Exposure to multiple sources of accessible, cheap, energy dense fast foods in a deprived community

This study assesses the levels of fats, including trans-fatty acids, and salt in common takeaway fast foods in a deprived urban community in the West Midlands England and implications in the context of the spatial distribution of fast food takeaways. The results of the compositional analysis of over 250 take out foods were compared with established and derived standards. 70% of products exceeded the recommendation that a meal should contain less than 30% of a Guideline Daily Allowance (GDA). More than half exceeded 50% GDA for at least one metric including 81% of all analyses for saturated fatty acids (SFA). Over 30% samples exceeded the children's GDA for total fat or SFA. 27% of salt analyses exceeded the GDA. For poorer social groups avoiding the expense of cooking entirely is a cost effective way of sourcing calories. These are the same populations experiencing high levels of unemployment and limited opportunities to develop businesses. People in Sandwell are exposed to large portion sizes and high levels of fats and salt in takeaway foods. Given this population's limited options to break out of a highly compromising environment of living simultaneously in a ‘swamp’ of unhealthy, readily accessible and cheap takeaways, and a ‘desert’ of healthy options, an innovative package of interventions is required. There are strong political, social and economic reasons for not considering a blanket restriction on takeaways given the role such businesses play in entry-level employment and business opportunities for disadvantaged communities Rather than trying to ban such foods, a more realistic and effective intervention is to challenge and change what's on offer, how much is on offer, and how it's been prepared, ‘change the menu not the venue', while at the same time enabling communities to access, prepare and cook good quality ingredients for a healthier diet. KEY MESSAGES: • This population is living simultaneously in a ‘swamp’ of unhealthy, readily accessible and cheap takeaways, and a ‘desert’ of healthy options. • A package of interventions is required including local planning and regulatory powers, educational interventions and working with industry to promote healthy and affordable food preparation techniques.