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Governments are increasingly implementing policies to improve population diets, despite food industry resistance to regulation that may reduce their profits from sales of unhealthy foods. However, retail food environments remain an important target for policy action. This study analysed publicly available responses of industry actors to two public consultations on regulatory options for restricting unhealthy food price and placement promotions in retail outlets in Scotland.
Design:
We conducted a qualitative content analysis guided by the Policy Dystopia Model to identify the discursive (argument-based) and instrumental (tactic-based) strategies used by industry actors to counter the proposed food retail policies.
Setting:
Scotland, UK, 2017-2019.
Participants:
N/A
Results:
Most food and retail industry responses opposed the policy proposals. Discursive strategies employed by these actors commonly highlighted the potential costs to the economy, their industries and the public in the context of a financial crisis, and disputed the potential health benefits of the proposals. They claimed that existing efforts to improve population diets, such as nutritional reformulation, would be undermined. Instrumental strategies included using unsubstantiated and misleading claims, building a coordinated narrative focused on key opposing arguments and seeking further involvement in policy decision-making.
Conclusions:
These findings can be used by public health actors to anticipate and prepare for industry opposition when developing policies targeted at reducing the promotion of unhealthy food in retail settings. Government action should ensure robust management of conflicts of interest and establishment of guidance for the use of supporting evidence as part of the public health policy process.
To examine how aligned the UK food supply is with the Eatwell Guide and identify discrepancies which should be addressed to support the availability of healthy diets for the population.
Design:
A dietary gap assessment was carried out on the 2022 UK food supply with FAOSTAT Food Balance Sheets (FAO-FBS) data, including domestic production, imports and exports, and excluding animal feed, seeds and non-food uses. Foods were grouped into potatoes and cereals, oils and spreads, dairy, protein, fruit and vegetables, and sugar. The percentage contribution of each food group to the food supply was compared to the Eatwell Guide. An overview of the food supply from 2010-2022 was also created. To triangulate the data, FAO-FBS data were compared with the 2022 data from the Department for Environment, Food and Rural Affairs (DEFRA).
Setting:
UK, 2010-2022
Participants:
N/A
Results:
The proportion of fruit and vegetables, potatoes and cereals in the UK food supply were lower than the Eatwell Guide, while dairy and oil were higher. Only 7% of the food produced in the UK in 2022 was fruit and vegetables. This was the second smallest proportion, after oils and spreads (6%), and about half the amount of sugar beet produced (13%).
Conclusion:
Although the relationship between food supply and consumption is complex, taking a more coherent approach by integrating dietary recommendations with the food supply could help increase the availability of the recommended healthy diet. Going forwards, DEFRA should include dietary gap assessments in future Food Security Reports.
Existing academic research has highlighted a connection between dietary habits and political beliefs. An individual’s dietary choices can mean more than just the need or pleasure of eating. Dietary choice can also be tied to a personal identity, in which food consumption reinforces through other beliefs and in-group identities, including partisan affiliation and political ideology. This study analyzes survey data from the Natural Marketing Institute’s (NMI) 2019 Lifestyles of Health and Sustainability (LOHAS) survey and compares the results to Mosier and Rimal’s original evaluation using the NMI’s 2016 LOHAS survey data. The results show most Americans continue to have a meat-based diet irrespective of political party, with gender being the most consistent and robust explanatory factor for dietary choice. However, there are some notable shifts in dietary choice and significance for certain partisan affiliations that highlight how in-group dynamics may be reflective of attitude and behavioral norms.
Despite strong evidence linking exposure to food and beverage marketing with poor diet quality and negative health impacts in children, the effect of brand marketing (i.e. marketing featuring branded content, but no food products) is uncertain. This study evaluated the impact of brand marketing v. product-based advertising on children’s food preferences and behavioural intentions.
Design:
An online survey was administered to participants randomised to one of four ad conditions; familiar product (i.e. from popular Canadian brands); familiar brand (i.e. no food product, Canadian brand); unfamiliar product (i.e. foreign products); and unfamiliar brand ad (i.e. foreign brand). Participants viewed three ads displaying features of that condition and answered three 5-point Likert-scale questions related to the study outcomes: food preference, purchase intent and pester power. The average of all outcomes determined the total impact. An ANOVA with Bonferroni post hoc tests evaluated differences in impact between conditions.
