Sarah Alderton gives a clear and detailed account of how the profit motive affects our culture of eating and drinking. Fat, salt and sugar are used to make low quality food and drink products taste and feel better than they otherwise would, so that they can be produced at minimal cost and maximum profit.

When it comes to food, the busy nature of our lives and shift in working patterns has led to an increased need for convenience. We have become reliant on pre-prepared foods that can be microwaved in minutes or simply placed in the oven, and fast food that is ready to eat on the go, take away or be delivered to our door. Though it may save on cooking (and washing up), this evolved way of eating can be expensive and compromise the nutritional quality of our diets.

These heavily processed meals are typically calorific and contain high amounts of fat, salt and sugar, whilst lacking whole fruit and vegetables and other beneficial nutrients. As a nation we are consuming too much salt, saturated fat and sugar, causing weight gain and obesity, high blood pressure and increasing the risk of heart attacks, strokes, type 2 diabetes and cancer. Given the trend for TV programmes and books showing cooking of increasing complexity and variety, why has food that is so detrimental to our health become so incredibly popular in modern food culture?  

Fast food is ubiquitous, available 24/7, 365 days a year. It’s heavily marketed by powerful multinational corporations, and found in close proximity to schools, sold at tourist attractions, sports grounds and entertainment venues. It’s also frequently coupled with price promotions encouraging people to go supersize or add extras for little or no money at all.

The out-of-home sector, including takeaways, now plays a much bigger part in the amount of salt, fat, sugar and number of calories we consume every day. Foods and drinks that were once considered a ‘treat’ are now regularly consumed, in vast quantities, and becoming a staple in many people’s diets. Alarmingly, a BBC survey published last year found that one in six young people in Britain eat ‘fast food’ twice a day.

Also, our perception of portion sizes has become distorted as servings have become super-sized. Some meals exceed 1000 calories and contain up to three times more salt than the maximum recommended daily limit - but without nutrition labelling, and often little feeling of fullness,, people have no idea what or how much they are eating. It’s no wonder that nearly two thirds of adults and a third of children are above a healthy weight.

The supermarkets are failing to compete with this immediate desire for ready-to-eat food, despite increasing numbers of in-store ‘hot takeaway’ foods and ready meals available. Takeaways now make up more than a quarter of all the country’s food outlets, with a greater density found in the most deprived areas. Blackburn, for example, has seen a 24% increase in the number of takeaways since 2014 and now has 236 in total, the equivalent of one for every 625 people.

Why so many? It’s a case of supply and demand – those on a tight budget want cheap, ‘tasty’ and highly accessible food - not all have access to fresh food and cooking facilities - and fast food outlets have responded by selling exactly that. Fat, salt and sugar are used liberally because they’re readily available, and are a cheap way of adding flavour and texture to food, making a low-quality product taste and feel better than it otherwise would.

This means food can be produced at minimal cost which maximises profit. In a competitive market, businesses are reluctant to change their recipes or the range of food they offer for fear of a dent in profits and sending custom elsewhere. The driving force behind menu choices is often primarily one of financial prospects, rather than health. So long as people buy their food, they’ll keep selling it.

Since 2014, the number of fast food outlets in England has risen by 8%. Only 12% of local authorities have seen the number of takeaways fall or stay the same since 2014. Some have enforced planning restrictions to limit the number of new ones built in an area, including none within a 400 metre radius of schools, but not all have followed suit despite being encouraged.  

Progress is hindered by budget cuts imposed by central government, meaning local authorities have to maximise their income from business rates. Yes, businesses need to thrive, but this shouldn’t be at the expense of people’s health. What’s more, planning restrictions are only applicable to certain types of outlet, specifically ‘hot food takeaways’, and not all. This means that places offering a takeaway service but that also provide sit-in seating, like bakeries, cafés and restaurants, are exempt because they are classified differently. This needs to be revised so that all types of fast food outlet are included.

It’s not only the number of outlets that must be addressed, but also the quality of the food sold. There is an urgent need for establishments to reduce the salt, fat and sugar content of the foods they sell and re-evaluate their menus to offer healthier options. The food industry has worked to significantly reduce the salt content of everyday packaged foods and has now been asked to do the same for sugar and calories in response to the Government’s obesity plan, proving that reformulation is achievable.

Over the last 10 years the salt content of bread, breakfast cereals and other processed foods has been gradually reduced by around 30-40%, with no impact on sales or consumer purchase behaviour - our taste buds adjust to less salt over time. In addition to reformulation, other small and inexpensive alterations can be made in fast food outlets, such as removing salt-shakers or sachets from the counter and offering alternative seasonings, swapping condiments and dressings for reduced fat, salt and sugar varieties, switching cooking oils to ones with less saturated fat, modifying recipes to include more vegetables, replacing full sugar drinks with low/no sugar alternatives and offering smaller or ‘lighter’ portions.

 These healthier options should be clearly signposted to customers so that they are fully informed when they place their order, along with incentives to purchase healthier options such as loyalty cards. Improving the quality of the food delivered doesn’t need to be difficult or compromise taste. It’s time for ALL businesses to act responsibly.    

The Good Food Bradford project, a partnership between Bradford Council and local NHS trusts, exemplifies how businesses can act responsibly by working with local takeaway and fast food outlets to increase the number of healthier menu options available, improve catering practices to reduce the fat, salt and calorie content of their meals, and raise awareness amongst consumers of the benefits of making healthier lifestyle choices. Businesses that actively promote healthy eating are rewarded. Healthy eating sessions are also run in schools to educate children on the detrimental impacts fast food can have if consumed in excess. This initiative could be rolled out across all local authorities at low cost and thereby create a level playing field and eliminate the issue of businesses losing out because all would be faced with the same task. 

The out of home sector has a crucial role to play in creating a healthier food environment that not only gives people access to healthy, affordable foods but also encourages them to make healthier food choices. Shirking responsibility or saying ‘it’s what the people want’ means the problem will continue to grow. Up to this point there has been a distinct lack of intervention by government, but that must change before people eat and drink themselves into an early grave.

Treating obesity costs £6bn a year, expected to rise to £10bn by 2050. Meanwhile the NHS spends £8.8bn a year on type 2 diabetes alone. Costs like this are likely to spiral if things carry on the way they are and our already struggling healthcare system will collapse under the strain. Yet huge cost savings could be made (reducing salt intake alone has the potential to save £1.5bn a year) and thousands of lives saved if comprehensive measures were employed to tackle the issue.

If we are to successfully combat obesity and the rise in diet-related diseases then improving our eating culture must become a top priority for government. If voluntary reformulation is not successful and the food industry does not comply then the Government must legislate, enforce mandatory targets for salt, sugar, calories and saturated fat and monitor progress to ensure that healthier food is produced.