THE BROKEN PLATE Ten vital signs revealing the health of our food system, its impact on our lives and the remedies we must pursue - Food Foundation
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THE BROKEN PLATE Ten vital signs revealing the health of our food system, its impact on our lives and the remedies we must pursue
Report
snapshot 01
01 46% of food and drink advertising goes on 05 Unhealthy foods are three times cheaper
confectionary, sweet and savoury snacks than healthy food
PAGES
14-15
PAGES
24-25
and soft drinks; while only 2.5% goes on What we decide to buy is influenced by price 02
fruit and vegetables With commentary from Jamie Oliver
Before we even decide what to eat,
we’re influenced by mass media 06 Half of breakfast cereals marketed to
With commentary from Hugh Fearnley-Whittingstall children are high in sugar and for these
PAGES
26-27
cereals a single portion would make up a
third of a child’s daily allowance
02 One in four places to buy food are fast Our choices are also influenced by the 10
food outlets – the lowest is 7% and the options available
PAGES
16-17
highest is 39% With commentary from Prof Graham MacGregor
We’re influenced by what’s available in
our local area 09 £££
07 Only 14% of ready meals have no meat
With commentary from Sadiq Khan
Many of the meal options available have a £££
PAGES
28-29
heavy impact on the environment 03
With commentary from Tony Juniper CBE.
08
03 The poorest 10% of UK households would 08 Obesity among children aged five is 2.2
need to spend 74% of their disposable times greater amongst the most deprived
PAGES
18-19
PAGES
32-33
5
income on food to meet the Eatwell Guide communities compared to the least 55
5
£
55
costs. This is compared to only 6% in the deprived ££
richest 10% Not surprisingly this impacts on our health,
When we decide what to buy, we’re especially if you’re struggling for money. 07
influenced by what we can afford. 04
With commentary from Prof Sir Michael Marmot
With commentary from Kathleen Kerridge
09 Children in deprived communities are
more than 1cm shorter on average than
PAGES
34-37
children in wealthy communities by the 06
04 17.6% of employees of the food industry
time they reach age 11 05
earn the minimum wage, compared to 7%
PAGES
20-21
With commentary from Shirley Cramer CBE
of workers across the UK
Ironically the people who work in the food
industry are typically on very low wages 10 In the last eight years the number of
diabetes-related amputations has risen by
With commentary from Lord David Willetts
PAGES
36-37
25%
With commentary from Tom Watson MP
2 The Food Foundation The Food Foundation 3
Thank you
This report has a wide range of contributors who are credited throughout.
We are hugely grateful for their collaboration with the Food Foundation on
this report. The following organisations have contributed:
The report has also benefited from expert advice from Dr Caroline Hancock at Public Health England
and John Lomas from National CardioVascular Intelligence Network (NCVIN) Public Health
England, Emma Coles, Nick Jones, and Debbie Bremner and Hannah Dineen at Nielsen AdDynamix.
We are extremely grateful for the funding we have received from the Health Foundation for the
production of the report and to the Nuffield Foundation and Esmée Fairbairn Foundation for their
long-term support to the Food Foundation.
4 The Food Foundation The Food Foundation 5
Foreword by Our Trustees
Food Foundation Laura Sandys
(Chair)
Baroness Rosie
Boycott
Tom Lindsay Prof Sir Charles
Godfray
Trustees
David Edwards Prof Sir Michael Pat Biggers
We established the Food Foundation in order to face hunger? Not keeping our eye on food- Marmot
examine the UK food system and to unpick some related public policy has caused the numbers of
of the underlying policy reasons for its failure to people facing food poverty to soar.
deliver the necessary public goods. The statistics
• 10% of children are estimated to be living in
are not encouraging…
households facing severe food insecurity
• 10% of five-year-olds are obese
• 16% of adults report skipping meals because
• 20% of 11-year-olds are obese of lack of money
• 3.1 million people are registered with
diabetes, up from 2.4 million in 2010
• 3.7 million children are living in
households for whom a healthy diet is
Our Team
unaffordable.
• There were 9,000 amputations due to
diabetes last year, up from 7,227 in 2010. We are therefore very proud to be publishing
our first annual ‘State of the Nation’s Food
In any other area of public life these figures
Health’ report, The Broken Plate. This will
would have caused a national scandal. However,
map the key metrics on the ‘health’ of our food
over the last 20 years, public
system annually, with recommendations for
Anna Taylor, Pandora Haydon, Jo Ralling,
policy has withdrawn from Executive Director Communications Head of
In any other area of public the food sector. These
how these should drive action from industry, Manager Communications
the Government and the third sector. Ensuring
life these figures would have shocking statistics should that the next generation is healthy and capable
demand policy makers re-
caused a national scandal. engage with the food system
of securing good nutritious food is crucial to
any society. The Broken Plate establishes the
and address these life-
UK’s current baseline. Its stark figures show how
changing (and potentially
much action will be required in order to realign
life threatening) outcomes.
the system with the outcomes which we all value
The health implications are compounded by – our health and wellbeing.
the significant and growing number of children
facing food poverty. Food insecurity has gone
We look forward to working with policy makers, Dr Courtney Scott, Will Nicholson, Cat Kissick,
industry and the public to ensure that each year Research and Policy Project Lead: Plating Research and Policy
unacknowledged until very recently. In the fifth
we can measure improvements – we all have a Adviser up Progress Advisor (Maternity Cover)
biggest economy in the world, how can children
lot to do!
6 The Food Foundation The Food Foundation 7
Our key findings
• Unhealthy foods are three times cheaper than What must be done
healthy foods, calorie for calorie (page 22).
• The Government’s recommended diet would The Government has started to take this challenge seriously.
require the poorest 10% of households to spend
and action
three quarters of their disposable income on food in • It has introduced the sugary drinks levy which has
order to afford it (page 16). helped to drive vast quantities of sugar out of our drinks.
• Many of the people working in the food system are • It has set targets for reductions in sugar for a
themselves struggling to put food on the table due number of other food product categories, though
to low wages within the food sector compared to progress is patchy.
recommendations
other sectors of the economy (page 18). Moreover, • It is proposing to tighten the rules on junk food
people working for food companies top the list of advertising and promotion (and Sadiq Kahn’s
those seeking payday loans. commentary on page 15 shows that the Greater
London Authority has already taken action) as well
as improving labelling.
