Professor Amanda Daley, Professor of Behavioural Medicine at Loughborough University, breaks down the problem with current food labelling, the potential for P.A.C.E (physical activity calorie equivalent) labelling to provide a solution, and what she thinks about all the controversies surrounding this idea.
Time Stamps:
0:00 – 07:20 – Introduction to guest, the topic and background
07:21 – 11:50 – Current strategy on food labelling in the UK
11:51 – 17:02 – Does the current strategy work or is it failing?
17:03 – 19:43 – P.A.C.E labelling… What is it?
19:44 – 26:56 – Where is P.A.C.E labelling going to appear if it is approved?
26:57 – 28:22 – Will this be seen as the government guilt tripping people into eating healthy food?
28:23 – 34:34 – Impact on people with eating or exercise disorders
34:35 – 38:32 – Why is P.A.C.E different to the negative impact of calories on menus?
38:33 – 43:07 – P.A.C.E controversy…
43:08 – 43:51 – What will it cost to implement P.A.C.E
43:51 – 45:33 – Future projects
45:34 – 48:26 – Outro
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So if you know that a carrot is going to take you one minute of running and a chocolate cake is going to take you 20 minutes of running then it might help or nudge you towards eating the carrot we’ve got a small number of people who experiened an eating disorder but we’ve
Also got 60% of the population that are overweight and many of those people that are overweight are dying of diseases that could have been prevented had they not been overweight I think the thing that bothers me the most is when I get calls from from parents uh of children
Who have got Eating Disorders you know you can’t not be moved by that and you know you do have to reflect on is this worth it and is this really the right thing thing to do IVF was hugely controversial chemotherapy was hugely controversial but could you imagine a
Life where we don’t have those treatments so just because something’s controversial and it might have negative effects for one population does it mean that we discount it I guess I’m going to choose not to answer that question because um I think it’s unfair hello and welcome to the experts
In health podcast brought to you by lfra University this podcast aims to highlight the latest research and Trends in health as we welcome a variety of guests from a host of different disciplines I’m Dr Chris McCloud an academic in the school of sports exercise and Health Sciences with an
Expertise in behavioral nutrition and public health and today I’m delighted to be joined by professor Amanda daily and Amanda is a professor of Behavioral Medicine at lre University Amanda it’s wonderful to have you on the podcast thanks very much for coming thanks Chris thanks for the invitation it’s great to
Be here not at all and here is the elite athlete Center at L University do you feel the same as me where you feel like you probably should be doing a bit more exercise when you come in here that’s how I feel anyway well I had a run this
Morning 40-minute run so I feel like I’ve done my exercise for the day and I won’t doing anymore so yeah that’s what is your exercise regime how much do you do a week o um so I like to try and get four or five 40 minute
Runs in a week and then two to three boot camps on top cuz the running’s good but uh you got to keep your muscles you know strong and uh think about core as well to support the running so yeah that’s intense sounds intense yeah yeah you enjoy it there yeah definitely enjoy
It’s a way of life I’ve done it all my life I think it’s important to practice what I preach so when people ask me this question and I can say you know I do it I know it’s hard but you got to you got to commit to it because it’s important
For health well we’ll get into the practicing what you’re preaching as over the course of this podcast but just to help our listeners and viewers can you give us a bit of an outline as to you know who you are and what you do yep so yeah I’m a professor of Behavioral
Medicine here at lbr I joined in 2018 so I started just before covid so I had about a year before covid so that was sort of quite interesting coming to a new University and then going straight into covid but um yeah so I’m the director of the center for lifestyle
Medicine and behavior at lra um where our main kind of goal is to develop research programs to develop good health policy you know we do the research and then someone else develops the policy and I’m also nhr research Professor uh in public health so I get uh quite a
Nice pot of money from the Department of Health and Social care to develop programs of work around health and and and wellbeing one of those is is Pace labeling and health communication which we’ll obviously talk about today but we do other things like um uh programs that work around prevention around Women’s
Health uh Children’s Health um digital Health um so we’ve got lots of different things going on with it within that busy yeah can imagine um for our listeners and viewers they might not have heard the term Behavioral Medicine before how would you you know how would you describe what what is Behavioral
Medicine yeah I guess it is fundamental basis Behavioral Medicine is really about bringing the mind and the body together the physical and the mental and thinking about how those two things might interact to impact Behavior obviously in our case we’re most interested in medicine and in health so
It’s really taking the person as a whole being and thinking about how those two things can interact in that person’s life um and I think it’s really important that we do that because we are a physical and we are a mental and it’s really important that we approach people
When we want them to change their health with both of those things in mind and do you have a particular area that you look to change People’s Health through as in like a type of location or a type of practitioner or is it in their own home
Where do you sort of aim your work um so one of the key I mean there’s a few different areas one of the key areas is really thinking about how we can use health professionals in the NHS to really drive and nudge Behavior I mean there are millions and millions of
