[The object of this joint position paper is to identify common ground on sugar

and childhood obesity that will be submitted to the UK government. The

stakeholders have differing views and likely will make their own separate
representations. Given the timescales I am approaching a small selection of
stakeholders. This is the initial list and Id be grateful if you passed onto me
details of anyone else you feel should be included. I would like your views,
especially over the proposals you think should be made mandatory and which
voluntary. My contact information is rend@platin.gs +44 7472086692.
Invited to participate in joint policy position: Action on Sugar, World Cancer
Research Fund International, The Institute of Food Safety, Integrity and
Protection (TiFSiP), Food Standards Agency, World Health Organization, Diabetes
UK, Childrens Food Trust, British Retail Consortium, Food and Drink Federation,
International Sweeteners Association, Advertising Association, British Soft Drinks
Association, Kantar WorldPanel, Reading University, WHICH, British Hospitality
Association]

Sugar and Childhood Obesity: (Draft) Joint

Policy Position
Obesity prevention depends on coordination between all stakeholders: government
departments, health organisations, international groups, and the private sector.
Effective changes in diet and activity can only be achieved by a collaborative
approach.1 The last 18 months major work on obesity and sugar includes:

Sugars Intake for Adults and Children: Guideline2

The McKinsey Global Institute on Obesity Report3
SACN Report on Carbohydrates and Health4
PHE Report Sugar Reduction from Evidence into Action 5
Age Watchs Health Action Campaign Report, Healthy and Wealthy?6

1 http://www.who.int/dietphysicalactivity/childhood/tools/en/
2 http://www.who.int/nutrition/publications/guidelines/sugars_intake/en/
3
http://www.mckinsey.com/insights/economic_studies/how_the_world_could_better
_fight_obesity
4 https://www.gov.uk/government/publications/sacn-carbohydrates-and-healthreport
5 https://www.gov.uk/government/publications/sugar-reduction-from-evidenceinto-action

House of Commons Health Committee report on Childhood Obesity? 7

Milken Report
[Lessons learnt and policy options for the World Bank] draw from developed
world instruments for conversations and impact
Pulling together literature review on the developing world, few doable
things bank
o http://www.milkeninstitute.org/publications/view/683

Reformulation
Reformulation is the most cost-effective policy intervention 8 over which there is
consensus. We recommend setting targets for incremental reformulation on added
(free) sugars. To meet the goal of no more than 5% energy intake from free sugars
in 5 years will avert over 77 thousand deaths in the UK, over 6 million cases of
dental caries and save over 14 Billion to the NHS9. We advocate encouraging
choice within the recommendations on sugar in all categories10 of food and drink
typically consumed by children, babies and toddlers.
Currently low (free) sugar choices are not readily available outside of soft drinks.
Yet they provide, especially for infants and younger children an opportunity for
early palates to develop in line with recommendations. A high growth sector 11 with
global export potential could further substantiate a case for significant incentives
to all who develop and carry such stock. These could include development grants,
procurement for government events and schools/nurseries, and free advertising.
Further, it is helpful to acknowledge and credit brands with their successes in
reformulation; as this will encourage more development along healthier lines.
Availability of Reformulated Products
6 http://www.agewatch.net/assets/documents/healthy-wealthy-2
7
http://www.publications.parliament.uk/pa/cm201516/cmselect/cmhealth/465/465
.pdf
8
http://www.mckinsey.com/insights/economic_studies/how_the_world_could_better
_fight_obesity

9 https://www.gov.uk/government/publications/sugar-reduction-from-evidenceinto-action
10 Soft drinks, biscuits, buns, cakes, pastries and puddings, breakfast cereals,
confectionary and fruit juice as well as savoury foods are the major sources of sugar in
childrens diets.

