I recently had the honor to be invited to speak at the United Kingdom’s Calorie Reduction Summit, held in June at the Royal Society in London. My role was to represent the US by sharing insights on the eight-plus years of the menu labeling journey and the FDA’s 399 pages of rules for posting calories on menus. I also shared the good works of US restaurants that are participating in the HealthyDiningFinder program to ultimately contribute to a healthier America.
To get ready for the Summit, I dove into reading about the world-leading nutrition-focused ambitions and initiatives already in place. I found that the UK government is very serious about bringing healthy, long-term change. In direct parallel with the US rates, nearly two-thirds of UK adults and one-third of children post-elementary school are obese or overweight.
Before I provide an overview of the Calorie Reduction Summit, let me give you a high-level summary of the healthful “ambitions” already in place (I like how they refer to these public health initiatives as “ambitions” -- it conveys the passion that I experienced at the summit):
A few days prior to the Calorie Reduction Summit, Public Health England released a 33-page report, “Childhood Obesity: A Plan for Action, Chapter 2.” This report follows Chapter 1, released in 2016. The UK government states that obesity rates have doubled in the past two decades, and Britain is now the most obese nation in Western Europe. PHE also released a progress report on sugar reduction in May 2018.
Prime Minister Theresa May emphasized in the Chapter 2 Childhood Obesity report that, “The health and well-being of our children critically determines their opportunities in life. Today, nothing threatens that more than childhood obesity.” The report states that the UK aims to “be the first country in the world to really do something about this,” with a “national ambition to halve childhood obesity rates by 2030 and significantly reduce the health inequalities that persist.”
In the report, Jeremy Hunt, the UK’s Secretary of State for Health and Social Care, explains the overall childhood obesity policy plan, which focuses on 1) empowering parents to make informed decisions about the food they are buying when eating out, 2) mitigating “pester power” by preventing stores from pushing unhealthy foods, and 3) protecting kids from food advertising.
The report states that the UK will “introduce legislation to mandate consistent calorie labelling for the out-of-home sector, (e.g., restaurants, cafes and takeaways) in England” with further direction by the end of 2018.
Soft drink sugar levy
In 2016, PHE announced a sugar levy on soft drinks as part of its plan to tackle childhood obesity. By the time the levy was enacted in May 2018, already 50% of manufacturers, including Great Britain-based Lucozade Ribena Suntory, Irn Bru and Tesco, had voluntarily reduced the sugar content of drinks sold by the equivalent of 45 million kg of sugar per year, resulting in an 11% decrease in sugar and 6% decrease in calories. Additionally, there was a shift in sales towards products with sugar levels below five grams per 100 ml. Soft drinks manufacturers who don’t reformulate will pay the levy, which amounts to 24 pounds per litre of drink if it contains eight grams of sugar per 100 millilitres or 18 pounds per litre of drink if it contains between five and eight grams of sugar per 100 millilitres.
Public Health Minister Steve Brine said money generated from the levy -- an expected 240 million pounds (roughly $306 million) each year -- would go towards funding sports programs and nutritious breakfast clubs for children.If all beverage companies comply, the UK government seems willing to call it a success and continue to fund these important youth programs at the full sugar tax rate.
Sugar reduction in food products
PHE also challenged manufacturers of food products to voluntarily reduce levels of sugar by 20% by 2020, with a 5% reduction in the first year. The recommended strategies for reducing sugar are: 1) reformulation to lower sugar levels, 2) reduction of portion size and/or 3) promoting a shift of consumer purchasing patterns towards lower/no added sugar products.
The results featured in the May 2018 Sugar Reduction report showed that across 8 of the 10 food categories, retailers and manufacturers achieved a 2% sugar reduction in the first year. Of the top 20 brands ranked by total sugar sales, 33% showed a decrease in sugar content; 56% showed no change, and 12% showed an increase in sugar levels.
