ADPH London

London Childhood Obesity Exchange

Developing a Healthier Food Offer

1

Outline of the Event

Introductory Presentations

1.30 Welcome and Introduction to the event

1.40 What is the Problem and the Opportunity?

The Food Offer within a whole systems approach

1.55 Examples of developing a healthier food offer in London

2.25 Into Action... Learnings for practical application

Facilitated Actions...

2.40 Working together to identify what is happening or could happen in

your borough / area

3.15 Coffee and Exchange of Knowledge and Ideas

3.35 Developing ideas and commitments to make small changes to make

a big difference.

4.20 Into Action ... Resources and support to implement change

4.30 Close

2

ADPH London

The Food Offer within a

Whole Systems Approach

3

What’s the problem?

4

Londoners see food provision as the

problem...

• 1. Too many cheap unhealthy food and drink options (60%)

• 2. Too many fast food shops (44%)

• 4. Too much advertising of unhealthy food and drink options (30%)

Great Weight Debate, 2016

They’re right!

#FDPHwebinars

Also see it as an opportunity....

How do you think children in London can be better supported to lead

healthier lives (please tick your top three solutions)?

• 1. Providing cheaper healthy food and drink (39%)

• 2. Supporting families to cook healthier food (34%)

• 3. Limiting the number of fast food shops (33%)

• 4. Less marketing and advertising of high fat and sugary food and drink

(31%)

Great Weight Debate, 2016

Food is a key contributor

8 Source www.bhr.org.uk

We underestimate the importance of calorie

reduction... The amount of exercise needed

to burn off calories...

What do you think?.... How many calories

would the following people burn by doing

moderate intensity cycling for an hour....

A 42 year old woman weighing 134 lb?

10 year old girl weighing 32 kg

Can’t do it by exercise alone.

9

Average 42 year old woman weighing 134 lb

would burn 483 calories.

Average 10 year old girl weighing 32 kg

would only burn 284 calories by cycling for

an hour.

Why is it a problem?

10

• The unhealthy choice is the ‘easy’, attractive, affordable and ‘normal’

choice.

• Childhood obesity isn’t just a matter of personal, rational choice – our

obesogenic environment influences our behaviour.

• We need to move the focus from encouraging the individual to change,

to enabling this change and enabling maintenance of change.

Influence of the food environment

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PHE London Awayday 30th November –

Childhood Obesity

It’s not just takeaways ...

Remember that complex system...

13

Opportunities within the complex system

Food provision – leisure

centres, govt buying

standards,

work, take-aways /

festivals

convenience stores,

markets...

Health care including Weight management programmes

Planning – density and ‘visibility’ and

normalisation of environment

Tax, incentives,

Recognition / awards

Early years, childcare and school setttings - School meals, fruit & veg schemes, water only

policy, nutrition guidance on pack lunches, stay

at school to eat policies, breakfast club, daily mile, active lessons...

Media and Community voice and social norms

Active

journeys

Parks and green / blue spaces

Where are our touchpoints and our opportunities?

At home At school or early years

settings

After school and

weekends

HM Government Childhood Obesity

A Plan for Action 1. Soft drinks industry levy

2. Taking out 20% of sugar in products

3. Supporting innovation to help businesses to make their products healthier

4. Developing a new framework by updating the nutrient profile model

5. Making healthy options available in the public sector

6. Continuing to provide support with the cost of healthy food for those who

need it most

7. Helping all children to enjoy an hour of physical activity every day

8. Improving the co-ordination of quality sport and physical activity

programmes for schools

9. Creating a new healthy rating scheme for primary schools

10.Making school food healthier

11.Clearer food labelling

12.Supporting early years settings

13.Harnessing the best new technology

14.Enabling health professionals to support families

15 Childhood Obesity Plan for Action: PHE Networks Briefing. Loretta Sollars Public Health England

Food actions in red

Schools actions in blue

Other actions in brown

The ‘Out of Home’ food provision toolkit supports you to consider where to take action...

And how to make that healthier action..

Turning

A Challenge...

#FDPHwebinars

Into An Opportunity...

https://www.kickstarter.com/projects/createlondon/chicken-town-tottenham

‘For us, tackling obesity isn’t about taking choice

away. It’s about improving what’s on offer and

making it affordable and delicious!’

Or working with the Healthier Catering

Commitment in Westminster

• To date, 19 businesses have successfully achieved Healthier Catering Commitment status and their efforts to serve healthier food were recognised at an awards ceremony at Westminster City Hall on 23rd February 2016.

• The main catering changes made by businesses include:

Use of grilling and baking methods rather than frying wherever possible.

Use of low fat fillings for sandwiches.

Use of semi-skimmed milk as a default for hot drinks.

Removal of high sugar drinks from prominent displays.

Offering smaller portion sizes.

Actively promoting healthier choices to customers

TCOP Annual Report 2016 20

Or working with schools and early

years settings and professionals to

change the environment. and

provision...

• Free School Meals & fruit / veg snacks

• Nutritional Standards of school meals

• Healthy Snacks only within school gates and around

• No ice cream vans -

• No takeaways within 500m of school

• No HFSS on cards only cash

• Move the salad bar in schools

• Encourage use of healthy start vouchers at markets as in Tower

Hamlets

TCOP Annual Report 2016 21

Or considering how we can use

planning, leases and licences

• Restrict density of fast food outlets in deprived areas

• Use supplementary planning documents to restrict new hot food

take-aways near schools, youth facilities, parks (Waltham Forest)

• Lower cost vendor licenses for street food – for example in

Warrington, street traders get £100 discount if meets nutrition

guidelines.