Consultations going on in the NHS every day that’s a massive resource that we’ve got for us so one of the K things that we’re interested in is how can we use that resource to get people to really think about their behavior in relation to physical activity and health not
Least because we’re using those services and those Health Care Professionals all the time so it’s a constant resource that we can keep nudging and pushing the public so we’re quite interested in training and organizing um healthc Care Professionals to do that yeah that it’s all really interesting stuff and in
Relation to what we’re going to talk about today can you just give like a give us a brief opening statement to sort of wet our appetites to say why what we are going to talk about today is important to you and should be important to the people listening well we all eat
And we all go shopping and we all make decisions about what we buy and what we eat and it’s really important for us to engage our minds in those decisions we shouldn’t be passively buying and consuming food I think we should think about it and so obviously one of the
Things we’re going to talk about today is Pace labeling as a form of communication and it’s at its core at its principle it’s trying to encourage people to engage in that thought process about what it is that they buy and what it is that they eat the idea being that
When you do that that the outcome is a better healthier decision than when you don’t do you in your mind do you think most people engage in their food choices when they’re at that point of picking up going y I’m going to have a masb bar
Today or whatever it is do you think people do have that active engagement no I think people engage in terms of price I think that’s particularly important at the moment in terms of cost of living and I think when you see a bargain in the supermarket and it’s got
The yellow sticker on that’s probably the driver of decisions rather than actually what the food is and the content of the food but I think it’s important that we think of strategies that help people make those decisions whether they do or not you might decide well that’s neither here nor there but I
Think as public health practitioner it’s our job to educate the public or at least put the right strategies in place to allow people to make the right decisions whether they do clearly we want them to but first and foremost it’s that’s our job Chris that’s not everybody else’s job and that’s uh I
Think really important for us to to engage in when we’re thinking about strategy so we have a a strategy that’s quite you know widespread in the UK at the moment about labeling on food what is the current labeling practice and for the particular labeling that we have why
Do we why have we come to have that particular labeling at this point so at the moment uh front of Pat labeling actually is voluntary it’s not compulsory everybody thinks it is but it’s not but most manufacturers sign up to uh front of uh front of package
Labeling and at the moment in this country we use traffic light labeling uh to try and alert customers to whether a food is a good food or a not so good food so I’ve actually brought an example here to show you so here’s a typical example you made earlier yeah uh so
We’ve got green orange and red uh following a typical traffic light process so based on whether or not something is Holy green red or Amber the idea is that can educate the public about whether that’s a healthy food or not so if I was looking at that I might
Think well actually there’s three segments there that are green there’s one red and one Amber so that’s a healthy food but that’s not always the case you need quite uh developed cognitive uh understanding to actually really work out whether this is a good food or a bad
Food um or less less healthy food um for you to buy the other thing we’ve got is per portion so it might say 30 grams of this particular food will contain X Y and Z calories or X Y and Z fat so when you’re in the Super Market you then have
To work out if this has got 265 grams then you have to work out what the proportion of that is so you actually need quite developed mathematical skills to work out whether this is a healthy food um or not and I guess one of the propositions we’ve made
Is that actually this is quite complicated for the public and it actually requires quite high levels of health literacy to understand whether that’s a good food um to to buy or not but that’s the system that we have um and that’s what we’re kind of working um
Towards do know why those particular um categories that are on there have been put there because there’s fat but then there’s this thing there called sat fat and Cal and salt and I don’t see other things like Pro maybe protein or car carbohydrates so do you know why those
Particular categories have come on I get I don’t particularly know why I think those are the main kind of drivers of nutritional um content and those are the things that um historically we’ve focused on in in relation to how we educate the public about what’s in the
Food and I guess one of the things that I’m quite interested in is to review that and to pause and to think is there a different way in which we can present information to the public that makes it really easy for them to understand so you can have a view about whether this
Is the right thing or or not but I think it’s always important for us to review and update how we give information to to the public and um I’m quite interested as you know in in changing the way in which we give information to the public because I feel quite strongly that it’s
Our duty to make it really easy for the public to to understand what they’re buying and what they’re eating so you would say that it’s good thing or helpful thing to have some sort of labeling on Foods is that do do you think it is a good thing to have some
Sort of labeling oh yeah and I think I haven’t heard anybody say that they think it’s it’s a bad thing I think the more information in some ways that you can give the public um the better um it’s just how you do it and the actual nature of the information that that that
