 24. The Department of Health has started work with the FSA to develop criteria that take account of fat, salt and sugar levels to indicate the contribution a food makes to a healthy balanced diet. By mid-2005 we aim to have introduced a system that could be used as a standard basis for signposting foods. This will build on the nutrient criteria for the 5 A DAY logo. The criteria will also be used among other things to identify which foods can be promoted to children (see paragraphs 48–52). The criteria for use of the 5 A DAY logo will be extended to processed foods and to foods targeted at children.

Signposting food

25. Some retailers are already considering different signposting approaches for food on the front of packaging in response to consumer demand. The aim of signposting foods is to make it easier for people to see at a glance how individual foods contribute to a healthy balanced diet. The form of signposting can vary.

26. The Government will work with the food industry to develop the signposting approach further on the completion of FSA consumer research. Our goal is, by early 2006, for there to be:

• a clear, straightforward coding system
• that is in common use, and
• that busy people can understand at a glance which foods can make a positive contribution to a healthy diet, and which are recommended to be eaten only in moderation or sparingly.
  

DEMAND FOR HEALTH AS AN INFLUENCE IN THE MARKET

Consumer influence and corporate social responsibility

38. The first part of this chapter has focused on creating demand for health through marketing campaigns, and making it easier for individuals to choose healthy lifestyles in a consumer society. Individuals and communities can also influence markets through the health choices they make.

39. For markets to work many thousands of people have to want a product. If consumers act together as a group, they can have a great deal of power. The consultation highlighted abundant evidence that groups of consumers can do a lot to influence others, and that industry and the market respond to such influences.

40. The public expects big organisations to be socially responsible corporate citizens, an expectation that industry is increasingly recognising. Many corporate organisations acknowledge that what they do for the community impacts on their reputation and that meeting these expectations can make good business sense. We recognise, for example, the commitment that retailers and food producers have already made towards promoting healthier eating and the scope that exists within the food industry’s policies and practices for further activity to ‘eat well, drink well’. This includes action in four key areas:

Product development – assessing market opportunities and making sure that the development of healthier foods, including ‘own brand’ products, meet customer requirements for affordability, convenience and taste, for example, in salt, fat and sugar content of foods.

• Labelling information – by developing nutrition labelling and associated messages such as 5 A DAY, well beyond legal requirements, some retailers are already helping customers make informed choices.
• Promotion and pricing – communication strategies to promote healthier eating, including fruit and vegetables, through point of sale information, leaflets and websites.
• Customer information and advice – including healthy eating and the promotion of sensible drinking messages to combat alcohol misuse.

41. Recognising that the public sector can never provide all the answers, we have been encouraged by industry’s commitment to working with us to improve the nutritional quality of food. But such commitments must deliver real change.

DRIVING FORWARD CHANGE - Developing partnerships with industry to promote health

42. In many areas consumer demand and better information, supported by strategies to market health, will be sufficient to secure the changes needed to improve health. But where urgent action is needed to tackle issues that are of national public concern – such as obesity or the increase in prevalence of diabetes and heart disease – the effect of market forces and corporate social responsibility are not enough on their own. Government has a role in engaging in the debate to speed up the natural pace of change.

43. The Government intends to discuss with the food industry how they might contribute to funding national campaigns and other national initiatives to promote positive health information and education.

44. Health ministers and the FSA are leading discussions with industry to identify and implement a range of proposals to increase opportunities for people to make healthy choices in what they eat. These are aimed at:

• increasing the availability of healthier food, including reducing the levels of salt, added sugars and fat in prepared and processed food and drink and increasing access to fruit and vegetables;
• reversing the trend towards bigger portion sizes; and
• adopting consistent and clear standards for information on food including signposting.

45. We will work with industry to develop voluntary action based on:

• longterm and interim targets for reducing sugar and fat levels in different categories of foods – compliance will be monitored through regular surveys; and
• development of guidance on portion sizes to reduce energy, fat, sugar and salt intake.

46. As a society we need to see significant change if we are going to be successful in tackling the health challenges set out in Chapter 1. We will work with the farming and food industries to coordinate action, including action to take forward policies in this White Paper, through a Food and Health Action Plan to be published in early 2005 fulfilling the commitment to such a plan in our Strategy for Sustainable Farming and Food . This will be backed up with wider action in the Food 8Standards Agency Strategic Plan.

