[ Results | Concerning Those Eating Fast Food Everyday ]

SUMMARY

The survey took the form of a structured interview, being carried out in Peckham outside four fast food outlets, interviewing consumers as they left the stores.

The majority of the population interviewed was between the ages of 20-34 years old.2/3rds were employed and over half of those interviewed were on a low income of <ú100/week.

The results show that those using these outlets consume much greater quantities than the national averages suggest, due to the masking effect caused by those who use the outlets very little.

87% of fast food eaters claimed to eat fast food at least once a week, with 31% of fast food eaters saying that they ate fast foods every day.

The main implications resulting from the findings of this survey are that due to the high frequency of use, the outlets must be serving a need for those surveyed. The potential is there to help improve the population's health, rather than jeopardizing it by providing unhealthy meals in an area where health is at a premium.

The provision and consumption of healthier meals is not just a question of consumer choice but is also the responsibility of the food manufacturers. Manufacturers should be urged to review their policies concerning nutrition and the quality of their products.

Local planning authorities also need to review the type of new businesses being opened in the area, and in this example of Peckham, Southwark Council could play a role in encouraging other outlets such as pizza, baked potato or sandwich into the area.

Health education also needs to be increased so that the public can understand what is being offered to them. For customers to make informed choices, fast food needs to be labelled with at least as much information as is found on the food in retail shops.

INTRODUCTION

Fast food now covers most areas of the commercial food market, ranging from American-style hamburger and pizza chains through Chinese and Indian take-aways, to the traditional British fish and chip shops. The past few years have also seen the emergence of baked potato outlets, and the introduction of croissant bars.

Although the type of food sold in these outlets may vary widely, the characteristics of outlet operation are similar across the board. The most important characteristic is obviously that of providing fast service, requiring no prior indication of custom.

Consequently the menu is generally limited and concentrates on one type of food, e.g.hamburgers, chicken or pizza. To increase the speed of meal production, table service has been replaced to a certain extent by counter service, although table service is still preferred in Wimpy and most of the pizza chains.

Fish and chip shops have been operating in Britain for over 100 years, with Chinese, Indian, Greek and Turkish growing up over several decades since the war. However the most rapid expansion has been in the American-style outlets, hamburgers especially, but also pizzas and chicken, since their introduction in the 1960s and 70s. Wimpy, the British owned hamburger chain, started operations in 1955 but did not introduce a take-away facility until 1978. Kentucky came to Britain from America in 1965 and was the first to offer an alternative hot take-away food to the long established fish and chips. Pizzas also started to filter into the market in the 1960s but have not really made any impact until recently. The American hamburger outlets came to Britain in the 1970s having already rooted themselves firmly in the States.

National Figures

Eating outlets are often associated with certain groups of people and fast food is mainly associated with the young. Popularity decreases as age and social class increase.

A survey by BMRB/Mintel in 1985 showed that fast food was eaten most often by 15-24 year olds in the social groups DE. 37% of those in the social groups, DE, had 'recently' eaten in a fast food outlet, compared to 15% in social groups ABC1. Twice as many were 15-24 years old as were 45-64. Hence they concluded that fast food was 'youth orientated and down market',(2).

HOTAG (Hot Take Away Group) found that 43% of 15-24 year olds, 54% of the unemployed and 36% of students ate fast food more than twice a week,(3).

Take-away sales account for 2/3rds of fast food's total turnover but this proportion differs by outlet,(4). In fish and chips, take-away is still dominating sales at 83%, although eat-in has increasd since tax was imposed on hot take-away food in 1984. Conversely only 37% of sales in hamburger bars come from take-away food and these outlets have the largest eat-in sales,(5). The Consumer Catering Report in 1986 reported "take-away food is for the young and less affluent because they can't afford restaurants and may lack cooking facilities."(6)

Fast food is eaten most often when the consumer is shopping or travelling,(7). About 2/5th of burger sales occur during shopping trips and 17% of all fast food is sold during work breaks,(8).

