ORCID Profile
0000-0001-6899-3983
Current Organisation
Deakin University
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Public Nutrition Intervention | Ecological Impacts of Climate Change | Ecological Applications | Economic Models And Forecasting | Health Economics | Public Health and Health Services | Applied Economics | Public Health And Health Services Not Elsewhere Classified | Health Promotion | Marketing Management (incl. Strategy and Customer Relations) |
ANZSRC Socio-Economic Objective (SEO)
Nutrition | Climate Change Adaptation Measures | Marketing | Social Impacts of Climate Change and Variability | Preventive medicine | Social structure and health | Health status (e.g. indicators of “well-being”)
Related Links
Publications
Globalization, first-foods systems transformations and corporate power: a synthesis of literature and data on the market and political practices of the transnational baby food industry
Publisher: Springer Science and Business Media LLC
Date: 21-05-2021
DOI: 10.1186/S12992-021-00708-1
Abstract: The global milk formula market has ‘boomed’ in recent decades, raising serious concerns for breastfeeding, and child and maternal health. Despite these developments, few studies have investigated the global expansion of the baby food industry, nor the market and political practices corporations have used to grow and sustain their markets. In this paper, our aim is to understand the strategies used by the baby food industry to shape ‘first-foods systems’ across its erse markets, and in doing so, drive milk formula consumption on a global scale. We used a theoretically guided synthesis review method, which integrated erse qualitative and quantitative data sources. Global milk formula sales grew from ~US$1.5 billion in 1978 to US$55.6 billion in 2019. This remarkable expansion has occurred along two main historical axes. First, the widening geographical reach of the baby food industry and its marketing practices, both globally and within countries, as corporations have pursued new growth opportunities, especially in the Global South. Second, the broadening of product ranges beyond infant formula, to include an array of follow-up, toddler and specialized formulas for a wider range of age groups and conditions, thereby widening the scope of mother-child populations subject to commodification. Sophisticated marketing techniques have been used to grow and sustain milk formula consumption, including marketing through health systems, mass-media and digital advertising, and novel product innovations backed by corporate science. To enable and sustain this marketing, the industry has engaged in erse political practices to foster favourable policy, regulatory and knowledge environments. This has included lobbying international and national policy-makers, generating and deploying favourable science, leveraging global trade rules and adopting corporate policies to counter regulatory action by governments. The baby food industry uses integrated market and political strategies to shape first-foods systems in ways that drive and sustain milk formula market expansion, on a global scale. Such practices are a major impediment to global implementation of the International Code of Marketing of Breastmilk Substitutes, and other policy actions to protect, promote and support breastfeeding. New modalities of public health action are needed to negate the political practices of the industry in particular, and ultimately to constrain corporate power over the mother-child breastfeeding dyad.
Using a qualitative vignette to explore a complex public health issue
Publisher: SAGE Publications
Date: 27-01-2015
Abstract: This article discusses how qualitative vignettes were combined with interviews to explore a complex public health issue that is, promoting unhealthy foods and beverages to children and adolescents. It outlines how the technique was applied in practice and the combination of vignette-based interviews with a broader approach involving Gadamerian hermeneutics. Twenty-one participants from the public health community and the marketing and food and beverage industries took part in vignette-based interviews between March and September 2012. Overall, the qualitative vignette method afforded an efficient, generally well-received technique that effectively explored the issue of promoting unhealthy foods and beverages to children and adolescents. The vignette provided structure to interviews but allowed certain responses to be investigated in greater depth. Through this research, we argue that qualitative vignettes allow researchers to explore complex public health issues. This article also provides a valuable resource for researchers seeking to explore this technique.
