The rising level of obesity is one of the biggest challenges that we face as a country and an important role for PHE is to advise the public - and the Government - on what constitutes a healthy diet.
Of course, there is a lot of advice already out there from expert clinicians or academics, but also from various people with an interest in this area, including commercial interests.
It can certainly be confusing for members of the public to know what they should and shouldn’t be eating, and in what amounts. From saturated fats to sugar – it can often feel like navigating a minefield of inconsistent nutritional advice.
It’s important to remember that information referred to as ‘expert advice’ is sometimes based on evidence that has known limitations. For example, it may involve a small sample of participants or ignore other factors that could affect the results.
Public Health England is committed to supporting the public to make healthier choices through the provision of credible advice based on the best possible evidence. So what exactly do we mean by that?
When we produce new guidance on a particular topic, our independent experts review all the available evidence on that subject – often hundreds of scientific papers.
We run full-scale consultations and go to great lengths to ensure that the evidence is considered fairly on its merits and without bias.
For example, PHE’s Scientific Advisory Committee on Nutrition produced new recommendations on carbohydrates, including sugars and fibre, in July last year.
The committee selected more than 600 peer-reviewed scientific papers for review, which were considered to be properly robust, out of an even longer list of studies. We also ran a full-scale public consultation.
Our approach to heathy eating advice
Another example of an evidence-based approach to producing dietary advice is the recent refresh of the Eatwell Guide. The eatwell plate was first introduced eight years ago to illustrate a healthy and balanced diet, and was updated earlier this year following some important developments in the evidence.
As part of this work we engaged with interested organisations and individuals through an external reference group and a public consultation with stakeholders, including academics, clinicians, non-profit organisations, commercial companies and industry representatives.
PHE has been criticised by some for working with industry on this guidance. However, the companies that supply our food have a major influence on what we eat, for example on how much sugar we eat.
The evidence shows that lowering the sugar content of the food and drinks offered in shops, restaurants, takeaways and the many places we eat could be a successful way of changing how much sugar the population consumes.
This has already been demonstrated through work to reduce salt consumption in the UK. Engaging proactively with industry was key to the success of that work.
Our analysis shows that a similar programme to reduce the levels of sugar in food and drinks would significantly lower sugar intakes, particularly if accompanied by reductions in portion size. In our view success depends on effective engagement with industry right from the start.
Although we have consulted industry and others on implementation, the underlying guidance behind the Eatwell Guide was not driven by the needs of industry.
It is entirely in line with the evidence and with advice from the World Health Organization and other government bodies worldwide. The modelling we used was commissioned by PHE from the University of Oxford, who have an international reputation for work of this kind.
But we know that one resource alone, such as the Eatwell Guide, is not enough to change the amount of food and drink consumed across the population.
Individuals, families, communities, the food industry and local and national government all have a role to play in tackling the obesogenic environment.
We are working to support this in a number of ways in partnership with government departments and local authorities – from making it easier for people to take part in physical activity to supporting behaviour change through public campaigns such as One You and Change 4 Life.
Alongside a number of upcoming reports, we are working to review the evidence on saturated fat and health through the Scientific Advisory Committee on Nutrition.
We hope to share a draft report for consultation next year – after we have reviewed and evaluated the entire body of evidence. All comments are welcomed and we hope that this comprehensive review of the evidence will continue to add clarity for the public on healthy eating.
We will continue to strive to give the public clear and actionable advice based on the best current scientific evidence.