Development of the Choices 5-Level Criteria to Support Multiple Food System Actions

In 2008, the Choices International Foundation developed its logo criteria, identifying best-in-class food products. More advanced, global and graded nutrient profiling systems (NPSs) are needed to substantiate different national nutrition policies. The objective of this work was to extend Choices NPS to identify five levels of the healthiness of food products, so that the Choices NPS can also be used to support other nutrition policies, next to front-of-pack labelling. Based on the same principles as the previous logo criteria, four sets of threshold criteria were determined using a combination of compliance levels, calculated from a large international food group-specific database, the Choices logo criteria, and WHO-NPSs developed to restrict marketing to children. Validation consisted of a comparison with indicator foods from food-based dietary guidelines from various countries. Some thresholds were adjusted after the validation, e.g., because intermediate thresholds were too lenient. This resulted in a new international NPS that can be applied to different contexts and to support a variety of health policies, to prevent both undernutrition and obesity. It can efficiently evaluate mixed food products and represents a flexible tool, applicable in various settings and populations.

Nutrition Accountability through Sub-National Scorecards in Tanzania – Policy Innovations and Field Realities

Over the past decade, the Government of Tanzania has paid increasing attention to accountability in its nutrition policies. This has coincided with the introduction of truly innovative efforts to advance and monitor government action towards and accountability for nutrition at subnational level. A multisectoral nutrition scorecard (MNS) has been rolled out across all districts in the country, with quarterly updates on district performance. Moreover, a Nutrition Compact instrument was introduced to incentivise senior civil servants within regional and district administrations to advance efforts to promote nutrition. This paper explores how the government has used these initiatives to give accountability a particular form and meaning, pertinent to context. The paper analyses a series of policy documents and complements analysis this with field-based interviews with local officials across five regions. We find that the MNS and Compact are designed predominantly for internal purposes of government. This renders ‘accountability tools’ largely in the service of a centralised state, advancing vertical accountability. Such a narrow framing and design inhibits the potential of these instruments for galvanising social accountability, whereby citizens can hold public service providers and subnational government actors to account directly.

Nutrition Policies in Germany: A Systematic Assessment with the Food Environment Policy Index (Food-EPI)

Objective: To systematically assess Germany’s nutrition policies, to benchmark them against international best practices, and to identify priority policy actions to improve population-level nutrition in Germany. Design: We applied the Food Environment Policy Index (Food-EPI), a methodological framework developed by the INFORMAS network. Qualitative content analysis of laws, directives and other documents formed the basis of a multi-staged, structured consultation process. Setting: Germany. Participants: The expert consultation process included 55 experts from academia, public administration, and civil society. Results: Germany lags behind international best practices in several key policy areas. For 18 policy indicators, the degree of implementation compared to international best practices was rated as very low, for 21 as low, for 8 as intermediate, and for none as high. In particular, indicators on food taxation, regulation of food marketing, and retail and food service sector policies were rated as very low to low. Identified priority actions included the binding implementation of nutrition standards for schools and kindergartens, a reform of the value added tax on foods and beverages, a sugar-sweetened beverage tax and stricter regulation of food marketing directed at children. Conclusions: The results show that Germany makes insufficient use of the potential of evidence-informed health-promoting nutrition policies. Adopting international best practices in key policy areas could help to reduce the burden of nutrition-related chronic disease and related inequalities in nutrition and health in Germany. Implementation of relevant policies requires political leadership, a broad societal dialogue, and evidence-informed advocacy by civil society, including the scientific community.

Nutritional Policies and Anaemia Among Under-five Children in Selected South Asian Countries: 1950-2016

This study provides an understanding between the nutrition policies and nutritional status of under-5 children in South Asian countries. It gives an overview of nutrition policies and actions taken to improve the nutritional status of under-5 children in the South Asian context, focusing on Bangladesh, India, Nepal and Pakistan. The efforts were taken to understand the legislative actions and children's nutritional status in these countries and their past efforts to deal with anemia. To execute the efforts, data has been taken from the Global Health Observatory Data Repository (GHODR), Demographic Health Survey (DHS) and reviews some of the critical interventions in nutrition within the different countries and draws out several issues that bear on these policies' future evolution. The findings show Around 57.3 percent in India, 40 percent in Bangladesh, 43 percent in Nepal and 59 percent in Pakistan under-5 children were found anaemic in 2016. There are 33 percentage, 31 percent, 20 percent and 12 percent points reduction took place in 26 years between 1990 and 2016 in Bangladesh Nepal, India and Pakistan respectively. The low anemia prevalence was observed in Bangladesh and Nepal despite fewer policies and programs than in India and Pakistan which manifests quality of policy is more important rather than quantity of policy. The findings show that the growth of nutrition policies and the program has a slow pace but positively affects anemia among the under-5 children in South Asian countries. To eradicate anemia among the children and to achieve Sustainable Development Goals (SDGs), India and Pakistan need to take a policy lesson from the neighboring countries. This study suggests that National Nutrition Program requires inter-sectoral coordination between major Ministries within countries to get required level success within limited time.

