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“For Starters”: Response to the 2012 Demos Report

15th Feb 2016

Demos is a UK political think-tank whose influence over UK government policy has been considerable. Their report For Starters, written by Louise Bazalgette and published in December 2012, is about the importance of childhood nutrition, and its potential as a tool of social policy.

The relevance of the For Starters report to the IFBB’s work is significant and we welcome its publication as encouraging evidence that, at last, early-years nutrition is being taken seriously by others seeking to influence UK policymakers.

While we agree with the author’s desire to advocate ‘a central role for early childhood nutrition in early years and public health policy’, we believe that the importance of nutrition has been underestimated.

The report’s insistence that such policy should be ‘joined-up’ and should make better use of existing systems, such as nursery provision, is commendable. Incremental changes which build on existing culture and infrastructure may achieve remarkable results in the medium and long term.

We agree, too, with the report’s focus on providing the best possible nutritional advice to parents, which is in line with our own mission to offer clear, impartial information about nutrition and nutrition research.

However, we would like to see the debate taken further, especially in the areas of information provision and consideration of the science.

Information provision

The Demos report relies in part on a survey of new mothers sponsored by Bounty. In this survey, and in the focus group research conducted by Demos, parents reported using company websites and online forums like Mumsnet as a source of nutritional information. They did not seem to use government websites such as the Department of Health, NHS Choices or Start4Life. The reliability of information did not seem to be an issue for parents; what mattered was whether the information was ‘useful’ (p. 82) As parents frequently complained of receiving conflicting advice, it is clear that information provision needs improvement.

Nutritional science

The IFBB notes the report’s discussion of micronutrients such as omega-3 fatty acids, particularly but not exclusively in connection with breastfeeding. However, the IFBB considers the evidence for their importance in child physical and mental health to be more compelling than Demos implies. For example, Demos cites high-quality work from the ALSPAC study, which links fatty acid consumption in pregnancy with the child’s cognitive development, as well as a US study which links childhood omega-3 consumption with cognitive ability. There is also considerable further evidence, including from cross-cultural research, of the benefits of fatty acids for children’s cognitive development, behaviour and educational achievement.

The only other nutrient specifically discussed in this section of the report (Chapter 1, ‘Why is early childhood nutrition important?’) is iron. The IFBB would have welcomed discussion of other important micronutrients, such as Iodine, Magnesium and Zinc.

More, larger scale, research studies on childhood nutrition, and especially the effects of poor nutrition on later behaviour, educational achievement, and mental and physical health are urgently needed, and we welcome Demos’s call to make childhood nutrition a policy priority.

Policy recommendations

We commend the emphasis in For Starters on the preventative principle in nutrition. Nutritional improvements in the early years are a relatively inexpensive policy option, especially when compared with the costs of treating major social and emotional/medical/health problems later in life. Links between poor nutrition and poor physical health are widely accepted, but the effect of food on the body also impacts the brain. Deficiencies of micronutrients such as fatty acids and vitamins also appear to affect brain function, and thus behaviour with potentially serious consequences.

Research increasingly suggests clear links between poor nutrition and poor mental health, educational achievement and even antisocial behaviour and criminality. Eating habits, set early in life, are likely to prove more difficult to change later on, as For Starters notes (pp. 31-32). Improving mothers’ understanding of early-years nutritional needs thus has the potential to improve much more, in the long term, than just our children’s physical health.

The Demos report makes 11 key recommendations (pp. 15-16, see also Chapter 10). These include:

  1. provision of better evidence: including measures of nutrition in routine developmental checks (Recommendation 1); providing evidence-based training materials for health professionals and those working with young children (Recommendation 2), and building the evidence base (Recommendation 11). Data about the UK population’s nutritional status, especially with respect to essential micronutrients, is currently inadequate, and the IFBB welcomes any call to improve the quality of the evidence. We also note with interest the remark, on page 19 of the report, that ‘there is some debate about exactly which nutritional practices are best’. This suggests that priority should be given to resolving such debate and developing consistent standards, so that guidance to parents can be as clear as possible, and misleading information can be identified.
  2. provision of better advice: a clearer message on bottle feeding, and a statutory duty to provide clear and timely information to mothers, from pregnancy onwards, about breastfeeding, weaning babies onto solid foods, and the specific requirements of toddlers (Recommendations 4-8).
  3. public health campaigning: on the benefits of vitamin D supplementation, and vitamins in general (Recommendation 3). We argue for the ‘special case’ of Vitamin D here.
  4. consensus building: Demos recommends that the ‘Department of Health, online parenting forums and brands and retailers that parents trust should work together to disseminate consistent and trustworthy advice on early childhood nutrition to parents’ (Recommendation 9, p. 16), and that governments should work with nurseries and children’s centres to spread good practice and support parents (Recommendation 10).

We fully agree that it is important to build consensus, improve the evidence base, and provide better advice – both directly to parents, and to the non-governmental sources of information (e.g. retailers, online forums) to which they look for support.

However, government, consumers and the food industry are motivated by different and sometimes conflicting priorities. Government hopes that improving childhood nutrition will reduce public health care costs, and perhaps also other costs, such as those resulting from antisocial behaviour and criminality. For industry, the motivation is to sell products while keeping costs at a minimum, while for consumers good nutrition may sometimes be a secondary consideration to price and convenience.

Bearing these differences in mind, we are concerned that consensus building, improving government advice, and educating consumers may not be sufficient to drive improving standards in childhood nutrition. IFBB would welcome further discussion of specific policy interventions and other approaches in the Demos report.

Conclusion

The For Starters report is a valuable contribution to the emerging consensus around the importance of good nutrition in childhood. The IFBB hopes that such a report, by so influential an organisation as Demos, will encourage the UK government to accept that helping our children eat well is not only good for them – in many different ways – but is a relatively inexpensive and feasible preventative policy with the potential for immense social benefit. While the IFBB is sorry not to see more engagement with specific policy initiatives, this report is a step in the right direction.

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