Limit children’s snacks to 100 calories, health body says

Child reaching for a cake

Half of the sugar young children in England consume comes from unhealthy snacks and sweet drinks, figures show.

On average, primary school children have at least three sugary snacks a day, Public Health England found.

This means they can easily consume three times more sugar than the recommended maximum.

PHE has launched a campaign to encourage parents to look for healthier snacks of no more than 100 calories – and to limit them to two a day.

The eight-week Change4Life campaign will offer money-off vouchers towards items including malt loaf, lower-sugar yoghurt and drinks with no added sugar in some supermarkets.

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Children between the ages of four and 10 consumed 51.2% of their sugar from unhealthy snacks, including biscuits, cakes, pastries, buns, sweets, juice and fizzy drinks, PHE’s National Diet and Nutritional Survey found.

Each year children consume, on average, some 400 biscuits, 120 cakes, buns and pastries, 100 portions of sweets, 70 chocolate bars and ice creams and 150 juice drink pouches and cans of fizzy drink, the data shows.

Too much sugar can cause tooth decay and obesity.


Calories in snacks

Image copyright Getty Images
Image caption Manufacturers are being challenged to cut sugar by 20% in their products by 2020
  • An ice cream – about 175 calories
  • A pack of crisps – 190 calories
  • A chocolate bar – 200 calories
  • A pastry – 270 calories

Source: Kantar research group

Snacks containing no more than 100 calories

  • Soreen malt lunchbox loaves (apple, banana or original malt)
  • Petits Filous fromage frais (strawberry and raspberry, strawberry, strawberry and apricot, strawberry and banana)
  • Fruit Shoot hydro water in apple and blackcurrant flavour
  • Fresh or tinned fruit salad
  • Chopped vegetables and lower fat hummus
  • Plain rice cakes or crackers with lower fat cheese
  • Sugar-free jelly
  • One crumpet
  • One scotch pancake

Source: Public Health England


The Change4Life campaign now wants parents to give their children a maximum of two snacks a day containing no more than 100 calories each, not including fruit and vegetables.

The campaign will offer parents special offers on a range of healthier snacks – ones with 100 calories or fewer – at selected supermarkets, Public Health England said.

Healthier suggested snacks include packs of chopped vegetables and fruit, malt loaf, sugar-free jelly, and plain rice crackers.

Public Health England said it had also improved its app that reveals the content of sugar, salt and saturated fat in food and drink.

Lunch box snacks

Dr Alison Tedstone, chief nutritionist at Public Health England, told the BBC she hoped the campaign would help to “empower” parents to make healthier snacking choices for their children.

“If you wander through a supermarket you see many more things being sold as snacks than ever before,” she said.

“What has changed is kids’ lunch boxes are getting full of snacking products. It leads to a lot of calories for lunch.

“Our research showed us that parents appreciated a rule of thumb. They were surprised how much sugar their children were consuming in snacks.”

Justine Roberts, founder of Mumsnet, said: “The volume of sugar kids are getting from snacks and sugary drinks alone is pretty mind blowing, and it can often be difficult to distinguish which snacks are healthy and which aren’t.

“This rule of thumb from Change4Life will help parents make healthier choices, which can only be a good thing.”

Public Health England has previously called on businesses to cut sugar by 20% by 2020, and by 5% in 2017, but experts have questioned how the targets can be enforced.

Taiwan dentist must repay mother for training fees

File photo: Close up of a dentist examining a patient's teeth

Taiwan’s top court has ordered a man to pay his mother almost $1m (£710,000) for raising him and funding his dentistry training.

The mother signed a contract with her son in 1997, when he was 20 years old, stating he would pay her 60% of his monthly income after qualifying.

She took him to court after he refused to pay her for several years.

The son argued it was wrong to demand a financial return for raising a child, but the court ruled the contract valid.

He has been ordered to make back payments, as well as interest, to his mother.

‘Responsibility to provide’

The mother, identified only by her surname Luo, raised both her sons after she and her husband divorced.

Ms Luo said she had spent hundreds of thousands of dollars funding both her sons through dentistry school, but became worried they would be unwilling to care for her in old age.

Subsequently, she signed a contract with both of them stipulating they would pay her a portion of their earnings as repayments for the school fees, up to a total of $1.7m.

The elder son reached an agreement with his mother and settled the contract for a smaller amount, local media report.

