Removing around 216 calories from the daily intake of people who are overweight or obese would set England on a path to halve obesity by 2030, according to research published today by the innovation charity Nesta. The analysis finds that it is possible to achieve up to a fifth (18%) of the target by ‘stealth’ measures like reformulation.

Halving the prevalence of obesity in the UK would return it to a rate last seen in England in 1992 when it was around 14%. Getting back to 1992 levels of prevalence across the UK would return a cost saving to the NHS of around £3.25 billion per year.

Cutting 216 calories from a daily diet is the equivalent of a 500ml bottle of cola. Calorie reduction typically places responsibility on individuals to cut items from their diet. In contrast, reformulation involves manufacturers making small changes across a large range of commonly consumed food and drinks. Most people won’t notice any change in the products they consume, but the overall health effect is significant.

Data analysis, also published today, shows how reformulating a limited number of everyday food items could make up around a fifth of the total calorie reduction needed per person. Researchers analysed the effects of reducing the calorie content of 10 suitable food categories by 10% and found that such an intervention would reduce the average person’s calorie intake by 38 calories. This is around twice the effect of the successful Soft Drinks Industry Levy (which is estimated to save 18 calories per day), introduced in 2018, and would remove around 1 billion calories from the national diet per day.

To get the UK on the path to addressing the obesity crisis, the report recommends:

• Government to set mandated calorie reduction targets for specific food categories that contribute most to excess calorie consumption, alongside incentives like R&D credits;
• An institution to lead the reformulation efforts, with statutory powers to design, set and monitor targets for calorie reduction by manufacturers and shops, with powers to levy fines where targets aren’t met;
• Statutory data collection of sales from all retailers, including leading supermarkets, to inform a public ranking of shops on progress in making food categories healthier, as well as provide consumers with more information on which supermarkets are healthiest

Ravi Gurumurthy, chief executive of Nesta, said: “Halving obesity is a significant but achievable challenge. The number of people living with obesity has doubled in 30 years and that has very little to do with willpower or our personal choices. Over three decades the food and drinks we buy have become bigger, cheaper, and far more calorific.

“There is a compelling case for the Government to invest seriously in prevention. The NHS is under dreadful strain, partly due to capacity and investment but also because of demand. Prevention and capacity will need to be the twin pillars of public service restoration.

“We know the mantra of willpower and personal responsibility is a dead end. Reformulating a selected few food categories by a fairly small amount is good value and requires zero effort from the consumer. The success of the sugar tax shows that good policy-making can help cut calorie consumption without affecting taste, price or profits.”

The analysis conservatively estimates that these modest changes to popular food categories would return around 300,000 quality adjusted life years (QALYs), using current models, to the British population over a 25-year period. HM Treasury estimates that a single quality adjusted life year is valued at around £70,000.

Reformulation is one way to improve nutritional value or reduce calorie content by changing the processing or ingredients of food or drink. The future of food: opportunities to improve health through reformulation is based on new analysis of shopping baskets of more than 29,000 British households from 2021. Nesta’s data science team set out to identify which food categories are most suited to reformulation using three indicators: impact on diet; feasibility of reformulation; and inclusion across income groups. The indicators were then combined into a single metric of reformulation suitability.

Based on calculations for a sample of around 6,000 individuals, Nesta’s analysis on halving the prevalence of obesity by 2030 found that on average men who are overweight or obese in England need to cut 241 calories from their daily intake, while women who are overweight or obese need to cut 190 calories, with an overall average of 216 calories. Public Health England has previously calculated the excess calorie intakes for children and adults, but Nesta's research is the first to calculate the calorie reduction needed to reach specific obesity reduction goals at population level.

