Study calls for tax on sugary foods and drinks – a proposal that David Cameron has dismissed – and crackdown on marketing unhealthy products to children

A report on sugar’s ruinous health effects that was controversially delayed by Jeremy Hunt has urged ministers to impose a sugar tax. It also pushes for a crackdown on the marketing of unhealthy products to children and two-for-one deals in supermarkets in an effort to tackle childhood obesity.

The report, compiled by Public Health England (PHE), the government’s advisory group, sets out a range of tough policies that it says need to be implemented to reduce the consumption of sugary foods and drinks that are fuelling the obesity crisis and costing the NHS £5.1bn a year. The report was published on Thursday afternoon; the Guardian had obtained an advance copy.

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Its recommendations – which include the stripping-out of high amounts of sugar from many everyday food products – pose a serious challenge for ministers, including the prime minister, David Cameron, who have consistently ruled out bringing in any sort of sugar tax, as advocated by Jamie Oliver along with many medical groups and health charities.



No 10 confirmed on Thursday that Cameron did not even read the report before dismissing the idea: “The prime minister’s view remains that he doesn’t see a need for a tax on sugar.” The Food and Drink Federation also vowed to fight any sugar tax.

The report, called Sugar Reduction: the Evidence for Action, was originally meant to be published in July but was delayed by the Department of Health, which PHE is part of, so its findings could be used to “inform” the government’s forthcoming strategy to combat childhood obesity.

Warning that the average sugar intake is 12%-15% of people’s energy intake instead of the recommended 5%, it makes the case for a tax of 10%-20% on sugary foods and drinks: “Research studies and impact data from countries that have already taken action suggest that price increases, such as by taxation, can influence purchasing of sugar-sweetened drinks and other high-sugar products, at least in the short term, with the effect being larger at higher levels of taxation.”

The report, a review of the international evidence on how to tackle rising sugar consumption, is clear and urgent from its very first line – “We are eating too much sugar and it is bad for our health” – that radical action is needed if that trend is to be reversed.

It goes on: “Consuming too many foods and drinks high in sugar can lead to weight gain and related health problems, as well as tooth decay. Almost 25% of adults, 10% of four- to five-year-olds and 19% of 10- to 11-year-olds in England are obese, with significant numbers also being overweight. Treating obesity and its consequences alone currently costs the NHS £5.1bn every year.”

Pointing out that the scientific advisory committee on nutrition, a panel of experts that advises ministers, recommends that sugar make up no more than 5% of an average Briton’s daily energy intake, the report warns that current levels of consumption are far beyond that. “Sugar intakes of all population groups are above the recommendations, contributing between 12% and 15% of energy. Consumption of sugar and sugar-sweetened drinks is particularly high in school-age children. It also tends to be highest among the most disadvantaged, who also experience a higher prevalence of tooth decay and obesity and its health consequences.”



A row erupted last week about the non-publication of the report when Dr Sarah Wollaston, the Conservative MP who chairs the Commons health select committee, made clear her anger that she and her fellow committee members had not been able to see it before they started taking evidence for their inquiry into childhood obesity. An exchange of letters with Hunt, the health secretary, failed to prompt its release, which led to her making public that she was “deeply concerned” by the secrecy surrounding the report.

And in a furious letter to the PHE chief executive, Duncan Selbie, Wollaston wrote: “Sending the wrong message on timely data transparency ... could cause immense damage and call into question the ability and willingness of PHE to act on publication in the public interest independently of the secretary of state or political considerations.”



The report makes eight recommendations, including forcing food manufacturers to reduce portion sizes, which it says would reduce obesity and save the NHS £500m a year.

The eight recommendations are:

Reduce and rebalance the number and type of price promotions in all retail outlets including supermarkets and convenience stores and the out-of-home sector (including restaurants, cafes and takeaways).

Significantly reduce opportunities to market and advertise high-sugar food and drink products to children and adults across all media including digital platforms and through sponsorship.

The setting of a clear definition for high-sugar foods to aid with actions one and two above. Currently the only regulatory framework for doing this is via the Ofcom nutrient profiling model, which would benefit from being reviewed and strengthened.

Introduction of a broad, structured and transparently monitored programme of gradual sugar reduction in everyday food and drink products, combined with reductions in portion size.

Introduction of a price increase of a minimum of 10%-20% on high-sugar products through the use of a tax or levy such as on full-sugar soft drinks, based on the emerging evidence of the impact of such measures in other countries.

