As I have argued before, the anti-smoking lobby created a playbook which has become the Bible of the anti-obesity, anti-alcohol and anti-gambling lobbies. Yesterday’s announcement follows that playbook to the letter. If you have something you would like to ban, here are some of the boxes to tick.
- Flatter politicians
Most parliamentarians are powerless pygmies with delusions of grandeur. Having no answers to the big problems facing the country, they indulge themselves in the displacement politics of petty prohibition. They want to be seen as heroic, so be sure to flatter them by portraying the policy you are proposing as “bold” and “brave”. When the Health Committee proposed a sugar tax in 2015, it subtitled its report “Brave and Bold Action”. Jamie Oliver urged ministers to be “big and bold”. This week’s report from the Health and Social Care Committee uses the words “bold” or “bolder” six times. The first line of the press release calls for “a new, bold approach”. The committee’s chair, Layla Moran, said: “We ask this government to be bold, not to fudge and delay food restrictions.”
In truth, there is nothing courageous about taking on food companies that have shown no interest in standing up for themselves, let alone individual kebab shop owners who are just trying to make a living, but that is the beauty of it. MPs want to feel brave but don’t want to take risks. You have just the policies for them.
Friday, 17 July 2026
How to get things banned
Tuesday, 12 May 2026
Deluded wowsers
It's time to laugh at the Aussies again.
The article is here. The delusion and hubris is strong in this one. Australia hasn't beaten tobacco. Tobacco is beating Australia. It has unleashed a crime wave, and it seems that the underworld is now expanding into bootleg alcohol. It will be bootleg hamburgers if the wowser who wrote this article gets his way.
There will be predictable objections. Industry will argue that taxes are unfair, advertising restrictions are excessive, and governments should stay out of people’s kitchens. Similar arguments were made about tobacco. But Australia did not become a world leader in tobacco control by accepting industry talking points. It acted because the health and economic costs were too large to ignore.
Thursday, 16 April 2026
Illiberal liberalism
Under the heading “The case for liberal paternalism”, he makes such a shallow and uninformed case for lifestyle regulation that one starts to doubt whether he has read On Liberty. In addition to making a number of factual errors, he puts forward a series of hoary old chestnuts that he seems to think are argument-winning zingers. So you think you like freedom, eh? What about the drunk driver that kills someone? (Drink driving is banned.) Why should thin people have to pay for the healthcare of fat people? (The obese take less out of the welfare state than the thin because they don’t live as long.) He cites Richard Thaler’s work on behavioural economics to justify “nudging” and “soft paternalism” and then lists a slew of anti-smoking policies that Thaler would consider to be unacceptable because they impose costs and cannot be opted out of.
He rejoices in people being banned from smoking not only inside but outside and then says that similar tactics need to be used against people who eat “fattening foods”. He celebrates governments that put “comprehensive taxes on unhealthy food” and cheers on Japanese companies that “measure the waistlines of employees to make sure that they are not getting too fat”. “We should go further”, he says. “Why not use the proceeds of food taxes to subsidize healthy foods?” (Because the government doesn’t control the price of food.)
The problem with this is not so much that the policies he proposes are ineffective, though they are (Britain’s sugar tax, which Wooldridge thinks is wonderful, did absolutely nothing to reduce obesity and nor did the warning labels put on “unhealthy” food in Chile.) The real problem is twofold. Firstly, whatever else they might be, policies that “demonise” (his word) consumers of tobacco, cast them out from private buildings, extort money from them through sin taxes and restrict where they can buy the product are not liberal; a word that, as the author helpfully reminds us, is derived from the Latin word libertas, meaning liberty. Wooldridge is right to say that John Stuart Mill was comfortable with more state intervention than some libertarians care to admit, but when it came to state-sponsored paternalism he was crystal clear. “To tax stimulants for the sole purpose of making them more difficult to be obtained,” he wrote, “is a measure differing only in degree from their entire prohibition; and would be justifiable only if that were justifiable. Every increase of cost is a prohibition, to those whose means do not come up to the augmented price; and to those who do, it is a penalty laid on them for gratifying a particular taste.” Laws restricting where alcohol can be sold, said Mill, are “suited only to a state of society in which the labouring classes are avowedly treated as children or savages.” If banning people from smoking outdoors and having the government define and prohibit “misinformation” is Wooldridge’s idea of liberalism, we can only be thankful that he never developed an interest in fascism.
The second problem is that if Wooldridge wants a government that will take on populism by hassling smokers, meddling with the food supply and censoring the internet, he has already got it. Under Boris Johnson — the supposed populist “strongman” — the UK put into legislation the most stringent restrictions on “junk food” marketing and promotion in the world. His successor, Rishi Sunk, announced the total prohibition of tobacco, albeit over a timeframe that is almost surreal. Both policies were eagerly pursued by Keir Starmer when he became Prime Minister, as was the Online Safety Act. The House of Lords recently tried to ban social media for under-16s, Kemi Badenoch has already said that the Conservatives will enact such a ban, and it is only a matter of time before it becomes official Labour policy. Is it any wonder that populists talk about the Uniparty?