The short- and long-term health
consequences are profound These are all vitally important steps but are in danger of
being too little too late. Moreover, in spite of an ambition
• Childhood obesity rates are double among poorer to reduce inequality in rates of childhood obesity, there
children (Page 30), and children in poorer areas is no target to drive action and very little provision for
Overview Are we really free to make don’t grow as well (page 32). households on a low income who can’t buy their way out
healthy choices? of the problem.
In the last 70 years the food system in Britain has • In later life the consequences are devastating.
evolved into a highly efficient, hi-tech, profitable Amputations due to diabetes complications have On the following page, we outline our recommendations
and interconnected web of companies which Our starting point, building on the Food gone up by 25% in the last eight years (page 34). for the Government.
does a remarkable job of bringing tasty food Foundation’s first report Force-Fed,
onto our plates at very low prices. It has become challenges the notion that we are all free
highly adapted to the demands made by our to choose a healthy diet if we want it. Our
market economy: greater and greater efficiency evidence shows that unhealthy options are
leading to increasing consolidation in both retail widely available, attractive and affordable;
and fast food, driving high volume on relatively and people’s choices are restricted and
low margins. manipulated.
But the outcomes of this system are wreaking • Food and drink advertising is
havoc on our health and on our disproportionately focused on
planet. The Broken Plate is the unhealthy foods (page 12).
Our evidence shows Food Foundation’s annual “State • One in four of all food vendors
that unhealthy options of the Nation’s Food Health” sell primarily unhealthy fast food
reporting on 10 key metrics (or
are widely available, vital signs) by which the health
(more than a third in some poorer
neighbourhoods) (pages 14-15).
attractive and affordable; outcomes of the food system
can be measured. We have a • Options available to us in two key
and people’s choices special focus on children and categories (breakfast cereals and
are restricted and the impact of their current diets ready meals) are skewed in favour of
less healthy options, which carry a
manipulated. on their health trajectory. These
higher carbon footprint (pages 24-25
vital signs will be published
every year to assess progress or deterioration. and 26-27).
We hope that like us, you will help monitor
these key indicators and work with us to deliver The discrepancies in cost
a food system that our society and our planet between heathy and unhealthy
deserve. We all know that there is not one silver
bullet, but this health disaster needs a range of food are stark and affect what
policies and measures taken by government, people living in poverty can
industry and society, and these are what we will afford.
be advocating for in 2019.
8 The Food Foundation The Food Foundation 9
These four clusters of action tackle the current situation:
1 Fix the price fix
•• Put in place a range of fiscal and
incentive measures which tip the
2 Address affordability
•• Use the Government’s costing of the
Eatwell Guide as the reference point for
balance of costs in favour of healthy food welfare payments by legally enshrining
including further expanding the sugar tax the cost of healthy living in social security
legislation
•• Re-design VAT on food to favour
healthier and more sustainable choices •• Expand and develop incentives such
as Healthy Start and the School Fruit
•• Stop price promotions on unhealthy food
and Vegetable Scheme to help tackle
•• Ensure that retailers (and fast food the affordability problem for those on a
chains) commit to make healthier low income. These schemes could be
products always cheaper than unhealthy expanded along with free school meals
products within specific food and drink and new schemes could be introduced,
categories drawing on international experience
•• All major food businesses should move to At the same time we need action to incentivise new
pay the Real Living Wage
ways of doing business within the food system by:
3 Swap the sparkle
•• Stop all forms of marketing of unhealthy
food to children and instead channel
this creative energy into healthy foods.
4 Ration the junk
•• Use the new calorie labelling scheme
for food eaten out of the home to
develop a healthy rating scheme to link
5 Harnessing the power
of public procurement 6 Innovating with
investors
•• Ensure that publicly procured food •• Use policy measures to stimulate investors
This can be achieved by tightening the with the existing hygiene rating. This to see the materiality of shifting their
sets the standard for healthy and
current regulations on advertising (digital should in turn, be linked to business finance into businesses which have a
sustainable diets
and broadcast) but also expanding these rates to incentivise the shift to healthier better scorecard on supporting healthy and
to cover sports sponsorship, marketing menus prioritising the most deprived •• Food eaten in schools, hospitals, care
sustainable diets. They have a critical role in
on packaging and in store and the neighbourhoods homes, prisons and the military not only
helping to reshape the food industry
banning of unlicensed characters on represent a huge volume but a huge
•• Ensure that all major food and drink •• Support new and healthy business models
unhealthy foods opportunity to show what good food is
categories in retail settings have at including creating new markets for surplus
•• Include public funding for marketing of least 50% of their products falling within •• Delivering meals which are in line with the
fresh produce which is currently wasted
fruit and vegetables within the scope of healthy thresholds (e.g. no red traffic Eatwell Guide should be mandatory for all
or given away; increasing investment in
the new agriculture policy lights, at least one of your five a day etc). publicly procured food even if this costs
R&D; cold chain, sustainable packaging
The same should apply to menus for food more. These changes would help to drive
which could reduce price points for fresh
on the go and food eaten out system wide change
produce, or harnessing technology to link
producers and consumers with shorter,
less carbon intensive supply chains for
fresh fruit and vegetables
10 The Food Foundation The Food Foundation 11
7
Step up and
show leadership
Ultimately, we need systemic change which the notion that they are simply meeting
reorients the entire business model driving customer demand, and have overlooked the
the food system, employing everything from critical role which they play in shaping that
farming subsidies, business rates, licensing demand. We show in a case study (page 29)
rules, taxes and marketing restrictions. This that a supermarket chain in the Netherlands
can only be realistically achieved by a bold has unilaterally decided to de-list all products
vision from the Government, and cross- which are marketed for children within their
departmental policies and programmes which store, immediately removing a large number
create new incentives for the private sector. of the unhealthier products. This is the sort of
leadership we need in the UK.
While government policy has a critical role to
play in creating a level playing field in what is We’re in need of radical change. We will
a very competitive sector of industry, we are track the vital signs in this report every
also in desperate need of business leadership. year to see whether that change is indeed
For too long, businesses have hidden behind being delivered.