Nutrition Policies in Germany: A Systematic Assessment with the Food Environment Policy Index (Food-EPI)

Objective: To systematically assess Germany's nutrition policies, to benchmark them against international best practices, and to identify priority policy actions to improve population-level nutrition in Germany. Design: We applied the Food Environment Policy Index (Food-EPI), a methodological framework developed by the INFORMAS network. Qualitative content analysis of laws, directives and other documents formed the basis of a multi-staged, structured consultation process. Setting: Germany. Participants: The expert consultation process included 55 experts from academia, public administration, and civil society. Results: Germany lags behind international best practices in several key policy areas. For 18 policy indicators, the degree of implementation compared to international best practices was rated as very low, for 21 as low, for 8 as intermediate, and for none as high. In particular, indicators on food taxation, regulation of food marketing, and retail and food service sector policies were rated as very low to low. Identified priority actions included the binding implementation of nutrition standards for schools and kindergartens, a reform of the value added tax on foods and beverages, a sugar-sweetened beverage tax and stricter regulation of food marketing directed at children. Conclusions: The results show that Germany makes insufficient use of the potential of evidence-informed health-promoting nutrition policies. Adopting international best practices in key policy areas could help to reduce the burden of nutrition-related chronic disease and related inequalities in nutrition and health in Germany. Implementation of relevant policies requires political leadership, a broad societal dialogue, and evidence-informed advocacy by civil society, including the scientific community. Keywords: nutrition, food environments, public policies, public health, health promotion

Total Fat and Fatty Acid Intake among 1–7-Year-Old Children from 33 Countries: Comparison with International Recommendations

This work reviews available data on dietary intakes of total fat, saturated fatty acids (SFA) and individual polyunsaturated fatty acids (PUFA) in children in different countries worldwide and for the first time, compares them with recent international recommendations. Studies published before June 2021 reporting total fat, total SFA and individual PUFA intakes in children aged 1–7 y were included. Observed intakes were evaluated against FAO/WHO and EFSA recommendations. 65 studies from 33 countries were included. Fat intake was too low in 88% of studies in young children (1–3 y). SFA intake was >10%E in 69–73% of children, especially in Europe. Linoleic acid intake was <3%E in 24% of studies in 1–2 y olds and within FAO/WHO recommendations among all other ages. Alpha-linolenic acid intake was <0.5%E in almost half of studies. Docosahexaenoic acid (DHA) or eicosapentaenoic acid + DHA intakes were below recommendations in most studies. In summary, while total fat intake was too low among younger children, SFA intake was above, especially in Europe and n-3 PUFA intake, especially DHA, were below recommendations for all ages. Intake of n-3 PUFA, especially DHA, is generally suboptimal. More data, particularly from developing countries, are required to refine these findings and guide implementation of adapted nutrition policies.

Benevolent Policies: Bureaucratic Politics and the International Dimensions of Social Policy Expansion

Research on the welfare state has devoted considerable attention to social policy expansion. However, little is known about why governments expand social policies serving groups with limited power on issues with low visibility. I call these “benevolent policies.” This class of social policies improves population well-being but produces minimal political gains for the governments enacting them. Why do governments expand benevolent policies if political incentives for reform are weak? I investigate this question by focusing on government responses to malnutrition. Drawing on nine months of fieldwork, including 71 interviews, I argue that the origins of policy expansion can be found in the government bureaucracy. Bureaucrats with technical expertise—technocrats—can play a defining role, deploying international pressure to court executive support and orchestrate policy change. Their actions help explain the Indonesian government’s unexpected expansion of nutrition policies, which serve low-income women and children and address micronutrient malnutrition.

Food and Nutrition Policies of African Countries

The food crisis that is currently being faced by the world is very vulnerable to the survival of mankind. A food crisis usually begins with a shock to either supply or demand for food and often involves a sudden spike in food prices. Food security is a flexible concept that is reflected in many attempts at every definition used in research and policy. Empowerment of farmers in the African agricultural sector is the key to realizing African food security. The strategy of privatizing agricultural inputs by prohibiting the circulation of traditional seeds indirectly forces small farmers to buy private agricultural inputs

An Italian Case Study for Assessing Nutrient Intake through Nutrition-Related Mobile Apps

National food consumption surveys are crucial for monitoring the nutritional status of individuals, defining nutrition policies, estimating dietary exposure, and assessing the environmental impact of the diet. The methods for conducting them are time and resource-consuming, so they are usually carried out after extended periods of time, which does not allow for timely monitoring of any changes in the population’s dietary patterns. This study aims to compare the results of nutrition-related mobile apps that are most popular in Italy, with data obtained with the dietary software Foodsoft 1.0, which was recently used in the Italian national dietary survey IV SCAI. The apps considered in this study were selected according to criteria, such as popularity (downloads > 10,000); Italian language; input characteristics (daily dietary recording ability); output features (calculation of energy and macronutrients associated with consumption), etc. 415 apps in Google Play and 226 in the iTunes Store were examined, then the following five apps were selected: YAZIO, Lifesum, Oreegano, Macro and Fitatu. Twenty 24-hour recalls were extracted from the IV SCAI database and inputted into the apps. Energy and macronutrient intake data were compared with Foodsoft 1.0 output. Good agreement was found between the selected apps and Foodsoft 1.0 (high correlation index), and no significant differences were found in the mean values of energy and macronutrients, except for fat intakes. In conclusion, the selected apps could be a suitable tool for assessing dietary intake.