Mayor’s draft London plan response

Note: Impact on Urban Health is part of Guy’s and St Thomas’ Charity.

We will be responding to the following sections of the London Plan:

• Policy GG3: Creating a healthy city
• Policy E9: Retail, markets and hot food takeaways

Policy E9

The strongest drivers of obesity are eating behaviour and physical activity, both key ingredients of ‘obesogenic environments’ – those that encourage people to eat unhealthily and not to do enough exercise. We believe that improving these environments is crucial if we want to create a long-term sustainable impact.

Our recently published report ‘Bite size: breaking down the challenge of inner-city childhood obesity’ highlights the latest evidence from behavioural science on childhood obesity. The report shows that many aspects of our built environment encourage behaviours that lead to childhood obesity – we are exposed to many food related prompts and our, often unconscious, decision making is biased towards unhealthy choices. As a result, in order to combat obesity, we need to make the healthy choices the norm.

We are strongly supportive of proposal E9 as part of a broader suite of policy initiatives to make the urban environments in which young Londoners spend their time as health promoting as possible. Our insights show that tackling children’s health works best when addressed in the three environments where children spend most of their time: with their parents/carers (home), education settings (schools/nursery) and consumer/community settings (streets).

Fast food outlet access is important because, typically, fast food is energy-dense and nutritionally poor, as well as highly accessible both in terms of time and money. That kind of food promotes weight gain as humans have limited innate ability to recognise how dense the food they are eating is, and down-regulate consumption appropriately to compensate and maintain energy balance.¹ Studies report that higher availability of fast food is consistently associated with lower dietary quality in children and adolescents.²

The availability of fast food close to schools is of particular concern with estimates that snacks bought close to school can account for a quarter of young people’s energy intake.³ However, it is not just access to fast food that may be problematic for childhood weight gain. Convenience stores and corner shops have also been found to be associated with higher BMI scores and may prompt increased food consumption.⁴ Some research has also suggested that supermarkets, instead of increasing access to fruits and vegetables and reducing the impact of food deserts, play a role in making unhealthy food more readily available and actually have a negative impact on weight control in children.⁵

1 Prentice, A. M., & Jebb, S. A. (2003). Fast foods, energy density and obesity: a possible mechanistic link. Obesity reviews, 4(4), 187-194.

2 Townshend, T., & Lake, A. (2017). Obesogenic environments: current evidence of the built and food environments. Perspectives in Public Health, 137(1), 38-44.

3 Sinclair, S., & Winkler, J. T. (2008). The School Fringe: What pupils buy and eat from shops surrounding secondary schools. London: Nutrition Policy Unit, London Metropolitan University.

4 Cetateanu, A., & Jones, A. (2014). Understanding the relationship between food environments, deprivation and childhood overweight and obesity: evidence from a cross sectional England-wide study. Health & place, 27, 68-76.

5 Epstein, L. H., Raja, S., Daniel, T. O., Paluch, R. A., Wilfley, D. E., Saelens, B. E., & Roemmich, J. N. (2012). The built environment moderates effects of family-based childhood obesity treatment over 2 years. Annals of behavioral medicine, 44(2), 248-258.