Thursday, 6 November 2025
Chris van Tulleken and the slippery slope
The prof confirms that the slippery slope is very real. pic.twitter.com/LoqwzGZ7HY
— Christopher Snowdon (@cjsnowdon) November 6, 2025
Van Tulleken says the quiet part out loud. He wants warning labels on food because it will start a cascade of taxes and regulation. #slipperyslope pic.twitter.com/4XVdtwraSp
— Christopher Snowdon (@cjsnowdon) November 5, 2025
“We should just not advertise food.” pic.twitter.com/1EEerV7gtF
— Christopher Snowdon (@cjsnowdon) November 6, 2025
Opinion differs on what drives van Tulleken's increasingly demented campaign against brown bread. Some say he is a grifter trying to sell copies of his book. Others say he is an attention seeker. My view has always been that he has an unhealthy relationship with food and suffers from orthorexia nervosa. He casually mentions in his book that he has been known to make himself vomit so he can eat more food, i.e. he has (or has had) bulimia, but seems to think that this is perfectly normal.
Professor Van Tulleken bravely opening up about his eating disorder. pic.twitter.com/m8OwkBgjUb
— Christopher Snowdon (@cjsnowdon) November 6, 2025
Tuesday, 16 September 2025
RIP Graham "mad dog" MacGregor
I was sadder than you might expect to read that Graham MacGregor has died, aged 84. The Telegraph focuses on his anti-salt advocacy, but you probably know him better for setting up Action on Sugar.
We sparred on TV and radio many times and I was always happy to let him talk because he was so zealous in his campaigning and so extreme in his demands that it could only put the median voter off. He was a fanatic and he didn't try to hide it. I don't mind that. I prefer a sincere crank to a fanatic who pretends to be a moderate. You knew where you were with Graham. Most of what he said was deranged and he told some outright lies, but he was upfront about his longterm goals, such as plain packaging for chocolate and halving the amount of sugar in all foods.
He was also, I think, an eccentric, and at least eccentrics are colourful. He said something to me once that gave me the strong impression that he was right-wing, which would certainly make him an eccentric in 'public health' circles. His accent and appearance were more military than medical, but he was a proper medical doctor and, as far I can tell, he never profited personally from Action on Sugar.
In 2014, we both appeared on 'Alan's Ding Dong', a Partridge-esque feature of the Alan Titchmarsh Show, to debate the merits of a sugar tax in front of an audience of pensioners who had been bussed in from middle England. It went to a public vote in which the audience were invited to hold up a yellow paddle if they were opposed to the idea. As you can see from the photo below, you should never get between OAPs and their sugar.
I also remember MacGregor and fellow nanny statist Susan Jebb shouting at each other at the 2015 Sugar Summit. I couldn't hear exactly what was being said but it started after Jebb accused him of using "loose words" and "factual inaccuracies" on stage.
I only had a private conversation with him a couple of times, but when we were chatting before doing the Spectator podcast in 2017, he told me with some reluctance that he had agreed with every word of an article I had recently written (unfortunately I can't remember which one). When I asked him about the departure of Aseem Malhotra from Action on Sugar, MacGregor called him "bonkers" and was just getting into his stride when he stopped himself said "Anyway, I'm not going to talk about Aseem - especially to you!"
I met him again at a small conference held by the sugar industry in a London hotel. MacGregor was only required for a panel on public health late in the afternoon but he turned up for the whole thing and ended up listening to industry folk talking about things like fertilisers, the climate and other issues that affect sugar farmers. After a dry and detailed discussion of the global sugar market from an American speaker via videolink, MacGregor raised his hand to talk about how sugar taxes and food reformulation were sweeping the world and asked how the industry was going to cope with the inevitable downturn in sales. The American looked rather baffled and said that he was not projecting any decline in sugar consumption.
His legacy was mostly malign and a lot of what he said was objectively wrong, but I could never bring myself to hate the old boy. At least he was a character. RIP.
Tuesday, 9 September 2025
The endless "public health" playbook
Food industry lobbying is leading Labour to drop public health plans, experts say
Labour has scrapped ambitious plans to tackle Britain’s growing toll of lifestyle-related illness after lobbying by food and alcohol firms, health experts have said.
Ministerial inaction on ill-health caused by bad diet, alcohol and smoking is so serious that the NHS could collapse as a result of conditions such as heart disease and diabetes, they warn.
The charge against ministers has been made by Sarah Woolnough and Jennifer Dixon, the chief executives of the influential King’s Fund and Health Foundation thinktanks.
"There is a long history of lobbying from the food, alcohol and tobacco industries weakening and delaying measures that would improve people’s health."
They have said Labour are repeating the mistakes of previous governments by letting “vested interests” wield too much influence and water down planned policies.