12 The Food Foundation The Food Foundation 13
THEME METRIC
Amount of money spent advertising
unhealthy food vs amount spent on
THE WORLD AROUND US
01 advertising fruit and veg
DATA EXPLANATION
BY CAT KISSICK
Commentary by
Advertising
How we got the data
The Food Foundation analysed data on
advertising spend in the UK during 2017 for
Hugh Fearnley
food and soft drinks (Nielsen AdDynamix, 2018),
covering advertising in cinema, direct mail, door
- Whittingstall
drops, outdoor, press, radio and TV. We calculated
the percentage advertising spend on fruit and Hugh Fearnley-Whittingstall is an award-winning writer, broadcaster
vegetables, confectionary, sweet and savoury and campaigner, widely known for his uncompromising commitment to
snacks and soft drinks. Our analysis indicates that
the amount of money spent on fruit and vegetable
sustainable and ethically produced food. He has earned a huge
46% of food and drink advertising goes on advertising is negligible, compared with that following through his River cottage TV series and books, as well as for
confectionary, sweet and savoury snacks and soft spent on unhealthy foods such as biscuits, cakes, Britain’s Fat Fight (BBC1) and environmental campaigns such as Hugh’s
crisps and sugary drinks. Fish Fight, and Hugh’s War on Waste, which brought about changes in
drinks; while only 2.5% goes on fruit and vegetables law at a European level.
In 2017, over £300 million worth of advertising
was spent on unhealthy food products,
compared to £16 million spent on fruit and What we’re eating in the UK is killing aggressively (why not?) sell healthy
vegetables in the UK. Soft drinks alone make us. Almost two thirds of adults in foods. Fruit and vegetables are not
up 11% of the food and (non-alcoholic) drink England are overweight or obese, and ‘owned’ by massive global brands, so
advertising spend, equating to £72 million. obesity sharply increases the risk of anyone is free to sing their praises (see
Annual food and drink advertising spend in the UK Evidence suggests that food environments
influence dietary choices, preferences and
ill health and early death. And with
80% of children and 95% of adults
the Veg Power case study on page 21).
This means everyone who wants to
eating behaviours (Cairns et al., 2013). With and teenagers not eating enough support this initiative can get involved,
unprecedented levels of childhood obesity in vegetables, it’s no wonder that we’re whether corporately, or personally.
Soft drinks Confectionary the UK, there is an urgent need to rebalance on track for half of all children to be
£72,888,087 £119,406,521 food and drink advertising by increasing the obese or overweight by 2020. At the same time we must continue
to urge the Government to restrict
promotion of fruit and vegetables and placing
advertising restrictions on unhealthy products. We are not to blame as individuals advertising of unhealthy food. So far
for these horrendous statistics. A they’ve been slow to act. But there
Advertising spend on fruit and vegetables is partly big part of the problem is that we’re are indications that the sea change
so low because producers have very small margins, bombarded with adverts for unhealthy we so urgently need might at last
leaving little finance available for investment. products that are high in fat, salt and be coming. The Mayor of London’s
Low margins are driven by the fact that almost sugar. The advertising used to pitch ban on junk food advertising across
all vegetables are sold through supermarkets, junk food and snacks at us is highly the TFL network will undoubtedly
which operate in an extremely competitive effective – hardly surprising when have an impact on the health of
11% 18%
environment. Furthermore, there are very few you consider it’s the result of £300 the city. But that’s just one city.
brands of vegetables, so any single producer group million worth of investment from And the recent Childhood Obesity
investing in advertising will be benefiting the food companies in the UK. Those Strategy’s proposal to prohibit junk
whole market and not just their share. companies – and our Government – food advertising on television before
really should be thinking about the the 9pm watershed suggests the
Advertisement of foods high in fat, salt and/or detrimental effect of their products on Government might at last be ready
sugar (HFSS) is currently restricted both online public health. to put the health of our kids above
and on television on channels and in time slots the profits of the big food companies.
The good news is that there’s Those proposals need to become
which are dedicated to children. There are, something we can do about the
however, lots of loopholes, and children’s exposure actions, without delay.
Fruits and vegetables Sweet and savoury snacks to advertising of junk foods and their associated
problem. Currently, only 2.5% of
advertising spend is going on fruit It’s within our reach to change the
£16,290,525 £111,413,680 brands remains high (Whalen et al., 2017). and vegetables. It’s time to shout loud system for the better: let’s all play our
about how great these fresh foods are, part in rebalancing food advertising,
The Government is considering extending the and how important it is for families to give everyone a better chance of
current ban on TV of HFSS advertising to include to buy, cook and eat more of them appreciating fruit and vegetables –
all programmes on air before 9pm (and considering every day. We can use the power and living longer, healthier lives.
measures for digital advertising). Additionally, of marketing, and social media, to
the Mayor of London has introduced advertising
restrictions across Transport for London’s network
to reduce exposure to advertisements for HFSS
foods and non-alcoholic drinks (see page 15). And The good news is that there’s something
2.5% 17%
in parallel we have worked with others to launch
the Veg Power advertising fund for vegetables (see
we can do about the problem. Currently,
page 21), which will use the power of advertising only 2.5% of advertising spend is going on
to inspire greater consumption of vegetables,
launching its first campaign in partnership with
fruit and vegetables. It’s time to shout loud
ITV in 2019. about how great these fresh foods are.
Advertising media type: Cinema, Direct Mail, Door Drops, Outdoor, Press, Radio, TV (January 2017 – Dec 2017)
Data kindly supplied by Neilsen AdDynamix
Data kindly supplied by Neilsen AdDynamix
14 The Food Foundation The Food Foundation 15
THEME METRIC
Proportion of food outlets that sell
THE WORLD AROUND US
02 fast food
Places
DATA EXPLANATION
BY DR TOM BURGOINE
to buy food
We used the Ordnance Survey’s Points
of Interest (POI) dataset, for June 2018
(Ordnance survey, 2018a).
The dataset contains information from over
Commentary by
170 suppliers, and is one of the most complete
sources of food outlet locations available
Sadiq Khan
in England (Burgoine and Harrison, 2013).
We extracted data on the locations of cafes, Sadiq Khan has been Mayor of London since 2016. Over the last several
convenience stores, restaurants, supermarkets, years, he has made it part of his mission to reduce childhood obesity
specialty and takeaway (‘fast-food’) outlets
and promote healthy eating across the capital.
