Thursday, 29 March 2018

Correspondence: Vaccine update: issue 277, March 2018

The March 2018 issue features:

  • HPV vaccination for MSM programme
  • hepatitis B vaccine supply constraints: phased re-introduction of vaccine
  • immunisation training resources for healthcare professionals
  • National Immunisation Network (NIN) conference - places available
  • children’s flu vaccines
  • Good Friday and Easter Monday Bank Holidays ordering and deliveries
  • May Bank Holiday ordering and deliveries
  • Spring Bank Holiday ordering and deliveries
  • BCG factsheet
  • Purified Protein Derivative PPD 10TU ordering through ImmForm
  • MMR vaccine ordering restriction
  • vaccine supply


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Corporate report: PHE Business Plan 2018 to 2019

The business plan for 2018 to 2019 outlines the main steps and actions PHE will be focusing on over the next year to protect and improve the public’s health and reduce health inequalities.



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Wednesday, 28 March 2018

News story: Resistant gonorrhoea case reminds importance of safe sex

Dr Gwenda Hughes, Consultant Scientist and Head of Sexually Transmitted Infection (STI) Section at Public Health England (PHE), said:

We are investigating a case who has gonorrhoea which was acquired abroad and is very resistant to the recommended first line treatment. First line treatment for gonorrhoea is a combination of 2 antibiotics (azithromycin and ceftriaxone). This is the first time a case has displayed such high-level resistance to both of these drugs and to most other commonly used antibiotics.

We are following up this case to ensure that the infection was effectively treated with other options and the risk of any onward transmission is minimised. PHE actively monitors, and acts on, the spread of antibiotic resistance in gonorrhoea and potential treatment failures, and has introduced enhanced surveillance to identify and manage resistant strains of infection promptly to help reduce further spread.

It is better to avoid getting or passing on gonorrhoea in the first place and everyone can significantly reduce their risk by using condoms consistently and correctly with all new and casual partners. Anyone who thinks they may have been at risk should seek an STI screen at a sexual health clinic.

Read the full Multi-drug resistant gonorrhoea in England: 2018 report.



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Collection: HPV vaccination for men who have sex with men (MSM) programme

The national HPV vaccination programme for MSM begins on 1 April 2018.

The purpose of the HPV for MSM programme is to opportunistically offer the vaccine to MSM up to and including 45 years of age through GUM and HIV clinics. At present, the vaccine is not available outside of the GUM and HPV clinics. PHE therefore encourages patients to continue attending GUM and HIV clinics where they normally receive care.

The detailed guidance is aimed at healthcare professionals involved in the HPV for MSM programme.



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News story: Measles outbreaks in Europe: Easter travel advice

Public Health England (PHE) is advising people planning to travel to Europe over the Easter holidays to ensure they are up to date with the MMR vaccine, due to ongoing measles outbreaks across the continent. Measles is a highly infectious viral illness that can lead to serious complications and in rare cases can be fatal.

The European Centre for Disease Prevention and Control has reported a high risk of measles in Europe, with cases being imported and exported between countries. This is largely due to lower MMR vaccine uptake in many European countries. Romania, Italy, Germany, Greece and France are all currently experiencing large measles outbreaks.

Although the overall risk to the UK population is low, in England there have been 168 laboratory confirmed measles cases this year. London, South East, West Midlands and the South West regions have reported the most cases. About half of the cases in England in 2018 have been in people over 15 years of age.

Whilst MMR vaccine coverage for the routine childhood programme is high in the UK, anyone who has missed out on MMR vaccine or has not had measles in the past is at risk of catching the disease.

The vaccine is available to all adults and children who are not up to date with their 2 doses. It is offered to children at 1 year of age with a pre-school booster at 3 years and 4 months. Anyone who is not sure if they are fully vaccinated should check with their GP practice.

PHE local health protection teams are working closely with the NHS and local authorities to raise awareness of the outbreaks in the UK and other parts of Europe with health professionals and local communities.

Dr Mary Ramsay, Head of Immunisation at PHE, said:

The measles outbreaks we are currently seeing in England are linked to ongoing large outbreaks in Europe. People who have not had 2 doses of the MMR vaccine are particularly at risk.

We want to remind people that measles is not just a disease of young children and we’re seeing many cases in people over 15 years of age. Adults or parents who are unsure if they or their children have been fully vaccinated should check with their GP and make an appointment to receive 2 doses of MMR vaccine.

The UK achieved WHO measles elimination status last year, so the overall risk of measles to the UK population is low. However due to ongoing measles outbreaks in Europe, we will continue to see cases in unimmunised individuals and limited onward spread can occur in communities with low MMR coverage and in age groups with very close mixing.



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Tuesday, 27 March 2018

Research and analysis: Multi-drug resistant gonorrhoea in England: 2018

This is the first report of multi-drug-resistant Neisseria gonorrhoeae (high-level azithromycin resistance combined with resistance to ceftriaxone).

PHE reminded clinical laboratories to refer N. gonorrhoeae isolates with resistance to ceftriaxone (MIC >0.125 mg/L) or azithromycin (MIC >0.5 mg/L) to the PHE Reference Bacteriology at Colindale for confirmation; General Practitioners were reminded to refer all suspected cases of gonorrhoea to genitourinary medicine services for appropriate management according to PHE guidance.



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Promotional material: HPV vaccination for MSM: posters and leaflets

The leaflet and record card are for MSM, up to and including 45 years of age, who are offered the HPV vaccine as part of the programme and provides information on HPV infection and the HPV vaccine.

The record card (product code: 3202636B), poster (product code: 3204637B) and leafletd (product code: 3204637A) are available to order from the DH health and social care orderline.

Health and Social Care Publications orderline

Health and Social Care Publications
PO Box 777
London
SE1 6XH

Copies of most printed publications can now be ordered online. Login to register and place your order.



