Evidence of meeting #42 for Health in the 39th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was children.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Karen Tonks  Chief Nutritionist, Tesco PLC
Tom Sanders  Head, Nutritional Sciences Research Division, King's College London
Jane Holdsworth  Consultant to the Food Industry, UK Food and Drink Federation
Sandy Oliver  Reader in Public Policy, Social Science Research Unit, Institute of Education, University of London
Roger Mackett  Professor, Centre for Transport Studies, University College London
Joe Harvey  Director, Health Education Trust

10:50 a.m.

NDP

Pat Martin NDP Winnipeg Centre, MB

Thank you, Ms. Tonks.

We've wrestled with labelling as an issue in a number of ways. My specific interest is trans fats, partially hydrogenated oils. We did have a thorough debate in Canada on whether labelling would be adequate or if this product should be just simply banned, eliminated from the food supply. It came to a vote in Parliament, and Parliament did vote to ban rather than label. The logic was that it isn't okay to put poison in our food just because it's properly labelled.

Has this debate been raging in the U.K.? Is there any interest in following Denmark as the European Union trading partner? How do U.K. companies market their product in Denmark? Do they simply forgo that market, or do they take the trans fats out of their product so they can sell it in Denmark? Can you help us with that?

10:50 a.m.

Chief Nutritionist, Tesco PLC

Karen Tonks

Yes. Trans fats is a hot topic in the U.K., but it's a very confused one, because, as I'm sure you're aware from the debate, there are artificially produced trans fats through partial hydrogenation of vegetable oil and there are also naturally occurring trans fats in milk and meat products—some meat products.

It's really about making sure that consumers understand the difference between them, but also the overall impact of trans fats, and not losing sight of the fact that total fat and saturated fat probably have a bigger impact on health overall—and the salt intake—than these particular elements. It's trying to keep the whole message in balance.

In the U.K., there has been no government position or guidance on this, nor any move to legislate or provide guidance. The industry has been watching what's been going on in the United States and Denmark, and the industry has said, if we don't have to put these in, why are we?

For example, I can say that Tesco has now removed all hydrogenated vegetable oil from its products. So we've taken out the artificially produced trans fats and we use alternatives in our food. Whilst our foods may not be trans fat free, because they still have dairy and meat products, they don't have any partially hydrogenated vegetable oil. Therefore, we are reducing the trans fat content of our food products, and a lot of manufacturers are doing the same.

10:55 a.m.

NDP

Pat Martin NDP Winnipeg Centre, MB

Just so I understand you, has your company eliminated trans fats from everything with the Tesco label?

10:55 a.m.

Chief Nutritionist, Tesco PLC

Karen Tonks

No. We've eliminated hydrogenated vegetable oil that produces the artificial trans fats, but you still get trans fat—

10:55 a.m.

NDP

Pat Martin NDP Winnipeg Centre, MB

Yes. This is what I mean, the manufactured—

10:55 a.m.

Chief Nutritionist, Tesco PLC

Karen Tonks

Manufactured, yes. We've eliminated hydrogenated vegetable oil from our products.

10:55 a.m.

NDP

Pat Martin NDP Winnipeg Centre, MB

I see.

In the United States there's mandatory labelling....

I'm sorry, Madam Chair. Am I out of time?

10:55 a.m.

Liberal

The Acting Chair Liberal Carolyn Bennett

I think we're pretty well done. Unfortunately, the other group has been waiting for a while.

I understand, Ms. Tonks, that you have quite a good website that the members could visit to see where a lot of this is laid out. I'm sure that if they have individual questions, you would respond by e-mail or whatever.

10:55 a.m.

Chief Nutritionist, Tesco PLC

Karen Tonks

Absolutely. Yes.

I can make sure you have my e-mail address, and I'm happy to answer any questions you may have. I can also send you a link to our website for you to look at as well.

10:55 a.m.

Liberal

The Acting Chair Liberal Carolyn Bennett

We thank you very much.

We're sorry it was rushed. We had a bit of a storm here that had our members late, so thank you for understanding and being so helpful.

Thanks very much.