You give if you’re going to give information you might as well give it about health in the right way in an accessible way and I also think we’ve got a responsibility to make it really easy for different segments of the population so I’m just wondering about you know children you know child obesity
Isn’t going away anytime soon so how do we educate our children about um making the right healthy decisions and so I think we should reflect on okay so we’re labeling food in this way how easy is it for a child to be able to understand
When they go in the shop we want them to be autonomous decision makers in their food but we actually set them up to fail we actually make it really really half for them to make healthy decisions based on the current types of traffic labeling approach and what does the academic
Literature say about these current labels do they work do they work for some people or not for others you or you know what’s the problem with them if if if there is a problem yeah so I mean there’s been quite a lot of evidence around different types um of labeling
And I think at the moment the current evidence is that the relationship between change in behavior and labeling it it is small small at best um and I am aware of other groups that have conducted and updated sort of systematic reviews which confirms that so if we
Agree that the the effect is small but that doesn’t mean that something small is not good at a population level if we could get everybody to make a small change to their health that would be fundamentally important in the number of people that die from diseases related to
Eating and obesity so um I don’t buy the argument when someone says oh it’s only small because at a population a public health level a small effect is really really important and um I will always uh drive towards making small changes because actually lots of
Little bits add up to a h huge bit I can see that would you say that you need a big change like a a big shift in the way you do things to even get that small change or you know is there a way that you might just want to tweak the current
Labeling to get that small change what do you think on that yeah so you know we are looking at that we are looking at different ways in which we might um we might operate and actually if we think about food manufacturing companies who are in themselves hugely profitable
Companies it wouldn’t take much to change reflect and review the way in which um we have labeling at the moment because that’s the right thing to do I think yeah a continual review yeah always a good thing isn’t it totally and I think you we I mean for example U last
Year in April the government brought out um compulsory um calorie labeling in out of H out of home settings um so you know we’re looking look to see what impact that has on um Behavior Uh that will take some years for us to be able to see
What impact that’s that’s had but in America they’ve had the um Affordable Care R for quite some time so calorie labeling in out of home settings has been in place for at least three years now I think and so we’re starting to see the studies come through and we are
Starting to see studies that are showing small effects again but again imagine a small effect in all of the American population is massive yeah so we’ll need to see what impact it has it’s only in England though it’s not in the other devolved Nations um so we
We’ll wait and see what impact that has when it was put in is that something that you were supportive of you know there’s there’s testing it and researching it and then there’s putting it right into the public and then seeing how it goes were you supportive of it
Coming in the calories on menus for example I was um partly because we already have calories on uh food that’s labeled in shops it’s not this is not a new thing this is just in an out of home setting so I think you know if you go
Out for a pizza and you’ve got a choice between two pizzas for example then you might want to know that one pizza has 400 calories than the other I’ve got a choice then about what what it is that that that I eat I think I definitely support um menus that do have calories
And that don’t so if you go into a restaurant and you choose not to then I think for whatever reason I think you’re entitled too uh but I think the default should be with calories was going to ask that there’s a lot in Behavioral Science about what the default is so that people
Get presented that and then they’re adoped out for it so calories on menus should be the default yeah so is it a good thing for people to know when they’re just going out for a birthday meal they’re just trying to to chill relax they just want to have the foods
That they like yeah that it’s a good thing to still put in front of their face how many calories are going to be in that food is that what you would say it’s it’s a good thing uh I mean I think your example of a birthday meal is quite
Exteme scam I think cuz that’s a oneoff I think if you go out for a meal a couple of times a month regularly then I think then I think it should I think that if you are out for a birthday meal to enjoy yourself then I think it’s okay
To request for example a menu for whatever isas without it and and and I’m okay with that but I think if you’re eating out and many of us do that regularly I think you know the it’s important to know what you’re eating um not least because food eaten out of the
Home has many more calories has much more fat is typically less healthy than when you eat healthy food at home I guess when people are booking into a restaurant if it’s online or you know via form could be a little box which says you know if you don’t want to have
A menu with calories on tick that then they are not even presented with the option at the time I guess y something that could be put in potentially could be there are different different ways to do this stuff and I’m no Matra D I can’t say what’s the best thing for restaurant
Or anything like that but today we’re you know mainly here to talk about quite a different type of labeling um Pace labeling physical activity calorie equivalent labeling Pace labeling I think not many people listening or watching this with no Pace labeling so can you explain you know
