Healthy Eating Revolution for Scotland’s Hospitals

Royal Voluntary Service logo


Our Guest Blogger, Andrew Roberts is the Business Enterprise Manager for the Royal Voluntary Service and leads the charity’s Healthier Choices programme. He worked closely with Scottish Government and NHS Scotland on the development and introduction of healthy eating criteria for retail outlets in healthcare settings. He is also part of the HRS Implementation Group and chairs the Healthy Living Award Stakeholder group.

How the Healthcare Retail Standard helped the Royal Voluntary Service transform its retail outlets into hubs for healthy eating

The Healthcare Retail Standard (HRS) was introduced with the aim of transforming the retail food environment in healthcare settings in Scotland. The HRS aims to change the provision and promotion of foods to deliver healthier food choices to customers. A number of partnerships were formed to take this forward and now 100% of premises in Scotland comply. In this blog we hear from The Royal Voluntary Service (RVS), the biggest hospital retailer in Great Britain about how they took on the challenge.

Healthy shopping basketDiet is vital to good health. That’s why it’s somewhat ironic that hospitals aren’t always the healthiest places to buy food and drink. We know through research that NHS hospital staff find it difficult to make the healthy choices they want:

  • 41% of Scottish hospital doctors and nurses told us they eat one or no pieces of fruit and veg during a typical working day
  • 14% said they have a poor diet
  • 74% wanted to see healthier options introduced into their hospital workplace
  • 63% believed this would have a positive effect on their overall diet.

Improving NHS Workforce Health

Workforce health is a major priority for NHS Scotland so it’s important that food and drink options are healthy and nutritious. As the biggest hospital refreshments retailer in England, Scotland and Wales (our volunteer-led retail operation spans 400 shops, cafes and on-ward trolley services, including 76 sites in Scotland, which fund the charity’s wider work enriching the lives of over 100,000 older people every year) and with a long relationship with the NHS, we knew this was a problem that we could help tackle.

In 2016, after much planning, we took a major strategic decision to transform our entire hospital retail estate into hubs for healthy eating. We would do this by improving and increasing the range of healthier choices available to NHS staff, visitors and patients in the hospitals we operate in.

The starting point for our Healthier Choices programme was Scotland. Here, the government and NHS have introduced a stringent new healthy eating framework for healthcare buildings. NHS Health Scotland’s Healthyliving Award Plus is the baseline standard for all our cafés, and the Scottish Grocers Federation Healthcare Retail Standard (HRS) for our shops and trolley services. The tough standard restricts the food and drink items that hospital retailers can offer, based on health criteria, and we have adopted it as the benchmark for our entire retail operation.

bananas654x672Throughout 2016, we worked closely with supply partners, store designers and renowned nutritionist, Dr. Mabel Blades, to prepare for the new standard. Measures taken included:

  • Delisting non-compliant items and dramatically reducing space for less healthy options
  • Reformulating products to reduce salt, sugar and saturated fat levels
  • Increasing the selection and range of healthier items like fresh fruit, salads, soups, sushi, smoothies, sugar-free syrups, healthier snacks and meal deals, plus dietary-specific ranges
  • Refreshing the look and feel of our shops and cafes to encourage customers to make healthier choices
  • Improving signage and labeling to enable customers to make healthier choices and to find items that meet dietary requirements
  • Training our staff and volunteers on the new menus, items and ranges.

By March 2017, with the support and commitment of our hospital retail staff and wonderful volunteers, our Scottish retail operation was fully HRS and HLA plus compliant - well ahead of the government’s deadline and long before other retailers had even begun the process.

Healthy shelfAchieving the HRS has been no quick and easy task, but the proof, as they say, is in the pudding (fresh fruit or low-fat yoghurt of course!). The transformation is having a profound effect on consumer behaviour and we are seeing a marked increase in sales of healthier items. During the first 3 months of rolling out our new product ranges, we have made healthier choices available to over 500,000 hospital staff, visitors and patients in Scotland, rising to 3.4 million in the next year.

