Six years ago, the canteen at Hackney’s Mandeville Primary School was a sea of lunch boxes filled with brightly coloured packaged chocolate, crisps and fizzy drinks. Today pupils are tucking into a well-balanced meal of chicken teriyaki, cabbage, rice and coleslaw that costs their families nothing.
Mandeville, in east London, is one of 300 UK schools to implement a programme run by charity Chefs in Schools, which trains cooks to prepare more nutritious food. Doing so can have a positive impact on educational attainment, mental and physical health and productivity, evidence shows.
“They just have more energy,” deputy headteacher Kaltum Yusuf says as children queue up in the canteen, where the menu is displayed on a blackboard, and colourful posters about food and nutrition cover the walls. “A lot of them used to never have fruit and vegetables,” she adds, explaining that many of them were eating mainly junk food at home.
The programme at Mandeville is one of the measures being rolled out by charities and local authorities to tackle a public health crisis. The rising price of healthy food and the prevalence of low-cost unhealthy food has led to increasing levels of malnutrition and obesity among young people in the UK. The country’s children are among the most unhealthy in the western world and are more likely to be shorter and more obese than their peers in Europe.
As many as one in five Year 6 pupils, aged 10 to 11, were classified as obese in the last school year — an 18 per cent increase since 2009, according to NHS data.
“Children are accruing harms day by day, harms that can’t be undone,” warns Anna Taylor, executive director of the Food Foundation charity, originally set up in 2014 as a think-tank to challenge flaws in the UK’s food system.
Obesity in childhood has long-term consequences. It can lead to a heightened risk of health problems in later life, placing further burden on the UK’s creaking health service and, according to recent studies, can even have a drag on the nation’s productivity.
It is a crisis that has been years in the making with successive governments failing to get a grip on this creeping public health issue. The outlook is made worse by a sharp increase in youth poverty in the UK, which this year has risen at its fastest rate in 30 years.
With the Labour government working out ways to relieve the overburdened NHS, public health experts and campaigners are hopeful ministers will now seize the opportunity to tackle diet-related poor health.
To move the dial, they say, a suite of preventive measures is required, ranging from sugar taxes and advertising restrictions, to enforcing stricter school food standards and universal free school meals.
“This government term would be the time that you could turn things around, but that’s going to require some primary legislation to build new protections,” says Katharine Jenner, director of the Obesity Health Alliance.
England’s chief medical officer, Chris Whitty, is urging the government to incentivise the food industry to make healthier options by taxing the unhealthy food flooding supermarkets and high streets.
“As humans, we are genetically wired to crave calorie-rich food; it is, therefore, unwise to think we can rely on education and willpower alone to curb our appetites and to prevent the many diet-related diseases that constitute some of the biggest threats to public health,” Whitty wrote in his annual Health in Cities report.
Health secretary Wes Streeting and Prime Minister Sir Keir Starmer have pledged to be bolder on preventive measures than their Conservative predecessors, who often balked at imposing interventionist measures for fear of being labelled a “nanny state”.
“This government is committed to tackling the obesity crisis head on, and we’ve already taken steps to protect our children,” says health minister Stephen Kinnock, pointing to new limits on advertising for junk food and expanded powers granted to local authorities to stop takeaways setting up shop near schools.
But nearly six months into the Labour government’s term, healthy eating advocates say there is much still to be done. “The big shift we’ve seen since the election is the government really bringing in ideas and getting the conversation going,” says Taylor of the Food Foundation. “Those signs are positive but we haven’t seen any new meaningful commitments.”
In the fight against child obesity, one of the levers the government has at its disposal is the power to impose levies on unhealthy foods.
Chef and food campaigner Jamie Oliver was one of the figures pushing for the so-called sugar tax, which was introduced in 2018, known as the UK soft drinks industry levy.
But when politicians have called for levies on unhealthy food in the past, the food industry has responded with warnings about higher food prices. The threat is effective, particularly during a cost of living crisis, when consumers are already under pressure to cut back their spending.
