Poor diet is the number one risk factor for disease in the UK that could be improved with some lifestyle changes. At this year’s Oxford London Lecture, Professor Susan Jebb of Oxford University, who has over 25 years of experience in nutrition research, spelt out a range of measures that could encourage more people to eat a healthy diet and reduce levels of obesity.
Professor Jebb suggested that the health benefits gained through tobacco control policies and the treatments offered to smokers show what can be achieved with effective treatments for individuals and the public and political will to make wider societal changes. She said a similar approach to overhaul food policy could include the introduction of taxes on sugar-sweetened drinks, new limits on promotions of unhealthy food, and a wider range of NHS treatments available to people who are obese.
At this year’s Oxford London Lecture, 'Knowledge, nudge and nanny: opportunities to improve the nation’s health', Professor Jebb commented that, to date, food policy has tended to rely mainly on educational programmes. It puts the responsibility on the individual for their food choices while doing little to improve a food system that makes less healthy choices the default for many. She argued that for more support for individuals trying to eat more healthily, and changes in places where food is available – in shops, food outlets and the workplace. This would make healthy eating a practical reality and cut the national rates of diet-related disease.
As Professor of Diet and Population Health in the Nuffield Department of Primary Care Health Sciences at Oxford University, she said: 'My research is focused on identifying and testing strategies to enable people to manage their diet in the circumstances in which they find themselves today, where food is abundant, palatable, convenient and cheap. But more generally, we need a fundamental shift to the prevention of ill-health through policies that make it easier for individuals to adopt a healthier diet without healthy eating feeling like taking up an extreme sport.'
She highlighted ‘a portfolio of actions’ that have persuaded many to stop smoking – from educational campaigns, restrictions on tobacco advertising, and tobacco taxes to treatments provided in doctors’ surgeries for those wanting to give up. She said this approach gave us important lessons about the need for treatment services for obese people.
'We know from long-term intervention studies that even modest reductions in body weight can substantially cut or at least delay the onset of diabetes by more than 50% in the first four years. All too often we think that we can’t treat obesity, yet we have clear evidence of effective interventions ranging from bariatric surgery right through to behavioural weight management services, or even self-help programmes.'
She called her public health approach ‘the 4 Ps: People, Products, Promotions and Places’. Alongside her research to support people to make changes, Professor Jebb is the Chair of the Public Health Responsibility Deal Food Network, the body that negotiates voluntary agreements with the food industry. She looked at the progress made, praising the achievements of some companies who have made cuts in the fat and sugar content in some products, or reductions in portion size. However, she said ‘a much stronger global alliance’ is needed to demand broader changes from the food industry.
Professor Jebb illustrated the power of sales promotions, with research into the effect of so-called ‘gondola ends’ in stores that showed an uplift in sales equivalent to a 4% price discount on beer and a 22% discount on soft drinks. She hinted that new laws might be necessary to limit the promotion of unhealthy foods, saying ‘This goes to the heart of business competitiveness and does not easily lend itself to voluntary action – a level playing field is required which may demand legislative action.’
Professor Jebb restated her support for a tax on sugary drinks, pointing out that there is now empirical data to show that food taxes reduce the consumption of the taxed products; and described sugar-sweetened beverages as an 'easily defined category with clear health harms'.
'Tax is an established part of alcohol and tobacco control policies, but we hesitate to use it to guide food choices,' she said. 'This may be unpalatable – few of us willingly sign up to pay more tax, but given the scale of diet-related ill health facing us can we afford not to?'
Finally, she urged the public sector to take a lead on healthy workplaces, describing the lack of healthy food options in hospitals as her own 'bugbear'. ‘This is short-term thinking – income for hospitals today at the expense of rising health care bills tomorrow.’
The Oxford London Lecture took place at the Assembly Hall, Church House, Westminster. It was delivered in association with The Times and was made possible through the generous support of the Romanes Fund.