Food rescue – an Australian example
Publisher: Emerald
Date: 26-08-2014
Abstract: – Food rescue is used in the emergency food sector internationally to reduce waste and improve food supplies to frontline providers and their clients. The purpose of this paper is to provide a perspective on why and how food rescue occurs in Australia. It also examines food rescue as a potential evolution within the emergency food setting. – A descriptive study of SecondBite, an Australian food rescue organisation, was conducted. Documents were reviewed, 14 weeks of participant observation occurred, and two focus group discussions were held. Framing analysis was used to design the research questions (why rescue food? and how?). The description of the organisation was then examined against critical literature to establish how food rescue conforms to and/or challenges the traditional limitations of emergency food. – Food rescue requires multiple resources within the emergency food space including surplus food, funding and labour. The frames used to justify this work provide an insight into the “problem” of food poverty in Australia and the “solution” of food rescue. The script for “people in need” requiring “fresh food” is well developed by SecondBite, with some tension around food waste reduction as a competing and yet complementary mission. – In light of the growing role of the not for profit sector in a “big society” political order, the rescuing of nutritious food for emergency parcels and meals, may provide some benefits for people already using emergency food. The opportunity for food rescue organisations to play a role in food poverty prevention requires further attention.
Processed Foods and Nutrition Transition in the Pacific: Regional Trends, Patterns and Food System Drivers
Publisher: MDPI AG
Date: 13-06-2019
DOI: 10.3390/NU11061328
Abstract: Background: The role of processed foods in nutrition transition in the Pacific is receiving some attention in the context of a significant obesity and diet-related noncommunicable disease health burden. However, trends, patterns and underlying drivers of processed food markets in the Pacific are not well understood. The aim of this study was to investigate recent trends and patterns of processed food markets in the region and interpret the findings by engaging key literature on relevant food systems drivers. Methods: We conducted a mixed-methods approach involving two steps (1) We analysed Euromonitor market sales data for processed food and beverage products sold from 2004–2018 for 16 countries differentiated by income level, and (2) guided by a food systems conceptual framework, we drew upon key literature to understand the likely drivers of our observations. Results: We observed plateaus and declines in processed food sales in some high-income countries but increases in upper-middle and lower-middle income countries, and most rapidly in the latter. Beverage markets appear to be stagnating across all income groups. Carbonated soft drinks, baked goods, vegetable oils, processed meats, noodles and sweet biscuits made up the majority of sales in transitioning countries. These observations are likely a result of income growth, urbanising populations, trade and globalisation, and various policies implemented by Pacific governments. Conclusions: A processed foods nutrition transition is well underway in the Pacific region and accelerating most prominently in lower-middle income countries.
The possibility of regulating for obesity prevention-understanding regulation in the Commonwealth Government
Publisher: Wiley
Date: 21-11-2012
DOI: 10.1111/OBR.12004
Abstract: A complex regulatory package is likely to be necessary to effectively reduce obesity prevalence in developed countries. This study investigated the barriers and facilitators to implementing regulatory interventions to prevent obesity within the executive arm of the Australian Commonwealth Government. Policy reviews were conducted on nine government departments to understand their roles and interests in obesity. From this process we identified regulatory review carried out by the Office of Best Practice Regulation as possibly posing a barrier to law reform for obesity prevention, along with the complexity of the food policymaking structures. The policy reviews informed subsequent in-depth semi-structured interviews with senior Commonwealth government officers (n = 13) focused on refining our understanding of the barriers to enacting obesity prevention policy. In addition to the two barriers already identified, interviewees identified a lack of evidence for interventions, which would reduce obesity prevalence, and the influence of politicians on executive decisions as posing obstacles. Most interviewees believed that the barriers to regulating to prevent obesity were strong and that intervention by elected politicians would be the most likely method of implementing obesity prevention policy.