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Monday, 26 March 2018

Guidance: Cervical screening: role of the cervical screening provider lead

This guidance includes information for cervical screening provider leads (CSPLs) on:

  • requirements of the role
  • accountability
  • working relationships
  • roles and responsibilities


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News story: Hepatitis C in the North West report released

Public Health England (PHE) North West’s hepatitis C: 2016 report, published today (Monday 26 March 2018), reveals that the number of people infected with hepatitis C has remained stable since 2014. The most recent estimates suggest at least 40,000 people across the North West acquired hepatitis C infection, and of those 27,000 have developed chronic infection.

The report also shows that the number of infected people who have not been diagnosed remains high with an estimated 16,000 out of 40,000 (40%). Many people may be unaware because they have no symptoms or only mild symptoms, but they could be at risk of liver damage as well as passing on the infection to others.

Data shows that the highest burden of disease is in the Greater Manchester area, while Lancashire and Liverpool also have high numbers of people living with hepatitis C.

Those most at risk of contracting hepatitis C infection in the North West are people who inject drugs or have injected drugs in the past - especially if they have shared injecting equipment. They are at increased risk even if they injected only once or twice in the past.

A nationwide survey carried out in 2013 revealed that, in the North West, up to 68% of individuals who inject drugs have hepatitis C infection. People in prison settings also have an increased risk of hepatitis C infection,

Evdokia Dardamissis from PHE North West said:

Hepatitis C remains a major public health concern and one that we are actively addressing in partnership with the NHS and drug services.

The rate of hepatitis C-related mortality and hospital admissions for hepatitis C-related end stage liver disease in the North West is almost twice as high as the rate in England.

However, we are committed to working closely with multiple stakeholders to improve surveillance, diagnosis and care pathways. By increasing public awareness, those people most at risk can take the necessary preventative measures to protect themselves, and those who are already infected can be brought into highly effective treatment programmes.

We encourage anyone who believes that they may be at risk to ask their GP or drug services to be tested for the virus. This is an infection which can be cured in most people. Simple measures such as using sterile injecting equipment and not sharing personal items like toothbrushes and razors will minimise chances of being exposed to hepatitis C.



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Research and analysis: Hepatitis C in the North West: annual review

Hepatitis C in the North West is still a major public health concern, however, rates since 2014 have remained stable. Estimates suggest at least 40,000 people across the North West acquired hepatitis C infection, and of those 27,000 have developed chronic infection.

However, the number of infected people who have not been diagnosed remains high with an estimated 16,000 out of 40,000 (40%) at risk.



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Friday, 23 March 2018

Corporate report: PHE remit letter: 2018 to 2019

This letter sets out:

  • the role that the government expects Public Health England (PHE) to play in the health and care system
  • the priorities of PHE in the period April 2018 to March 2019

See also the Public Health England strategic plan.



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News story: PHE publishes consultation on Nutrient Profiling Model

Public Health England (PHE) has today (23 March 2018) published a consultation on an updated Nutrient Profiling Model (NPM), the model that differentiates which food and drink products can be advertised during programming where children make up more than a quarter of the audience.

The NPM is a tool used by the Office of Communications (Ofcom) and Committee of Advertising Practice (CAP) to give food and drink products a score. This score determines whether products can be advertised during children’s television programming and non-broadcast media including print, cinema, online, and in social media. The score is based on the balance between ‘negative’ and ‘beneficial’ nutrients that make up a product. The more beneficial nutrients, such as fruit and vegetables, protein and fibre, and the fewer negative nutrients, such as sugars, saturated fat and salt, the more likely a product will be given approval to be advertised during children’s programming.

As part of the government’s childhood obesity plan, PHE was tasked with updating the current model to bring it in line with current UK dietary recommendations, especially around sugar and fibre.

Dr Alison Tedstone, Chief Nutritionist at PHE said:

It is important the Nutrient Profiling Model reflects the most up to date dietary recommendations in order to help support healthier food choices. We welcome comments on the modifications to the model.

Given current UK dietary recommendations advise the population to consume less sugar and more fibre, we can expect some products which currently pass the model to fail the revised version.

In this consultation, PHE is asking for views on the technical basis of bringing the draft revised version in line with current UK dietary recommendations. It does not cover the application of the NPM or further restrictions to advertising during children’s programming.

The consultation opens today and closes on 15 June 2018.



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Open consultation: Consultation on the UK Nutrient Profiling Model 2018 review

Public Health England (PHE) was asked by the Department of Health and Social Care to review the UK Nutrient Profiling Model to bring it in line with current UK dietary recommendations. The review included developing a modified Nutrient Profiling Model (draft 2018 NPM).

This consultation seeks your views on the modifications made to the UK Nutrient Profiling Model, specifically its alignment with current UK dietary recommendations.

Please read the introduction to the consultation document for more information about this consultation.

Respond with your comments on the 2018 review of the UK Nutrient Profiling Model consultation to nutrientprofilingmodel@phe.gov.uk

A summary of responses will be published following the conclusion of the consultation.



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News story: Tuberculosis (TB) cases fall by over a third in last 6 years

New Public Health England (PHE) data released for World TB day show a 9.3% decline in cases of TB in 2017. This represents the lowest rate of TB in 35 years. This contributes to the 38% decline in the number of people with TB in England over the last 6 years.

However, there is still more work to do. TB is one of the leading causes of death worldwide and England has one of the highest rates in Western Europe with just under 5,200 people affected by TB in 2017.

To mark World TB Day on 24 March 2018, PHE and its partners are supporting the international Stop TB Partnership and World Health Organisation’s campaign to ‘Light up the World for TB’ and illuminate buildings and landmarks across the world in red. This will occur in various locations over the weekend (23 to 25 March 2018). The activity will highlight the continued focus that is required to meet the ultimate ambition of making England TB-free.

Dr Sarah Anderson, Head of the National TB Office, PHE said:

We are pleased to announce that we have seen a 9.3% fall in TB cases in the last year. This continues the declining trend of the last 6 years and is the lowest rate of TB we have seen in 35 years.

People often think that TB is a Victorian disease that is no longer a problem in England but in fact it still affects over 5,000 people a year and there is still a lot to do until the target to eliminate TB is met.