Hugo Harper, director of healthy life at Nesta, said:

“It should be easier and cheaper for people to consume fewer calories without making drastic changes to how they shop. We set out to find the easy wins in terms of food categories where small changes could make a bigger difference. To maximise the benefits of changes we focused on popular food and drinks that tend to pack in a lot of calories. Some foods are too difficult or expensive to reformulate, but we know the technology and method exists to make helpful changes to a range of items that are widely consumed. No one measure is enough but this gets us some of the way towards halving obesity - 38 calories is about a fifth of the reduction needed on average among men and about a quarter among women. ”

In England 28% of adults (12.6 million people) are obese and a further 36% are overweight. Obesity is linked with significant negative health effects including type 2 diabetes, several types of cancer, heart disease and stroke. A 2022 study estimated the annual cost of adult obesity to UK society at around £54 billion while the NHS spends around £6.5 billion a year on treating obesity related ill health.

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Notes to editors

1. Obesity levels have increased from 14% in 1991-2 to 28% in 2019, according to the Health Survey for England (data for 1991 and 1992 is not separated). According to the Health Survey for England 2019, 28% of adults are obese and 36% are overweight.
2. A 2022 study by the consultancy Frontier Economics calculated that the annual cost of adult obesity to UK society is around £54bn and the annual cost to the NHS is around £6.5 billion. Nesta calculated that the cost savings to the NHS of halving obesity would be around £3.25 billion.
3. Nesta calculated the amount of weight people would need to lose to halve obesity rates by comparing the distribution of BMI in 1991-2 with rates in 2019, using the Health Survey for England. This involves calculating the necessary weight loss in percentages for about 6,000 individuals in the HSE sample, using an estimated daily calorie intake based on factors like sex, age, height and weight. This is calculated differently for men and women, and for people in different BMI groups of normal weight, overweight and obese. The average across genders and overweight and obese categories is 216 calories per day.
4. A 2021 paper by the IZA - Institute of Labor Economics estimated that the Soft Drinks Industry Levy, introduced in 2018, saves around 6,500 calories annually per person, which is around 18 calories per day.
5. Nesta’s report, the future of food: opportunities to improve health through reformulation, involved data analysis of in-home food and drink purchases for over 29,000 households in Great Britain in 2021, using data provided by an international market research company commissioned by Nesta, alongside 39 interviews with experts across the food retail and manufacturing sector, a policy design workshop, and a technical report on opportunities and barriers for reformulation to reduce calorie consumption, produced for Nesta by product development consultants Bingham and Jones.
6. Nesta identified its 10 key food categories by creating three indicators that took into account the most important factors in deciding whether a product should be reformulated. We combined our indicators into a single metric of reformulation suitability by averaging scores within each of the criteria. The three indicators were: impact on diet based on the volume of calories purchased, whether reformulating a product is commercially and technically feasible based on the variance of calorie density within a category, and whether reformulating certain products or categories may impact low income groups across society more or less.
7. QALYs are calculated by estimating the years of life remaining for a person following a particular treatment or intervention and weighting each year with a quality-of-life score (on a 0 to 1 scale). The Department of Health outlined this further in Quantifying health impacts of government policies. HM Treasury outlines in its Green Book that the current monetary “willingness to pay” (WTP) value for a QALY is £70,000 in 20/21 prices. Nesta calculates the QALY savings monetary equivalent modelled over 25 years at £23 billion, using the Department of Health and Social Care’s Calorie Model.
8. Public Health England calculated excess calorie intakes for children in its 2018 report Calorie reduction: The scope and ambition for action.
9. For more information on the analysis or to speak to one of the experts involved, please contact Kieran Lowe, Media Manager, on 020 7438 2576 or [email protected]. Spokespeople are available for broadcast interviews.

About Nesta

We are Nesta, the UK's innovation agency for social good. We design, test and scale solutions to society's biggest problems. Our three missions are to give every child a fair start, help people live healthy lives, and create a sustainable future where the economy works for both people and the planet.

For over 20 years, we have worked to support, encourage and inspire innovation. We work in three roles: as an innovation partner working with frontline organisations to design and test new solutions, as a venture builder supporting new and early stage businesses, and as a system shaper creating the conditions for innovation.

Harnessing the rigour of science and the creativity of design, we work relentlessly to change millions of lives for the better. Find out more at nesta.org.uk