Setting:
Canada participants: n 1341 Canadian children (9–12 years)
Results:
Familiar product ads had a higher total impact on children (mean score 3·57) compared with familiar brand ads (2·88), unfamiliar brand ads (3·24) or unfamiliar product ads (3·09; P < 0·001 for all pairwise comparisons). Total impact was lower for familiar brand ads than for unfamiliar brand ads or unfamiliar product ads (P < 0·001 for all pairwise comparisons). The impact of an unfamiliar brand and product did not differ (P = 0·53).
Conclusions:
Results suggest that familiar product ads seem to have a stronger impact on children’s food preferences and behavioural intentions than familiar brand ads, unfamiliar brand ads and unfamiliar product ads.
Public food procurement incentives and targeted policies by state and Federal governments are one of the most frequently enacted strategies to leverage food spending to promote co-benefits related to economic, environmental, and social outcomes. Here we use an optimization model to explore potential outcomes of policy alternatives and integrate co-benefit dimensions into schools' agri-food supply chains via Farm to School procurement incentives. We find that in the absence of policy supports, school food authorities are unlikely to participate in local food procurement programs. We then place the findings in context by inferring the level of financial incentives that are needed to reduce barriers to schools' participation. Our findings have implications for community and economic development policies, particularly those seeking to support agriculturally dependent areas via elevated institutional food procurement using the case of policies framed for a school setting.
The United States is one of the largest consumers of meat globally. The traditional production of meat contributes substantially to climate change due to the levels of greenhouse gases emitted and the amount of land, water, feed, and other natural resources required to raise animals used for meat. Conventional meat production is also a major source for the emergence of zoonotic diseases and antimicrobial-resistant pathogens. Nevertheless, Americans consume more meat now than at any time in the nation’s history.
Advocates for policy change aimed at addressing the risks currently associated with meat production have typically focused on reducing meat consumption, alternatives to meat, or improving the standards of conventional meat production. These are laudable goals, but an emerging technology now promises meat production that may avoid these risks entirely. Enter “lab-grown meat” — meat cultivated in an efficient and controlled laboratory environment without the need for fields, feed, or even animals.
The technology has been in development for over 100 years but has seen exponential growth in the past five years. What was previously considered a science fiction fantasy became a reality in the United States in 2023, when UPSIDE Foods and GOOD Meat received approval from USDA for sale of their cultivated chicken to U.S. consumers.
This article highlights the benefits and drawbacks associated with lab-grown meat, assesses the existing regulatory framework, and offers considerations for policy reform as regulators address the emergence and scale-up of this important technology.
To investigate the concordance between Australian government guidelines for classifying the healthiness of foods across various public settings.
Design:
Commonly available products in Australian food service settings across eight food categories were classified according to each of the seventeen Australian state and territory food classification guidelines applying to public schools, workplaces and healthcare settings. Product nutrition information was retrieved from online sources. The level of concordance between each pair of guidelines was determined by the proportion of products rated at the same level of healthiness.
Setting:
Australia.
Participants:
No human participants.
Results:
Approximately half (56 %) of the 967 food and drink products assessed were classified as the same level of healthiness across all fifteen ‘traffic light’-based systems. Within each setting type (e.g. schools), pairwise concordance in product classifications between guidelines ranged from 74 % to 100 %. ‘Vegetables’ (100 %) and ‘sweet snacks and desserts’ (78 %) had the highest concordance across guidelines, while ‘cold ready-to-eat foods’ (0 %) and ‘savoury snacks’ (23 %) had the lowest concordance. In addition to differences in classification criteria, discrepancies between guidelines arose from different approaches to grouping of products. The largest proportion of discrepancies (58 %) were attributed to whether products were classified as ‘Red’ (least healthy) or ‘Amber’ (moderately healthy).
Conclusions:
The results indicate only moderate concordance between all guidelines. National coordination to create evidence-based consistency between guidelines would help provide clarity for food businesses, which are often national, on how to better support community health through product development and reformulation.
