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									        Public Health South West: Food and Health update                                            Page 1

    Food and Health update                                                                                  Nov

 This is a monthly update for the South West on food and health issues based on local, regional
 and national developments.
 It is published on the South West Public Health Observatory website and as part of the Public
 Health South West monthly E-bulletin, which covers all public health issues in the region.
 If you have any suggestions for the Food and Health update please send them to Lucy Eastment
 on: 0117 900 3507.

New addition to the Food Standards Agency South West Regional team

The FSA are delighted to welcome Nick Mann as Deputy Regional Co-ordinator in the SW. Nick, an
Environment Health professional by background previously worked for Exeter City Council and joined
Toni Smith, the Co-ordinator at the end of October. He can be contacted at 0117 900 1885

Nick‟s work will initially include working with Environmental Health and Trading Standards officers to
develop sustainability policies to ensure they identify how their work contributes to their local
government‟s sustainability agenda. He will also be part of GOSW‟s workplace health team, which is
bringing key agencies who have a role in workplace health together to develop an effective regional

Third annual survey of take up of school meals in England

The final version of the School Food Trust and LACA survey on the take-up of school meals 2007/08 is
now available. The 2008 survey was carried out jointly with the Local Authority Caterers Association
(LACA), and in consultation with other organizations and agencies with an interest in school food
provision. Provisional findings were published in July 2008 and the final report was published in October

View survey:

Georgie Porgie Pudding and Pie: Exposing the truth about nursery food

This new Soil Association report, produced with Organix, reveals that our toddlers are not getting the
healthy start they deserve. This is the first detailed investigation into the state of food fed to young
children attending nurseries in England and Wales. This report covers research questioning nursery
workers and parents, researching case studies of good practice, and looking in detail at the legislative
background to food provision in nurseries.

View report:

FSA Public Attitudes Tracking Survey

The Food Standards Agency (FSA) places five questions on a face-to-face omnibus survey on a quarterly
basis. The September 2008 survey in which a representative sample of 2082 adults in the UK were
interviewed indicated that concern about food safety issues in general has remained stable since March
this year at 69% and the main food issues of concern are food poisoning (52%), food prices (48%) and
the amount of salt (45%) and fat (46%) in food.
        Public Health South West: Food and Health update                                             Page 2

Additional questions were asked this wave to gauge concerns about particular types of foods, foods
people are trying to avoid/reduce consumption of and awareness of 5-a day (these questions have
previously been asked in the annual Consumer Attitudes Survey which is currently being reviewed).
Results showed that:
    Adults are most likely to be trying to cut down on foods containing fat (25%) and food /drinks
        containing sugar (16% each) and salt (15%)
    The most frequent response given by parents when asked if they are trying to reduce their child‟s
        consumption of any particular food/drink (mentioned by 43% of parents) was drinks containing
       78% correctly stated that you should eat 5 or more portions of fruit and vegetables a day. This is
        the same as the result recorded in the Consumer Attitudes Survey last year.

Changes in food and drink advertising and promotion to children: a report outlining the changes
in the nature and balance of food and drink advertising and promotion to children, from January
2003 to December 2007

This report sets out the current restrictions for broadcast and non-broadcast media; the findings of the
Thomson Intermedia research on overall food and drink advertising spend across a range of media, child-
themed ad-spend and TV viewing figures; and the output of the Food and Drink Advertising and
Promotion Forum.

Read more:

Pregnant women advised to limit caffeine consumption

The Food Standards Agency has issued new advice on caffeine consumption during pregnancy. This
follows the results of new FSA-funded research carried out by the Universities of Leeds and Leicester.
Pregnant women are advised to limit their daily caffeine intake to 200mg a day – roughly two mugs of
coffee a day. This is because too much caffeine might result in a baby having a lower birth weight than it
should, which can increase the risk of some health conditions in later life. There is also some evidence
which suggests that high levels of caffeine can result in spontaneous miscarriage. Caffeine is found in
coffee, tea, chocolate, some soft drinks, and certain medicines.

The FSA had previously recommended a maximum daily intake of 300mg. However, the new research,
published by the British Medical Journal today, suggests a limit of 200mg per day will help to reduce this
low risk even further. Pregnant women who have been following the previous advice, and limiting
consumption to below 300mg a day, should not be concerned. Not only is the risk likely to be very low,
but the research also showed that the average daily caffeine intake during pregnancy was already below
200mg, so many pregnant women will not be affected by this change in advice. Those currently
consuming more than this 200mg a day are advised to simply reduce their caffeine consumption to less
than 200mg a day for the remainder of their pregnancy.These findings and the results of other studies
were considered by independent experts of the FSA's Committee on Toxicity, who advised a change in
the FSA's advice on daily caffeine intake for pregnant women.