“And once again long-promised restrictions on junk food advertising have been delayed while Labour’s proposals to extend smoking restrictions to outdoor areas of pubs and restaurants were squashed,” Woolnough and Dixon say in a joint blog.
“Minimum unit pricing for alcohol – successfully implemented in Scotland ..."
– and a Clean Air Act, regularly promised by Labour in opposition, have both failed to materialise.”
Woolnough and Dixon single out the health secretary Wes Streeting’s threat to food firms in February 2024 that he would use a “steamroller” to force them to reformulate their products by putting less fat, salt and sugar in them. He has not acted on that pledge while in office, though, and instead published weaker plans intended to promote the take-up of more nutritious food.
The lesson of the last fifteen years is that the amount of screaming the government will be subjected to if it does nothing that 'public health' lobbyists want is identical to amount of screaming it is subjected to if it does most of what they want. They will accuse politicians of being in the pocket of various industries. They will accuse the Health Secretary of being weak. They will claim that the NHS is going to collapse.
It is the same script regardless. The government gets no thanks for capitulating to them again and again. Their list of demands is endless and their autistic screeching is loud and constant regardless of what any government does. On tobacco and food, in particular, no government in the world has done more to appease these fanatics in the last two decades. It hasn't worked. The obvious lesson is that politicians should stop trying to appease them. The only thing that is likely to make them shut up is a government that makes is clear that it will not be giving into any further demands.
The Department of Health and Social Care rejected the thinktank bosses’ criticisms. A spokesperson said: “We are legislating to make sure children today can never legally smoke, introducing a ban on high-caffeine energy drinks for children and new rules to make baby food better for families, preventing fast food shops from setting up outside schools, banning junk food adverts targeted at children, introducing supervised toothbrushing to prevent kids teeth from rotting, a Healthy Food Standard to make the healthy choice the easy choice, and investing an extra £200m in the public health grant after years of cuts.”
Friday, 14 March 2025
How slushy ice drinks became a health hazard
A study in Archives of Disease in Childhood identified 21 cases of children in the British Isles developing hypoglycaemia and suffering from what the authors describe as ‘an acute decrease in consciousness’ after drinking ‘slush ice drinks’ such as Slush Puppies. None of the children had a history of hypoglycaemia. None of them had an episode like this again, apart from one child who became ill after drinking another slushy ice drink.
The cause of their collapse was glycerol intoxication, and the finger of blame falls on the sugar tax.
Monday, 17 February 2025
What is the Marcela Trust?
Action on Sugar is back in the black. After receiving just £74 in voluntary donations in 2022/23, the pressure group - formally known as Consensus Action on Salt, Sugar and Health - raised £201,225 last year.
In June 1991, the Inland Revenue raided Nissan UK's headquarters, as well as Mr Botnar's home and the homes of other company officials. The tax authority accused Botnar of evading more than £200 million in taxes. The scam involved using a third party shipping agent to deliberately overcharge Nissan UK for the shipment of vehicles from Japan so as to artificially depress its own profits thus reducing the company's exposure to corporation tax. Botnar left for Switzerland and lived for the rest of his life there in Villars-sur-Ollon.
THE CHARITY PROVIDES SUPPORT TO SELECTED CAUSES IN LINE WITH THE CHARITY'S OBJECTS.
Friday, 27 December 2024
Defanging the nanny state
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| AI generated |
I have a new IEA report out today. It's called Defanging the Nanny State and it looks at what politicians would have to do to get the UK to the bottom of the Nanny State Index. I suggest the following steps:
1. Alcohol taxes: set them at 13p per unit for all drinks to cover the external costs. This would be a significant reduction for most products. Wine duty would still be higher than in most EU countries.
2. Tobacco taxes: halve them to bring them in line with places like Italy and Cyprus. This wouldn't even cost HMRC much money because so much tobacco is sold illegally in the UK at the moment.
3. The sugar tax: get rid of it. It hasn't worked and most European countries don't have one.
4. E-cigarette and heated tobacco advertising: legalise it on all platforms with appropriate regulation of content. The e-cig ad ban is a hangover from EU membership. Ditto all other silly EU regs, e.g. banning vape juices bottles larger than 10ml.
5. Legalise snus. Another hangover from the EU.
6. Maintain the smoking ban in all state-owned buildings open to the public and have no-smoking as the legal default in privately owned buildings unless the owner explicitly permits it.
7. Abolish minimum pricing in Scotland and Wales. Ireland is the only other country that has it. The policy hasn't worked and has cost drinkers a fortune.
8. Abolish restrictions on where tasty food can be positioned in shops and cancel the forthcoming advertising ban.
9. Abolish licensing hours. Of the 30 countries in the 2023 Nanny State Index, 18 have no national legislation dictating when licensed premises have to close. Restaurants and bars should close when their owners wants them to.
Doing all this would get the UK below Germany in the Nanny State Index - but only just. Is it going to happen? No. More nanny state legislation is on its way. But this wish list shows two things.
Firstly, we have a hell of a lot of nanny state regulation and our sin taxes are sky high.
