Eating for Health: a Diet Action Plan for Scotland

10.1 The activities of producers, manufacturers, processors and retailers are aimed ultimately at the consumer whose response is the yardstick of success. Consumer power is, therefore, crucial. But it can also be influenced and directed, although no single factor can effect rapid change.

10.2 Personal preferences motivated by taste, cultural and social habits, persuasive product marketing, family pressures, availability and cost are all potent influences on consumer choice. It follows, therefore, that to influence consumers to move to healthier eating habits a multifaceted approach is required. This has to involve all those interests with the capacity to exercise such influence, notably:

all the interests in the food supply chain
the Health Education Board for Scotland and the Health Boards #
community organisations
local authorities, including social work departments
employers
schools
the media
consumer organisations
the voluntary sector.

10.3 All, to varying degrees of extent and effectiveness, are already encouraging healthier eating. For a significant proportion of the public the media are the most likely source of information on nutritional issues and, therefore, have enormous potential to influence dietary behaviour. But the promotional activities of all these interests have often been undertaken independently of each other and this fragmentation has resulted in the consumer being subjected to a vast array of food product advertisements, promotional material and dietary advice, some of it conveying conflicting or misleading messages about the benefits or disbenefits of certain foods. The consequence is that the public is now confused by the inconsistency of the messages. This confusion is further compounded by the slimming industry which is constantly introducing new "diets" for people wishing to lose weight. There is a need, therefore, for all those in a position to influence dietary behavour to ensure that the healthy eating messages which they promote are accurate, consistent and reflect the Scottish dietary targets.

10.4 In part, too, the confusion about the importance of dietary change has stemmed from misinformed media reporting and from the widespread and incessant promotion and advertising of foods which should form only a very small part of the overall diet. The results of a UK wide survey of television food advertisements undertaken by the National Food Alliance and published in December 1995 show that television advertising of high fat, high salt and high sugar foods such as biscuits, cakes, confectionery, sausages and pies, ice cream and soft drinks is currently heavily biased towards the early part of the evening when children are watching and accounts, at present, for between 80 and 100% of food advertising in children's viewing hours. Overall, fatty and sugary foods, which should make up no more than 7% of the weight of the total diet, account for around 50% of television food commercials. Consideration should be given by the Scottish Consumer Council to the commissioning of a similar survey of food advertising on Scottish television, and possibly more widely to embrace the totality of food advertising to which the Scottish population is exposed, and its results reported to Scottish Office Ministers.

10.5 There is, thus, a need for greater co-ordination of health education and food promotional initiatives to ensure that consistent healthy eating messages are communicated clearly to consumers. To facilitate this coherent approach, the Health Education Board for Scotland should examine the feasibility of a promotional publicity/branding device which could be applied to all relevant materials concerned with healthy eating. The Board should also seek to collaborate with all those interests involved in producing diet-related materials and should commission the development of guidelines which will assist their preparation. These will be based, in part at least, on the Guidelines for Educational Materials produced by the Nutrition Task Force in England (see paragraph 6.24). Specific input from experienced State Registered dietitians will be essential in formulating promotional materials. As a first step, however, in order to provide the Scottish public with a sound information base both on healthy eating and on the action envisaged in this Action Plan for the improvement of the Scottish diet, the Board should explore the feasibility of issuing a mailshot on healthy eating to every household in Scotland. Its content should be positive and constructive in tone and be 'consumer friendly' in its presentation of information.. The mailshot might form one part of an integrated and continuing campaign on healthy eating, comprising a variety of media and approaches.

10.6 The workplace offers a prime opportunity for increasing consumers' awareness of healthy eating. Employers, in both the public and private sectors, are in a position to make a major contribution to "getting the message across" for they have the potential to offer an environment in which to encourage employees to make healthy eating choices.

10.7 For example, employers could ensure that staff canteens provide, to a much greater extent, a selection of foods from which their employees could choose healthily balanced meals; the Model Nutritional Guidelines for Catering Specifications for the Public Sector in Scotland provide a useful reference for employers in this context (see also Sections 6, 7 and 9). Employers could also introduce more widely into workplace vending machines a range of healthy food snacks such as fruit, and fruit juices, in addition to the customary crisps, confectionery and sugary drinks. And staff notice boards could usefully display information about dietary issues and healthy eating; such material is readily available from Health Boards and the Health Education Board for Scotland. These are the kinds of initiatives which health education and promotion interests are concerned to see developed. The Group, therefore, strongly supports the recent introduction by the Health Education Board for Scotland, in collaboration with key employers and employee organisations, of the Scotland's Health at Work National Award Scheme, designed to raise the profile of health promotion in the workplace, including that of healthy eating.

10.8 The Group considers that considerable scope exists for additional research activity to make a major contribution to improving dietary awareness. Continuing research on nutritional aspects of health should remain, therefore, a high national priority as recently determined in the conclusions on Technology Foresight published by the Office of Science and Technology. A strong and well funded research capability exists in the fundamental scientific areas, i.e. in the biomedical, physiological, metabolic and social science-related areas, and the forward programme is understood to be comprehensive. But there is less focus on applied social science and clinical research relating to possible intervention target groups who may offer high potential pay-off in health gain.

10.9 Effective and comprehensive strategies have been developed by governmental funding bodies (Departments and Research Councils) for research to improve diet. Efforts to co-ordinate their implementation on a UK basis should be continued and strengthened. The principal elements of the proposed research strategy for diet and nutrition in Scotland are:

research in applied social science which would appraise dietary interventions;
research on new approaches to changing eating behaviour by targeting groups such as school children, pregnant women and the elderly;
intervention studies to develop education packages for those recovering from heart disease and for their families;
further studies to determine the benefits of changing dietary behaviour;

10.10 Research clearly must be of high quality and the Human Nutrition Research Forum, the Technology Foresight Programme, the Scottish Office Agriculture, Environment and Fisheries Department and the Chief Scientist Office, Scottish Office Department of Health should continue to review research activity, facilitate access to information on funding and disseminate outcomes.

Action Points

As part of an integrated and continuing campaign on healthy eating, the Health Education Board for Scotland should explore the feasibility of issuing to every household in Scotland a carefully targeted mail-shot conveying information on healthy eating.
All interests in a position to influence dietary behaviour should ensure that the healthy eating messages which they promote are accurate, consistent and reflect the Scottish dietary targets.
The Scottish Consumer Council should consider commissioning a survey of food advertising on Scottish television, and possibly more widely to embrace all the food advertising to which the Scottish population is exposed, reporting its results to Scottish Office Ministers.
The Health Education Board for Scotland should commission the preparation of guidelines to which the food industry and its representative bodies and other interests promoting healthy eating can make reference when preparing promotional and educational material in order to ensure consistency in healthy eating messages.
The Health Education Board for Scotland should explore the scope for, and utility of, a promotional publicity/branding device which might be used on all relevant materials concerned with healthy eating.
Employers should explore ways of encouraging healthy eating by their staff, including the wider provision of healthy food choices in staff canteens and restaurants.
Research activity on nutritional aspects of health to improve dietary awareness should remain a high national priority. The Human Nutrition Research Forum, the Technology Foresight Programme, the Scottish Office Agriculture, Environment and Fisheries Department and the Chief Scientist Office, Scottish Office Department of Health, should continue to review research activity, facilitate access to information on funding and disseminate outcomes.