We're off to your colleagues at King's College now.

10:55 a.m.

Chief Nutritionist, Tesco PLC

Karen Tonks

You're very welcome.

Have fun.

Thank you very much.

10:55 a.m.

Liberal

The Acting Chair Liberal Carolyn Bennett

We will take a short pause to make the connection with our next videoconferenced witnesses.

11 a.m.

Liberal

The Acting Chair Liberal Carolyn Bennett

We'll start the second part of our hearing today.

Welcome from London, and we're here in Ottawa.

You can see our committee here, but we would love you to introduce yourselves. I should have introduced myself. I'm Carolyn Bennett, the member of Parliament for St. Paul's.

We are a little thin on the ground here because of a snow storm, so I think our chair, Rob Merrifield, is still in the air.

11 a.m.

Prof. Tom Sanders Head, Nutritional Sciences Research Division, King's College London

Hello. I am Professor Tom Sanders from King's College, London.

11 a.m.

Dr. Jane Holdsworth Consultant to the Food Industry, UK Food and Drink Federation

Hello. I'm Dr. Jane Holdsworth, a consultant working with the food industry in the U.K.

11 a.m.

Dr. Sandy Oliver Reader in Public Policy, Social Science Research Unit, Institute of Education, University of London

I'm Dr. Sandy Oliver with the Institute of Education, University of London.

11 a.m.

Prof. Roger Mackett Professor, Centre for Transport Studies, University College London

I'm Professor Mackett from the Centre for Transport Studies here at University College, London.

11 a.m.

Liberal

The Acting Chair Liberal Carolyn Bennett

We have about an hour and fifteen minutes.

You each have about ten minutes for your presentation, so it's about forty minutes for the presentations. Then we will use the rest of time for questions.

Is that your understanding?

11 a.m.

Professor, Centre for Transport Studies, University College London

11 a.m.

Liberal

The Acting Chair Liberal Carolyn Bennett

Perfect. Shorter is always better. These people love questions.

Dr. Sanders.

11 a.m.

Head, Nutritional Sciences Research Division, King's College London

Prof. Tom Sanders

Hello. I am a professor of nutrition and dietetics at King's College, London. I have over 30 years' experience working in nutrition science.

My observation on childhood obesity is that the epidemic has occurred in the United Kingdom and other countries despite any changes in the relative proportions of fat or sugar in diets. The evidence from weighed food intake surveys tends to indicate that total food energy has fallen by between 20% or 30% over the past 30 or 40 years, yet the increase in obesity has gone up.

One of the fundamental questions is whether the relative proportions of fats and carbohydrates in diets are important or whether it's total energy intake. I would put to you that the major determinant is the food energy intake, regardless of whether it's primarily from fats or carbohydrates. In support of that, I would point to the results of some recent randomized controls trials. One of the longest ones was carried out in a women's health initiative that basically showed that if you gave advice to get people to reduce the proportion of their food energy derived from fat, it didn't really lead to any long-term changes in weight.

I would argue that the focus in terms of diet should be on matching calorie intake with energy expenditure. It is quite clear that energy expenditure has fallen, but the fall in calorie intake hasn't been sufficient to match the drop in energy expenditure.

One of the issues that has occurred in the U.K. is actually how to inform consumers best to change their dietary habits so that they can avoid obesity—and particularly, the focus on children.

There are two areas that I think deserve consideration. One is the way in which the information is put across, whether it's put across as numerical information or as qualitative information, high, medium, or low, or whether it's a colour-coded system, such as traffic lights, red, amber, and green.

I don't really want to spend any time talking about the methods of display, which I think will vary between cultures, but I want to spend a little bit of time on the way in which you derive what is high, medium, or low that might be used potentially for a regulatory instrument to restrict advertising or to give consumers advice.

The U.K. Food Standards Agency has come out in favour of a traffic light system based on the grams per hundred grams of food for labelling. It has used, as the basis for its labelling, fat, sugar, salt, and saturated fat. Unfortunately, it has not used calories in that labelling.

