Want a healthier UK? Alcohol policy must be part of the recipe

Lucy Holmes | July 2020 | 10 minutes

The Government has announced a new plan to tackle obesity, and has included alcohol in their strategy - but if they're serious about our health, there's much more to do.

We welcome the news [27 July 2020] that the Government has included action on alcohol in its plan to tackle obesity, in particular its announcement that a new consultation will be launched before the end of the year on plans to provide calorie labelling on alcohol products.

The situation that has led to this new Government plan is, unsurprisingly, COVID-19. Evidence suggests that being overweight or obese increases the risk of serious complications for people who develop COVID-19.

Tackling obesity isn’t simple. There are many factors that have led to the high incidence of obesity in the UK. There are social and environmental factors (for example poverty and the availability and price of different types of food), psychological factors (for example adverse experiences), and biological factors (for example appetite control genes).1

All of which is to say that obesity cannot and must not be addressed on just an individual level. Doing so leads to stigma of some of our bodies – and besides, it doesn’t work. Obesity is part of a big public health picture – and alcohol policy must be part of the solution.

In this blog I’ll take a look at why it’s vital that alcohol is included in this strategy and why it’s also essential that, if the Government is serious about our health, they go much further.

What's the problem?

Alcohol is high in calories, and often sugar too

Alcohol is a significant contributor to our calorie consumption. A three-year survey for the Department for Health and Food Standards Agency found that alcohol accounted for nearly 9% of energy intake for drinkers aged 19 to 64 and nearly 7% of that of over-65s.2

Alcohol’s calorie content is often shockingly high. According to the Baileys website, a 50ml typical pub serving contains 160 calories – nearly the same as a Cadbury’s Crème Egg (177 calories). Research by Action on Sugar found that a 275ml bottle of blue WKD contains 23g of sugar – a smidgen more than a KitKat Chunky (21.2g).3

It’s not just sweet drinks that are high in calories, either. A 440ml can of Guinness from a supermarket contains 154 calories, a 440ml can of Tetley’s contains 145 calories, and a large 250ml glass of red wine contains around 180 calories.

Yet people don’t know how many calories are in common alcoholic drinks – because this information is hidden

Most people – 80% in one study – do not know the calorie content of common drinks.4

The reason for this is no mystery. The Government’s announcement mentioned “hidden ‘liquid calories’” – and ‘hidden’ is the right word. Unlike all other food and drink, alcohol is currently exempt from on-package calorie labelling requirements. Alcohol producers are only subject to ‘recommendations’ when it comes to labelling, and the result is that far too many labels are inadequate.

Our upcoming research, in partnership with the Alcohol Health Alliance, shows that a shocking proportion of alcoholic drinks sold in supermarkets fail to display calorie information, ingredients or nutritional information like sugar content. For years, manufacturers have resisted calls from public health professionals for alcohol labels to include this vital information.5-15You can read more about this in this blog about last year’s All Party Parliamentary Group on Alcohol Harm event on alcohol labelling.

There is absolutely no good reason for calories to be hidden. Calories, nutritional information and ingredients should be easily available to consumers at the point of purchase. That they are not already is an indictment of the voluntary approach to alcohol labelling in this country.

Health is about more than obesity

If the Government is serious about getting the UK’s population healthy, action on alcohol is vital. That’s because, aside from the calories, alcohol itself can lead to many of the same adverse health impacts as being overweight or obese.

Many people are aware that alcohol causes liver disease, but as many as 90% of people don’t realise that alcohol is linked to seven types of cancer.16 Alcohol is a risk factor for over 200 health conditions and, like obesity, is a major cause of diabetes and cardiovascular disease.17, 18

Alcohol labels need to include more than just calories – they must also include information on units of alcohol, the low risk drinking guidelines and more. Find out much more in our upcoming research into alcohol labelling.

What are the solutions?

The COVID-19 pandemic means we live in a time of great change. We have been reminded of the importance of public health, and the pressure widespread ill-health places on our public services like the NHS. That makes this the perfect time to implement policies which put health first.

There’s much more the Government can do around alcohol that will improve our health. Tackling the full extent of alcohol harm will need a comprehensive set of policy measures, outlined in a national cross-government strategy with adequate resources. Take a look at some of the policies that evidence suggests would make the biggest difference.

But for the time being, let’s focus on the Government’s new measures around obesity. We are calling on the Government to:

Mandate that alcohol labels include calories, ingredients and full nutritional information, as well as health warnings and low-risk drinking guidelines

There’s much more information on this in our upcoming research into alcohol labelling.

Restrict alcohol marketing

For example by banning alcohol sponsorship of sport.19-21

Ban ‘Buy One Get One Free’ and other special offers on alcohol

Many of the policies outlined in the Government’s obesity statement are targeted at food, but should also apply to alcohol. It makes no sense to ban ‘Buy One Get One Free’ offers on chocolate bars when they’re still allowed on high calorie alcoholic drinks – and when alcohol comes with additional major health risks.

References

1 British Psychological Society (2019) Psychological perspectives on obesity: Addressing policy, practice and research priorities

2 Department of Health & Food Standards Agency (2011) National Diet and Nutrition Survey

3 Action on Sugar (2020) Sugar content of ready-to-drink alcoholic beverages

4 Royal Society of Public Health (RSPH) (2014) Increasing awareness of ‘invisible’ calories from alcohol

5 Eurocare, European Alcohol Policy Alliance (2012) Preliminary library of alcohol health information and warning labels

6 Martin-Moreno, J. M., Harris, M. E., Breda, J., Møller, L., Alfonso-Sanchez, J. L. and Gorgojo, L. (2013) Enhanced labelling on alcoholic drinks: reviewing the evidence to guide alcohol policy in European Journal of Public Health, 23(6), 1082–1087. doi:10.1093/eurpub/ckt046

7 Alcohol Health Alliance, University of Stirling and British Liver Trust (2013) Health First: An evidence-based alcohol strategy for the UK

8 Royal Society of Public Health (RSPH) (2014) Increasing awareness of ‘invisible’ calories from alcohol

9 Eurocare, European Alcohol Policy Alliance (2014) What’s not on the bottle? Eurocare Reflections on Alcohol Labelling

10 Alcohol Health Alliance UK (2018) Our Right to Know: How alcohol labelling is failing consumers

11 RSPH (2018) Labelling the Point: Towards better alcohol health information

12 Blackwell, A. K., Drax, K., Attwood, A. S., Munafò, M. R. and Maynard, O. M. (2018) Informing drinkers: Can current UK alcohol labels be improved? in Drug and alcohol dependence, 192, 163-170. doi: 10.1016/j.drugalcdep.2018.07.032

13 RSPH (2018) Labelling the Point: Towards better alcohol health information

14 Action on Sugar (2020) Sugar content of ready-to-drink alcoholic beverages

15 World Health Organization (WHO) (2020) What is the current alcohol labelling practice in the WHO European Region and what are barriers and facilitators to development and implementation of alcohol labelling policy?

16 Cancer Research (2016) 9 in 1 don't link alcohol and cancer

17 World Health Organization (2018) Alcohol factsheet

18 NHS website (2019) Obesity overview

19 Alcohol Health Alliance, University of Stirling and British Liver Trust (2013) Health First: An evidence-based alcohol strategy for the UK

20 WHO (2010) Global Strategy to reduce the harmful use of alcohol

21 Purves, R. I. and Critchlow, N. (2020) The extent, nature, and frequency of alcohol sport sponsorship in professional and rugby union in Scotland