RAVI: Hello.

Welcome to another Nesta Talks to.

I am the Chief Executive of Nesta.

And today, we're talking about the obesity, and whether the Government gets the right to tell us what to eat.

As you know, Nesta is focused on three, big missions over the next 10 years.

Is about how we can reduce obesity.

Our starting point, in order to tackle obesity you probably have to reduce people's calorie in take.

That's probably not going to happen to just encourage people to diet and assume individuals won't do that.

You probably have to change the food environment.

You have to make it easier for people to do the right thing. Us to discuss that are two people, who come at the issue from quite different perspective.

We have Dolly Theis.

At the Cambridge epidemiological and Christopher Snowdon, who described himself as a writer, commentator and the scourge of the The Nanny Statist.

What drives obesity and what you can do about it.

We kick off with Dolly and Christopher with their opening position and ask a few questions.

It would be great to get your comments and questions in the chat, as we go through the next hour.

Without further adieu.

Let me turn it over to our panellists Dolly, welcome.

Let me hand over to you.

DOLLY: Thank you so much, Ravi.

Thank you so much for having me for this debate.

One of my favorite topics.

And delighted to be joined by Chris, as well.

So I wanted to start off by addressing the title of this talk.

'should the government get to decide what we eat?

" some may agree it is provocative and largely misleading title.

The Government doesn't decide what we he'd.

If you ate today, I'm pretty sure the government didn't decide.

What it can do it can help shape what options are available to us.

So I want to flip the question.

And ask should the Government intervene to insure it is easy for everyone, regardless of circumstance to enjoy good, nutritious food?

My answer to that is, yes

Everyone should be able to enjoy delicious food that doesn't then end up making us sick.

Because if the balance like it is today of what is sold.

What is marketed.

What's available is massively tilted in favor of unhealthy options, then should Government intervene to help rebalance that.

What about helping people be free from unhealthy food environments.

If the main options around us are likely to lead to poor health out comes, then how free really is our choice?

Whether that's in our schools and high streets or supermarkets, food outlets.

How easy is it to enjoy healthy, delicious food without having to think about it that much.

And that's really a crucial bit, without having to think about it that much.

Because why should it require more conscious effort and resource to eat well, versus unhealthfully?

>> Should it be hard to be healthy?

So going back to the debate should it be about whether or not Government should intervene?

Or should it be about why and how it should intervene?

It is highly unlikely we would even be having a whole event on this topic, if there wasn't a problem in the first place, and there is.

The UK diet is making us sick.

Four out of the top five risk factors for healthy years of life lost to disease, disability and death are related to our diets.

Four out of the top five.

In other words, the UK diet is leading to disease, disability and death, but we have known that for decades.

In fact, this years marks 30 years since the UK Government announced it would release policies related to obesity, in particular and set target to reduce the prevalence of obesity those targets were to reduce for men 50%.

And women 50% to 80%.

How well has the government done.

The obesity is not 6%.

It is 26%.

And for women, it is not 8%, it is 29%.

Now, obesity is just one of many out comes of our food environment and culture.

And the more that we can move away from a focus on weight, and the more that we can move towards a focus on just better, quality, delicious, diets and making that easy and enjoyable for everyone, the better.

Now my researchers looked at the last three decades to ask why, after 30 years of Government obesity policy as broadly known have things not only got better.

They've got worse.

I found although Government has published 14 Government obesity strategies in the last 4 years containing almost 700, individual policies.

They have largely been proposed in a way that's unlikely to lead to being action and seen right through.

So, we've often had the same ideas proposed again and again.

Often in very sort of conceptual years.

In fact we're more likely to see the Government publish another obesity strategy then to implement, monitor and evaluate the policy it has already been proposed and I examined how easy it is to make policy change on obesity.

Essentially it is not very easy.

Largely because we spend so much time debating whether Government should intervene, like in this event.

Rather than getting on with actions that will actually make a better diet easy for everyone to enjoy.

It is common for politicians to be Secretary of State, health or prime minister and we need to tell industry to help make food healthier or they will.

Or tell people to eat better, and they will.

Despite all of the evidence that shows why that doesn't work back to the original debate should the Government get to decide what we eat be?

No and it doesn't should the government rebalance things so the food around us doesn't make us sick?

Yes.

But how do we do that in a way that insures that the actions the ideas are done not just publishing more ideas.

And how do we insure that policies lead to real change, IE, it is made easier for people, for everyone regardless of circumstance to enjoy a delicious, nutritious diet those are the more interesting questions and those are the ones I would like to focus on this discussion.

So thank you.

RAVI: Thanks very much, Dolly.

Let's turn to Christopher now.

CHRIS: Thank you.

Nice to be here, virtually.

I don't actually agree that we spend too much time asking whether the Government should intervene.

I think it is a novelty to be able to do that today we don't ask enough with regards to obesity or many policy areas.

People jump in, see a problem and assume the Government can solve it and off the Government goes.

I think with any public policy areas you need to ask four or five questions.

First, what is the problem?

Secondly, is it the Government's responsibility to do something about it?

Can the Government do anything about it?

Will the solutions proposed actually work?