Consumer advice on what to eat and what to avoid when pregnant can be found at:

Free meal plan for Scottish pupils

All pupils will receive free meals in the first three years of primary school, the Scottish Government has
announced. The move follows a year-long £5m pilot scheme in Glasgow, West Dunbartonshire, East
Ayrshire, Fife and the Borders. That scheme, which involved 35,000 pupils, saw the take-up of school
meals rise from 53% to 75%.
        Public Health South West: Food and Health update                                              Page 3

However, the government will not be allocating extra money to fund the roll-out of the initiative. It expects
councils to find the money from the funding settlement already agreed.
The evaluation of the trial aimed to investigate practical issues and to assess early indications of health
and other benefits. The research found:
       The trial resulted in significantly increased uptake of school meals. Among the target group of P1-
        P3 pupils not free school meal (FSM) registered, uptake of school meals increased from 41per
        cent to 69 per cent
       Uptake also increased slightly among P1-P3 pupils who were previously FSM registered (from 89
        per cent to 94 per cent) and among P4-P7 pupils (from 47 per cent to 50 per cent)
       Parents, teachers, local authority staff and catering staff were very positive about the provision of
        FSM for P1-P3 pupils
       Some pupils taking part in the trial were trying and enjoying new foods and some were asking for
        new foods at home, including healthier options

There were no unexpected impacts from the pilot and roll-out by other local authorities should not be
problematic. The government said the free school meals would be introduced from August 2010. The
timetable is intended to give local authorities time to carefully plan for the introduction of free school
meals, to learn lessons from the local authorities which piloted the scheme and to negotiate contracts with

The first-ever cross-cutting National Food and Drink Policy for Scotland, to boost the industry, support
healthier and more environmentally sustainable choices and enhance Scotland's reputation as a land of
quality food and drink, is currently being developed by the Government.

Read more:

New online incidents section and strategy published

The Food Standards Agency has published a new website section to bring together information and
guidance on how to report, respond to and prevent a food or animal feed incident. The dedicated section
aims to help enforcement authorities and members of the food industry find key incidents guidance and
services quickly. It includes the online report form for businesses to notify the FSA if they need to recall or
withdraw products from the market. The form can also be used by local and port health authorities to
report incidents.

The new section includes: guidance on food safety for farmers, caterers, manufacturers and others; FSA
annual reports on incidents that show how many incidents were handled in a year and what action was
taken to protect consumers; and details of post-incident reviews, which aim to make sure as much as
possible is done to prevent future and similar incidents.
In addition, statistics and analysis information for the period 2000 to 2007 is available, as well as details
of international information-sharing forums and networks that work to identify emerging risks and facilitate
incident prevention.

The FSA will be bringing more incident information online as it becomes available. This includes incident-
related exercises, which are carried out to improve incident handling, and details of other incident

The FSA's incident prevention strategy plan has also been published. This sets out a cross-Agency
programme of work to help deliver the Agency's Strategic Plan target of developing, by the end of
December 2010, effective interventions to tackle food safety problems at source before they become
incidents. The broad aims are to:
      learn from past incidents to ensure that past mistakes are not repeated
      identify and address the main sources of incidents
      be as prepared as possible in future to anticipate and deal with emerging, and re-emerging risks
        Public Health South West: Food and Health update                                              Page 4

The plan, which was consulted on May to August this year, can be found at

Hospital meals high in salt and fat, says Which?

Some hospital canteens are regularly serving meals with too much salt and saturated fat, according to a
new Which? report. Dietitians were sent to test catering facilities at 21 hospitals across the UK. Measured
against Food Standards Agency (FSA) guidelines, 18 of the 21 main meals (86%) contained too much
salt, 14 (67%) contained too much saturated fat and 11 (52%) contained too much fat.

Which? also surveyed more than 1,500 people who had eaten in a hospital canteen in the previous year.
Around one in five were disappointed with the options available. One customer said: „Lots of dishes in the
canteen were served with chips and high in fat. This surprised me, as the hospital is dedicated solely to
heart surgery.‟ Only four of the 21 hospitals Which? investigated highlighted a healthy option on their
menu. Vegetarian hot meals were sold at all hospitals visited by the dietitians, but in 13 cases they were
cheese-based and high in fat.