What is Pace labeling so Pace labeling seeks to demonstrate in physical activity terms the energy that contained in a food so it tries to say okay if there’s x amount of calories in a food item what would it take in relation to walking dancing swimming whatever activity it might be uh are equivalent
To the number of calories um in a Foods I’ve actually brought some some different examples so here’s here’s a sort of a basic example here so we can see here there are 345 calories in this food item and that would take about 70 minutes um to walk uh
Equivalent and 35 minutes equivalent um to run off those calories so it’s not saying you have to burn off all the calories in that food it’s just trying to put in context in a different easy understandable way what the calories equates to it’s not saying you have to
Do that it’s trying to make it more meaningful than just you know if I just say oh Chris the 345 calories in this food food then that doesn’t mean anything how how do you know what that means in terms of energy so it’s just trying to put things in context and
Whether we like it or not we have uh calorie amounts in the United Kingdom so 2,000 uh for a woman and 2,500 for a man on average and so it just allows you to put those um numbers in context so who are they for those numbers is that based
On the average male female calories per day or exercise per day or you know how is that calculated cuz I don’t see the little thing which says you know on average women should have 2,000 men should have 2,500 so yeah how’s that worked out so I’ll come back to in a sec
That specifically so we just talked about the number of calories that are recommended um each day 2,500 for a man and 2,000 for a woman so that’s a a general term and clearly you know someone small like me may not need 2,000 they might need 1,800 and you might be a
Slightly bigger man and you might need 2,600 so it works on the same principles it’s based on an average amount of calories so um it you could you can vary it but typically it might be uh the average of a of a female it might be the
Average of a man in terms of kilograms so it’s the average kilograms he might alter it for children to make it more applicable um to them is this going to be on my apple is this on every food is this on my banana is this on my pizza
What where am I seeing this so there’s two parts to that um we’ve done some research across the United Kingdom to asked the public about where would you like to see if if it was implemented and it’s not where would you like to see it and overwhelmingly that the view is that
The public would like to see on really high dense energy foods discretionary Foods crisp biscuits alcohol uh was one of one of the particular other areas um and I think part of that is that the public understand that those are the not so good foods and that’s potentially
Where they might need a little bit more health with nudging towards making decisions so that so that’s fine and so going back to your question you know where where should we see this it doesn’t make sense to me to put it on a carrot it doesn’t make sense to me to
Put it on a banana those are the foods that we want people to eat um so anything that gets in the way of you eating that is not necessarily good but the problem that we’ve got is that when you go into a supermarket or a shop you’re always making decisions between
One thing over another right so if I’ve got Pace on one item I want you to compare that the pace or the amount of calories or physical activity is less in one compared to the other so if you know that a carrot is going to take you one
Minute of running and a chocolate cake is going to take you 20 minutes of running then it might help or nudge you towards eating the carrot over and above the chocolate cake and that’s probably not a great example but hopefully you can see what I mean so in that scenario
You would want past on the carrot because then you could clearly see that the carrot is a better option than taking the cake or you know two different types of crisps one that’s lowfat one that’s high fat you know you can see how you want people to engage in
The comparison between the decision making um is it mainly meant to be um a nudge you know it’s a CU to nudge people to choose one thing over the other or is it you know people should be counting how many calories they’re having a day and how much they’re expending and this
Is a part of that calculation that they would have which of which of those two not directly I think I think it’s it can be both I don’t think it has to be one over the other whatever cognitive process you go through in terms of making a decision about what to eat is
Okay and so for some that might be calories and for others that might be a comparison between one food over another we’re not all exactly the same in terms of how we choose food so for me I think it’s more about encouraging you to make a healthy decision uh between different
Types of foods you know we’re not really here to encourage people to be thinking oh I can only eat 2,000 calories because I’m a woman and I’m 2,500 because a man that’s never that’s not the goal of pace at all um that’s that that wouldn’t be
Its purpose do you think have you got any evidence so far from the research that you’ve done or other people have done that shows whether the general public when they look at these they get the implied nature as as you were talking about of what this is meant to
Say or do people read it and say oh this means I actually have to do this sort of exercise in order to burn off inverted commas this food because I remember you just saying that there’s sort of a lot of implication through those numbers have you got any evidence on that yet
Not not specifically in terms of what people think in relation to um the amount of physical activity that they can do what we do know is that they do think gosh if I have to do you know an hours for example that chocolate cake isn’t worth it so it’s not that they
