scholarly journals Relative contributions of recommended food environment policies to improve population nutrition: results from a Delphi study with international food policy experts

2018 ◽  
Vol 21 (11) ◽  
pp. 2142-2148 ◽  
Author(s):  
Rewena Mahesh ◽  
Stefanie Vandevijvere ◽  
Clare Dominick ◽  
Boyd Swinburn
Keyword(s):  
Delphi Study ◽  
Food Environment ◽  
Food Policy ◽  
Good Practice ◽  
Food Prices ◽  
Healthy Food ◽  
Healthy Foods ◽  
Analytic Hierarchy ◽  
Analytic Hierarchy Process Method ◽  
Expert Ratings

AbstractObjectiveTo determine weightings for the relative contributions of nineteen widely recommended good practice food environment policies to improve population nutrition, based on evidence of effectiveness and expert ratings, to facilitate benchmarking of the implementation of food environment policies globally.DesignA two-round Delphi study was performed in 2015, whereby international food policy experts (nRound127,nRound221) compared effectiveness of all possible pairs of policy domains and good practice policies within domains to improve population nutrition according to the Saaty scale (1 to 9). Weightings for each domain and policy were derived from expert ratings based on the Analytic Hierarchy Process method.SettingInternational.SubjectsFood policy experts.ResultsOut of the seven policy domains, Food Prices and Food Promotion received the highest weightings for impact on improving population nutrition, while Food Trade received the lowest weighting. Among the nineteen specific policies, taxing unhealthy foods (3·8 (0·7)), healthy food provision in schools (2·8 (0·4)) and minimizing taxes on healthy foods (2·6 (0·4)) were given the highest weightings, while nutrient declarations on packaged foods (1·2 (0·2)) and healthy food policies in private-sector workplaces (1·0 (0·2)) received the lowest weightings (mean (95 % CI)).ConclusionsExpert-derived weightings on the relative contributions of recommended food environment policies to improve population nutrition will facilitate monitoring and benchmarking the implementation of these policies by governments among countries globally. Additional weightings for contributions of policies to reducing nutrition inequalities and improving consumer and child rights could be developed in the future.

scholarly journals Implementation level of best practice policies by Italian government for healthier food environments

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Zace ◽  
M L Specchia ◽  
A Di Pilla ◽  
E Carini ◽  
P Cacciatore ◽  
...  
Keyword(s):  
Policy Implementation ◽  
Burden Of Disease ◽  
Food Environment ◽  
Good Practice ◽  
Critical Role ◽  
Food Prices ◽  
Healthy Food ◽  
Food Environments ◽  
Level Of Evidence ◽  
Italian Government

Abstract Background Government actions play a critical role in shaping healthy food environments, which can improve population's diet and decrease the burden of disease. This study aims to determine and compare the level of policy implementation for healthy food environments in Italy with reference to international benchmarks and make prioritized recommendations based on the identified implementation gaps. Methods The Healthy Food Environment Policy Index (Food-EPI) tool from the International Network for Food and Obesity/NCDs Research, Monitoring and Action Support (INFORMAS) was adapted for the Italian context. This tool includes two components, thirteen domains and fifty good practice indicators, which were verified with experts from National Health Institute (NHI). Evidence for implementation was gathered and summarized for all fifty indicators from data sources such as governmental websites, non-government organizations publications and websites and via direct contact with government officials. After collecting all evidence, experts from the NHI verified the completeness and accuracy of it. The evidence document will be presented to stakeholders, aiming to seek consensus on the priority actions to be implemented by the Italian Government to improve food environments. Results The evidence for policy implementation concerning Italy varied among domains and indicators. We found the highest level of evidence within three domains: Food Composition (2/2 indicators), Food Labelling (3/4 indicators) and Food Promotion (4/5 indicators). The domains with less identified evidence were Food Prices (1/4 indicators), Food Retail (0/4 indicators), Food Trade and Investment (0/2 indicators) and Platforms and Interaction (1/4 indicators). Conclusions The evidence summarization and the upcoming stakeholders' meeting to rate the level of implementation for each indicator in Italy, have the potential to improve government commitment to shape healthier food environments. Key messages Food environment policies, implemented by the government, play a key role in the health of the population, decreasing the burden of disease. Several food environment policies have been implemented and supported by the Italian government but there are still some priority actions to be taken towards healthier food environments.