Adopt, implement and monitor the government buying standards for food and catering services across the public sector, including national and local government and the NHS, to ensure the provision and sale of healthier food and drinks in hospitals, leisure centres, etc.

Ensure that accredited training in diet and health is routinely delivered to all those who have opportunities to influence food choices in the catering, fitness and leisure sectors and others within local authorities.

Continue to raise awareness of concerns around sugar levels in the diet to the public, as well as health professionals, employers, the food industry, etc, encourage action to reduce intakes, and provide practical steps to help people lower their own and their families’ sugar intake.

Despite its recommendation to look at price increases through a tax or levy, PHE believed reducing price promotions, curbing advertising and marketing aimed at children, and cutting sugar content in – as well as portion size of – everyday food and drink products were likely to be more effective.

Alison Tedstone, PHE’s chief nutritionist, said its evidence review “shows there is no silver-bullet solution to the nation’s bad sugar habit. A broad and balanced approach is our best chance of reducing sugar consumption to healthier levels and to see fewer people suffering the consequences of too much sugar in the diet.”

The British Medical Association said: “Doctors said ministers must give ‘real and urgent consideration’ to the PHE recommendations”, stressing their concerns that “publication was delayed by the government in July just as the British Medical Association called for a 20% sugar tax and other measures”.

Professor Sheila Hollins, chair of the BMA’s board of science, said: “Doctors are increasingly concerned about the impact of poor diet, which is responsible for up to 70,000 deaths a year, and has the greatest impact on the NHS budget, costing £6bn annually ... While sugar-sweetened drinks are very high in calories, they are of limited nutritional value, and when people in the UK are already consuming far too much sugar, we are increasingly concerned about how they contribute towards conditions like diabetes.”

Dame Shirley Cramer, the chief executive of the Royal Society for Public Health, said the report should act as a spur to counter obesity. “We welcome this report, and the contribution this will make to reduce obesity levels, particularly among children. Hard-hitting action is necessary on pricing, reformulation and promotion of high-sugar products, as these are a major factor in fuelling our obesity epidemic,” she said.

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“We fully support these measures, which are backed overwhelmingly by both the public and expert opinion. There can be no excuses for further delay and it is now vital that these recommendations are taken forward along with a comprehensive package of other measures to reverse the obesity epidemic”.

Jamie Oliver welcomed the publication of the report: “I’m excited and relieved that we finally got to see Public Health England’s courageous, forward-thinking report and its excellent recommendations, such as a proposed sugar levy, cutting down on the advertising of high-sugar food, all of which are powerful weapons in improving our children’s health.

“Doctors, dentists, scientists, a large and growing percentage of the British public and many in the media are calling for action. The ball is firmly in the government’s court. They have the opportunity now to be bold and brave and ensure Britain leads the way against obesity and diet-related disease. Healthier, happier and brighter kids ensure a more sustainable and prosperous Britain. There has never been a better time than now. Lets tackle this like parents not politicians.”

Malcolm Clark, coordinator of the Children’s Food Campaign, said: “Finally, all politicians, as well as parents, teachers and the food industry, have the opportunity to look at the evidence themselves and understand why tough measures to tackle the marketing, advertising and promotion of less healthy food and drink to children and their families are necessary.

“All options should be on the table to protect children’s health. So it is irresponsible of the government to continue to refuse to consider a sugary drinks tax, especially now Public Health England lists it as one of their eight areas for action.”

He added: “The economic and human costs of continuing softly, softly approaches and further inaction are well set out by PHE in their report. The government’s childhood obesity strategy needs to take PHE’s eight action areas and run with them all immediately – including introducing a 20p-a-litre duty on sugary drinks, bringing in a 9pm watershed for junk food ads on TV, and ensuring that there are strong marketing rules across all forms of media.”

Ian Wright, director general of the Food and Drink Federation, said it would oppose any sugar tax. “Steps are already in hand to ensure that high-fat, -salt and -sugar foods will not be advertised to children. Likewise, the industry has already removed millions of calories from the food chain and will continue to make progress on this through reformulation and changes to portion and pack sizes.

“It may also be possible, by negotiation, to improve the definition of ‘high-sugar foods’ as the report suggests. However, we do not agree that the international evidence supports the introduction of a sugar tax and for this reason would oppose such a move.”