​Shirley Cramer CBE, Chief Executive of RSPH, considers the place of providing limited food options in public areas in a bid to tackle obesity.

Italian cooking and healthy eating might not usually be considered together, especially when on holiday, with the mounds of delicious pasta and quantities of excellent wine. But on a recent trip there I had a real revelation ( of the public health variety).

While driving from the Dolomites in the north east towards sunny Tuscany, my better half and I decided to stop at one of the many service stations on the motorway for coffee.

The A1 towards Florence is one of Italy’s oldest motorways and the Autogrill service stations looked equally elderly and rather past their prime. They are much smaller than their UK counterparts, having a small ‘ food court’ area and a cafe with about 20 tables.

The relative size of the food area meant that the choices were much smaller than their UK equivalents , but what they lacked in quantity they made up for in quality and freshness. I was both surprised and thrilled to see a variety of enormous salads with a range of first class ingredients which would not have looked out of place in some of our best restaurants. In addition there was succulent looking , lean chicken, risotto , soups and a diverse selection of fresh fruit salads and Italian cheeses.

In fact it was the opposite of the food that is available at almost any UK service station with the exception of the well known Tebay in Cumbria which is filled with locally sourced food and is a destination in its own right for sausage lovers. I digress.

As the food looked so tempting, we decided to have lunch and having chosen our respective platters we moved to the cafe where tables were crowded with families eating an assortment of fresh, healthy food with evident enjoyment. I contrasted the whole experience with the array of fast food joints so readily available at our own services stations with their unpleasant aroma of fried food and families tucking into burger and fries, doughy pizza or fried chicken.

In public health we talk often about people making better choices about food, promoting healthy eating by increasing awareness of the problems of overeating and obesity. Perhaps what we should be doing is promoting the provision of a limited food offer, less choice but more healthy fresh foods. How tempting it is to come into a service station at lunchtime when you are hungry and grab something unhealthy, especially if that is all that is on offer apart from supermarket sandwiches.

In England in 2011, 41% of men and 33% of women were classified as overweight or obese and more worryingly so were 14% of our children. Overweight people account for 44% of those with diabetes and 23% of heart disease, not to mention a myriad of cancers. In global trends on health, obesity is on the rise in most western countries.

Tackling this serious public health issue will never be easy but limiting the food offer in public areas to healthy, cheap, and tasty meals might at least move us in the right direction. Let’s not put such emphasis on people making the right choices if we haven’t made the right offer. Choice is a two way process and I like the Italian motorway model.