Diet and nutrition: policy context

Diet and nutrition policy: current

In Scotland, poor diet and nutrition is a major cause of health problems such as coronary heart disease, certain cancers, diabetes and stroke. In 2013, the Scottish Government and Food Standards Scotland set out their ambition to work collaboratively with partners to improve the nation’s health and tackle health inequalities through the Supporting Healthy Choices (SHC) framework. The final ‘Supporting healthy choices’ proposals were launched in Spring 2014 and have a particular focus on children’s health, promotions, helping consumers with better information, and making products and menus healthier.

The Scottish Reformulation Strategies (FSAS) are part of the voluntary proposals to support healthier choices (above). They aim to improve Scotland’s diet through a range of voluntary targets aimed at the food industry and are intended to reduce the amount of calories, sugar and salt readily available in food. The strategy contained a number of targets set for achievement by 2015.

In 2015, the Scientific Advisory Committee on Nutrition (SACN) undertook an extensive review of the evidence surrounding Carbohydrates and Health. The review contains a number of key findings which include the following:

The dietary reference value for total carbohydrate be maintained at approximately 50% of the total dietary intake
Average population intake of free sugars should not exceed 5% of the total dietary energy for age group of 2 years upwards
Consumption of sugar-sweetened beverages be minimised in adults and children
Dietary fibre reference value at 30g per day for adults; 15g a day for children aged 2 to 5 years; 20g a day for children aged 5 to 11 years; 25g a day for adolescents aged 11 to 16 years old

In December 2015, Food Standards Scotland published a review of the Scottish Dietary Goals in light of the SACN recommendations on carbohydrates and health. It was agreed that the Scottish Dietary Goals should be reviewed to reflect the new SACN recommendations. The Revised Dietary Goals for Scotland were published in March 2016.

A soft drinks industry levy was proposed in the UK Government’s 2016 budget. This was introduced in April 2018.

In June 2014, the Scottish Government published Becoming a Good Food Nation. This document reaffirmed the Scottish Government's commitment to promoting an economically sustainable food and drink industry and sets out the following:

A proposed 2025 vision for what we, as a country, should be aiming to achieve
Plans for a Food Commission and local champions to drive change
Proposed priority areas such as food in the public sector, children's food and local food
A commitment to a variety of approaches

In July 2018 ‘A healthier future: Scotland’s diet and healthy weight delivery plan’ was launched by the Scottish Government, setting out the challenge of improving Scotland’s diet and reducing the impact of poor diets. Acknowledging that problems can start early, there is a strong focus on ensuring children have a healthy diet and aim to maintain a healthy weight. Other outcomes include ensuring the food environment supports healthy choices and that health inequalities related to diet are reduced.

The Healthcare Retail Standard was published in 2015 and links into a number of diet and nutrition policies. It sets out the vision:

"develop a consistent approach to healthy eating for all food service providers across the NHS. Caterers will be required to follow Healthyliving Award (HLA) criteria at the point of contract (re)negotiation and retailers will be required to join the Scottish Grocers Federation (SGF) Healthyliving Programme (HLP) and meet their Gold Standard criteria at the point of contract (re)negotiation."

There is now 100% compliance in retail units within hospital settings.

In October 2019, outgoing UK Chief Medical Officer, Professor Dame Sally Davies, published the report 'Time to solve childhood obesity'. The report emphasises the role of the obesogenic environment, particularly in how it influences child health through diet and exercise. Aspects of the obesogenic environment which received particular attention included the commercial marketing of unhealthy food to children; the prevalence of fast food and takeaway outlets in close proximity to schools; the relative affordability of unhealthy food compared to healthy food; increased portion sizes over recent decades; how the built environment can discourage physical activity in children; and more.

Diet and nutrition policy: origins

In 2001, Scotland’s first Food and Health Coordinator was appointed with the priority of making healthy foods more widely available in all parts of the country. This was followed by publication of Eating for health: Meeting the challenge (Scottish Executive, 2004) establishing a multi-agency strategy for implementation of this Scottish Diet Action Plan (SDAP).

In 2003, the Scottish Executive published Improving health in Scotland: The challenge, a framework for action to improve health in Scotland, in which low fruit and vegetable intake is one of the five key risk factors for action in the first phase.

Meanwhile, in recognition of the need to be able to measure progress towards the targets, the Scottish Executive Health Department (SEHD) and Food Standards Agency Scotland (FSAS) set up a Working group on monitoring Scottish dietary targets. The Scottish Executive joined with FSAS in 2005 to set up a national healthy living Food and Health Alliance to support the implementation of national food and health policy in Scotland.

In June 2008 the Scottish Government published the Healthy Eating, Active Living: Action Plan (2008-2011), which outlined a number of healthy living initiatives targeting various population groups in order to improve diet and levels of physical activity in Scotland. This was followed by the publication of Recipe for success, Scotland's first national food and drink policy in 2009, aimed at promoting sustainable economic growth by ensuring that the Scottish Government's focus in relation to food and drink, and in particular their work with Scotland's food and drink industry, addresses quality, health and wellbeing, and environmental sustainability, recognising the need for access and affordability at the same time.

In February 2010, the Scottish Government and COSLA (Convention of Scottish Local Authorities) published Preventing overweight and obesity in Scotland: A route map towards healthy weight. This 'obesity strategy' unveils ambitious plans to work across every area of government to make healthy choices easier for Scotland's population and sets out a range of preventative actions primarily targeted at decision makers in central and local government.

School meals and nutrition for children

There has been an enormous amount of work on school meals in Scotland since 2003, which started with Hungry for success. In January 2006 the Scottish Executive published Nutritional guidance for early years. The Schools (Health Promotion and Nutrition) (Scotland) Act 2007 and the Nutritional requirements for food and drink in schools (Scotland) regulations 2008 built on the earlier achievements of Hungry for success by setting standards for all food and drink in schools. Other initiatives include free school lunches, fruit and breakfast initiatives.

In 2014, the Scottish Government published Better Eating, Better Learning - a new context for school food. This refreshed guidance is intended to support schools, local authorities, caterers, procurement departments, parents, children and young people to work in partnership to make further improvements in school food and food education.

Beyond the School Gate – Improving Food Choices in the School Community was published by the Scottish Government in 2014. It provides guidance for local authorities, schools, retailers, caterers and other partners on how they can influence the food environment around schools and support children and young people to make healthier choices. The Scottish Government introduced free school meals for all children in primary one to three in January 2015.

Maternal and infant nutrition

In January 2011, the Scottish Government published the Improving Maternal and Infant Nutrition: A Framework for Action which is aimed at a wide variety of organisations with a role in improving maternal and infant nutrition in Scotland. The ‘Scottish maternal and infant nutrition survey 2017’ reported in 2018.