Obesity levels in Scotland are among the highest in the developed world. The Scottish Government knows this and recently launched a consultation on a new obesity strategy with proposals to help combat this problem.
The proposals are a good start, particularly for working towards legislative action to restrict supermarket deals involving unhealthy foods. Most supermarket promotions, such as buy one get one free, involve foods high in fat, sugar and salt. Reducing their consumption is a key public health priority.
However, to tackle rates of obesity, a focus on larger supermarkets is not enough and the role of independent retailers, including fast food outlets, needs to be considered too.
Almost a third of Scotland’s children are overweight or obese. This carries significant risk for long-term health consequences such as type 2 diabetes, heart disease and certain cancers in adulthood.
Our research looked at the availability of food outlets around secondary schools where many of the pupils choose to buy their lunch.
We mapped out all the 29 state secondary schools in Glasgow along with the location of food shops and takeaways. We found that, on average, there were 35 food or takeaway outlets within a 10 minute walk. Although this showed the extent of the choices available to buy foods, this didn’t tell us what pupils actually bought.
We worked with the Glasgow Centre for Population Health and conducted a study of five Glasgow schools to see where pupils bought food. We noted what they purchased and afterwards we purchased samples and had them analysed for their fat and salt content. Most pupils eating out of school bought unhealthy convenience food such as chips, burgers or kebabs.
Nutritional analysis revealed that more than half exceeded recommended saturated fat levels and more than 40 per cent were above recommended salt levels. Many food outlets were offering meal deals and promotions that contrasted markedly with the food available in school canteens. We found that deals aimed at schoolchildren tended to offer cheap foods such as chips and curry sauce, often with a can of sugary fizzy drink.
We then interviewed shopkeepers to explore what interventions might work to help children make healthier food choices. Working with colleagues at the University of Aberdeen and the Glasgow Centre for Population Health, we found independent shops in low-income areas may face more barriers to offering healthy food choices than those in affluent areas.
Higher costs of more healthy foods may not be able to be absorbed as well as in affluent areas. Local initiatives involving schools, retailers and local government working together could hold the key but implementation would need to be careful not to widen the inequality gap.
Furthermore, a joined-up approach to public health needs to be prioritised. Some local authorities in Scotland have implemented bans on burger vans parking within 250 metres of schools. However, in North Lanarkshire this was challenged by a group of vendors, leading to the zones being ruled unlawful and the ban overturned. The current statutory framework under which all street traders are licensed by councils unfortunately does not currently include any policy objective of improving public health.
It will be interesting to see what the final version of the obesity strategy contains and to what extent both local-level and population-level interventions are included.
The proportion of children in Scotland consuming sugary drinks is amongst the highest in Europe. A UK tax on sugary soft drinks will be introduced in April. A similar strategy in Mexico resulted in a drop of 8 per cent in sales of soft drinks.
Some soft drink producers have already altered their recipes to meet the requirements. Others will instead sell smaller bottles at higher prices to get around the legislation. The levy is estimated to raise around £520 million a year in England, which will be spent on increasing sport funding in primary schools. The plans for how any funds raised from the tax will be spent in Scotland is not yet decided.
Our research would suggest that subsidising healthy food choices and lifestyles in less affluent communities could be a health initiative worth consideration.
Dr Anne Ellaway of the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Dr Ellaway is also an honorary professor with the Institute of Health and Wellbeing.