It isn't all bad news as 47% of those surveyed thought the quality of hospital canteen food was excellent
or good. Which? researchers did find examples of good practice. Two hospitals - East Surrey Hospital
and University College Hospital, London - provided meals within FSA guidelines; three hospitals provided
nutrition labelling, making it easier for people to choose healthier options; and five had healthy eating
promotions around the hospital.

The NHS is the largest employer in the UK, with around 1.5 million staff. It serves more than 300 million
meals a year, mainly to staff, visitors and out-patients in hospital canteens.


The Hospital Caterers Association Response:

Food Standards Agency signs up to sustainable policies

The Food Standards Agency has taken a major step forward in formalising its commitment to sustainable
development. At its Board meeting in September, it agreed an approach that will ensure decisions made
by the Agency are in line with the Government‟s sustainability goal. This is to allow people all over the
world to satisfy their basic needs and enjoy a better life, without compromising the quality of life of future

The FSA‟s work on food safety, health and protecting the interests of the consumer can all help to
underpin and foster this objective. Many of the Agency‟s decisions impact on sustainability, which
includes economic and environmental factors, alongside social ones. For example, the Agency‟s current
advice on guidance on fish consumption – which falls into the social factor – is based on scientific
evidence about the impact of fish on health and the potential safety effects of contaminants. However,
when that policy was made, the Agency would not have considered the environmental, wider social and
economic sustainability of its advice.

The FSA‟s move to put sustainability at the heart of its policymaking is part of a Government-wide
strategy on sustainable development, incorporating this aspect in all policy decisions. With this approach,
the Agency will choose the most sustainable policy option, unless there are exceptional reasons for doing
otherwise. In these cases the reasons will be clearly communicated and efforts made to reduce negative
impacts. The approach is likely to lead to more cross-Government working.

Read more:

New council of food policy advisers
         Public Health South West: Food and Health update                                             Page 5

A new team of advisers on food policy from the farm to the fork has been announced to advise
government on food affordability, security of supply and the environmental impact of food production. It
will also contribute to the policy for food security and supply which is expected to be published later this
year. The Council of Food Policy Advisers will include expertise from every sector of our food.

Further information:

Food Safety Week 2009

Following on from the success of Food Safety Week 2008, the Food Standards Agency is pleased to
announce the dates for Food Safety Week 2009 as 15– 21 June. The focus for this year‟s activity will be
targeting the over 60s (particularly those with reduced immunity) with food hygiene advice on the correct
advice for the storage and handling of food in the home.

The FSA‟s current advice in this area can be found at:

The reason for this focus is the recent rise that has been since of cases of listeria within this age group.
There are various ways in which you may be able to work with these audiences: day centres, lunch clubs,
housing associations, GPs‟ surgeries, post offices & libraries to name but a few.

For those of you that may work with professional caterers that cater for this group then please refer to the
Care Homes supplement of Safer Food, Better Business:
or our Listeria Fact sheet – „Listeria – Keeping Food Safe‟:

The Food Standards Agency will also be developing some new materials to use with these audiences,
details of which will follow in due course. We are also pleased to say that our existing GermWatch
materials will still be available.

To be kept informed of future developments, please make sure that you have registered your details at and include „Register‟ in the subject line.

For further information please contact Catherine Clarke (020 7276 8842,

Examining nutrition food labels

A large independent study evaluating the three main types of front-of-pack (FoP) nutrition food labels
used in the UK has started the next phase of its research. The study has already explored, and recently
reported on, how people use FoP labels, and work is now underway testing how well consumers
understand each of the different label types.

This next phase will identify which elements of the labels are most effective in helping people make
healthier choices. Ultimately, the aim is that the final research report will provide robust evidence to
inform future UK Government policy on FoP nutrition food labelling.

At present the three main FoP food labels used are:
     monochrome schemes that provide information on the percentage of Guideline Daily Amount
        (GDA) in a recommended portion of food
     the traffic light colour coded scheme which indicate nutrient levels per 100g and in a portion of
     hybrid schemes, which provide both a traffic light colour code per 100g and the percentage
        (GDA) in a portion of food
        Public Health South West: Food and Health update                                            Page 6

Last month‟s e-bulletin referred to initial insights from the qualitative work already undertaken to
understand how consumers use the labels. The research has already been discussed at an initial meeting
with stakeholders and other interested parties, held on 13 October, to consider how it might be translated
into policy recommendations to ministers. This discussion and the final research report, which will be
published next year following peer-review, will inform a formal public consultation on front-of-pack
labelling policy to be held in spring 2009.

