Mandate the out of home (OOH) sector to implement maximum calorie limits

There are not any mandatory calorie reduction schemes in the UK, for OOH or for food retailers and manufacturers. There is no maximum calorie limit for single serve portions. In August 2017, the Department of Health and Social Care (DHSC) commissioned PHE to develop a UK-wide voluntary calorie reduction programme, which was one of the key commitments in all chapters of the UK Government’s Childhood Obesity Plan. The OOH sector has since been monitored against achieving a 20% calorie reduction on the simple average calories across the categories identified in the programme while ensuring that individual meals and products do not exceed the maximum calories to be consumed in a single occasion. 

In February 2024, an update on the calorie reduction programme was published by the Office for Health Improvement and Disparities (OHID), finding limited progress towards achieving the target between 2017 and 2021. In the OOH sector, the report found an increase in the number of calories per serving in main meals, starters, side dishes and sandwiches. The deadline for the final report on the programme has been extended until the end of 2025.

The voluntary calorie reduction guidelines are UK wide, however, responsibility for monitoring progress towards calorie reductions is shared across different agencies in different nations. 

The Welsh Government could legislate for this, which would be an extension of the proposals it put forward in the 2022 Healthy Food Environment consultation. In an effort to manage calorie reduction, two proposals were included. The first proposal refers to restrictions on free refills of sugary soft drinks. The second proposal refers to a restriction on larger portion sizes of sugary soft drinks.

The Scottish Government could legislate for this based on their recommendations in the Diet and Healthy Weight Delivery Plan. There is currently a voluntary Eating Out, Eating Well framework for OOH businesses being piloted by Public Health Scotland which contains advice on maximum calorie recommendations for a range of popular OOH products.

Estimating the per-person impact

We estimated that this policy would reduce average daily calorie intake by approximately 4 kcal per person

• We assumed that this policy would implement the maximum calorie per portion guidance reported in PHE’s calorie reduction technical report (see table 3 on page 18). We did not model this policy for children.
• Only large businesses would be in scope of this policy and we assumed that on average, an adult’s daily energy consumption from large OOH premises is approximately ~100 kcals.
• Further, we used data built for Nesta’s analysis on how eating out contributes to people’s diets? for our analysis. This dataset was developed with the OOH subset of Kantar’s Worldpanel service to capture purchases of food and non-alcoholic beverages for OOH consumption in 2021. Nesta’s analysis uses a subset of this data for the period 1st April 2021 to 31st December 2021 for individuals aged 18 and above, at its core, combined with nutritional data(for more information see Nesta’s report linked above). We use the same data for our analysis focussed primarily on large out of home businesses (referred to as Chains).
• The different products in this dataset were recategorised by their name, description and nutritional content into product categories listed in the PHE guidelines. Then, we identified products whose calorie content was above the maximum calorie thresholds prescribed for each product category in the guidelines. We then set the calorie content values of these products to just below the thresholds and recalculated the average calories per person per day purchased from the large businesses.
• Through this modelling, we find that the calories purchased per person per day from large out of home businesses are reduced by approximately 4 kcals.
• We then apply a compensation effect of 23% to find the reduction to be approximately 3 kcals per person per day.

Changes in the prevalence of people living with obesity

Table 2 shows the percentage reduction of adults moving from BMI≥30 or BMI z-score >85 into healthier BMI category following introduction of this policy (5- year follow up). After five years of policy implementation, approximately 1% of adults in England and Scotland would move to a healthier BMI category as a result of this policy. 

We are in the process of modelling the impact for children and will update findings upon completion. 

Cost over 5 years

We estimated that this policy would cost the governments approximately £10 million over five years

We commissioned HealthLumen to estimate the cost of the policy to both industry and governments over a five-year period.

Table 3 below shows a breakdown of costs. The direct costs to the governments are estimated at approximately £10 million for enforcement and monitoring. The costs to the food industry are estimated at approximately £2 billion over five years. 

Impact on disease incidence

We commissioned HealthLumen to report disease incidence avoided if the policy were implemented. These estimates do not represent the total health benefits. The specific diseases selected are those where there is good evidence that living with obesity is associated with the development of the disease. 

Table 4 presents a summary of incidence avoided (rounded to the nearest 100).