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Campaign launches to improve lives of diabetics

17th Mar 2022 - 05:00
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Abstract
A campaign to mandate the availability of full nutritional data on all foods has been launched to improve the lives of diabetics. It has, though, been greeted cautiously by the foodservice industry.

On the face of it the YouGov petition to ‘Require Full Nutritional Data For All Food Products - Packed/Pre-Packed & Loose’ seems a reasonable request.

It simply builds on the existing EU Food Information for Consumers regulation, which was itself augmented by Natasha’s Law on allergens last year, to expand the information made available to consumers.

The man behind the petition, which was launched in October 2021, is the father of a diabetic daughter who says that the extra information is needed to help diabetics, especially children and young people, manage their condition.

Ron Cook, a retired senior technical manager in the food industry and a former BRC auditor, believes that the hospitality industry, including the public sector, needs the legislative shove his petition would provide if it became law.

He says: “Carbohydrate values are an important detail for those with diabetes, but many in the hospitality sector aren’t providing this important detail.

“I have been campaigning for a while against the apparent discrimination against diabetics specifically, and other vulnerable food groups generally, with regard to the total absence of nutritional data on foods outside of the supermarket shelves.

“Everyone deserves to enjoy an active social life, including eating out, but it appears we still have a long way to go before the hospitality sector becomes truly inclusive.”

The figures he provides to back up his argument are certainly stark. He says that there are 4.9m diabetics in a UK population of 67m, a figure set to rise to 5.5m by 2030. He adds that there are a further 13.6m people currently ‘at an increased risk of type 2 Diabetes’.

The charity Diabetes UK is a little more conservative in its estimations, suggesting the figure for those diagnosed with the condition is 3.5m, with ‘at least’ a further 500,000 currently undiagnosed but living with it, which still puts the figure at more than 4m – or one in every 16 people.

The figure was only 1.4m in 1996, so whichever way you look at it the scale of the problem is huge, meaning that if Cook’s proposal could help, it has the potential to benefit a large number of people.

Nutritional information on foods is important for diabetics as they need to check carbohydrate levels in food before administering their insulin. Without this data, it’s difficult for them to correctly calculate the dosage they need.

Most food is labelled - but some isn’t, such as bakery items, or any meal eaten out-of-home.

Cook points out that the extra nutritional data would not only be useful to diabetics, but also the estimated 2m people with food allergies and the many more who choose restrictive diets for religious, health, moral or environmental reasons.

The allergy and ingredient app ‘And It Has…’ estimates this latter group could be as high as 35% of the population – more than one in three of us.

His own interest in seeking out nutritional information began when his daughter, then eight, was diagnosed with type 1 diabetes just over two years ago.

He says: “Life becomes suddenly very difficult for the child because insulin doesn’t cure, it keeps them alive. It’s also tough for the parents. Diabetes UK describes the disease as ‘relentless’ and they’re absolutely right. It can bring mental health issues too.

“We were on holiday shortly afterwards and my daughter wanted an ice cream so I asked them if they knew the carbohydrate value of it and they looked at me as if I was mad. They didn’t have a clue and it occurred to me that it is very rare to find that sort of information.”

He says the problem extends to other areas, such as schools.

His daughter would like to eat school meals and be with her friends at lunchtime, but he claims the school says it cannot provide him with the carbohydrate value of meals.

“The NHS has given her a CGM [continuous glucose monitor]. She has a phone with her that transmits the levels and we can see that on our phones. We do that 24/7.

“But even with that, she can’t make a meal choice – and we can’t help her – without knowing the carbohydrate value.

“Like my daughter, many children cannot have a good warm meal because the school does not or cannot provide nutritional data for them to be able to calculate their insulin dosage.

“So they go in with a packed lunch instead. That might be OK for my daughter because she does have a cooked breakfast and evening meal, but she is one of the lucky ones because not every parent is able to do that.”

And there seems to be a fair amount of support in principle for his plea for more nutritional information to be made available.

When The Sun newspaper recently picked up his story and challenged the Department of Health and Social Care, it quoted a spokesman as saying: “We are taking action to help those living with diabetes to manage their condition and to prevent type 2 diabetes - including £100m of extra funding for healthy weight programmes – and we have launched the Office for Health Improvement and Disparities to build on this support.

“While there are no current plans to mandate carbohydrate labelling outside of pre-packaged food, restaurants, cafes and takeaways are encouraged to consider the needs of their customers and can choose to provide information on carbohydrate content.”