If they will work, will they actually solve the problem or make it slightly better, leading to demand for even more intervention?

In other words slippery slope?

What are the costs and benefits?

What are the--

Consequences of obesity.

(audio interruption ) is obesity a public it is consequences from being obese.

No one disputes that.

We have seen that over the course of the pandemic exacerbating factor does it make it the Government's business?

It doesn't seem to be any obvious market failures in the food supply.

And no doubt be exclusively talking about food and ignoring physical activity, because the Government can't do much by way of regulating physical activity.

All of the focus wrongly is on the food supply.

But there isn't any be obvious market failure.

Possibly you could say that people are under informed in some areas.

I think that's probably true.

I would argue maybe most people underestimate how many calories there are in a pint of beer, possibly and mandatory calorie labeling has brought in around the world it has shown to make absolutely no difference.

People might know how many calories in the chocolate biscuit but they know they aren't health foods and buy them, because they like the taste of them.

People often Brie up the costs of obesity to the healthcare service usually reason for interventions and of course, there are specific costs you can attribute to obesity, someone gets Type II Diabetes has to have a foot cut off or something.

You can argue very strongly that wouldn't happen, had they not been obese.

On the other hand.

People obese do pay taxes like everyone else.

They would have health conditions that need treating in the absence of obesity.

And the evidence shows pretty clearly in most respects that in actually fact people tend to cost more the longer they live.

It is certainly true of smoking.

There's quite a bit of evidence showing it is true of obesity, if it is a net cost small and not something we would not normally worry about if not the issue of obesity where there's a strong moralistic element to it.

And the solutions them.

What's proposed will they actually work?

Dolly is quite right probably lots of proposals haven't been introduced in the United Kingdom.

About to be introduced a who last as food advertising bans.

Telling shops where they can stalk so-called unhealthy products.

Stuff like this has been tried.

Sugar taxes have been tried many places over the course of the last 10-15 years.

No evidence whatsoever that they reduce obesity.

There's remarkably little evidence they reduce consumption of soft drink and not much evidence they reduce consumption of sugar or indeed calories.

People tend to competence.

The economic evidence is pretty strong.

It is fairly large literature, ignored by advocates of sugar taxes because to be doesn't work in their favor.

Advertising bans produce aggregate consumption there have been food advertising restrictions not that many.

Not so many that you could say the evidence is particularly robust.

But we know from other categories, other products that advertising restrictions don't really make difference to overall consumption.

The talk as opposed to consumption of different brands and know that the advertising band for so-called junk food on children's television introduced 15 years ago had absolutely no effect whatsoever.

Or Jamie Oliver school mails programme had effect on childhood obesity measure it properly, which we don't.

Reformation is something we have been trying in this course over the last five years or so.

Lots of people want that extended in some way make it mandatory.

They need to look at the last public health England report on sugar reduction.

A hilarious flop.

Not because, companies didn't reduce the amount of sugar in the products.

A lot did.

When he reduced the sugar content they stopped buying them and started buying more sugary products and there was absolutely no decrease in overall sugar consumption from those products.

From the products in the reformation scheme, pretty much any package product you can buy in the shop.

In fact overall the amount of sugar consumed in Britain increased there are randomized control studies showing the same thing for the same reason sugar taxes don't work and people competence.

People are free enough to get around these things.

They will follow their tastes and preferences and they are not the same as those of Dolly and other public health campaigners on the whole.

Finally the whole systems approach when you point out to public health people that none of their policy advise ever been shown to reduce obesity or reduce salary consumption they say it is naive to expect one policy to make a difference instead you need to introduce lots of policies and hope the combined weight will, the sum will be greater than the sum of the parts as it. The obvious problem with this, in ocean, it makes it impossible to additional a policy that doesn't work from a policy that does work.

The ideas of evidence based policy goes out the window in waiver of a smorgasbord of untested policies or policies tested and shown to fail

And throwing them at this issue.

Hoping together they will stick.

Which wouldn't be so bad if these policies didn't bring their own unintended consequences and other problems.

The obvious example is the regressive nature of the sugar taxes.

A study came out last week from the United States showing that 20% of households in the U.S. pay 90% of all of the sin taxes taxes on soda, and alcohol, and cigarettes.

These are incredibly regressive taxes.

Against the whole ideas of health inequality is.

I'll leave it there for if now.

That's my basic position as we look at these things through the prism of evidence based policy there isn't much evidence and the justification for the Government intervening in the first place is extremely weak.

RAVI: Thank you very much, Christopher.

So you're not a fan of this approach.

Can we just start.

You laid out a helpful structures to work through on this conversation.

The first point.

Is it a problem?

You accept it is a problem.

But you characterize it as a personal one rather than one that justifies State intervention.

Surely there are big externalities and social costs as the result of the obesity.

Does that not justify the State having some role?

CHRIS: I don't think there are big social or economic costs.

In so far as those two things are distinguishable.

You will of course get studies saying obesity costs some vast sum of money £50 trillion or something around the world.

These kind of cost benefit analyses are designed to use as weapons in public policy debates if you drill in you almost in variably find the vast majority of the supposed cost are neither external nor indeed financial.

