Improving the Scottish diet: Effort over guidelines

The Food Standards Scotland (FSS) agreed today to advise the Scottish Government that the Scottish Dietary Goals should be updated.

The FSS took over responsibilities from the UK-wide Food Standards Agency in April this year as a new public sector food body to provide independent information and advice on food safety and standards, nutrition and labelling to consumers in Scotland.

These proposals coincide with the publication of a very accessible Situation Report, ‘The Scottish Diet: It Needs To Change’, providing facts and infographics on the health effects and public costs of the Scottish diet.

Following recent recommendations from the independent Scientific Advisory Committee on Nutrition (SACN) on carbohydrate and health, the FSS proposes:

  • to reduce sugar to 5% of total energy (vs. 11% now)
  • to increase dietary fibre intake to 30g per day (vs. 18g noScreen Shot 2015-12-09 at 16.48.30w)
  • to maintain total carbohydrate at 50% of total energy with no more than 5% total energy from sugar

In the report the FSS notes that the average diet in Scotland hasn’t changed significantly over the past 15 years and that during that time we’ve been consistently missing the Scottish Dietary Goals. Our diet is too high in calories, fats, sugars and salt, and too low in fibre, fruit and vegetables, and other healthy foods like oil-rich fish. Sound familiar?

To meet the Dietary Goals the FSS specifically proposes cutting down on ‘discretionary foods’: high-calorie, low-nutritional value foods and drinks mostly purchased outside of the home.

The report’s conclusion carefully states: “Changing current habits is a huge challenge but making reductions in discretionary foods, that have little nutritional value, makes sense. If these reductions could be achieved together with increases in fruit, veg and fibre we would have a legacy of a slimmer, healthier Scotland and that is something worth aiming for.”

 

Affordability and access 

But exactly how do we create that desired legacy? If we’ve made so little progress in the last 15 years and we’re now setting much more ambitious targets, then surely more exhortation won’t cut it.

The FSS notes the need for “collective action”, but as an independent body with a mere advisory function, the report lacks bold political asks. Rather than more guidelines, what we need is more effort – both from the public and private sector.

At Nourish we’d like to see the Scottish Government meaningfully apply the Individual-Social-Material (ISM) framework to food and public health, as it does in other policy areas. The ISM framework recognises that what people do is shaped by material factors such as infrastructure, schedules, rules and regulations, technology, time and objects; and by social factors such as relationships, meanings, norms, institutions, roles and identity; as well as by individual factors such as habit, skills, agency, emotions, values, beliefs, attitudes and cost-benefit.

Disproportionately with food the Government’s focus has been on the individual, through public education and campaigns –but for people to start to make different food choices, we need to create a material and social environment to enable and support these choices.

Regulating junk food advertising and promotion offers of ‘discretionary foods’ would be a good place to start. As the FSS report flags up, discretionary foods are by proportion more frequently sold on promotion than healthier foods.

But price is an even bigger influencing factor: Today a healthy diet is financially inaccessible for many in Scotland. A recent UK study found that on average healthy foods are approximately three times more expensive than less healthy foods per calorie[1].

Unable to afford healthy foods – or the fuel to cook them – low-income households consume more highly-processed foods high in sugar, fat and salt, which also tend to be marketed towards such groups[2]. Health inequalities are marking ever-deepening lines through Scottish society.

How did we end up in a situation in which a head of broccoli costs more than a ‘discretionary’ donut? There are many drivers but public subsidies form a crucial part of the puzzle. Financial support for farmers through the EU’s Common Agricultural Policy (CAP) is currently not linked in any way to what they’re producing (e.g. healthy food), while for example sugar giant Tate & Lyle is the top recipient of CAP subsidies in the UK between 1999-2013, cashing in more than 700 million pounds. We believe public money should deliver public benefits and CAP support, through the Scottish Rural Development Plan, should go first and foremost to farmers that produce healthy food for Scottish people in a sustainable way.

 

Towards a healthier food culture

In addition to this, there are many other ways the Scottish Government could begin to promote a food system that reduces health inequalities, empowers communities and is sustainable, such as:

  • Improving the quality, nutrition and sustainability of meals served in the public sector.
  • Extending the healthy start voucher scheme to subsidise fruit and vegetables for all low-income families.
  • Providing fruit and vegetable on prescription, with primary care teams forming an integral part of improving public nutrition, just as they have helped to reduce smoking.
  • Supporting a network of well-trained community growing advisors working alongside the local authority’s ‘food growing strategy’ to double urban production of fruit and vegetables.
  • Exempting fresh fruit and vegetable shops on the high street from business rates, providing training for staff to work as informal providers of nutritional advice and encouragement.
  • Exempting restaurants using predominantly local produce and serving healthy food from business rates, as well as exempting vegetarian and vegan meals from VAT.

In the lead-up to the Scottish elections, Nourish will be campaigning for a Food, Farming and Health Act that will include these and other measures, as part of the new Scottish Food Coalition.

We hope that the FSS report and proposed revised goals will help trigger both public conversation and political action towards building a healthier food culture in Scotland.

 

[1] . Jones, NRV, Conklin, AI, Suhrcke, M and Monsivais, P. The Growing Price Gap between More and Less Healthy Foods: Analysis of a Novel Longitudinal UK Dataset (2014)

[2] Why consider what people eat?, Nutrition and food poverty: A toolkit, Faculty of Public Health