The diets of children in the UK do not meet the nutritional standards recommended by government advisers.
On average, British children are exceeding targets for saturated fat, processed sugars and salt, and they are not consuming the recommended quantities of fruits and vegetables. Large minorities of children in the UK are deficient in vitamins A and D, and iron.
The incidence of diet-related ill-health is increasing in children as in adults. In 1996, 5% of 6-15 year-olds were obese, meaning that their large weight posed a serious threat to their health; by 2001, this figure had risen to 8.5%. Obesity is also a risk factor for type 2, or so called 'adult onset', diabetes. In recent years, unprecedented cases of this condition have been found in obese children from ethnic groups without a recognised predisposition to the illness.
The human cost of overweight and other diet-related diseases is very great. A marginally obese young adult has twice the mortality risk of another whose weight is within the healthy range for their height. In addition to the quantifiable health risks, children suffering from overweight are stigmatised, not only by other children but also by adults. The National Audit Office estimates the public costs of obesity for adults and children in the UK to be at least £2.6 billion per year. This includes the direct costs of treating dietary disease and the cost to the economy from lost working days. Rising levels of childhood obesity mean that these costs are likely to increase, because overweight adolescents have a 70% chance of becoming overweight or obese adults. The chair of the Food Standards Agency has described childhood obesity as 'a ticking timebomb'.
Whilst it is clear that children's diets are substandard and that diet-related ill-health and obesity are on the increase, the link between the two is contentious. For instance, the annual National Food Survey of household consumption shows average diets to be improving on many counts. The speed of the rise in diet-related ill-health suggests genetic changes cannot be the main cause. The role of decreasing physical activity rather than dietary deterioration is contested; in practice, the increase in diet-related disease is probably a product of both. The trends reported by the National Food Survey do not take full account of the growing proportion of food eaten outside the home. This is crucial, because food prepared at home may be healthier, and lower in sugar and saturated fat, than food consumed elsewhere. Both the National Audit Office and a United Nations expert consultation have agreed there is convincing evidence that the growing amounts of energy-dense and micronutrient-poor 'fast' foods, consumed outside the home, have contributed to rising obesity.
The increase in fast-food consumption is just one aspect of a profound shift in the ways that children and families eat, which has occurred over the past two decades. Not only are more meals consumed outside the home, but more food is purchased directly by children, in and out of school, from vending machines and shops. Food products are also heavily promoted to children, targeting older children directly and tapping the 'pester power' of younger children.
The combined effect of such changes has been rapid social and economic upheaval in children's food consumption. Where previously children's diets were socially mediated by their families and the state, children now increasingly play a direct part in the food economy. They have a growing number of direct relationships with food manufacturers, restaurants and retailers, which take place in the marketplace rather than at home or in school. The commercialisation of children's diets raises serious issues.
The capacity to regulate what children eat is no longer confined as it once was, in large part, to the family and the state. It lies increasingly with the companies that make and sell food. Yet there is a near absence of ethical concepts and legal instruments to describe and enforce the rights and responsibilities that come with this relationship between firms and children. As a society, we are poorly equipped to cope with children being consumers, particularly in the food arena.
We believe there is a need to create conceptual tools to re-couple the responsibility for children's diets with the capacity to regulate what children eat. This would clarify the ethical issues around children's food and help to develop the legal instruments needed to hold key actors accountable for their effects on children's welfare.