Actually believe that they need to do those that sort of physical activity but it just prompts them to make a decision um again against taking or eating the cake or whatever whatever it might be have you got any you know what what is the evidence for Pace more broadly so
Far does it does it work does it work for certain people and not others what is out there at the moment so the evidence that we’ve got if you were to sort of pile it all together points towards it been useful we don’t have enough long-term studies to be able to
You know to sit here now and say categorically it’s an absolutely an effective approach to um labeling food uh we do have some initial evidence that suggest that it does encourage you to reduce the number of kind of high calorie foods that that you consume and
We also have a couple of studies that also indicate that it makes a difference in terms of weight only in a small way but again small effects in a large population are still really important so we are starting to see consistently some evidence towards it working there are
Studies also um that have shown no effect um I would argue that some of the studies that we’ve got haven’t been welld designed um and it’s really important that we have welld designed studies in order to make a decision when they’re not well design designed it’s difficult to know what what’s really
Going on here um so we do need to up our game as a as a community in terms of the labeling types of foods that we do the other thing to say is that a lot of studies uh have been done in hypothetical scenarios and laboratory or
Online what we really need is studies taking place in real context and we’ve started to do some of those studies um both in adults um in children so for example uh we’ve done a study in school canteens uh looking at PACE labeling we’ve done an online study uh and then
We’re going to be doing some stuff around vending machines uh there are very few vending machines that serve healthy food so vending machines are a really good context and scenario in which in which to do it and vending machines typically are places where we’re trying to eat foods that that are
Snacks we don’t tend to eat meals from a vending machine so that’s what we’re trying to do and is is G know if the aim of this is targeted at a particular population or a particular problem is it people living with obesity is it anyone looking to just manage their weights is
It an educational tool for the General Public to to know about it and then make decisions on it you know what can you speak to that I think my view is that any labeling is for everybody you know once it’s implemented as a as a law then it’s something that’s important for us
All and even if you’re not overweight you know you may well still have a tendency to to gain weight or not to make healthy decisions so it can act as a preventative tool but equally if someone’s living with overweight or obesity it might also help and guide
Them towards making you know to making good good decisions um I’ve sort of talked about children as well I think children are in the mix here and often when we think about public health policy at a broader population level their View and their behavior are often forgotten
The focus tends to be on adults and what’s best for them but actually if we think about children coming through whatever it might be whether it’s Pace or whatever we need to think about the implications of interventions for them for them too because they’re the ones
That that we worry about the most yeah uh so when I look at when I look at this and I’m uh 6′ tall male slim let’s say slim enough for me um and I and I think about you know do I do I really want to
Be sort of guilt tripped into not having the marsall that I really like and you know it kind of feels like if this is implemented I’m not sort of targeting this you at all but if it’s an implemented it’d be seen as a policy thing it be it taken politically because
Things like that always is and would it be seen by people as the the government the department whatever it is of whichever Department are just trying to guiltrip people to buy one product over the other that’s one thing that I can see as a critique that it’s is it guilt
Tripping is that and is that a good thing so I don’t believe the Department of Health and Social care is set up to Guilt Trip the British people that department is set up to improve our health and everybody in it is is is working and serving to improve the
Population of the people in the United Kingdom so but we need to think about strategies that work and you know so I would take exception to guilt tripping that’s not that’s not the point that’s not the reason why we get out of bed every day we get out of the bed every
Day to save lives and improve lives um so I’m I guess I’m going to choose not to answer that question because um I think it’s unfair I can come further into it then I’ll be a little bit more precise because you mentioned about you know small effects within the population
Is a really important thing and you can take that as a positive but on the negative a small effect a negative effect yeah on a on a smaller population of the UK is important and I can see with this people and this is not just me
I’ I try to do a little bit of homework when I do these podcasts and I know that there’s been a lot of critique about this on the lines of does it exacerbate yeah people who have symptoms with eating disorders or exercise disord orders Charities have come out and being
Very vocal to say this is not going to be a good thing and a part of that is it does it make people you know feel guilty especially with eating disorders about choosing a certain food yeah when trying to have that relationship with food and try to build positive relationships is
Something that they try to do and does that go against it there’s the sort of does it trigger you know whether people are in recovery or whether they’re in the middle of having eating disorder issues this Obsession again with counting calories and there’s there’s lots and I can go into it encouraging
Excessive exercise restrictive eating uh self perception body dysmorphia problems things like that so where’s your stand at the moment on the impact that it has not whether that’s a good thing or not if it does but does it have an impact at the moment on people with E and exercise
