In Malaysia, it sometimes seems like all you have to do is turn a corner to find food; in fact, oftentimes, all you have to do is to turn your head!
Restaurants, cafes, roadside or under-the-tree stalls or gerai, food courts, food trucks, mamak shops – the list of places where you can find food seems endless.
And this is not including food delivery services that make it convenient for us to have outside food in the comfort of our own homes.
No surprise then that the Malaysian Food Barometer (MFB) found that more than a third (37.2%) of meals consumed daily were bought, with the number increasing to nearly half (46.5%) if food bought from outside, but consumed at home, was included.
Nearly three-quarters of individuals (74.2%) had at least one meal outside a day (61.7%) or bought food to eat at home (12.5%).
This survey involving 2,000 respondents who were semi-randomly selected to be representative of the Malaysian population, was organised by the Chair of Food Studies at Taylor’s-Toulouse University Centre, and published in 2014.
Overall, the MFB estimated that Malaysians ate almost one out of every two meals out, similar to the United States and more than the United Kingdom at almost one in every three meals, and this is likely to go up with increasing urbanisation – a factor positively correlated with eating out.
Long working days, compounded by lengthy commutes to and from work, make preparing our own meals an extra chore we are all too willing to forego.
After all, the abundance of decent eating options that fit most budgets makes eating out or taking away food to eat at home all too easy.
The problem with this, however, is that we have no control over what goes into the food we eat as someone else is preparing it.
We are basically partially surrendering control of our diet and nutrition to people whose priorities include – and sometimes, completely revolve around – making a profit out of food.
In your face
Says University of Cambridge, United Kingdom, Centre for Diet and Physical Activity Research (Cedar) career development fellow Dr Thomas Burgoine: “What we generally tend to think is that when you prepare food yourself, you’ve got a lot of control.
“You can choose how much food you make, you can choose what goes into it, and that’s very important.”
He adds: “So, the characteristics of takeaways in general is that they tend to be higher in saturated fats, high in salt, more energy-dense, have loads of calories, are nutrient-poor, and they tend to come in really big portions (for the UK).
“So, people who eat more takeaway food do tend to gain weight. And that’s been shown.”
Dr Burgoine was the lead investigator for a study looking at the associations between takeaway food outlets, takeaway food consumption and body weight in the county of Cambridgeshire in England.
Using a geographic information system and data from the Fenland Study – an ongoing, population-based study of adults born between 1950 and 1975 in Cambridgeshire, the researchers plotted out the number of takeaway outlets each participant would be exposed to at home, on their usual way to work and at work.
This involved 5,594 people, who also provided their weight and body mass index (BMI) as part of the Fenland Study.
Sharing the findings of the study published in the March 2014 edition of the medical journal The BMJ, Dr Burgoine says: “People have access to over 150 takeaway outlets on a daily basis. That’s astonishing!”
He explains: “This is all about environments being the arbiter of diet.
“Of course, some people would be able to make healthy choices even when they are faced with all that, but some people won’t.
“And it’s a challenge; it’s an affront to the senses. If you are giving them that message all the time, ultimately, we think it will have an effect.
“You’re bound to give in at some point, just because it’s there, in that volume.
“And of course, generally, what it means is that there’s not just more of it, there’s more choice – there’s something for everyone.”
The results showed that indeed, the more a person is exposed to takeaway food outlets, the more likely they were to eat such food, especially at work.
More importantly was that between those who were the most exposed to takeaway food outlets and those who were the least exposed, those most exposed were over one BMI unit heavier, and were twice as likely to be obese. The takeaway foods included in the study were pizza, burgers, fried food (e.g. fried chicken) and fries.
In the name of health
Some local authorities around the world have already started controlling the number of takeaways or fast food outlets in their jurisdiction in the name of public health.
Dr Burgoine shares the example of the ban on new stand-alone fast-food restaurants in south Los Angeles in the United States beginning in 2008 in a bid to help combat obesity in that area – a first in the world.
“They were not closing places, but they said they were not allowing any more places to open, which was a pretty bold move, and the first time, I think, a government has tried to intervene in the takeaway food outlets (for public health).”
He adds: “And we’re seeing similar things in the UK.
“Since 2010, there have been areas in London and other areas in the country that have said, in our region, we don’t want to have any more takeaway food outlets.
“So, they’re looking at initiatives like, on any one high street (main street), you’re not allowed to open a takeaway food outlet next to an existing takeaway food outlet.
“Or on this high street, no more than 5% of the shops are allowed to be takeaway food outlets.
“Or even, because children are believed to be particularly vulnerable, you are not allowed to open a takeaway food outlet within half a mile (800m) of a school.”
However, he notes that while these measures are being increasingly implemented, they are not popular ones.
“A lot of time, the business or economic case is all that is important. If there is a vacant lot on a high street, people would want that to be filled and it really doesn’t matter what they fill it with.
“Ultimately, if they can put a takeaway food outlet there and it can help generate money for the local economy, that seems to be all that matters.
“There doesn’t seem to be the understanding that bad diet and poor health also have economic consequences.”
Public health, he says, needs to play a more important role in urban planning, not just economics.
But even the general public had problems accepting the evidence from his study, saying that it doesn’t matter if the takeaway outlets are there as they don’t patronise them anyway, or that they can eat takeaway food everyday and not get fat.
But, Dr Burgoine says: “A lot of it is based on anecdotes.
“What we know is that on a population level, with big samples, on average, it’s bad for you to eat takeaway food.
“And yes, some people will be able to ignore those takeaway food outlets on their doorstep, but some people won’t.
“And a lot of areas with a lot of takeaway food outlets will also have no access to fresh food.
“So you have people saying it’s all about choice, but how do you make a choice when you have nothing to choose from?”
Tan Shiow Chin was a 2015 Khazanah-Wolfson Press Fellow at Wolfson College, University of Cambridge. This article is part of a series from her fellowship project on the subconscious cues that influence us to eat more and unhealthily. Her next article will be on attitudes towards healthy eating.