Food and drink reformulation to reduce fat, sugar and salt

Most people in the UK consume too much saturated fat, sugar, salt and calories. These diets are associated with increased risk of health conditions such as cardiovascular disease, type 2 diabetes, and some cancers. Food and drink reformulation is one of several tools to support healthier diets and it is supported by public health stakeholders in the UK and worldwide. In recent years, the UK Government has implemented voluntary and fiscal policy approaches to encourage reformulation across the food and drink sector. Food and drink reformulation will be further examined in the second report of the National Food Strategy, an independent review of the UK food environment, due to be published in Spring 2021.

Key points:

• There are different reformulation programmes in England. These are overseen by Public Health England (PHE) and supported across the devolved nations.
• Currently, voluntary reformulation programmes aim to reduce levels of salt, free sugar, and calories in products. The Soft Drinks Industry Levy (SDIL) applies a tier tax on soft drinks with 5 or more grams per 100 millilitres, encouraging manufacturers to reduce sugar content. Saturated fat is not specifically included in any of the current programmes.
• In only a few years since its introduction, the Salt Reduction Programme contributed to considerable salt reductions in products. The latest PHE evaluations report mixed progress against reduction targets, depending on the products and the sector (in-home or out-of-home).
• Mixed progress also characterises the latest evaluation of the Sugar Reduction Programme. The next report will be published by PHE in 2021.
• Sugar content in drinks subject to the SDIL has decreased by around 40% in the last 5 years. However, direct comparisons across the different reformulation programmes targeting free sugars cannot be made, because they include different kind of products.
• Evaluations of the Calorie Reduction Programme are not available yet and they will be published by PHE in 2022.
• Evidence demonstrates that decreasing levels of saturated fat, salt and free sugar in diets improves health outcomes. However, examining the direct impact of reformulation programmes on public health is difficult. Most policies have only been implemented recently and their effects cannot be observed yet. Moreover, there are many factors –other than diet– that can influence health, including physical activity, age, genetics, the environment, and socio-economic factors.
• There are various challenges and opportunities for reformulation. Maintaining product quality is an important aspect and can present some technical challenges. Industry engagement with reformulation programmes varies, and some stakeholders advocate for policies promoting a ‘level playing field’, or better support for businesses. Manufacturers consider meeting consumer preferences a priority while reformulating products. Some academics warn that current programmes do not target eating behaviours of socio-economics groups who are more likely to have unhealthy diets.
• Nutrition researchers argue that improving the nation’s diet requires complementary policy approaches to promote healthy lifestyles, such as incentivising healthy food consumption or restricting advertising of unhealthy food.

Acknowledgements

POSTnotes are based on literature reviews and interviews with a range of stakeholders and are externally peer reviewed. POST would like to thank interviewees and peer reviewers for kindly giving up their time during the preparation of this briefing, including:

• Michael Adams, Campden BRI*
• Avril Aslett Bentley RD and Dr Sally Moore RD, British Dietetic Association
• Mhairi Brown, Action on Salt and Action on Sugar*
• Prof Judy Buttriss, British Nutrition Foundation*
• Prof Janet Cade, University of Leeds
• Valia Christidou, Food Technologist
• Fionnuala Close, Ben Goodhall and Kathleen Mooney, Food Standards Agency*
• Linda Cudjoe, Harrods
• Prof Richard Frazier, University of Reading*
• Kate Halliwell, Food and Drink Federation*
• Charlotte Huckvale and Ruth Powell, Marston’s
• Prof Susan Jebb, Nuffield Department of Primary Care Health Sciences, University of Oxford*
• Helen Lo, Out-of-Home Independent CSR Advisor*
• Dr J Bernadette Moore, University of Leeds*
• Members of the POST Board*
• National Food Strategy*
• Public Health England*
• Vanessa Richardson, British Retail Consortium*
• Jenny Rosborough, Jamie Oliver Group*
• Richard Sangster, Department of Health and Social Care*
• Rebecca Tobi, The Food Foundation*
• Dr Rachel Ward, Institute of Food Science & Technology*

*denotes people and organisations who acted as external reviewers of the briefing.