We urge everyone to join the fight to confine TB to history. World TB Day is an opportunity for people everywhere to be informed about TB, educate others and urge governments to take action. This global movement will make a powerful statement and show solidarity for people who have been affected by TB.

Infection with the TB bacteria may not always develop into TB disease; it can also result in latent (sleeping) TB and become active TB later in life. Free testing and treatment of latent TB is available in England for persons from areas where TB is common. A new animated film will be launched on World TB day to raise awareness about this.

When TB disease does develop, the vast majority of cases are curable with a 6-month course of specific antibiotics. Testing and treatment for TB are free and can be easily accessed from a GP.

TB is an infectious disease that usually affects the lungs, but can affect other parts of the body such as the lymph nodes (glands), the bones and the brain and can lead to serious complications. The most common symptoms of TB are a persistent cough for more than 3 weeks, unexplained weight loss, fever and night sweats.

TB is difficult to catch and you need to spend many hours in close contact with a person with infectious TB to be at risk of infection. Although TB can be fatal if left untreated, it is curable for the vast majority of people with a course of antibiotics.

Background

For further information on TB visit the NHS Choices website. For more information on TB reduction targets visit Collaborative TB Strategy for England.

For further information about World TB Day visit:

The full annual TB report from PHE will be published in September 2018.

Buildings being illuminated in red for World TB Day

Buildings and date building to be lit:

23 and 24 March 2018

‘The Curve’ Building in Slough

23, 24 and 25 March 2018

Wilkins building - University College, London

24 March 2018

Bridge Street, Peterborough Christchurch pedestrian bridge, Reading Godiva statue and Broadgate, Coventry City Hall, Fountains Park and City Railway Station, Bradford City Park, Mirror Pool and Fountains, Bradford Margaret McMillan Tower, Council offices in Prince’s Way, Bradford Civic Hall and Town Hall, Leeds Illuminated telephone kiosks and bus shelters, Leeds Batley Town Hall, Kirklees Castle Hill monument, Huddersfield

25 March 2018

Portsmouth Spinnaker Tower, 6pm to midnight



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Official Statistics: Tuberculosis (TB) in England: ad hoc provisional data

This ad hoc statistical publication presents a provisional release of tuberculosis (TB) case notifications and rates in England for 2017.

Data for 2000 to 2016 was previously published in the Tuberculosis in England 2017 annual report.

Although data for 2017 is provisional and subject to revision, we are releasing the figures on World TB Day for the purpose of informing the ongoing work to implement the Collaborative TB Strategy for England 2015 to 2020.

We will publish the full analysis for the period 2000 to 2017 in the Tuberculosis in England 2018 annual report in September 2018.



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Thursday, 22 March 2018

Corporate report: PHE stakeholder research: 2017 to 2018

Public Health England (PHE) commissioned Ipsos MORI to carry out its annual stakeholder research, seeking the views and perspectives of leading stakeholders on:

  • their working relationships with PHE
  • our priorities, ambitions and impact
  • expectations of us now and in the future
  • how we can improve what we do and how we work with stakeholders

The results give valuable reflections of the progress of PHE’s relationships and provide useful insight of how we can build on progress to date.

For further information about the research, contact Louise Park: Louise.Park@ipsos.com or Joanna Barry: Joanna.Barry@ipsos.com.



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Guidance: The Prioritisation Framework: making the most of your budget

Local public health teams are facing increasingly complex and challenging decisions over what services to invest in and disinvest from. The Prioritisation Framework is designed to help local authorities conduct a systematic prioritisation exercise, by greatly reducing the burden and complexity of the task.

The approach is based on Multi Criteria Decision Analysis, a recognised decision support technique which has been successfully used in a variety of contexts.

Throughout the tool users are provided with extensive guidance and links to other relevant resources. A supporting materials pack is available from the PHE Health Economics team at healtheconomics@phe.gov.uk.

Additional PHE Centre support for local authorities using the Prioritisation Framework will be launched, starting with East Midlands, North East, Yorkshire and Humber and North West. Interested teams within those areas should contact their PHE Centres for further details.



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News story: PHE publishes water fluoridation health monitoring report

Public Health England (PHE) has today published its Water fluoridation: health monitoring in England 2018 report on behalf of the Secretary of State for Health and Social Care.

Public Health England (PHE) has a duty under the Water Industry Act 1991 to monitor the effects of fluoride on people living in areas covered by water fluoridation schemes on behalf of the Secretary of State. PHE will report on this at least every 4 years.

Today’s is the second such report; the first was published in March 2014. The findings of both the 2014 and 2018 reports are consistent with the view that water fluoridation is an effective and safe public health measure.

Professor John Newton, Director of Health Improvement at PHE, said:

The evidence in this report shows water fluoridation is a safe and effective method to reduce tooth decay, especially among deprived communities. We would encourage local authorities to consider this evidence carefully when deciding on their plans to improve dental health in their areas.

The report found:

  • 5-year-olds in areas with water fluoridation schemes were much less likely to experience tooth decay, and less likely to experience more severe decay than in areas without schemes

  • the chances of having a tooth/teeth removed in hospital because of decay were also much lower in areas with water fluoridation schemes

  • children from all areas benefited from fluoridation, but children from relatively deprived areas benefited the most

  • dental fluorosis, at a level that may affect the appearance of teeth, was observed in 10% of children/young people examined in 2 fluoridated cities; however, there was no difference between children and young people surveyed in fluoridated and non-fluoridated cities when asked about their opinion on the appearance of their teeth, taking into account concerns which have resulted from any cause (for example, poor alignment, decay, trauma or fluorosis)

  • taken alongside the existing wider research, our results do not provide convincing evidence of higher rates of hip fracture, Down’s syndrome, kidney stones, bladder cancer, or osteosarcoma (a cancer of the bone) due to fluoridation schemes

The Water fluoridation: health monitoring report for England 2018 report is available online. The next report will be due by March 2022 at the latest.



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Research and analysis: Water fluoridation: health monitoring report for England 2018

This 2018 monitoring report compares data on the health of people living in areas of England with enhanced levels of fluoride in their drinking water supply.