Secondly, it is politically feasible insofar as other countries have a much smaller nanny state and their governments don't get kicked out for not being paternalistic enough.
Some people might consider the proposals above to be dramatic but they would leave us in a very similar position to the likes of Luxembourg and the Czech Republic. I could have gone much further. I haven't touched daft policies like plain packaging (which only a small handful of European countries have) and I have kept the cigarette advertising ban in place. That doesn't mean I agree with them, but the task I set myself was to do the minimum required to get the UK to the bottom of the index.
Read the full report here.
Wednesday, 27 November 2024
Calorie labelling didn't work
Of all the anti-obesity policies that have been tabled in recent years, calorie labelling is the least objectionable. It is not regressive like the sugar tax or anti-competitive like the advertising ban. If it’s nannying, it is of the gentlest sort; a nudge rather than a shove. It would have been a nightmare for small businesses to implement, but they were given an exemption when the government made calorie counts mandatory in cafés, pubs and restaurants two years ago.
You could argue that the number of calories in a meal is basic information that consumers have a right to know, even if it doesn’t make any difference to what they eat. That is just as well because we now know that it doesn’t change what people eat. An evaluation funded by the National Institute for Health and Care Research was published this week and concluded that “the introduction of the mandatory kcal labelling policy in England was not associated with a significant decrease in self-reported kcals purchased”. Monitoring the behaviour of 6,578 customers in pubs, fast food outlets, cafés and restaurants before and after the introduction of mandatory calorie counts, the authors found that the number of calories consumed actually rose from 909 per meal to 983 per meal.
Read the rest at the Telegraph.
It's been another bad week for 'evidence-based' public health policies. I've written about three of them on my Substack.
Wednesday, 6 November 2024
Not Invented Here (1): obesity
The Department of Health and Social Care says that obesity costs the NHS ‘up to £6.5 billion a year’. The health secretary Wes Streeting has claimed that it costs the NHS £11 billion a year. When wider societal costs, including lost productivity, are included, Frontier Economics estimated that obesity cost Britain £58 billion in 2020, and when they made a further estimate to include the cost of people being overweight in 2023, this rose to £98 billion, of which £19.2 billion were direct costs to the NHS.
Obesity is routinely referred to as a ‘crisis’ in the UK and elsewhere. Fifteen million adults (28 per cent) have a body mass index of 30 or more and are therefore classified as obese. The number of obese Britons has been gradually growing for decades and none of the anti-obesity policies enacted so far, such as the sugar tax and traffic light labelling on food, has made any tangible difference. Some countries have gone further. Hungary, for example, has an extensive system of taxes on food that is high in fat, salt or sugar (HFSS). Chile has had mandatory health warnings on HFSS food since 2016 and has banned the use of cartoon mascots such as Tony the Tiger. Both countries have seen obesity rates continue to rise.
Given how seriously public health campaigners take obesity as a health problem, you might think that they would be delighted to find something that makes people lose a great deal of weight in a short space of time. But you would be wrong. A new generation of pharmaceuticals that have been shown in randomised controlled trials to help people lose an average of 15 per cent to 20 per cent of their body weight have been given a cautious welcome at best by those who should be most excited by them.
Wednesday, 30 October 2024
Rachel Reeves' taxes on working people
Not entirely unpredictably, taxes and spending are set to go through the roof after Labour's first budget since 2010. Having promised not to tax working people, Rachel Reeves announced tax rises for smokers and drinkers, announced a new vape tax and increased the sugar tax. Details below from the Red Book.
"A wealth of economic evidence shows that taxing e-cigarettes leads to more people smoking. Taxing vape juice shows that the government is not serious about its 'smokefree' ambitions.“Reeves says that yet another 'one-off' tax hike on tobacco will dissuade vapers from switching back to smoking, but with 26% of the cigarette market already in the hands of organised crime, the legal price of cigarettes is irrelevant to a growing number of smokers. Tobacco duty revenue has fallen by £1.5 billion in the last two years and it will go on falling, despite the tax rate rising, because smokers feel no moral duty to buy legal cigarettes and give money to politicians who so obviously hold them in contempt.“Cutting draft beer relief so that a pint in a pub is 1p cheaper doesn't come close to compensating from this tax raid. Drink 600 pints and get one pint free? It is a cheap gimmick."
Wednesday, 9 October 2024
Child obesity stats
As you may know, I have a long-running obsession with the fact that Britain's child obesity stats are a complete fiction. This came up in Radio 4's More or Less today in which I featured. The hook was the silly story in The Times claiming that child obesity is in decline (thanks to the sugar tax, of course). This is not true (as I discussed on my Substack).
You can listen here or, better still, subscribe to the podcast.
Tuesday, 17 September 2024
Taxes. Is there anything they can't solve?
