New Research Shows That Gradual Fat Reduction in Processed Food Would Prevent 4.5 Million Cases of Overweight and Obesity in the UK

2 March 2021

• A reformulation strategy to reduce fat content in manufactured and out of home foods by 20% over 5 years would reduce mean energy intake1 by 68kcal/person/day
• New modelling shows this reduction could reduce prevalence of overweight and obesity by 6.8%, the equivalent of 4.5 million fewer people going on to develop overweight and obesity
• Over 20 years this could prevent 183,000 cases of type 2 diabetes and, if focused on saturated fat, 97,000 deaths from coronary heart disease and stroke
• The Government must now act to force the food industry to reformulate their food by setting mandatory targets and/or imposing appropriate levies

A NEW study led by researchers from the Wolfson Institute, Queen Mary University of London published in the American Journal of Clinical Nutrition (Potential impact of gradual reduction of fat content in manufactured and out-of-home food on obesity in the UK: A modeling study (https://doi.org/10.1093/ajcn/nqaa396) [1] has proposed a comprehensive fat reduction model which would be an effective strategy to reduce excessive calories in manufactured and out of home food and over 5 years prevent 4.5 million people going on to develop overweight and obesity.

Action on Sugar is calling on the Government to set mandatory targets and/or impose appropriate levies on food manufacturers who fail to comply with them.

With fat being the most calorie dense nutrient (9kcal per gram) compared to protein and carbohydrates (4kcal per gram), this new analysis proposes the food industry follow a gradual and stepwise reduction in the fat content (preferentially saturated fat [2]) of 46 food categories, including pizza, burgers, biscuits, ice-cream, sauces, and cakes which, together, account for 40% of the calorie intake in the UK population.

Using national food consumption data for the UK population, the authors modelled a 20% reduction in fat content in the selected food categories over five years, with an annual reduction of ~4%.

With gradual reductions being made unobtrusively by the food industry, as seen in the successful salt reduction programme, it was assumed there would be minimal changes in consumer behaviour i.e. people would continue to purchase and consume the same food. Both food manufacturers and chefs could easily use fibre-rich ingredients such as vegetables and fruit or category-specific food technologies to compensate for the small fat reduction, so there would be no change in portion size, but a meaningful reduction in calorie content with an increase in fruit, vegetable and fibre content.

Potential Impact

Using the proposed model, the researchers estimate average energy intakes would be reduced by 68kcal/person/day, with greater reductions seen in 11-18 year olds. This reduction in energy intake would result in an average weight loss of 2.7kg over 5 years, and could potentially avert 4.5 million people from going on to develop overweight and obesity, in turn preventing 183,000 incident cases of type 2 diabetes over 20 years.

Total daily fat intake would also be reduced by 7.5g/person/day at the end of the five year period, and if focused on saturated fat, would bring us in line with recommendations on population saturated fat intake, which we currently exceed [3]. The reduction in saturated fat consumption would result in a decrease in serum LDL cholesterol by 0.13mmol/L, preventing the equivalent of 97,000 deaths from heart disease and strokes over twenty years.

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Lead author Roberta Alessandrini, Doctoral Researcher at Queen Mary University of London said: “This is an effective, feasible and acceptable strategy to meet the government’s task of improving population health. Our strategy could be used in combination with an energy density levy, focusing on the retail and the out-of-home sector, as evidence shows that these measures can ensure greater compliance and create a level playing field for the industry.”

Dr Kawther Hashem, Campaign Lead for Action on Sugar said: “The UK Soft Drinks Industry Levy has been remarkable and unique in encouraging reformulation and has already resulted in a much bigger reduction of sugar content of drinks in the UK than originally anticipated, as well as ring fencing £340million of income directly from manufacturers - not the public - to spend on improving children’s health.

“The same could be achieved either by mandatory targets or creating a levy to reduce excess calories (whilst not exceeding salt or sugar), but we need a firm commitment from the Government. The levy could raise substantial amounts of money and this could be invested back in a comprehensive approach to improve children’s health.”

Professor Graham MacGregor, Chair of Action on Sugar said: “For four years, the Government and Public Health England have wasted time and cost lives - with only one action, the soft drinks industry levy, being successful. The time has come for the Government to tackle the obesity pandemic, and this new research clearly shows one simple and practical approach that could easily be achieved by the food industry and would benefit even the worst off in our society.”

