Obesogenic' environments were first introduced to us by Garry Egger and Boyd Swinburn in 1997.(paper). Today's food environments are often described as toxic, not because they instantly make you violently ill, but because they are not making it easy for us to be healthy.
Almost two-thirds of Australian grocery purchases are purchased from the duopoly of Coles and Woolworths. These businesses quite reasonably are driven by profit motive. But could these supermarkets become health promoters through appropriate product placement rather than their eye level, easy to reach often less healthy food choices. Research conducted in Melbourne showed that major chains make exposure to snack foods ‘almost unavoidable' through such placement of unhealthy options at end of aisles and checkouts.
Are supermarket foods affordable and what does a healthy diet cost? The healthy market basket survey shows that it can cost up to 40% of welfare income to buy a healthy food basket.
Recently, ‘convenience stores' have made a bit of a come-back, particularly as inner-city apartment living increases, this re-surgence of the old corner store has not gone un-noticed by Coles and Woolworths as they bid to join this market share. What this will mean to long-term food environments is open for speculation. I really enjoyed reading this research that took a positive approach to healthy food environments and asked was there any association between healthy food outlets and childhood obesity rates in Perth. It showed an association between more healthy food outlets within 800m of home was significantly associated with a reduced risk of being overweight or obese. Perhaps we need more of this positive research to encourage healthy food retailing and further investigation into the economics of such a model. Perhaps the corner store rather than a mini- chain supermarket could be a mini healthy food outlet.
In our workplaces, shopping centres, leisure venues, even hospitals we literally bump into vending machines of some sort - those ‘things' so strategically placed ‘in the way', near entrances, opposite lifts and YES very visible in hospitals. Is it time to say goodbye to vending machines, or can they be turned into a healthier food environment? We've tossed the idea of banana vending machines around before, but then even better came the fruit and veg vending machine AND placed inside a hospital! Tasmania has been onto healthy vending machines for a while now with HOVER (Healthier Options in Vending - an Employer Resource) which is worth checking out. Internationally Chicago Park District trialled a 100% Healthier Snack Vending Initiative. Mostly it worked pretty well and sales exceeded expectations. Is there a CO-OPS case study on a healthy vending machine out there?
Then there's children's settings: childcare, pre-school and primary school. There is ample evidence of what works to prevent childhood obesity within children's settings but we are yet to establish a permanent shift in child and adolescent health behaviours. We know that impacting the food environments where children spend much of their time can help prevent obesity, but for various reasons the recommendations are not able to be fully implemented, although significant work is underway in this area. We know breastfeeding has a protective effect on children's health and advocacy groups work to improve this by providing breastfeeding friendly environments.
Fast food often bears the brunt of our discontent with the food environment. With rows of outlets at the entrance to almost every regional town and despite a 7% drop in profit in the Asia Pacific region, McDonalds recent announcements of eight more stores opening soon in Regional Victoria was not welcomed by the public health sector, so the debate will continue. Fast food companies pledge they have come to the table with reformulation of product to reduce salt, improvement of the quality of oil, and the addition of healthier choices. The often heard catch-cry for ‘a level playing field' is heard from both sides of this debate. The fast food industry considering they are shut out of the obesity conversation, with their huge marketing budgets, giveaways and up-sizing, and the primary producers, green-grocer and sandwich bars struggling to find where the debate takes place. Who do we welcome to our ‘level playing field?' ... and what does it even look like?
America - The Healthy Weight Commitment Foundation (HWCF) is a great example of industry leaders who have publicly committed to help reduce obesity, especially childhood obesity. As part of that commitment, 16 major food companies that participate in HWCF pledged to reduce the number of calories they sell to the American public.
Insights into Landmark Calorie Declines in the U.S. Food Marketplace
In an unprecedented review of the U.S. food system, researchers have, for the first time, used big data to track the number of foods and beverages consumed and purchased by Americans. The assessment, conducted by University of North Carolina (UNC) researchers, was part of an evaluation of the Healthy Weight Commitment Foundation's (HWCF) pledge to remove 1 trillion calories from the marketplace by 2012, and 1.5 trillion by 2015.
Australia - The Healthier Australia Commitment (HAC), is an industry led, multi-year strategy to assist Australians improve their health and wellbeing. The Commitment brings together the Australian food and grocery industry, in partnership with not-for-profit and other organisations, with the aim of building healthier families.
UK - the Public Health Responsibility Deal's aims to tap into the potential for businesses and other influential organisations to make a significant contribution to improving public health by helping us to create this environment. Public health is everyone's responsibility and there is a role for all of us, working in partnership, to tackle these challenges.
Too many of us are eating too much, drinking too much and not doing enough physical activity. Creating the right environment can empower and support people to make informed, balanced choices that will help them lead healthier lives.
Here is a youtube from Dr Lukar Thornton presented at the NSW Food Forum 2014 if you would like to learn more about ‘creating healthy food environments'.