Obesity and Cancer Awareness Week: Policy Paper

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About Obesity and Scotland’s biggest killer

Obesity is the biggest preventable cause of cancer after smoking. Scotland has the worst obesity rates in the UK. Two-thirds of adults and over one-quarter of children are overweight or obese. Excess weight costs NHS Scotland an estimated £600 million a year, with wider societal and economic costs of up to £4.6 billion.

The Scottish Government should ensure its upcoming diet and obesity strategy:

  • Uses regulation to tackle price promotions on junk foods
  • Tackles junk food advertising
  • Supports UK wide work on reformulation
  • Tackles growing portion size in the places where we eat out
  • Invests money raised from the Soft Drinks Industry Levy to help prevent obesity

What is the link between obesity and cancer?

Obesity is the biggest preventable cause of cancer after smoking1. Obesity is linked to 13 different types of cancer, including two of the most common – bowel and breast – and two of the hardest to treat – pancreatic and oesophageal2.

Extra fat in the body can have harmful effects, like producing hormones and growth factors that affect the way our cells work. This can raise the risk of several diseases, including cancer.

Yet public awareness is low: only a quarter of Scottish adults know that being overweight can cause cancer3.

How many people are overweight or obese in Scotland?

Scotland’s levels of overweight and obesity are the worst in the UK, and among the worst in OECD countries4
Two-thirds of adults, and over one-quarter of children are overweight or obese5
Obese children are five times more likely to become obese adults6

Every year, excess weight is estimated to cost up to £600 million to NHS Scotland, and £4.6bn in wider economic impacts of lost productivity and absenteeism7. None of the Scottish Dietary Goals on saturated fat, sugar consumption or fruit and vegetable intake have been met in the last 15 years.

Regulating price promotions and multi-buy offers

We want the Scottish Government to commit to regulating multi-buy price promotions (offers including ‘buy one get one free’ and ‘X for £Y’) in its forthcoming obesity strategy.

Price promotions are one of the most effective ways that the food industry gets people to buy their products. They typically use ‘multi-buy’ offers or straight price discounts to increase the volume of their items being bought.
Junk food special offers are a major contributor to obesity, helping create an environment that promotes unhealthy food choices.

A disproportionate amount of the food and drink sold on promotion is unhealthy. Food Standards Scotland found that nearly 40% of all calories, 40% of total sugar and more than half of regular soft drinks were purchased on price promotion8.This is double the levels of promotions purchased in any major European economy9.

We also know that price promotions can contribute to increased consumption of food and drink high in fat, sugar and salt. Evidence produced by Public Health England that finds price promotions can increase the amount of food and drink people buy by one-fifth and increase sugar purchased from higher sugar foods by 6.1%10.

Polling shows that the Scottish public supports action on junk food price promotions:

  • 89% of parents believe supermarket promotions impact what they buy
  • 71% parents said that there is too much junk food on promotion in supermarkets
  • Three quarters of parents would like to see the balance of promotions shifted towards healthier items11
  • 7 in 10 adults in Scotland support banning supermarket promotions on unhealthy food12

Supporting action on junk food marketing for children

We support the Scottish Government’s call for the UK Government to do more to address/ tackle junk food marketing on TV, particularly aimed at children. We would urge the Scottish Government to consider action on advertising where devolved powers exist.

Junk food marketing drives children’s obesity. It influences the type of food that children eat and persuade their parents to buy. Research shows that children exposed to junk food marketing eat more unhealthy food than those who do not13.

TV adverts for junk food reach almost twice as many low income than high-income households14. Adverts disproportionately feature unhealthy food items, and young children from less wealthy backgrounds are especially vulnerable to marketing techniques that promote unhealthy food15.

Working to reformulate unhealthy foods to reduce sugar, calories and portion sizes

We want the Scottish Government to continue to work with the UK government to reformulate food and drink to make them healthier. This means working with Public Health England (PHE), Food Standards Scotland and industry on ongoing activity to reduce sugar in food by 20% by 202016, and to reduce calories through reducing portion sizes in single-serve products. This must also lead to updating official UK Government information on portion sizing for the first time in over 20 years17.

Reformulating fat, sugar and salt levels in food and drink is a cost-effective policy to reduce levels of obesity18.

Action in the places where we eat out

We want the Scottish Government to tackle portion size and improve the nutritional information available when we eat out.

In 2015, 948 million visits were made to out of home eating establishments in Scotland. The number of times we eat out of home is growing, ahead of any of our European neighbours. Quick service restaurants, fish and chip shops, and bakeries are visited more in Scotland than in the rest of Great Britain19.

Ring-fencing money from the Soft Drinks Industry Levy to spend on obesity prevention programmes

We want the Scottish Government to ensure that any additional money allocated from the Barnett formula, as a result of the Soft Drinks Industry Levy, is ring-fenced for spending on obesity prevention programmes. We believe this can be a valuable source of additional revenue for obesity prevention until 2020.


References

 Parkin, DM. (2011). ‘1.The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010’. British Journal of Cancer. 105(Suppl 2): S2-S5. (website)
2  Cancer Research UK. (2016) Bodyweight facts and evidence. (website)
3  Cancer Research UK. (2016). ‘Three in four don’t know obesity causes cancer’. (website). 
4  Food Standards Scotland (2016) Diet and Nutrition: Proposals for setting the direction for the Scottish diet (pdf
5  Scottish Government. (2016). ‘The Scottish Health Survey 2015: Volume 1: Main Report’. (website)
6  Simmonds, M., et al. (2016). ‘Predicting adult obesity from childhood obesity: a systematic review and meta-analysis’. Obesity reviews: an official journal of the International Association for the Study of Obesity’. 17(2): 95-107. (website)
7  SPICe. (2015). ‘SPICe Briefing: Obesity in Scotland’. (pdf
8  Food Standards Scotland. (2016) ‘Foods and drinks purchased into the home in Scotland using data from Kantar WorldPanel’. (pdf
9  Public Health England. (2015). Sugar reduction: the evidence for action. Annexe 4: an analysis of the role of price promotions on the household purchases of food and drinks high in sugar. (pdf)
10  Public Health England. (2015). ‘Sugar reduction: the evidence for action’. (website)
11 Survation poll of 1,037 Scottish adults, of which 312 are parents (16+), in June 2017, on their attitudes towards purchasing junk food. Data collected 9-13 June 2017.
12 YouGov survey of 1,542 people in the UK, including 142 Scots. Fieldwork was undertaken between 1 December 2016 and 2 December 2016.
13 Sadeghirad B, Duhaney T, Motaghipisheh S et al. Influence of unhealthy food and beverage marketing on children’s dietary intake and preference: a systematic review and meta-analysis of randomized trials. Obes Rev 2016;17(10):945-59. doi:10.1111/obr.12445.
14 Adams J, Tyrrell R, Adamson A et al. Socio-economic differences in exposure to television food advertisements in the UK: a cross-sectional study of advertisements broadcast in one television region. Public Health Nutr 2012; 15(3):487-93. doi:10.1017/S1368980011001686.
15 Mennella JA. Ontogeny of taste preferences: basic biology and implications for health. Am J Clin Nutr 2014;99(3):704S-11S. doi:10.3945/ajcn.113.067694.
16 Public Health England (2017) Sugar Reduction: Achieving the 20% (pdf)
17 Department of Health (2017) ‘Next stage of world-leading childhood obesity plan announced’ (website)
18 McKinsey Global Institute. (2014). ‘Overcoming obesity: an initial economic analysis’. (website)
19 An assessment of the out of home food and drink landscape in Scotland, FSS 1 October 2016 (website)

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