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Flashcards in Lecture 15/16 Deck (24):

Questions for today

How does the environment influence our food choices?
What is the relationship between environment(s) and body weight?
Is there support for the concept of an obesogenic environment?
How may we explain the rise of food insecurity in the UK?
What are current policy & charitable responses to food insecurity?


Macro vs Micro scale

Macro scale

Policy – where fast food outlets able to be located?
Legislation – taxes or formulation of foods
Food prices
Cultural norms


Macro vs Micro scale

Micro scale

What’s in the cupboard?
What’s in the neighbourhood?
Easy access to unhealthy food?
- What can be delivered?
- What can you afford?
Dictates what you eat.
- High in fat, salt, sugar being advertised
Family norms
- What's normal in the family? - Sit down at table or in front of TV


Modify the environment

“The amount of food eaten is strongly influenced by factors such as portion size, food visibility and salience, and the ease of obtaining food.”
“…people at a restaurant who were served a baked pasta dish that was 50% larger than the normal portion ate 43% more than people served the normal portion of the dish, increasing their caloric consumption at the meal by 159 kcal”
“office workers who had chocolate Kisses within reach on their desks ate an average of 5.6 more candies (total of 136 kcal) per day than did workers for whom candy was placed on a shelf 2 m away”


Modify the environment...

Minimum Unit Pricing
Reducing the Strength initiatives

Ban in 2007
Price increases via taxation


Food environments

What is known?

Local retail environments may influence diet, particularly for people with limited mobility
Price is the biggest driver for food purchasing, but proximity to home is still important


Food environments

What we need more

Decision making is complex.
More data on how factors interact- price, proximity
Longitudinal research vs cross-sectional studies to consider impact on physical health


What is the relationship between environment(s) and body weight?

Food deserts- the beginning

In the 1990s, a new area of research emerged – Food Deserts!
Access, affordability, availability were the main considerations
The original research was flawed and led to policy being made without adequate evidence


Food deserts

Implied assumptions

Living in a food desert is a risk to public health – some evidence to support this in the late 2000s
Higher risk of ill health via poor diet pathway
What about wellbeing and the stress of affording a healthy diet? Pressure to choose the right, healthy foods?
Intervention in Leeds


Seacroft and Tesco

Via Social Exclusion Unit’s focus on food deserts
Employed local people
Closed other, smaller shops
Did it change diet?


2006 review

“The picture from North America is thus reasonably consistent; places inhabited by poorer people and black people have poorer access to ‘healthier’ foods. ”
“…a situation where residents of the US are particularly susceptible to the contextual determinants of health at the neighbourhood level or may suggest that macro-level processes currently make the US a very different place to live compared with other developed nations. ”


A recent study in the UK found that food environments are relevant – at work.

“Exposure to takeaway food outlets in home, work, and commuting environments combined was associated with marginally higher consumption of takeaway food, greater body mass index, and greater odds of obesity. Government strategies to promote healthier diets through planning restrictions for takeaway food could be most effective if focused around the workplace”


What do we think about obesogenic environments?

Spend 3-4 minutes considering what you think of the evidence.
Is it different in a range of countries, such as the US and UK?
Is there scope for interventions that are not currently outlined to address this issue?


From food deserts to food poverty

What is ‘food poverty’?

The inability to access a sufficient diet through socially acceptable means, due to financial constraints.
May also encompass the associated anxiety about not being able to maintain a sufficient diet (food insecurity)


Food poverty
Why are we concerned?

More people* in the UK are turning to emergency food aid


How may we explain the rise of food insecurity in the UK?

Inflation (for a start)

•All measured between 2003-13
•General: 30.4%
•Housing: rent up by 30.4%
•Food: 47%
•Fuel: 153.6%
•Wages? Up by 28%
•Loss of manufacturing jobs, high numbers of low paid employees


How may we explain the rise of food insecurity in the UK?

‘Shocked’ into food poverty

- Lack of savings means that many households are one ‘shock’ away from serious problems
o Loss of job
o Boiler quits working
o Car repairs
o Increase in rent or forced move
o Breakdown of relationship
o Illness



What do we know?

Most referrals to the biggest group of foodbanks is due to low/loss of income
Many people access foodbanks are in work
Only about 20% of people who are food insecure are using foodbanks (Loopstra et al 2015)


Reasons that low income tips over into needing assistance for food

Universal Credit
Foodbanks in areas of full Universal Credit rollout (n=71) to single people, couples and families, have seen a 16.85% average increase in referrals for emergency food, more than double the national average of 6.64%.
People in insecure or seasonal work are particularly affected, suggesting the work incentives in Universal Credit are not yet helping everyone.
“Universal Credit delays are contributing to the exacerbation of mental health issues due to anxiety about how to cover basic living costs and uncertainties about the future.”


Food poverty vs food insecurity

Two terms which are often used interchangeably
Food poverty is far more emotive
Food insecurity is what we often see measured elsewhere – NOT in the UK


Food banks: a sticking plaster

Long present in the US & Canada
First food bank in the US: 1967
First food bank in Canada: 1982
First food bank in England: 1999
Very hard to know how much informal food banks/emergency food aid is shared in the UK


Food banks challenges

Foodbanks are only one solution – and require a referral from a GP, social worker
- Vouchers are given with a limit of three per household
- Foodbanks exist where there are volunteers and space to hold the goods. Are they always in areas of greatest need?


What are some alternatives to food banks?

Food banks – limited choices, you get what you’re given.
Community shops – subsidised shops open to people claiming benefits
Dare we mention food stamps?


Are food banks making the situation worse?

Why doesn’t the UK (all of the UK) make some effort to measure food poverty?
What happens if we don’t know where food poverty is most likely?