The Implications of Fast-food restaurants on enhancing Obesogenic Environments and life-long obesity
Obesity in adults and children continues to be a dire public health issue, leading to many academics exploring ways to reduce the impact this has on mortality and quality of life. This suggests that many of the current interventions have lacked effectiveness in terms of long-term sustainability and the influence of long-term improvements to the health and wellbeing of the population. Public Health England (PHE) reported that 22.6% of children aged 4 to 5 years, 34.3% of children aged 10 to 11 years, and 61.4% of adults were classed as either overweight or obese in 2017 (Public Health England, 2017). In the modern-day, this has grown to include adult males (67%) and women (60%), with 26% of men and 29% of women being classed as obese, and 20% of year 6 (11-12yo) being classified as obese, especially those in the most deprived areas (NHS, 2020). This poses a significant risk to the population’s health and increases the demands on the NHS due to many obesity-related diseases such as heart disease, type 2 diabetes, some forms of cancer, and strokes becoming more prevalent amongst the population.
Such issues have led to discussions regarding the impact of the environment, namely the immediate food environment and the implications on the obesity link. In many instances, focuses have been drawn towards the immediate environment whereby their environment can influence the population, but more specifically, the impact of the basic environmental factors of interest, namely relating to fast-food restaurants (Jia et al., 2019). The term ‘obesogenic environment’ is defined as ‘the sum of influences that the surroundings, opportunities, or conditions of life have on promoting obesity in individuals or populations (ESFA NDA Panel, 2015), or more specifically, any form of environmental characteristics that can impact or challenge an individual’s ability to maintain healthy body weight. In most instances, a focus can be placed on a community level whereby food retailers and food service outlets can be examined and characteristics such as food and cultural factors that may influence behaviour (Lakerveld et al., 2017).
The need to understand the influence of an individual’s environment on their likelihood of becoming obese is key, with many studies during earlier investigation periods demonstrating the influence of fast-food restaurants in proximity to schools being seen as a predictor of childhood obesity (Davis & Carpenter, 2009; Austin et al., 2005). These studies have provided an insight into the influence of easily accessible poor nutritional choices, which has led to several studies investigating the influence of obesogenic environments leading to recommendations to understand the individuals within these environments, their interactions, and how their environment influences their nutritional choices and levels of physical activity (Lake & Townshend, 2006). When focusing on fast-food restaurants, some studies have focused more on the food provisions and advertisements that healthier food options are less desirable due to higher costs (Howse et al., 2018) and further factors that influence food choice (Lambert et al., 2019).
One such factor relates to the proximity of fast-food outlets and restaurants to educational establishments, namely secondary schools and higher education facilities, where individuals have greater control over spending money. Consider the findings from Sanchez-Vaznaugh et al. (2019), who found that lower-income families were more likely to be impacted by fast-food restaurants availability near urban schools than those in more affluent areas. Such findings were shared by Cheung et al. (2021), who found that more affluent areas in Hong Kong were less likely to have fast-food restaurants with 400m and 800m of a school, while seven in ten secondary schools in less affluent areas had at least one fast-food restaurant within 400m. This has led to suggestions that are focusing on either restricting the number of fast-food restaurants within primary and secondary school locations or implementing new, more stringent policy could be beneficial and aid reductions in obesity on a local, national and global scale (Chapman et al., 2019; Cutumisu et al., 2017).