The report states that, “…due to data limitations, it has not been possible to report on progress by the out-of-home sector (e.g., quick service restaurants, takeaway and meal delivery businesses) in the same way as for retailers and manufacturers…this should be included in the next report in 2019.” To emphasize: both the Sugar Reduction and Childhood Obesity reports signal that the next “ambitions” will focus on the restaurant sector and menu labeling.
Sodium and saturated fat reduction
PHE has also published targets for levels of sodium in food products and drinks with the understanding that businesses are expected to work towards achieving these targets as part of the sugar reduction and wider reformulation plan. A saturated fat plan is anticipated later in 2018.
Calorie Summit summary
The first ever Calorie Reduction Summit in the UK included industry and retail speakers, academia, policymakers, public health and science and nutrition stakeholders to discuss the challenges and opportunities presented by current developments in nutrition policy. UK-based representatives from Subway Restaurants and McDonald’s provided an overview of their healthful initiatives.
The topics presented addressed issues such as:
- Does the childhood obesity plan go far enough? And can voluntary schemes ever achieve the level of change required to be impactful?
- With a quarter of calories now coming from outside the home, how will changes be made in this notoriously challenging sector?
- Should menu labelling be mandated as it is in the US? What can the UK learn from the US?
US menu labeling and healthful initiatives
My presentation focused mainly on this last area. I started out by showing a slideshow of CDC’s Obesity and Diabetes maps of the US, which show that both increased dramatically between 1994 and 2015.
As far as menu labeling, defined as providing a calorie count on menus, here are my recommendations:
The obvious: It shouldn’t take 8 years or 399 pages of rules. In fact, there is growing demand for transparency, and more than ever before, restaurant customers want and need nutrition information. It would be best if restaurants were in control of the guest experience related to how they provide nutrition information to their guests.
Use tech tools: When menu labeling was first being discussed in the US -- and even when it passed as a provision in the 2010 Healthcare Act, mobile and digital technology was in its infancy compared to today. Online and mobile ordering and payment are fast growing trends in the restaurant industry worldwide, and it’s important to consider how this technology can also enhance public health.
Think beyond calories: Healthy eating is really about a lifestyle emphasizing high nutrient foods. A focus solely on calories on the menu may steer a consumer to a 500-calorie burger high in saturated fat on a white refined bun instead of a 650-calorie salmon taco dish with fresh grilled vegetables. The latter is filled with high quality nutrients our bodies need. There is no reason to limit the information provided to diners -- it should be easy to access and include sodium, carbohydrates, sugar, fiber, protein, fat, saturated fat and food allergens. This information can be easily accessed through mobile phones.
What does all this mean for US restaurants?
We are experiencing a huge paradigm shift -- in our cultural values of food and in how technology guides our choices. Even though calorie counts on menus are in full force now for restaurant chains with 20 or more US locations, restaurants should not stop there. US consumers want to eat healthier and cleaner -- they want a full spectrum of information about the food they eat. They want to track what they are eating and understand where the food comes from and how it affects their bodies and the planet. Restaurants of all sizes and types can prosper by transitioning to a healthier way of creating and serving food.
It is Healthy Dining’s passion to partner with restaurants for a healthier America. We don’t need to wait for our government to enact more legislation. US restaurants can be proactive and support their guests in finding menu items that meet their health and lifestyle preferences. Healthy Dining provides healthful strategy guidance, nutrient analysis and new MyMenu interactive technology to provide a personalized digital and mobile experience.
If you are a restaurant that wants to join us in a proactive way to give your guests the information they crave and help make the world a healthier place to eat, contact me at Anita@HealthyDining.biz.
Anita Jones-Mueller, MPH, is CEO and founder of Healthy Dining. She is a nationally known public health nutrition expert and a market innovator, thought leader and strategist in the healthy eating landscape. Healthy Dining supports restaurants of all kinds and sizes with a variety of nutrition-related services that include nutrient analysis, allergen and gluten identification, and validation of attributes such as “organic,” “clean,” “vegan,” and other terms.
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