The rise of take-out food

In a study published today in the journal Health & Place, researchers from the Centre for Diet and Activity Research (CEDAR), at the University of Cambridge, analysed the change in density of takeaway food outlets across Norfolk between 1990 and 2008 and how this related to levels of neighbourhood socioeconomic deprivation.

Takeaway food outlets, such as fish and chip shops, kebab shops, and Indian and Chinese takeaways, primarily offer ready-to-eat, energy-dense foods that are associated with higher total energy and fat intakes. Frequent consumption of takeaway food has been associated with excess weight gain over time.

Previous studies have shown that people of low socioeconomic status and living in deprived areas are more likely to be overweight and consume unhealthy diets than other sectors of the population. One possible explanation could be that more unhealthy food environments -- for example, a greater density of takeaway food outlets -- could be contributing to unhealthy lifestyle choices. Last year, a team at CEDAR showed that people who lived and worked near a high number of takeaway outlets tended to eat more takeaway food and were more likely to be obese than those less exposed.

Cambridge researchers used Yellow Pages telephone directories to collect data on the number and location of takeaway food outlets across six time points from 1990 to 2008. The researchers then mapped these onto electoral ward boundaries for Norfolk, a large county with a resident population in 2001 of almost 800,000 people.

Over the 18 year period, the number of takeaway food outlets rose by 45%, from 265 to 385 outlets. This equated to an increase from 2.6 outlets to 3.8 outlets per 10,000 residents. The highest absolute increase in density of outlets was in areas of highest deprivation, which saw an increase from 4.6 outlets to 6.5 outlets per 10,000 residents (a 43% increase).

This is in contrast to areas of least deprivation, which saw an increase from 1.6 to 2.1 per 10,000 residents over the time period (a 30% increase).

PhD student Eva Maguire, lead author of the study from CEDAR, University of Cambridge said: "The link we've seen between the number of takeaway food outlets and area deprivation is consistent with other reports, but this is the first time the changes over time have been studied in the UK. There were differences in the densities of takeaway outlets as far back as we looked, but these differences also became more extreme."

Dr Pablo Monsivais, also from CEDAR, added: "The growing concentration of takeaway outlets in poorer areas might be reinforcing inequalities in diet and obesity, with unhealthy neighbourhoods making it more difficult to make healthy food choices. Our findings suggest that it might be time for local authorities to think hard about restrictions on the number and location of outlets in a given area, particularly deprived areas."

In 2012, the Greater London Authority proposed the idea to limit the percentage of store frontage dedicated to takeaway food outlets on high streets in the Capital. Such initiatives have been endorsed by bodies including Public Health England, the National Institute for Health and Care Excellence (NICE) and the Academy of Medical Royal Colleges.

The researchers also looked at the spread of supermarkets. Although they found an increase in the number of supermarkets over the same time period, from 31 to 40 (an increase of 29%), the proportion of supermarkets in deprived areas did not differ significantly from other types of areas.

Although the study was only carried out in Norfolk, the county shares characteristics with other areas of the UK and so the researchers believe the findings will be generalizable across the country.