Disorders there’s a lot of questions there Chris so one final one I’ll go with the final one um what is the current literature on that it’s an important question so I want to answer it well answer it as you would like to yeah I think I think the first thing to
Say is is that it’s always important to think about the harms and the positives of any intervention whether it’s labeling of food or any health care intervention so and the you know the first approach to healthare is to do no harm and and and that has to be at the
Front of your mind whenever you’re thinking about what you do so I think you know it’s clear that there are a small number of people in let’s go with the UK that are experiencing um an eatting disorder and there is no doubt in my mind that those that group needs
Support and they need proper support um in terms of helping them deal with their relationship um with food and I kind of want to say that first and foremost and upfront because it’s one of the most asked questions that I get in relation to pace and I don’t want people to think
That I haven’t considered it it is on my mind it does worry me as any good citizen working in this area would be so that’s so that’s so that’s out there the other thing we’ve got to think about is well we’ve got a small number of people who experience an eating disorder but
We’ve also got 60% of the population that are overweight and many of those people that are overweight are dying of diseases that could have been prevented had they not been overweight know the NHS today we’ll see thousands and thousands of people excuse me because they’re overweight so so you have to in
Public health terms you’re always thinking where does the line go where where do you draw it on the one hand you’ve got this group who clearly needs support you know we need to you know be actively encouraging this group but on the other hand we’ve got a very large group of
People that also need our help too and my job is to is to save lives and I’m employed to think about the people that are overweight and obese but that’s not to say that I’m not concerned about the people that that have an eating disorder who you know having a tough time you
Know and I get lots of calls and conversations from lots of parents not lots but a few who ring me up and say right Amanda you’ve been talking about labeling and uh and Pace labeling in particular and you know my daughter’s got an eating disorder and it’s going to
Have this effect and that effect um and it’s going to trigger D D D D D So and I’ve listened to those views I haven’t just disregarded them um but I think it’s really important that we we we get the evidence we get the evidence around what works best and then the policy
Makers can make the decision about what what they what they do next so I don’t know if that answers your question or or not uh in terms of the evidence evidence um so we have so in so there’s no evidence at the moment that that is the
Case and I’ve asked lots of people including the Charities that you’ve talked about show me the evidence that says that labeling food of whatever type leads to uh an increase in Eating Disorders but also um unhealthy relationships with food because it’s not just about the small number of people
That have got an eating disorder actually You’ be concerned about the whole population if it led to people having unhealthy relationships with food did you see what I mean if if if it had an effect in that way it could increase the number of people for example not so
It’s important for every and so and so that’s what I mean you always have to think about the harms and benefits and one of the things that we’re doing all of our research is that we ask about those things so again we’re not being negligent we we we build it in and we’re
Starting to get data in terms of the participants in the studies and that’s not what we’re finding we’re not finding a change in the relationship with or negative thoughts or or or any of those kinds of things that would be indicators of concern or indicators that someone starting to move towards
Um kind of an eating disorder that that’s so I can only tell you what the evidence is and that evidence is out there it’s published you know it’s in high quality medical journals um that’s not to say that it isn’t there I’m just saying based on what we’ve collected and
Others it isn’t there yeah and because I know there I I had a look up at the um the impact on just menu calorie labeling and there was a paper there was one one quote and I’m not trying to do a typical interview of journalist thing when I say
Like I’ve got Steve from har H and Steve does this and he’s being impacted negative one of Quita intervies on a lab is exra fight I didn’t ask I I can’t no I’m going to ask it in a different way why might Pace be different to the the the negative impact
That there is yeah evidence for out there on just calorie labels on menus is there a reason why it would be different or is it just at the moment we don’t have the evidence there’s not enough evidence to say that pace is you know yeah has any negative or positive effect
On people with eating disorders well we have evidence that says in Pace studies that it doesn’t I mean I don’t know what the longer terms might be for those people in those studies over a lot I can only tell you what we have now um and it isn’t any different you know labeling
And health communication it’s it’s the same um I guess it’s more about your your position on on something and and I get asked that question a lot as I’ve already said and I always sort of say lots of things in healthcare are controversial lots of things in healthcare might benefit one population
Over another and this is just one of those scenarios where we kind of need to make a decision where do we draw the line you know IVF was hugely controversial chemotherapy was hugely controversial I mean could you imagine a life I always use these examples but
Could you imagine a life where we don’t have those treatments so just because something’s controversial and it might have Nega negative effects for one population does it mean that we discount it and say because there’s an you see what I mean it’s Balan and it’s saying okay overall though the benefits