The major problem of using nutrient composition per hundred grams is that it does not tell you the amount of food consumed, so you label a food as being high for a small portion as well as a large portion. Portion size, I believe, is a major driving factor for obesity. It has become quite clear that portion sizes have been increasing, particularly in the last ten years. You can just think of it as regards cups of coffee or carbonated beverages. They get bigger every year.

The alternative way of expressing dietary intake is relative to a benchmark, and the benchmark that has been most widely used is the guideline dietary amount. The guideline dietary amount is an arbitrary benchmark that can be used to give you an idea of the amount of calories an individual requires and then a proportion of the calories provided by the food.

I think guideline dietary amounts for the appropriate groups are the way in which to base food labelling, rather than on the amount per hundred grams. There are instances where the amounts per hundred grams as a labelling basis being used by the Food Standards Agency become particularly confusing. For example, if you take a food like mustard, mustard would be labelled as red, as high, because it has a high fat content, but you wouldn't consume 100 grams of mustard. Similarly, you need to be aware that certain foods that you need to encourage children to consume in moderation—for example, cheese—would be labelled in an adverse manner by expressing it as an amount per hundred grams.

So in conclusion, I think if you're considering a format of food labelling, I would strongly advise that you go for the amount provided in a portion, and I would focus on really just one thing: food calories. I don't believe the evidence is there to show that the proportion of calories from sugar or fat is particularly useful. It's the total calorie intake that's most useful.

That's all I have to say.

11:05 a.m.

Liberal

The Acting Chair Liberal Carolyn Bennett

Thank you very much.

Dr. Holdsworth, please.

11:05 a.m.

Consultant to the Food Industry, UK Food and Drink Federation

Dr. Jane Holdsworth

Thank you.

I'm Jane Holdsworth. I'm a consultant, and I've worked with a wide range of food manufacturers in a marketing and technical career within the U.K. and overseas that has spanned 20 years. Most recently, I've worked with the U.K. Food and Drink Federation to help them shape their approach to front-of-pack labelling and to create and manage a campaign to encourage consumers to use that scheme.

I'd like to provide some background about the Food and Drink Federation and also to outline how the members came to adopt a guideline daily amount-based labelling scheme, and I'll explain why we think that is effective in helping consumers become better informed about the food they eat so they can make more informed food choices.

The FDF in the U.K. represents the interests of the largest manufacturing sector, with a combined turnover of $70 billion. There are around 7,000 food and drink manufacturing enterprises in the U.K., and the vast majority are small or medium-sized businesses. The Food and Drink Federation has a strong scientific base and ethos that runs through all aspects of its activity. Its manifesto consists of a seven-point pledge that focuses on a number of key issues, one of which is food labelling.

The U.K. government white paper, “Choosing Health”, was published in November 2004, and amongst other things, it made clear the government's priorities regarding food labelling. Against this backdrop, the food industry, through the Food and Drink Federation, sought to consider how it could define and implement a food labelling scheme to assess consumers to make better food choices. In mid-2005, Tesco, which is the U.K.'s largest food retailer with about 30% of the market, opted for a guideline daily amount-based front-of-pack labelling scheme. They had previously trialled a traffic light scheme but found that consumers preferred the GDA-based approach, largely because it gave them more information, thus allowing an informed choice.

Guideline daily amounts are widely used and well respected in the U.K. They were developed by the Institute of Grocery Distribution in partnership with government and are based on COMA recommendations. They're included on the backs of a wide variety of food products to provide nutrition information in context. They also form the basis for high-level limits within the FSA traffic light scheme. GDAs are similar to the percentage daily values that are widely used in Canada.

In parallel with the introduction of the guideline daily amount front-of-pack scheme by Tesco in 2005, various food manufacturers conducted their own research into reactions to a Tesco-type scheme and found similar positive responses from consumers. They also found that consumers were keen to see clearer food labelling on all food products, not just on the five composite food categories that were being considered for front-of-pack labelling by the Food Standards Agency.

By late 2005, Tesco had consumer data that showed the public were responding well to the scheme, and early data showed that it was driving healthier choices within the sandwich category. We tested the scheme with 700 consumers and found that 87% of them found it clear and simple. They liked the scheme, and the most common benefit cited, selected by 38%, is that it would help make healthier food choices.