By working with suppliers on product reformulation and range change:

  • Calorie intake from sandwiches alone will reduce by two million in the year ahead
  • Fat consumption from crisps will reduce by three million grams and salt consumption by 15,000 teaspoons
  • Sugar intake from soft drinks will be reduced by the equivalent of 50,000 sugar cubes a year
  • A focus on fruit will result in 30,000 additional portions of ‘1-of-your-5-a-day’ being consumed in Scotland over a year.

The impact of these changes speaks for itself. We’re delighted to be helping millions of customers make healthier food and drink choices and have been ranked top of the Healthy Hospital Food League Table by Sustain’s Campaign for Better Hospital Food. We look forward to seeing other hospital retailers follow our lead. 

Organisation website:


Life Skills in Primary School Tackle Obesity

Preparing filo parcels
Our community interest company The Ridge has been running the Plenty Project since December 2016, in and around Dunbar in East Lothian.
A series of classes that take in budgeting, nutrition and basic cooking skills were initially offered for adults, and continue to be.

In May this year we were approached by the headteacher of nearby West Barns Primary School to deliver a version of our programme to each year-group of pupils, and in October P 6/7 took part in the first week of classes. 

The Plenty Project is funded by SCVO, and in this instance we have been able to fund the teaching and ingredients for the project.
To overcome the lack of on-site cooking facilities, the school won a grant from Education Scotland to buy a mobile kitchen (comprised of oven and two induction hobs) and the necessary equipment to get the classes off the ground.

The focus of the nutrition class was the importance of a varied, balanced diet, with emphasis on encouraging a willingness to try new foods, and keeping an open mind about likes and dislikes.

We explored international school lunches and snacks to illustrate the huge global variations in what is considered ‘normal’ food, and shared seaweed crisps.
In a tasting session the class were proud to win a perfect score of every pupil trying fruit and vegetables including beetroot, celeriac, passion fruit, fennel, pomegranate, cauliflower and watermelon (against the initial inclinations of many!).

This was the first of many moments throughout the week that children discovered they enjoyed a food that they’d previously refused, and sparked noisy discussions about taste, preferences and eating habits.

Recipes were devised to engage, enthuse and challenge the pupils into trying new foods, as well as to be simple, healthy and affordable. At the beginning of each cooking class the children pulled a task out of a bag to make sure that everyone was included.

The menu for the week took in potato latkes (tying in with recent learning about Judaism), coleslaw, cheesy bannocks, butter bean dip, smoked mackerel pate, filo baskets with fresh apple yoghurt and cherry sauce, quiche muffins and vegetable tart with kale pesto. We arranged a visit to Belhaven Community Garden where the children harvested fruit and vegetables for our ingredients, which also included surplus produce donated by local greengrocer The Crunchy Carrot.

Each course will coincide with an end-of-term event in the school’s calendar, in this case the Harvest Assembly. Pupils read out an account of their Plenty Project week to pupils and parents, before every child in the school was given some bannock, mackerel pate, butter bean dip and quiche muffin to try.

The remainder was then offered to parents, with many giving enthusiastic feedback about their child’s reaction to the classes and asking for copies of recipes (which were distributed to every child).

The content will, of course, be tailored to the ages of each class, but the basic outline will remain the same.

By the end of the year, every child in the school will have had an immersive week getting thoughtful and creative around food, with the chance to show off their work to the rest of the school.

Recipes used in classPreparing a meal are from the "Time To Cook" Website:

Potato Latkes
Cheesy Bannocks
Butter Bean Dip
Smoked Mackerel Pate
Filo Baskets with Fresh Apple Yoghurt and Cherry Sauce
Quiche Muffins
Vegetable Tart with Kale Pesto  |



Obesity Action for Scotland

The Scottish Government has announced proposals for a strategy to tackle obesity. We welcome the challenges they set out, but we have our work cut out.

Obesity affects one in every four adults and almost one in five children.
65% of adults are overweight.

Whatever we have done before has not been enough to address the most pressing modern epidemic we face, a condition that gives rise to many diseases that blight our physical and mental wellbeing and contributes to social isolation and exclusion. We cannot grow a modern economy if overweight – the condition of the majority across Scotland - impairs our performance at work and at home.

No business - whether it is NHS Scotland, food and drink producers and retailers, or carers in our homes and communities - wants to face a future where their workforce struggles to cope with the changing demands of jobs that need done as they grow older.
By and large, people do not make a wilful attempt to eat too much, to put on weight and stay overweight.