Outweigh the risks and for that reason it might be a useful thing to do but that still means that people with eatting disorders still need to get the support that they need why does it have to be one or the other why can’t it be
Both yeah I can see that so if someone has I think of another population that’s been it’s te Pace again but uh this is can be seen as quite an ableist uh labeling it it only has running walking cycling tend to be thing where people
Ulate walk Etc with two legs yeah and so it’s not inclusive of people with physical disabilities in that way is there any plans for that to change or is there a way that you could make it more inclusive or does it fit into that category again of you know it’s for this
Population but not for that so we got to think about the manufacturers and what they put on their foods and so there’s always going to be a limit um to the number of activities that that can go on mean I guess you know if it was ever implemented then we could have websites
That we do have them now where you can um convert um so it might be that we do that and the same is true for people who you know for example who are blind um you know um so there’s lots there’s lots of there’s lots of work for us to do to
To make it more more more accessible but I don’t think we should apply a different criteria to Pace labeling than we do for all the types of labeling and we don’t have that now for current labeling so yeah no fair point do you know where the industry is behind this
Have you had you know are they or they really resilient because you’re going to be saying don’t have these foods and you know they want you to buy them I don’t think industry are that that that Keen but we’re you know I think industry have
To come to the party we can’t do this alone we have to work with industry rather than than against them because ultimately they’re the ones that make the food uh and the labeling industry have massive marketing budgets and in healthcare we don’t so we’re fighting
That um from the outset so we’ve got to bring them with us um I think the goal for industry for us is really re reformulation MH because if we can reformulate the foods or make them smaller because of pace because of the alarming amount of physical activity
That it might take then that would be a good out for us I think we’ve got to do it with them we can’t we can’t do it on our own there’s a lot of fire associated with this in the media as in you get a
Lot of flack thrown at you you take a lot on y do you take it on the chin or does it affect you how how do you feel when you get that controversy um that doesn’t bother me so much the controversy I think the thing
That bothers me the most is when I get phone calls from from parents uh of children who uh I’ve got Eating Disorders you know you can’t not be moved by that and you know you do have to reflect on um is this worth it and is
This really the right thing thing to do um I for me I think the right thing to do is to get the evidence and then to make an informed choice and decision about whether it’s the right thing to do I don’t think we should just be stopped
Getting evidence we we need to get the evidence and lay on lay on the table and then make that’s better science I’m not into science by opinion I’m into science by science yeah yeah but it does it does affect you as you say listening to those
It’s not great yeah it’s not great it’s not um it’s not and I have in you know in this again just to show that I you know I am taking it seriously I have spent time with people who have had um Eating Disorders uh and with um parents
You know I have listened to their concerns uh I have taken them on the chin uh I’m not neglecting those but also I’m mindful of the 60 something percent of the population who are dying and let’s not get away from that you know thousands of people tens of
Thousands around the world are dying of diseases or their quality of life is massively impacted by the fact that they’re overweight we need to address that this might be one of the ways there might be lots of other ways but we can’t ignore that in terms of helping the
I’d love to tap into more on that your experience around the table at the population level in trying to change make or change policy because I know that you you work as you know in in the team that’s part of that work trying to make the change right at the heart of
Government level um what is it like at that table when you’ve got the one priority which is Do no harm but you know in some situations that it’s going to affect one population significant large population let’s say and then it might have a might have a detrimental
Impact on one person who you’ve had on a phone call what’s that risk tolerance like for negative impact when does it become not okay is there a percentage of the population that is used to say you know once it’s more than 10% of people being negatively affected by this new
Policy it doesn’t matter how good it is we don’t do it or is it I think that’s a hard question I think that’s that varies you know if if you open if you’re on antibiotics and you go to a doctor today it will have all the benefits and it
Will have the risks and at some point someone’s decided that the the benefits outray the risk the risks but that will vary depending on what the what the intervention or what the treatment happens to be here we’re talking about a populationbased intervention so I can imagine the uh the tolerance would be
Higher at a population level intervention where you could get lots of people to to benefit I mean you’re talking about Millions potentially aren’t you relative to you know treatment or uh something in an NHS context so I don’t think there is a magic magic number um but it is
Considered yeah it is so a committee like nice for example will sit and look at the evidence both pros and cons and make a decision about whether this is the right thing thing to do so the government for example last year decided that the right thing to do was to um