Public Health England (PHE) has a legal duty to monitor the effects of water fluoridation schemes on dental health and report on it every 4 years.

The 2014 report is also available online.



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Tuesday, 20 March 2018

Research and analysis: Child health profiles: summary of feedback exercise

We carry out regular user engagement activities to make sure the child health profiles continue to meet the changing needs of stakeholders. This includes carrying out a user survey every two years.

This report summarises the results and planned actions following the latest 2017 survey of child health profile users.

The survey was available between 9 August and 29 September 2017 via a link on the child and maternal health section of Fingertips.



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Research and analysis: HIV: North East annual data spotlight

HIV remains an important public health problem in the North East. The focus should continue on increasing testing and improving HIV treatment, and testing all newly diagnosed patients for recent transmission.



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Consultation: UK SMI TP 1: Example reference strains for UK SMI Test Procedures

Public Health England has opened a consultation this week in joint partnership with professional organisations.

This consultation asks for feedback in relation to the Standards for Microbiology Investigations TP 1: Example reference strains for UK Standards for Microbiology Investigations test procedures.

We have refined the process so that UK SMI users can comment more easily if they see no requirement for amendments to the document out for consultation.

This information is as important to the consultation process as comments.

Use this form to provide comments or amendments for TP 1

Use this form if you have no amendments for TP 1



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Consultation: UK SMI TP 2: Aesculin hydrolysis test

Public Health England has opened a consultation this week in joint partnership with professional organisations.

This consultation asks for feedback in relation to the Standards for Microbiology Investigations TP 2: Aesculin hydrolysis test.

We have refined the process so that UK SMI users can comment more easily if they see no requirement for amendments to the document out for consultation.

This information is as important to the consultation process as comments.

Use this form to provide comments or amendments for TP 2

Use this form if you have no amendments for TP 2



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Consultation: UK SMI TP 3: Agglutination test for Salmonella species

Public Health England has opened a consultation this week in joint partnership with professional organisations.

This consultation asks for feedback in relation to the Standards for Microbiology Investigations TP 3: Agglutination test for Salmonella species.

We have refined the process so that UK SMI users can comment more easily if they see no requirement for amendments to the document out for consultation.

This information is as important to the consultation process as comments.

Use this form to provide comments or amendments for TP 3

Use this form if you have no amendments for TP 3



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Monday, 19 March 2018

Policy paper: Improving health and care through the home: MoU

This renewed memorandum of understanding (MoU) has been signed by over 25 government bodies and organisations in the health, social care and housing sector. It sets out:

  • our shared commitment to joint action across government, health, social care and housing sectors in England

  • principles for joint working for better health and wellbeing outcomes, and to reduce health inequalities

  • a framework for national and local cross-sector partnerships to provide healthy homes, communities and neighbourhoods

  • conditions for developing integrated and effective services to meet the needs of individuals, carers and families with a range of local stakeholders

  • what shared success might look like

The organisations signed up to this MoU are:

  • Alzheimer’s Society
  • Association of Directors of Adult Social Services (ADASS)
  • Association of Directors of Public Health (ADPH)
  • Building Research Establishment (BRE)
  • Care & Repair England
  • Chartered Institute of Environmental Health (CIEH)
  • Chartered Institute of Housing (CIH)
  • Department of Health and Social Care
  • Foundations
  • Homeless Link
  • Homes England (formerly Homes and Communities Agency)
  • Housing Associations’ Charitable Trust (HACT)
  • Housing Learning and Improvement Network (Housing LIN)
  • Local Government Association (LGA)
  • Ministry of Housing, Communities and Local Government (MHCLG)
  • National Housing Federation (NHF)
  • (New) NHS Alliance
  • NHS England
  • NHS Property Services (PropCo)
  • NHS Providers (formerly Foundation Trust Network)
  • Public Health England (PHE)
  • Royal College of Occupational Therapists (RCOT)
  • Royal Society for Public Health (RSPH)
  • Royal Town Planning Institute (RTPI)
  • Skills for Care
  • St Mungo’s


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Friday, 16 March 2018

Press release: PHE publishes latest data on nation’s diet

The figures from the latest National Diet and Nutrition Survey (NDNS) collected from 2014 to 2016 show:

  • sugar makes up 13.5% of 4- to 10-year-olds, and 14.1% of teenagers’ (11- to 18-year-olds) daily calorie intake respectively; the official recommendation is to limit sugar to no more than 5%
  • 4- to 10-year-olds consume two thirds of the amount of sugary drinks they did 8 years ago – down from 130g per day in 2008 to 2010 to 83g in 2014 to 2016
  • for teenagers, sugary drink intake is more than double that of younger children (191g) even though consumption has decreased by 30%; sugary drinks remain the main source of sugar (22%) in their diets

The survey confirms the UK population continues to consume too much saturated fat and not enough fruit, vegetables, and fibre:

  • average saturated fat intake for adults (19 to 64 year olds) is 12.5% of daily calorie intake, above the 11% recommended maximum
  • adults consume on average 4.2 portions of fruit and vegetables per day, 65- to 74-year-olds consume 4.3 portions and teenagers consume just 2.7 portions per day
  • only 31% of adults, 32% of 65- to 74-year-olds and 8% of teenagers meet the 5 A Day recommendation for fruit and vegetables
  • average fibre intake in adults is 19g per day, well below the recommended 30g per day

Dr Alison Tedstone, chief nutritionist at PHE, said:

Poor diets are all too common in this country and, along with obesity, are now one of the leading causes of disease such as cancer, heart disease and type 2 diabetes. It’s clear from these data that the nation’s diet needs an overhaul.

A healthy balanced diet is the foundation to good health. Eating 5 A Day and reducing our intake of calories, sugar, and saturated fat is what many of us need to do to reduce the risk of long term health problems.

The data underscores PHE’s call for the population to follow a healthy balanced diet, based on the Eatwell Guide, which includes eating at least 5 portions of a variety of fruit and vegetables per day, increasing consumption of oily fish and fibre and limiting the amount food high in saturated fat, sugar and salt.