So, a very large section, usually the majority of the total figure put forward will tend to be things like lost productivity.

This doesn't apply maybe so much for obesity, but it is a large component very much with things like smoking and alcohol.

Loss productivity can be absenteeism or another way of measuring lost years of life.

So people, who are not alive, obviously can't work.

It is not an external cost in any sensible definition of the world.

Even other if were an external cost, for if you are obese and work and don't get as much done.

That would be reflected in your salary.

There's clearly a very strong link between what people produce and how much they earn.

So people like that would be passed over promotion.

In other words it is an internal cost on them.

The more direct economic cost mentioned with regards to health service.

You can always portray being a very large cost for all sorts of things if you ignore the counter factual, how much would have to be spent in the absence of that problem.

In the case of obesity, you let's take a case of someone very overweight.

They have a heart attack.

They drop dead or need hospital care for a few weeks before they drop dead.

What would they cost, had they not been obese and lived another 20 years and died of cancer, which is the most likely thing they would have died from.

And the cancer wasn't obesity related we never find out because they never include the other side of the ledger in the other studies you get a partial view.

They're not really cost benefit analysis because you don't see the benefit the savings you would see in a counter factual.

RAVI: By this principle, presumably you would not be in favor of seatbelts being compulsory for the same reason.

CHRIS: They should be compulsory but not going to the wall for.

But yeah, the ethical case for finding someone for not wearing a seatbelt is very, very--

Thin I would say.

It is more of a case for putting seatbelt in the back than the front.

In the back seat you can potentially kill the person in the front seat, if you fly through the car.

But let's not get on to that.

It is relatively small issue.

I think the Government control of the food environment is quite a big issue.

RAVI: Dolly, how do you see this on the actually case for Government intervention at all in this area.

DOLLY: Yeah.

Coming back to some of Chris' points.

There are sort of little signals towards the position like.

What is a big liberty cry versus a smaller liberty and the role government plays.

I think this whole debate area can so easily get wrapped up in the ideas that the Government is coming in and taking away vast sections of choice, in relation to food.

And forgetting to focus so much on the positive, active provision side of healthier options and making that more accessible, affordable, convenient for everyone.

Which is massively the focus from the public health community.

Of wanting that to be a reality for everyone.

And the reality now is it is not.

It is massively disproportionately tilted towards unhealthy options.

It is very far from the ideas of restricting freedoms and liberty it is more in line with increasing freedom.

Increasing choices.

And increasing the ability to have options that don't lead to negative health out comes.

Coming back down to the health side there again tends to be more of a focus on the obesity element, in particular.

I was very careful to select that statistic around the diet-related diseases, disability and death, because it is four out of the top five risk factors related to those things are about poor diets.

It is not just about obesity.

It is about what all poor diets can lead to.

I think it is really important we move away from that focus just on weight.

Towards the quality of diets that are available to everyone.

And finally, there was one thing Chris was saying, in terms of the intervention side.

And how effective and they are likely to be.

Having been spending these past, few years really looking at how hard it is to make policy change happen, the reality is the nit-picking how likely each one becomes being is so politicized you end up with the situation where the Government will not feel that it is politically feasible to expand for example the soft drink industry levy to all products that have high amounts of sugar.

The milky drinks you have in Starbucks and whatever, if I'm allowed to say any names.

Popular coffee shops or fruit juices and because of the milk in relation to its links with the 80s under Thatcher.

That these sorts of things can't be as effective as they possibly can be, because of these issues these political issues and the debate around it of the sort of liberties there's a bit of a catch-22 with it.

You end up in a situation with smaller scopes of policies, just because of that political debate around it.

So you're already reducing its ability to be as effective by that debate in the first place.

I would be interested in, I can see Chris smiling.

Interested in Chris' thoughts on that.

How can you possibly expect effectiveness to occur if you're debating and reducing that scope with these positions around exacerbating the limits of freedom, when talking about trying to create freedoms.

CHRIS: Oh, it is my fault these policies didn't work.

I didn't realise.

I thought it is they were in effective it is just talking about it makes it less effective in that example.

The sugar tax, I don't think people like Jamie Oliver thought it would come in.

I think they used that to push the envelope and move the window to get other policies through.

I think it came as much of a shock to me as me when George Osbourne actually introduced it when people like Oliver were campaigning for it.

They kept going on about how many children are overweight and obese the strong implications was obviously if you bring in the sugar tax you won't have so many children overweight and obese.

Now it has come in and aren't really made any difference.

Saying negotiate and naive to think policy would do something.

Naive to extend to milk shakes and maybe some coffees in Starbucks.

You will see suddenly this policy that failed in every country in the world where it is tried.

Suddenly has an effect

And absolutely we should be arguing about these policies.

Because they have very significant consequences for people.

A tax on all sugary products for example, would be yet, another regressive tax.

The sugar taxes in you know--

In cash terms, you need to be realistically drinking a huge amount of sugar for it to really significantly--

Effect your disposable income.

Still it could work out £50, for a low income family I would rather than or as Henry Dimbleby extend it to salt and to fat.