Estimates of average expenditure differ. One report says that it is over ú3,(7) and another finding that over 50% of consumers spent less than ú1.50,(3). Consumers who use outlets frequently spend less on a meal, and although the higher social groups eat fast food less often, their proportion of the expenditure is higher,(5).

Nutritional Context

FATS

It is the high levels of saturated fatty acids and low levels of some 'essential' polyunsaturated fatty acids in the diet which are thought to be connected with high levels of heart disease. An adjustment in fatty acid proportions is also thought to be benefical, i.e. a decrease in saturated fatty acids and an increase in 'essential' polyunsaturated fatty acids. Current recommendations for people in the U.K. are that not more than 35% of the energy in the diet should be provided by fat, and not more than 15% from saturated fatty acids,(10). The following table illustrates the relatively high levels of fats and saturated fatty acids in fast food.

Chicken products tend to be lower in saturated fatty acids, but the percentage of energy from total fat is not that different from other foods. Indian food can be particularly high in fat because large quantites of oil are often used in its preparation. The amount of saturated fatty acids will depend on exactly which oil is used.

SALT

No recommended intake for salt has been proposed in the U.K. because there is a need for further evidence of its effects on the body. However the present average intake is estimated as being over 10g/head/day which is well in excess of the body's requirements, and so recommendations have been made, for example by NACNE, to reduce the intake by 1g/head/day short-term, and by 3g/head/day in the long-term(9). One of the ways in which individuals can reduce their salt intake is by reducing the amount used in cooking, and so for those eating fast food, this is not possible.

The following table shows fast food products found to be relatively high in salt. This is before the addition of discretionary salt by the consumer.

SUGAR

As well as the amount of sugar consumed being a factor, its form and frequency is thought to be of much greater importance. Sugar eaten between meals is more cariogenic than sugar incorporated into a meal.

Regardless of snacks or meals though, fast foods contain large amounts of sugar and not always where it's expected? For example a McDonald's Hamburger Bun contains 13% sugar.

Below are listed foods in which sugar appears unexpectedly:-

Overweight

FIBRE

In general fast food is low in fibre, as the upper half of the table shows. However some products, such as baked potatoes, contain adequate amounts of fibre, suitable for one meal.

OTHER NUTRIENTS

By looking, in detail, at the diets of pregnant women, it appeared that those women who consequently gave birth to low birthweight babies(<2500g) were eating greater amounts of fast food and less fresh vegetables and fish, than those whose babies weighed over 2500g(11). As well as their diets being lower in vitamins and minerals, they were also found to be consuming significantly lower levels of essential fatty acids, re-emphasising the point made earlier about the proportions of fatty acids in many fast foods.

Another study showed that schoolgirls who regularly had lunch in 'cafes, fish and chip shops or take-away outlets' were gettimg over 40% of their calories from fat and were not getting the recommended amounts of vitamins A, B2 or D, iron or calcium(12).

Therefore as well as being low in fibre, fast food is also low in vitamins and minerals. This is mainly due to the lack of fruit and vegetables in the limited menus, although salads are becoming more popular in pizza houses, for instance.

The following table shows the recommended amounts of four nutrients to be obtained from 100kcal, and compared to the amounts obtained from every 100kcal of some typical fast food meals.

These figures support the findings of the two studies outlined above, showing that the amounts of nutrients in these fast foods fall well below the recommended. One pregnant woman interviewed in our study said that she was eating fast food twice a day, hamburgers at lunchtime and chinese in the evenings.

Choosing Southwark

Peckham covers 4-5 of the wards within Southwark, and makes up about 1/5th of Southwark's total population.

Within the Peckham area the problems of multiple deprivation are the most severe, showing the highest concentration of financial problems, this being inextricably linked to the Peckham constituency having the highest rate of unemployment(30-35%) in the London Borough of Southwark. Up to 85% of the households in Peckham have a gross income of less than ú10,400, with 20% receiving less than ú2,600 gross in a year,(14).