The drivers, trends and dietary impacts of non-nutritive sweeteners in the food supply: a narrative review
Publisher: Cambridge University Press (CUP)
Date: 05-11-2020
DOI: 10.1017/S0954422420000268
Abstract: Poor diets, including excess added sugar consumption, contribute to the global burden of disease. Subsequently, many nutrition policies have been implemented to reduce added sugar intake and improve population health, including taxes, education, labelling and environmental interventions. A potential consequence of these policy actions is the substitution of added sugars with non-nutritive sweeteners (NNS) in a variety of foods and beverages. NNS are used to reduce the energy and sugar content of foods and beverages while maintaining their palatability. Evidence of the toxicological risks of NNS is inconsistent, though concerns have been raised over the potential substitution effects of ultra-processed foods containing NNS for whole foods. This review aimed to provide an overview of current NNS food supply and consumption patterns, assess added sugar-reduction policies and their impact on NNS, and determine the impact of NNS on food choice, energy intake and diet quality. NNS are widely available in a variety of products, though most commonly in carbonated beverages, dairy products, confectionery, table-top sweeteners and fruit drinks. However, the longitudinal trends of different product categories, and differences between geographies and economy-income levels, require further study. Few studies have examined NNS consumption trends globally, though an increase in NNS consumption in beverages has been observed in some regions. Research examining how the increased availability of low-sugar, NNS-containing products affects global dietary patterns is limited, particularly in terms of their potential substitution effects.
Evidence Synthesis and Translation for Nutrition Interventions to Combat Micronutrient Deficiencies with Particular Focus on Food Fortification
Publisher: MDPI AG
Date: 08-09-2016
DOI: 10.3390/NU8090555
Food and nutrition security in the Australia-New Zealand region: Impact of climate change
Publisher: S. Karger AG
Date: 2011
DOI: 10.1159/000327823
Healthy and Environmentally Sustainable Food Procurement and Foodservice in Australian Aged Care and Healthcare Services: A Scoping Review of Current Research and Training
Publisher: MDPI AG
Date: 11-10-2021
DOI: 10.3390/SU132011207
Abstract: Balancing the adoption of environmentally sustainable food systems in Australian healthcare and aged care settings whilst meeting nutritional requirements has never been more critical. This scoping review aimed to identify: the major authoritative reports/guidelines related to healthy and environmentally sustainable food procurement and foodservice in aged care and healthcare services released by international and Australian governments/organizations and the scope of healthy and environmentally sustainable food procurement and foodservice research and training initiatives in aged care and healthcare services implemented in Australia over the past decade. A systematic search yielded n = 17 authoritative reports/guidelines and n = 20 publications describing Australian research and training initiatives. Implementation of healthy and sustainable food procurement and foodservices were limited by staff knowledge and self-efficacy, and unsupportive management. Further intervention and monitoring of healthy and sustainable food procurement and foodservice practices is needed. Whilst professionals working in and managing these services require upskilling to apply evidence-based approaches, no system-wide training programs are currently available. There is an urgent need to resolve the existing gap between recommendations to adopt environmentally sustainable practices and staff training across these sectors.
Ultraprocessed foods and cardiovascular health: it’s not just about the nutrients
Publisher: Elsevier BV
Date: 02-2021
DOI: 10.1093/AJCN/NQAA333
Barriers and potential facilitators to the implementation of government policies on front-of-pack food labeling and restriction of unhealthy food advertising in Thailand
Publisher: Elsevier BV
Date: 08-2017
Obesity Policy Action framework and analysis grids for a comprehensive policy approach to reducing obesity
Publisher: Wiley
Date: 23-12-2009
Moving beyond 'rates, roads and rubbish': How do local governments make choices about healthy public policy to prevent obesity?
Publisher: Springer Science and Business Media LLC
Date: 23-08-2009
Regulatory and Legal Aspects of Functional Foods: The Australian Perspective
Publisher: Oxford University Press (OUP)
Date: 27-04-2009
DOI: 10.1111/J.1753-4887.1996.TB03838.X
Abstract: The present study was conducted to identify the novel QTLs controlling salinity and sodicity tolerance using The online version contains supplementary material available at 10.1007/s12298-022-01174-8.