Then you would be looking at a very, significant impact on everybody, actually.

But of course, it is especially on people on low incomes, who as we also know the behaviours, at least likely to change in the face of these interventions we have seen that clearly with tobacco.

RAVI: Let's dive in the sugary drink levy.

Thomas Abraham in the chat saying I hope we can touch on it.

He thinks it is a success.

My understanding what of happened there.

When the sugary drinks levy was announced around half of eligible soft drinks contained 5 grams or more of sugar by the time the actually levy was operational, all of these drinks manufacturers had reformulated their drinks and taken sugar out, only 15% sold were above that threshold.

And actually sugary drink levy has been re-effected at taking sugar that's often not very, people don't notice out of people's diets.

And then taking a bit of calories out of people's typical in take.

And that's my understanding of things.

Dolly, I don't know whether you can flush out your view of the evidence around the effectiveness of the levy.

Then we'll come to Christopher.

DOLLY: Yeah.

Absolutely.

You set it out, in terms of the reduction was really in the sugar content around a lot of these drinks.

It was designed in a very clever way to make sure that it wasn't about a tax to increase consumer prices.

But really, it was about incentivizing manufacturers to reformulate to reduce the amount of sugar and the high sugar drink.

And to really make sure that was incentivized in the way that wasn't only punitive to the manufacturers.

There were two tiers of the levy.

So that there was a top end and could reformulate and pay a bit less, if you hit within the middle point.

And then anything below that

You wouldn't pay anything at all.

It was sort of really pushing companies, if they didn't pay anything at all, if you reformulate below that bottom rate.

And there has been a massive reformulation effort, which was already happening as the industry made clear before.

It was sort of Excelled that progress that was made.

And coming back to the links for certain health out comes.

It is so critical with anything with public health.

Not just have one, outcome, which is often the case with government strategies on this issue.

You just have the main target is a kind of obesity prevalence reduction.

Really there are so many positives that can be had as the result of the intervention in the short, medium and long-term.

The biggest example with the soft drink is around dental health.

The main reason why children end up in A and E is getting their teeth extracted it is a shocking statistic.

And yet, it is something that one intervention like this.

Yes, you can focus on the obesity side of things.

All that we can absolutely look at all of the outcomes, as the result of this.

It is not just that you stop at it there.

It is about what other products are likely to need to be included or what knock on effects a negative unintended consequences you may have.

That's the nature of the whole issue.

There is no, one thing.

>> To keep looking and evaluating and monitoring.

RAVI: I'll bring Chris in a second.

Dolly, to push on the sugar tax.

Do you think the right path now is to do another levy for another food group?

And do what has been done with the sugary drink tax.

To calibrate it specifically with a particular be thresholds you think manufacturers can duck under and therefore not push prices up and drive reformation?

Or do you think you can't do that for every food under the sun.

Do we need a single sugar tax.

It might push prices up a little bit.

It is much more sensible than having 100 different sugar taxes in the economy?

DOLLY: Yeah.

It is a really, interesting question.

It is at the heart of this whole area.

It is a very, very fine balance between that, how in terms of prices of certain products up, at the same time of really trying to reformate thing just to make food healthier.

This is where, if you go in the detail in the national food strategy, there is a lot of consideration around this.

They have absolutely made crystal clear that where there are prices increased, as the result of it of the sugar and salt tax they propose in it.

That absolutely has to be invested into making healthier, delicious options.

Also more available and accessible for people, particularly on lower incomes.

And the point is again.

Shifting to the positive, if you only focus on this as a taking away.

Reducing things or whatever.

And not on the fact that the reality is about increasing provision.

Increasing choice, and access around delicious, healthy food.

I know that isn't necessarily good evoking images of delicious food.

High want to make it clear.

It isn't about making food unenjoyable.

It is absolutely making food the most enjoyable part of the society.

We know it is central to that.

So this is about increasing the quality.

Increasing the deliciousness for everyone and that access to it.

RAVI: Chris.

CHRIS: Thanks well, these hardened point and the goal of the sugar tax was to reduce obesity.

You are right to mention tooth decay as well.

Haven't seen the figures on tooth decay I know they have been falling for decades I have seen the figures on obesity, child and adult and no effect whatsoever from the sugar tax now in place for a good three years.

You're quite right about the reformation.

I think you're figures are a little wrong.

I think I'm right in saying 16% before the sugar tax fell below the threshold in terms of the sugar context and I think you're right it went up to 85%.

That had been rising for a very long time.

Diet drinks have been around since the 1960s and really took off in the 1980s and a gradual shift towards the diet drinks and bolted water over the last 20 or 30 years.

Even before the sugar tax came in the amount of sugar consumed had fallen by 45% over a period of 10-12 years.

One of the indicators that sugar tax wouldn't effect obesity is that drop didn't effect obesity either it is not that surprising that a further increase in the number of diet drinks available hasn't made any difference.

What it did do.

RAVI: Don't you have to look at the whole diet.

Of course, one, particular item of food is probably not going to make the difference, but if it is done across a wider set.

You would expect it to be effective?