To improve public health and promote environmental sustainability, widespread dietary changes are necessary in high-income countries. However, adopting and maintaining dietary goals is challenging and requires repeated self-regulation. Effective public policies can facilitate healthy food choices and reduce the likelihood of goal failure. This study examines the relationship between individuals’ dietary goal failures and their acceptance of public food policies, using data from an experience-sampling study (Ni = 409 and Nobs = 6,447). Regression analyses revealed that participants who experienced more frequent dietary goal failures were generally less accepting of health-promoting food policies and perceived them as less effective. Additionally, perceived policy effectiveness positively predicted policy acceptance. Exploratory analyses showed that the negative relationship between dietary goal failure and food policy acceptance varied depending on the type of intervention (pull policies vs push policies) and the location of food selections (home vs out-of-home). Notably, we found a positive relationship between dietary goal failure and acceptance of pull policies for food selections made out-of-home. These findings highlight the importance of better understanding the complex interplay between public policy attitudes, the food environment and adherence to dietary goals.
The objective of the study was to compare the potential dietary impact of proposed and final front-of-pack labelling (FOPL) regulations (published in Canada Gazette I (CG1) and Canada Gazette II (CG2), respectively) by examining the difference in the prevalence of foods that would require a ‘High in’ front-of-pack nutrition symbol and nutrient intakes from those foods consumed by Canadian adults.
Design:
Foods in a generic food composition database (n 3676) were categorised according to the details of FOPL regulations in CGI and CGII, and the differences in the proportion of foods were compared. Using nationally representative dietary survey data, potential intakes of nutrients from foods that would display a ‘High in’ nutrition symbol according to CGI and CGII were compared.
Setting:
Canada
Participants:
Canadian adults (≥ 19 years; n 13 495)
Results:
Compared with CGI, less foods would display a ‘High in’ nutrition symbol (Δ = –6 %) according to CGII (saturated fat = –4 %, sugars = –1 %, sodium = –3 %). Similarly, potential intakes of nutrients-of-concern from foods that would display a ‘High in’ nutrition symbol were reduced according to CGII compared with CGI (saturated fat = –21 %, sugars = –2 %, sodium = –6 %). Potential intakes from foods that would display a ‘High in’ nutrition symbol were also reduced for energy and nutrients-to-encourage, including protein, fibre, calcium and vitamin D.
Conclusions:
Changes to FOPL regulations may have blunted their potential to limit intakes of nutrients-of-concern; however, they likely averted potential unintended consequences on intakes of nutrients-to-encourage for Canadians (e.g. calcium and vitamin D). To ensure policy objectives are met, FOPL regulations must be monitored regularly and evaluated over time.
This study investigates whether wording a promotional marketing message as originating from the US government vs. the US president impacts consumers’ responsiveness to the message. Using a discrete choice experiment, it examines consumer responsiveness to President Biden’s order promoting domestic production. Results indicate that consumers are willing to pay a premium for domestically produced tomatoes, with variations based on political affiliations and product attributes like organic labeling and farm employment practices. However, findings on the significance of information treatment effects are mixed, suggesting that consumer responsiveness is unaffected by wording the message as originating from a broad political body vs. a specific politician.