So what has happened to make us this way?

The chief explanation is that we live in a society that makes it easy to gain weight; where we buy or consume food, the kind of food that retailers make it easy for us to choose, and tempt us to come back for more.
It takes more than experts and diets, magazines and services that advise and help us to take the weight off. It takes governments – local and national – to step in and help to curb excess, and prevent the epidemic persisting that we see in front of our eyes.

This is what is happening now.

Action must start with a national movement; a settled will towards choosing, buying and eating fewer, better, calories - on average, every day. Of course there are exceptions – e.g. people recovering from debilitating illness, women who are pregnant and people who are underweight – but for most, these are temporary states. The overall message has to be less overall; more balanced foods that mirror guidance about more fibre, fruit and vegetables, less fat, salt and a lot less sugar.

One further point is pertinent: no strategy on obesity will succeed if it focusses predominantly on higher levels of exercise. Regular physical activity is important and a good thing to do for many reasons, but it will not address Scotland’s weight problem by itself.

Scotland has a health record that is improving all the time, yet it lags behind our neighbours, and is in a particularly bad way when we tip the scales.
The health consequences are well documented; what we can do about obesity is also well documented.
It’s time we just agreed and got on with it.

The consultation closes on 31st January 2018
Details on how to respond can be found in the consultation document itself
Visit the government consultation hub to find out more


Obesity and Cancer Awareness Week: Portion Size

Obesity is the biggest preventable cause of cancer in the UK after smoking and Scotland is one of the most obese nations in the OECD.

This is bad news as obesity is linked to 13 types of cancer including 2 of the most common; breast and bowel, and 2 of the hardest to treat; pancreatic and oesophageal.
Research shows that in the UK sizes of ready meals and fast foods are increasing, and increasing portion size results in more calories consumed.


For example, a report by the British Heart Foundation (BHF) found an individual chicken pie was 40% larger and a chicken curry with rice was 53% larger compared to 1993.
This has a double-whammy effect on how much we eat as there becomes a tendency to eat larger portions and overestimate the amount that should be eaten, and increasing portion sizes shape public views of what is a normal amount to eat. Yet eliminating large portions from our diet could reduce average daily energy intake among UK adults by 16%.

Packaging of food and drink does not always encourage consumption of portion sizes recommended in the UK. The suggested portion of fruit or vegetable juice is 150ml; however, small cartons usually contain 200ml.

The food industry should consider the following:

  • Introduction of calorie caps, varying container sizes and a greater price differential between large and small portions
  • Adopting ‘front of packet’ food labelling, ensuring that portion sizes are standardised, clearly labelled and easy to understand
  • Promote consumption of appropriate portion sizes by matching size of single portions with the recommended ones, marking on the side of packaging or other clear labelling

As part of Obesity and Cancer Awareness Week we are calling for the Scottish Government tackle growing portion size in the places where we eat out.
Statistics in this post have been taken from our briefing paper entitled ‘OBESITY and PORTION SIZE’, available to download as a pdf.

Obesity and Cancer Awareness Week: Advertising & Marketing

  • Scotland is one of the most obese nations in the OECD
  • 110 tonnes of sugar is bought on special offer in Scotland every day
  • Obesity is the biggest preventable cause of cancer in the UK after smoking
  • Obesity is linked to 13 types of cancer

Facts and evidence highlight the issue, but we must start taking the actions required to halt the rise of obesity and then reduce it across Scotland.
This means tackling the obesogenic environment (the term obesogenic, according to the Collins English Dictionary, means “pertaining to or tending to cause obesity”).
Advertised food and drinks are generally less healthy than those recommended as part of a healthy balanced diet.

In 2014 the UK food industry spent £780m on the advertising and marketing of food and drink and £256m alone was spent on promoting ‘junk food’.

Junk Food Salad Advert

So far, voluntary measures to address marketing and advertising to improve dietary health in Scotland, suggested in the Supporting Healthy Choices framework, have proved to be insufficient.

We are calling on the Scottish Government in Obesity and Cancer Awareness Week to tackle junk food advertising to consumers across all channels, including online and social media platforms so we can start to create healthier environments for everyone in Scotland.