CHRIS: Maybe people like Jamie Oliver should have said this won't make a difference.

It will be unpopular.

And Warren Lucas aid.

And Iiron Beau and launch the same product with the different name a couple of years later and a lot of consumers will dislike it.

It will not make a difference just the first step towards taxing our food supply.

That would be more honest way to go about it.

I mentioned the slippery slope earlier on.

You get the slippery slope because policies don't work.

In most areas of public policy.

If it doesn't work, it is repealed.

At least that's what should happen with public health you do more of the same thing.

RAVI: So, one area that you might possibly agree or you indicated some possible openness to was around labeling.

You did say that actually people are probably not understanding the calorie in take of a particular food and maybe they could be helped to help themselves.

Would you accept that, experimenting with different labeling schemes and mandating labeling schemes that are more effective front and back labeling could get on board, because it still preserves choice.

CHRIS: Absolutely you can govern action in two, possible ways one if there are negative and a market failure if is there something in the market leading people to not follow their own tastes and preferences.

And the obvious one there is what is called information asymmetry, meaning consumer ignorance

So if people are stuffing cream cakes down their throat three times a day.

Thinking they're health foods.

That is a problem.

If the manufacturers has misled them into believing they will not make them fat, then a cause for government intervention possibly.

We don't have warning labels on that many things.

Cigarettes the obvious one we sort of have sort of labeling about pregnancy and drunk driving on alcohol.

We're not talking about that.

Just talking about ingredients I don't think it should be controversial there should be calorie labeling on all products with calories and I think it should be on alcohol and mandatory on food the only reason it is not mandatory is because of the EU it is hang over.

It is an EU compensation. We couldn't do it if we wanted to

The voluntary system left to the vast majority of packaged food like the traffic light system and the ingredients.

I think those labels system is pretty clear.

I have no objection to legislation to make it mandatory across the board.

I think you need to be careful however, with very, small cafes, restaurants, pubs.

The Government has acknowledged that with the calorie labeling it is not practical for a pub to do a different dish of the day and have some chemical analysis to find out how many calories are in it for mass produced package foods I see no issue.

There's no infringement on freedom so long as you don't have a slippery slope to having graphic warnings on packaging a danger or idiotic ideas having teaspoons on each to show how many teaspoons of sugar.

Then I see no issue at all.

RAVI: Dolly, did you want to come in.

DOLLY: Yeah.

There's a couple of points.

I'll get on to the labeling point in a second.

On the kind of what do people want?

And if they're stuffing cream cakes is such a patronizing image.

The reality the health halos and difficult to navigate what is healthy good, et cetera is a very, real challenge.

And there's a lot more coming out on this, in with regards to that misleading marketing at the moment.

So that shouldn't be underestimated if you actually go to again, the national strategy citizens assembly were engaging with people across the country.

Representative of the country about what they wanted and you look at polling over so many years.

People want help on this.

They know that it is difficult to enjoy healthy diet

And there are so many different factors that contribute to why people be end up having making the food choices that they make it.

Can be so complex around what is available.

What's easy?

If you have pester power. If you have a tight budget the and the only thing you're children will eat and leads to food choices there are so many factors the ideas you can limit to people stuffing their face was cream cakes.

Not knowing if those are healthy or not.

It is just so in accurate of how things actually occur.

And the kind of desperation a lot of people feel wanting it to be easy and not be about feeling like we're all weak-willed we know is not the case, because our morale strength hasn't changed over decades.

We know the environment has.

On the labeling front.

There are two important points to make on this.

So labeling is typically an intervention that's discussed as about increasing information for people to improve their choices or know what they're able to choose.

Actually there is weak or mixed evidence on the effectiveness of that.

And also discussions I see some comments about the sustainability agenda.

There are also discussions about increasing information on food about the sustainability side of things.

Carbon emissions, et cetera.

We run some research on that.

And actually found that, if you introduce a labeling what it can do is incentivize the manufacturers and the producers to realise that their products their serving or the thing they're serving in restaurants for example, don't offer that many healthy options, healthy, nutritious options it actually can possibly lead the manufacturers, restaurants, producers to present and provide better options or more of a balance that is much more appealing in a way it means a consumer can go to a restaurant and not have to fight to find the healthy options.

Or not have to try to navigate all of the different pieces of information that can be so much.

And the same if they're going shopping as well.

So the menu labeling or the front back labeling thing, whatever labeling often discussed as the consumer focus it should be focused more or equally more on the manufacturers, producers and restaurants changing the options to again, rebalance things some there is a fairer choice for everyone.

RAVI: One of the issues that Christopher mentioned in his opening talk.

How people tend to competence for things.

They might eat less calories in one part of the meal, but have something more calories in another.

It is a real issue with sugar and salt taxes, Dolly?

I wanted to ask, how do you understand whether that compensation is happening? What do you do about it?

DOLLY: The compensation say again?

.

RAVI: One of the risks I guess with say you put in place a salt tax or a sugar tax.

Potentially the manufacturers may well reformate but they may reformate with something else that, is calorie increasing.

How do you actually do this in a way that doesn't have an unintended consequence it has less salt or sugar but the actual calorie level is no better.

