This research aims to identify, map and explore the use of policy levers and interventions that can be used to influence population health change, in the common local food system across English Local Authorities (LA).
July 2018 - June 2019
Transforming the ‘foodscape’: development and feasibility testing of interventions to promote healthier take-away, pub or restaurant food
Research Team: Professor Ashley Adamson, Dr Frances Hiller-Brown, Louis Goffe, Professor Charles Abraham, Dr Jean Adams, Dr Vera Araujo-Soares, Dr Amelia Lake, Dr Helen Moore, Professor Carolyn Summerbell, Professor Martin White
Who's involved: Fuse & University of Exeter.
October 2013 - March 2017
Reducing obesity requires a change in what and how we eat. The ‘Foodscape’ study aimed to identify effective interventions to change the meals offered by takeaways, test them in the real world and evaluate their potential for improving diets and /or reducing obesity.
Using the UK National Diet and Nutrition Survey researchers found that about a fifth of people ate takeaway meals at home once a week or more and this was most common in those aged 19–29 years, therefore interventions may be more effective if tailored to and targeted at those aged under 30.
Researchers found that calorie labelling and rewarding food-outlets with healthy eating accreditation were two of the most common interventions tested but there was little evidence that these were effective. Businesses were positive about interventions when they came at no extra cost and did not change perceived value or taste for the customer.
The research highlighted that takeaways were particularly difficult to engage with to improve healthy food choices due to tight profit margins and competition. Interventions that were tailored to the takeaway types and appreciated the need to maintain profit, were expected to be the most successful.
Building on this work researchers identified, developed and sought to test small scale interventions. An intervention aiming to reduce salt intake examined shakers and found 66% less salt was delivered from 5 hole compared to 17 hole shakers, when tested in the laboratory. Similar takeaway portion sizes were compared and a small difference was found in the salt content of meals from shops using the different shakers.
Researchers worked with a Local Authority who delivered a “Healthy Takeaway Masterclass” with staff from 18 takeaways. Each takeaway made at least one ‘pledge’ and 15 businesses reported achieving at least one pledge. Changes requiring minimal effort and cost were most popular (e.g. reducing sugar or salt, or using semi-skimmed instead of whole milk). Researchers found this intervention was feasible and while initial uptake was low (about 10%) the Local Authority are planning further training.
Researchers worked with a leading industry partner to promote and design smaller portion packaging for fish and chips shops resulting in significant fewer calories per meal. This intervention was acceptable to business owners; as of March 2017, over 50,000 of the ‘lite bite’ boxes had been distributed to 250 shops across the UK.
SPHR final report: Transforming the foodscape
Goffe, L., Penn, L., Adams, J., Araujo-Soares, V., Summerbell, C., Abraham, C., White, M., Adamson, A. and Lake, A.A. (2018) ‘The challenges of interventions to promote healthier food in independent takeaways in England: qualitative study of intervention deliverers’ viewsT‘, BMC Public Health, 18:184
Goffe, L., Rushton, S., White, M., Adamson, A.J. and Adams, J. (2017) ‘Relationship between mean daily energy intake and frequency of consumption of out-of-home meals in the UK National Diet and Nutrition Survey’, International Journal of Behavioral Nutrition and Physical Activity, 14:131
Hillier-Brown, F.C., Summerbell, C.D., Moore, H.J., Wrieden, W.L., Adams, J., Abraham, C., Adamson, A.J., Araujo-Soares, V., White, M. & Lake, A.A. A description of interventions promoting healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England: a systematic mapping and evidence synthesis. BMC Public Health 2017 17:93.
Adams, J., Hillier-Brown, F.C., Moore, H.J., Lake, A.A., Araujo-Soares, V., White, M. & Summerbell, C.D. Searching and synthesising ‘grey literature’ and ‘grey information’ in public
health: reflections on three case studies. Systematic Reviews 2016 5:164.
Hillier-Brown, F.C., Summerbell, C.D., Moore, H.J., Routen, A.C., Lake, A.A., Adams, J., White, M., Araujo-Soares, V., Abraham, C., Adamson, A.J. & Brown, T. The impact of interventions to promote healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets open to the general public: a systematic review. Obesity Reviews 2016 18:2.
Goffe, L., Wrieden, W.L., Penn, L., Hillier-Brown, F.C., Lake, A.A., Araujo-Soares, V., Summerbell, C.D., White, M., Adamson, A.J. & Adams, J. Reducing the salt added to take-away food: within-subjects’ comparison of salt delivered by five and 17 holed salt shakers in controlled conditions. PLoS ONE 2016 11:9.
Goffe, L., Hillier-Brown, F.C., Doherty, A., Wrieden, W.L., Lake, A.A., Araujo-Soares, V., Summerbell, C.D., White, M., Adamson, A.J. & Adams, J. Comparison of sodium content of meals served by independent take-aways using standard versus reduced holed salt shakers: cross-sectional study. International Journal of Behavioral Nutrition and Physical Activity 2016 13:102.
Adams, J., Goffe, L., Brown, T., Lake, A.A., Summerbell, C.D., White, M., Wrieden, W.L. & Adamson, A.A. Frequency and socio-demographic correlates of eating meals out and take-away meals at home: cross-sectional analysis of the UK National Diet and Nutrition Survey, waves 1-4 (2008-2012). International Journal of Behavioral Nutrition and Physical Activity 2015 12:51.
Hillier-Brown, F.C., Moore H. J., Lake, A.A., Adamson, A J., White, M., Adams, J., Araujo- Soares, V., Abraham, C., Summerbell, C.D. The effectiveness of interventions targeting specific out-of-home food outlets: protocol for a systematic review. Systematic Reviews 2014 3:17.
SPHR project poster: Intervention deliverers experience with takeaways
SPHR project poster: Interventions targeting out-of-home food outlets