Childhood obesity and overweight rates in New Zealand are considerably higher than that globally with one in three children aged between 2-14 years being overweight or obese(1). Children’s dietary knowledge and food preferences are influenced by various factors including the food environment. Schools are an excellent setting to influence children’s dietary behaviours since they have the potential to reach almost all children during the first two decades of their lives. However, previous analyses indicate many school canteens and food providers do not supply foods that promote healthy eating and nutrition behaviours (2,3). The Ministry of Health (MoH) recently implemented a ‘Food and Drink Guidance for Schools’ which utilises a traffic-light framework dividing foods into three categories: ‘green’, ‘amber’, and ‘red’(4). The aim of this study was to assess primary school canteen food menus against the newly implemented MoH Guidance. A convenience sample of 133 primary school canteen menus were collected in 2020 as part of the baseline evaluation of the Healthy Active Learning initiative across New Zealand. Four researchers (three nutritionists and one dietitian) developed a menu analysis toolkit to undertake the analysis of all menus collected. The toolkit provided a breakdown of commonly packaged foods and meals/menu items available to purchase within schools based on Health Star Ratings, ingredients, and/or standard recipes. Assumptions were created for menu items requiring additional detail to be categorised according to the guidance through consensus by all four researchers. Primary school menus were coded by two researchers, and intercoder reliability was ensured by independent coding and cross-checking of 10% of menus. Descriptive and inferential analyses were conducted using IBM SPSS and P<0.05 denoted significance. Analyses of canteen menus revealed that most menu items belonged to the less healthy amber (41.0%) and red (40%) food categories. Low decile schools had a lower percentage of green food items (8.6%) and a higher percentage of red food items (48.3%) compared to high decile schools (p = 0.028). Similarly, schools in low deprivation areas had a significantly higher percentage of green food items (14.2%) compared to high deprivation areas (8.6%) (p = 0.031). Sandwiches, filled rolls, and wraps were the most commonly available items (86%) followed by baked foods and foods with pastry (71%). Sugar-sweetened beverages were just as prevalent as water on school food menus (54% each). Over half of in-house catered canteen menu items were classified as 'red’ foods (55.3%). This study highlights that most school canteens were not meeting the guidelines for healthy food and drink provision outlined by the MoH. Improving school food availability for children in socioeconomically deprived areas needs to be prioritised to reduce inequities. Findings suggest the need for more robust national policies and mandated school guidance to improve the food environments in New Zealand schools.
To better understand how the public defines ‘healthy’ foods and to determine whether the public considers sustainability, implicitly and explicitly, in the context of healthy eating.
Design:
We conducted a content analysis of public comments submitted to the US FDA in 2016 and 2017 in response to an invitation for feedback on use of the term ‘healthy’ on food labels. The analysis explored the ways in which commenters’ definitions of ‘healthy’ aligned with the 2015–2020 Dietary Guidelines for Americans and whether their definitions considered sustainability.
Setting:
The US Government’s Regulations.gov website.
Participants:
All 1125 unique comments from individuals and organisations.
Results:
Commenters’ definitions of ‘healthy’ generally mirrored the recommendations that the Dietary Guidelines for Americans put forth to promote a ‘healthy eating pattern’. Commenters emphasised the healthfulness of fruit, vegetables, whole grains, fish and other minimally processed foods and the need to limit added sugars, sodium, saturated and trans fats and other ingredients sometimes added during processing. One-third of comments (n 374) incorporated at least one dimension of sustainability, mainly the environmental dimension. Commenters who mentioned environmental considerations primarily expressed concerns about synthetic chemicals and genetic modification. Less than 20 % of comments discussed social or economic dimensions of sustainability, and less than 3 % of comments (n 30) used the word ‘sustainability’ explicitly.
Conclusions:
This novel analysis provides new information about the public’s perceptions of ‘healthy’ foods relative to nutrition and sustainability considerations. The findings can be used to advance policy discussions regarding nutrition labelling and guidance.
Obesity is a leading cause of death and disability globally. There is a higher proportion of women living with obesity than men, with differences in prevalence rates between women and men particularly staggering in low- and middle-income countries. The food environments that most people live in have been defined as ‘obesogenic’, characterised by easy access to energy dense, highly palatable foods with poor nutritional value. There is an established need to intervene to change food environments to prevent obesity. However, minimal successes are evident with no country set to meet the WHO goal of reducing obesity prevalence to 2010 numbers by 2025. In this review, we provide a narrative around the sex (biological)- and gender (sociocultural)-related considerations for the relationship between nutrition, interactions with the food environment and obesity risk. We provide an argument that there are gendered responses to food environments that place women at a higher risk of obesity particularly in relation to food industry influences, due to gendered roles and responsibilities in relation to paid and unpaid labour, and due to specific food security threats. This review concludes with hypotheses for addressing the obesity burden in a gender-responsive manner, with a call for gender equity to be a key component of the development, implementation and monitoring of obesity prevention focused policies going forward.