The Institute for Public Policy Research (IPPR) has published what it calls “the most ambitious blueprint for the nation’s health since Beveridge”. I wouldn’t get too excited. Their previous contributions to the debate about the nation’s health include demanding plain packaging for crisps and sweets. Surprisingly, that doesn’t get a mention this time around but the report does include 20 recommendations, many of which don’t have much to do with health but are things that left-wing think tanks always want, including “a full restart of Sure Start”, a legal “Right to Disconnect” at work, abolition of the two child benefit cap, more spending on research, more work for quangos, even more “free” school meals, etc.
But the IPPR also wants a “healthy industrial strategy” based on the “polluter pays principle”. Their thinking is rooted in two absurd beliefs that have become the orthodoxy in ‘public health’ through repetition. The first is that if you drink yourself to death, it has nothing to do with you and is instead the fault of Heineken or the French wine industry or some other commercial entity. The second is that the greatest public health win of the last ten years was Lucozade putting more artificial sweeteners in their drinks. Despite the sugar tax having no effect on childhood obesity, the IPPR reckons it was “among the most successful government policies of the last decade” (to be fair, it hasn’t been a great decade for government policies) and wants it to be “expanded’, not just to food and drink but to a bunch of products and services that are already heavily taxed.
Read the rest at The Critic.
Meanwhile, EU countries have got their own problems...
European Union countries should consider extending smoking bans to cover children’s play areas, outdoor pools, amusement parks, and terraces, the European Commission will recommend Tuesday, according to a document obtained by POLITICO.
The EU executive will also recommend stricter rules on e-cigarettes “whether containing nicotine or nicotine-free” as it looks to tackle the “uptake and appeal” of vapes among children and young people.
Sunday, 14 July 2024
Sugar tax claims jump the shark
The Guardian is trying to find out how gullible its readers are. How else can you explain a headline like ‘Children’s daily sugar consumption halved just a year after tax, study finds’? It can only be deliberate. The alternative explanation is that Guardian journalists cannot read a simple study and are highly credulous, but since that is unthinkable we must assume that such headlines are designed to be idiot tests.
Tuesday, 7 May 2024
Ultra-processed food - my comments to the House of Lords
The House of Lords Food, Diet and Obesity Committee started its pointless proceedings in February and is still slogging on. It has managed to avoid asking anybody who is sceptical of the ultra-processed food panic from appearing (last week it heard from three 'ambassadors' from the Food Foundation and three 'ambassadors' from Jamie Oliver's BiteBack front group). The committee did, however, ask for written submissions so this is what I sent them back in February after Dimbleby, Spector and Coco Pops guy kicked things off....
I was concerned to see that six out of the seven people who appeared at your first three oral evidence sessions were activists and/or authors who subscribe to a particular view of the food system and favour heavy regulation. Whilst I am sure you plan to invite some mainstream scientists, economists and consumers to future sessions, I felt it might be of use to respond to some of the questions in your call for written evidence below.
The definition of a) ultra-processed food (UPF) and b) foods high in fat, sugar and salt (HFSS) and their usefulness as terminologies for describing and assessing such products.
The official HFSS definition, which campaigners use as the implicit definition of ‘junk food’, creates many absurdities, partly because the limits laid out in the Nutrient Profiling Model (NPM) are so low. HFSS food includes raisins, sultanas, most tinned fruit, most yoghurts, two-thirds of morning goods, nearly all cheese, cream crackers, tomato soup, hummus, ham, pesto, cereal bars, olive bread and salami. Whether these foods are ‘high’ in fat, sugar and/or salt is a matter of opinion, but few people would view all of them as ‘junk food’ and want to ban them from being advertised. It is doubtful whether the general public considers even very high sugar foods like jam or very high fat foods like butter to be ‘junk food’.
Campaigners such as Jamie Oliver have exploited the confusion about what ‘junk food’ is (it has no scientific definition and is legally meaningless) to push for legislation against the much broader category of HFSS food. Having capitulated to these campaigners in 2020, the government has tacitly acknowledged that it bought a pig in a poke by exempting a number of HFSS foods from its list of ‘less healthy’ food in the Health and Care Act (2022). There is no scientific justification for exempting these foods - the NPM has the virtue of at least being consistent - but they are so far removed from the popular idea of junk food that the government would look ridiculous if it included them.
‘Ultra-processed food’ is an even broader category which demonises the vast majority of food that isn’t eaten raw or prepared by hand in a domestic kitchen. As a phrase, it was never uttered in the House of Lords until 2020 but there has been a flurry of mentions and several specific debates in the chamber since Chris van Tulleken published his book Ultra-Processed People in April 2023. Van Tulleken is responsible for introducing many people to the concept of UPFs. He makes many claims in his book and in his media appearances that are at best contentious and at worst demonstrably false. For example, based on a misreading of an academic study, he falsely claims in Ultra-Processed People that Chilean miners burn the same number of calories as sedentary office workers and that exercise therefore does not help people lose weight. He has falsely claimed on Twitter/X that the very idea that exercise assists weight loss was invented by the Coca-Cola company.