Protecting children and young people

47. Responses to the Choosing Health? consultation indicated that whilst people felt it was generally right to leave lifestyle choices up to each individual, the government should take specific steps to protect children and help them to make healthier choices. Even those commentators who felt it was inappropriate for the Government to take a role in encouraging adults to make more healthy choices felt it was appropriate to intervene with children.

Food promotion

48. When it comes to food, people feel that it is wrong for children to be bombarded with sophisticated marketing that might confuse them and reduces their ability to make healthy choices before they have been able to develop the skills and experience to negotiate their way through the array of choices on offer. In the responses to Choosing Health? there was overwhelming support for some restrictions on the marketing of unhealthy food and drinks to children.

49. The FSA commissioned a Review of Research 9on the Effects of Food Promotion to Children. This review found that children’s food promotion is dominated by television advertising, and that most of the research has focused on this area. However, it found that this research may ‘understate the effect that food promotion has on children’ and ‘the cumulative effect of television advertising combined with other forms of promotion and marketing is likely to be significantly greater’ than television alone. It concluded that ‘food promotion can have and is having an effect on children, particularly in the areas of food preferences, purchase behaviour and consumption’ and that ‘these effects are significant, independent of other influences and operate at both a brand and category level’.

50. The Office of Communications (Ofcom), which regulates broadcasting and already has some restrictions on food promotion to children commissioned research10 into its impact. Their report focused on the effects of television advertising of products high in fat, salt and sugar (HFSS) to children. Ofcom concluded that television has ‘modest direct effects on children’s food choices. While indirect effects are likely to be larger, there is insufficient evidence to determine the relative size of the effect of TV advertising on children’s food choices by comparison with other relevant factors.’

51. On the basis of their research, Ofcom’s overall conclusion is that there is a need for some specific and targeted tightening of the rules on television advertising, in the context of other changes. However, Ofcom also concluded that a total ban on television advertising of food and drinks to children would be neither proportionate nor, in isolation, effective. In addition, the report made a number of observations in relation to children’s viewing patterns and found that:

• an average child watches around 17 hours of television each week (including noncommercial broadcasting);
• younger children see more advertising for core category products (ie foods, soft drinks, chain restaurants) in children’s airtime than older children (eg 4–9 year olds see just over half of the core category adverts that they are exposed to during children’s airtime); and
• children spend 71% of their viewing time outside children’s airtime, with more children and young people watching television at peak times (between 6pm–9pm) than at any other part of the day. In the Choosing Health? consultation, although some respondents called for an outright ban, some discussed restrictions during peak times for children’s viewing.

52. But we need to look at all food advertising and promotion that is aimed at children. In line with the research conclusions and the responses to the consultation, the Government considers there is a strong case for action to restrict further the advertising and promotion to children of those foods and drinks that are high in fat, salt and sugar. To have maximum effect, action needs to be comprehensive and taken in relation to all forms of food advertising and promotion, including:

• broadcast;
• nonbroadcast;
• sponsorship and brandsharing;
• point of sale advertising, including vending in schools; and
• labels, wrappers and packaging.

53. Most of current advertising spend is through television. In 2003 advertisers for food, soft drinks and chain restaurants spent 72% of their budget promoting their products on television, making this a key medium for food advertisers.

54. There is a range of ways in which the rules governing food and drink advertising and promotion could be enhanced and strengthened. These might cover:

• when, where and how frequently certain advertisements and promotions appear – for example, an option would be to consider different restrictions during children’s television (pre 6pm), during peak times (6pm–9pm) and after the 9pm watershed;
• the use of cartoon characters, role models, celebrities and glamorisation of foods that children should only eat seldom or in moderation as part of a balanced diet; and
• the inclusion of clear nutritional information – perhaps based on a signposting system – and/or balancing messages in advertisements to counteract the influence of high fat, salt and sugar food advertisements.

Options will be dependent upon the nutrient profiling scheme being developed by the Department of Health and the Food Standards Agency discussed earlier in this chapter. Ofcom’s recent tightening of rules governing alcohol advertising is a good example of regulation evolving and modernising to keep up with changes in society and marketing techniques.

55. The Government is keen to see real progress in this area. On television, we will work with the broadcasting and advertising sectors on ways to help drive down levels of childhood obesity. In particular we will look to Ofcom to consult on proposals on tightening the rules on broadcast advertising, sponsorship and promotion of food and drink and securing their effective implementation by broadcasters in order to ensure that children are properly protected from encouragement to eat too many high fat, salt and sugar foods – both during children’s programmes and at other times when large numbers of children are watching. It should also include options for broadcasters and advertisers to participate in healthy living promotions.