IUNS Task Force on Sustainable Diets - LINKING NUTRITION AND FOOD SYSTEMS
Publisher: Elsevier BV
Date: 12-2022
Integrating Agriculture and Food Policy to Achieve Sustainable Peri-urban Fruit and Vegetable Production in Victoria, Australia
Publisher: Lyson Center for Civic Agriculture and Food Systems
Date: 11-04-2011
Response to folic acid article
Publisher: Elsevier BV
Date: 10-2012
Regulation to Create Environments Conducive to Physical Activity: Understanding the Barriers and Facilitators at the Australian State Government Level
Publisher: Public Library of Science (PLoS)
Date: 27-09-2012
Global trends in added sugars and non-nutritive sweetener use in the packaged food supply: drivers and implications for public health
Publisher: Cambridge University Press (CUP)
Date: 28-07-2023
DOI: 10.1017/S1368980022001598
Abstract: The health implications of excessive added sugar intakes have led to national policy actions to limit their consumption. Subsequently, non-nutritive sweeteners (NNS) may be used to maintain product sweetness. We aimed to assess trends in quantities of added sugars and NNS sold in packaged food and beverages worldwide, and the association between these trends and the number of national policy actions across regions to reduce added sugar consumption. (i) Longitudinal analysis of Euromonitor sales data (2007–2019) to assess the quantity of added sugars (kg) and NNS (g) sold in packaged foods and beverages globally, across regions, and across country income categories (ii) policy-mapping of policy actions targeting added sugar consumption globally from the NOURISHING database and (iii) Spearman’s correlations to assess the association between national policy actions across regions and changes in added sugar/NNS sales. Worldwide. Not applicable. Per capita volumes of NNS from beverage sales increased globally (36 %). Added sugars from beverage sales decreased in high-income countries (22 %) but increased in upper-middle-income countries (UMIC) and lower-middle-income countries (LMIC) (13–40 %). Added sugars from packaged food sales increased globally (9 %). Regions with more policy actions had a significant increase in NNS quantities from beverage sales ( r = 0·68, P = 0·04). The sweetness of the packaged food supply (the sweetness of each NNS and added sugar, relative to sucrose, multiplied by sales volume) increased over time. The increasing use of NNS to sweeten beverages globally, and in packaged food in UMIC and LMIC, may have health and dietary implications in the future. Their use as a substitute for added sugar should be considered in public health nutrition policymaking.
Health Promotion: Philosophy, Prejudice and Practice
Publisher: Oxford University Press (OUP)
Date: 1998
Historical Developments and Paradigm Shifts in Public Health Nutrition Science, Guidance and Policy Actions: A Narrative Review
Publisher: MDPI AG
Date: 28-02-2019
DOI: 10.3390/NU11030531
Abstract: Public health nutrition (PHN) seeks to protect and promote the nutrition-related health and wellbeing of populations. PHN science is dynamic and has evolved over time, helping to inform our understanding of the changing nature, scope, causes and solutions to PHN problems. This scientific basis has informed nutrition guidance and policy. Using a narrative synthesis method and guided by Kuhn’s theory on the structure of scientific revolutions, this paper reviews the historical development of PHN, aiming to understand the emergence of major scientific paradigms, paradigm shifts and evidence-informed guidance and policy. We propose that the development of PHN is characterized by the successive layering of paradigms resulting from interactions between science, social change and policy-making. Four eras of PHN are evident: the foundation, nutrient deficiency, dietary excess and imbalances, and environmental sustainability (ES). Dominant paradigms have been communicated through nutrient reference standards, dietary goals and dietary guidelines. Transitions from one era to the next indicated new ways of thinking about PHN, amounting to a paradigm shift. The bidirectional relationship between nutrition and ES is the latest challenge confronting PHN. Investigating PHN paradigm transitions reveals how we have arrived at current guidance and policies, and how PHN might progress into the future.