Following a healthy, balanced diet and reducing calories will help reduce obesity and the economic and social burden of its consequences.

Public Health England press office

Background

  1. The NDNS rolling programme is a continuous cross-sectional survey, designed to assess the diet, nutrient intake and nutritional status of a representative sample of around 1,000 people per year (500 adults and 500 children) from the general population aged 18 months upwards living in private households in the UK. The NDNS comprises an interview, a 4-day diet diary and collection and analysis of blood and urine samples. Results are used by government to monitor the diet and nutritional status of the population, to provide the evidence base for policy development and to track progress towards public health nutrition objectives such as reducing sugar, saturated fat and salt intakes. This report covers data collected over a 2-year period – from year 2014 to 2015 to year 2015 to 2016.

  2. Work to deliver years 7 and 8 of the NDNS rolling programme was carried out by NatCen Social Research and the Medical Research Council Elsie Widdowson Laboratory (formerly known as MRC Human Nutrition Research).

  3. The last NDNS report covering years 5 and 6, (2012 to 2013; 2013 to 2014) was published in 2016.

  4. Reference to poor diets being one of the leading causes of disease: Newton JN et al (2014) - Changes in health in England, with analysis by English regions and areas of deprivation, 1990 to 2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 386(10010):2257-74.

  5. The Scientific Advisory Committee on Nutrition (SACN) advice is to limit free sugars to no more than 5% of daily calorie intake:

  • adults should have no more than 30g of free sugars a day, (roughly equivalent to seven sugar cubes)
  • children aged 7 to 10 should have no more than 24g of free sugars a day (six sugar cubes)
  • children aged 4 to 6 should have no more than 19g of free sugars a day (five sugar cubes)
  • there is no guideline limit for children under the age of 4, but it’s recommended they avoid sugar-sweetened drinks and food with sugar added to it

Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. We do this through world-leading science, knowledge and intelligence, advocacy, partnerships and providing specialist public health services. We are an executive agency of the Department of Health and Social Care, and a distinct organisation with operational autonomy. We provide government, local government, the NHS, Parliament, industry and the public with evidence-based professional, scientific expertise and support. Follow us on Twitter: @PHE_uk and Facebook: www.facebook.com/PublicHealthEngland.



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Official Statistics: Children living with parents in emotional distress: 2010 to 2016

Public Health England has published an update to four indicators reporting on the ‘proportion of children living with’:

  • at least one parent reporting symptoms of emotional distress
  • a mother reporting symptoms of emotional distress
  • a father reporting symptoms of emotional distress
  • both parents reporting symptoms of emotional distress

Data is up to 2010 to 2016 and is by family type and work status. These indicators were published previously by the Department of Work and Pensions (DWP).



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Official Statistics: NDNS: results from years 7 and 8 (combined)

The National Diet and Nutrition Survey (NDNS) rolling programme is a continuous, cross-sectional survey. It is designed to collect detailed, quantitative information on the food consumption, nutrient intake and nutritional status of the general population aged 1.5 years and over living in private households in the UK. The survey covers a representative sample of around 1000 people per year. Fieldwork began in 2008 and is now beginning its eleventh year.

Public Health England (PHE) and the UK Food Standards Agency (FSA) jointly fund the UK NDNS. Under the contract for years 6 to 10, government bodies in Wales and Northern Ireland have funded additional recruitment in their countries to allow them to report their own results.

The contract for years 6 to 10 was delivered by NatCen Social Research, working with the Medical Research Council (MRC) Elsie Widdowson Laboratory (formerly known as MRC Human Nutrition Research).

A contract to deliver years 11 to 14 of the rolling programme (2018 to 2019 up to 2021 to 2022) has been awarded to NatCen Social Research working with the MRC Epidemiology Unit at the University of Cambridge.

NDNS provides essential evidence on the diet and nutrition of the UK population to enable PHE to identify and address nutritional issues in the population and monitor progress towards public health nutrition objectives.



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Thursday, 15 March 2018

News story: Yellow fever reported in traveller returning from Brazil

We are aware of a traveller who has returned from Brazil with yellow fever. Yellow fever does not pass from person to person, you usually only get infected by being bitten by a mosquito that carries the virus. Such mosquitoes are not found in the UK and so there is no risk to public health here.

There is a risk of yellow fever transmission in parts of the tropical and sub-tropical regions of Africa and South and Central America (including Trinidad). It does not occur in the UK, Europe, Asia, Australia, New Zealand or the Pacific Islands.

A highly effective vaccine is available for people travelling to areas where yellow fever transmission is reported or where yellow fever vaccination is a condition of entry under the International Health Regulations (2005). Vaccines should be administered at least 10 days prior to travel and provides lifelong protection. The vaccine can only be administered in registered yellow fever vaccination centres; a list of yellow fever vaccination centres in England, Wales and Northern Ireland is available on the Yellow Fever Zone website. For travellers in Scotland, details of centres can be found on the Health Protection Scotland website.

If you’re travelling to an area where yellow fever transmission is reported, you should try to avoid mosquito bites, even if you’ve been vaccinated. This includes wearing loose-fitting clothing with long sleeves and trousers; wearing insect repellent on exposed areas of the skin, and using mosquito nets while sleeping. Mosquitoes can also spread other serious illnesses, such as malaria, dengue, chikungunya and Zika.

There has been a surge of human cases of yellow fever in Brazil since December 2017. Other cases of yellow fever in unvaccinated travellers who travelled to risk areas in Brazil have also been reported recently. This resurgence of yellow fever virus circulation in Brazil highlights the importance of seeking pre-travel advice and, if appropriate, vaccination before travelling to Brazil even if you didn’t need vaccine previously.

If you have recently returned from Brazil and have any symptoms, such as fever or flu-like illness, you should seek medical advice and make sure your doctor knows your travel history.



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Wednesday, 14 March 2018

Guidance: Obstetrics and gynaecology: exposure prone procedure categories

The UK Advisory Panel for Healthcare Workers Infected with Bloodborne Viruses (UKAP) specialist obstetrics and gynaecology working group have compiled a list of exposure prone procedures (EPPs) and non-EPPs carried out in obstetrics and gynaecology.

