The Rt Hon David Cameron
The Prime Minister
10 Downing Street
London
SW1A  2AA

A. citizen
100 Any Road
Typical Town
County
England

Dear Prime Minister                                                                            3rd November 2014

Food drink and obesity

We all know that if we eat too much we get fat. So why not say so?  Is it because it is so obvious or is it because people are in denial?  

 Ideally, we should eat enough food to maintain our weight and also our diet should ensure that we consume enough food of the right type to meet our requirement for protein, carbohydrate and fat.  Our diet should also ensure that we get enough vitamins and trace elements.

People don’t get fat because they eat junk food (an unscientific term if there ever there was one) or because they don’t get enough exercise, they get fat because they eat too much. 

They eat more than their body needs. Perhaps they eat more than they need because their body is trying to get enough nutrients from the junk food or unbalanced meals.  Scientists have shown that we need X calories per day to maintain our body weight and its healthy functioning, neither more or less.

People who are worried about being overweight go on a diet which means they reduce their daily food intake till they lose weight. But then they resume their usual diet and put on weight again! 

The supermarkets and their suppliers provide all the nutrition information for the food and drink they sell. This is either done by labelling or by shoppers selecting information about the produce on the company websites, but how can shoppers make best use of this information, the supermarkets do not provide any.

What I think the government needs to do is be honest with the people,  by that I mean don’t blame sugar or fast food or lack of exercise for being overweight but state the truth:  People need to eat less food because that is the only reason why they gain excess weight. 

Eating is also a pleasure as is alcohol. Both are becoming a problem. Unfortunately, eating too much and drinking too much alcohol is a comfort in a world that seems at times to be struggling against crumbling into chaos.  It could be a lot worse. People need to be provided with some tools to help manage their food consumption daily. The Five a Day campaign is a success as is the Eatwell Plate but there needs to be more.

There is a Microsoft Excel spreadsheet which is designed to manage a person’s diet over a week. It is a non commercial product but it works. Weight loss or gain is calculated on the food and drink that is consumed. Protein, and fat needs are calculated according to a person’s gender, height, weight, age and level of activity. Five a Day portions a day are also calculated and alcohol units. Pie charts are used to give an easy to understand interpretation of the data- a sort of Eatwell plate. The website link [updated 18th October 2017] for a download is:

Healthy Diet Excel Spreadsheet

Yours Sincerely,

 

A Citizen

The Prime Minister's office asked the Ministry of Health to reply to my letter. I have received a reply below

Department of Health

Richmond House 79 Whitehall London SW1A 2NS

Our ref: TO00000905920                                                                                                         

Tel: 020 7210 4850

Dear Citizen,

Thank you for your letter of 3 November to David Cameron about obesity and nutrition. As your letter concerns health-related issues it was passed to the Department of Health. I have been asked to reply and I apologise for the delay in doing so.

I note your concerns about obesity and diet and I acknowledge your comments and suggestions.

The Government is concerned about levels of overweight and obesity and the impact on individual health.

The Department has published the Call to action on obesity in England which sets out the steps it is taking to help people to make healthy choices for themselves and their families. This includes its commitment to programmes such as the Change4Life campaign, the National Child Measurement Programme, and NHS Health Checks.

Public Health England (PHE) is reviewing a number of actions to address obesity and to make a healthier lifestyle the easiest choice for people to make. PHE's role is to support local authorities and, along with the Department of Health, PHE shares the ambition to reduce child and adult overweight by 2020. PHE acknowledges that poor diet is linked with obesity and type 2 diabetes, as well as a range of other chronic diseases.

The Government currently recommends that people consume, on average, no more than 11 per cent of their total energy as saturated fat. This is based on recommendations made by the Committee on Medical Aspects of Food Policy (COMA) in 1994, to reduce the risk of coronary heart disease. These recommendations were endorsed by the Scientific Advisory Committee on Nutrition

(SACN), an advisory committee of independent experts which replaced COMA in 2001 and which provides the Government with independent scientific advice on matters involving nutrition.

The Institute of Medicine, the World Health Organization and the European Food Safety Authority reviewed the evidence in 2005, 2008 and 2010 respectively. All three reviews reaffirmed the link between saturated fat intake, raised cholesterol levels and the effect on coronary heart disease.

Advice to replace some saturated fat in the diet with unsaturated fats is supported by evidence from meta-analyses of dietary intervention trials. A 2009 meta-analysis found that replacing saturated fat with polyunsaturated fat significantly reduced both heart attacks and deaths from heart disease. A more recent meta-analysis concluded that reducing saturated fat intakes reduced the risk of cardiovascular events by 14 per cent. SACN monitors the evidence, and should robust new studies emerge it would consider reviewing them along with existing evidence and would, if appropriate, amend its advice to Government.

On the role of sugar in the diet, SACN recently published a draft report on carbohydrates and health. This followed a rigorous assessment of an extensive evidence base, which included consideration of the evidence on carbohydrate intake and the risk of developing obesity, type 2 diabetes and heart disease. SACN found that increased sugar consumption leads to increased energy intake and that it is associated with a higher risk of dental cavities. SACN's draft recommendation is therefore that the population should reduce its sugar intake. SACN considered that there was no evidence to show that sugar intake causes increases in blood lipids, insulin resistance or blood pressure. SACN also decided there was strong evidence that increased intake of dietary fibre was beneficial for health, reducing the risk of heart disease and type 2 diabetes and lowering blood pressure and blood cholesterol levels.

The report was subject to a public consultation and SACN is currently considering the responses. Once the report is finalised, SACN will provide recommendations to Public Health England which will, in turn, advise the Department of Health. On this basis, Government dietary advice and any recommendations on specific foods may be updated accordingly.

I hope this reply is helpful.

Yours sincerely,

AW

Anne Lavan

Ministerial Correspondence and Public Enquiries

Comment on the above reply [updated 11th May 2016]

My letter is reminding the Prime Minister that the reason, the only reason that people are getting fat is that they are eating too much. A tool has been developed at no cost to the NHS that can be used by the public to ensure that what they eat and drink is a healthy choice.

The tool is conveniently constructed as a Microsoft Excel workbook consisting of seven [19 spreadsheets] spreadsheets.

The rationale is that people need to manage their diet and to do this they need advice that is readily available both before and after they eat. One would have thought that the least the prime minister could have done is suggest to the NHS that they should investigate this new tool.  There is no mention of the action that the NHS could take to assist in the further development of this tool.