Today nearly a third of children aged 2 to 15 are overweight or obese
Choice For Life supports the childhood obesity action plan - we need to start somewhere!
Today nearly a third of children aged 2 to 15 are overweight or obese and younger generations are becoming obese at earlier ages and staying obese for longer. Reducing obesity levels will save lives as obesity doubles the risk of dying prematurely.
The burden is falling hardest on those children from low-income backgrounds. Obesity rates are highest for children from the most deprived areas and this is getting worse.
Children aged 5 and from the poorest income groups are twice as likely to be obese compared to their most well off counterparts and by age 11 they are three times as likely.
Obesity is a complex problem
With many drivers, including our behaviour, environment, genetics and culture. However, at its root obesity is caused by an energy imbalance: taking in more energy through food than we use through activity. Physical activity is associated with numerous health benefits for children, such as muscle and bone strength, health and fitness, improved quality of sleep and maintenance of a healthy weight. There is also evidence that physical activity and participating in organised sports and after school clubs is linked to improved academic performance.
Long-term, sustainable change will only be achieved through the active engagement of schools, communities, families and individuals.
We aim to significantly reduce England’s rate of childhood obesity within the next ten years. We are confident that our approach will reduce childhood obesity while respecting consumer choice, economic realities and, ultimately, our need to eat. Although we are clear in our goals and firm in the action we will take, the launch of this plan represents the start of a conversation, rather than the final word.
Introducing a soft drinks industry levy
Our children are consuming too many calories - and, in particular, too much sugar. Teenagers in England are the biggest consumers of sugar-sweetened drinks in Europe.
As a first major step towards tackling childhood obesity, the Government will be introducing a soft drinks industry levy across the UK. In England, the revenue from the levy will be invested in programmes to reduce obesity and encourage physical activity and balanced diets for school age children.
This includes doubling the Primary PE and Sport Premium and putting a further £10 million a year into school healthy breakfast clubs to give more children a healthier start to their day. The Barnett formula will be applied to spending on these new initiatives in the normal way.
Taking out 20% of sugar in products
Evidence shows that slowly changing the balance of ingredients in everyday products, or making changes to product size, is a successful way of improving diets. This is because the changes are universal and do not rely on individual behaviour change.
PHE will advise Government on setting sugar targets per 100g of product and calorie caps for specific single serving products. The 4-year, category-specific targets for the nine initial categories will be published in March 2017. Progress will be measured on the basis of reductions in the sales weighted average sugar content per 100 grams of food and drink, reductions in portion size so that these contain less sugar, or a clear sales shift towards lower sugar alternatives.
To ensure that the achievement matches expectations, progress will be reviewed by PHE who will publish interim reports on progress every 6 months. This will include reviewing reductions achieved through analysis of sales data and food composition data along with plans for further reductions. Some companies have led the way in addressing sugar reduction and it is important that existing work is recognised. Therefore, PHE will use 2015 data as the baseline for this reduction programme.
PHE will provide an assessment at 18 and 36 months (September 2018 and March 2020) on the approach adopted by industry. Government will use this information to determine whether sufficient progress is being made and whether alternative levers need to be used by the Government to reduce sugar and calories in food and drink consumed by children. If there has not been sufficient progress by 2020 we will use other levers to achieve the same aims.
Sugar reductions should be accompanied by reductions in calories and should not be compensated for by increases in saturated fat. Work to achieve salt targets should continue alongside the sugar reduction programme. From 2017, the programme will be extended to include setting targets to reduce total calories in a wider range of products contributing to children’s calorie intake and across all sectors, including the out of home sector. Work on saturated fat will be further reviewed in light of SACN recommendations due in 2017.
Developing a new framework by updating the nutrient profile model
To help families to recognise healthier choices, the government need a new way to determine which food and drink products are healthier and which are less healthy. The restrictions on food and drink advertising that are already in place to protect children are based on a tool called a ‘nutrient profile’. Each food and drink is assigned a score based on working out how much sugar, fat, salt, fruit, vegetables and nuts, fibre and protein it contains.
The current nutrient profile is over 10 years old and does not reflect recent scientific advice such as the SACN report or new products introduced. Having a strong, effective model will be crucial for underpinning all areas of this plan: giving clear guidance on how products will be treated will encourage companies to make their products healthier so they can avoid potential sanctions. Therefore, PHE is working with academics, industry, health Non-Governmental Organisations (NGOs) and other stakeholders, to review the nutrient profile model to ensure it reflects the latest government dietary guidelines. This should ensure that an updated profile focuses on the most unhealthy products, rather than adversely affecting products which are consumed as part of a healthy diet.
Making healthy options available in the public sector
We need to harness the true potential of the public sector to reduce childhood obesity. The public sector in England spends over £2 billion on food and catering services annually, with just under half, £1 billion, being the cost of food and ingredients.19 These buildings, services and spaces should set an example to children and families.
Every public sector setting, from leisure centres to hospitals, should have a food environment designed so the easy choices are also the healthy ones. Therefore, we will continue to work with local authorities and the Local Government Association to support them to tackle childhood obesity. This will include encouraging local authorities to adopt the GBSF standards, particularly in leisure centre vending machines. We will also ensure that there is full uptake of the Government Buying Standards for Food and Catering Services (GBSF) in central government departments Ukactive, whose members manage a large proportion of the fitness and leisure centres in England, are committed to making the environment in those places healthier by considering ways to provide and promote healthy options and restrict the sale of unhealthy food and drink.
