20 Sep 2023

Sugar, salt and portion size limits pushed by health officials

Domino's and McDonald restaurants with stylised red and yellow borders
From Off the Shelf, 5:00 am on 20 September 2023

Setting maximum levels for sugar and salt in food and limiting the size of fast food portions are being pushed by top health officials trying to halt the obesity crisis. 

Ministry of Health proposals for a sweeping crackdown on junk food are revealed in documents obtained under the Official Information Act for RNZ’s investigation Off the Shelf: The Quiet Struggle to Stop us Eating Ourselves Sick

One document, a November 2022 email from a senior official with the Public Health Agency, says the Ministry for Primary Industries (MPI) is already looking to introduce rules limiting how much sugar can be added to drinks.

“MPI, through the Trans-Tasman food regulatory system, is developing case studies to potentially pilot regulatory limits for sugar in sugar sweetened beverages.”

In a surprise move, the Food and Grocery Council (FGC), which represents food manufacturers and suppliers including the large multinationals, says it supports reductions in sugar and salt - a process known as reformulation.

“It can be a really good idea,” FGC chief executive Raewyn Bleakley said. “We are certainly up for talking about that. Reformulation over time and innovation is one of the best measures to change what a population is eating.”

Bleakley said it should be done “incrementally over time, in a way that was palatable” for consumers. “When we change how food tastes, if it's too dramatic, people will just add extra salt or add extra sugar,” she said. 

“You need to have those measures being moved very gently over time, so that you can get the sustained uptake of those foods - not have them displaced by other less healthy foods - so yes, we are absolutely up for that conversation.”

Health Minister Ayesha Verrall said the government had asked for advice on introducing regulatory limits for sugar, salt and fast food portion sizes but wouldn’t commit to implementing them.

She said obesity was “one of our major public health issues to confront” but regulation wasn’t always the solution. “I don't want to step into it with regulation that I don't think will stick.”

Ineffective voluntary measures

New Zealand has the second highest rate of childhood obesity in the developed world and the third highest rate of adult obesity.

A Ministry of Health briefing to ministers, titled 'Action to Improve Food and Active Environments' and marked ‘In-Confidence,’ says voluntary schemes run by the food industry have failed and the government should step in.

“We are falling behind other countries internationally in taking strong action in this space,” according to the advice, signed off by Deputy Director-General of Health Andrew Old.

New Zealand has voluntary reformulation targets developed and monitored by the Heart Foundation and Te Whatu Ora, the government agency responsible for the day-to-day running of the health system. 

“However, research suggests the targets are set too low and cover a limited range of foods. Overall, there has been little positive change in the sodium and sugar content of New Zealand foods over time,” the advice says.

“Stronger regulation of fast-foods through setting compositional limits or portion-size limits would also support a reduction in the consumption of salt and sugar.”

Salt shaker with stylised red and yellow borders

The Health Ministry advice urged limits on the amount of salt in food items. Photo: 123rf / RNZ

Health inequities

The advice paints a bleak picture of New Zealand’s food environment. 

“Communities are struggling to access affordable, healthy foods, with almost a third of Māori and Pacific children living in a food insecure household,” officials told ministers.

The documents say “inequitable rates of obesity, driven by unhealthy food and active environments are one of the most important causes of health inequities” for Māori and Pacific people. 

“Children and their caregivers are actively targeted by food and beverage companies and are surrounded by unhealthy food options.”

It says there are three times as many fast food outlets and convenience stores per 10,000 people in the most deprived communities compared with the least deprived.

With fruit and vegetable prices rising 23 percent in a year, 36 percent of the average grocery bill is now spent on “unhealthy highly processed foods and drinks” and just six percent of children get the recommended seven servings of vegetables and fruit each day. 

The briefing also highlights huge holes in monitoring what New Zealanders are eating, saying nutrition surveys have not been done for decades. 

“Detailed New Zealand specific food intake data haven’t been collected in over a decade for adults and two decades for children.”

Funding new nutrition surveys was one of the recommendations of the 2018 Food Industry Taskforce, a group of key players in the food and drink business who were asked by ministers to look at addressing obesity. 

Bleakley said she was disappointed the government never followed through. “That is 20 years of not knowing what children in our country are actually consuming in a reliable, scientific way. The cost of those surveys is about $10-$15 million - that's less than a roundabout would cost,” she said. 

“Having a lack of data in such a critical area when we have an enormous challenge with obesity and diabetes, just perplexes me.”

Health Minister Ayesha Verrall at a post Cabinet meeting media standup on 3 July, 2023.

Ayesha Verrall Photo: RNZ / Angus Dreaver

Slow progress

The FGC was the hub for the Food Task Force and Bleakley says the industry spent a year on a 150-page report and presented 51 recommendations to ministers but had very little response. 

“There was a three paragraph letter back from the Minister of Health to the New Zealand Food and Grocery Council, thanking the industry for the work and acknowledging the valuable role that we play in representing suppliers and making positive change and that was the extent of their response.”

But Health Minister Ayesha Verrall said the government had done a lot to combat obesity, including ensuring productive land was available for growing food, rather than used for housing or other purposes.

She said the government had also delivered 27 million servings of fruit and vegetables under its free lunch in schools programme, established the Grocery Code of Conduct to keep supermarket prices down and, if re-elected, would exempt fruit and vegetables from GST.

“I think those are quite meaningful actions along the supply chain of food,” Verrall said. “I accept progress is frustratingly slow and I am aware of the large burden of diabetes that we have in the community. But I think those are really impactful actions.”