scholarly journals A study on implementation of food-related policies in Poland using the Healthy Food Environment Policy Index

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Romaniuk ◽  
K Kaczmarek ◽  
K Brukało ◽  
E Grochowska-Niedworok ◽  
K Lobczowska ◽  
...  
Keyword(s):  
Delphi Study ◽  
Food Environment ◽  
Food Policy ◽  
Healthy Food ◽  
Public Authorities ◽  
Public Intervention ◽  
Environment Policy ◽  
Online Study ◽  
Study Results ◽  
National Workshop

Abstract Background Existing studies indicate obesity and diseases associated with diet and sedentary lifestyle as leading health problem in Poland that cannot be solved without explicit public intervention. The purpose of this study is to evaluate actions to create a healthy food environment, undertaken by public authorities in Poland. Methods We used the Food Environment Policy Index (Food-EPI) to describe the Polish national food environment policy. We analysed available government documents, studies, reports, legal acts and other relevant materials to compile a evidence document, which has been then validated with government officials. In the next stage (March 2020), national policies will be subject to assessment in reference to international best practices by independent experts through an online Delphi study. Results of the survey will be then used during a national workshop (April 2020) in order to formulate and prioritize actions. Results For 15 out of 47 indicators we found no evidence for government actions that would meet the criteria set out in the Food-EPI definition. In case of the other 6 indicators it was observed that the existing solutions are non-binding and result from government-independent policies. The lack or limits of government involvement was observed in particular in the domains related to food promotion, food provision, food in retail, and Health in All Policies. Results from the online study and the workshop will be presented during the conference. Conclusions The preliminary results obtained through the review of the evidence point to the need for intensified government activities in the area of shaping food policy in Poland. Full conclusions will be formulated after the study is completed. Preliminary findings of the Food-EPI project suggest the need for strengthening food environment policy in Poland.

scholarly journals Implementing healthy food environment policies in New Zealand: nine years of inaction

2022 ◽  
Vol 20 (1) ◽  
Author(s):  
Sally Mackay ◽  
Sarah Gerritsen ◽  
Fiona Sing ◽  
Stefanie Vandevijvere ◽  
Boyd Swinburn
Keyword(s):  
New Zealand ◽  
Policy Implementation ◽  
Food Environment ◽  
Best Practice ◽  
Good Practice ◽  
Healthy Food ◽  
Government Officials ◽  
Stimulate Action ◽  
National Governments ◽  
Implementation Gaps

Abstract Background The INFORMAS [International Network for Food and Obesity/Non-communicable Diseases (NCDs) Research, Monitoring and Action Support] Healthy Food Environment Policy Index (Food-EPI) was developed to evaluate the degree of implementation of widely recommended food environment policies by national governments against international best practice, and has been applied in New Zealand in 2014, 2017 and 2020. This paper outlines the 2020 Food-EPI process and compares policy implementation and recommendations with the 2014 and 2017 Food-EPI. Methods In March–April 2020, a national panel of over 50 public health experts participated in Food-EPI. Experts rated the extent of implementation of 47 “good practice” policy and infrastructure support indicators compared to international best practice, using an extensive evidence document verified by government officials. Experts then proposed and prioritized concrete actions needed to address the critical implementation gaps identified. Progress on policy implementation and recommendations made over the three Food-EPIs was compared. Results In 2020, 60% of the indicators were rated as having “low” or “very little, if any” implementation compared to international benchmarks: less progress than 2017 (47%) and similar to 2014 (61%). Of the nine priority actions proposed in 2014, there was only noticeable action on one (Health Star Ratings). The majority of actions were therefore proposed again in 2017 and 2020. In 2020 the proposed actions were broader, reflecting the need for multisectoral action to improve the food environment, and the need for a mandatory approach in all policy areas. Conclusions There has been little to no progress in the past three terms of government (9 years) on the implementation of policies and infrastructure support for healthy food environments, with implementation overall regressing between 2017 and 2020. The proposed actions in 2020 have reflected a growing movement to locate nutrition within the wider context of planetary health and with recognition of the social determinants of health and nutrition, resulting in recommendations that will require the involvement of many government entities to overcome the existing policy inertia. The increase in food insecurity due to COVID-19 lockdowns may provide the impetus to stimulate action on food polices.

scholarly journals Linking the Flint Food Store Survey: Is Objective or Perceived Access to Healthy Foods Associated with Glycemic Control in Patients with Type 2 Diabetes?