Over 60% of the housing is rented, with 2-5% of households being without the exclusive use of a kitchen.

Educationally the area's school leavers are amongst the lowest achievers in London.

With regard to health, the highest death rate comes from coronary heart disease which, as shown before, is related to a high dietary fat intake, particularly saturated fat. Coronary heart disease accounts for 24% of male deaths and 19% of female deaths, for all ages. A high salt intake has been linked to the incidence of high blood pressure which is also a risk factor for coronary heart disease. Raised blood pressure is also a contributory factor for circulatory diseases which the middle-aged are most prone to,as well as cancers, while circulatory and respiratory diseases together are the biggest killers of the elderly.

The mortality rate in children is low by national standards, but there is a high rate of low birthweight babies(below 2500g), the Peckham area having the highest rate in Southwark at 9.4%. As discussed before (11), the incidence of low birthweight babies appears to be related to ante-natal nutrition.

As mentioned earlier dental health is worst for children in North Southwark, which includes the Peckham area, and as fast food frequently contains sugar, even where it may not be expected, the link between the incidence of dental caries and sugar intake cannot be overlooked.

Peckham also presented itself as a suitable site for the survey when it was found to contain a range of fast food outlets within a fairly localized area. Along the two main streets of Rye Lane and High Street, were a range of the main fast food chains and several other independent outlets, with the exceptions of pizza, and baked potato. It was therefore felt that the consumer had a wide enough choice to be able to choose between them, rather than a single outlet simply being the only one available.

METHODS

As shown already, younger people and those unemployed tend to use fast food outlets at above average rates. If it were the case, that a significant proportion of fast food eaters consume large amounts of fast food, then there is some cause for concern about the quality of the food and the impact this has on their overall diet and health.

This survey was principally concerned with examining whether such a significant proportion was likely to be found in an area known to have poor health characteristics related to dietary factors.

When faced with a survey involving the collection of data from the public, there are two main options available, the interview and the questionnaire. Both have advantages and disadvantages, and the suitability of one over the other is unique to the survey being carried out.

For this survey it was felt that a structured interview would be the most appropriate method. The limitation on time meant that a high response rate was essential for enough results to be collected and this can only be guaranteed by using the interview technique. Comprehension of the questions is sometimes a problem, and so if an interview is being used the interviewer can help explain the meaning of the questions. However the main disadvantage of using the interview is that bias can occur, mostly unintentionally ,in the way the questions are being asked, especially when asking respondents for their opinions, as in part of this survey. However this should be overcome to a certain extent by practise and question design.

This is a descriptive survey, i.e. one in which the population's attributes are being estimated, rather than an explanatory one in which a cause and effect relationship is being investigated. So for this type of survey representativeness is crucial in order for any conclusions about the whole population to be drawn from the results(15).

Interviewing was carried out during lunchtime and tea-time. Evening interviews were not undertaken for reasons of safety. Therefore the population was not wholly representative of fast food consumers. Also for practical reasons, interviewing did not occur at the week-ends and so the sample is again biased. However conclusions can be drawn from the sample collected as it stands, but by taking into consideration the limitations experienced.

Choosing the Questions and the Pilot Study

The questionnaire was piloted in Angel, Islington. From these surveys and the experiences encountered during the interviews, a few minor changes were made to the questionnaire layout until it was finalised ready for the main survey.

The questionnaire schedule is shown in Appendix (i).

It was also necessary for the sample population to be situated away from the main survey population in Peckham, so that the same people were not interviewed twice, hence avoiding a learning bias. Respondents were selected randomly as they emerged from the fast food outlet and asked if they would participate in the survey. Responses were obtained as follows:-

RESULTS

Sample Description

* Over 50% of the sample had incomes of <ú100/week, and 85% had incomes of <ú200/week, which is comparable with the figure quoted for the whole population in this area-'only 16% of households have more than ú10,399 per annum'(14).