(Ordnance survey, 2018b). We combined POI
One in four places to buy food are fast food outlets classes ‘fast food and takeaway outlets’, ‘fast
food delivery services’, ‘fish and chip shops’ Food has a major impact on the As part of our London Food Strategy,
and ‘bakeries’ as takeaways (Food environment health, happiness and prosperity of us we’re working to improve London’s
assessment tool, Feat, www.feat-tool.org.uk), all. That’s why I want every Londoner food environment. This includes
2018). We calculated takeaway food outlets as to have access to healthy, affordable restricting new takeaways from
a proportion of all food outlets (%) within local food – regardless of where they live, opening within 400 meters of any
authorities. Local authority deprivation scores their personal circumstances or school. We’re also working with
were from the Index of Multiple Deprivation income. Yet this is far from the case at partners through the Healthier
Fast food outlets as a proportion of all 2015 (Department for Communities and Local
Government, 2015).
the moment. Catering Commitment to help
existing takeaways make their menu
food outlets by local authority The average takeaway food outlet proportion
London has one of the highest
childhood obesity rates in Europe,
healthier. We’re supporting local
councils to improve their retail offer
Densest locations in a local authority is 25.1%. This is about a with almost 40% of children aged
10 and 11 overweight or obese. This
through Good Food Retail Plans. And
4% increase in takeaway proportion since we’re banning junk food advertising
1. Blackburn with Darwen June 2014. The map shows variation in this is not only unfairly harming the across the entire Transport for
proportion across local authorities in England, future life chances of many young London network to help address
39% ranging from 7% (Isles of Scilly) to 39% Londoners but placing pressure on London’s childhood obesity epidemic.
(Blackburn with Darwen). our already strained health service.
2. Hyndburn It’s also a social justice issue. The
I’m confident that these policies – and
On average, there is a trend for more deprived the many others we’re implementing
38.2% local authorities to have a greater proportion
evidence shows that it’s children in London – can make a real
from poorer areas of our city who difference. But we will never be able to
3. South Ribble of takeaway food outlets. If we rank all 326
local authorities by deprivation score from
are disproportionately affected, fix everything about our food system
with young people in Barking and
38.2% least to most deprived, an increase of 20
places is linked to a 0.7% greater proportion of
Dagenham almost twice as likely to
from City Hall. If we are to ensure
that everyone can access healthy,
takeaway food outlets. Compared to the fifth be overweight or obese as those from affordable food, we need to see bold
least deprived local authorities, which have Richmond. action from local communities,
an average proportion of 20%, the fifth most In a city as wealthy and prosperous as the food sector and all levels of
deprived local authorities have an average ours, it can’t be right that where you government.
proportion of 31%. live – or how much your family earns –
can have such a significant impact on
There is evidence linking greater exposure your access to healthy, nutritious food.
to takeaway food outlets, to the likelihood
of being overweight and obese (Burgoine et Doing nothing is not an option – we
al., 2014, 2018). Greater exposure to takeaway must make it easier for people to
food outlets in more deprived areas may be make healthier food choices.
contributing to observed socioeconomic
health inequalities.
Planners in English local authorities are In a city as wealthy and prosperous as ours,
6.5% - 19.5% increasingly implementing planning
regulations that limit growth in the takeaway it can’t be right that where you live – or
19.6% - 23.2% food sector, for example including exclusion how much your family earns – can have
zones around schools, and restrictions on
23.3% - 26.2%
the amount of retail frontage dedicated to such a significant impact on your access to
26.3% - 30.5% takeaway food (Cavill N and Rutter H, 2014). healthy, nutritious food.
There is often a focus on areas of perceived
30.6% - 39.0% need, such as in areas where current takeaway
food access is plentiful or where obesity levels
are high. These areas are often more deprived,
which may help to address inequalities.
Crown copyright and database rights 2019 (Ordnance Survey, 100025252). This material includes data licensed from PointX Database Right/Copyright 2019
16 The Food Foundation The Food Foundation 17
THEME METRIC
Percentage of disposable income which
AFFORDABILITY OF HEALTHY FOOD
03 is needed to afford the Eatwell Guide
for the poorest 20% vs richest 10%
Affordability DATA EXPLANATION
BY JENNY SUTHERLAND
of a healthy diet We used data on household income from the
Family Resources Survey 2016/17 (Department
for Work and Pensions, 2018) to look at the
affordability of Public Health England’s
Eatwell Guide, the Government’s official
guidance on a healthy diet (Public Health Commentary by
Kathleen Kerridge
England, 2018). Previous research has shown
for an adult to follow the Eatwell Guide, it
The poorest 10% of UK households would need to spend 74% of would cost them an estimated £41.93 per week
their disposable income on food to meet the Eatwell Guide costs. (Scarborough et al., 2016). We adjusted this
cost based on a household’s composition, as Kathleen Kerridge is a freelance writer and campaigner for food equality.
This compares to only 6% in the richest 10% well as economies of scale that might affect She lives in Southsea with her husband, children, and dog.
the overall cost1. The proportion of disposable
income (after housing costs were removed)
Buying food for the poorest 10% of was stressful. It was soul destroying
that would be used up by a healthy diet was
households is a challenge: healthy to have to walk past the vibrant
then calculated.
food can feel unattainable, an greens and bright reds of the fresh
impossibility. After I had made sure vegetables, heading for the marked-
These findings highlight the challenges
Proportion of disposable income* used up if the Eatwell Guide low-income households across the UK face in
the rent and bills were paid, what
I had left had to stretch to near-
down bread and reduced-stickered
foods. Vegetables were out of my
affording the Government’s recommendations
Cost was spent by all households, by income decile for a healthy diet. The poorest 20% of UK
impossible lengths. I would count it
an achievement if I managed to fill
price-range. They added to a meal, but
wouldn’t fill bellies and sustain us all
households would need to spend an estimated
the cupboards – with anything at all. for very long. Per pound in money, the
42% of their after-housing income on food in
74% order to eat the Government’s recommended
I searched for foods that would give
me the ‘most bang for my buck’. That
yield of vegetables and ‘good food’
wasn’t financially feasible.
diet, compared to just 8% for the richest 20% of
meant cheap food and starchy carbs.
households. The picture is very similar across Things become basic, on a basic
each of the four UK nations. Across mainland Europe, cheap foods income, with basic questions:
are healthy choices. It’s sensible that
The results of this research echo those from a kilo of tomatoes should be cheaper Will it fill a stomach? Can I afford to
previous studies in the UK and internationally. than a kilo of sausages. In the UK, buy it? Will the kids eat it?
