Thomas works at the Centre for Diet and Activity Research in Cambridge, where researchers study the factors that influence dietary and physical activity behaviours, develop and evaluate public health interventions, and try to make a difference to public health policy and practice. His research focuses on social and neighbourhood determinants of diet and dietary inequalities. Here he tells Nursery World about food access around schools and what it means for the diets of our children.
How does food access near schools affect children’s diets?
There is a growing interest in how the distribution of food outlets in towns and cities might be related to what we eat. Researchers have focused on the effects of food access on the school fringe – the neighbourhoods immediately surrounding schools. Children spend a lot of time here. Fast-food outlets hold particular appeal because they sell tasty, cheap, large portions, which represent good value for those with only pocket money. Some enhance their appeal by offering discounts and clustering disproportionately around schools.
The effects are difficult to isolate and quantify, particularly in relation to body weight. Nevertheless, recent UK research has linked consumption of a healthy diet to attending a school where fast-food outlets are relatively far away, or where the balance of fringe retailing is mixed. In Canada, more frequent junk-food consumption was associated with more access around school.
Is there a link between the rise in the number of takeaways in poorer areas and childhood obesity?
Deprived parts of England typically have the highest numbers of fast-food outlets. CEDAR evidence also suggests that while numbers of outlets have increased, deprived parts have seen the greatest and fastest rate of change. This is concerning both for overall levels of obesity, and for the generation of inequalities in obesity across the deprivation spectrum. But for the time being, simultaneous changes in the environment and in levels of childhood obesity remain unconnected trends.
What does a healthy school fringe food environment look like for early years children?
CEDAR research using data from the ‘Nutrition in Nurseries’ study found a link between the proximity of a nursery to its nearest supermarket (as a commonly used source of a variety of fresh, healthy produce at a number of price points) and the provision of fruit and vegetables to children.
Nurseries farthest away were more likely to serve both fruit and vegetables infrequently, compared with those with better access. This finding suggests that even for nurseries, neighbourhood food access is important for enabling consumption of a healthy diet among children, only this time indirectly through the caregivers responsible for buying food in settings.
Can you comment on moves to ban takeaways near schools?
Since about 2010, a number of local authorities have begun to restrict fast food access on the school fringe, predominantly through very strict regulation of future fast food outlets opening in these important spaces. Increasingly popular, this approach has been most recently drafted into the Mayor of London’s London Plan, potentially encouraging widespread adoption of the policy across all Boroughs in Greater London.
While the number of contributing factors to diet is such that this policy alone won’t solve childhood obesity, it’s true that no single action will be capable of this. But it has the potential to work effectively alongside other policies, and to complement strategies such as healthier school meals and nutrition education in schools, both of which are potentially undermined by current levels of fast food access. To find out for sure, the research community will be looking for opportunities to evaluate this new type of public health intervention.
What do you think policymakers should be doing to stem the rise in childhood obesity?
Childhood obesity is a major public health concern in the UK. Accordingly, policymakers are already working hard, and no more so than in the realm of population-level childhood obesity prevention. In 2016, Public Health England (PHE) launched Childhood obesity: a plan for action, in which they set out a broad remit for changing our collective national waistline, including: a levy on the soft drinks industry intended to encourage sugar-sweetened beverage reformulation; a 20 per cent reduction in the amount of sugar included as an ingredient in everyday food products such as breakfast cereals, cakes and confectionery; improvements to the food offer in institutions such as leisure centres and hospitals; and updates to the already successful School Food Standards.
For early years care settings, PHE have also recently released a revised set of example menus, which now reflect the updated dietary recommendations for UK children. Many of these initiatives drew criticism from the public health community – deemed insufficient in the face of such a looming obesity ‘epidemic’ – but this strategy will hopefully act as a catalyst for further action.