Make it law that out of home um eating settings needed to display calories uh I wasn’t party to that decision but I guess the people in that room sat down and said overall look we’re going in the wrong direction here with with with with um the number of people living with
Obesity this may well be one way in which we can help people let’s start to do that and also the other thing to say about that is that I know that the the government have commissioned um research to look at the impacts of that decision
Over time so in the next two to three years will start to see some of those results coming through so again it’s linked to research and until you put it into real practice you can’t get real research to see so there will be have some level of risk yeah to get the
Evidence that you need yeah and is it going to cost a lot if you implement this at a population level is is it quite a high cost intervention or is actually quite low cost compared to other things you to the public purse it would be very low because most of it
Would be manufacturers or uh retailers that that do it I can’t think of many scenarios where it would be a cost of the public purse I guess schools would be a one place where it would but workplaces for example that were funded by the public purse universities or uh
Leisure Center I don’t know I’m trying to think of places or hospitals or what you know that would be a cost of the public purse but it’s very very cheap yeah if you think very very cheap yeah and you get small effect lots of people MH the actual cost Effectiveness is is a
No-brainer yeah fair enough and what are you currently exploring then right now what’s cooking what’s you know what’s what’s happening in your team I hope to do a food related plan always but yeah so we’ve just completed some studies in different different contexts and as mentioned earlier vending machines um is
One of the areas that I’m particularly focused on there aren’t many healthy foods dispense from vending machines so I think that’s an area to to focus on and um you know we are looking to work with more uh kind of food retailers to to think about Pace labeling or at least
Triing it and to see um what impact it has but also to get real kind of live information about how um customers when they go into restaurants for example or fast food takeaways how they respond to having the pace labeling is it as bad as
We think uh or is it okay do they even look at it um you know is it is it going to be the same as other types of labeling um I suspect it’s more emotive so I imagine that people will engage with it but it might engage with it for a short period
Of time and then actually they just don’t look at it um anymore and then we’ll need to think about so what do we do to encourage people to engage with it once it’s there so there’s a lot more that needs to be done before it’s going to be implemented at policy level yeah
Yeah we’re we’re we’re in we’re in the phase of trying to gather evidence with the pros and the cons um but um and I think you know if it ever was implemented it would be not on its own it wouldn’t be uh traffic light labeling wouldn’t be taken off or front of Pat
Labeling it might just be you know the little icon in terms of walking for example is is added or maybe on a menu it’s added okay and where can people find out more information about this about you to watch out for the next bit of work that’s going to be coming out
Where can they go so we’re on Twitter so the center for lifestyle meds and lra is uh we have a quite strong uh Twitter presence uh and then we have the website the CLI website at lra so you can have a look at some of the studies and some of
The media stuff that I’ve been doing around um health communication and some of the links um done quite a bit of stuff for Channel 4 and BBC around this work so those are on there as well so yeah take a look s good yeah do take a
Look and have make an opinion yourself without look into it and see but also once your opinion’s there look at what’s the science saying look at what the limitations are and totally see where we’re at um but just turning to you to finish sort of finish off um you’ve been
Very successful in in your work and uh you you know you are an inspiration to many people you because you’re Professor young age ethnic minority within the UK um so how would you sort of sell your area your area of expertise to that next Generation who might look to you and say
Like oh I’d love to be am Manda one day but why this area why what you’ve done and I’ll do it so gosh um well thank you Chris for your kind words um I think for me I’ve got the opportunity to save lives through research and to some extent through through health health
Policy and that’s an amazing position to to be you know when I go home at the end of the day you know if you think about what we’ve done think well wow you know the studies that we’re doing could make a population impact you know we could change whatever not just the pace
Labeling but whatever the interventions that we’re doing we could make a fundamental difference to the way in which people live their lives we could help them think about the way in which they eat and help them um reduce their weight you know we do a lot of weight
Management studies as well so I think that’s hugely satisfying to think that you know you could do research that impacts across the United Kingdom and actually not just the United Kingdom but actually across the world I mean the work that we do you know we make sure
It’s high quality so that any government around the world can use it to to make decisions about health policy well it sounds very inspiring from my side thank you very much Amanda for being part of this podcast no problem Chris thanks for the invitation at all and thank you very
Much for listening or watching to the episode if you’ve liked it then feel free to like or subscribe to the podcast on the platform of your choice you can also try out our other podcast experts in sport and you can find a link to that into in the show notes so that just
Leaves me to say thank you very much once more for tuning in and we look forward to welcoming you back to another Health focused podcast in the future bye-bye for now