Against this backdrop of a scheme that was both useful and informative for consumers and showed early signs of being effective in changing consumer behaviour, a number of food and drink manufacturers pledged to adopt a GDA labelling-based scheme. To ensure consistency for consumers, a style guide based on the Tesco model was also developed. The scheme was first introduced on some products in mid-2006 and the adoption of it has grown markedly, such that there are now four retailers using the scheme, representing almost half of the U.K. retailing sector, and 24 manufacturers. It's already on over 10,000 products, representing about 40% of packaged food products, and it's the most widely applied scheme in the U.K. market.

Consumers of this are reacting very positively to the introduction. There's a high level of awareness of the scheme and usage of it across all social grades, and importantly, Tesco data continues to show that it's driving healthier choices. Importantly, the scheme is also driving reformulation decisions by retailers and manufacturers as they seek to improve the nutrition profile of existing products. Some retailers are also setting GDA composition benchmarks for new product development. It's my understanding that Health Canada has told the committee that Canada's mandatory nutrition labelling system is having a similar effect on the nutritional profile of food products sold in Canada.

We've supported the introduction of the scheme with our advertising campaign, which aims to help to increase awareness of the scheme and deepen understanding of how it can be used to help support a healthier lifestyle.

Our website, called www.whatsinsideguide.com, is a core element.

We believe that the scheme is effective and has wide consumer appeal for six core reasons.

The first is that it gives consumers the facts, so they can make informed choices. That was something our initial research showed was key for any scheme.

Second, it helps consumers see individual foods in the context of their whole diet, thus giving them perspective on what it is they're eating.

Third, it provides per portion information, with the portion clearly stated on the pack.

Fourth, it's not hectoring or judgmental; it simply provides the facts. Again, our early research showed that this was really important to consumers.

Fifth, it's consistently applied across food categories and is very widely available.

The sixth point is that it links directly to the more detailed information on the back of the pack.

Importantly, the scheme also shows calories as well as the four key nutrients—sugars, fats, saturated fat, and salt. We believe this is an essential component of any front-of-pack scheme designed to tackle the obesity issue.

We have agreed to carry out joint research with the Food Standards Agency in the U.K. Department of Health and with retailers to determine which of the front-of-pack labelling schemes used in the U.K. at the moment are effective. We're confident this independent research will further demonstrate what the GDA labelling scheme is.

To summarize, there is a front-of-pack signpost labelling scheme in the U.K. that shows per portion, percentage, GDA information. It's widely used by manufacturers and retailers in the U.K. Initial results from its introduction are very positive, with many consumers already aware of it and using it to become better informed about the food they eat. Early signs also indicate that it's changing our purchasing behaviour.

The food industry is working with the U.K. FSA, the Department of Health, retailers, and others to assess the effectiveness of the GDA scheme, alongside the alternative traffic light food scheme. The results of this work are likely to be available in 12 to 18 months.

Thank you.

11:10 a.m.

Liberal

The Acting Chair Liberal Carolyn Bennett

Thanks very much.

I think the committee will have lots of questions. This is great.

Professor Mackett.

11:15 a.m.

Professor, Centre for Transport Studies, University College London

Prof. Roger Mackett

Good morning, ladies and gentlemen.

My interest in this area started from a project we were carrying out for the U.K. Department for Transport. We were looking at ways to reduce the number of short trips by car. One of the things that came out of that was the very large number of trips made on behalf of children, taking them to and from school and to multiple activities. We then undertook a project to look at ways of reducing the effects of car use on children's volume of physical activity, among other things.

One of the things we did in that study was to fit 200 children aged 10 to 13 with activity monitors, small things the size of pagers, which they wore around their waists. We also asked them to keep diaries of all their activities and travel over a period of four days. From that we found a number of conclusions. We found, for example, that walking and playing provided more exercise than most other activities they undertook. We found that some children spent more calories walking to and from school for a week than they did in two hours of physical education and games lessons. That got into the national newspapers here in the U.K.

