Why is it so much more difficult to eat a healthy diet these days than it was for our parents and grandparents? DR CHARLOTTE ROWLEY explains.
As our lives seem to grow ever busier, many of us can find it a challenge to eat as well as we might like.
Is this because we struggle to find time to prepare healthy meals? Or do we simply lack the willpower to make healthy choices?
One answer to these questions might lie in an unexpected source: urban design, meaning the way our cities are planned and organised.
The layout of our suburbs and towns has a significant impact on the foods we eat. Perth suburbs have almost three times more unhealthy food stores, such as fast food and takeaway outlets, than healthy food outlets, such as supermarkets and grocery stores.
This trend is particularly true in lower socio-economic status areas, and the relationship between fast food outlet locations and schools is particularly alarming.
On average, Perth schools have 1.8 fast food outlets within 400m, and 8.1 fast food outlets within 1km, according to a 2022 study by the Department of Health.
Secondary schools, particularly those in lower socio-economic areas, are more likely to have fast-food outlets nearby than primary schools, leading to increased fast-food intake by secondary school students. Approximately 45% of secondary school students purchase fast food close to their school at least once a week.
Having a healthy food outlet, such as a supermarket, within 800m of the home is consistently associated with reduced risk of overweight or obese children and increased healthy food intake.
Moving to an area with a greater number of healthy food outlets is associated with increased healthy food intake, while moving to an area with more unhealthy food outlets is associated with increased intake of unhealthy foods.
In short, having more places nearby to buy healthy food improves a community’s overall diet and its long-term health (Bivoltsis et al., 2020).
So, what is the solution?
Understanding these differences in food availability is only the beginning. We also need to understand why urban sprawl is so intertwined with fast food services.
The answer lies in our industrialised food system. In his 2006 book, In Defence of Food, Michael Pollan outlines how modern agriculture excels at generating energy-dense but nutritionally poor foods at low cost, which form the basis of the fast-food industry due to their simpler and cheaper logistical supply chains.
Fresh, nutrient-rich foods don’t just cost more to grow, they also to tend to be more complex to deliver and store. Supplying fresh food to more remote areas – including outer suburbs – eats into profits.
This is why we see unhealthier foods, such as chips, sausage rolls and pies, in regional service stations.
When people eat too much of this nutrient-poor but calorie-rich food, we see something called ‘hidden hunger’ – where people start to suffer from chronic nutrient deficiencies. This in turn drives the increasing prevalence of chronic metabolic conditions including type 2 diabetes.
This ‘hidden hunger’ is something that can be addressed through appropriate urban planning and regulations.
This might include mandated access to fresh food providers in new residential developments. Additionally, ensuring new developments have footpaths and good access to public transport can encourage physical activity.
In remote communities, a new federal government scheme subsidises 30 household items, including fresh fruit and vegetables, to bring prices in line with comparable urban supermarkets.
As these examples show, the answer is big picture action. Interdisciplinary cooperation is needed to reform zoning laws and adjust both public health and agricultural policies to create and support environments that ensure fresh, nutritious food is accessible for all.
Read about the impact of a gardening and cooking program at Rangeway primary school in Geraldton.
Do you have a question about diabetes and food? Call the Diabetes WA Helpline on 1300 001 880 to speak to one of our diabetes educators.
