People in cities with high density of ready-to-eat food outlets have 11% higher risk of developing the condition, research shows

People who live in cities with a high density of food outlets such as takeaways, restaurants and fast-food vendors have an 11% higher risk of developing type 2 diabetes than those who live far from an instant meal, according to new research.

Previous studies have suggested having fast food on the doorstep is a risk factor for obesity, but this is the largest to focus on type 2 diabetes, which is associated with obesity.

The obesity epidemic has been blamed on the “obesogenic environment” around us. Fast-food restaurants, kiosks and snack shops selling cheap, high-calorie food seem to be everywhere. Sales are boosted by advertising campaigns on TV, the internet, in the cinema and on billboards. And life has become sedentary, with most people spending much of their time in front of the computer and TV or in the car.

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The latest research is published in the Lancet Planetary Health journal. It was led by the Healthy High Density Cities Lab at the University of Hong Kong, in collaboration with Oxford University. It involved nearly 350,000 men and women who signed up to the UK Biobank study and lived in one of 21 UK cities.

The authors looked at the density of a number of different food outlets, including pubs and bars, restaurants and cafes and hot and cold takeaways within 1km of the home of the participants. They found that those people closest to the densest clusters of ready-to-eat food outlets had 11% higher odds of type 2 diabetes than those who lived in a street more than 1km away from fast food.

In some cities there are food deserts, with little availability of healthy foods, and food swamps, where streets are crowded with shops and takeaways offering “unhealthy, calorie-dense foods and drinks”, says the paper. “Sedentary lifestyles and consumption of energy-dense and processed food that is rich in fats and sugars both constitute major risk factors of type 2 diabetes.”

Dr Chinmoy Sarkar, the lead author of the study, said the team’s work focused on ways to create inherently healthy cities. “We have to move away from the economic model to a more public health model,” he said, advocating “city-scale intervention for the benefit of public health”.

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The paper argues public health authorities should intervene. “The results have important public health implications and make the case for a shift from an exclusively corporate-driven economic model to a public health-driven health economic model of urban food access and consumption,” the authors write.

This could involve policies to reduce the clustering of fast-food outlets in residential areas and restricting the number that are allowed to open, they say. National policies should encourage food outlets to make menus healthier. There is an argument for nutrition labelling on ready-to-eat meals and fast-food takeaways.

In a comment in the journal, Buyun Liu and colleagues from the University of Iowa say that, although the 11% increased risk is relatively small, “given the large number of people living close to a ready-to-eat food environment, the population-wide health effects of exposure to these food environments would be substantial.” They call for more evidence to give policymakers the information they need to create a healthier food environment.