‘the association between UPF consumption and the risk of multimorbidity would disappear if the data were adjusted not only for the consumption of sugary or artificially sweetened beverages, but also for foods of animal origin at the same time. Indeed, in our opinion, the article underlines the absolute need to return to the evaluation of foods on the basis of their nutritional role (including their nutrient composition, quantities consumed, metabolic effects, etc.) and not on the basis of their degree of processing.’
One peculiarity about the UPF system is that some of the few ingredients that are not portrayed as inherently dangerous are fat, sugar and salt. So long as they are used to make cakes, biscuits, etc. in a domestic kitchen, they are de facto healthy. It is the industrial processing, not the nutrients, that somehow creates the risk. This not only turns the scientific consensus of recent decades on its head but is palpable nonsense and it is a sign of how quickly the West is retreating from Enlightenment values that anyone is taking it seriously.
Growing fanaticism from certain policy entrepreneurs would lead us to portray a large number of food products as inherently dangerous and urge us to abstain from them all. This is not only unscientific but useless in terms of practical public policy because people are never going to abstain from eating chocolate and bacon let alone sliced bread.
The cost and availability of a) UPF and b) HFSS foods and their impact on health outcomes.
Processed/HFSS/UPF food is typically more expensive than what the government defines as healthy food (fruit, vegetables, starchy carbohydrates, white meat, etc.). Campaigners often claim the opposite by comparing food prices using the cost-per-calorie method. This turns the virtue of being low in calories into a vice since the cost-per-calorie naturally rises as the number of calories in the product declines. A better method is to measure the cost per meal or the cost per kilogram. Under these measures, the cost of healthy eating is relatively low and is far lower than the cost of eating takeaways and fast food (Snowdon 2017).
The impact on heath of HFSS and UPF has been partially addressed in the previous answer, but it is worth mentioning the study by Kevin Hall et al. (2019) which will doubtless be cited a lot in the written and oral evidence to your inquiry. By the low standards of nutritional science, this was a well conducted randomised controlled trial. It found that the people who ate the UPF diets consumed significantly more calories than those on the non-UPF diet and that the former gained weight while the later lost weight. Unfortunately, due to cost pressures, the researchers were not able to offer UPF and non-UPF versions of the same meal. Instead, the UPF group was given a diet that differed more fundamentally than in the way it was processed. For example, one lunch consisted of burger and fries for the UPF group while the non-UPF group got salmon and green beans. The non-UPF food was not merely non-UPF, but was minimally processed which perhaps explains why those who ate it lost weight. As a control group, it would have been more useful (and more realistic) to give them processed (but not ultra-processed) food. The hypothesis that ultra-processing causes over-eating/obesity can only really be tested by giving people processed and ultra-processed versions of the same meal, but no RCT has yet done this to my knowledge.
Lessons learned from international policy and practice, and from the devolved administrations, on diet-related obesity prevention.
I am aware of no country that has reduced obesity rates through deliberate government action (although a few socialist countries have done so as an unintended consequence of its economic policies, e.g. Venezuela). An obvious approach would be to look at comparable countries that have significantly lower rates of obesity than the UK and emulate their policies. This is rarely suggested by ‘public health’ campaigners, presumably because countries with lower obesity rates do not have the kind of taxes and bans they support.
The impact of recent policy tools and legislative measures intended to prevent obesity.
The most significant measure in recent years has been the sugar tax which plainly had no impact on childhood obesity (rates of which rose for three successive years after it was introduced). The ban on HFSS food advertising on television during children’s programmes also failed to have any impact on rates of obesity. Food reformulation didn’t work because consumers couldn’t be forced to eat the reformulated products. It is highly doubtful that forthcoming bans on advertising and promotion will lead to a decline in obesity. Even the government’s own Impact Assessment, based on a starry-eyed interpretation of weak and biased research, only predicts a trivial effect on calorie consumption.
The persistent failure of anti-obesity policies to reduce obesity never leads to any apologies or resignations from the activists and academics who campaign for them. Rather than repealing unsuccessful policies, governments tend to double down with further restrictions, thereby creating a runaway train of regressive, anti-competitive policies that logically leads to some form of prohibition (as we are now seeing with tobacco). Policy entrepreneurs who seek to regulate the food supply are in the privileged position of never having to show that their policies work. This sets them apart from doctors and nurses who cannot, in the modern era, get away with conducting unnecessary and harmful operations or prescribing useless drugs.
No one expects a single policy to reduce obesity rates to zero, but it should not be too much to ask for them to reduce them by a little bit, even if only a fraction of one per cent. This, however, has so far been beyond the purported experts of Britain’s lavishly funded ‘public health’ institutions. To disguise their failings, they have invented something called the ‘whole systems approach’ to obesity which amounts to throwing as many untested and unproven policies at the problem as possible, regardless of cost and unintended consequences, in the hope that one or more of them might work. When each of them predictably fails to move the dial, they mutter something about there being ‘no silver bullet’ and move on to the next idea. This, I submit, is neither a wise nor evidence-based approach to policy-making.