• Developing healthier environments at festivals / events to build

social / cultural norms

• Developing markets within easy access of communities

• Food growing projects, green spaces prioritised within planning

TCOP Annual Report 2016 22

Or considering how we can use

planning, leases and licences

• Restrict density of fast food outlets in deprived areas

• Use supplementary planning documents to restrict new hot food

take-aways near schools, youth facilities, parks (Waltham Forest)

• Lower cost vendor licenses for street food – for example in

Warrington, street traders get £100 discount if meets nutrition

guidelines.

• Developing healthier environments at festivals / events to build

social / cultural norms

• Developing markets within easy access of communities

• Food growing projects, green spaces prioritised within planning

TCOP Annual Report 2016 23

ADPH London

Stealthy Eating

Wholesalers working with independent take-aways

Terry Larkin JJs Cash and Carry

24

ADPH London

Improving the Food Offer in Greenwich

Claire Pritchard

Greenwich Community Development Agency

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ADPH London

Developing Healthier Food Business

Jessica Attard– Healthy London Partnership

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By Jessica Attard

Make Kit, part of the Healthy Communities Project

01 Introduction

Transforming London’s health and care together

To implement, test and evaluate sustainable and commercially-viable healthy lifestyle

interventions, created with - and led by - the local community and local delivery partners.

Aim

Introduction In-depth ethnographic research and co-design of 3 initiatives to tackle childhood obesity

Piloted and evaluated initiatives in partnership with local people and organisations

Transitioning successful initiatives into sustainable and locally owned entities. Sharing learnings and model more widely

Uscreates and Apteligen brought on-board as implementation and evaluation partners

• Healthy recipe kit launched in Hackney (Haggerston Estate)

• Kick-started by the NHS, in partnership with Hackney’s Public Health team, but owned and run by two local entrepreneurs – Steve Wilson and Justine Fish.

Make Kit

• Community driven and locally owned

• Designed with business viability in mind from the start

• Working in partnership with others

• Capitalising on local assets

• Engaging with businesses both locally and nationally

A sustainable approach

• NHS in partnership with Hackney’s PH team and Uscreates (Design Consultancy)

• With support from: – Community (volunteers, champions) – Business (UBS Consultants, Mindful Chef) – VCSE sector (Make in Hackney, Hackney Cooperative

Developments and others)

• Consisted of business modelling, sharing market intelligence and operating models, provision of community space and kitchen, support with branding, marketing, comms and PR, finance and sharing of other skills and experience

An incubation model

Make Kit:

• £68,000 matched funding and in-kind resource secured during pilot

• 57 families reached with 372 kits distributed

• Participants reported eating less high fat, salt and sugar foods; more home cooked meals, fruit and vegetables

• 83% reported more confidence in cooking healthy meals

• 80% reported being inspired to try new recipes and different types of food

• 50% reported being inspired them to get more involved their community

• 67% reported their knowledge of cooking on a budget had improved

• 57% reported that they’d learnt new cooking skills through participating in the pilot

• Secured £30,000 grant from Hackney Council to further roll-out Make Kit and transition the

business into a sustainable venture.

Early impact

“In 12 months, we forecast 300 customers per week. By the end of year 2 we estimate to have 500 customers per week, year 3, approximately 900

customers. We aim to double our customer base in each subsequent year to approximately, 4000 by the end of year 5.”

- Justine Fish, owner of Make Kit

Ambitious plans for the future

A chance for questions

Thank you for listening

For more information visit: www.healthylondon.org/prevention Or e-mail me at: jessica.attard@nhs.net

Into Action

37

Key learnings we can put in practice:

- Small changes across the system, by all players can make a big

difference and achieve the tipping point needed to reverse norms.

- Consider ‘what’s in it for me?’ for all stakeholders, engage them with

their priorities not just ours.

- Consider the changes made and adapt, based on intended and

unintended outcomes, keep evolving.

- Make sure we can measure changes and see what is working and isn’t

working...

- No blame..... Work together to make the system better...

- And believe it’s possible......

ADPH London

So how can we adopt this approach?

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ADPH London

Activities

39

40

Opportunities within the complex system

Food provision – leisure

centres, govt buying

standards,

work, take-aways /

festivals

convenience stores,

markets...

Health care including Weight management programmes

Planning – density and ‘visibility’ and

normalisation of environment

Tax, incentives,

Recognition / awards

Early years, childcare and school setttings - School meals, fruit & veg schemes, water only

policy, nutrition guidance on pack lunches, stay

at school to eat policies, breakfast club, daily mile, active lessons...

Media and Community voice and social norms

Active

journeys

Parks and green / blue spaces

ADPH London

Wrap Up and Into Action

41

What’s next...

42

Make the Change....Obesity leads co-ordinate action from today’s event...

Access the Website ..(www.....) after election June 9th...

. With presentations, resources, posters examples, toolkit

Feedback progress, challenges and experiences at Ideas Exchange

Wednesday July 12

Share knowledge, examples and activities with wider teams across

Boroughs with materials available on the website.