Once the party season is over, the beginning of a new year sees many of us determined to eat better and become more active. This tends to be accompanied by a surge of reminders by the government and the media that being overweight and under-active is dangerous for our health.
In October, I began a DECIPHer-funded PhD investigating the impact of school travel routes on child health, particularly their BMI (body mass index). To explore this, I’ll use GIS – geographic information systems, which allow analysis of data relating to location and space – and anonymised health data. As I become familiar with the literature and attend conferences, it becomes increasingly clear that the answer to the obesity epidemic is far more complex than relying on enough determined individuals to give up ‘bad food’ or exercise more. Tackling obesity is a complicated issue because our eating habits and activity level are linked to where we live, study and work, what we do in our spare time, and our social backgrounds. These factors make up our ‘neighbourhood environment’ – which is fundamental to our health.
Before Christmas, I went to a research and policy meeting on ‘Neighbourhood food environments, diet and health research’ in Churchill College at Cambridge University. This meeting was organised by the UKCRC Centre for Diet and Activity Research (CEDAR). Unlike other academic conferences I’ve attended, there was a real mix of policy makers, practitioners and campaigners. This meant there was a great variety of subjects discussed and perspectives given.
The research presented at the meeting focussed on understanding physical environment factors that affect obesity rates. Professor Steven Cummins (London School of Hygiene & Tropical Medicine) highlighted that outside the USA, there is little longitudinal evidence on how the physical environment is associated with unhealthy diet and obesity. This was encouraging for me to hear as I am hoping to produce a longitudinal investigation, focussing on whether the physical environment that children are exposed to, on their way to and from school, affects their BMI. It seems intuitively sensible that travelling to school shouldn’t overexpose children to unhealthy food outlets, as exposure to these is associated with unhealthy food attitudes. However, we need robust evidence of how school travel routes relate to children’s diet and physical activity in order to think about how to improve these.
My favourite presentation was given by Peter Wright, the Environmental Health and Trading Standards Manager at Gateshead council. Despite being named the ‘condiment Nazi’ by a popular UK tabloid, he was honest and passionate about reducing obesity rates. He shared how his team at Gateshead Environmental Health investigated the nutritional content of meals from about 200 takeaways in the borough. When businesses were shown how nutrition-void their food was, he was disappointed to find that the owners struggled to see a competitive advantage in providing a more nutritionally balanced meal. Businesses are the owners’ livelihood, and they are responding to the public’s demand for cheap takeaway food that tastes good. It’s not really surprising that they don’t want to make menu changes that could potentially put them out of business. I think it is going to take a whole overhaul in our nation’s attitude to food to cause a fall in the demand for takeaways.
As the trend of eating away from home and eating takeaways has increased over past years, takeaway restaurants have become increasingly prevalent in our towns and cities. Many of the presenters highlighted a link between socioeconomic status and number of local takeaway restaurants. This inequality in neighbourhood food environments may be contributing to inequalities in health. It seems that as well as teaching people the health risks of eating too much fast food, policy is needed to limit the availability of fast food outlets. Helping vulnerable populations should take priority in order to work towards addressing socioeconomic health inequalities.
Foods high in fat, sugar and calories are advertised in so many places now (billboards, magazines, TV and social media, to name a few) that it’s hard to escape their allure. Professor Martin White (the lead for CEDAR’s ‘dietary behaviours and public health interventions’ research programme) called for researchers and policy makers to have a better understanding of the food industry. He argued that this is needed if researchers are not to just play catch-up with the food industry and research social trends that have already evolved.
I thoroughly enjoyed my time in Cambridge. The day highlighted that there is still much research needed to understand how people interact with their neighbourhood environment, and how this relates to obesity. The day reinforced to me the complexity of the obesity epidemic and the importance of interdisciplinary cooperation in addressing this. Importantly for me, at this early stage of my PhD, attending the conference helped me to see where my own work fits in to the bigger picture of public health research.
About the author: Amy Mizen is a DECIPHer PhD student at Swansea University. Her PhD research is entitled Does the relative density of fast food outlets near to schools affect childhood obesity?’.