One recent study looked at the affordability however, the opposite is true. There can be no risks, there can be no
of a “socially acceptable diet” as defined by waste, and above all, no hunger.
the Joseph Rowntree Foundation as part of To eat a healthy diet, the poorest 10%
establishing their Minimum Income Standard. of households need to spend three- I would like to see the UK take note of
quarters of their disposable income the European model. I think with food
They found that the proportion of families
to meet the Eatwell Guide costs. In education and more affordable fresh
spending less than the amount needed to
comparison, those in the top 10% need produce, we could turn the tide for
reach that diet has risen from 41% to 52%
only spend 6%. the poorest households and see us all
between 2005 and 2013 (O’Connell et al., 2018).
This problem is not confined to workless For me, struggling to feed my eating ‘well’.
households. Research from the Living Wage children after I had paid everything
Foundation found that 37% of working
parents who earn less than the living wage
29% have regularly skipped meals due to a lack of
resources (Living Wage Foundation, 2018).
Things become basic, on a basic income,
20% 21%
We think the Government should be actively
tracking the affordability of a healthy diet with basic questions: Will it fill a stomach?
18% by including analysis like ours in its annual Can I afford to buy it? Will the kids eat it?
15% Family Food Survey report. We also think
13% the Government should be gathering annual
11% 9%
data on household food insecurity using
the approach recommended by the United
6% Nations. This is important because it captures
people’s lived experience of food insecurity,
and allows them to track whether policy
measures are making a difference. Unless
we can see the problem by gathering and
Income decile presenting the data, we can’t solve it.
* After housing costs 1 Using the McClements equivalence scale
18 The Food Foundation The Food Foundation 19THEME METRIC
Percentage of employees in the
food industry who are paid the
AFFORDABILITY OF HEALTHY FOOD
04 minimum wage
DATA EXPLANATION
BY STEPHEN CLARKE
Wages Using data from the Annual Survey of Hours
and Earnings (ASHE), the largest survey
of employees in the UK, we analysed the
pay of people in the UK food industry. The
data shows that across the whole of the food
industry, which includes food manufacturing,
Commentary by
Lord David Willetts
wholesaling, retailing, catering and
agriculture, 1.4 million employees (46.5% of
the total) are low-paid, earning less than two- The Rt Hon Lord David Willetts is Executive Chair of the Resolution
17.6% of employees of the food industry earn the minimum wage, thirds of typical hourly earnings. Furthermore, Foundation.
compared to 7% of workers across the UK 520,000 people (17.6% of the total) are paid
the minimum wage. To put this in perspective
approximately 18.1% of employees in the UK We have made big strides in Boosting wages across the food
are low-paid and 7% are paid the minimum combatting low pay in the UK in industry will require concerted action
wage. recent years. The share of employees from government, businesses and
paid below two-thirds of the typical consumers. Government can boost
The prevalence of low-pay varies across hourly wage has fallen from 22% productivity by promoting innovation
different parts of the food industry. We
Percentage of employees in the UK paid below the real estimate that catering (bars, restaurants) has
in 2013 to 18% in 2017. Rises in the
minimum wage, particularly the new
by co-investing with business in
agri-tech. Government can also
the highest proportion of low-paid workers
Living Wage by industry (59.6%) while food manufacturing has the
National Living Wage (NLW) for
people 25 and over, have driven this
do more to ensure that changes
to the world of work, particularly
lowest proportion (24.8%). The most poorly decrease, with voluntary initiatives the rise of more flexible forms of
Agriculture & fishing Waiters paid occupations in the food industry are such as the ‘real living wage’ and a employment, benefits workers as
waiters (79.1% of whom are low-paid) and tighter labour market lending a hand. well as firms. Businesses need to take
kitchen staff (76.2%). Low-pay is incredibly Although more progress needs to a more proactive approach to staff
prevalent in such roles where between a
be made, we can take heart from development, boosting productivity
quarter and a third of staff are paid just the
this success. and paying higher wages. Finally,
legal minimum.
consumers need to be aware that
However, one area of the economy sometimes food is ‘good value’ or
Although the food industry has a higher-rate of where low-pay is still the norm is ‘affordable’ because of low wages or
low-pay than many other parts of the economy, the food industry. Almost half of all low prices paid to suppliers. In some
the situation has improved over the past few employees in the food and agriculture cases this may need to change.
years, particularly as a result of the introduction sector are low-paid, with almost one
36% 83%
and increased generosity of the National Living in five people in the sector earning Having witnessed the first sustained
Wage (NLW) (the minimum wage for those the legal minimum. More needs to decline in low-pay in this country
25 and over), and rises in the minimum wage. be done to make sure that the people since the 1970s, which has also been
In 2012 over half (56.3%) of employees in the who pick, cook and serve the food we felt in the food industry, we can take
food industry were low-paid, today this figure eat are paid a decent wage. Change is heart that change is possible. To
is 46.5%. The sharpest falls in the prevalence of possible: other advanced economies, ensure more rapid progress in future,
low-pay have happened in the food wholesaling particularly many in Northern Europe, though, we must do more.
industry and amongst cashiers and kitchen combine lower rates of low pay and
staff. With further rises in the NLW planned in low unemployment. Productivity, and
the years ahead we can expect more progress, so wages, are higher in hospitality,
but to significantly reduce the prevalence of
Food retail Kitchen staff low-pay in the sector more is needed. More
food processing and agriculture in
the majority of Western European
firms should be encouraged to pay the ‘real countries.
living wage’ of £9.00 and £10.55 in London. At
the moment over half of people working in the
food industry are paid less than the real living
wage compared to around a fifth for the UK as
a whole. Firms should also be encouraged to
invest more in staff and automation, increasing Almost half of all employees in the food
skills, productivity and raising wages.
and agriculture sector are low-paid, with
almost one in five people in the sector
62% 81% earning the legal minimum.
Chart shows employees earning less than the Living Wage rate in their industry as promoted by the Living Wage Foundation. In April 2017, the London Living
Wage rate was £9.75 and the UK Living Wage rate was £8.45
20 The Food Foundation The Food Foundation 21CAS E ST UDY: CHILD HO OD OBESITY CASE STU DY: A DV E RTISING
Amsterdam Veg Power
KEY ENABLERS OF THE VEG POWER PARTNERED
AMSTERDAM HEALTHY WITH ITV TO CREATE A
WEIGHT PROGRAMME BOLD NEW CREATIVE CAM-
PAIGN TO INSPIRE CHILDREN
1.