Each procedure has been categorised into the level of risk of bleed-back (EPP level 0 to 3) where injury to the healthcare worker (HCW) could result in the worker’s blood contaminating a patient’s open tissues and subsequent BBV transmission occurring from the HCW to the patient.

This list is not exhaustive of all procedures carried out in obstetrics and gynaecology, but is to be used as a guide only (namely for EPP clearance in occupational health settings and patient look-backs).



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Tuesday, 13 March 2018

Press release: Four in 10 smokers incorrectly think nicotine causes cancer

Over 58% of smokers still try to quit without using an aid and going ‘cold turkey’ despite this being the least effective way. A Public Health England (PHE) report highlights that public misunderstanding of the harmfulness of nicotine containing products, such as nicotine replacement therapy (NRT) and e-cigarettes, may be linked to inaccurate and confused perception of the risks of nicotine.

The risks of nicotine use are likely to be very low or negligible. NRT is safe and licenced for use in pregnancy and for people with cardiovascular disease. And there is now wide international consensus that e-cigarettes are far less harmful than smoking. It is the cocktail of deadly chemicals in cigarette smoke, including tar and carbon monoxide, which causes almost all of the harm of smoking.

Four in 10 smokers and ex-smokers incorrectly think that nicotine in cigarettes is the cause of most of the smoking-related cancer. Understanding of the harms of nicotine among the general population is similarly poor. In 2017:

  • only 7.5% thought that none or a very small part of the risk of smoking comes from nicotine
  • 14% thought that it was nearly all the risk
  • almost a quarter (24.2%) of the population didn’t know

The use of quit aids can greatly increase your chances of quitting successfully. Research shows that:

  • using NRT as a quit aid, such as patches and gums, or e-cigarettes makes it one and a half times as likely you’ll succeed
  • your chances of quitting are doubled if using a stop smoking medicine prescribed by a GP, pharmacist or other health professional
  • expert support from a local stop smoking service gives you the best chance of quitting successfully
  • combining quit aids with expert support makes it four times as likely you’ll stop smoking successfully

Professor John Newton, Director of Health Improvement at PHE said:

Misunderstanding about the risks from nicotine may be deterring smokers from using quit aids such as e-cigarettes or nicotine replacement therapies like patches and gums.

Nicotine is addictive but it’s the many thousands of chemicals in tobacco smoke that are responsible for almost all of the harm caused by smoking. Using nicotine quit aids helps manage cravings and can be one of the solutions to helping you stop for good. Going ‘cold turkey’ is not recommended as it’s the least successful way.

To get the most benefit, make sure you use as much nicotine replacement as you need, and for as long as you need, as this will help you stop smoking and stay smokefree. Combining quit aids with support from a stop smoking service gives the best success rates. With the wide range of aids now available, there’s never been a better time to stop.

PHE has been supporting all NHS trusts across the country to do all they can to become truly smokefree. The government and NHS England have both made commitments to a smokefree NHS, in the latest tobacco control plan and the NHS five year forward view.

Professor Newton comments:

For a truly smokefree NHS to become a reality, our emphasis is to support hospitals shift their efforts away from simply ‘enforcing’ no smoking towards offering on-going support to help smokers stop for good, including encouraging them to use quit aids.

Smoking rates are at their lowest ever level (15.5% of the adult population), but there are still nearly 7 million smokers in England. Smoking kills 79,000 people in England every year and for every death another 20 smokers are suffering from a smoking-related disease.

Background

For further information or interview bids contact:

Public Health England press office

NHS Smokefree

Visit the NHS Smokefree site for support and advice on quitting smoking.

PHE’s e-cigarette evidence review

Read the annual update of PHE’s e-cigarette evidence review by leading independent tobacco experts.

Smoking prevalence figures

In 2016, 15.5% of adults aged 18 and over in England currently smoke, down from 19.9% in 2010. In 2000, 26.8% of adults aged 16 and over were smokers. Prevalence since 2010 has fallen most in younger age groups according to Statistics on Smoking, England 2017.

PHE’s Tobacco Control Profiles

For local smoking prevalence figures and additional local data see Local Tobacco Control Profiles.

Costs of smoking

The total cost from smoking to society in England is approximately £14.7 billion a year. This includes the cost to the NHS of treating diseases caused by smoking which is approximately £2.5 billion a year.

Source: ASH: The Local Cost of Tobacco – ASH Ready Reckoner and Towards a Smokefree Generation: A Tobacco Control Plan for England.

Tobacco Control Plan for England

The government’s new Tobacco Control Plan sets a series of challenging ambitions:

  • reduce adult smoking rates from 15.5% to 12% or less
  • reduce the prevalence of 15 year olds who regularly smoke from 8% to 3% or less
  • reduce the prevalence of smoking in pregnancy from 10.7% to 6% or less

Public Health England

Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. We do this through world-leading science, knowledge and intelligence, advocacy, partnerships and providing specialist public health services. We are an executive agency of the Department of Health and Social Care, and a distinct organisation with operational autonomy. We provide government, local government, the NHS, Parliament, industry and the public with evidence-based professional, scientific expertise and support. Follow us on Twitter: @PHE_uk and Facebook: www.facebook.com/PublicHealthEngland.



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Promotional material: Breast screening for women over 70

Women over the age of 70 don’t receive routine breast screening invitations, but are still entitled to screening every 3 years. This leaflet explains how older women can continue to have free NHS breast screening by contacting their local breast screening unit.



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Monday, 12 March 2018

Guidance: Criminal justice interventions teams (CJIT) business definitions

This document contains business definitions for criminal justice interventions teams to use when collecting and submitting data to the NDTMS.

It’s part of a collection of documents that support the reporting requirements for the NDTMS dataset.



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Press release: PHE scientists lead science workshops for 1,800 pupils

As part of this year’s British Science Week, 1,800 pupils from 10 schools across England are being given the opportunity to take part in interactive science workshops hosted by Public Health England (PHE) scientists.