Background

More than 60% of the UK population are currently living with overweight or obesity, and ill health caused by poor diet is costing us over £40 billion a year [4]. In the UK, a large proportion of our daily calories come from processed foods, which are often energy dense and nutrient poor: high in saturated fat, salt or sugar (HFSS) and low in fibre, fruit and vegetables. This poor diet is a leading risk factor for obesity and ill health [5], which in turn is making people more vulnerable to worse outcomes of COVID-19 [6]. There are also ever present and widening social inequalities, with young people from poorer backgrounds being twice as likely to be living with obesity, consume a range of less healthy products and be exposed to more adverts promoting unhealthy food [7].

Calorie Reduction Programme

Last year the Government published Calorie Reduction Targets [8], which includes only a small number of categories contained within this analysis. The programme should be strengthened to include a broader range of categories as proposed in this analysis, with an energy density levy imposed on manufactures and restaurants who fail to produce healthier food.

ENDS

National PR – David Clarke: M: 07773 225516

Website www.actiononsugar.org

Notes to editors:

About Action on Sugar

Action on Sugar is a group of experts concerned with sugar and obesity and its effects on health. It is working to reach a consensus with the food industry and Government over the harmful effects of a high calorie diet, and bring about a reduction in the amount of sugar and fat in processed foods to prevent obesity, type 2 diabetes and tooth decay.

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1 The amount of energy produced by an individual taken in from food consumption; this is typically measured in calories (kcal). Energy intake must be matched with energy expenditure to ensure energy balance.

References

1. Alessandrini R, He FJ, Ma Y, Scrutinio V, Wald DS, MacGregor GA. Potential impact of gradual reduction of fat content in manufactured and out-of-home food on obesity in the United Kingdom: a modelling study. American Journal of Clinical Nutrition, 2021 https://doi.org/10.1093/ajcn/nqaa396

2. The research models a 20% fat reduction in manufactured and out-of-home foods. Most of the fat reduced would be saturated fat.

3. Current recommendations by the Scientific Advisory Committee on Nutrition state that saturated fat intake should not exceed 10% total energy consumption. Scientific Advisory Committee on Nutrition. Saturated fats and health (2019) https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/814995/SACN_re port_on_saturated_fat_and_health.pdf 

4. Estimated combined costs to the NHS of ill health through poor diet - at minimum £42.5bn per year based on the following figures:

   • Hypertension=£2.1bn (https://www.gov.uk/government/publications/health-matters-combating-high-blood- pressure/health-matters-combating-high-blood-pressure)

   • Malnutrition(i.e.undernutrition)=£15.3bn (https://www.bapen.org.uk/pdfs/economic-report-short.pdf)

   • Obesity=£6.1bn (https://www.gov.uk/government/publications/health-matters-obesity-and-the-food-

     environment/health-matters-obesity-and-the-food-environment--2)

   • Type2diabetes=£6bn (https://www.england.nhs.uk/blog/type-2-diabetes-and-the-importance-of-prevention/)

   • CVD=£7bn (https://www.england.nhs.uk/blog/the-long-term-plan-is-a-game-changer/)

   • Alcohol=£6bn (https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/733108/alcohol_public_health_burden_evidence_review_update_2018.pdf)

5. Murray, Christopher JL et al. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet, Volume 396, Issue 10258, 1223 –1249. https://doi.org/10.1016/S0140-6736(20)30752-2 

6. Tan Monique, He Feng J, MacGregor Graham A. Obesity and covid-19: the role of the food industry BMJ 2020; 369:m2237

7. Bann, David et al. Socioeconomic inequalities in childhood and adolescent body-mass index, weight, and height from 1953 to 2015: an analysis of four longitudinal, observational, British birth cohort studies. The Lancet Public Health, Volume 3, Issue 4, e194 – e203. https://doi.org/10.1016/S2468-2667(18)30045-8 

8. Public Health England. Calorie reduction: guidelines for the food industry (2020) https://www.gov.uk/government/publications/calorie-reduction-guidelines-for-the-food-industry