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Fast food nation

“Chips only €1.80, 12-4pm” screams the giant, colourful lettering on Macari’s shopfront in Balbriggan, Co Dublin. The glass visage of a local secondary school across the road shimmers against the shopfront window; another secondary school is a couple of minutes’ walk away. Lunchtime ‘specials’ at Macari’s include baguettes with ketchup and mayo for just €1.90.

Drogheda Street comprises half of the town’s thoroughfare and is also home to Borza fish and chip shop; FLC (Finger Lickin’ Chicken), Apache Pizza and, continuing down onto the start of Bridge Street, Deli Burger.

These fast-food outlets do what fast-food outlets do: advertise tasty, energy-dense, nutrient-poor foods at cheap prices. At FLC, one piece of fried chicken and chips is among the ‘deals’ for €1.99. In the Medical Independent’s (MI) survey, only Apache Pizza advertised calorie information.

Three ethnic takeaways with later opening hours are also on Drogheda Street, while on an adjacent street is an Indian restaurant. It is a tight geography: 300 metres separate Borza from Deli Burger, according to Google Maps.

In Balbriggan, the northernmost town in Fingal, which is Ireland’s fastest-growing administrative county, the concentration of fast-food outlets has been raised in various fora over several years.

In 2013, the Fingal Independent reported that a survey by Fingal County Council listed some 16 fast-food outlets in Balbriggan and another four going through the planning process.

Last year, a submission to the consultation process on the Fingal Local Economic and Community Plan by resident Mr Seán Barry referred to the town having seen a “large rise” in fast-food outlets and betting shops and a decline in “most other forms of suitable town centre-type businesses”.

Balbriggan is a good example of how planning processes fail communities, although it is far from unique.

According to a study by researchers at the Health Promotion Research Centre, NUI Galway, 75 per cent of schools had one or more fast-food outlets, while 29.7 per cent of schools had five or more such outlets, within 1km of the school. The paper, Food for thought: analysing the internal and external school food environment, was published last year in the journal Health Education. The external school food environment for 63 schools was assessed by mapping food businesses within 1km of schools using a Geographic Information System (GIS). 

Concerning

Deeply concerning statistics on overweight and obesity in Ireland have trundled off the bad news conveyor belt over recent years. The Healthy Ireland Survey 2015 reported that 37 per cent of adults were overweight and a further 23 per cent obese.

According to the report Obesity in an Aging Society (2014) by the Irish Longitudinal Study on Aging at Trinity College Dublin and St Vincent’s University Hospital, Dublin, 36 per cent of over-50s were obese and a further 43 per cent were overweight.

Obesity prevalence has risen dramatically worldwide over the past 30-to-40 years, such that it is now considered a global epidemic, noted the paper. Several societal factors have contributed to obesity’s “rapid spread”, including increasingly sedentary lifestyles and widespread availability of energy-dense foods.

The epidemic is ensnaring the young.  The Growing Up in Ireland study (2011) reported that 19 per cent of nine-year-olds were overweight and 7 per cent were obese.

Girls were more likely to be defined as being overweight (22 per cent) or obese (8 per cent) than boys (17 per cent and 5 per cent). The study also referred to “pronounced social-class inequalities” calculating that 19 per cent of boys and 18 per cent of girls from ‘professional households’ were overweight/obese, in comparison to 29 per cent of boys and 38 per cent of girls from semi-skilled and unskilled social class households. “Research suggests that living in an area with fewer food outlets or fewer outlets selling affordable, high-quality food may lead to poorer dietary quality,” noted the study.

Between 1990 and 2011, obesity in Ireland rose from 8 per cent to 26 per cent in men; and from 13 per cent to 21 per cent in women, according to the National Adult Nutrition Survey 2011. This research described obesity as a “major public health problem in Ireland”.

Prof Anthony Staines, Chair of Health Systems at Dublin City University, trained in paediatrics in the 1980s when there was a vastly different patient profile. “Type 2 diabetes didn’t occur in children; it just never happened. One of my colleagues now runs a clinic for teenagers with type 2 diabetes”,” he tells MI.