DOLLY: The evidence on--

It is fascinating at the moment because of that question.

In terms of the healthier food all-around.

Because there's the whole increased attention on ultra processed foods.

Our understanding of how processing of foods can effect the way we digest them and it is still very much emerging.

It is critical with all of this.

There is an absolute, sort of promise.

These one things will lead to the solution for all.

That there may indeed be unintended negative consequences.

I think on the labeling front, I can't help but step back and say.

Say you're in that food environment in the supermarket or whatever.

We're so focused on just the provision of labeling on each, individual product.

Actually what you're around is a massive disproportionate function on objects just unhealthy and available for all.

Would you even have to have labeling, like that level of detail, if the balance was just massively in favor of healthy options, where it doesn't matter because you're not thinking about it that much what is more convenient or available is just healthier.

Then consumers it is not lumped on the consumers to be navigating that.

And I sort of think about that a lot, when I go around.

When you start to focus on the individual labeling as "the solution" one can easily forget about the wider picture.

It is like that with the reformation.

As the wider picture what is food most available?

Most consumed most marketed whatever, if it is not necessarily the best thing.

Then we need to make sure it is the rebalanced.

So what is easier for everyone.

Again coming back to my point.

Should it be hard to be healthy?

It seems crazy that we have to make that argument

RAVI: I want to bring in some questions.

Anna Tomilo has asked, she would be interested in Christopher thoughts of limiting marketing strategies by companies, to insure they are not infringing on choice.

CHRIS: Do you mean the limiting the marketing strategy or the marketing strategy are an infringement? It is hard to see how marketing would be infringement in some Orwellian reworking of the concept of choice.

RAVI: Marketing that target junk foods advertisements for children.

Should we band those?

Or other marketing strategies should we intervene, because your manipulating individuals to buy something that's not necessarily in their best interests.

CHRIS: We have the advertising standards authority, which is actually pretty strict on these things.

Their watch word is advertising has to be decent, honest and truthful.

I don't see why anyone would want to band something decent, honest and truthful for me the marketing area is pretty straightforward issue of free speech, actually.

And commercial free speech doesn't get as much attention as other forms of free speech but free speech of all kind is under massive attack now.

Across the western world.

So long as the advertisement is not dishonest or misleading.

Then I don't have an issue at all.

Absolutely it should be, these companies should be allowed to get their message out

I think what the Government is proposing in terms of banning so-called junk food advertising is absolutely beyond the pale.

It is we have a bit of a conversation going that this is not junk food.

High fat, sugar and salt these are not even high in fat sugar and salt and not junk food.

The government got itself in the position where they realise they would be inadvertently banning lots of things people consider to be normal and healthy, because they are.

Whether it is jam, mostly sugar.

Or cheese or sausages or whatever it may be, raisins.

Now the government has changed in the actual legislation. It doesn't give a definition of junk food it says whatever the Secretary of State thinks is junk food or "less healthy" food.

You cause unintended consequences and problems when you do this.

Dolly alluded to this before.

Action Sugar among others including Dimbleby were complaining about supposedly misleading marketing on food products on baby food products saying no added sugar these products don't have added sugar it is not dishonest to say that.

If people assume it hasn't got any sugar at all, that's--

That's their--

It is a problem largely created by groups like Action Sugar with the distinction between added and intrinsic sugar which doesn't have any scientific validity.

To scare people about added sugar and companies are using fruit juice concentrate or whatever.

And now they're accused of misleading marketing Henry Dimbleby was complaining about Percy pigs having vitamin C.

They do.

What are you supposed to do?

Who is being misleading?

The people telling you what's in the product or the people trying to stop you doing so.

RAVI: Dolly did you want to come in?

And the rational or the reason to do a band on junk food advertisement?

Is it to shift consumer behaviour or the reason, as you were suggesting to shift the behaviour of producers so they start to reformate to, they don't get restricted from advertising?

If that is the case, there's a slight risk in of the sort of intellectual dishonesty in the argument.

In the reason we're doing this is to change the food environment and we're using instruments to do that.

And perhaps honest what we're up to.

DOLLY: Yeah.

Honesty is part so hard there are so many ways to frame it.

That's why I'm trying to move the focus on to the positive and the provision and the rebalancing element.

In an ideal world you wouldn't have to have a restrictions to some extent, because the balance would just be in favor of healthier options.

I have to say on the marketing front.

There are so many things to say about this.

I really have to point to the work of Fight back 2030 the youth-led campaign organisation calling massively for the marketing and advertising of healthy foods to be tackled and they very powerfully the youth ambassador doors talk about the fact that they realise now that how heavily bombarded they are with unhealthy food afferents and again, don't want to be.

It is unhelpful to have those triggers all the time.

Just to get under the hood of marketing strategies I remember talking to someone who worked for one of the major snack companies.

Their marketing strategy was developed around six snack points in a day.

So, when you're talking about honesty around marketing.

If the business model de signed around getting people to six-snack point per day outcome.

That is dishonest.

The idea that you can have honesty on the packets.

Yes, you can put vitamin C.