2021 ◽  
Vol 18 (19) ◽  
pp. 10080
Author(s):  
Richard Casey Sadler ◽  
Amanda Y. Kong ◽  
Zachary Buchalski ◽  
Erika Renee Chanderraj ◽  
Laura A. Carravallah
Keyword(s):  
Glycemic Control ◽  
Food Environment ◽  
Food Access ◽  
Diabetes Management ◽  
Healthy Food ◽  
Food Store ◽  
Healthy Foods ◽  
Objectively Measured ◽  
Healthy Food Access

Type 2 diabetes mellitus (DM-2) remains a significant public health concern, particularly in low-income neighborhoods where healthy foods may be scarcer. Despite the well-known relationship between diet and diabetes, little evidence exists on the connections among the objectively measured community and consumer food environment, perception of food access, and diabetes management or outcomes. This cross-sectional, ecological study represents the first example of combining a GIS-based, objectively measured food store audit considering quality, variety, and price of foods in stores with a clinical survey of patients with DM-2 (n = 126). In this way, we offer evidence on the relationship between healthy food access—measured more robustly than proximity to or density of certain store types—and diabetes management knowledge, medication adherence, and glycemic control. Better glycemic control was not correlated with better overall food store score, meaning that people in neighborhoods with better access to healthy foods are not necessarily more likely to manage their diabetes. While perceived healthy food access was not correlated with glycemic control, it was strongly correlated with objective healthy food access at shorter distances from home. These results have great importance both for clinical understanding of the persistence of poor diabetes management outcomes and for the understanding of the influence of the food environment on health behaviors.

scholarly journals Policies to Create Healthier Food Environments in Canada: Experts’ Evaluation and Prioritized Actions Using the Healthy Food Environment Policy Index (Food-EPI)

2019 ◽  
Vol 16 (22) ◽  
pp. 4473 ◽  
Author(s):  
Lana Vanderlee ◽  
Sahar Goorang ◽  
Kimiya Karbasy ◽  
Stefanie Vandevijvere ◽  
Mary R L’Abbé
Keyword(s):  
Policy Implementation ◽  
Food Environment ◽  
Good Practice ◽  
Critical Role ◽  
Food Choices ◽  
Healthy Food ◽  
Food Environments ◽  
Promising Practices ◽  
Environment Policy ◽  
Health Promoting

Food environment policies play a critical role in shaping food choices, diets, and health outcomes. This study endeavored to characterize and evaluate the current food environment policies in Canada using the Healthy Food Environment Policy Index (Food-EPI) to compare policies in place or under development in Canada as of 1 January 2017 to the most promising practices internationally. Evidence of policy implementation from the federal, provincial, and territorial governments was collated and verified by government stakeholders for 47 good practice indicators across 13 policy and infrastructure support domains. Canadian policies were rated by 71 experts from across Canada, and an aggregate score of national and subnational policies was created. Potential policy actions were identified and prioritized. Canadian governments scored ‘high’ compared to best practices for 3 indicators, ‘moderate’ for 14 indicators, ‘low’ for 25 indicators, and ‘very little or none’ for 4 indicators. Six policy and eight infrastructure support actions were prioritized as the most important and achievable. The Food-EPI identified some progress and considerable gaps in policy implementation in Canada, and highlights a particular need for greater attention to prioritized policies that can help to shift to a health-promoting food environment.

scholarly journals An assessment of implementation gaps and priority recommendations on food environment policies: the Healthy Food Environment Policy Index (Food-EPI) in Japan

2021 ◽  
pp. 1-36
Author(s):  
Miwa Yamaguchi ◽  
Marika Nomura ◽  
Yusuke Arai ◽  
Stefanie Vandevijvere ◽  
Boyd Swinburn ◽  
...  
Keyword(s):  
Best Practices ◽  
Food Environment ◽  
Food Composition ◽  
Food Prices ◽  
Healthy Food ◽  
Japanese Government ◽  
Alcoholic Beverages ◽  
Food Environments ◽  
Environment Policy ◽  
Implementation Gaps