Many cases are primarily related to obesity. “We have a serious problem with our diet in most Western societies and increasingly in the rest of the world as well,” notes Prof Staines. “This is reflected in essentially higher rates of obesity, higher rates of overweight, particularly among children, but also throughout life. We have to ask ourselves, what is going on?”

Prof Staines believes a shift of attitude is required, whereby fast-food is fundamentally viewed as a treat. “And treat means what it says — it is something you have occasionally, not every day or every week.”

It is well-established that proximity of fast-food outlets to schools contributes to overweight and obesity in children. However, so-called ‘no-fry zones’ in isolation will not prove a panacea, argued Prof Staines. Rather, they should be “part of a process of sending a message to everyone” about thinking about what we eat. The solution must encompass education, easier access to affordable healthy food and cookery skills, he outlined.

Health campaigners agree that directly tackling fast-food consumption is just one piece of the jigsaw. However, it is an important piece, and within that, many consider reforms of the planning protocols as a key element.

In June 2013, the then Department of the Environment, Community and Local Government published statutory guidelines for planning authorities on Local Area Plans under the Planning Act 2000 (as amended). Section 5 offered advice on the structure and content of local area plans and set out policies that could be implemented to promote and facilitate active and healthy living patterns for local communities.

This included “careful consideration” of the appropriateness of the location of fast-food outlets in the “vicinity” of schools and parks.

A spokesperson for the Department of Housing, Planning and Local Government commented: “A practical effect of these guidelines with regard to fast-food outlets is that consideration can be given to the appropriateness of their location in the vicinity of schools and parks, for example in newly-developing areas, while at the same time taking into account wider land use considerations.

“However, with regard to the many schools located in or near town centres, restriction of fast-food outlets in these kinds of situations needs to be carefully considered on a case-by-case basis, in view of the mix of existing uses typically found in central areas.”

Question marks hang over the relevance and influence of these planning guidelines. In January 2013, McDonald’s applied to build a fast-food outlet in proximity to two primary schools and a secondary school in Greystones, Co Wicklow.

Mr Philip Moyles was one of the residents who objected to the development. Subsequently, he and other locals formed the ‘No-Fry Zone 4 Kids’ campaign.

Mr Moyles, who is chairperson of the campaign committee, recalled that when Wicklow County Council approved the planning application in July 2013, residents objected to An Bord Pleanála, which refused the application.

However, an amended application by McDonald’s was approved by the County Council and An Bord Pleanála. Nevertheless, it transpired that the owners of the proposed development site, Lidl, decided not to sell the land to McDonald’s. This brought a finality of sorts.

“In some respects, we thought ‘that’s it, job done, we can rest on our laurels now’,” says Mr Moyles. “Then when we dug into it, the reason we found ourselves in the situation was because there was no actual ‘no-fry zone’ objective in the county development plan. There is a loophole that these companies can exploit.”

Vague

The wording in the planning guidelines on local area plans is vague and lacks definition of ‘vicinity’, he outlines.

The No-Fry Zone 4 Kids campaign has been actively working on trying to get a specifically-worded ‘no-fry zone’ guideline into the new Wicklow County Development Plan, 2016-2022. Mr Moyles describes a painstaking process, which has required a lot of commitment on the part of campaigners.

“For the last 12 months we have gone through various steps of convincing the Council that this guideline should go into the draft plan, then the draft plan went to public consultation and this is where the public can either agree with an objective or disagree,” he explains.

Over 200 supportive submissions were received by the Council. The campaign attracted support from influential stakeholders in the health arena, including the RCPI Policy Group on Obesity, the Irish Heart Foundation (IHF), safefood and the Irish Nutrition and Dietetic Institute (INDI), among others. Minister for Health Simon Harris, a Greystones native,  also submitted a supportive submission in his previous role as Minister of State at the Department of Finance. 

“After the public consultation phase, it went to a vote in July,” continues Mr Moyles. “At that stage, the councillors could decide to kill it completely in the water, or they could decide that, yes, they’d like to progress it to the final stage of the plan and that happened on 4 July. Of the 30 councillors present, 18 voted for and 12 voted against it.”