You're not being honest how much you're expecting consumers to buy and consume.

And, taking zero responsibility if that's actually not what people or the world that people want to live in.

And Fight Back makes the case strongly that is not something that young people want.

RAVI: Great.

Thank you.

Anna swan has some further points.

Do check those out on the chat.

I Want to turn to Christian basta question.

We talk a lot about taxing what about reducing the cost of healthy food what do speakers think of subsidising fresh healthy fruits, grains, vegetable as the other side of taxation.

Christopher it is equally objectionable because it will have to come from another tax to subsidize these things.

CHRIS: Yeah,it would do.

It is in distinguishable with regards to the consequences to people.

It is totally impractical.

You hear people saying this.

Okay let's not tax the unhealthy stuff make the healthy stuff cheaper.

How will you do that?

Given the Government doesn't control the price of food in this country.

I can't see any way to do it.

Which at the least would leave you wide open to fraud,

Because someone would have to decide what is the natural price is.

And then you give it to who is this farmers, supermarkets?

I don't understand how it would work.

I guess food stamps to people, only used to spend on fruit and vegetables.

They do that in America.

It is quite controversial, but they do it.

So, it is in practical.

It is commence rate to a tax on people, who are not buying these products and totally unnecessary, because fruit and vegetables are really cheap.

There's this weird delusion among a lot of people, especially in public health that it is really expensive to eat potatoes and carrots and peas.

It isn't, there are of course, expensive vegetables if you go down the exotic end of the market.

There's a reason that the poor of the world have had vegetables as their staple diet for all of human history.

That is because, they're really cheap

And they've never been cheaper than now.

People are not neglected to buy fruit and vegetables because they can't afford it.

They do it, because they don't really like the taste of them and most vegetables actually don't taste very nice and most including myself don't have the cooking still to make them taste nice to want to give people to cooking skills to make a vegetable casserole.

Feel free.

See if they follow through in later life.

It has nothing to do with the price.

We will cause enormous problems if we think it is the issue of affordability and relative cost.

I'm very concerned of the ideas of taxings salt.

We have people who don't really understand what's going on.

They don't really understand, if you ask them how, why obesity has risen in the first place it has no relationship with sugar the main target.

Because sugar consumption has gone down.

What has been the consequence?

What has been the consequence of reducing salt according to Graham Mcgregor a big cam anker it is a tremendous success bus it is an example of someone marking their own homework.

The evidence of the salt in the human diet is extremely shaky the salt doesn't have any calories about the only part of the food supply without any calories a good way of making food taste nice, without adding calories take salt and put something that has calories in it.

We're messing around with forces we don't truly understand.

I hate to invoke the precautionary principle.

I think before we let public health people loose with a half baked ideas.

We should look carefully what the unintended consequences including in the final point on people, who suffer from anorexia and malnutrition.

If the government reformation scheme works in the way it in tends to, to reduce everybody's calorie in take by a set amount.

The consequences for people underweight would be quite profound.

Fortunately, of course it won't work if it did work it would have serious, negative consequences.

RAVI: Dolly there's loads to comment on feel free to comment on, is it practical to subsidize and make healthy food cheaper?

I think the other point Christopher made which is interesting.

It does feel harder to actually introduce a salt tax than a sugar tax.

There are potentially more unintended consequences would you be more cautious on that?

DOLLY: Comment on to the subsidy point first.

I always I just have to say Chris, it makes me want to cook for you.

The ideas that you think vegetables are disgusting makes me sad.

I feel like you clearly--

That is--

So subsidies already happen and have the healthy start scheme for example.

Where vouchers are provided to low income families.

And there are various thing like that.

There will be lots of schemes out of the many, hundreds of policies proposed over the last 30 years on that sort of free provision of fruit and vegetables supermarkets have done it, as well.

It is not enough to get at the real, issue around why fruit and vegetables aren't healthier foods move weather from just fruits and vegetable but healthier foods.

Healthier foods are not as cheap.

Because we're talking about when it is convenient and set against each other as a fair choice related to calories and convenience and accessibility and all of those things.

That's when it is harder.

Just talking about raw ingredients is not an accurate reflection of what is meant by access to affordable, convenient, healthy options.

And any research that has been done on this area, really does demonstrate that when people try to shift towards a diet of healthier foods they can be more expensive when you're looking at it calorie to calorie or looking at it around convenience issues.

That's a really, clear distinction.

It is a case made often by opposition arguments that you can just cook.

The reality is there are many reasons why that doesn't happen.

It is not necessarily just because people don't know how to cook.

When we live in a culture of convenience and things available.

It is options and even people that cook don't necessarily do it.

Just reducing the ideas of choice, again too simplistically misses lots of important considerations within that.

On the salt tax side.

Yes, the unintended consequences need to be addressed I think it comes back.

It comes out to what I was saying before about all of the thing where the shift must be stepping back and looking at what options are around us, in terms of the balance towards the healthier, and making sure that it is not lost in that detail where you end up on very, real feasibility practicality issues around some of the reformation rather than looking how to shift the environment so what it most available is the healthy options.