STRONG VERTICAL
TO EAT MORE VEG
LEADERSHIP
2.
A T
‘whole-systems’ approach is years) (Obesity Action Scotland, 2017) he low level of advertising spend
COLLABORATIVE, CROSS-
DEPARTMENTAL APPROACH often highlighted as key to and there is a focus on both obesity on vegetables was a key problem
creating an environment that prevention and care as well as support highlighted by the national Peas
3.
STRATEGIC USE OF POWER
makes it easy for individuals to make
healthy choices at every opportunity.
We can learn from successful initiatives
for those who are already overweight
(The Centre for Social Justice, 2017).
Activities have included public drinking
Please initiative coordinated by the Food
Foundation, Nourish Scotland, Food
Sense Wales and WWF. Peas Please aims
AND INFLUENCE internationally, including the Amsterdam fountains, a ban on marketing unhealthy to drive up vegetable consumption in the
Healthy Weight Programme. foods at sports facilities, training UK by inspiring businesses and public
4.
CLEAR PARAMETERS AND
The programme was launched in 2013
in response to substantially higher rates
300 health ambassadors in different
neighbourhoods, healthy playgrounds,
authorities working right across the food
system to take action to make it easier
EXPECTATIONS of childhood overweight and obesity partnerships with food businesses for everyone to eat veg. But we know that
compared to the Netherlands national and specific treatment for obese demand needs to keep pace with supply
5.
AN ACADEMICALLY RIGOROUS
average, with certain groups such as low-
income children and those from migrant
and minority ethnic backgrounds
children (Amsterdam Healthy Weight
Programme, 2017).
if real change is going to happen, and
so at the first Veg Summit in October
2017 we launched a competition for ad
BASIS FOR ACTION particularly affected. Although there are no evaluations agencies to develop a veg advert aimed
directly linking Amsterdam’s Healthy at children. The shortlist was judged by
6. The programme’s whole-system Weight Programme to changes to the legendary ad man Sir John Hegarty om deep unde rground...
CULTURE OF REVIEWING, approach ensures consistent childhood obesity, the prevalence of and TV presenter and food campaigner They come fr
MONITORING AND messages are delivered by politicians, overweight children in Amsterdam Hugh Fearnley-Whittingstall. The
REFLECTIVE ACTION local authorities, schools, medical dropped from 21% in 2012 to 18.5% in winning advert was displayed in over
professionals, planning bodies, sports 2015, with the biggest decrease among 5,000 locations around the country
7.
CREATIVE APPROACH TO
organisations, communities, charities
and the business sector to ensure all the
children with a low socioeconomic
status (Amsterdam Healthy Weight
and features on the BBC documentary
Britain’s Fat Fight.
range of donors including Tesco, Birds
Eye, Sodexo, the National Farmers
Union and a large number of public
January 25th 2019 and will make use of
£2 million of donated media space on
ITV, backed by a unique alliance of all
complex and multifactorial determinants Programme, 2017). Recent reviews of the
ADDRESSING BARRIERS donations through a crowdfund the major supermarkets and Birds Eye. It
of childhood obesity are covered. Areas programme emphasise how factors that Together with Peas Please, John and
with the highest childhood obesity have been important to the programme’s Hugh constructed a plan to develop an reaching more than 10 million people is an entirely fresh approach to inspiring
rates have been targeted with specific success can be replicated elsewhere: advertising fund for vegetables called on social media. Having successfully veg consumption which makes eating
programmes for high risk schools, ethnic strong political leadership and a shared Veg Power, and we set a target to raise reached our target, we were asked veg fun, and makes no reference to the
groups, neighbourhoods and parents. responsibility through cross-party, £100,000 and get a proof of concept by ITV to partner with them to run a health benefits. This is an unprecedented
Monitoring is frequent (children have cross-departmental and cross-sector stage underway, under the guidance national campaign to inspire children opportunity for advertising veg, and for
their height and weight measured 13 collaboration (Hawkes et al., 2017; The of an informal steering group. We to eat veg. The ITV campaign called testing the potential power of advertising
times between the ages of zero and four Centre for Social Justice, 2017). received contributions from a wide #EatThemToDefeatThem began on for inspiring children to eat their greens!
22 The Food Foundation The Food Foundation 23THEME METRIC
Price per kcal of unhealthy food
THE FOOD ON OFFER
05 vs healthy food
DATA EXPLANATION
BY CAT KISSICK
Food prices
Building directly on the work conducted by
CEDAR at Cambridge University we matched
price data for 94 foods and drinks tracked by
the UK Consumer Price Index (CPI) to food
and nutrient data from the UK Department of
Commentary by
Health’s National Diet and Nutrition Survey,
producing a graph for the period 2007–2017.
Jamie Oliver
Each item was assigned to a food group and
categorised as either ‘healthy’ or ‘high in fat, Jamie Oliver is a chef and campaigner. During a 20-year television and
salt and/or sugar (HFSS)’ using the nutrient publishing career he has inspired millions of people to enjoy cooking
Unhealthy foods are three times cheaper than healthy foods profiling model developed by the Food from scratch and eating fresh, delicious food. Jamie has committed
Standards Agency (Jones et al., 2014). The
CPI data does not capture all price reductions his business to work towards the goal of halving the rate of childhood
from promotions, though we know that obesity by 2030.
unhealthy foods tend to be promoted more
than healthy foods (Which?, 2016). Using price
per kilocalories is a helpful way to understand Cheap as chips: What’s the price tag Walk into any UK supermarket and
the relative prices of foods which make up on healthy eating? you’ll see all the price reductions
– ‘buy one, get one free’, or ‘two for
Price per kcal of unhealthy food compared to healthy food whole diets, rather than comparing individual
products within specific food categories You’re hungry, fancy a snack and one’ – on unhealthy food. When was
(Monsivais, Mclain and Drewnowski, 2010; are on a tight budget – what do you the last time you saw those sorts of
Drewnowski, 2011;). choose: a punnet of raspberries for promotions on affordable healthy
Healthy Unhealthy (HFSS) £3 or two chocolate bars for £1? Yeah, family meals?
