Calorie caps on all out-of-home food and a ban on eating on public transport are among a series of suggestions by the former Chief Medical Officer to reduce childhood obesity.

Time to Solve Childhood Obesity, a new independent report by Professor Dame Sally Davies, stated that progress on voluntary reformulation of food and drink, as overseen by Public Health England, had been “disappointing”.

“Cheap unhealthy food options now take centre stage in our lives and in our shops,” wrote Dame Sally.

“Shops and takeaways overwhelm us with large portion sizes, far exceeding those recommended. Unhealthy options dominate the checkouts.”

The report added that children were “constantly exposed to advertising for unhealthy food and drink. Companies often use children’s cartoon characters and sponsorship of major sporting events to market these items, casting them as the shining star in children’s minds”.

Dame Sally said the systems of applying VAT to food that may not be aligned with healthy eating advice contributed to healthy food and drink often being pricier than unhealthy options.

“When government sets targets or legislates, business innovates and can still make a profit – for example when it develops better and healthier foods,” she added. “But currently the playing field is not level – it is too easy to make money from selling unhealthy food and too hard to make money from selling healthy food.”

Dame Sally has made recommendations that include:

  • Accelerate the reformulation programme and, if sufficient progress is not made, the government should apply either a fiscal lever or tobacco-style standardised packaging.
  • Develop a system to apply an upper-level cap on calories per serving for all food and drink sold by the out-of-home food and drink sector.
  • Following Brexit, an urgent review of VAT rates on food and drink to rebalance the cost of food and drink in favour of health.
  • Review all tax-deductible expenses, including advertising expenses, so businesses can only claim tax relief for advertising healthy and not unhealthy products.
  • Phase out all marketing, advertising and sponsorship of less healthy food and drink products (as defined by the revised Nutrient Profile Model) across all mediums including online, at major public venues or public-funded events and on any public-sector-owned advertising site.
  • Prohibit eating and drinking on urban public transport, except fresh water, breastfeeding and for medical conditions.
  • Ensure all publicly-funded sporting facilities and major sporting events only advertise and sell low-calorie, low-fat, salt and/or -sugar products.
  • Work with suppliers, cash-and-carry businesses and packaging companies to introduce smaller portion-sized packaging for fast food.

In response to the report, the Food & Drink Federation said the industry wanted the government to support its work in reducing salt, sugars and calories.

“As Public Health England acknowledge, reformulating products takes time, and we must always take the consumer with us,” said FDF UK Diet and Health Policy head Kate Halliwell.

“We agree more needs to be done to tackle obesity, and welcome the report’s clear steer that everyone needs to play their part, including schools, local councils and the NHS. Manufacturers alone will not solve this. We believe money should be put behind specific, targeted measures for those most affected by the burden of obesity.”

Health campaigners Action on Sugar described Dame Sally’s call for “bold action” as “a beacon of hope and her sound recommendations are precisely what’s required if we are to ever achieve the government’s target to half childhood obesity in 10 years”.

“Key to this, and outlined in Dame Sally’s report, is the urgent need to take unhealthy food and drink out of the spotlight by restricting promotions and marketing – this simply cannot be achieved without legislation,” added Action on Sugar nutritionist and campaign director Katharine Jenner.

“Legislation and fiscal measures are not always politically popular, but that doesn’t mean they aren’t right; the unprecedented results of the sugary drinks levy speak for themselves.”