1. The National Food and Health Agenda Imogen Sharp Health Improvement and Prevention Department of Health

2. Why diet matters Contribution to early death 1 in 4 from cancer, 1 in 3 from coronary heart disease Contribution to obesity 22% men and 23% women obese; 17% 2-15 year olds obese. Obesity reduces life expectancy by 9 years Total cost of £3.3-3.7 billion (HSC estimate) Benefits of improving diet Breastfeeding - less infant morbidity/mortality; reduced childhood obesity 5 A DAY - reduced risk of death from CVD and cancers by up to 20% Salt down to 6g/day - hypertension down 17%, CHD 6%, stroke 15%

3. Obesity in England: A growing problem Source - Health Survey for England 1993 - 2002 6 8 7 12 13.8 17.3 21.2 22.1 22.8

4. Improving England’s diet: Nutritional priorities Fruit and vegetables - 5 varied portions per day Fibre - increase to 18 grams per day Salt - reduce to average 6 grams per day Fat - reduce total (35% energy) and saturated (11%) Added sugars - reduce to 11% energy Action along lifecourse or for specific groups

5. National dietary intakes Maintain a healthy body weight (BMI 20-25kg/m2)

6. Comparison of household purchases in 2002-03 with purchases in the previous year shows increases in fresh fruit and veg consumption - fresh fruit is 5.8 per cent higher. Estimates of Food Consumption and Energy and Nutrition Intakes in the UK in 2002-03, National Statistics, 24 June 2004

7. Policy context for action Existing NHS Plan and Priorities and Planning Framework Targets to reduce premature death from CHD and Cancer National Service Frameworks Tackling Health Inequalities - a programme for action Sustainable Farming and Food Strategy Emerging The NHS Improvement Plan: Putting People at the Heart of Public Services –key theme; healthier and fitter population Public Health White Paper (Choosing Health? and Choosing a Better Diet and Choosing Activity) Recommendations from Wanless, Health Select Committee WHO Global Strategy

8. Current action Welfare Food Scheme - Healthy Start Reducing salt, fat and sugar in the diet 5 A DAY Programme National School Fruit Scheme Whole school approach to diet and nutrition National Diet and Nutrition Surveys Action to encourage physical activity - obesity

9. Food and Health Action Plan Commitment in Sustainable Farming and Food Strategy Problem Analysis, Summer 2003 Stakeholder event, 23 February 2004 Must be developed in context of Public Health White Paper Out to consultation now as part of Choosing Health

10. Towards a White Paper (1) Choosing Health: a consultation on action to improve people’s health Two important strands: –Choosing a Better Diet: a consultation on priorities for a food and health action plan –Choosing Activity: a consultation on how to increase physical activity

11. Towards a White Paper (2) All three consultation documents asked questions about a wide range of public health issues Key questions for Choosing Health? Choosing a Better Diet included: - What role should different organisations play in improving consumer information and skills, and influencing behaviour? - What are the priorities for producers and manufacturers in stimulating demand and increasing availability of healthy choices in foods? - What are the priorities for retailers, caterers and the workplace for improving food supplied? - What are the key priorities for improving nutrition in pregnancy and early years? - What are the key priorities for improving nutrition in schools, the NHS and in communities?

12. Towards a White Paper (3) John Reid has said - “We know what we want to achieve, what the consultation has been about is how we are going to achieve it and how we are going to balance the health outcomes we want to see, with the personal control and social freedoms that all of us want to maintain” All three consultations end next week They will inform Public Health White Paper development

13. Responses to the consultation By 2 June the Department of Health had already received over 1500 responses by email and 400 by post Responses from 40 PCTs and SHAs indicate that over 17,000 people have been directly involved in local consultation events or responded to surveys Three of the key themes from the public consultation are - smoking in public/workplaces - obesity - increased physical activity

14. New direction for public health The NHS Improvement Plan: Putting People at the Heart of Public Services - 5 year plan White Paper will give new direction to public health Too early to say exactly what it will do - that will emerge in response to consultations Will cover nutrition, obesity and activity Food and health action plan will help deliver what White Paper says on nutrition (and obesity)