There were relatively minor amendments to the wording of the objective (known as RT 17). It now reads: “Conscious of the fact that planning has an important role to play in promoting and facilitating active and healthy living patterns for local communities, the following criteria will be taken into account in the assessment of development proposals for fast-food/takeaway outlets, including those with a drive-through facility: Exclude any new fast-food/takeaway outlet from being built or from operating within 400m of the gates or site boundary of schools or playgrounds, excluding premises zoned town centre; fast-food outlets/take-aways with proposed drive-through facilities will generally only be acceptable within major town centres or district centres and will be assessed on a case-by-case basis; location of vents and other external services and their impact on adjoining amenities in terms of noise/smell/visual impact.”

“A fast-food/take-away outlet shall mean any outlet whose business will primarily be the sale of hot or otherwise prepared food that is high in fat, salt or sugar.” This amended objective is out to consultation until 26 August 2016, 5pm (planreview@wicklowcoco.ie).

“Now we are at a stage where the last step is going to take place in September/October, when the councillors will vote to finally adopt the plan and if they vote in favour, then it will be amended into the local area plan,” states Mr Moyles. “We are not there yet. The fact we got 18 councillors to support it at the original vote, assuming they all continue to vote the same way, it should go through. But there are no guarantees.”

Some councillors who voted against the objective considered it akin to ‘nanny state’ policy, or felt it was parents’ responsibility to guide children’s eating habits, or that it could block employment.

The common good

Mr Moyles refers to a number of State-directed restrictions made in the common good. He says no-fry zones alone will not address overweight and obesity but are an important element. A national approach is also required, he adds.

“This is about putting in the right steps to protect children. Children are vulnerable… this is not about banning fast-food outlets, far from it, we are just saying don’t locate it within 400 metres of schools.”

According to Mr Moyles, research has found that if a fast-food outlet is located within 400 metres of a school, the rate of obesity in those schoolchildren will go up by at least 25 per cent.

“The primary reason for that is, within 400 metres, particularly on school breaks, children have enough time to get from the school to the outlet, have their fast food and get back in time. Whereas if you insist on at least a 400-metre radius, it generally comes too far for kids to get out and back in that time frame… In an ideal world, it probably should be 800 metres or 1km, but in the real world we are living in, 400 metres is the minimum distance shown to be effective.”

Interestingly, the board of management of Temple Carrig Secondary School, Greystones, challenged by way of judicial review An Bord Pleanála’s decision to grant McDonald’s planning permission.

 The school, in its appeal, made reference to the 2013 planning guidelines. An Bord Pleanála’s response was that its inspector had regard in this context to the zoning of the neighbouring lands for educational uses.

However, the inspector concluded that “the decision of the County Council not to include a specific objective to limit fast-food outlets near schools outweighed the applicant’s arguments in circumstances where the proposed development is located in a neighbourhood centre, where café and restaurant use are acceptable in principle”.

According to An Bord Pleanála’s argument, the development plan and local area plan are democratic documents adopted by local councillors and it is required by Section 34 and Section 37 of the 2000 Act to have regard to those plans.

“Where the County Council as local authority has determined that it is appropriate to locate a neighbourhood centre and schools close together, and that it is appropriate to allow cafes and restaurants in the neighbourhood centre, it is open to the Board in the exercise of its expert jurisdiction to prefer the conclusion of the Council over the Applicant’s contrary submission.”

The matter is back in court for mention on 11 October. There is no date as yet for a full hearing, according to the Courts Service.

Targeted

Ms Cliona Loughnane, Policy and Research Manager at the IHF, describes the No-Fry Zone 4 Kids group as an “extremely impressive group of campaigners”. However, she says protecting children from over-exposure to fast-food outlets should not depend on members of the public becoming planning experts.