Statistics in this post have been taken from our briefing paper entitled ‘ADVERTISING, MARKETING and OBESITY’ which is available to download as a pdf.

Obesity and Cancer Awareness Week: Price Promotions

Evidence linking obesity and cancer is increasing and it is now known that overweight and obesity is the biggest preventable cause of cancer in the UK after smoking.

Obesity is also linked to 13 types of cancer including 2 of the most common, breast and bowel, and 2 of the hardest to treat, pancreatic and oesophageal.

With this growing body of evidence it is becoming increasingly urgent that we address the factors that are creating an obesogenic environment in Scotland (the term obesogenic, according to the Collins English Dictionary, means “pertaining to or tending to cause obesity”). This means taking action to reduce the promotion of junk food (processed foods high in salt, sugar and fat).

Price Promotion Montage

Price promotions increase the amount of food people buy by about one-fifth. In Scotland 40% of all food and drink purchases are made on price promotion - twice as high as levels seen in other European countries. Researchers from the University of Stirling suggested that price promotions together with advertising were the most salient forms of marketing to young people.

A survey of the impact of food and drink marketing on young people in Scotland found that 74% of promotions were for ‘junk foods’. In fact, 54% of all marketing-prompted-purchases were related to a price promotion with over a third of those (35%) being sugar-sweetened beverages, chocolate or sugar based confectionery.

As evidence of the links between obesity and cancer get stronger we can no longer continue to perpetuate environments that encourage and facilitate unhealthy lifestyles that can lead to overweight and obesity.

As part of Obesity and Cancer Awareness Week we’re calling for the Scottish Government to use regulation to tackle price promotions on junk foods as part of the forthcoming Diet and Obesity Strategy.

Statistics in this post have been taken from our briefing paper entitled ‘OBESITY and PRICE PROMOTIONS’ which is available to download as a pdf.

What to Do to Eat Less Sugar?

Sugar montageThe past few days have seen two sugar stories: one from Scotland and one from England. Although sugar has been talked about for quite some time now, it still makes the news.

In Scotland, Cancer Research UK reported that every day Scots buy 110 tonnes of sugar through promotions of unhealthy food and drinks. Promotions make us buy more and we definitely do not need any more sugar or calories in our diets.

In England, Action on Sugar exposed that many perceived ‘healthy’ cereal brands fail to include the Department of Health endorsed colour-coded labelling at the front of their packs despite some products containing high levels of sugar which would equate to a red label. How can we make a healthy choice if we don’t know what is in the food we buy?

As a result of the above and more, we eat almost 3 times the maximum recommended amount of sugar. And it is not good for us. So, what can we do about it?
What comes to mind first is: stop eating so much sugar! Easy to say, very difficult to do. It is almost impossible to resist cheap, extra, moreish treats that are present absolutely everywhere and all the time. It is hard to say no to such temptations. What is easier to do, is to eliminate the temptations. Some do it by excluding sugary foods and drinks from their weekly shop. Yet, they still have to resist them at work, schools, petrol stations, cafes, restaurants, train stations, airports, etc.
What is easier is to create an environment that does not tempt. We can do it by stopping promotions on unhealthy foods and drinks and stopping adverts for them. Imagine how different your diet could be if you did not see, hear and think about unhealthy food so many times a day. How different could your diet be if supermarkets did not discount and put the sugary, fatty and salty products right in front of you? You could actually buy only what you meant to buy.
New action to help us improve diet and health is needed. The Scottish Government is soon to publish a new Diet and Obesity Strategy. Let’s hope that it will have brave and responsible actions to create a healthy world for Scots.


The Childhood Obesity Plan – One Year On

Childhood Obesity Plan Front CoverOne full year has passed since the UK Childhood Obesity Plan (COP) was quietly published.

At the time of publication we were part of the dismayed, disappointed response made by a number of public health organisations. Organisations that had been promised a world leading, comprehensive strategy instead received a watered down plan with promises of a further “conversation”.

The COP did contain some valuable commitments including a sugar reformulation programme with industry, revisions of the nutrient profile model and the previously announced Soft Drinks Industry Levy. However it fell short by not tackling the top priorities, recommended to them by Pubic Health England, including price promotions and advertising and marketing of unhealthy foods.

