Hot Food Takeaways in Brent Policy Evidence Base 1.0 Introduction 1.1 The purpose of this report is to provide an evidence base for the hot food takeaway policy in the emerging Development Management Development Plan Document (DMDPD). This report summarises the policy context and evidence which have informed the council’s decision to regulate takeaways through the planning system. 2.0 Planning Policy Context 2.1 The National Planning Policy Framework (2012) emphasises that the purpose of the planning system is to contribute towards sustainable development. One of the three dimensions in achieving sustainable development is for the planning system to perform a social role by supporting ‘strong, vibrant and healthy communities.’1 Consequently one of the core planning principles is to ‘take account of and support local strategies to improve health, social and cultural wellbeing for all and deliver sufficient community and cultural facilities and services to meet local needs.’ 2 In relation to plan making, local authorities should have an up to date and relevant evidence base for the Local Plan. To develop this evidence base local planning authorities are to work with public health organisations to understand and take account of the health status and needs of the local population and information about relevant barriers to improving health and wellbeing. 2.2 The important role the planning system has to play in improving health and wellbeing of Londoners has been recognised for some time. In 2006 the London Development Authority published The Mayor’s Food Strategy which includes the strategic objective to improve Londoner’s health and reduce health inequalities via the food they eat. The London Plan (2011) states as well as promoting healthy lifestyles through the detailed design of neighbourhoods this can be complemented by other measures, such as local policies to address concerns over the development of fast food outlets close to schools. 2.3 The Mayor’s Draft Town Centre Supplementary Planning Guidance (SPG) (2013) provides guidance on the implementation of London Plan Policy 2.15 Town centres and other policies in the Plan with specific reference to town centre development and management. The SPG highlights it is important that the planning system is used to help manage clusters of uses in the interests of having diverse and therefore more vital and viable town centres. There may, therefore, be occasion for regulation through the planning system, if a concentration of a particular use has a significant negative impact on the objectives, policies or priorities of the London Plan. The SPG goes on to state consumption of fast food can have significant negative side effects on the 1 National Planning Policy Framework (2012), DCLG, page 3 2 DCLG, National Planning Policy Framework (2012), DCLG, page 6 1 local environment and on people’s health such as risk of cardio vascular disease, obesity and type two diabetes. 3.0 Evidence Review 3.1 The GLA Food Team has developed a ‘takeaway toolkit’3 which highlights the range of tools and interventions available to local authorities to balance the economic benefits of hot food takeaways with associated environmental and health concerns. The toolkit provides a detailed overview of existing evidence on the impact of takeaways. This section provides a brief summary of the key evidence and issues. 3.2 Studies demonstrate that the number of takeaways in London’s town centres are increasing,4 this trend is of growing concern in light of rising obesity levels and the health implications. Takeaway foods often have high levels of salt, sugar, fat and saturated fat, all of which can contribute to a number of negative health outcomes including obesity. This was reflected in a study undertaken by Brent Council’s Food Safety Team which tested 10 products from 10 premises near schools. All samples taken were well above the recommended nutritional guidelines for children. Some results were quite alarming, the worst being a deep fried sausage meal that contained 1059Kcal, 23.6g sugar and 57.7g fat (11g saturated). It is well documented that high levels of salt contribute to increased blood pressure, a risk factor for stroke. Saturated fats can increase levels of cholesterol in the blood, which is a risk factor for coronary heart disease. Transfats can also raise cholesterol in the blood. A study undertaken in 2008 found a direct link between an increased density of takeaways and increased BMI.5 3.3 It is also of concern that there is evidence of a correlation between the concentration of takeaways and areas of deprivation. The National Obesity Observatory (NOO) has found a strong association between deprivation and the density of takeaways, with more deprived areas having more takeaways per 100,000 population.6 Lower income groups spend a greater proportion of their income on food. Access to cheap healthy food is therefore of crucial importance. 