The Conversation Continues… Call for Theresa May to Introduce an Energy Density Levy on Confectionery, Make Nutritional Labelling on Menus & Packaging Mandatory and Ban Marketing of HFSS Products
Today Action on Sugar and Action on Salt (based at Queen Mary University of London) have launched a combined updated seven-point evidence-based plan to prevent obesity, type 2 diabetes, raised blood pressure, cardiovascular disease and cancer in the UK – with an urgent call for the Prime Minister to include ALL crucial recommendations in Chapter Two of her long-awaited obesity strategy.
Click on the link to view the evidence-based plan: Action on Sugar and Action on Salt Evidence-Based Plan [PDF 473KB]
NEW mandatory imperatives include:
- An energy density levy introduced on confectionery (set at a minimum levy of 20%)
- Uniform colour-coded labelling on front of pack and ALL menu items in restaurants and cafés
- Only healthy (non-HFSS) products marketed across all platforms, including TV, digital and print marketing – with a longer-term view to ban all HFSS advertising and promotion, similar to cigarette advertising
Energy Density Levy on Confectionery
Chocolate and sweet confectionery are among the highest contributors of sugar in the British diet, providing together 10% of the total sugar in diets of children (4-10 year olds) and 11% in teenagers (11-18 years). Chocolate confectionery is also among the highest contributors to saturated fat intake, providing 5% of total saturated fat intake in children’s diets (4-10 year olds) and 7% in teenagers (11-18 years).
Setting a levy to a minimum of 20% on all sweet and chocolate confectionery produced by manufacturers and retailers (and also those sold in cafés and restaurants) will provide an opportunity to reformulate based not on sugar content, but on overall energy-density of products (i.e. removal of both fat and sugar).
Recent evidence suggests that taxes on confectionery can have a greater impact than the Soft Drinks Industry Levy. Evidence from other countries with taxes on energy-dense products, such as Mexico with an 8% tax on non-essential foods with energy density ≥275 kcal/100 g, show they reduced purchases. We suggest that the energy density levy should be similar to the successful tax in Mexico and if companies decide to reformulate below this level, then they won’t need to pay any levy.
It is strongly advised that the levy should be invested in the creation of an independent agency to enforce reformulation and tackle marketing and promotion of HFSS products.
Uniform Colour-Coded Labelling on Front of Pack and All Menu Items
Mandatory hybrid labelling i.e. the colour-coded labels, alongside percentage reference intakes, is one of the most effective ways to communicate nutrition information and should be visible on all products sold in retail and out-of-home.
Currently the recommendations are voluntary which means that different (and often confusing) labels are used. Current government policy has no legal requirement for manufacturers to adopt a consistent use of hybrid labelling in retail or the out-of-home sector such as cafés and restaurants. This must now be made mandatory across all products sold in retail and must be publicly available on packaging or on menus for food and drink available in restaurants, cafés and other out-of-home eateries (which have more than 20 outlets).
Table 1: Examples of meals with dessert in colour-coded nutrition labelling sold in fast food and café outlets
Only Healthy Products (not high in fat, salt and sugar) Marketed, Promoted and Advertised
Current regulations have major loopholes. It is vital that only non-HFSS foods and drinks can be marketed and promoted, including in-store price promotions and sweets at the checkouts.
Cigarette advertising has been banned in the UK for many years because it causes cancer and cardiovascular disease, yet HFSS foods and drinks, which are now a bigger cause of death and disability, can be advertised without strong restrictions to vulnerable children. A similar longer term strategy needs to be implemented.
Summary of seven evidence-based actions:
- Reduce calorie intake by incremental reformulation:
- To achieve a 50% reduction in sugar content across all products
- To achieve a 20% reduction in energy density in unhealthy food and drink products (focused on saturated fat)
- Reduce salt intake by incremental reformulation to below 6g/day (adults), and less for children.
- Escalate the Soft Drinks Industry Levy and introduce a confectionary levy
- Sugar-sweetened drinks - the current threshold of 5g and 8g per 100ml should be slowly reduced and the amount of levy paid slowly escalated.
- Confectionery - a similar levy should be introduced for confectionery, with the opportunity to reformulate based not on sugar content, but on energy density.
- Ensure only healthy products (not high in fat, salt and sugar) are marketed, promoted and advertised.