For the last 10 years, the mean price of healthy I know, that’s not a fair question, is
food has consistently been greater than it? And that’s the point – the price of But it doesn’t have to be this way.
the mean price of HFSS food, peaking at our food can push us to eat and drink These promotions are organised
8 £7.80/1,000kcal for healthy, and £2.43/1,000kcal unhealthy options. by supermarkets and paid for
for HFSS in 2013. Between 2007 and 2013 the by manufacturers. It’s a tactic to
price differential between healthy and HFSS It’s not a fair playing field. Public influence what we buy. And it works.
food grew. While this difference declined Health England has found that But why can’t we use these powerful
7 somewhat in the subsequent three years, it is higher-sugar food and drink items
are more likely to be promoted, and
tactics to create a level playing field,
and give healthy food a bigger voice?
now rising again. The recent levy on sugary
drinks may start to affect this which would be are more heavily promoted. And right
welcome news, and the Government’s current now, Year Six kids in England from Last summer, the Government
6 proposals to consider restriction on the deprived backgrounds are twice as
likely to be obese compared to their
committed to halving childhood
obesity by 2030. To make that
promotion of HFSS foods could also positively
affect relative prices. better-off peers. happen, we need to look closely at
precisely why poorer kids are twice
5
£/1000 kcals
Despite a steady increase in price for HFSS We need to talk about why health as likely to have obesity. To me, the
foods, the price difference between healthy comes with a price tag. We can most imperative part of the solution
and HFSS foods is bad news for the health change this crazy situation! is to make healthy convenient food
of the UK population. The negative impact more widely available and much
4 will be greatest for those from lower socio- For the last 10 years, the cost
of healthy products has been
more affordable. We need to listen
to organisations like the Food
economic backgrounds, where price is a
stronger driver of food choice, but for whom consistently higher than less healthy Foundation campaigning for change.
convenience is also important. The figures ones. New research shows that on The health of your child shouldn’t
3 suggest that for those with limited budgets the average unhealthy products are three
times cheaper, calorie for calorie.
depend on how much money you’ve
got in your pocket.
current food system incentivises the purchase
of HFSS food, exacerbating social inequalities
in health.
2
We need to look closely at precisely why
1 poorer kids are twice as likely to be obese.
The health of your child shouldn’t depend on
how much money you’ve got in your pocket.
0 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
year
24 The Food Foundation The Food Foundation 25THEME METRIC
Proportion of breakfast cereal
THE FOOD ON OFFER
06 range which is low in sugar and salt
Products with too DATA EXPLANATION
BY KAWTHER HASHEM
much sugar We present here the results of a survey on
breakfast cereal products with packaging
that may appeal to children conducted in
November 2018 by Action on Sugar and
Commentary by
Prof Graham
Cereals
Action on Salt. All major supermarkets were
visited: Aldi, Asda, the Co-op, Lidl, Marks
& Spencer, Morrisons, Tesco, Sainsbury’s
MacGregor
and Waitrose. A total of 77 products met the
inclusion criteria. Graham MacGregor is a Professor of Cardiovascular Medicine at the
Wolfson Institute of Preventive Medicine (Barts and The London) and
38 out of 77 products received a red label, 37
Half of breakfast cereals marketed to children are high received an amber label and only two received
Honorary Consultant Physician at Queen Mary, University of London.
in sugar, and for these cereals a single serving would a green for sugar per 100g. The recommended
He has published more than 500 refereed scientific articles on various
serving size ranged from 30 to 45g. 84% of aspects of blood pressure, cardiovascular medicine and nutrition and
make up a third of a child’s daily sugar allowance products state a typical serving is 30g. public health.
For the products high in sugar a single serving
would make up over a third of a child’s daily The Global Burden of Disease shows in the UK diet (75%) comes from
allowance (19g). 65 products (84%) contain that the consumption of products salt added by the food industry to
more than one teaspoon of sugar per serving. high in fat, salt and/or sugar are by processed food or food eaten out of
Of these, 25 products (32%) contain more than far the biggest cause of premature the home. As a result, many people
Breakfast cereal products two teaspoons of sugar per serving, which is death and disability (IHME, 2017).
In the UK, two thirds of calories
do not realise they are eating too
much salt and remain unaware of
over 40% of a child’s (aged four to six years)
with packaging that may daily allowance. consumed by families come from
highly processed packaged foods,
the effects it is having on their blood
pressure and health. Our high sugar
appeal to children... For salt, one out of 77 received a red label, which are likely to be high in fat, intake is contributing to increasing
65 received an amber label and 11 received a salt and/or sugar (HFSS) and low risk of overweight and obesity, Type 2
green label for salt per 100g – i.e. the majority in fibre, fruit and vegetables. The diabetes and tooth decay.
of cereals had enough salt to provide about diets of UK children are particularly
3% or more of a child’s daily allowance in a worrying, where 47% of primary There are thousands and thousands
serving. school children’s calories come from of packaged processed products on
Sugar Salt Fibre HFSS foods, 85% of secondary school supermarket shelves that can be
86%
We created a scoring system for fibre: children are not eating enough fruit improved. One of our leading calls to
and vegetables, more than 90% are government has been to put in place
• ≥ 10g fibre per 100g received green light not eating enough fibre. All are a robust reformulation programme
49% 48%
• ≥ 5g and < 10g fibre per 100g received eating too much salt and sugar.(Food to get food and drink companies to
amber light Foundation, 2016; PHE, 2018). gradually improve the nutritional
• < 5g fibre per 100g received red light profile, by reducing salt, sugar
At the same time the UK has one of and saturated fat content in their
Five out of 77 products received green light. the highest overweight and obesity products.
35 products received amber light and 37 rates among developed countries.
products received red light for fibre per 100g. The UK currently spends about £6.1 Children’s breakfast cereals are
This means that only 8% of cereals had 3.3g or billion a year on the medical costs often promoted as a healthy and
more of fibre in a portion (which is only 17% of of conditions related to obesity and easy breakfast option, but as you
what a child (aged 5-11 years) needs each day). overweight (PHE, 2017) and more can see from the data, there is plenty
than £14 billion in treatment of Type of space for improvement. Not just
The recommended fibre intake for a child aged 2 diabetes (Cost of Diabetes, 2019). changing the nutritional profile of
5-11 years is 20g per day. We are told breakfast Neither of these two figures include these products but also making high
cereals are a primary source of fibre. However, the social cost, which is estimated fibre, low salt and sugar breakfast
worryingly 75 products (97%) contained 20% at £47 billion (McKinsey Global cereals more appealing to children,
High in sugar High or medium in salt Low in fibre or less of the recommended daily requirement Institute, 2014). by removing all the children-friendly
of fibre per serving and only one product cartoon characters from unhealthy
provided more than 30% of recommended Our high salt intake raises blood products and putting them on more
Sources daily requirement of fibre. pressure. Raised blood pressure is nutritionally balanced products. This
the single biggest risk factor for is a challenge that the food industry
Scoring system for sugar: Scoring system for salt: Scoring system created for fibre:
We found only two products with packaging cardiovascular disease, including must meet over the next few years.
