Ethical Hub: Policy Statement - Health and Nutrition within the Food and Beverages Industry

Preamble

The CFB published a Policy Statement in 2005 entitled ‘Ethical Issues Relating to the Food Industry’. Growing concerns over poor health, nutritional wellbeing and the global rise in obesity led clinical illness has prompted a review of this Policy. A basis from which to engage more fully with companies on these issues was also recognised.

A Position Paper, ‘Ethical Issues Related to Health and Nutrition within the Food and Beverages Industry’ in support of this Policy Statement, was published in March 2017. This:

  • considered relevant biblical teaching and Methodist tradition;
  • surveyed the ethical issues relating specifically to nutrition, wellbeing and health within the food and beverage industry; and,
  • posed questions regarding health and nutrition issues for engaging with companies from an ethical perspective.

Biblical teaching

The opening chapters of Genesis teach that food is given by God. Both the availability of food and humankind’s attitude to it are affected by the fall, and this good gift is often abused. When food is not used in the way it was intended it can have a detrimental effect on the body and the ability to use it to honour God.

The role of food as an important and central aspect of Christian fellowship is also evident in the New Testament and was an important part of the early Church. Jesus often ate with his followers and at the last supper when he broke the bread and poured the wine, he commanded his followers to “do this in remembrance of me”.

However, there are also clear warnings against the misuse of food in the Bible. Whilst food is a blessing to be received from God with thanksgiving, it can be abused when the true purpose of food or God’s authority over humankind is not acknowledged. When this is the case, other influences such as financial greed, bodily appetite or the opinions of others can determine how individuals and corporations view and use food. As a consequence of the misuse of food, many around the world face the health implications of over-nutrition whilst others face the prospect of malnutrition and its associated problems.

In his sermon, The Good Steward (sermon 51) John Wesley speaks about the role of humankind as steward of all that the Lord has entrusted to them, including food. He goes on to remind believers that they will be called to account for how they have stewarded these goods, the implication being that Christians must use food to preserve health and godliness and ensure that others do not hunger but are treated with love and care.

John Wesley believed that spiritual disciplines which help a Christian grow and mature in loving God, are bound together with acts of justice and compassion through which disciples live out their love for God in the world by loving their neighbours as themselves. Christian perfection is loving God with all your heart and loving your neighbour as yourself, where the spiritual and practical needs of your neighbour must be recognised. This means that throughout its history, the Methodist Church has sought to address poverty and injustice, including tackling food poverty.

Key Issues

The range of ethical issues within the food and beverages industry is broad, encompassing labour and business ethics; nutrition; health and food security; environmental ethics, and animal welfare among others. This Policy focuses solely on issues related to health and nutrition since these are unique to the food and beverage industry. Other issues, which apply across different sectors, are addressed elsewhere in CFB policy work.

Issues relating to nutrition and health are of major ethical concern when considering the impact of the food industry. It is possible for the activities of companies, whether involved in food production, distribution, or retail, to encourage unhealthy and unbalanced diets, or inhibit access to a healthy, balanced diet. Issues that will need addressing with companies might include, but are not limited to, the following:

Food Security
Food security has been defined as existing when all people have access to sufficient amounts of safe, nutritious and affordable food to provide the foundation for active and healthy lives. Whilst food security might be seen as more of a challenge for the developing world, even in the UK food poverty is a growing issue. Companies may pose a threat to food security when they do not:

  • adequately manage risks to production and supply whether caused by political instability, weather-related production shortfalls or other influences;
  • control and minimise food waste;
  • make food affordable, accessible or nutritionally balanced;
  • make good use of resources risking food productivity; or,
  • use efficient and sustainable methods for producing and distributing food.

Undernutrition
A lack of food security can lead to undernutrition where there is insufficient access to nutrients from food. Undernutrition can lead to stunting (underdevelopment), wasting (underweight), or vulnerability to infectious disease through immune system compromise. Undernutrition remains a systemic problem affecting millions of people, not just as a result of having insufficient food, but also where sufficient food is lacking in the micronutrients needed to sustain heath and wellbeing. Companies can help to combat undernutrition by making their food products more widely available and by fortifying products with micronutrients.

Obesity
Worldwide, obesity has more than doubled since 1980. Most of the world’s population live in countries where overweight conditions such as obesity kills more people than underweight. Increased BMI is a major risk factor for non communicable diseases (NCDs) such as cardiovascular diseases (which were the main causes of death in 2012); Type 2 diabetes; musculoskeletal disorders, and some cancers. Childhood obesity is also reaching alarming proportions around the world. Companies can help to combat overweight and obese conditions by encouraging and enabling people to make healthier dietary choices in four main ways:

  • changing the content or impact of food by reformulating content or decreasing portion sizes;
  • labelling products clearly and responsibly;
  • ensuring the availability and affordability of healthy choices for all; and,
  • marketing lower nutritional foods more responsibly, especially to groups such as children.