The Department of Health is building on this requirement by collaborating with PHE, NHS England and the Behavioural Insights Team to trial behavioural interventions in NHS hospitals. These interventions will measure changes in purchasing behaviour and the impact on revenue from sales.
Continuing to provide support with the cost of healthy food for those who need it most
We are re-committing to the Healthy Start scheme, which provided an estimated £60 million worth of vouchers to families on low income across England in 2015/16. These can be exchanged for fresh or frozen fruit or vegetables and milk. The scheme also provides free vitamins to support intake during pregnancy and early years. Last year over 1.7 million vouchers were issued every four weeks and an average of 480,000 children in low income families were benefiting from the scheme in each month of the year.
Helping all children to enjoy an hour of physical activity every day
There is strong evidence that regular physical activity is associated with numerous health benefits for children. The UK Chief Medical Officers’ recommend that all children and young people should engage in moderate to vigorous intensity physical activity for at least 60 minutes every day. Many schools already offer an average of two hours of PE or other physical activities per week. However, we need to do more to encourage children to be active every day. Every primary school child should get at least 60 minutes of moderate to vigorous physical activity a day. At least 30 minutes should be delivered in school every day through active break times, PE, extra-curricular clubs, active lessons, or other sport and physical activity events, with the remaining 30 minutes supported by parents and carers outside of school time.
Given the considerable new funding that the soft drinks industry levy will make available for school sports, the Government is keen that schools are supported as much as possible in how they spend the available funds for maximum impact. During inspections, Ofsted assess how effectively leaders use the Primary PE and Sport Premium and measure its impact on outcomes for pupils, and how effectively governors hold them to account for this. Physical activity will be a key part of the new healthy schools rating scheme, and so schools will have an opportunity to demonstrate what they are doing to make their pupils more physically active.
Schools will continue to have the freedom to consider spending the Primary PE and Sport Premium on specific interventions but to help schools understand what help is available, PHE will be developing advice to schools for the academic year 2017/18. This will set out how schools can work with the school nurses, health centres, healthy weight teams in local authorities and other resources, to help children develop a healthier lifestyle.
Furthermore, we will make available a new interactive online tool which will help schools plan at least 30 minutes of physical activity every day. This will help schools identify gaps in the existing opportunities for children to be active and will recommend a number of solutions they can choose, for example after school clubs, initiatives such as the daily mile, creating an active playground or having an active lesson.
Improving the co-ordination of quality sport and physical activity programmes for schools
We have asked the County Sports Partnerships to work with National Governing Bodies of sport, the Youth Sport Trust and other national and local providers to ensure that from September 2017, every primary school in England has access to a co-ordinated offer of high quality sport and physical activity programmes, both local and national. As part of this, National Governing Bodies will offer high quality sport programmes to every primary school.
Whilst children spend a significant amount of time in school, keeping children active is a shared responsibility and parents and carers need to play their part. The Sport England Strategy ‘Towards an Active Nation’ (2016) has already set out a major new investment of £40m into projects which offer new opportunities for families and children to get active and play sport together. This investment will focus on helping children acquire a basic level of competence in sport and physical activity as well as supporting them to have fun, regardless of their level of ability.
We will continue investing in walking and cycling to school. Walking or cycling to school provides a healthy way to start the day. The Government has committed to producing a Cycling and Walking Investment Strategy. The first strategy will set out plans for investing £300m to support cycling and walking. It will set a clear target to increase the number of children walking to school as well as continued support for Bikeability cycle training for children.
Creating a new healthy rating scheme for primary schools
Schools are a vital part of our plan, and have opportunities to support healthier eating, physical activity and to shape healthy habits. Schools also have unique contact with parents and can signpost them to information and advice on keeping their children healthy.
In addition, in 2017, Ofsted will undertake a thematic review on obesity, healthy eating and physical activity in schools. The review will provide examples of good practice and recommendations on what more schools can do in this area.
Choice For Life support making school food healthier
We have already done a lot to improve school food: many school canteens are unrecognisable from those 20 to 30 years ago. The School Food Plan, published in July 2013, has helped bring about whole school improvements in food.
Clearer food labelling
In order to make healthier choices, families need to be presented with clear information about the food they are buying. The UK has led the way, working with industry to implement a voluntary front of pack traffic light labelling scheme, which now covers two thirds of products sold in the UK. However, an issue of increasing concern to families is understanding which sugars they should be cutting out of their diet. Current sugar labelling shows the total sugar content of foods but the new maximum intake recommendations are based on the specific sugar that are easily over-consumed, not all sugars.
The UK’s decision to leave the European Union will give us greater flexibility to determine what information should be presented on packaged food, and how it should be displayed. We want to build on the success of our current labelling scheme, and review additional opportunities to go further and ensure we are using the most effective ways to communicate information to families. This might include clearer visual labelling, such as teaspoons of sugar, to show consumers about the sugar content in packaged food and drink.
Choice For Life supporting early years settings
The early years are a crucial time for children’s development. One in five children are already overweight or obese before they start school21 and only one in ten children aged two to four meets the UK Chief Medical Officers’ physical activity guidelines for this age group.
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Curriculum for Excellence (CfE) is transforming learning experiences for children and young people across Scotland
The World Health Organization (WHO) regards childhood obesity as one of the most serious global public health challenges for the 21st century.