From pupils extracting DNA from their own cells using household products, to a science and health-related game of Pictionary and quizzes on air pollution, the aim of these workshops is to inspire the young people to consider a career in science and showcase the variety of areas within science they could pursue.

British Science Week is an annual 10-day event, with this year being its 24th year running. It encourages organisations, professionals in the science sector, science communicators and the general public to hold events that get people involved in scientific activities.

This year, PHE is expanding its reach to 10 schools across 3 regions: the North (Manchester, Salford), South West (Bristol, Cheltenham and Torquay) and South East (Harlow). During the week, there will be 25 PHE scientists leading interactive science workshops for pupils aged 13 to 14 years old.

The scientists taking part specialise in a range of disciplines, including toxicology, microbiology, environmental public health, microscopy, vaccine research and epidemiology.

Duncan Selbie, Chief Executive of PHE said:

It’s important that the current generation of scientists informs and inspires the next generation, and shows young people the range of routes and opportunities they can pursue within world-leading UK science. We are thankful for the scientists taking part in British Science Week workshops across the country, and hope that their efforts encourage the pupils to consider a career in science as a viable and exciting option.

Sarah Robertson, Senior Environmental Health Scientist at PHE said:

I speak for all of the scientists involved when I say that we are excited to take part in British Science Week and showcase just a few of the many disciplines within science to the students. Although a large proportion of our time is dedicated to research, outreach work such as these interactive workshops is also our responsibility, particularly to highlight the breadth of our roles to young people. Science and research are imperative in our world and we must ensure that the future workforce continues to be made up of talented and passionate individuals.

PHE is in the process of creating a world-leading centre of excellence for public health research, improvement and protection, and a new headquarters, at the vacant GlaxoSmithKline site in Harlow. This will involve relocating facilities from Porton in Wiltshire and Colindale in north London, as well as the current central London headquarters. PHE Harlow is expected to be fully operational by 2024.

Public Health England press office

Background

  1. British Science Week is an annual event and in 2018 takes place between 9 to 18 March.
  2. Schools attending the sessions are:
    • Burnt Mill Academy
    • Forest Hall School
    • Mark Hall Academy
    • Stewards Academy
    • Passmores Academy
    • Torquay Academy
    • Fairfield School
    • All Saints’ Academy
    • All Hallows R.C. High School
    • Walkden High School
  3. Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. We do this through world-leading science, knowledge and intelligence, advocacy, partnerships and providing specialist public health services. We are an executive agency of the Department of Health and Social Care, and a distinct organisation with operational autonomy. We provide government, local government, the NHS, Parliament, industry and the public with evidence-based professional, scientific expertise and support. Follow us on Twitter: @PHE_uk and Facebook: www.facebook.com/PublicHealthEngland.


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Sunday, 11 March 2018

Guidance: Public health advice following Salisbury nerve agent incident

The advice in this guidance document is for those who visited:

  • the Mill pub in Salisbury between 1.30pm on Sunday 4 March and 11.10pm on Monday 5 March 2018
  • the nearby Zizzi restaurant between 1.30pm on Sunday 4 March and 9pm on Monday 5 March 2018


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Friday, 9 March 2018

Research and analysis: Salmonella and shigella infections from faecal specimens in England and Wales: laboratory reports 2018

For previous years’ salmonella data, see the laboratory reports 2017.



from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/salmonella-and-shigella-infections-from-faecal-specimens-in-england-and-wales-laboratory-reports-2018
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Guidance: Supporting the public health nursing workforce: employer guidance

This guidance is for all employers of health visiting and school nursing teams to help support recruitment and retention of health visitors and school nurses, to sustain the quality and consistency of local services.

This guidance should be read in conjunction with the Standards for Employers of Public Health Teams in England. This document provides additional specific guidance on health visiting and school nursing services.

It has been developed by Public Health England in partnership with the Local Government Association to help employers support an effective workforce to sustain high-quality outcomes for children, young people, families, carers and local communities.



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Thursday, 8 March 2018

Guidance: Best start in life: cost-effective commissioning

The return on investment tool pulls together evidence on the effectiveness and associated costs for a number of interventions aimed at providing children with the best start in life.

The interactive resource allows results to be tailored to local situations based on the knowledge of the user. The tool is accompanied by a report providing further details on how the tool was constructed.

Local authorities and clinical commissioning groups can use results from the tool to protect and improve the health of their local populations when making commissioning decisions.



from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/best-start-in-life-cost-effective-commissioning
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Guidance: Women in prison: standards to improve health and wellbeing

The standards set out evidence-based good practice in addressing the health and wellbeing needs of women in prison.

They are designed to complement existing national and international health standards and guidance for women in prison.

The standards have been developed from a literature review of current evidence and reviewed through consultation with national and international experts.



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Guidance: Weight management interventions: standard evaluation framework

This document is an update of the ‘Standard Evaluation Framework (SEF) for weight management interventions’, (2009) which was originally published by the National Obesity Observatory, and is now widely used across England.

It has been updated as a result of feedback from practitioners in the field following a consultation exercise, and to provide support for the Weight management: guidance for commissioners and providers collection.



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Guidance: Bowel cancer screening programme: standards

These documents present the national screening standards for the NHS bowel cancer screening programme (BCSP).

The most recent standards apply to data collected from 1 April 2018. They replace previous versions.



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Wednesday, 7 March 2018

News story: Public Health England statement regarding events in Salisbury

Paul Cosford, Medical Director and Director of Health Protection at Public Health England (PHE) said:

All known first responders have been contacted through their organisations and encouraged to seek further advice should they experience any symptoms. The sites recently visited by the 2 people affected have all been secured and PHE is reminding local clinicians of the symptoms to look out for.

Based on current evidence, the risk to the wider public is low and it is likely that, had any member of the public been exposed to the substance, they would have presented with symptoms by now. However, anyone who was in the area and is concerned because they feel unwell, should dial 111 or 999 depending on the severity of their symptoms.



