Speech Title: The nutritional status of the UK population. Overview of the key issues and examples of initiatives to address them
Dr Alison Tedstone retired from the Office of Health Improvement and Disparities (OHID) in March. There she was the Chief Nutritionist and led the nutrition programmes including the National Diet and Nutrition Survey, scientific advice (including the Scientific Advisory Committee on Nutrition) and actions to improve diet and promote physical activity. Her team led work aimed at tackling obesity including providing advice on Tier 2 obesity treatment services and by supporting marketing campaigns and whole systems approaches. Alison worked closely with colleagues on obesity policy. Her team monitored food industry action to reduce the sugar, salt and calories in everyday foods and the soft drinks industry levy (SDIL).
Over the years, Alison led technical support to UK actions on improving diet including salt reformulation, front of pack labelling, controls on TV advertising, the SDIL and numerous expert reports on, for example, folic acid, salt, carbohydrates, iron and vitamin D. She led assessment of the relationship between COVID-19 severity and excess weight.
Alison’s team transferred from Public Health England (PHE) to the Department of Health and Social Care (DHSC), where OHID is based, in 2021. She and nutrition colleagues were moved to PHE from DHSC in 2013 and from the Food Standards Agency (FSA) in 2010. Until 2001, she was lecturer at the London School of Hygiene and Tropical Medicine. She completed post doctorate research in Oxford and has a BSc and PhD in physiology. She is a registered public health nutritionist and a fellow of the Association for Nutrition. She has honorary fellowships from the Nutrition Society and Royal Colleges of Physicians and Paediatrics and Child Health. She is a member of the WHO Nutrition Guidance Expert Advisory Group Subgroup on Policy Actions. She now chairs the Association for Nutrition.
Diet is a primary determinant of health (1). In the UK, diets do not meet recommendations and are high in saturated fat and free sugars and low in fruit and vegetables, fibre and oily fish (2). It is estimated that for adults average energy intake exceed those for a healthy body weight by 800-1200 kJ/ day (3). Prevalence of overweight and obesity in both children and adults in England has increased incrementally over the last three decades: approximately 28% school children aged 4-5 years are living with overweight or obesity and this increases to 41% by aged 10-11 years (4). During the Covid-19 pandemic, obesity prevalence in primary school aged children rose sharply by an unprecedented 4.2-4.8 percentage points. Obesity in childhood increases the risk of obesity in adulthood. In England 68% of men and 60% of women are living with overweight and obesity (5). Deprivation and obesity are strongly associated (5,6). While there is some evidence of poorer diets in lower income groups, where diets fail to meet recommendations, this is seen across all income groups. Since 2016, a number of strategies aimed at reducing population (7) and childhood diet-related ill health and obesity (8,9) have been published. From these strategies, a number of voluntary and legislative cross-government policies have been enacted with differing measures and levels of success. These include structural policies that shape dietary choices at a population level (salt reduction, sugar reduction and reformulation, Soft Drinks Industry Levy, banning advertising to children of foods high in saturated fat, salt and free sugars). However it is clear that continual changes in the food environment favouring fast-food outlets and meal delivery companies alongside the adverse impact of the Covid-19 pandemic on diets, will require further action to deliver sustained improvements to diet and health.