RAVI: Sticking with Christopher culinary competence or lack thereof, there is a question in the chat about--

Let me find it.

Kim Townsend.

What do the panellist think of education role in nutritious food and in the earlier years another question along similar lines about education.

Chris, that's something that doesn't in fringe on any choice.

Should we educate people on how to make and eat nutritious food.

CHRIS: Yeah.

Of course.

It is perfectly reasonable part of Home Economics or whatever they call it.

Whether it makes much of a difference in the long-term I don't know.

It is true people like me don't know how to cook and true people like me don't like to cook.

And Dolly dismisses convenience as a negative thing.

Convenience is a good thing not everyone wants to spend Anita hour and a half cooking it is great.

It is the people who like doing it most keen to intervene.

That's why you have so many celebrity chefs.

They're obsessed with foods restaurateurs and cooks.

DOLLY: I have to correct you on the convenience point.

I didn't say that convenience is a negative thing.

It is just that what is convenient or what is most likely to be convenient tends to be unhealthier option.

Absolutely if we can have convenient, healthier options fantastic.

CHRIS: I don't see what they would involve?

The points someone is making in the comments is that, you know if you add in the time it takes to cook and acquiring the cooking skills it works out more expensive.

That is true, I guess, if you compare it to, a pizza that you fling in the oven.

It is obviously not true comparing it to a meal that you would cook at home.

The cooking time is likely to be, very similar.

You know convenience is a good thing.

Time is precious.

And a lot of us don't want to spend a huge amount of time cooking.

And that is a perfectly reasonable choice to make. If it means you put on a few pounds, which I would say is still debatable, then that's up to you.

If you want to eat healthy, you can munch on a raw carrot.

A bag of carrots you can eat one like a horse.

My daughter is happy munching on a carrot it is not for me and everybody.

But we're all different, aren't we?

RAVI: Dolly, what's the actually evidence on if education can't help people to cook better or choose better, convenient food.

DOLLY: It is not the evidence on the education programmes.

It is not my area.

But I absolutely, it is funny enough politically, in terms of the my area more on the policy side.

It is an area that pretty much everyone agrees needs to be done.

It is kind of fascinating how, when you start to look into why those barriers occur within government around education-based policies there's sadly quite a lot of push back or has been a lot of push back from the Department of Health over the years of not feeling health is really their issue and lots of things that department has to focus on.

That's a major barrier that one sees, when it comes to getting policy change across government.

That other government departments outside of the Department of Health and maybe downing street, if the prime minister at the time is really focused on it didn't always feel like health is their responsibility.

And even more than that.

They may see certain policies that are being proposed jar with the policies that they have, in their given department or vested interest in their different department.

The case on advertising for many years there's a barrier within government on having all departments feel like health is their responsibility or they have a role a very key role to play.

That is certainly something that prevents policy change happening when it really should ask could.

RAVI: Thanks.

As are all of the questions are coming right at the end, but we have to wrap-up.

I just want to ask one final question of both of you we have been having a go at this argument for the last hour.

I'm interested in your predictions about the politics of food going forward?

Christopher, do you think your perspective is winning out?

That there is a backlash that's growing?

And or do you think you're losing the argument and Dolly are you an optimist about political and policy progress in this area?

Do you fundamentally think it is--

No one is actually going to do what's needed?

CHRIS: I'm very absolutely not optimistic my side is winning my side is never winning.

You know the mentions that Jonson has announced they're unprecedented.

I don't think they'll want to do any more for the time being.

I think there's going to be quite a few negative consequences from the policies already introduced in particular the 24-hour digital on-line band for so-called junk food advertising.

I will pick up so too many cases companies producing food that almost any normal person considers to be healthy are banned from advertising that's what you saw with the London underground band hopefully there will be a backlash.

They have watered down quite a few in the light of reality and maybe learned a lesson.

You shouldn't just take a wish list of measures from people in public health, because they are not really in touch with the real world.

But in the long-term we're only going one direction.

Everything is getting more nanny state.

The only prospect of any liberalisation in any area is probably cannabis.

But no, smoking will be banned sooner or later.

And alcohol tax also go up, and the advertising for that will probably be banded and probably see more taxation in the food supply.

Apart from anything else the government needs some money I wouldn't worry my final point. I wouldn't worry about food being too cheap the economy is about to collapse over the next 12 months we will have a massive inflation problems.

Interest rates.

And people in ivory towers will talking food is too cheap and the rest of society will try to get the costs down.

RAVI: Thank you.

Dolly, final word for you.

DOLLY: I am an optimist, yes?

Are things moving in the direction where policy is more likely to lead to action and better public health out comes yes.

Hopefully that will continue I think anyone watching keen to be part of that.

Absolutely encouraged to do so.

And thank you also for opening debates like this.

I think it is so important that we keep attention on this issue up, as it is critical.

RAVI: Thank you very much, thank you both for joining us.

The talk was a really interesting conversation.

It is great to challenge our assumptions on this.

As I said at the beginnings.

It is one of our three big missions we're focused on keep in touch to hear more from the team on the work over the next few years.

Thank you, Dolly and Chris.

Thank you audience for great questions.

Cheers.