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Guidance: Breast screening: Fujifilm AMULET Innovality DBT system

This report describes the evaluation of the technical performance of of the Fujifilm AMULET Innovality digital breast tomosynthesis system. It includes information about:

  • dose
  • contrast detail detection
  • contrast-to-noise ratio (CNR)
  • reconstruction artefacts, z-resolution
  • detector response
  • projection modulation transfer function


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Tuesday, 6 March 2018

Guidance: NHS population screening: glossary of terms

This provides a single glossary of common terms and is linked to from our other publications, including the key performance indicator definitions and screening standards.



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Official Statistics: Dementia Profile: March 2018 data update

The Dementia Profile is designed to improve the availability and accessibility of information on dementia. The data are presented in an interactive tool that allows users to view and analyse them in a user-friendly format.

The profile provides a snapshot of dementia care, broken down by geographical area, to help local government and health services improve dementia care.

A statistical commentary has also been produced which provides a summary of what is new in this release.

View the Dementia Profile.



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Official Statistics: 2018 child health profiles

Annual update of data in the child health profiles interactive tool.

The profiles draw together information to present a picture of child health and wellbeing in each local area in a user-friendly format.

Those working in local government and health services can use the profiles as a tool to help:

  • understand the needs of their communities
  • improve the health and wellbeing of children and young people
  • reduce health inequalities

Due to delays in receiving the source data, we will publish the 2018 child health profiles pdf reports at a later date (provisionally in June 2018).



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Monday, 5 March 2018

News story: Plans to cut excess calorie consumption unveiled

Major steps to cut people’s excessive calorie intake have been unveiled by Public Health England (PHE) and the Department of Health and Social Care (DHSC), as part of the government’s strategy to cut childhood and adult obesity.

The package includes:

  • new evidence highlighting overweight or obese boys and girls consume up to 500 and 290 calories too many each day respectively
  • a challenge to the food industry to reduce calories in products consumed by families by 20% by 2024
  • the launch of the latest One You campaign, encouraging adults to consume 400 calories at breakfast, and 600 for lunch and dinner. This comes as adults consume 200 to 300 calories in excess each day

Too many children and most adults are overweight or obese, suffering consequences from bullying and low self-esteem in childhood, to type 2 diabetes, heart disease and some cancers as adults. An obese parent is more likely to have an obese child, who in turn is more likely to grow up into an obese adult.

Obesity affects us all, as it is a burden on the NHS and local authorities. The NHS spends around £6 billion a year treating obesity-related conditions. Obesity-related health problems also keep people out of work, stifling their earnings and wider economic productivity.

The government’s challenge to the food industry is set out in Calorie reduction: the scope and ambition for action, published today, Tuesday 6 March 2018, by PHE. As with the sugar reduction programme, the industry has 3 ways to reduce calories:

  • change the recipe of products
  • reduce portion size
  • encourage consumers to purchase lower calorie products

Categories of food covered by the programme include pizzas, ready meals, ready-made sandwiches, meat products and savoury snacks.

If the 20% target is met within 5 years, more than 35,000 premature deaths could be prevented and around £9 billion in NHS healthcare and social care costs could be saved over a 25 year period.

The report also includes new data on children’s daily calorie consumption. Depending on their age, overweight and obese boys consume between 140 to 500 calories too many each day and for girls, it is 160 to 290 when compared to those with healthy body weights. Adults consume on average 200 to 300 calories too many each day.

Duncan Selbie, Chief Executive of PHE, said:

The simple truth is on average we need to eat less. Children and adults routinely eat too many calories and it’s why so many are overweight or obese.

Industry can help families by finding innovative ways to lower the calories in the food we all enjoy and promoting UK business leadership on the world stage in tackling obesity.

Steve Brine MP, Public Health and Social Care Minister, said:

There can be no doubt that obesity is now one of our greatest challenges - one that is fuelling an epidemic of preventable illnesses like type 2 diabetes and cancer. These not only shorten lives but put unsustainable pressure on our health service.

We have a responsibility to act, which is why we are supporting families to make the healthy choice. Our calorie reduction programme – the first of its kind from any country in the world – will continue to build on the progress of our world-leading childhood obesity plan, which has led to positive steps by industry.

The latest One You campaign aims to support people to be more calorie-aware when they are out and about with its simple tip 400-600-600. Aim for 400 calories at breakfast, and 600 for lunch and dinner. Major high street brands are partnering with PHE on the campaign, signposting to meals that meet the 400-600-600 tip. Total daily calorie intake recommendations remain at 2,000 for women and 2,500 for men.

Dr Alison Tedstone, chief nutritionist at PHE, said:

It’s hard for people to make healthy food choices, whether for themselves or their families. That’s why we are challenging the food industry to take 20% of the calories out of everyday foods, building on their good work on salt and promising announcements on sugar.

We are also working through our campaign and its partners, to give the public the information they need to help make those choices easier.

The 20% reduction target is the result of analysis of the new calorie consumption data, experience of sugar and salt reduction programmes, and more than 20 meetings with the food industry and stakeholders.

The next step in the programme involves engagement with the whole food industry such as retailers, manufacturers, major restaurant, café, takeaway, and delivery companies, and health and charity sectors, to develop category guidelines. These will be published in mid-2019.

Background

For further information on the calorie reduction programme and One You nutrition campaign please contact:

Razeeb Ahasan 020 3682 0093 Jamie Mills 020 7654 8039

Public Health England press office



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Research and analysis: Calorie reduction: the scope and ambition for action

This report sets out the evidence on children’s calorie consumption and the details of the calorie reduction programme.

In terms of the evidence the report includes details of:

  • recommendations around calorie intakes, sources of calories and reported levels of intake
  • calculated estimates for daily energy intakes and excess calories consumed by children and adults
  • evidence on reformulation and portion size reduction; and public perceptions and attitudes to calories
  • estimated health economic benefits of a calorie reduction programme

For the calorie reduction programme, the reports sets out:

  • the overall ambition and structure of the programme
  • the food categories included
  • suggested mechanisms for action
  • timeline and next steps for PHE


from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/calorie-reduction-the-scope-and-ambition-for-action
via IFTTT

source https://tennissurfacingspecifications.tumblr.com/post/171572264299

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