Abstract Objective: This study aimed to evaluate policies and actions for food environments by the Japanese Government using the Healthy Food Environment Policy Index (Food-EPI). Design: Public health experts rated the extent of implementation of food environment-related the Policy and the Infrastructure-support components, compared to international best practices. Subsequently, the experts proposed and prioritized future actions to address implementation gaps in an online workshop. Setting: Japan Participants: A total of 66 experts rated policy implementation by the Japanese Government, and 23 participated in the workshop on future actions. Results: The implementations of regulations on unhealthy foods and non-alcoholic beverages were rated low in the domains of Food composition, Food labelling, Food promotion, Food prices, and Food retail in the Policy component. The implementations of several domains in the Infrastructure-support component were, overall, rated at a higher level, specifically for monitoring and intelligence systems. Based on the rating, reducing health inequalities by supporting people, both economically and physically, was the highest priority for future actions in both components. Conclusions: This study found that Japan has a robust system for long-term monitoring of population health but lacks regulations on unhealthy foods and non-alcoholic beverages compared to international best practices. This study confirmed the importance of continuous accumulation of evidence through national monitoring systems. Developing comprehensive regulations to restrict food marketing, sales, and accessibility of unhealthy foods and non-alcoholic beverages are needed to improve the health of food environments in Japan.

scholarly journals At-a-glance - "A tough sell": findings from a qualitative analysis on the provision of healthy foods in recreation and sports settings

2018 ◽  
Vol 38 (1) ◽  
pp. 18-22 ◽  
Author(s):  
Jessie-Lee D. McIsaac ◽  
Sherry L. Jarvis ◽  
Rebecca Spencer ◽  
Sara F.L. Kirk
Keyword(s):  
Physical Activity ◽  
Food Environment ◽  
Health Behaviours ◽  
Healthy Food ◽  
Cultural Norms ◽  
Healthy Foods ◽  
Personal Choice ◽  
Telephone Interviews ◽  
Stakeholder Perspectives ◽  
Food Provision

Recreation and sport settings (RSS) typically promote health in the form of physical activity, but the healthfulness of their food environment is often neglected. We explored stakeholder perspectives on barriers to healthy food provision in RSS through telephone interviews with ten representatives from RSS across Nova Scotia. Three key barriers were identified: 1) cultural norms associated with food in RSS and the broader environment, 2) the persisting notion of personal choice and responsibility, and 3) financial implications of healthy food provision. These barriers challenge healthy food provision in RSS and require multi-faceted strategies to overcome social norms that undermine health behaviours.

scholarly journals Benchmarking the implementation of recommended food environment policies in Norway using the Healthy Food Environment Policy Index (Food-EPI)

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L E Torheim ◽  
A L Løvhaug ◽  
S Henjum ◽  
L Terragni ◽  
G Roos
Keyword(s):  
Public Health ◽  
Policy Implementation ◽  
Food Environment ◽  
Social Inequalities ◽  
Good Practice ◽  
Critical Role ◽  
Healthy Food ◽  
Food Environments ◽  
Policy Action ◽  
Environment Policy

Abstract Background Obesity prevalence in Norway has increased over the past decades despite political objectives and strategies for obesity prevention. Healthy food environments have the potential to improve the diet of the population and decrease the burden of disease. Governments play a critical role to form such environments. The aim of the study was to assess the efforts of the Norwegian Government towards creating healthier food environments and suggest actions using the Healthy Food Environment Policy Index (Food-EPI) methodology. Methods Evidence of policy implementation was assembled and verified by government stakeholders for 45 good practice indicators across 12 policy and infrastructure support domains. Independent public health nutrition experts from academia and civil society (n = 34) assessed the level of implementation of each indicator compared with international best practices, using an online tool. Results Most indicators were rated at “medium” level of implementation (51%). An almost equal number of indicators were rated at “high” and “low” level of implementation (21% and 28%, respectively). None of the indicators were rated as “very low, if any” level of implementation. More indicators under the infrastructure domain were rated at “high” or “medium” as compared with the policy domain. The expert panel developed a list of priority actions that should be implemented to improve the food environment, including actions regarded as most effective in decreasing social inequalities in diet. The top priority action was that the Government should to a larger extent use price and taxes to change food consumption. Conclusions The Food-EPI framework and process can be used to identify gaps in national policy implementation and to develop recommendations for strengthened policy action supported by a coalition of public health experts.

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