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While the price of healthy, whole foods — such as fish or staple vegetables such as carrots — has soared, unhealthy processed foods are more likely to be placed on enticing promotions and cost significantly less than fresh alternatives. Per calorie, healthy food is almost three times as expensive as unhealthy options, says the Food Foundation.
The most deprived fifth of the population would need to spend half of their disposable income on food if they stuck to the government-recommended healthy diet, the charity found. This compares to just 11 per cent for the highest earners.
To put together a children’s packed lunch that meets healthy eating guidelines, typically involving fresh fruit and vegetables, unsweetened yoghurt and brown bread, costs up to 45 per cent more than a lunchbox filled with chocolate, flavoured yoghurt and processed snacks marketed at children, according to the charity.
The imbalance in grocery baskets between whole foods and junk foods has contributed to higher levels of obesity in lower-income groups, with poorer families becoming more reliant on less-healthy diets, data shows.
The trend has also been exacerbated by food inflation. Between 2021 and 2023, healthier foods increased in price by £1.76 per 1,000 calories compared with £0.76 for less healthy foods, according to the Food Foundation. Fruit and vegetables are the most expensive grocery category, costing an average of £11.79 per 1,000 calories, while food and drink high in fat and sugar costs £5.82.
One of the biggest obstacles to nutritious diets is the relative price, says the Food Foundation’s Taylor. The government urgently needs to increase fiscal incentives to encourage companies to “make money from healthier food”, she adds.
“We’re seeing a little bit of movement in that direction,” she adds, pointing to Labour’s decision in October to increase the rates of the soft drinks industry levy. “But there is scope for it to be more ambitious.” For example by introducing a similar levy on the sugar and salt contents in processed food.
The tax led to a 46 per cent decrease in average sugar content of those drinks subject to the levy between 2015 and 2020, according to the Department of Health and Social Care. One study estimates it has prevented about 5,000 cases of obesity in girls aged 10 to 11.
In contrast, a scheme introduced by the Conservative government in 2016, which asked industry to sign up to a commitment to reduce sugar in products by 20 per cent by 2020, fell flat.
“There’s no financial incentive for these foods to be healthier,” says the Obesity Health Alliance’s Jenner. “They’re highly profitable to the companies.
“So the only way that you can disincentivise their production is by whacking a penalty on top,” she adds, arguing that this money could then be used to fund healthy eating.
But it is not just the cost of healthy food that limits parents in what they can feed their children, campaigners warn. The ubiquity of cheap junk food and comparative availability of healthy food is another obstacle.
Children are constantly tempted by brightly coloured packaged food placed strategically in shops and advertised on TV and social media platforms. Young people are also influenced by what their friends are eating.
Soft drinks, confectionery, snacks and desserts account for about a third of food and soft drink advertising spend, compared with just 1 per cent on fruits and vegetables, says the Food Foundation. Brand advertising, which accounts for about 40 per cent, also contributes to unhealthy eating as consumers tend to associate companies with their products, such as snacks, even if they are not directly promoted.
Boris Johnson’s government introduced proposals to tackle junk food advertising by banning ads on television before 9pm and online at all times, but the rollout has been repeatedly delayed, with the government citing concern around the knock-on effect on living costs. The Labour government is pressing ahead with the measures, which will come into force in the UK from October 2025.
Researchers have also found that some companies deliberately market junk food to deprived communities. “Advertising on TV is one thing. But what about the billboards that deliberately target low-income areas?” asks Jenner, of the Obesity Health Alliance.
According to research by Impact on Urban Health, which mapped food availability in London boroughs, unhealthy food outlets were significantly more concentrated in deprived neighbourhoods.
“The economic aspect of food accessibility cannot be overlooked,” says Nikita Sinclair, co-head of the children’s health and food programme at Impact on Urban Health, which is part of the Guy’s & St Thomas’ Foundation charity. “Healthy eating remains out of reach for many families living on lower incomes.”