However, the younger son, identified by his last name Chu, argued that he was very young when he signed the agreement, and the contract should be considered invalid.

Mr Chu also argued that he had worked in his mother’s dental clinic for years after graduating and had helped her make more than the amount he was now ordered to pay her.

A Supreme Court spokeswoman told the BBC the judges had reached their decision mainly because they thought the contract was valid since the son was an adult when he signed it and was not forced to do so.

Under Taiwan’s civil code, adult offspring have the responsibility to provide for their elderly parents, although most parents do not sue if their children fail to take care of them in old age, the BBC’s Cindy Sui in Taipei reports.

This case is seen as particularly unusual because it involves a parent-child contract, our correspondent adds.

Gaming addiction classified as disorder by WHO

Boys playing video game

Gaming addiction is to be listed as a mental health condition for the first time by the World Health Organisation.

Its 11th International Classification of Diseases (ICD) will include the condition “gaming disorder”.

The draft document describes it as a pattern of persistent or recurrent gaming behaviour so severe that it takes “precedence over other life interests”.

Some countries had already identified it as a major public health issue.

Many, including the UK, have private addiction clinics to “treat” the condition.

The last version of the ICD was completed in 1992, with the new guide due to be published in 2018.

The guide contains codes for diseases, signs and symptoms and is used by doctors and researchers to track and diagnose disease.

It will suggest that abnormal gaming behaviour should be in evidence over a period of at least 12 months “for a diagnosis to be assigned” but added that period might be shortened “if symptoms are severe”.

Symptoms include:

  • impaired control over gaming (frequency, intensity, duration)
  • increased priority given to gaming
  • continuation or escalation of gaming despite negative consequences

Dr Richard Graham, lead technology addiction specialist at the Nightingale Hospital in London, welcomed the decision to recognise the condition.

“It is significant because it creates the opportunity for more specialised services. It puts it on the map as something to take seriously.”

But he added that he would have sympathy for those who do not think the condition should be medicalised.

“It could lead to confused parents whose children are just enthusiastic gamers.”

He said he sees about 50 new cases of digital addiction each year and his criteria is based on whether the activity is affecting basic things such as sleep, eating, socialising and education.

He said one question he asked himself was: “Is the addiction taking up neurological real-estate, dominating thinking and preoccupation?”

Many psychiatrists refer to the Diagnostic and Statistical Manual of Mental Disorders (DSM), the fifth edition of which was published in 2013.

In that, internet gaming disorder is listed as a “condition for further study”, meaning it is not officially recognised.

Lots of countries are grappling with the issue and in South Korea the government has introduced a law banning access for children under 16 from online games between midnight and 06:00.

In Japan, players are alerted if they spend more than a certain amount of time each month playing games and in China, internet giant Tencent has limited the hours that children can play its most popular games.

A recent study from the University of Oxford suggested that, although children spend a lot of time on their screens, they generally managed to intertwine their digital pastimes with daily life.

The research – looking at children aged eight to 18 – found that boys spent longer playing video games than girls.

Researcher Killian Mullan said: “People think that children are addicted to technology and in front of these screens 24/7, to the exclusion of other activities – and we now know that is not the case.”

“Our findings show that technology is being used with and in some cases perhaps to support other activities, like homework for instance, and not pushing them out,” he added.

“Just like we adults do, children spread their digital tech use throughout the day, while doing other things.”

Health secretary Jeremy Hunt sorry as A&Es struggle to cope

Surgery in a hospital

Health Secretary Jeremy Hunt has apologised to patients in England affected by a decision to postpone tens of thousands of operations in January.

Non-urgent treatments had already been cancelled until mid-January, but NHS England said on Tuesday that would now be extended to the end of the month.

It came after hospitals reported they were struggling to cope with the surge in patients being seen since Christmas.

Mr Hunt said it was “absolutely not what I want”.

But he said the move was needed given the pressure hospitals were under.

“This is the busiest week of the year for the NHS.”

And he also said the whole country was grateful for the work NHS staff were putting in working “incredibly long hours through the night, beyond the call of duty in every possible way”.

His thanks were echoed by Prime Minister Theresa May, who also denied the health service was in crisis.

“The NHS has been better prepared for this winter than ever before,” she added.

If you can’t see the NHS Tracker, click or tap here.

