Food Environments, Health Behaviours and Outcomes

Why was the research needed?

Child overweight and obesity is a major public health challenge. In England in 2023/24, almost one in ten children aged 4-5 were living with obesity, rising to more than one in five among children aged 10-11. Obesity rates are more than twice as high in the most deprived areas compared with the least deprived. These communities also experience the highest and fastest-growing concentration of unhealthy food outlets, such as hot food takeaways. While local authorities can use planning policies, including exclusion zones, to restrict new openings, there is limited evidence on whether and how local food environments directly influence children's health outcomes.

What did we do?

We assessed the impact of local planning regulations on the spread of hot food takeaways, and the causal impact of exposure to hot food takeaways on children's health outcomes and behaviours. To do this, we analysed data from local populations of children and nationally representative samples of children and families collected over the past decade. We linked these data with information on the density of different types of food outlets from the Food Standards Agency and developed a database of local planning regulations affecting hot food takeaway outlets. We then used statistical models to examine changes in food environments resulting from policy interventions, while accounting for other factors that may affect children's health behaviours and outcomes, including access to green space, sex, ethnicity and household income.

What did we find? 

We analysed neighbourhoods across Essex, Hertfordshire and Leicestershire to identify areas where high numbers of takeaway outlets, limited access to healthy food, child poverty and children living with obesity occur together. Takeaway outlets were concentrated in more deprived areas, and inequalities in childhood obesity widened between Reception and Year 6.

We brought together a national database of takeaway planning policies in England and linked it to local data on takeaway outlets, employment, household food purchases and diets. We compared neighbourhoods before and after policies were introduced and found that exclusion zones slowed takeaway growth, while caps on takeaway numbers did not. Exclusion zones may also improve children's diets without harming employment and may encourage more sit-down dining businesses. 

What will the impact and benefits of this research be? 

The research informed the All-Party Parliamentary Group on Obesity policy paper and was presented at its parliamentary launch. By providing evidence on the relationship between takeaway outlet density and children's weight, the findings can support local authorities and central government in making informed planning and regulatory decisions that shape local food environments, including policies on exclusion zones around schools, outlet density, opening times and age restrictions on purchases.

How will we share and apply the findings? 

We held a Knowledge Mobilisation event with Essex County Council and its District Councils, and presented to the Hertfordshire Whole Systems Healthy Weight Board, to share findings and understand the barriers to implementation of food environment-related planning policies. The research team are currently seeking access to national child measurement data to assess the impact of these planning policies on childhood obesity at a national level.