* 62% of this sample were employed, with 13% unemployed, this being lower than the figures quoted for the whole population of the area-Liddle ward,one of the wards within the Peckham area, has 35% of its economically active population unemployed(14).

* 56% of the sample interviewed were female, and 44% male.

Eating Habits

* Therefore only 13% of those interviewed ate fast food less than once a week.

* The overall average number of meals or snacks eaten at fast food outlets each week by this sample population was a little over 4, meals accounting for 2/3rds of these occasions, and snacks 1/3rd.

* Of those who ate fast food at least once a day, 46% were on low incomes, earning <ú100/week, but this was lower than the overall proportion of those on low income in this sample.

* The proportions of males to females reversed in those whose used the outlets every day.

* The rating of 'general' food decreased in those interviewed who ate fast food every day.

* 'Convenience' was the most popular reason given for using the outlet, with only 8% giving 'fast' as their reason, the majority of these being employed. Less than 1% chose the outlet because it was cheap. The younger children chose the outlet because they 'like the taste'.

* The time of the interview did not appear to affect the reasons given for using the outlet.

* Those who earned a higher salary were found to be using McDonalds more than the other outlets.

* 27% of those interviewed stated that the food being consumed at the time of interview, was their main meal of the day.

Expenditure

* Expenditure increased with age, except in those over 60years old, whose expenditure was much lower, below ú1. Expenditure was generally lower in the fish and chip shops, but unrelated to income.

Perceptions of Health

* There was no correlation between the type of food eaten on that occasion and the consumer's rating of that food.

* When the respondents were asked 'if the food manufacturer told you that the food you've just bought is good for you, would you believe them?', only 20% replied that they would.

TABLES CONCERNING THOSE EATING FAST FOOD EVERY DAY

Crosstabulation Tables

Discussion

In this survey of fast food eaters, 87% said that they ate fast food at least once a week, with 31% of those interviewed eating fast food every day. The quantity of fast food being eaten by this population is far greater than being just 'a matter of interest'.

If, as this survey suggests, significant numbers of people are using fast food outlets on a daily basis, the outlets are obviously serving a need and so their validity is unquestionable. However, for these people, a large and significant part of their diet consists of fast food and so the question of responsibility for providing adequate nutrition needs to be raised.

In an area where coronary heart disease is the biggest killer, the high quantities of fast food being eaten by some of the population must arouse concern. The outlets available are those which tend to sell high saturated fat products. Saturated fat is a major risk factor of coronary heart disease. There is a need for change in the nutritional policies of these manufacturers, to improve the quality of the products they are providing and to help decrease the risk of the diet-related diseases common to this area. The introduction of healthier products also involves the local planning authority, in this case, Southwark, to introduce new outlets into the area, which sell products with a lower fat content, such as pizza, baked potato and sandwiches. At present, they are all absent from the Peckham area. The frequency of their use was therefore low amongst those interviewed, but many remarked that they would use the outlets if they were available to them.

When the level of belief in the manufacturer is so low it would be ineffective for the product information to come soley from this source.

A survey done for MAFF in 1982, of 15-25 year olds, investigated their sources of information about diet and food(16). For men, the most important sources were television and their parents, but for women, it was magazines and friends.

One may question the level of consumer concern regarding a healthy diet, but the MAFF survey showed that nearly a quarter of the women were concerned about ingredients, although only 9% of the men showed very much concern. Half of the respondents would like more information, the majority would like this information to come from food labels, men also favouring the media as a source of information and women, manufacturer's leaflets.

If labelling was introduced into a fast food outlet the consumer would be able to relate the food about to be eaten to the information on the label. This would help the lady in Peckham who claimed that she doesn't eat red meat but had just bought a hamburger! This form of information has to be provided by the manufacturers, but labelling could easily be accommodated by the packaging used by most outlets, paper and cardboard, and also on the screens used to display the products.

