11 Oct 2019
Wider Food Systems
This second submission covers the wider issues that need to be included in any strategy in order to deliver a robust, sustainable and affordable food system that works for everyone.
What is needed:
- An end to food insecurity - everyone has a fundamental right to healthy, affordable and nutritious food.
- A food environment that is conducive to good health - in most cases our food environment is obesogenic, and we need to take strong, joined-up action to change this.
- A food system that produces food that is both good for human health, and the health of the planet.
- Significant investment in food and food system research
Increasing access to and affordability of good quality, healthy food, and tackling food insecurity
Systemic food insecurity is a serious problem[i] across the lifecycle. Estimates are that as many as 8.4 million people are struggling to get enough to eat. Our food system needs to deliver beyond ensuring that food is “affordable” to actually supporting everyone’s fundamental right to food[ii],[iii]. Our welfare system is not currently doing enough to prevent food poverty, and in some cases is a cause. Although this is not a direct part of the food system it is fundamental to meeting one of the central aims of the National Food Strategy. It may not be possible to produce food that is affordable if people remain in poverty.
We also know that many people cannot access good quality and healthy food for reasons other than poverty, including social isolation, physical disability or mental ill health. Disease and old-age related malnutrition impacts on millions of people in the UK each year[iv]. Ensuring we have comprehensive support mechanisms in place to help people access appropriate nutrition, such as dietetic support (including nutrition education), Meals on Wheels, lunch clubs and properly funded health and care services is vital.
Changing the food environment to encourage healthier diets
Evidence shows that our eating habits are strongly influenced by advertising, marketing and promotions, so any food strategy needs drive change in the way that everyone from producers to retailers sell us food. Children in particular should not be exposed to advertising of unhealthy high fat, sugar and salt foods[v], and retailers need to change their shop environments to encourage healthy choices and reduce unhealthy ones. Such a change needs to be mandated by central government, not undertaken on a voluntary basis[vi],[vii].
Voluntary reformulation of products has so far been a mixed success[viii]. The significant reduction in sugar in soft drinks as a result of the soft drinks industry levy shows that mandatory approached can be very successful. Although the BDA would not advocate the taxation of a wide range of other products, mandatory reformulation targets would create a level playing field and ensure all manufacturers play their part.
Breastfeeding is the best form of nutrition for babies. It’s a complete food. The National Food Strategy should therefore include specific actions to ensure that more women are able to breastfeed if they wish to, including requirements that workplaces and businesses support breastfeeding[ix].
Our physical food environment needs to support us to eat a healthy diet. Local authorities, as part of multi-sector food partnerships, should act through the planning system to reduce the number of unhealthy options while increasing healthy options[x]. Tackling food deserts[xi], where access to food is restricted, is a key issue. Governments and public services should lead by example to create healthy environments for their staff and users.
Controlling portion sizes is key in achieving energy balance, but many consumers have poor understanding of portion sizes appropriate for age and activity level. The government’s Foresight report[xii] makes clear that reduced exposure to an obesogenic diet includes a focus on reducing portion sizes. The BDA supports PHE’s suggestion that relevant foods and drink should have portion sizes capped
Ensuring our diets are good for us and good for the planet
There are a number of well-recognised steps necessary to improve environmental sustainability, such as reducing red and processed meat intake, consuming more plant proteins and reducing intake of high fat, sugar and salt foods. No one diet is suitable for all, and we would not advocate a shift towards prescriptive limits, but there are broad changes that should be encouraged. Our farming and food production systems will need to transform to meet this challenge[xiii] and the Grand Challenge of clean growth[xiv], as will government support to the agricultural sector[xv], which has the power to drive diversification and technological innovation.
We believe all healthcare professionals who discuss diet and nutrition with patients and those who work within food systems need to have an understanding of environmental sustainability, in particular those on lower incomes or who are more vulnerable. The BDA’s One Blue Dot toolkit[xvi], amongst others, may be a useful model on which to take forward such education.
Research and evidence-based policy
It is vital that we invest more in nutrition and food systems research and development. This can help us better understand key food issues, how we might apply lessons from other countries, and what nutrition and policy interventions are effective. Dietitians, as evidence-based professionals, are well placed to help drive this forward.
Although this National Food Strategy will be evidence based, it should also identify where gaps in our understanding exist and advocate strongly for investment to help fill them. Calls such as this from UK Research and Innovation[xvii] are a great start but need to be expanded. We need to research and development of new farming methods, new food technologies, public health approaches and better models of nutritional care to name just a few. This should be coordinated across the food system to ensure we are continually building the evidence base behind the whole National Food Strategy.