And what of the promised “conversation”?
Well, there has been little indication that the UK Government is ready to listen to the requests for further action on the obesogenic environment.

The UK position remains important to Scotland as there are areas of reserved powers that influence our diet, not least TV advertising. Evidence tells us the current broadcast restrictions do not go far enough. Experts from across the world, including WHO, recommend restricting advertising of unhealthy foods, particularly to children. In fact there are many countries around the world who have already taken stronger action than the UK.

Today the Obesity Health Alliance published a report card on the UK Government’s Childhood Obesity Plan which concluded “must try harder”. With a lack of action to tackle advertising “it is scraping along with a C grade rather than topping the class with an A star”.

Read their report in full. 

The conversation on TV and online advertising of unhealthy foods needs to progress with urgency.

We have the opportunity in Scotland to create a comprehensive, world-leading strategy that plugs those gaps and gives everyone in Scotland a chance at a healthier life.

A Scottish Government consultation document on diet and obesity is imminent. We must make sure the bold and ambitious actions needed to change the current food environment are front and central.

It Takes a Village to Tackle Childhood Obesity

Or in this case a city: the city of Amsterdam.

Obesity Action Scotland has recently returned from a study trip to Amsterdam where our hosts were the public health department of the city of Amsterdam. Amsterdam is the first area in the world to see a decrease in rates of childhood obesity across all socio-economic groups. A unique and inspiring achievement given that in Scotland we are seeing a widening inequalities gap.

What is the secret of their success? What did we see while we were there?

Read More

Taking Inspiration from the Nordic Approach

SP PresentationsOver the past 10 years the Nordic governments have collectively taken a new approach that seeks to change the food culture and consumption patterns of their people.

On Wednesday 14th June, the Scottish Parliament heard from a Dane who works for the Nordic Council of Ministers about “New Nordic Food”. The event titled ‘Food: a solution to a health crisis’ was organised by Obesity Action Scotland with the Scottish Food Coalition.
Liam McArthur MSP sponsored the event and gave a warm and clever introduction. Among the guests were MSPs, Nourish, RSPB, Federation of City Farms and Community Gardens, Cancer Research UK, Alcohol Focus Scotland, SPICe, Food Standards Scotland, NHS Health Scotland, Rowett Institute, Glasgow University and many others.
Mads Frederik Fischer-Moller who is a Senior Advisor on Food, provided illuminating views on Nordic food culture, nutrition policy and the impact of food programmes and activities in the Nordic Countries. The aim was to solve the problem of poor diet and to create a food culture and identity for Nordic food.
Government policies played a key role in promoting a new and more sustainable Nordic cuisine to international fame but others played their part including world renowned chefs and the private sector.
Through public-private partnerships, product innovations and reformulation these new ideas are being incorporated in everyday life in the Nordic countries.

Read More

Elections, Elections, Elections!

Polling StationIt seems that we are visiting our local polling stations with some degree of regularity over the past few years and the most recent result of the general Election has still to fully play itself out.

Read More

A Parent Shares Their School Meals Experience

School Meals

Just over a year ago I decided to volunteer as a parent helper in my child's school.

Along with photocopying and helping with craft projects and classroom resources, one of my jobs is to oversee lunch in the dining hall. This has been the most eye opening experience of my life because I see what the children eat and do not eat every day.

All pupils must clear away their plates when finished their meal. They do this at a station at the end of the dining room, which has soapy water buckets for cutlery, bins for general waste and food. An adult always oversees what the children are disposing of. If we feel a child has not eaten enough we will often send them back to their table to try and eat some more.

Read More

Amsterdam’s Success in Tackling Childhood Obesity

AmsterdamTxtDo you want to be inspired?

Here is some good news: Amsterdam has been successful in tackling childhood obesity!

They launched the ‘Amsterdam Healthy Weight Programme’ and the whole city managed to reduce the total number of overweight and obese children by 10% within the first two years.
This means 2000 fewer overweight children.

Moreover, the programme proved especially successful for children from low socioeconomic backgrounds. 