11 http://www.marketresearchworld.net/content/view/750/77/

With sugar there is a difference to salt and fat in that there are no essential dietary
sugars. However, as sugar performs functions beyond flavor, reformulation is more
challenging. There are nonetheless effectively reformulated products in all the food
and drink categories where sugar is ordinarily consumed, including confectionary.
Education promoting positive healthy choices has limited value in areas where those
choices are not available to make. We therefore propose that steps be taken to
encourage the availability of these options, such as government procurement.
Portion Control
Reduce Portion sizes of high sugar foods, targeting the same categories that are
major contributors to sugar intakes. There are concerns that the trend towards
larger portion sizes of sugary products12 has led to portion distortion and
overconsumption13. As McKinsey and others have identified portion control is one of
the more effective means of tackling obesity. A starting point here would be to bring
the promotion of sugar rich foods (such as Buy One Get One Free) down to the level
of our European counterparts, to help manage levels of consumption.
Eating Out
People in the UK spend around 31billion p.a. on takeaways and fast food. 14 It is our
recommendation that low (free) sugars options (e.g., fruit salad) are incentivized on
food menus by making such items exempt from VAT.
School Food Standards
Evaluating the School Food Standards is an important area in sugar reduction and
childhood obesity strategy. Areas that we think should be reviewed are (1) current
advice to offer pudding, cakes and biscuits after lunch every day, (2) extending the
standards to all schools and nurseries, including academies and free schools; and
(3) considering policies on lunchboxes, and birthdays.
Advertising
We call for an end to broadcast advertising before the 9pm watershed for food and
drink products that are high in sugar, referencing the new targets. This should be
extended further into non-broadcast advertising, especially online.
12 Church S. 2008. Trends in portion sizes in the UK - A preliminary review of
published information. Report for the Food Standards Agency.
http://multimedia.food.gov.uk/multimedia/pdfs/reviewportions.pdf
1313 Benson C. 2009. Increasing portion size in Britain. Society, Biology and Human
Affairs, 74(2) p4-20. www.biosocsoc.org/sbha

14 http://www.bha.org.uk/wordpress/wpcontent/uploads/2013/08/BHAHealthReportAdobePrint.pdf

Targets should be set and guidance given to retailers to improve in-store

architecture to reduce the display of unhealthy foods in checkouts and end of aisle
displays; and increase price promotions of healthier alternative products.
Exercise
Exercise appears to have limited effect when it comes to weight control.
Nevertheless it has both physical and mental health benefits. It should therefore
be actively promoted in its own right, to complement action to tackle obesity.
Research
We acknowledge that obesity is a complex area with multiple factors contributing.
More research should be supported relevant to disentangling these factors, as well
as assessing data on the impact of regulatory actions and incentives.
We welcome the Governments introduction of an effective Childhood Obesity
Strategy that we wish to support by sharing our experience and perspectives
and, in the medium to long term, by enabling the kind of policies that will lead
to a significant and substantial impact on all the problems associated with
childhood obesity.
--- END --[This does not form part of the joint position paper on sugar and childhood obesity
but is feedback to establish views of the stakeholders on what should be voluntary
and what should be regulated over which there is the most disagreement at
present. I have set an option of mandatory for large retailers as there is precedent
for separate mandatory treatment as in the case of Sunday trading laws in the UK.
I have also set an option to make a proposal or target mandatory in government
procurement. Please put a cross [X] next to the policy recommendation in the
relevant place. For example, under proposal (2) below put an X in the Mandatory
in government procurement column if you think the government should be
mandated to procure options in items that are already at the 5% or less in free
sugars level for government events, at hospitals and at schools and nurseries.

Please put a cross [X] next to the policy recommendation in the relevant place
Proposal

Mandatory
for all

Voluntary
for all

Mandatory
out of home
caterers

Mandatory
Retailers 280m2
(3000 sq ft)

Mandatory in
government
procurement

To set
incremental
formulation
targets (as in
salt)
To set targets
in provision of
options low in
free sugars (5%
or less by
calories)
Targets to
reduce the
display of
unhealthy
foods in
checkouts and
end of aisle
displays
Targets to
provide price
promotions of
healthier
options
End broadcast
advertising to
9pm
Extend to
online and
other
advertising to
children
FYI
[About Rend Platings: Rend is a Cambridge mother and advocate for sugar
labelling. She founded Sugar Smart the international certification scheme she is
campaigning the food industry to join. The scheme has been on the News at Ten
certifies food and drink low in free sugars15 and has received support from the
University of Cambridge and Cabinet Office as part of the prestigious Social
15 5% or less by calorie of monosaccharides, disaccharides or sugars naturally
present in honey, juice or syrups

Incubator East program; as well as support from Enterprise Europe as part of the
Innovate 2 Succeed coaching program. The BBC are following her progress.]