Public Health Nutrition Editorial Highlight ‘Seven-year itch: The UK Government’s difficult relationship with the food and drink industry since ‘Healthy Lives, Healthy People: A call to action on obesity in England (2011)’ Authors Stuart W. Flint, Emily J. Oliver discuss their research below.

Unhealthy food and drink consumption is associated with a range of physical and mental health concerns, and in particular, diabetes and obesity. The prevalence of these health concerns has led to the development of public health policies that aim to ultimately reduce their prevalence and support healthier population choices. Governments have tried to work with industry on these policies – in this commentary we argue this has reduced effectiveness and explore why.

Our focus is on the implementation of a specific national policy, Healthy Lives Healthy People: A call to action on obesity in England. Here, industry involvement has presented three interrelated challenges for the UK Government: (i) balancing collaboration whilst maintaining appropriate distance from industry stakeholders; (ii) resultant production of ‘watertight’ and effective legislation or intervention; and (iii) actual or perceived limited sanctioning or bargaining power.

Drawing on broader critiques, we argue that involvement of the food and drink industry in obesity-related policy development has prevented implementation of the most robust interventions. Industry is not motivated by public health goals, does not have expertise in public health policy to contribute, and therefore must not be involved in policy development. Indeed, explicitly industry is motivated to reduce regulation and legislative impact. The UK Government must strengthen its approach through restrictions, enforcing reformulation of unhealthy food and drink, and by involving industry solely in implementation discussions rather than policy development.

We acknowledge that there are financial concerns that are associated with restricting food and drink industries, and for that reason we argue that the UK Government has a choice to make: toughen their approach or attempt to maintain a conflicted partnership and compromise the pace of public health improvement. We argue that currently Government is failing in its responsibility to the public by prioritising protection against potential loss of economic or employment-related benefits from industry over actual and current damage that existing practice has on public health. Not so long ago, the UK had the same predicament regarding tobacco consumption and industry involvement. Government cutting ties with the tobacco industry can be argued to have made a significant difference to the reduction in smoking and overtime health conditions associated with tobacco consumption such as cardiovascular diseases.

Why does this matter?
Healthy Lives Healthy People: A call to action on obesity in England (1), had bold and explicit aspirations to achieve both a sustained downward trend in the level of “excess weight” (wording used in ‘the call to action’) in children by 2020, and a downward trend in the level of “excess weight” averaged across all adults by 2020. However, as of 2018, there has been little progress in reducing ‘excess weight’ during the seven years since the policy was released. We argue that this is at least partially attributed to industry involvement in policy, resulting in weak action.

Collaborative working, support with policy implementation (rather than development), and genuine ‘buy-in’ from industry could accelerate the pace of public health improvement. However, history informs that in relation to public health intervention, pursuing partnerships rather than adopting a stronger governance approach reduces effectiveness. Ultimately, and understandably, the priority for the food and drink industry is profit, not to support population health. The Government’s priority should be to support population health. Herein lies an important and currently a non-negotiable conflict of interest.

The full article ‘Seven-year itch: The UK Government’s difficult relationship with the food and drink industry since ‘Healthy Lives, Healthy People: A call to action on obesity in England (2011) is available to download for free for a limited time.

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