Saturday, 16 December 2023
Sugar tax study retracted
A study from 2021 which claimed that the sugar tax reduced sugar consumption from soft drinks by 10% was retracted last week. It appears the 13 authors made an enormous cock up and the 'real' figure is a trivially small 2.7%.
This is not just any old bunch of researchers. They are conducting the official evaluation of the sugar tax and have been given £1.6 million of taxpayers’ money to do so. The same team has since produced a study claiming that the sugar tax reduced obesity among one group of girls but not among another group of girls and not among any boys (and obesity rates actually rose among all age groups), and a study claiming that it reduced tooth decay extractions among a subset of children who never drank many sugary drinks to begin with (I wrote about the latter last month). Almost unbelievably, they have a study in the pipeline that will claim that the sugar tax reduced childhood hospital admissions for asthma by more than 20 per cent!
The retraction casts further doubt on all these claims, partly because it raises serious questions about the team’s competence and partly because the reduction in sugar consumption attributed to the tax is now so tiny that any measurable difference in health outcomes is less plausible than ever.
Friday, 17 November 2023
Did the sugar tax reduce dental extractions by 12%?
The study is therefore making the extraordinary claim that George Osborne’s announcement in March 2016 had an almost immediate effect on rates of tooth decay despite there being little change in the sugar content of soft drinks for the first 18 months and there being no change in the price of sugary drinks for the first two years. Furthermore, the effect was most pronounced among pre-school children who are least likely to consume the drinks in question whereas there was no effect on teenagers who drink more of them than any other age group.
Saturday, 9 September 2023
The unintended consequences of the ‘junk food’ advertising ban
(First publisher in Spectator Health in March 2019)
It’s only been a week since Sadiq Khan’s ill-conceived ban on ‘junk food’ advertising across London’s public transport network came into effect, but the unintended consequences are already coming to light.
As I explained last June, ‘junk food’ has no legal definition. Those who want to restrict food advertising clearly have American fast food chains in mind, but the government is not so arbitrary and capricious that it is going to put McDonald’s, Pizza Hut and KFC on a blacklist. That would not only be illegal, it would also make the thinly veiled snobbery behind the anti-obesity crusade awkwardly explicit.
The model was devised by our old friend Mike Rayner who literally believes that God told him to bring about a sugar tax in Britain. All the obvious stuff gets a black mark under Rayner’s model: pizza, crisps, biscuits, confectionery, milkshakes and sugary drinks. It also rules out lots of products that are not typically considered to be ‘junk’ but which can be expected to get caught up in a system that focuses on sugar, salt and fat: ice cream, clotted cream, jam, marmalade, honey, bacon, pretzels, salted peanuts, sweetened fruit juice, smoothies and most sausages.
But then there are the foods that hardly anyone would consider ‘junk’ but which still fail the test: cheese (including half-fat cheese), raisins, sultanas, soy sauce, mustard, most tinned fruit, most yoghurts, most breakfast cereals (including high fibre varieties), peanut butter, Marmite, mayonnaise (light and regular), tomato soup, most cereal bars, many pasta sauces, all butter, fat spreads and olive oil.
Having spent much of the last year warning of the unintended consequences of half-baked anti-obesity policies, I welcomed the jolt of schadenfraude I got from reading about Farmdrop’s battle with TfL. Farmdrop is the woke mirror image of the stereotypical fast food company. It bills itself as an ‘ethical grocer delivering delicious food direct from local farmers’ and specialises in organic produce.
If it is organic, it must be ‘healthy’, right? Not according to the Nutrient Profiling Model. Farmdrop’s wholesome advertisement showing a family admiring their latest delivery was rejected by TfL because it shows butter and bacon. Butter is high in saturated fat and calories. Bacon is high in saturated fat, calories and salt. Ergo, they are what disingenuous health campaigners describe as ‘junk food’.
If you think this is ludicrous, I don’t disagree, but rules is rules. I would have more sympathy for the people at Farmdrop if they hadn’t been enthusiasts for the ban right up until the moment they realised that it wasn’t just their competitors who were going to be clobbered.
In fact, they still support the ban. Like the party member screaming loyalty to Comrade Stalin as he is dragged off to the gulag, they assume that there must have been some mistake. In a charmingly bewildered blog post, Farmdrop say that ‘the ban is coming from the right place’ but that the ‘handling has been clumsy’. They ‘fully support the Mayor of London’s decision to prohibit junk food advertising on the transport network’ but are ‘concerned about how it’s being applied’.
Alas, they are not victims of an administrative error by an over-zealous jobsworth. The law is being applied as it was written, with HFSS food forbidden and non-HFSS food allowed. What is the alternative? There has been talk of TfL offering exemptions from the ban if the food in question is “not generally consumed by children” or if there are “exceptional grounds”. Neither seems to apply in this case, and if the authorities started making ad hoc exceptions on the basis of common sense, the whole house of cards would soon fall apart.