As well as improving the products available and the availability of the information regarding them, the ability to understand the information also needs to be improved in order for any other steps to become effective, as shown by the experience of Wendy's, an American burger chain. Wendy's aimed to provide a burger with better quality ingredients, but then tried to diversify by introducing salads and baked potatoes. Although this is nutritionally sound and could be encouraged, it confused the consumers, diluted their image, and they lost the 'beef' reputation they had initially aimed to build up(18).

This indicates that health education should be improved, and was highlighted by the low level of consumer ability to rate the food that they ate, in terms of health. Some respondents admitted that they didn't know how to rate the food, and one respondent rated her general food as good simply because she ate no sweets.

This need for improving education is made more apparent when the majority of the consumers are seen to be young in age, and so health education in schools is important. One set of local school children was being encouraged to use fast food outlets the school bus stopped right outside McDonalds after school.

References

1. Gordon Simmons Research Limited, 'Take-away and eating out at Restaurants', 1987.
2. Mintel, 'Catering Markets for Foods', 1985.
3. HOTAG Survey, from the Consumer Catering Report, 1986.
4. MSI:Database, 'Fast food:UK', March 1987.
5. 'Keynote Report 1987', Keynote Publications Ltd.
6. Consumer Catering Report, 1986.
7. Gallup Survey for 'Caterer and Hotelkeeper', February 1986.
8. AGB-Attwood Market Monitor, 1985.
9. National Advisory Committee on Nutrition Education, 'A discussion paper on proposals for nutritional guidelines for health education in Britain'. Health Education Council 1983.
10. Committee on Medical Aspects of Food Policy, DHSS Report no.28, 'Diet and Cardiovascular Disease'. HMSO 1984.
11. G.Vines, 'Takeaway diet leads to underweight babies' from 'New Scientist' 25 December/1 January 1987.
12. R.W.Wemlock, M.M.Dusseldorf and R.K.Skinner, 'The Diets of British Schoolchildren'. DHSS 1986.
13. R.Passmore and M.A.Eastwood 'Davidson and Passmore Human Nutriton and Dietetics'. Churchill Livingstone 1986.
14. Southwark Council:'Southwark's Health: A report on the health of the borough of Southwark' and 'Fair Shares?: The Southwark Poverty Profile'.
15. J.S.M.Band, 'Planning a survey by questionnaire' from 'Applied Nutrition:1'. John Libbey:London. 1981.
16. Nicola L. Bull 'Dietary habits of 15 to 25-year-olds' from 'Human Nutrition:Applied Nutrition' Vol.39a Supplement 1:1-68 John Libbey:London. 1985.
17. J.Pascoe, J.Docherty & J.Ryley 'Fast Foods', from R.Cotterell 'Nutrition in Catering'. Parthenon Publishing. 1987.
18. 'Marketing Week'(p.21), 8-8-1986.

Tables of Results

Respondents' stated frequency of using a fish and chip shop Frequency Percentage never 141 39.8 1adayformeal 6 1.7 2-3aweekformeal 27 7.6 1aweekformeal 47 13.3 2-3amonthformeal 15 4.2 1amonthformeal 25 7.1 <1amonthformeal 17 4.8 1adayforsnack 4 1.1 2-3aweekforsanck 12 3.4 1aweekforsnack 23 6.5 2-3amonthforsnack 8 2.3 1amonthforsnack 20 5.6 <1amonthforsnack 9 2.5 TOTAL 354 100.0

Respondents' stated frequency of using a pizza take-away Frequency Percentage never 244 68.9 1adayformeal 3 0.8 2-3aweekformeal 3 0.8 1aweekformeal 12 3.4 2-3amonthformeal 18 5.1 1amonthformeal 31 8.8 <1amonthformeal 21 5.9 2-3aweekforsnack 1 0.3 1aweekforsnack 5 1.4 2-3amonthforsnack 2 0.6 1amonthforsnack 11 3.1 <1amonthforsnack 3 0.8 TOTAL 354 100.0