Free play tends to use more calories than equivalent organized activities. For example, a child kicking a football around will consume more calories than he or she would in a normal organized activity over the same length of time.

Children tend to walk when they go out to play, but when they are taken to organized activities, they tend to be taken by car, so not only do they use more calories when they go out to play, but they also use more getting there than in an organized activity. Of course, the trend nowadays is toward these organized activities, rather than letting children just go out and play.

We also found that children who walk more than they use the car tend to be more active in other aspects of their lives, whereas children who use the car more tend to be less active in other activities.

Among other things, we did find that many of the trips taking children to school were often part of a longer trip, usually by a parent--often, but not always, the mother--so that even if the children did stop travelling by car, there would not be an equivalent reduction in the number of cars on the road.

In that project we also looked at interventions such as walking buses. That's a group of children being escorted to school. These are quite common in many countries around the world nowadays. We did find they could encourage children to walk, but they require a lot of effort to organize, particularly in order to maintain their existence. We found that about half the trips made by walking buses in the area we were looking at were previously made by car; there was quite a large transfer from car to walking by the children taking part, but as I said earlier, there wasn't an equivalent reduction in the number of cars on the road.

We found the children who did switch from car to walking or to walking bus were spending about 22 minutes a day on the walking bus. In other words, that could be an extra 110 minutes a week in physical activity. We also found that children tend to drop out of walking buses when they get to the age of about eight because they simply lose interest in the whole concept; their mothers, who are usually the volunteers, drop out at the same time, which is why there is this problem of continuity.

More recently we carried out another project, which we called CAPABLE: children's' activities, perceptions, and behaviour in the local environment. We fitted the children with GPS--global positioning satellite--monitors, which are worn on the wrist. They walk around; these communicate with GPS satellites up in the sky, and we can tell with reasonable accuracy where the children are, so we can actually match up with the diaries telling us what the children are doing. The GPS monitor is telling us where they're going, and the activity monitor is telling us how active they are, so we have a very rich body of data on a number of children.

We also conducted surveys and questionnaires of both the children and their parents, with a particular interest in things like the effects of allowing children to go out without an adult.

The following factors seem to correlate with being allowed out alone: living with one parent; having an older sibling, particularly for girls; a household not owning a car; a house having a garden, which we assume associates with the type of area they're living in; and having access to a park or a communal area. So those factors seem to encourage children to be allowed out.

We found that children being allowed out alone were given a greater experience of a variety of places, more opportunity for exercise, and more opportunity to be with their friends and have their own social networks. But of course there are many complicating factors; for example, the nature of the area they live in, cultural factors, and so on. For example, we looked at some children in London, and they were allowed out, but not at such an early age as those living in more rural and suburban areas.

We also found that children tend to walk more vigorously when with adults than when unaccompanied by adults, which we believe reflects the tendency of children to explore more when they're on their own. They can often sit and chat with their friends when there's no adult present, whereas often, when a child has been walking with a parent, they are forced to walk rather fast, which might, at first sight, seem quite a good idea. Nonetheless, we would like to get children out playing, learning, exploring, and using the environment.

The GPS equipment has enabled us to improve the quantity of the results from the diaries. We're currently analyzing the findings from these in relation to the level of activity and the types of places they go to. That's very much ongoing research, and we're still analyzing those findings, but I can let you have those later, if you wish.

The third issue I'd like to go back to briefly is children's car dependency, because that's one thing we're very interested in. Our conclusion is that in order to reduce children's car dependency, you need to reduce their parent's car dependency, because children's car use tends to reflect that of their parents.

One of the major concerns for parents in this country is letting children out without an adult. There's a very high level of concern, often rather irrational, about letting children go out without an adult, so we need to overcome these parents' concerns about letting children out alone or with just their friends. We need to find ways of making the local environment more pleasant for children, and therefore for everybody. We need to get across to parents the message about the risk the lack of exercise is posing to their children's health in the long, medium, and even short term. And finally, we need to stress the message about the benefit of using everyday activity as a way of gaining exercise.

That's all I wish to say at the moment, but I'm very happy to answer your questions and provide more information in due course.

Thank you.