View report on the development of the quantitative phase of the study:

Grants for food hygiene initiatives

Subject to funding, the grants scheme for 2009/10 should be launched in mid-January 2009 but projects
may only be on food hygiene. The themes for which applications will be requested have not yet been
decided. Please look at our website from mid-January 2009 for further details.

All projects from the 2008/9 scheme have now commenced and should finish by the end of March 2009.
Further details, including a summary of the projects, have been published on the website at

For further information please contact:

Nutrition advice best served with family in mind

Researchers at the University of Sheffield and Royal Holloway, University of London have argued that the
nation‟s diet is unlikely to improve significantly if healthy eating policies fail to take into account the
diverse nature of contemporary family life. The researchers argue that if government initiatives, such as
improving the quality of school meals or increasing the nation‟s consumption of fresh fruit and vegetables,
are to succeed they need to acknowledge that families have differing domestic routines, relationships and
resources and this affects how and what they eat.

The researchers discovered that decisions about what to eat aren‟t simply a matter of individual choice
but are instead rooted in people‟s diverse family circumstances, embedded in the routines and rhythms of
their everyday lives, subject to their available resources and shaped by their social, ethnic and religious

Most people are aware that they need to eat `five-a-day´ but many don‟t achieve these targets because
they are forced to act within their circumstances. Poorer families may be acting rationally when serving
`junk´ food to their children knowing that `healthier´ meals will simply go to waste. To truly improve the
nation‟s diet a better understanding of social and cultural conventions is required in order to inform more
effective health advice and social policy around families and food.

Other research findings include:

• While the emphasis on women‟s body size and shape is often seen as a current preoccupation, the
research shows that women‟s magazines have been full of dietary advice since the 1940s, even though
the nature of that advice has changed dramatically over time

• The introduction of `Healthy Start´ (food support benefit for pregnant women) has meant that a higher
proportion of pregnant and postnatal women met the recommended intakes for key nutrients, like calcium,
folate, iron and vitamin C but at a cost of a considerably increased calorie intake. The results also
suggested that `Healthy Start´ women ate significantly more portions of fruit and vegetables per day.

• While many people have seen the decline of the `family meal´ as a sign of the breakdown of
contemporary family life, the research suggests that even in the Edwardian period (in the early 1900s),
family meals were a middle-class aspiration rarely achieved in practice
        Public Health South West: Food and Health update                                              Page 7

Read more:

California restaurants will soon count calories

Trend-setting, health-conscious California on Tuesday became the first U.S. state to require fast-food
restaurant chains to list calories on their menus. The state estimates that residents collectively have
gained 360 million pounds (165 million kg) in the last decade, and it sees the calorie count as one way to
stem the obesity epidemic. A calorie information rule took effect in New York City this year, and more
than a dozen states are considering similar health code provisions.

Starting July 1 2009, chains with more than 20 locations must offer brochures with calorie and nutritional
information. By January 1, 2011, they must list calorie information on menus and indoor menu boards. In
July, California became the first state in the nation to prohibit restaurants from preparing foods with trans
fats, which clog arteries and increase the risk of heart disease.

Read more:

Case Studies needed for Fresh Look guide

The School Food Trust is developing the next in its series of “Fresh Look” guides. The new guide will
focus on marketing and will show case best practice, case studies and techniques that will assist schools,
caterers and local authorities successfully market school food.

The SFT want to showcase the very best of what has gone before and would like you to send any case
studies which show a marketing project, plan or initiative that has been successfully implemented and has
had lasting results.

If you can help email:

Nutrient profiling

The FSA is seeking views and comments on the European Commission's working documents on the
setting of nutrient profiles under Regulation (EC) No 1924/2006 on nutrition and health claims made on
foods. This is the first piece of specific legislation to deal with nutrition and health claims and aims to
provide a higher level of consumer protection as well as harmonise legislation across the EU to facilitate
intra-Community trade.

The aim of the nutrient profiles is to protect consumers from being misled where foods high in saturated
fats, sugars and salt may be made to seem healthier choices when accompanied by a nutrition or health
claim. For example, a food with the claim 'low in fat' may appear to be a healthy choice, but it could also
be high in salt and a less healthy choice. Under Regulation 1924/2006, if a product fails the profile on one
nutrient then no health claim can be made and a nutrition claim can only be made if the statement 'high
[name of the nutrient that fails the profile] content' is also made. If the product fails on two or more
nutrients then no claim can be made. The only exception to this is a 'reduced' claim, where the nutrient
about which the claim is made does not count toward calculating the effect of the nutrient profile. For
example, to make a 'reduced saturated fat' claim the product does not need to comply with the threshold
set for saturated fat. However, if the product is also high in salt then the statement 'high salt content'
would need to be made.