“This doesn’t seem right — that it is up to individuals at local level to oppose these plans,” she tells MI. According to Ms Loughnane, the IHF wants a national, standardised approach that local authorities will adhere to. It proposes that an effective no-fry zone would be set at 1km around a school, which is approximately a 10-minute walk. Ms Loughnane describes the 400-metre exclusion zone proposed for Wicklow as “a step in the right direction”.

She says the focus to date has been on education and awareness-raising in respect of overweight and obesity. The IHF would like to see a shift towards greater regulation in respect of calorie postings and food labelling, for example, and more supports for people experiencing overweight, obesity and food poverty. The emphasis has also been “a little too much on the individual”, which doesn’t properly acknowledge the social environment of highly-accessible, cheap convenience food, she adds.

Speaking to MI, Minister of State for Health Promotion Marcella Corcoran Kennedy says there is a “very clear direction” in the planning guidelines that local authorities carefully consider the location of any new fast-food outlets. However, she says that work is ongoing to make the guidelines “more specific and that they would be standardised across the country”.

The Department of Health, Department of Housing, Planning and Local Government and the HSE are currently working on this issue. The Minister says she was impressed by the determination of the Greystones campaign group.

The Minister would not be drawn on potential measures in the new guidelines. However, they “will certainly be a very important part of the new Healthy Weight for Ireland [obesity] strategy, which we will be launching in the autumn”.

MI understands that creation of the new planning guidelines is an action point in the forthcoming obesity strategy, expected to be launched in September.

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Minister of State for Health Promotion Marcella Corcoran Kennedy

The strategy has been eagerly awaited for some time. Asked if it will have a ring-fenced budget, Minister Corcoran Kennedy responds that every department “will be challenged to factor into their budgets initiatives that are rooted in the obesity strategy and action plan”.

On the proposed sugar-sweetened drinks levy (aka, the controversial ‘sugar tax’), Minister Corcoran Kennedy reveals that “what we are hoping to do is ring-fence a certain amount of that funding to set up a Healthy Ireland fund and this is a really good initiative that is directly in the Healthy Weight for Ireland [obesity strategy]”.

In reference to the fund, she describes how departments or local authorities could apply for funding for initiatives that promote healthier living.

Further detail surrounding the fund is still being worked on, she says. Getting the fund established is a “key” element of the obesity strategy.

The strategy will include new healthy eating guidelines, with lesser emphasis on carbohydrates and a greater focus on vegetable and fruit intake.

Work is also ongoing on developing legislation for mandatory calorie postings on food menus. A number of the bigger fast-food chains have voluntarily included this information. Standalone fast-food outlets have generally been less inclined. In late 2015, an independent survey commissioned by the Department revealed that just 7 per cent of food businesses were providing calorie information on a voluntary basis.

Would the Minister be somewhat concerned about buy-in?

“Well, I wouldn’t really,” answered Minister Corcoran Kennedy. “I think most of the fast-food outlets are anxious to make sure that people make good choices — I mean obviously, they have to sell their product, and if they are finding that there is an increasing demand for this [information], they will certainly do it.

“And it has become easier than ever really, as there are an awful lot of apps out there now that have been developed that you can actually do calculations on what the calorie content of certain items are… ”

MI also asked Minister Corcoran Kennedy if she believes local authorities should introduce health and wellbeing sponsorship criteria, referencing the controversial sponsorship of local bike schemes by Coca-Cola Zero.

“What is happening there at the moment is that the Department of Health is working with the food industry to develop a code of practice around marketing, sponsorship and advertising, so it would come in under that,” states the Minister. 

Sponsorship by the food and non-alcoholic drinks industry is among the issues being considered by the Working Group to develop a Voluntary Code of Practice (the group includes representatives of relevant Departments, food industry, advertising and promotion industry, Broadcasting Authority of Ireland, consumer advocates and NGOs).

Does she think Coca-Cola’s sponsorship of such schemes is appropriate?

The Minister responds that she will await the outcome of the code of practice process. “I am not going to jump into the middle of something that people are working on,” she stated.

The Department is also working with the food industry in relation to examining how to reduce fat, salt and sugar, she notes.

There are many coals in the fire, it seems. Health advocates will be hoping they burn brightly rather than burn out.

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