A hard-hitting report from the UK health watchdog group National Institute for Health and Clinical Excellence (NICE) calls on government and the food industry to cut salt and fat from processed foods — a move it says would save tens of thousands of lives a year.
The report recommends a public health approach to combat the effects of poor diet on cardiovascular disease, including:
• A ban on trans fats, and a reduction of saturated fats in processed foods and take-aways
• Slashing individuals’ daily salt intake by nearly two-thirds over coming decades
• Bringing in the “traffic light” colour coding system to show whether a product has high, low or medium levels of salt, fat and sugar
• Making low fat and low salt foods cheaper than unhealthier versions
• Banning television ads for high-salt, high-sugar and high-fat foods before 9pm, to protect children
• Urging local councils to forbid take-aways and junk food outlets near schools
The recommendations followed two years of extensive consultation and review of existing evidence, but have been largely dismissed by the UK government. The SMC asked local nutrition and public health experts for their views on the NICE report and its implications for the New Zealand population.
Robyn Toomath, Endocrinologist, Capital and Coast District Health Board, spokesperson for Fight the Obesity Epidemic:
“This piece of news is very significant – not so much for what is being recommended but because these are coming from the NICE group. Public health experts have always known that the way to improve the diet of the population is not through persuading individuals to change behaviour but rather in creating a supportive environment that affects everyone. Clear traffic light labelling is key to this approach as a means of inducing food manufacturers to reformulate their products with lower fat/salt and sugar content in order to avoid a red traffic light label.
“Similarly the removal of the most adverse environmental influences in the form of television advertising and fast food outlets adjacent to schools are both obvious place to start. In New Zealand as elsewhere in the world food that is advertised on television during the hours that children watch are massively skewed in favour of unhealthy food. The NICE guideline group are echoing the recommendations made by large numbers of submissions to New Zealand’s Health Select Committee Inquiry into obesity and diabetes as well as groups such as the International Obesity Task Force, WHO and so on.
“As a hospital based physician my experience of NICE guidelines are in the careful evaluation of evidence in support of specific treatments for clinical conditions. They provide the best information as we seek to improve the evidence base for our work and are highly respected in medical practice. The fact that this group is making such clear statements is an indicator of the impact that obesity has mortality and morbidity and I predict that NHS and the British Government will take these very seriously.”
Delvina Gorton is the Nutrition Advisor at the Heart Foundation:
“Cardiovascular disease (heart disease and stroke) remains the leading cause of death in New Zealand, responsible for 40% of deaths annually. People’s unhealthy food choices certainly play a major role in this.
“The Heart Foundation is supportive of strategies which help consumers to eat more healthily. The Heart Foundation Tick is an example of a food labeling system that sign posts healthier products within a food category.
“NICE has made some wide-reaching suggestions in their report for improving the food environment. In line with some of their suggestions, it is the Heart Foundation’s position that junk food advertising to children should be restricted. It also believes there is a need for some form of simplified, interpretive front of pack label on food to help consumers make healthier food choices, and FSANZ is currently looking at this issue.
“The Heart Foundation also encourages and works with food industry to continue improving the nutritional content of foods. The other specific proposals made by NICE would require consideration and development in a New Zealand context, but the Heart Foundation supports their intention. The UK government’s response that it is up to the individual to make healthy choices is true, but first the food environment needs to change to be supportive of those choices.”
Amy Liu, registered dietitian, Metro Consultancy Ltd.:
“The health of New Zealanders could improve significantly if we implement these changes by the National Institute for Health and Clinical Excellence (NICE).
“We (New Zealanders) are currently eating double the amount of recommended salt intake and excess fat (saturated and trans fat) leading to increasing overweight and obese numbers.
“Permanent lifelong healthy changes are not reliant dependently on individual choices but environmental factors play an important role.
“By banning trans fat, reducing individual salt intake, reducing saturated fat hidden in convenience food, we would reduce the incidence of obesity, diabetes and cardiovascular disease in the near future. Costs and media exposure also affects individual behaviour. If we increase the cost and reduce media exposure of unhealthy food, we are less likely to ‘want’ and therefore choose that particular high salt, high fat snack.
“The cost to implement these changes would be minimal when compared to the amount we would be saving by preventing obesity, cardiovascular disease, diabetes and complications related to these chronic diseases.”
Sport Waitaki Coordinator and registered dietitian Louise Bee comments:
“I think the article raises a number of good points. Processed and commercial foods are often high in saturated and trans fats, salt and sugar. Consumption of these nutrients above recommended levels has been repeatedly proven to have adverse health effects. However, simply providing individuals with this knowledge does not necessarily motivate them to change their diet accordingly.
“Environmental changes, such as the ones recommended by Nice, can reach a number of people almost by default. They do however, take a lot of time, money and effort to implement, and as stated in the article, may be seen as taking away an individual’s right to make their own dietary choices. At the end of the day, what do we value most – health? convenience? personal responsibility?
European Society of Cardiology has expressed support for the NICE report:
As has the British Heart Foundation:
Cancer Society of New Zealand recently issued the following submission on NZ food labelling policy:
For more information, or to contact any of the experts above, contact the SMC on 04 499 5476 or email@example.com