Once nutrient profiles have been established, and following a two-year transition period to allow food
business operators time to adjust to the new requirements, foods that are high in saturated fat, sugar or
salt will face restrictions on making claims.

Further information can be found at:
        Public Health South West: Food and Health update                                             Page 8

The Really Good School Dinner

In November, the School Food Trust will be launching a new initiative as part of its GET REAL campaign,
aiming to encourage children to have a school lunch. The initiative, which is called The Really Good
School Dinner, is a collaboration with the UN World Food Programme and is designed to demonstrate the
value of a school meal, not only in this country but in parts of the developing world.

The simple notion is that during the last week of January children will be encouraged to have a school
meal and to donate an extra 10p to be used by the UN World Food Programme to provide children in the
Developing World with a school meal. This campaign encourages children to eat school food, recognise
its value, and give where possible to help others. In previous trials it has proved an enormous success. In
a few weeks we will contact all school councils in England, Las and caterers, encouraging them to
register for the campaign.

For more information please contact

FSA South West sharing good practice

FSA South West recently held a special event for local authorities in the region to share good practice on
how best to develop a local healthy eating award. More than 40 officers attended from environmental
health, trading standards, primary care trusts (PCT) and public health.

The event showcased the Healthy Options Wales award with Shelia Dooley, who piloted the award, and
Sarah Rowles from FSA Wales explaining the purpose behind creating it. Allyson Jones from Cardiff City
Council and Simon Rolfs from Staffordshire environmental health then shared their experiences of
implementing it.

The event also looked at the Cornwall Healthier Eating and Food Safety award (CHEFS). Carol
Thorogood from Carrick District Council and Sophia Aston from Cornwall PCT gave an overview of the
award which has been running since 2004.

For more on Healthy Options Wales go to:
For more on CHEFS go to:

FSA South West Regional Update Events

Like last year, there will be two update events for Environmental Health Officers and Trading Standards
Officers. One event is in Liskeard at Caradon District Council Offices on November25th and the other will
be in Bristol at GOSW on December 3 . Alongside an update from the FSA on better regulation,
auditing, monitoring, Lacors update, and HPA update, there will be a session on LAA and six workshops
covering social marketing, sustainability, incident prevention, putting public health into regulatory
services, seeking funding for projects, and food fraud.

For further information contact

Eatwell Trays designed for hospital use

The Eatwell tray has now been designed specifically for use in hospitals where they can be washed in
high temperature to reduce the spread of infection. Temperature range resistance from -40 to 130c make
these trays ideal for meal delivery carts. They are dishwasher safe – wash up to 3 times a day with good
resistance to chemicals, scratching, breakage & staining. They are also thermal shock resistant.

For further information on having eatwell trays in hospitals contact

How the New Thrift is making family mealtimes healthier
        Public Health South West: Food and Health update                                           Page 9

A new survey of 2633 parents by the influential parenting website reveals that mums
and dads are changing their shopping and cooking habits as a result of the credit crunch. 59% of the
parents surveyed as part of this year‟s Back to the Table Week said their shopping habits had changed
and 42% said they‟d altered their cooking habits as well.

Families are eating healthier with fewer sweets and snacks and fewer processed, ready-made meals.
Almost a third of the parents surveyed said they bought less sweets or snacks as a result of the credit

Read more:

Transition: Food and Farming in 21st century Britain
18-19 November 2008, British Empire and Commonwealth Museum, Bristol

Fossil fuel depletion, climate change, diminishing soil and water resources and population growth present
an unprecedented threat to global food security. To address these challenges Britain and every country in
the world needs a future food plan.

More details:

Public health nutrition: Challenges for the 21st century
25 November 2008, London

To celebrate its 20th anniversary the Caroline Walker Trust is holding a one day conference designed to
appeal to policy makers, practitioners, health professionals, students and supporters of the Trust.

Read more:

‘Healthy Ageing: The Role of Nutrition and Lifestyle’,
13 January 2009

The British Nutrition Foundation is hosting a one-day conference on to celebrate the launch of the Healthy
Ageing report.

View details:

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