The government is set to start driving forward its health plan, with a focus on nutrient profiling and salt targets. Liz Hamson reports

If you’re not on holiday, chances are that as well as taking on your absent colleague’s workload, you have been reading about or taking part in one of the many government consultations and ‘stakeholder’ debates on health.
In the past few weeks, the Food Standards Agency has launched two new consultations - on nutrient profiling and on proposals to set UK targets for levels of salt. They follow two major stakeholder meetings, one on salt and another on saturated fats and energy, last month.
And, come the autumn, the government is expected to really start driving forward its health action plan, first unveiled in the Public Health White Paper last November. In addition to the next round of stakeholder meetings, two pieces of research on signposting will be published, the European Commission’s Platform for Action on Diet, Physical Activity and Health will take place in London and the UK will play host to the Health Inequalities summit.
It is little wonder that Martin Paterson, the Food and Drink Federation deputy director general, has this wry verdict: “Consultation seems to be the new black as far as the government is concerned. It’s really quite difficult to keep a handle on everything.”
He’s not the only one struggling. So, The Grocer decided to chew over what’s on the government’s diet table and ask what, if anything, should be spat out.
At the moment, the jury is still out. A Department of Health spokeswoman insists that “most of the industry is now on board in the battle to combat obesity, but there is still more to come”.
This last clause - as well as the huge scope of the government’s plans - have sparked growing alarm within an industry that is already struggling to understand, let alone comply with, the demanding and, some argue, unrealistic new targets on salt reduction, product reformulation and labelling.
And it’s not over yet. As Paterson says: “A whole lot of chickens are about to come home to roost.”
The question is: will the industry’s concerns be heard?

Advertising and promotion
Just over a fortnight ago, the Food Standards Agency launched what it said would be its final nutrient profiling consultation.
The proposed system, which would score foods on the basis of whether they are high, intermediate or low in fat, saturated fat, salt or sugar, is intended to underpin communications regulator Ofcom’s review of the advertising and promotion of food to children this autumn.
Needless to say, it has prompted furious reaction from elements of the food and drink industry, which argue that the “simple scoring system” rating overall balance of nutrients in foods is overly simplistic.
Martin Paterson, deputy director general of the Food and Drink Federation, says: “Simplistic approaches that label foods good or bad, without taking account of actual consumption behaviour, will be irrelevant to real consumers’ lives.”
He points out that Ofcom itself has said that TV advertising has only a modest direct effect on children’s food consumption and has acknowledged that it needs to be considered alongside other factors linked to childhood obesity.
He also questions the appropriateness of a broadcasting watchdog attempting to influence food as well as advertising content. “It’s a remarkable concept, a broadcasting regulator regulating on nutritional profile.”
The FSA and Department of Health are nevertheless pushing ahead with their plans. A DoH spokeswoman says: “The main impact we hope to see is a rebalancing of the wide range of food promotion activity aimed at children. In practice, this means a reduction in the number of promotions on children’s foods high in fat, salt and sugar.”
She stresses that the industry will be consulted properly. “Membership of the forum includes key trade and marketing associations and we have enlisted their expertise to help identify gaps and recommend where existing codes of practice need to be updated.”
Meanwhile, a Food and Drink Advertising Promotion Forum has been set up to look at how new arrangements could be made to work in practice. Andrew Opie, the British Retail Consortium’s food policy director, adds that further clarification is needed over what is and is not permissible or achievable as far as in-store promotions and marketing go.

Salt reduction
Following last month’s stakeholder meeting on salt, the FSA kicked off its consultation last week on whether it should set a wider range of salt reduction targets for the industry. It originally intended to focus on the top 10 contributors, such as ready meals and bread, but has now identified 15 food categories and a raft of foods within those categories that it believes should be set targets.
The nature of the targets is also under discussion, says Gill Fine, the FSA’s director of consumer choice and dietary health. “When the agency set out originally to reduce salt, it set out average values - for example, taking out 10% over three years. Others have set upper and lower limits. This is to set out whether upper limits are more helpful.”
However, the FDF’s Paterson argues that it is not always feasible to reduce salt - when it is used as a preservative or is naturally present in a food, for instance. Fine agrees there may be some exceptions, but says “the evidence is clear” that salt is a concern and that there are benefits in reducing it.
The FSA appreciates that targets will not be possible across the board, she says. “We’ve been looking at products, looking at categories and whether there is scope for reduction. In some areas, there may be scope to do more reduction - and in others there may be less scope because action has already been taken.
“It’s important to recognise that we’re not saying, ‘let’s get rid of salt’. There are some products for which salt is an important part. It’s about getting the right balance.”
The targets take into account the amounts set out in the FSA’s salt model, as well as technical constraints, food safety issues and consumer acceptability, she adds.
So far, 52 food and drink companies have committed to the FSA’s salt programme and Fine urges more to get involved. “The target of 6g a day by 2010 is challenging and will require industry engagement across the food chain. The fact that 52 companies are doing it is very encouraging and the more that come on board the better. That’s partly why the consultation on targets is so important.”
The FSA is also poised to launch the second phase of its salt advertising programme in October. Fine won’t comment on the nature of the new campaign, but a spokeswoman confirms that Sid the Slug has been killed off.
The campaign will take on board public awareness generated by the previous campaign and move on to influencing behaviour with the warning that 6g of salt a day should be the daily limit,she says.
What will be interesting, says the BRC’s Opie, is how the government will go about achieving its targets with so many different parties involved.