Diabetes UK has published its own position on the issue after reviewing national and international evidence on nutritional labelling and conducting focus groups in England, Scotland and Wales to gather the opinions of people living with diabetes.

A spokesman says: “Clear and consistent nutrition labelling is important to people living with diabetes, those at risk of developing type 2 diabetes, and the general public.

“At the moment, nutritional information is often confusing and inconsistent, or even absent in out-of-home settings.

“Everyone should be able to access quality nutritional information about their food wherever they eat and drink, so that they can make informed choices.

“People treating their diabetes with a basal-bolus insulin regime also require accurate information about the carbohydrate content of their food and drink in order to calculate and adjust their meal time (bolus) insulin doses.”

But is the school experience of the Cook family typical of the way the issue is being handled?

Jacquie Blake, chair of LACA, the national organisation of school meal providers, says she has spoken to a number of her members about it.

“The general consensus is that in primary schools there would be engagement with the parent and agreement as to the menu required, as we would with any medical diet.

“With secondary pupils, as the service is usually cash cafeteria, there is a much wider choice available and therefore greater options to meet the pupils needs.

“The new calorie labelling requirement exempts schools, however there are the School Food Standards in place.

“The usual practice would be that any diabetic pupil would be treated the same way as with any medical diet. The school should provide details to the caterer, who would then liaise with the parent and pupil.”

She added that LACA had a risk assessment tool to be used for all medical diets that was available to all members on its website.

Beyond school age, the provision of nutritional data is less of an issue for university catering and students, and more of a wider consumer issue, according to Phil Rees-Jones, chair of The University Caterers Organisation (TUCO).

“Most of our customers are over 18, and as such are adults and can make their own choices. In any case, it’s not as easy as looking at a label and deciding how much or what you should eat, it’s a question of balancing a whole myriad of influences that can affect your blood glucose levels.

“And many of these students that have been diagnosed with type 1 diabetes will have already received some support from the NHS to help them manage.

“But if it was easy to calculate the required data, I can’t see why the industry wouldn’t support any proposed labelling legislation.”

However, not everyone is in support of mandating nutritional labelling, certainly within the public sector, while Cook says others have flat out ignored his petition and calls for support on the issue.

Since he launched the YouGov petition in October last year he has also written to many politicians and influencers looking for support.

“I have published an open letter on LinkedIn, Facebook and Twitter which has also been sent to a number of print journalists, my MP [Robert Jenrick] and Jo Churchill MP [Under Secretary of State at Defra] plus Will Quince [Under Secretary of State for Education].

“I’ve heard nothing back.” He says letters to the Food Standards Agency, celebrity chef and food campaigner Prue Leith and Gordon Ramsay have similarly gone unanswered.

He does, though, have a list of contacts in the world of nutrition who he claims support the campaign. However, when I contacted one at random, they denied backing it.

Jacqui McPeake of JACS Ltd, who makes clear her area of interest is allergens and she has no expertise in diabetes, says that although she had heard of the petition, she’d had no conversation with Cook.

She said she would worry about part-time school catering staff, for example, being obliged to ‘advise on medical conditions’.

“They don’t know, they are not trained for this sort of thing, which as I understand it varies from person to person.”

She suggests that the process of carb-counting would probably be too difficult for some school catering teams.

Cook, though believes that ‘most food professionals’ cannot understand the lack of legislation to make nutritional labelling happen, nor the actual root causes of why the hospitality industry, including school catering, ‘do not want to be more inclusive and empathetic’.

He adds: “Remember there are twice as many diabetics in the UK as allergen sufferers. There are about ten food-related allergen deaths a year in the UK but there are 24,000 diabetic deaths per year - obviously not all food-related but some are because the children, and parents, cannot control the condition because they cannot calculate the insulin dosage because too few schools provide nutritional data.”

He concludes: “Is it achievable? Definitely. Would it be expensive? Probably not. And it’s not just diabetics who would benefit. Kidney patients need to know the potassium content, cancer patients will want to know the potassium and sodium levels of the food they have.

“So many people can’t currently get the information they need in so many places, so they are just not going out to eat. Surely there’s a business and a moral case for nutritional labelling.”

The petition to ‘Require Full Nutritional Data For All Food Products - Packed/Pre-packed & Loose can be found at: https://petition.parliament.uk/petitions/598957.  

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Written by
David Foad