Access to adequate food is one of the Human Rights set out in international law and hence its delivery (through policy) is the role of government. ‘Food policy’ cannot be the role of a single government department, however, since regulations must take care of public goods (e.g. public health and protecting the natural environment) while also creating an economic environment attractive to private sector participation. From the mid-20th century, much of food policy was driven by a need to encourage the production base, but more recently the importance of considering food policy through the lens of nutritional requirements is increasingly recognised, alongside the importance of minimising environmental damage. This review paper draws on experience of working with policymakers (in particular the Scottish Government) and of active participation in an EC-commissioned project. It highlights the need for the research community to invest time and resources in understanding what evidence policymakers are asking for and to consider that alongside evidence from those who will be impacted by the policy (stakeholders). Examples of effective ways of engaging stakeholders and policy communities simultaneously are outlined and the paper provides some thoughts on the boundaries between the science and policy communities and how to bridge them. The Case Study also highlights the importance of evidence to inform prioritisation and consultation at a local level when aiming to meet multiple policy goals nationally.
To measure the effects of health-related food taxes on the environmental impact of consumer food purchases in a virtual supermarket.
Design:
This is a secondary analysis of data from a randomised controlled trial in which participants were randomly assigned to a control condition with regular food prices (n 152), an experimental condition with a sugar-sweetened beverage (SSB) tax (n 131) or an experimental condition with a nutrient profiling tax based on Nutri-Score (n 112). Participants were instructed to undertake their typical weekly grocery shopping for their households. Primary outcome measures were three environmental impact indicators: greenhouse gas (GHG) emissions, land use and blue water use per household per week. Data were analysed using linear regression analyses.
Setting:
Three-dimensional virtual supermarket.
Participants:
Dutch adults (≥ 18 years) who were responsible for grocery shopping in their household (n 395).
Results:
GHG emissions (–7·6 kg CO2-eq; 95 % CI –12·7, –2·5) and land use (–3·9 m2/year; 95 % CI –7·7, –0·2) were lower for the food purchases of participants in the nutrient profiling tax condition than for those in the control condition. Blue water use was not affected by the nutrient profiling tax. Moreover, the SSB tax had no significant effect on any of the environmental impact indicators.
Conclusions:
A nutrient profiling tax based on Nutri-Score reduced the environmental impact of consumer food purchases. An SSB tax did not affect the environmental impact in this study.
Food and beverage marketing influences children's food preferences and dietary intake. Children's diets are also heavily influenced by their family environment. The aim of this study was to assess the relationship between parent's self-reported exposure to unhealthy food marketing and a range of outcomes related to children's desire for and intake of unhealthy foods and beverages. The study also sought to examine whether these outcomes varied across different countries. The analysed data are from the International Food Policy Study and were collected in 2018 using an online survey. The sample included 5764 parents of children under 18, living in Australia, Canada, Mexico, the United Kingdom, or the United States. Binary logistic regressions assessed the link between the number of parental exposure locations and children's requests for and parental purchases of unhealthy foods. Generalized ordinal regression gauged the relationship between the number of exposure locations and children's consumption of such items. Interaction terms tested if these associations varied by country. Parental exposure to unhealthy food marketing was positively associated with parents reporting child purchase requests and purchase outcomes; and differed by country. Increased parental exposure to unhealthy food marketing was associated with slightly lower odds of children's weekly consumption of unhealthy foods, and this association varied by country. In conclusion, parental report of a greater range of food marketing exposure was associated with a range of outcomes that would increase children's exposure to unhealthy food products or their marketing. Governments should consider developing more comprehensive restrictions on the marketing of unhealthy foods.
The link between school feeding programmes (SFP) and the promotion of healthy eating and health is being explored in studies performed in different countries. The coronavirus disease-19 pandemic has revealed flaws and weaknesses in contemporary food systems, with many school-age children experiencing food insecurity and hunger. There is intense debate among policymakers regarding whether government SFP should be universal or targeted. Countries such as Brazil and India, which have two of the most comprehensive universal free-of-charge programmes, have shown the benefits of SFP, including improved nutritional status, support for more sustainable food systems, attendance and academic performance. Evidence shows and supports actions advocating that it is time to offer healthy and free school meals for all students.