... and the rest
Saturated fat and energy
Fat and energy is next on the government hit list. A stakeholder meeting last month concluded that a series of smaller groups should be set up to assess particular food categories.
They are expected to hold their first meetings this autumn and will look at what needs to be achieved in terms of regulation, healthier choices and portion sizes.
The government’s focus appears to be on product reformulation, consumer education and awareness.
Martin Paterson, FDF director general, is worried that the FSA wants all products to be reformulated regardless of whether it is feasible or not.
He says: “We take the view that you can’t do this in the same way as salt. There are health benefits to consider: a reduction could be disadvantageous for some people.”
Platform for Action on Diet, Physical Activity and Health
The European Commission launched the platform in March.
On September 21, industry bodies, consumer groups, health NGOs and political leaders will gather in London to debate the rise in obesity across the EU member states, particularly among children.
The FSA is expected to publish the agenda shortly.

Health Inequalities Summit
The government has identified health and diet as one of the key issues it wants to tackle during its presidency of the EU. As well as pushing ahead with legislation on nutrition and health claims, expected to come to a head by the end of the year, it is also gathering policymakers from across the EU together for the the Health Inequalities Summit on October 17 to 18.
Public information campaign
The DoH is planning a cross-government campaign to raise awareness of the health risks of obesity and promote the steps people can take through diet and physical activity to improve health.
A spokeswoman says: “We are looking at a long-term campaign and steps that can be taken in the short term to address obesity in the groups most at risk.”

... Big Brother
The department also plans to keep a close eye on the industry’s progress.
The DoH spokeswoman says: “We are putting in place a monitoring mechanism so that we can track improvements, and tackle those that we think are lagging.”
In other words, woe betide those who don’t jump on the health and diet bandwagon - the fat police will be watching your every move.

Confusingly, there are two pieces of research on signposting currently under way - one by the FSA and the other by IGD.
The former will this month conclude its consumer survey into a variety of front-of-pack signposting models: single traffic lights, multiple traffic lights, monochrome Guideline Daily Amounts and coloured GDAs.
It is to put out the results of the one-to-one interviews and focus groups involving 2,600 consumers to full consultation next month. The FSA’s Gill Fine says: “The research takes account of both preferences - that is, do they like the look of it, and also whether it works for them. Can they identify what is good for them and are they eating better as a result?”
In the first round of research, consumers rejected the GDA system, but after industry criticism, the two GDA models were added to the mix. Fine won’t be drawn on which is now the frontrunner, but says of the first round of research: “Some said multiple traffic lights were complicated. People said of GDAs that they helped but there were a lot of numbers. Single traffic lights were deemed simple but some asked whether they were actually saying anything. The key is: does it help them make informed choices?”
Whatever is selected, it will only work as a voluntary scheme if it is backed by the industry, she concedes, acknowledging the schemes already adopted by industry.
Meanwhile, the IGD has been carrying out focus groups and face-to-face interviews with 1,000 consumers to gauge their views on back-of-pack GDA-based models.
Tanya Footman, senior analyst, says: “Consumer research showed that 72% of consumers have seen GDAs and 34% are using them. Motivating consumers to look at all the information is key.
“This research looks at whether we can put all the information in one box or whether it should be separated into two boxes - a nutrition panel and a separate box containing the GDA guidelines.
“In 1998, when we put out the Voluntary Nutrition Labelling Guidelines, we had male and female GDAs. Now we’re looking at whether consumers want just an adult value, whether they like percentage GDAs or an actual amount, and also whether or not they are appropriate for children.”
The complication with children’s GDAs is that several different targets may have to be included on already crammed labels. There is also the question of whether they should only feature on children’s foods.
Fine and Footman both insist they are keeping one another informed and the two pieces of research are not necessarily contradictory. It makes sense not to duplicate research, says Footman, adding: “In an ideal scenario, the two would go together.”
That remains to be seen, as does the issue of whether the FSA is complicating matters by throwing another scheme into the mix.
However, the whole area of signposting will become less of an issue if the FSA agrees to go with a GDA-based system, believes Opie. “Retailers are comfortable with it and it’s good that it’s voluntary,” he says.