Reports have emerged of patients facing long waits for treatment and being stuck on trolleys in corridors, while ambulances are left queuing outside A&E.

It has prompted at least 16 hospitals to declare major incidents – sometimes known as black alerts – which can lead them to divert ambulances elsewhere and call in extra staff.

And some ambulance services have started asking 999 callers with less serious problems to make their own way to hospital so they can prioritise the most life-threatening calls.

Meanwhile, in Scotland there has been a 20% jump in A&E attendances compared with the previous year, prompting an increase in patients waiting over four hours, and in Northern Ireland the Antrim Area Hospital has been forced to bring in St John ambulance volunteers to help with a surge in demand.

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NHS England’s Prof Keith Willett admitted the pressures were severe – the worst he had seen since the 1990s – but said plans were in place.

As well as the cancelling of non-urgent treatments, such as knee and hip replacements, hospitals have been given the green light to put patients on mixed sex wards and to bring GPs into A&E to help deal with patients.

“A crisis is when you haven’t got in place mitigations and you haven’t got a plan to deal with it,” Prof Willett said.

“We’ve gone into this winter in a way we’ve never prepared before.”

Doctor warns of ‘huge tragedy’

But Prof Suzanne Mason, of the Royal College of Emergency Medicine, said the measures were “too little too late” as hospitals simply had no beds free and these treatments would have had to be cancelled anyway.

She added: “Patient safety is being compromised – there’s no doubt about that. When patients are in crowded emergency departments and staff cannot actually move between patients and provide the basic level of care that’s required, then safety is compromised.

“Patients who spend many hours on a trolley – and these are often elderly patients – they are the sickest patients in our department.

“They are much more likely to have a poorer outcome and even die as a result of their experience in the emergency department. And that is a huge tragedy for us in our specialty and that’s why we are so desperate to see things improve.”

Reports have emerged of serious problems in a number of places over the past 24 hours:

  • Nottingham’s Queen’s Medical Centre has asked patients to avoid its A&E after being deluged on Tuesday evening
  • Southend Hospital said it was dealing with an “internal critical incident” with all its beds full, which has led them to call in extra staff
  • A consultant at University Hospitals of North Midlands NHS Trust apologised for “third world conditions” in his hospital department
  • Milton Keynes University Hospital is telling people only to attend for emergency treatment
  • Two ambulance trusts in the east and north-east of England are on the highest alert
  • A concentration of major incidents declared at hospitals across the West Country and South East

Doctors and nurses have also been speaking about their own experiences.

Dr Adrian Harrop, an A&E doctor at Scarborough Hospital, said he felt he was “fighting a losing battle” as he was not able to do his job properly and care for his patients in the way he wanted.

Meanwhile, Mark Nevison, a senior nurse in the north-east, tweeted he had worked in A&E for 10 years and had “never been so ashamed of the sub-standard care” now being offered.

Why has this happened now?

The first week of the year is always difficult.

The lack of availability of community services, such as GPs, over the festive period means hospitals tend to see a surge in really sick patients at the turn of the year.

Respiratory illnesses also tend to spike after families have been mixing over Christmas bringing frailer older relatives in contact with young family members, increasing the risk of infections being passed on.

But it is also true to say that this is part of a pattern. Last January was the worst in a generation and that followed the previous worst the year before.

Labour shadow health secretary Jonathan Ashworth has blamed this on “Tory underfunding”.

The health service is in the middle of its toughest cash settlement since it was created.

How bad is the situation?

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It is very hard to tell. The performance stats – covering waits in A&E, the number of ambulances queuing outside A&E and the amount of operations that have been cancelled – will not be known for a few weeks.

In the lead-up to Christmas, all the indications were that the NHS was in as bad a position as it was the previous winter.

Twice as many patients as there should have been were waiting for more than four hours in A&E, while bed occupancy rates were well above safe levels.

But last winter the really bad spell only lasted a couple of weeks before the pressure eased.

What should patients do?

The public are being urged to play their part by using the health service responsibly.

NHS England said calling 111 was often a quicker and more convenient way of obtaining clinical assessment and advice in non-emergencies and allowed staff in A&E to focus on the sickest patients.

The Royal College of GPs has also set out three basic steps that all patients should consider before seeking an appointment with their GP for an acute illness including self-care, using online guidance from NHS Choices and consulting with a pharmacist.