Reformulation and Nutritional Content
Food companies should be committed to reformulating food and beverage products, where possible, to increase nutrient content and reduce salt, sugar and fat where it is unnecessarily high. Some products which might be regarded as ‘luxury’ or ‘treat’ items, such as confectionary are often high in sugar, fat and salt. Whilst this does not make them inherently unethical, such products should be marketed and priced appropriately to discourage over-consumption. Producers and retailers can also reduce the negative impact of foods high in sugar, salt and fat by reducing portion sizes.

Responsible Labelling
It is important that consumers are able to make informed choices about their diet, with nutritional content such as fat, salt and sugar clearly labelled on products. The major UK food retailers currently use conflicting labelling systems which may increase consumer confusion and dilute awareness. Nutritional content labelling can also be applied to ‘out of home’ dining by adding calorie or nutritional content information to menus in restaurant and fast food outlets.

Availability and Affordability of Healthy Options
Food retailers, such as supermarkets, should endeavour to stock healthy option choices to enable consumers to make informed choices. It is also important that cost does not become a barrier to healthy choices; suppliers and retailers should seek to price products fairly and appropriately so as not to encourage ‘nutrition discrimination’. The same principles apply to ‘out of home’ dining. To ensure consumers are given the opportunity to make healthy choices, the range of items available should contain healthier options which are fairly priced. Where restaurants and fast food outlets offer ‘meal deals’ these should include healthy options or allow for the possibility of substituting items such as rice or salad in place of fries.

Responsible Marketing and Promotion
In addition to clearly labelling products with their nutritional content, retailers should also ensure that their marketing practices are responsible with regards to nutrition and health. Producers and retailers have a particular responsibility to ensure the way they market products does not encourage an over consumption of those products that are higher in sugar, salt and fat, but rather encourages a healthy, balanced diet. Retailers have particular responsibility as it relates to marketing to children. Examples of marketing campaigns which might promote the purchase of unhealthy foods are those which offer significant discounts for multiple purchases of unhealthy products or offer prizes or discounts for collecting tokens on packaging. Irresponsible product placement can lead to the impulse purchasing of unhealthy products such as positioning confectionary at supermarket checkouts.

Product Content Transparency and Traceability
Producers and retailers have a responsibility to ensure that the food they sell is clearly labelled with the contents, and that consumers are not misled. Where foods contain GM ingredients this should be made clear to consumers under EU regulations. The use of genetically modified crops remains controversial for a number of reasons including the potential risks to human health and the environment, and unease about the ‘unnaturalness’ of the technology.

Breast Milk Substitutes (BMS)
The marketing of Breast Milk Substitutes (BMS), particularly in developing countries, has been an ethical concern since the 1970s. Dubious methods of marketing these products has in the past contributed to infant mortality where women have been unable to afford formula milk or where water impurities have led to illness. In 1981 the World Health Organisation published its International Code of Marketing of Breast-Milk Substitutes to provide guidelines to companies marketing BMS. The main principles of the Code are that BMS products should not be advertised nor should they be promoted through healthcare facilities or the giving away of free samples to mothers or healthcare professionals. All information on BMS products should be purely scientific and factual and give clear information on the benefits of breast feeding and the hazards of artificial feeding. The Code also states that all products should be labelled in the indigenous language and should not depict pictures of babies.

Alcohol
The misuse of alcohol has significant impacts on health and society. Excessive, rapid and chronic drinking pose serious health risks, with alcohol rated as the third largest lifestyle risk factor for disease and death in the UK after smoking and obesity. Societal problems linked to excessive alcohol consumption include increased crime and violence, family breakdown, and financial loss to individuals, employers and public services, such as the NHS. Companies have a responsibility to market and price products appropriately so as to guard against over-consumption and ensure that measures are in place to comply with age restrictions. Because of the seriousness of problems linked to the misuse of alcohol, the CFB does not invest in companies with significant exposure to alcoholic beverage manufacturing or retailing (pubs and ‘wet’ led drinking hospitality groups). The CFB published a Position Paper and Policy Statement on ‘Alcohol Related Companies’ in November 2012, focused on business behaviour and responsible consumption.