However, studies have suggested several beneficial interventions involving key stakeholders that can improve obesity outcomes. Love et al. (2020) noted that schools provide the optimal environment to support obesity prevention due to the opportunity it presents to target a large number of children, frequently and over a prolonged period whereby continual opportunities to learn about health behaviours can be provided. Several stakeholders have often encouraged the use of such interventions, including parents who believe that food and nutrition education in primary schools is key to improving children’s knowledge of food and healthy eating behaviours (Aydin et al., 2021; de Vlieger et al., 2020). On the contrary, Folkvord and Hermans (2020) suggested focusing on food marketing for the potential promotion of healthy foods to children. The review highlighted that while only a few studies examine the effects of healthy food promotion on children’s dietary behaviours, many did see a focus placed on fruit and vegetable intakes, with 60% of the studies identifying a positive effect that can influence dietary behaviours. The use of such focuses has further been supported within the literature, which supports promoting healthy food in a child-friendly manner, such as through cartoon characters and effective food labelling (Folkvord et al., 2020; Coates & Boyland, 2019). This demonstrates that while obesogenic environments are challenging and continue to present various barriers to maintaining a healthy and active lifestyle, there are effective ways to reduce these barriers throughout partnership working.
To conclude, the current literature demonstrates a strong association between the proximity of fast-food restaurants and increasing rates of obesity. This highlights a need to understand the complex nature of the environment and how this can determine the potential characteristics which may place a population at a greater risk of being overweight or obese. It is strongly recommended that future studies continue to investigate the complex nature of such phenomena but further explores new and innovative approaches to combat childhood, and adulthood, obesity on a local, national and global scale.
References
Aydin, G., Booth, A., Margerison, C. & Worsley, A., 2021. Food and nutrition education in Australian primary shcools: parents’ views. Health Education.
Chapman, O., Henggeler, M. & Senne, M., 2019. Proximity of fast food restaurants to schools in Eastern Jackson County, Missouri., mISOURI: aMERICAN pUBLIC hEALTH aSSOCIATION.
Cheung, J. T., Tang, K. C. & Koh, K., 2021. Geographic Clustering of Fast-Food Restaurants Around Secondary Schools in Hong Kong. Preventing Chronic Disease, 18(1).
Coates, A. & Boyland, E., 2019. Food marketing to young children. In: The Psychology of Food Marketing and (Over) Eating. London: Routledge, pp. 6-24.
Cutumisu, N. et al., 2017. Association between junk food consumption and fast-food outlet access near school among Quebec secondary-school children: findings from the Quebec Health Survey of High School Students (QHSHSS) 2010–11.. Public Health Nutrition, 20(5), pp. 927-937.
de Vlieger, N. et al., 2020. Nutrition Education in the Australian New South Wales primary school curriculum: knowledge and attitudes of students and parents. Children, 7(4), pp. 24-31.
ESFA NDA Panel, 2015. Scientific opinion on the essential composition of total diet replacements for weight control. EFSA Journal, 13(1), pp. 52-64.
Folkvord, F., Roes, E. & Bevelander, K., 2020. Promoting healthy foods in the new digital era: An experimental study on the effect of a popular versus fictitious ‘Insta-influencer’on brand attitude and purchase intentions.. Research Squaare.
Howse, E. et al., 2018. Buying salad is a lot more expensive than going to McDonalds’: young adults’ views about what influences their food choices. Nutrients, 10(8), p. 996.
Jia, P. et al., 2019. Fast-food restaurant, unhealthy eating, and childhood obesity: a systematic review and meta-analysis. Obesity Review.
Lakerveld, J., Mackenbach, J. D., Rutter, H. & Brug, J., 2017. Obesogenic environment and obesogenic behaviours. In: C. Hankey, ed. Advanced Nutrition and Dietetics in Obesity. Newark, NJ, USA: John Wiley & Sons, pp. 132-137.
Lambert, M., Chivers, P. & Farringdon, F., 2019. A qualitative study exploring influences on the food choices of university students. Health Promotion Hournal of Australia, 30(1), pp. 66-75.
Love, P. et al., 2020. Food and nutrition education opportunities within Australian primary schools. Health Promotion International, 35(6), pp. 1291-1301.
Sanchez-Vaznaugh, E. V., Weverka, A., Matsuzaki, M. & Sanchez, B. N., 2019. Changes in fast food outlet availability near schools: unequal patterns by income, race/ethnicity, and urbanicity. American journal of preventive medicine, 57(3), pp. 338-345.