Farmdrop have their own definition of junk food, describing it as ‘calorific foods with little or no nutritional value’, but this only underlines how difficult it is to come to an objective judgement. If a food has no nutritional value, it is not food. Tellingly, they add: ‘We all know which foods we mean here.’ And so we do. We mean burgers that don’t come in a Rye Burger Bun topped with seeds (£1.75 for two). We mean mass-produced chocolate bars from Nestlé, not Belgian Dark Chocolate Tiffin (£3.50). What a shock it must be to discover that the authorities think that Organic Wyfe of Bath Cheese is just as fattening as the cheese on a Domino’s pizza and that Organic Dry Cured Streaky Bacon clogs the arteries just as much as the bacon served in a bap in a greasy spoon caff.
I said months ago that the public has been sold a pig in a poke by campaigners who talk about banning junk food advertising. The fact that a company like Farmdrop, which is in the food industry and regularly advertises on the tube, had no idea about the true scope of the law shows how far the wool has been pulled over our eyes. If a bland advertisement for ordinary food by a self-consciously virtuous business can fall foul of the law, anything can.
The chickens are coming home to roost. In the meantime, Londoners should reflect on the fact that they now live in a city where a photos of butter, raisins and ham are considered dangerous.
Tuesday, 25 July 2023
Sugar taxes don't work, let's have more of them!
Action on Sugar pleads for industry action as global study connects soft drink consumption to teenage obesity
Teenagers’ overconsumption of soft drinks has been directly associated with the prevalence of overweight and obesity in a global study. Soft drink consumption contributes to at least 12% of the variations in overweight and obesity rates among adolescents across different countries.
In light of the study, conducted by the Wolfson Institute, Queen Mary University of London, Action on Sugar, another university division, cautions that there is a dire need to implement effective strategies such as the Soft Drinks Industry Levy to reduce the consumption of such beverages.
Approximately 17.2% (95% CI, 17.0%-17.5%) of all the school-going adolescents were overweight or obese, and the population-weighted prevalence of overweight and obesity among adolescent students in countries and regions with soft drink taxes was marginally higher compared with those in countries and regions without soft drink taxes (17.4% [95% CI, 17.1%-17.7%] vs 16.3% [95% CI, 15.9%-16.8%]; P = .05).
... in countries with soft drink taxes, the prevalence of daily soft drink consumption among school-going adolescents was lower than in countries without such taxes (30.2% vs 33.5%).
These findings suggest that governments, particularly those in low- and middle-income countries, should take actions such as levying taxes on soft drinks to lower soft drink consumption or to reduce the amount of sugar consumption from soft drinks, to help curb the rapid increase in obesity.
Monday, 24 July 2023
It's that man again
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| Cooey! |
The Sunday Telegraph ran an article titled ‘I’m a doctor – here’s how I would solve Britain’s obesity crisis’ yesterday. Unsurprisingly, it didn't involve people eating less and exercising more, nor did it mention the miracle weight loss jab. Instead, it featured three slightly different awful people giving their Big Government prescriptions.
After the usual recitation of bogus facts ("obesity now affects two thirds of UK adults [actually 26%] at a cost of £6 billion to the NHS each year [actually a lot less]") we were treated to the views of three self-proclaimed experts, one of whom isn't even a doctor.
I head up the Behavioural Insights Team, also known as the Nudge unit, which was set up by the government in 2010 with the idea that nudging people towards better choices without regulation or force is the best way to spark change long term. (We are now fully owned by Nesta, a charity.) We suggested nudges, such as the sugar tax in 2014 (implemented in 2018), and placing high-calorie foods away from checkouts in supermarkets. We also backed junk food advertising bans and an end to buy-one-get-one-free deals on such products...
To state the obvious: a BAN is not a NUDGE. The opposite in fact. So don't blame Bloomberg's ban on large soda cups on us.
— Richard H Thaler (@R_Thaler) May 31, 2012
It is evident that information, exercise and willpower will not reduce levels of obesity.
Two thirds of adults are overweight or obese in Britain, and as doctors, we’re worried about what this means for the future of chronic diseases. We need to raise healthy food and healthy eating on the nation’s list of priorities, and to do this together.
That starts with GP services, who need more resources to be able to support their patients in losing weight to improve their health.
What I would really love is if they left my surgery and saw a public health campaign advertised on a bus, reiterating the benefits of weight loss, building on what we’re doing in consultations.I often say to people that if they can make these changes for themselves, they can do more for their health than any doctor can.
We know that what drives weight gain and other diet-related diseases in this country is eating foods that are ultra-processed, high in fat, salt and sugar...
...yet at the moment, children see marketing for all of the above everywhere they turn.
Countries like Mexico, Colombia and Brazil are beginning to better label food – they don’t use our confusing traffic-light system, rather big black hexagons on unhealthy products, so you can spot them immediately. They also ban cartoon characters on packaging, to make them less appealing to children.
We need to avoid eating rubbish food from cradle to grave. At the moment, people don’t have a choice.