Read More

Put the Health of Young People First

JanUary2017In 2017, Scotland’s young people suffer from obesity more than any generation before them. Dr Anna Strachan, Policy Officer for Obesity Action Scotland, calls for urgent action to make the healthy choice the easy choice.

Monday 9th January marks the start of National Obesity Awareness Week. Organisations and companies from across the UK are coming together to invite everyone to ‘Do something good for JanUary’. Whether it’s cooking more healthily, avoiding snacks or being a little more physically active, the aim is to make a healthy New Year’s resolution now!

Read More

Dreaming About the 21st Century Food Policy: Unthinkable!

Girl with an apple

Smoke-free buses, hospitals, or pubs were a wild, unthinkable idea forty years ago. Yet, today the opposite is unthinkable. Big dreams change the world.

The 12th of December 2016 was a day to dream big at the 2016 City Food Symposium in London. A day of reflection on the past and the future of food policy, over thirty speakers, reasons to be depressed, reasons to be cheerful, effortless networking, comedy, drama, stories of lost battles and of success, all concluded with a festive cup of mulled wine.

Read More

World Obesity Day – Action vs. Talking


Tuesday 11th October 2016 marked World Obesity Day. It was a day to take stock and assess the situation we are currently in, where 29% of adults and 15% of children in Scotland are obese and to look at the vision of universal healthy lifestyles and consider: how can we get there?
With adult obesity rates at unacceptable levels and a growing gap in obesity related to inequalities, we must be serious about how we tackle the obesity crisis.

Read More

Obesity, Physical Activity and Cancer

Map of a run round London

What do obesity and physical inactivity have in common?
If you said that they both sound unhealthy, you'd be right: they are serious cancer risks.

In fact, they increase the risk of many cancers: breast, bowel, prostate, uterus, liver, pancreas and others.

Read More

Body Fatness and Cancer

Annie AndersonGuest Blog: Professor Annie S. Anderson

For decades cancer has been associated with weight loss and under nutrition. Cancer survivors still report health care staff being concerned if they report a decreased body weight – even if this is due to intentional weight loss.

Today's paper from the International Agency for Research on Cancer (IARC) provides a timely reminder about why we need to take the growing evidence on excess body fat and the opportunity for cancer risk reduction seriously.

Read More

The UK Government has bottled it


The UK Government has bottled it. They have backed out of the bold action needed to tackle the obesity epidemic within the UK. How did we get here? How did such a long wait in anticipation become such a frustrating disappointment?

In October 2015 the chief executive of PHE Duncan Selbie was being grilled by the UK Health Select Committee on PHE evidence on the actions needed to tackle sugar consumption. Duncan Selbie said at the time that this was a “marvellous moment” that Government was accepting PHE advice and the outcome would be a childhood obesity strategy that will work. “One which doesn’t exist in the world and we are on the cusp of having” were his exact words. The Heath Secretary and Prime Minister promised a “game-changing strategy” to tackle a “national emergency”.

Read More

Walking round Italy in speedy fashion!

Rome photograph




We made it!

Two weeks ago we ‘arrived’ in Rome after our big walk round Italy. Logging our respective steps (all 1,691,922 of them!) got us round Italy and into Rome much faster than the 100 days we had allowed.

So perhaps the next walking challenge needs to be, well, more challenging!
We’ve still to arrange our Mediterranean feast to celebrate, but maybe we should use this as a carrot for our next walking adventure?
We are now embarking on a grand tour of Poland – home country of our Policy Officer, Anna.

A Guideline is Just a Guideline

Brazil Dietary Guidelines Report Cover

University of Edinburgh logo“Values are as important as evidence. Do we need a randomised control trial to tell us that eating food together is a good idea?”

A striking statement that stimulated reflection from the audience at a recent event we were delighted to co-host with the University of Edinburgh.

The event saw two representatives from Brazil, who were instrumental in the creation of the recently published Brazilian dietary guidelines, speak about the journey from concept to published dietary guidelines. A process filled with challenges, not least opposition from industry, but also from fellow nutritionists who were initially reluctant to see change.

The distinct and ground breaking aspect of the Brazilian work has been the move away from nutrient based guidelines to ones based on real meals. They used the ‘NOVA system’ which classifies foods according to the extent of processing involved.

Read More


The OAS Monthly Newsletter