> 22.5g sugars per 100g received red label >1.5g salt per 100g received red label < 5g fibre per 100g received red light
that may appeal to children have green front stroke and heart disease, which are
< 5g sugars per 100g received green label ≤ 0.3g salt per 100g received green label ≥ 10g fibre per 100g received green light
of pack labels for sugar and salt. the leading causes of death and
disability in the UK. Most of the salt
Coloured labels based on the criteria from the Department of Health colour-coded nutrition labelling system: https://www.food.gov.uk/
sites/default/files/media/document/fop-guidance_0.pdf
Department of Health for salt and sugar criteria: https://www.food.gov.uk/sites/default/files/media/document/fop-guidance_0.pdf
26 The Food Foundation The Food Foundation 27THEME METRIC
Proportion of ready meal range And our choices are also influenced
THE FOOD ON OFFER
07 which is vegetarian
by the options available.
DATA EXPLANATION
BY SIMON BILLING
Products with too little veg Nine out of ten of us in the UK eat ready meals
from supermarkets and a third of us eat them
at least on a weekly basis (Mintel, 2017). Commentary by
Tony Juniper
Ready meals Eating Better surveyed 1,350 ready meals
(April-May 2018, all those available online
and in large store visits) in ten supermarkets:
Aldi, Asda, the Co-op, Iceland, Lidl, Marks & Tony Juniper CBE is a campaigner, writer, sustainability adviser and a
Spencer, Morrisons, Sainsbury’s, Tesco and well-known British environmentalist. He is now the Executive Director
Waitrose. We included both own-brand and of Advocacy & Campaigns at WWF. For more than 30 years he has
branded meals, chilled and frozen options,
which were all designed to be eaten as a hot worked for change toward a more sustainable society at local, national
Only 14% of ready meals have no meat main meal. and international levels. Tony speaks and writes widely on conservation
and sustainability themes and has authored many books, including the
We wanted to find out how far supermarkets
are providing options for those wanting to eat multi-award winning bestseller ‘What has Nature ever done for us?’
less meat and dairy foods, and whether the published in 2013.
meat sourced is produced to higher welfare
standards. The production, distribution and
consumption of food generates some 30% The most significant single factor two billion biggest consumers cut
of global greenhouse gas emissions, uses now impacting our planet’s web of life their meat and dairy consumption by
In a survey of 1,350 ready meals on offer in the UK... 70% of our global water supply, and is a key
source of damaging pollutants in soils, air
is the manner in which humankind
feeds itself. The WWF living planet
40% then we would free up an area
of land twice the size of India. On
and waterways. Agricultural production takes report published last year revealed top of the impacts on ecosystems
up to 40% of the earth’s surface and as such the shocking fact of how vertebrate and the climate, the current high
is the main cause of habitat destruction and populations have declined on average consumption of livestock-derived
associated biodiversity loss. The rearing of by 60% since 1970. Two thirds of this foods also runs against health advice,
farm animals accounts for about 15% of all rapid and drastic decline has been with many consumers eating far more
global greenhouse gas emissions (i.e. half of caused by our food system. On top meat and dairy products than is good
14%
food related emissions) and utilises about of the profound impacts on wildlife for them.
three quarters of all agricultural land. populations, our food system is
also responsible for about a third That only 14% of ready meals offer
We found that meat is still the main ingredient a meat-free option is extremely
of greenhouse gas emissions. The
meat-free in 75% of ready meals surveyed, with chicken
conclusion that must be drawn from concerning. An increasing number
featuring in half of these meals. Only 14% of of consumers are looking to change
the ready meals were vegetarian or vegan with these and other findings is at one
level quite simple: we must stop their diets to benefit their health
the best choice in Waitrose and worst choices and the planet’s, and manufacturers
in Asda, Morrisons, Lidl, Iceland and Aldi. eating like this.
and retailers are evidently behind
86%
Ninety percent of the vegetarian ready meals
One key question relates to the curve of shifting demand.
were cheese-based and on average higher
demand for protein. The impact Considering what we now know about
in calories, saturated fats and salt than the
meat-based options. We found that some, but of animal protein-based diets on the pressures on our planet, and
not all supermarkets were selling vegetarian land, freshwater and climate is on indeed some troubling public health
meat and fish and vegan ranges at a premium over their full average much greater than that of trends, it is vital that retailers and
range, on average 14% more. Eight out of ten plant-based diets. For example, in food companies take responsibility
of the meals labelled within healthy ranges tropical regions the cultivation of for their offerings. We must also
contained meat, often red and processed. The soya to supply animal feed in meat encourage policymakers to help
World Cancer Research Fund advise eating ‘no and dairy supply chains drives the agriculture restore the environment,
more than moderate amounts of red meat’ and conversion of natural habitat. This whether through ambitious
eating ‘little, if any, processed meat’. is one major factor contributing to environmental policies and the
continuing tropical deforestation switching of farm subsidies, or via the
Globally, meat production accounts for... We’re asking supermarkets to increase
the number of plant-based and healthier
over an area the size of England
annually – 150,000km². The impact
management of global supply chains,
so that consumers in one part of the
vegetarian ready meals. We want to see of our Western diet, rich in animal world don’t contribute to ecological
these options priced comparatively to meat,
products, is so great that one leading devastation elsewhere.
and price promotions and support instore
study estimated that if the world’s
and online to encourage people to try these
75% 15%
options. On the meat ingredients we want
to see labelling of the source of meat, and
commitment to UK sourcing and higher
animal welfare standards. We’re encouraging
Consumers are looking to change their diets
Agricultural land Greenhouse gas emission
the public and their families to try swapping to benefit their health and the planet’s, and
meat for vegetarian and vegan ready meals, or
better still, to prepare your own. manufacturers and retailers are evidently
behind the curve of shifting demand.
28 The Food Foundation The Food Foundation 29You can also read