Respondents' stated frequency of using an indian take-away Frequency Percentage never 269 76.0 1adayformeal 3 0.8 2-3aweekformeal 7 2.0 1aweekformeal 15 4.2 2-3amonthformeal 8 2.3 1amonthformeal 21 5.9 <1amonthformeal 25 7.1 2-3aweekforsnack 1 0.3 1aweekforsnack 1 0.3 1amonthforsnack 3 0.8 <1amonthforsnack 1 0.3 TOTAL 354 100.0

>From Robin.Houston@wadham.oxford.ac.uk Mon Feb 12 15:20:46 1996 Date: Mon, 12 Feb 1996 16:30:07 GMT From: Robin Houston To: fran@oneworld.org Subject: Grazing in Peckham - finished version - for Brian Respondents' stated frequency of using a chinese take-away Frequency Percentage never 162 45.8 1adayformeal 4 1.1 2-3aweekformeal 19 5.4 1aweekformeal 45 12.7 2-3amonthformeal 28 7.9 1amonthformeal 35 9.9 <1amonthformeal 31 8.8 1adayforsnack 1 0.3 2-3aweekforsanck 4 1.1 1aweekforsnack 7 2.0 2-3amonthforsnack 7 2.0 1amonthforsnack 6 1.7 <1amonthforsnack 5 1.4 TOTAL 354 100.0

Respondents' stated frequency of using a kebab house Frequency Percentage never 211 59.6 1adayformeal 1 0.3 2-3aweekformeal 10 2.8 1aweekformeal 21 5.9 2-3amonthformeal 12 3.4 1amonthformeal 23 6.5 <1amonthformeal 12 3.4 1adayforsnack 2 0.6 2-3aweekforsnack 6 1.7 1aweekforsnack 11 3.1 2-3amonthforsnack 11 3.1 1amonthforsnack 23 6.5 <1amonthforsnack 11 3.1 TOTAL 354 100.0

Respondents' stated frequency of using a deep-fried chicken outlet Frequency Percentage never 159 44.9 1adayformeal 4 1.1 2-3aweekformeal 24 6.8 1aweekformeal 31 8.8 2-3amonthformeal 18 5.1 1amonthformeal 28 7.9 <1amonthformeal 18 5.1 1adayforsnack 3 0.8 2-3aweekforsnack 7 2.0 1aweekforsnack 21 5.9 2-3amonthforsnack 9 2.5 1amonthforsnack 18 5.1 <1amonthforsnack 14 4.0 TOTAL 354 100.0

Respondents' stated frequency of using a sandwich or croissant bar Frequency Percentage never 280 79.1 1adayformeal 13 3.7 2-3aweekformeal 11 3.1 1aweekformeal 10 2.8 1amonthformeal 4 1.1 <1amonthformeal 1 0.3 1adayforsnack 5 1.4 2-3aweekforsnack 11 3.1 1aweekforsnack 7 2.0 2-3amonthforsnack 3 0.8 1amonthforsnack 3 0.8 <1amonthforsnack 6 1.7 TOTAL 354 100.0

Respondents' stated frequency of using a baked potato stand Frequency Percentage never 326 92.1 1adayformeal 1 0.3 2-3aweekformeal 2 0.6 1aweekformeal 5 1.4 2-3amonthformeal 2 0.6 1amonthformeal 3 0.8 <1amonthformeal 1 0.3 1adayforsnack 1 0.3 2-3aweekforsnack 1 0.3 1aweekforsnack 1 0.3 2-3amonthforsnack 2 0.6 1amonthforsnack 3 0.8 <1amonthforsnack 6 1.7 TOTAL 354 100.0

N.B. there were no pizza, croissant or baked potato outlets in the area.