Intended for healthcare professionals


Public Health England’s report on sugar reduction

BMJ 2015; 351 doi: (Published 19 November 2015) Cite this as: BMJ 2015;351:h6095
  1. Mike Rayner, director,
  2. Peter Scarborough, university research lecturer,
  3. Adam Briggs, Wellcome Trust research training fellow
  1. 1British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK
  1. Correspondence to: M Rayner mike.rayner{at}

Its list of actions is good; now we need priorities

Public Health England (PHE) has published its long awaited report on the evidence for sugar reduction.1 It sets out eight key levers that the government could use when formulating a programme to reduce the population’s intake of free sugars (all sugars added to foods plus those naturally present in fruit juices, syrups, and honey).

There is much to applaud. PHE is often criticised for not being bold enough in its recommendations to government, taking a cautious approach to its interpretation of the evidence and what it should mean to policy makers. However, at least four of the eight levers may need some form of legislation, and the range of suggested interventions goes beyond simply nudging individuals through health education (box). The breadth of the review is a strength: diet is complex and there is no silver bullet. No single policy will reduce sugar intake, and reducing sugar consumption in itself will not solve the obesity epidemic. A multifaceted approach is needed.

However, the breadth of the report is also its biggest problem. The mixed methodological approach is clumsy, ranging from systematic reviews of the evidence underlying fiscal interventions and reducing opportunities for marketing, through to a specially commissioned analysis of Kantar Worldpanel data to assess the effectiveness of reducing price promotions. …

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