The UK must get serious about sugar reduction

Action on Sugar is calling for the UK government to start taking sugar reduction seriously for the sake of the nation’s health, environment and economy

With the release of the National Food Strategy earlier this year, Henry Dimbleby brought attention to the state of the UK’s food system: a system that does not allow us all access to affordable food and drinks that meet dietary guidelines, nor does it nourish us and support our health.

Instead, a highly globalised food industry, dominated by a few multinational corporations, extensively produces and markets highly processed and nutrient-poor food and drinks – high in fat, sugar and salt (HFSS). These products are cheaper than nutrient-dense products and are at the centre of the billions in profit made by global food companies annually, profits that are often made at the expense of workers’ wages and consumer health.

Sugar is bad for our health, environment and economy

Indeed, excess sugar, salt and fat in our diets leads to an increased risk of health conditions such as high blood pressure, cardiovascular disease (i.e. strokes and heart disease), tooth decay, type 2 diabetes and obesity. Our food system also puts an untold cost on our environment by converting natural ecosystems to crop production or pasture. The production of sugar beet, for example, is causing irreversible damage to soils, with British Sugar being responsible for removing hundreds of thousands of tonnes of precious topsoil every year.

What can the UK government do?

To address the impact of diet on health, the government has implemented numerous policies – despite threats this year that they would be scrapped (which thankfully appear to have been baseless) – including colour-coded front-of-pack nutrition labels, food and drink procurement guidelines for the public sector and some restrictions on the placement of HFSS products in prominent retail locations. The Government’s world-leading reformulation programme, in particular, is a key policy with the potential for a huge, positive impact on our food system and health.

Reformulation involves food companies improving the nutrition profile of their products by gradually reducing harmful elements such as excess sugar. This removes the barrier of behaviour change or financial considerations from consumers, who can continue to buy the same products they always have, but over time they will become healthier.

2003 Salt Reduction Programme has been successful – why not sugar too?

Food companies have gradually reduced salt levels for many years following the introduction of a Salt Reduction Programme in 2003. Correspondingly, the nation’s salt intake and blood pressure have reduced.

In 2017, the programme was expanded to include a focus on sugar, with a 20% reduction in sugar levels in certain key contributors to children’s sugar intake expected by 2020. It is worth noting that this does not include young children and infants; products marketed for this age group are not subject to the Sugar Reduction Programme and can be very high in sugar, as data due to be released by Action on Sugar this week will demonstrate.

UK one of first countries to implement sugar reduction targets

The UK was one of the first countries to implement sugar reduction targets, and WHO Europe was recently asked to learn from the UK on sugar and calorie reduction.

The Sugar Reduction Programme had not achieved the targeted reductions in sugar levels

However, the third progress report, published in 2019, showed that the Sugar Reduction Programme had not achieved the targeted reductions in sugar levels. The fourth and final progress report was due for release in Autumn 2021; following several delays, our recent Freedom of Information request revealed that the Department of Health and Social Care plan to release the report by the end of 2022.

Why has the Sugar Reduction Programme not been a success?

With the release of this report will come the Government’s recommendations for the Sugar Reduction Programme’s next steps. First, it is important to understand why the current programme has struggled to elicit progress.

• One reason may be that targets were set as overall percentage reductions as opposed to evidence-based and data-backed specific targets at the category level (as used in the Salt Reduction Programme).
• Alongside this, by giving the food industry the option to shift sales to lower or no added sugar products in their portfolios, sugar reduction became a short-term marketing opportunity rather than a long-term strategic aim. I’m certain you will have seen ‘30% less sugar’ versions of products on supermarket shelves, which may appeal to the health-conscious among us but are ultimately not the aim of a reformulation policy.
• To help take consumers on a journey, gradually lower sugar intakes and deliver true benefits to population health, sugar reduction must occur across all products at an achievable pace.
• However, by far, the leading reason for lack of progress is that the programme is voluntary rather than mandatory. Globally, public health experts and organisations recognise that voluntary programmes no longer work. In the case of reformulation, a company can choose to invest as much or as little into reducing sugar in its products as it wants under a voluntary measure, making full compliance unlikely – as the UK’s programme shows. Indeed, even salt reduction progress has faltered in recent years. The CEOs of the UK’s major food retailers even went as far as telling the National Food Strategy team that they will not reformulate all products without government legislation and that “they need a level playing field if they are to start making their products healthier; otherwise the competition will simply move in and undercut them”.

The next steps for the Sugar Reduction Programme must be bold

The UK’s sugar reduction journey may not have been successful to date, but the evidence on the link between excess sugar intake and health has not changed, and the nation’s consumption has not gone down.

The importance of a healthy, productive population has come into even sharper focus as the UK’s health and care service and economy come under increasing strain. The next steps for the Sugar Reduction Programme must be bold: now is the time for the government to implement an evidence-based, comprehensive and mandatory programme that benefits the whole population.

Written by Prof Graham MacGregor CBE, Professor of Cardiovascular Medicine at Queen Mary University of London and Chair of Action on Sugar and World Action on Salt, Sugar and Health and Harriet Burt, Policy and Communications Officer at Action on Salt and WASSH