Summary

This Policy Statement recognizes that since the CFB first adopted a policy on the Food and Beverage Industry in 2005, much has changed, principally:

  • Trends in consumption away from home-cooking and locally bought fresh foods towards dining out and buying of convenience foods at supermarkets;
  • The significant increase in the availability of fast and nutritionally poor foods both in terms of access and cost;
  • The rise in marketing, particularly to children and young people, through the internet and social media;
  • The cost to society in terms of treating non-communicable diseases, loss of employment due to ill health, and general wellbeing has continued to grow;
  • The impact of an obesogenic environment on children is of particular, and growing, concern;
  • The failure of producers and retailers adequately to accept responsibility for marketing food and
    beverages responsibly, protecting and encouraging food security, particularly in developing countries, and reformulating products with fortified nutrients to tackle under-nourishment.

Policy: Health, Nutrition and Wellbeing

Given the increasing concern about the impact of poor nutrition to individuals and to society:

  • There is a clear need for the CFB to increase the level of proactive engagement with companies that have a material exposure to health, nutrition and wellbeing issues;
  • With increased exposure, there would need to be escalated engagement around food and beverage industry corporate practices, marketing and promotion;
  • Should a company have significant and material exposure to these issues but refuse to engage, then there may be a question of whether it is suitable for investment.

The CFB’s strategy for influencing change relies primarily on dialogue and constructive engagement with companies. Engagement is pursued until it becomes clear that a company is not open to dialogue or does not respond positively to the concerns that are raised. If engagement fails, then disinvestment is an option the CFB will consider.

The areas in which the CFB will seek to engage with companies within the food and beverage industry are various but may include:

  • General company approaches towards the manufacture or retail of products so as to support informed choice in terms of health, nutrition and wellbeing;
  • General company approaches towards the reformulation of products so as to support informed choice in terms of health, nutrition and wellbeing;
  • Company initiatives (including marketing and labelling) targeted towards reducing the potential for clinical diet related non-communicable diseases or undernutrition;
  • Companies whose main business is the production or sale of food and beverages which are high in sugar, salt or fat, such as sugar-sweetened drinks, fast food or confectionary products, should be subject to enhanced scrutiny compared with those involved with more nutritionally balanced food and beverages;
  • Products with higher sugar, fat, or salt content which are not marketed as ‘treat’ products or priced appropriately, are a particular cause for concern;
  • Companies which offer a range of products, including healthy choices, and which seek to address undernutrition through fortification and distribution to undernourished populations will be looked on more favourably;
  • The CFB will take particular care to monitor the approach companies take to the production, sale or marketing of products high in sugar, fat or salt to children.

Policy: Breast Milk Substitutes

The marketing of Breast Milk Substitutes (BMS), particularly in developing countries, has been an ethical concern since the 1970s with dubious marketing practices being widely viewed as having an impact on, or contributing to, infant mortality where water impurities may have led to illness and early death.

Whilst the World Health Organisation International Code of Marketing of Breast Milk Substitutes (the Code) is designed to be implemented globally, in certain circumstances, the use of breast milk substitutes may be deemed necessary, desirable or a matter of choice, the key principle being that the Code is nevertheless applied and upheld in the host country. BMS are therefore viewed as legitimate products, and their sale is not viewed as inherently unethical.

CFB will monitor and engage particularly closely with manufacturers of BMS. Specifically, should a company have significant and material exposure to the manufacture of BMS products but refuse to engage, there may be a question of whether investment is appropriate.

The CFB fully subscribes to the principles contained within the Code, and wherever possible priority should be given to natural feeding.

The CFB will seek to ensure, as part of its engagement, that companies with manufacturing exposure to BMS products fully endorse the Code, and in particular have policies and approaches that ensure its key points are enforced and adhered to i.e.

  • No advertising of breast milk substitutes to pregnant mothers is allowed;
  • No direct approach to pregnant mothers by manufacturers with product samples;
  • No free gifts distributed to pregnant mothers and no ‘in-shop’ promotion of such goods;
  • No direct approach to health workers with product samples of such goods;
  • Strict accountability regarding labelling including indigenous languages.

Overall the CFB has articulated its approach and position on BMS manufacturers thus:

  • There are occasions when the appropriate response to an ethical issue is to disinvest from, or avoid investment in, the company involved. There are other occasions when the appropriate response to an ethical issue is to engage with the company in expectation that concerns will be heard and appropriate changes will be instigated.
  • There may be instances however, where a company’s application of the Code is so poor, the only ethical response is to exclude or divest.
  • There are some products whose manufacture and sale may be considered incompatible with Methodist aims and values; breast milk substitutes do not fall into this category.
  • As a minimum, companies should have publicly endorsed support and adherence to the Code, and have been selected for inclusion into the FTSE4Good Indices which sets a standard of ongoing monitored compliance with the Code for this group of manufacturers.

This Policy, approved in March 2017, supersedes earlier CFB policies on the food and beverage industry where it related to health and nutrition (2005) and on Nestlé (2005).