The fourth in this series of articles continues to explore investment issues affecting children that have, by and large, been neglected by responsible investors. Whilst the issues themselves may have been addressed, their relevance to an oft neglected constituency – children and young people – requires, in our view far more attention. This article, the second of three ‘deep dives’, concentrates on health and wellness, and how investors can be a focus for engagement around two material themes; the obesity crisis in mature economies, and malnutrition in developing ones.
Obesity is complex and global and represents an acute public health risk that reduces life expectancy and life chances as well as aggravating the likelihood of contracting chronic illnesses such as type 2 diabetes, respiratory disease, cardio-vascular disease and a range of cancers.
A UK Government Obesity Profile published in 20241 suggested around 64% of the adult population is overweight or living with obesity, whilst an NHS Survey2 from the same year, put obesity among the under 18s as 12% of those aged 2-10 and 19% for those aged 11-15. This worrying statistic suggests that unless addressed in the very young (toddlers and infants) the likelihood of the problem spiralling in later adolescence is very great. It’s worth noting that as well as the human cost, obesity related costs to the NHS exceed £6.5bn a year (all age groups) and that whilst obesity manifests itself across all demographics, it is particularly prevalent among more deprived communities and can be linked to other social vulnerabilities such as poor housing and poverty.
It could be argued there is nothing more pressing than driving a progressively improving health & wellness agenda where it concerns young people given the benefit transfers into adult life chances and higher life expectancy. There is clearly a vital public policy role here, and successive governments have played a part in ‘nudging’ behaviour via instruments such as the sugar tax. Introduced in 2018 and applied to drinks with added sugar content up to a certain threshold, this has acted as a product refreshment incentive to manufacturers in order to avoid the tax. The threshold was set at 5g/100ml of product, with a higher rate applied where the added sugar content is over 8g/100ml. The evidence is compelling; between 2015-2019 total sugar content reduced by 35.4% with sales weighted average sugar content reducing by 43.7% to 2.2g/100ml3. Whilst Government is the central actor for public health interventions, investors have a powerful role to play via engagement with food and beverage manufacturers to place product refreshment at the heart of any discussion.
One such area where investors have been instrumental actors in changing behaviour is encouraging food retailers to place ‘sweet treats’ away from the checkout area where impulse buys are more likely. Tesco was the first major food retailer to do this in 2014, however as late as 20234 a survey suggested a quarter of shops visited were ‘flouting’ guidelines around where confectionary, crisps and high-in-salt-content snacks were being positioned in store, suggesting there is still work to do. Investors can engage meaningfully for change across the health spectrum from food and beverage manufacturers to processors, restaurants (particularly on-the-go outlets) and food retailers. A useful investor tool to inform thinking is the ‘Access to Nutrition Index’ (ATNI) which benchmarks company performance across a number of indicators including access to affordable and healthy diets, and at least 50% of sales being derived from ‘healthy’ products. ATNI’s overall mission is to see half of global food sales derived from healthy products by 2030. The latest Index surveys 30 global companies representing 23% of the global food market5. Their overall findings from the 2024 Index suggests that whilst companies are moving faster and further to refashion their products, there is a pressing need to be bolder if global obesity trends are to be checked – for instance Nestlé is shown as deriving 33% of sales from healthy products, compared to Danone’s 70%6. These results provide a template for focused engagement. Worryingly, the Index suggests the crisis of poor dietary health is growing fastest in low to middle income countries, where there is an increasing take up of highly processed diets that are now standard in high income countries. Investors can exert influence here to ensure products sold in low to middle income countries are focused strongly on healthy outcomes, especially where public health policy intervention may be weak or absent.
Finally, the flip side of addressing the health and wellness deficit is malnutrition. Although especially pronounced in low-income countries, it is not exclusively so. In the UK this is an increasing health concern where under-nutrition linked to poverty is being seen in stunted growth and other health related conditions among young children. This is a complex area, but the Food Foundation7 suggests 10% of children in the UK may be living in households linked to extreme food insecurity. Typically, malnutrition is associated with low-income territories where food security may be poor owing to rural poverty or crop failure. ATNI’s third theme is reducing diet-related illness and improving health for all. The Index notes here that whilst adult underweight prevalence has halved between 2000 and 2020, the impacts, especially on poorer economies is brutal in health and economic terms. Investors have a role to play in supporting increasing access to healthier options that are fortified with minerals and vitamins absent from the standard diet. Examples include Nestlé fortifying a range of children’s cereals with zinc, iron, Vitamin A and a number of essential micro-nutrients. Soberly, the Index notes however, that access to affordable options remains poor, with overall product healthiness remaining lowest for products sold in low-income countries.
Health & wellness represents a complex arena of issues for investors, but one that affects children and young people in the most profound way given the impact on future life chances. Food and beverage related companies may represent a material part of any investment portfolio, and for responsible investors, this is an area where maximum engagement and influence can and should be exerted.
July 2025
1 UK Government Obesity Short Statistical Summary 2024 Obesity Profile: short statistical commentary May 2024 - GOV.UK
2 NHS September 2024 NHS England » One in eight toddlers and primary school aged children obese
3 Institute for Government ‘Sugar Tax’ 2022 Sugar tax | Institute for Government
4 Obesity Health Alliance/Food Active Survey reported by The Guardian December 2023 Supermarkets in England ‘blatantly disregarding’ rules over where they place crisps, sweets and fizzy drinks | Health | The Guardian
5 Access to Nutrition Index 2024 www.accesstonutrition.org
6 ATNI ibid
7 Food Foundation 2017 1-Briefing-Malnutrition_vF2.pdf
Online Resources
Access to Nutrition Index www.atni.org
NHS advice Advice for parents of overweight children - NHS and How to help your child gain weight - NHS