56. Marketing spend is not limited to television advertising and, indeed, may be increasing in other areas: this increase would probably be magnified when broadcast restrictions are increased unless a more comprehensive approach is adopted. Government is therefore also keen to see stronger controls on nonbroadcast and other types of marketing. We will work with industry, advertisers, consumer groups and other stakeholders to encourage new measures to strengthen existing voluntary codes in nonbroadcast areas, including:

• setting up a new food and drink advertising and promotion forum to review, supplement, strengthen and bring together existing provisions; and
• contributing funding to the development of new health initiatives, including positive health campaigns.

57. There was a clear call in the responses to Choosing Health? for restrictions on the promotion and sponsorship of food and drink in schools. As noted in the Healthy Living Blueprint launched earlier this year, a challenge for schools is to balance the benefits of food promotional activity – including sponsorship, advertising and branding of materials – with the ethos of a healthy school and whole school approach to healthy eating. This will be considered further as part of the comprehensive approach outlined above.

58. The Government is committed to ensuring that measures to protect children’s health are rigorously implemented and soundly based on evidence of impact. We will therefore monitor the success of these measures in relation to the balance of food and drink advertising and promotion to children, and children’s food preferences to assess their impact. If, by early 2007, they have failed to produce change in the nature and balance of food promotion, we will take action through existing powers or new legislation to implement a clearly defined framework for regulating the promotion of food to children.

59. In addition, there are a range of creative ways for positive campaigns to promote healthy lifestyles in order to counteract the impact of advertising of high fat, sugar and salt foods, and Government is keen to see these used by industry. We will look to the broadcasting and advertising sectors, including Ofcom, to consider how they could have a positive impact on children’s food choices. The power of broadcasting could be harnessed, such as in recent campaigns like ITV’s Britain on the Move. Marketing devices such as cartoon characters, role models, celebrities and glamorisation could also be used to promote foods that children should eat more often.

Alcohol and health

60. The Portman Group has already created a mechanism to use some of the profits of the alcohol industry’s success in the market place to promote health messages. We will work in partnership with the Portman Group to develop a new and strengthened information campaign to tackle the problems of binge drinking.

61. We will also work with industry to develop a voluntary social responsibility scheme for alcohol producers and retailers to protect young people by:

• placing information for the public on alcohol containers and in alcohol retail outlets;
• including reminders about responsible drinking on alcohol advertisements; and
• checking identification and refusing to sell alcohol to people who are under 18.

62. During the development of the Alcohol Harm Reduction Strategy for England, concerns were raised about the effectiveness of the current rules on alcohol advertising, which are aimed mainly at preventing an inappropriate influence on children and people under 18 and at preventing advertising condoning antisocial or selfdestructive behaviour by any age group. Ofcom, which has statutory responsibility for the regulation of broadcast advertising, has been undertaking a review of the rules on broadcast advertising of alcohol and has published its code amendments, aimed at significantly strengthening the rules in many areas, particularly to protect the under18s.

63. The new rules, which will take effect from 1 January 2005, include requirements that:

• advertisements for alcoholic drinks on television must not be likely to appeal strongly to people under 18, in particular by reflecting or being associated with youth culture;
• advertisements must not link alcohol with sexual activity or success or imply that alcohol can enhance attractiveness;
• television advertising for alcoholic drinks must not show, imply, or refer to daring, toughness, aggression or unruly, irresponsible or antisocial behaviour; and
• alcoholic drinks must be handled and served responsibly in television advertising.
  

CHAPTER 3 : Children and young people - starting on the right path

Nutrition

37. Nutrition is a key component of a healthy start in life and we are taking a number of steps to support healthy lifestyles for both parents and children.

38. From 2005,11 we will provide eligible pregnant women (including all pregnant women under 18), breastfeeding mothers and young children in low income families with vouchers that can be exchanged for fresh fruit and vegetables, milk and infant formula12 through a new scheme – Healthy Start. The scheme will be backed by a new communications campaign to help these families improve their diets and wider health, and make effective use of the vouchers. Infant formula milk will no longer be available from healthcare premises, which will reduce its promotion in the NHS.

39. Further action will include the review of Infant Formula and Follow-on Formula Regulations (1995) with a view to further restrict the advertisement of infant formula. We will continue to press for amendments to the EU Directive on infant formula and follow-on formula.