1. LIVING WELL IN THE WEST MIDLANDS CONFERENCE: FOOD & NUTRITION WORSHOP DAVID ELLIOTT DEPARTMENT OF HEALTH WEST MIDLANDS

2. Health and Well-Being 2 Obesity is growing at an alarming rate, with a significant impact on individuals, the NHS and society as a whole Foresight report: By 2050, 60% of men and 50% of women could be clinically obese: BMI > 30kg/m 2 [70% of men in the West Midlands] Health impact of obesity: –58% type-2 diabetes –21% of heart disease –10% of non-smoking related cancers –9,000 premature deaths a year in England –Reduces life expectancy by, on average, 9 years. Costs of obesity: –NHS - £4.2bn –Wider economy - £15.8bn –Foresight estimate costs to economy of £50bn by 2050

3. Health and Well-Being 3 Tackling Obesities: What role does Food & Nutrition have?

4. Health and Well-Being 4 Cabinet Office: “Food Matters” (July 2008) Estimated 70,000 premature deaths (more than 10% of current annual mortality) in the UK could be avoided each year if UK diets matched nutritional guidelines Reaching 5 A DAY target could 42,000 premature deaths avoided each year Economic burden of diet-related ill health estimated to be £6 billion in additional NHS costs each year (7% of its budget) UK consumers spend an average of £420 per household/per year on food that they throw away Average UK household spends about 9% of its expenditure on food, down from 16% in 1984 Poorest 10% of households in the UK saw 15% of their expenditure spent on food in 2005/06 – whereas the richest spent just 7% Low-income households spend more on basic food staples, the products which have seen the biggest price increases recently

5. Health and Well-Being 5 Healthy Weight, Health Lives: Guidance for Local Areas (March 2008) Promoting Healthier Food Choices – success looks like: –More eligible families signing up to the Healthy Start scheme –Less consumption of HFSS foods; especially by children –More consumption of fruit and vegetables – more people eating 5 A DAY, especially children –More healthy options in:  Convenience stores  School canteens  Vending machines  Supermarket checkouts  Non-food retailers

6. Health and Well-Being 6 Corner shops in the North East pilot Corner shops in the North East will be the first in England to pilot an £800,000 scheme to get the country eating more fruit and vegetables and reduce obesity The Department of Health is providing £200,000 this year and £300,000 for the next two years to help local shops sell and promote fruit and vegetables. Twelve stores have already signed up to the pilot with the aim of 120 coming on board by next May. Depending on the results from its evaluation, the scheme may roll-out across the regions

7. Health and Well-Being 7 Recent ethnographic research suggest we need to ‘reframe’ the issue for all families While parents acknowledge childhood obesity is a problem they do not think of it as ‘their’ problem Parents underestimate the amount they and their children eat A host of ‘unhealthy’ behaviours which we would wish to challenge have no perceived risks to parents: e.g. sedentary behaviour, snacking, portion sizes ‘Healthy Living’ is perceived to be a middle class aspiration which ‘at risk’ families believe is undesirable and/or unattainable Parents prioritise their children’s immediate happiness over their long-term health Source: TNS Segmentation Study; 2CV Ethnographic Research

8. Health and Well-Being 8 Changing behaviour towards diet Parents have surrendered food choices to children Parents are prioritising filling up their children over feeding them the right foods Parents can lack knowledge, skills and confidence to cook from scratch and rely on convenience food Snacking has become a way of life and is being used in emotionally complex ways: e.g. as a reward for good behaviour and overcoming ‘guilt’ Coping strategies to deal with fussiness are creating chaotic, unhealthy family mealtimes

9. Health and Well-Being 9 The key challenges Changing dietary habits involves creating a greater consciousness of parents of their food habits and raising awareness of the long term consequences for their children Parents are motivated by the long-term ‘hidden’ health risks of a poor diet Source: Healthy Weight Healthy Lives: Consumer Insight Research

10. Health and Well-Being 10 Key ‘high risk’ family audiences: “Pressured parents” – 13.6% of children aged 2-10 “Inexperienced parents” – 19% of children aged 2-10 “Treater parents” – 14.8% of children aged 2-10 Between them the high risk families, with children 2-10, represent 1.6 million people – PCT level maps to be published soon of segmentation

11. Health and Well-Being 11 “Pressured Parents” [Cluster 1] Lack time, knowledge and money Diet one of convenience, struggling to cook healthily from scratch Obese and overweight mothers Low income single parents Higher levels of intention to change than other clusters Need to increase knowledge and provide cheap diet solutions

12. Health and Well-Being 12 “Inexperienced Parents” [Cluster 2] Not interested in healthy living Children fussy eaters, rely on convenience foods Obese and overweight parents and children Young, single parents, low income Low intent to change on diet Need to create recognition of problem and motivate to change behaviour

13. Health and Well-Being 13 “Treater Parents” [Cluster 3] Affluent, overweight families Enjoy food, snacking habits, parents watching weight Obese and overweight parents and children Affluent parents of all ages, varied household size Low intent to change Create recognition of problem and awareness of diet levels

14. Health and Well-Being 14 Government action alone will not be successful, everyone must play a part

15. Health and Well-Being 15 Change4Life has gone public..

16. Health and Well-Being 16 Change4Life consumer advertising campaign To be launched 3 rd January 2009 Includes TV, posters, press, direct marketing, a website and a call centre Making it easier to join Change4Life Supported by toolkits to deliver Change4Life locally Change4Life brand assets available to use in communications

17. Health and Well-Being 17 Initial Campaign: Promoting specific behaviours for 2-11s Reducing sugar intake (“Sugar Swaps”) Increasing consumption of fruit and vegetables (“5 A DAY”) Having structured meals, especially breakfast (“Meal Time”) Reducing unhealthy snacking (“Snack Check”) Reducing portion sizes (“Me Size Meals”) Reducing fat consumption (“Easy On The Fat”) Others for physical activity

18. Health and Well-Being 18 Feedback to Conference To capture three key points/issues arising from this food & nutrition workshop One person to report back on these PLEASE

19. Health and Well-Being 19 Further reading… DH/DCSF: Healthy Weight, Healthy Lives: A Cross-Government strategy for England (2008) Foresight Report: Tackling Obesities: Future Choices (2007) Cabinet Office Strategy Unit: Food - an analysis of the issues (2008) MRC: The ‘Healthy Living’ Social Marketing Initiative: review of the evidence (2007) Department of Health West Midlands Tackling Obesity in the West Midlands: Foresight and beyond (2008) DH/DCSF: Healthy Weight, Healthy Lives: Consumer Insight Research (2008) DH/DCSF: Healthy Weight, Healthy Lives: Guidance For Local Areas (2008) Cabinet Office Strategy Unit: Food Matters: Towards a Strategy for the 21 st Century (2008) EMPHO A Review of Needs Assessment of Local Level Diet and Nutrition Data (200)