- Ensure all products sold and provided in the public sector, e.g. schools, hospitals, meet strict nutritional standards.
- Make uniform colour-coded labelling on front of pack mandatory on all products sold in retail and out-of-home, with stricter criteria for sugar.
- Ensure the food and drink industry increases fruit and vegetable content of products through reformulation, promotion and marketing.
Professor Graham MacGregor, Chairman of Action on Sugar and Action on Salt says: “Theresa May launched her Prime Minister campaign in 2016 by saying that she wanted to tackle health inequalities – obesity being a major factor in this. Whilst some progress has been made, a much more robust and hard-hitting strategy is required to tackle the greatest threat to the health of our children. Theresa May could lead the world in tackling obesity and type 2 diabetes and must put the nation’s health first.”
Kawther Hashem, Researcher and Nutritionist at Action on Sugar says: “Currently supermarkets provide traffic light coloured labelling on their products, making comparison between products easier than ever. However, when eating out, we cannot easily check and make those comparisons. It is time restaurants and cafes are forced to be as transparent.”
Sonia Pombo, Nutritionist and Campaign Manager at Action on Salt says: “Reformulating foods to contain less salt is key to reducing population salt intake, lowering blood pressure and decreasing the prevalence of cardiovascular disease such as strokes and heart disease. As part of the obesity plan chapter two, the government must now take action to reduce salt intake by incremental reformulation to achieve average adult population intakes of 6g/day and less for children.”
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Notes to editors:
Action on Sugar - Action on Sugar is a group of specialists concerned with sugar and its effects on health. It is successfully working to reach a consensus with the food industry and Government over the harmful effects of a high sugar diet, and bring about a reduction in the amount of sugar in processed foods.
Action on Salt - Action on Salt is a group concerned with salt and its effects on health, supported by 22 expert scientific members. Action on Salt is successfully working to reach a consensus with the food industry and Government over the harmful effects of a high salt diet and bring about a reduction in the amount of salt in processed foods as well as salt added to cooking and at the table.
 Smith et al. 2018. Are sweet snacks more sensitive to price increases than sugar-sweetened beverages: analysis of British food purchase data. BMJOpen http://bmjopen.bmj.com/content/8/4/e019788
 Batis C, Rivera JA, Popkin BM, Taillie LS. 2016. First-Year Evaluation of Mexico’s Tax on Nonessential Energy-Dense Foods: An Observational Study. PLOS Medicine. 13:e1002057.
 Survey details
- Six meal examples were chosen from popular UK out-of-home retailers with more than 20 outlets - McDonalds, KFC, Burger King, Leon, Pret A Manger and Pizza Hut.
- Meals included - main (e.g. sandwich/burger), side (e.g. crisps, fries), drink and dessert.
- Meals chosen and data collected from online menus for all six outlets on 17th May 2018.
- Each individual item was colour coded using criteria defined by Public Health England and the Food Standards Agency in Annex 3 of 'Guide to creating a front of pack (FoP) nutrition label for pre-packed products sold through retail outlets' – https://www.food.gov.uk/sites/default/files/media/document/fop-guidance_0.pdf
- Where 100 g data was not available (McDonalds, KFC, Burger King, Leon and Pizza Hut) colour-coded labelling were based on the per portion information. The only outlet with 100 gram data available was Pret A Manger which resulted in a red light for Pret popcorn bar and sea salt crisps.
- For all sides (excluding Pret A Manger) where 100 g data was not available we estimate that this is the most accurate representation of nutrients in colour-codes, but it may slightly differ if the per 100g nutrition information was made available.
- For all the desserts (excluding Pret A Manger) where 100 g data was not available, we estimated the colour-coding based on per portion nutrition information. However, if the per 100g nutrition information was available, it is highly likely that the menu item would receive more red for fat, saturated fat, sugar and/or salt.
- Nutrition information for J20 was unavailable from Pizza Hut website, although it is sold there, so was obtained from here: https://www.j2o.co.uk/flavours/apple-and-raspberry
- Nutrition information for Tropicana smooth juice was unavailable on Burger King website, although it is sold there, so was obtained from here: https://www.sainsburys.co.uk/shop/gb/groceries/tropicana-smooth-orange-300ml