3.4 There is growing evidence that children are likely to be at risk from the health threats posed by the fast food takeaway proliferation. The Burger Boy report published by Barnardos in 2004 identified that ‘fast food’ was identified by children as being the most tasty and desirable food. A study in 2005 found evidence that having a takeaway within 160m of a school is associated with a 5% increase in obesity. 7 Other evidence demonstrates takeaways and 3 Takeaways Toolkit (2012), A London Food Board & Chartered Institute of Environmental Health Publication Based on a consultancy report by Food Matters. 4 Caraher, Lloyd, and Madelin (2007). Fast-Food in Tower Hamlets. City University, London. 5 Mehta NK, Chang VW. Weight status and restaurant availability: a multilevel analysis. American journal of preventive medicine 2008;34(2):127-33. 6 National Obesity Observatory website. Obesity and the Environment: Fast Food Outlets www.noo.org.uk/uploads/doc/ vid_15683_FastFoodOutletMap2.pdf 7 Currie; DellaVigna; Moretti; Pathania (2010). The Effect of Fast Food Restaurants on Obesity and Weight Gain. American Economic Journal: Economic Policy, Vol 2, Number 3, August 2010, pp. 32-63(32). 2 convenience stores clustering around schools,8 which can play an important role in influencing daily dietary habits of school pupils who purchase food and drink off-site. More recently in light of concerns about children's lifestyles and increasing childhood obesity Prof Mitch Blair, of the Royal College of Pediatrics and Child Health, which represents the UK's 11,000 specialist children's doctors, called for limits on the number of fast food premises allowed to open near schools.9 This echoes the recommendation of the National Institute for Health and Care Excellence for local authority to encourage healthy eating by using existing powers to control the number of takeaways and other food outlets in a given area, particularly near schools. 10 3.5 Behaviour problems in children have also been linked to imbalances of different types of fats.11 Trans fats in the diet are suggested by some to be linked to negative behaviour. Any effect on brain chemistry is of particular concern in children since the brain continues to develop through the teens so is likely to be more susceptible. Low levels of other micronutrients in the diet have also been associated with negative mood and behaviour, for example folic acid and zinc.12 4.0 Health Indicators in Brent 4.1 The Joint Strategic Needs Assessment (JSNA) for the Borough of Brent has been developed by Brent’s teaching Primary Care Trust and the council to inform Brent’s Health and Wellbeing Strategy. The purpose of the JSNA is to assess the needs of the local population and inform policy decisions and investment. The JSNA highlights Brent’s key health and wellbeing challenges as including:- Rising levels of obesity. - One in five of all children in reception year in Brent are overweight (12.8%) or obese (11.5%). In year 6 23.7% of children are obese, which is far higher than the average in England (19%). This places Brent with the 10th highest obesity levels for year 6 in England (compared against 152 PCT areas). Approximately 21.2% of all adults in Brent are obese. Cardiovascular disease which in part accounts for much of the inequalities in life expectancy in the borough. - Cardiovascular disease is one of Brent’s biggest killers. Brent has higher rates of cardiovascular disease mortality than London and England. Emergency admission rates for coronary heart disease, heart failure and stroke are continuing to rise in Brent, whilst in other parts of London admission rates for coronary heart disease and stroke are actually falling. 8 Day PL, Pearce J: Obesity-Promoting Food Environments and the Spatial Clustering of Food Outlets Around Schools. American Journal of Preventive Medicine 2011, 40:113-121. 9 The Guardian, Doctors sound alarm on child fitness and health, 21 August 2013 10 Local government public health briefings (May, 2013), NICE www.publications.nice.org.uk 11 Associate Parliamentary Food and Health Forum (2008). The links between diet and behaviour: the influence of nutrition on mental health. www.foodforthebrain.org/download.asp?id_Doc=96 12 Food additives and children’s behaviour (2008). Food Standards Agency www.food.gov.uk/science/socsci/ssres/ssarchive/ssarchivesafety/foodaddchild 3 High levels of long-term chronic conditions which are often related to poor lifestyles and relative deprivation such as diabetes. - Brent has the second highest diabetes prevalence in London at 5.61%. 4.2 All of these health challenges are linked to a poor diet. Further evidence that poor diet is a significant contributing factor to health issues is the finding that only 2 out of 5 adults in Brent have a healthy diet as measured by consumption of five or more portions of fruit and vegetables a day.