There is an “urgent need” to make healthy food more affordable and accessible, especially for Black and other ethnic minority communities who are disproportionately affected, Sinclair adds.
Analysis by the Financial Times of data from the Health Foundation charity and Food Standards Agency found takeaway shops accounted for 18 per cent of food businesses in the most deprived parts of England, compared with 12 per cent in the least deprived parts. In the highest density areas, such as Slough, in Berkshire, and Sandwell on the outskirts of Birmingham, takeaways account for more than 26 per cent.
At the same, the highest rates of obesity are in the most deprived parts of England, exceeding 30 per cent in Sandwell and also Knowsley, in Merseyside, while the lowest prevalence is in affluent parts of London and the south such as the borough of Richmond and Surrey, according to NHS England.
In inner city areas such as Hackney, poorer families are not able to access healthy food at affordable prices, says Naomi Duncan, chief executive of Chefs in Schools. Meanwhile, they are surrounded by corner shops with no fresh food, chicken shops and other junk food outlets. “Parents are feeding their kids what’s available in their environment,” she adds.
While the government cannot control eating habits outside of school, it can ensure that what is consumed during school hours is at least in line with national health guidelines. This argument is at the heart of the growing call among campaigners for universal school meals.
In 2023, London mayor Sadiq Khan made free meals available to every primary school pupil regardless of income, an initiative he has pledged to fund for the rest of his term, which ends in 2028.
“I remember the embarrassment, the shame, the stigma” Khan tells the FT about his experience of being signed up to means-tested free school meals. Amid a cost of living crisis, he says, some parents are skipping meals so their children can eat, while other young people were coming into school with empty packed lunches and pretending to eat.
But Khan’s initiative is not replicated across the country and campaigners believe that following suit would make a huge difference.
At present, all children in local council-run schools can get free school meals up to the end of Year 2, aged 6 to 7. After that only households on certain benefits can access the scheme.
Just under a quarter of UK children were eligible for free school meals in the year to January 2024. But according to the Child Poverty Action Group, 900,000 children in poverty in England do not qualify for free school meals under existing rules.
“We need universality to exclude shame,” says Stephanie Slater, founder of the School Food Matters charity. She and other child nutrition experts are calling on the government to make free school meals an opt-out, rather than an opt-in sign-up process, in order to get more people across the country who qualify into the scheme.
School Food Matters found that making high-quality school meals free on a universal basis reduces children’s body weight throughout the first year of learning. Enrolling children in free school meals also helps families that would not otherwise be registered to save approximately £20 per month, the charity found.
However, many families who qualify for free school meals are not opting in, say campaigners, often because they are unwilling to accept government handouts, or because they are scared their child will feel stigmatised. “They don’t want their kids getting a handout, they don’t want them to be singled out,” says Taylor, of the Food Foundation. “Which is why it would be better expanded to more children.”
Doing so would not be cheap. Extending free school meals to all families receiving universal credit, a social security benefit, would cost £6.4bn, while extending to all schoolchildren regardless of income over 20 years would cost £24bn. But the investment would return about £99.5bn in societal and economic benefits, according to Impact on Urban Health.
As well as providing funding, campaigners say the government must raise the standards of what schools are expected to provide.
At Mandeville in Hackney, where children have now switched entirely to free school meals, Duncan, of Chefs in Schools, says that school food standards are “10 years out of date”, pointing to the high levels of added sugar still permitted.
Campaigners add however that government school food standards were not being properly enforced. “We know there are brilliant caterers out there. But unless there’s contract management, and [if] no one at school has eyes on [it], standards slide,” says Slater, of School Food Matters. “If we’re underfunded it’s a race to the bottom.”
“If we’re campaigning for more people [to claim free school meals], the worst possible outcome is universally poor school meals,” she adds.