This scoping review aimed to explore international evidence on the impact of Food Policy Groups (FPGs) on local food systems, in urban and rural regions of high-income countries. Peer-reviewed and grey literature were searched to identify thirty-one documents published between 2002 and 2022 providing evidence on the impact of FPGs. Activities spanned domains including increasing food equity (e.g. strengthening school meals programmes); increasing knowledge and/or demand for healthy food (e.g. food literacy programmes with children and adults); increasing food access (e.g. enhancing local food procurement); environmental sustainability (e.g. promoting low-waste food items on café menus); economic development (e.g. ensuring local businesses are not outperformed by large food distributors); and increasing food system resiliency (e.g. establishment of local produce schemes). Most FPGs reported conducting activities that positively influenced multiple food system domains and reported activities in urban areas, and to a lesser extent in rural areas. Our study highlighted a range of qualitative and quantitative evaluation strategies used to measure FPGs’ impact on local food systems. Our recommendations focus on regular and systematic evaluation and research surrounding the impact of FPG activities, to build the evidence base of their impact. Ideally, evaluation would utilise comprehensive and established tools. We recommend exploring the establishment of FPGs across more regions of high-income countries, particularly rural areas, and forming partnerships between FPGs, local government and universities to maximise implementation and evaluation of activities.
To examine differences in noticing and use of nutrition information comparing jurisdictions with and without mandatory menu labelling policies and examine differences among sociodemographic groups.
Design:
Cross-sectional data from the International Food Policy Study (IFPS) online survey.
Setting:
IFPS participants from Australia, Canada, Mexico, United Kingdom and USA in 2019.
Participants:
Adults aged 18–99; n 19 393.
Results:
Participants in jurisdictions with mandatory policies were significantly more likely to notice and use nutrition information, order something different, eat less of their order and change restaurants compared to jurisdictions without policies. For noticed nutrition information, the differences between policy groups were greatest comparing older to younger age groups and comparing high education (difference of 10·7 %, 95 % CI 8·9, 12·6) to low education (difference of 4·1 %, 95 % CI 1·8, 6·3). For used nutrition information, differences were greatest comparing high education (difference of 4·9 %, 95 % CI 3·5, 6·4) to low education (difference of 1·8 %, 95 % CI 0·2, 3·5). Mandatory labelling was associated with an increase in ordering something different among the majority ethnicity group and a decrease among the minority ethnicity group. For changed restaurant visited, differences were greater for medium and high education compared to low education, and differences were greater for higher compared to lower income adequacy.
Conclusions:
Participants living in jurisdictions with mandatory nutrition information in restaurants were more likely to report noticing and using nutrition information, as well as greater efforts to modify their consumption. However, the magnitudes of these differences were relatively small.
Consumption of snacks and ultra-processed foods (UPF) high in fat, salt and sugar (HFSS) is associated with rising rates of obesity and growing socioeconomic disparities in nutrition. While infancy, childhood and adolescence are critical periods for development of dietary preferences, there remains a dearth of research exploring factors that underpin snacking behaviour over this time. This review aims to address this gap by drawing from qualitative lived experience research, with 122 families of different socioeconomic position (SEP), to explore how the (i) home food environment, (ii) food environment and (iii) social value and meanings of food shape parental provision of snacks. This review shows that snacking holds important meanings in everyday family life, with infants integrated into existing snacking practices from an early age. Price promotions, low-cost and long shelf-lives all make UPF and HFSS snacks an appealing option for many low-SEP parents; while children's requests and preferences for HFSS snacks present a challenge across SEP. However, higher-SEP parents can ensure fresh fruits are always available as an alternative snack, while fruit is described as a financially risky expenditure for low-SEP families. The present findings also indicate that retailers and producers are increasingly promoting ‘healthier’ snacks through product packaging and marketing, such as ‘meets one of your five a day’, despite these products displaying similar nutritional profiles to traditional UPF and HFSS snacks. We outline a series of policy recommendations, including extending Healthy Start Vouchers and the Fruit and Vegetable Scheme in schools and action to address misleading product marketing and packaging.