Public Health Scotland says the launch of a consultation to transform the country’s food environment marks a turning point placing health as the most important priority as experts call for a ‘new story’ when it comes to food and health.

This week’s Public Health Scotland (PHS) event on the commercial determinants of health, health equity and our food system heard from researchers and policymakers.

Last week saw the government move to restrict promotions on unhealthy food and drinks as it opened a consultation on proposed regulations to create a food environment which ‘supports healthier choices’.

PHS says this represents an “important opportunity to drive change” – adding that the burden of diet-associated ill health and mortality rests disproportionality on those in the most deprived communities.

Announcing the proposals, Public Health Minister Jenni Minto said supporting people to eat well is a public health priority:

“We need to address the high levels of excess weight, obesity and poor diet we know are contributing to worsening trends in Scotland’s health. The association between these issues and health outcomes such as heart disease, type 2 diabetes and certain cancers has been established for some time. 

“The Scottish government is committed to restricting promotions of foods high in fat, sugar or salt at the point of purchase as research shows this is when people make decisions about what and how much to buy, for themselves and their families.”

Ms Minto added that the consultation is part of the government’s “ambitious and wide-ranging” work across Scotland to support healthy diet and wellbeing:

“This consultation, together with our Diet and Healthy Weight Delivery Plan, demonstrates the ambitious and wide-ranging action we believe is needed to address this challenge, and support improvements in diet and health and wellbeing in Scotland.”

This comes as Glasgow researchers revealed that people who use diet and nutrition to manage their weight can stay in remission from type 2 diabetes for years.

Reframing responsibility

However, the University of Edinburgh’s Dr Nason Maani, Lecturer in Inequalities and Global Health Policy, told the PHS event that a balance must be struck between individual responsibility and wider efforts to improve public health.

Dr Maani explained that some marketing efforts and even policies directed at individuals or families can “undermine efforts to reframe obesity away from individual behaviour”:

“We want economic growth, but not at the expense of health. We want growth to be sustainable and equitable.

“At the moment, we see a big divergence between what we know and what is done in policy – there’s quite a big knowledge gap that hopefully will continue to change.”

Dr Maani showed that most marketing money is spent promoting unhealthy products and that influences start as early as infants feeding.

While breastfeeding is associated with reduced risk of later obesity, childhood mortality and malnutrition and infectious disease, Dr Maani explained the infant formula industry is a key barrier to increasing breastfeeding.

He revealed that shifting norms perpetuated by marketing – including portraying breastfeeding as generic and outdated – contributed to the world formula sales growth more than 100% since 2005.

Echoing Dr Maani’s concerns, Sophie Gordon from non-profit research and communications organisation Frameworks UK said Scotland needs a “new story for health and food” which better recognises “what surrounds us, shapes us”.

She said that we need to show that change is possible to “counteract that sense of fatalism” and share where solutions are working positively to improve health, to meet the scale and urgency of changes needed.

Responding to the proposals, Chief Executive of Food Standards Scotland, Geoffe Ogle, said targeting the “heavy promotion of unhealthy food” is necessary to addressing this critical public health issue, adding:

“If now is not the time to take action, when is? When levels of overweight and obesity reach 85% from the current two thirds of the population? “Not now” cannot be an argument any longer.

“We can’t rely on personal responsibility alone to change our eating habits any longer: that approach has not worked for at least 40 years and won’t work now. And we have had significant increases in preventable diseases and higher costs to the NHS. Personal responsibility is a component, but it’s not the solution.”

The government’s consultation is open for views until 21 of May 2024.

Read more: Study shows diet can hold diabetes at bay for years; Economic change key to Scotland's health inequalities; Medics warn pollution is risking children's health; A question of action; Analysis: Why people are left behind; Can Scotland make health fairer?

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