Shrinking the food-print: A qualitative study into consumer perceptions, experiences and attitudes towards healthy and environmentally friendly food behaviours
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.APPET.2016.09.030
Abstract: Internationally, there is increasing recognition of the importance of multilevel policies and actions that address healthy and environmentally friendly food behaviours. However it is not yet clear which actions are most suitable to support consumers to adopt both behaviours concurrently. To this end, we undertook a qualitative study to assess consumer perceptions, experiences and attitudes towards healthy and environmentally friendly foods and four target behaviours: reducing overconsumption of food beyond energy needs, reducing consumption of low-nutrient energy dense foods, eating less animal- and more plant-derived foods, and reducing food waste. Online in-depth interviews were held with 29 Australian food shoppers representing different levels of involvement with health and environment in daily food choices. The results indicate that compared to health, the relationship between food and the environment is rarely considered by consumers. The four target food behaviours were primarily associated and motivated by an impact on health, except for not wasting foods. Participants had the most positive attitude and highest motivation for eating less processed and packaged foods, mostly to avoid excessive packaging and 'chemicals' in foods. This was followed by the behaviours reducing food waste and overconsumption. Conversely, there was a predominantly negative attitude towards, and low motivation for, eating less animal-derived products and more plant based foods. Overall, consumers found a joined concept of healthy and environmentally friendly foods an acceptable idea. We recommend that health should remain the overarching principle for policies and actions concerned with shifting consumer behaviours, as this personal benefit appears to have a greater potential to support behaviour change. Future consumer focused work could pay attention to framing behavioural messages, providing intermediate behavioural goals, and a multiple target approach to change habitual behaviours.
Awareness of nutrition problems among Vietnamese health and education professionals
Publisher: Oxford University Press (OUP)
Date: 22-03-2016
Abstract: Professionals who provide nutrition education and consulting to the public are encouraged to take into account the health, environmental and social contexts that influence health-related attitudes and behaviours in the population. This paper examined the awareness of shifts in population health outcomes associated with the nutrition transition in Vietnam among university nutrition lecturers, health professionals and school education professionals. Most of these professionals held accurate views of the current population health issues in Vietnam. However, they differed in their awareness of the seriousness of overweight and obesity. Although the majority indicated that the prevalence of obesity and non-communicable diseases (NCDs) had increased, nearly half believed that the government should complete its attempts to control undernutrition before trying to control obesity. More health professionals believed that food marketing was responsible for the growing prevalence of children's obesity, and more of them disapproved of the marketing of less healthy food to children. In contrast, the university nutrition lecturers were least aware of food marketing and the seriousness of obesity. Of the three groups, the university nutrition lecturers held less accurate perceptions of nutrition transition problems and their likely drivers. There is an urgent need for greater provision of public nutrition education for all three groups of professionals.
Do food regulatory systems protect public health?
Publisher: Cambridge University Press (CUP)
Date: 11-2009
Government regulation to promote healthy food environments - a view from inside state governments
Publisher: Wiley
Date: 29-09-2011
Approaches to Defining Healthy Diets: A Background Paper for the International Expert Consultation on Sustainable Healthy Diets
Publisher: SAGE Publications
Date: 12-2020
Abstract: Healthy diets promote optimal growth and development and prevent malnutrition in all its forms, including undernutrition, obesity, and diet-related noncommunicable diseases (NCDs). This background paper for the International Expert Consultation on Sustainable Healthy Diets characterizes healthy diets and their implications for food system sustainability. Three complementary approaches to defining healthy diets are compared: World Health Organization (WHO) guidelines or recommendations developed between 1996 and 2019 2017 Global Burden of Disease (GBD) risk factor study estimates of diet-related risk–outcome associations and analyses associating indices of whole dietary patterns with health outcomes in population studies and clinical trials. World Health Organization dietary recommendations are global reference points for preventing undernutrition and reducing NCD risks they emphasize increasing intakes of fruits, vegetables (excepting starchy root vegetables), legumes, nuts, and whole grains limiting energy intake from free sugars and total fats consuming unsaturated rather than saturated or trans fats and limiting salt intake. Global Burden of Disease findings align well with WHO recommendations but include some additional risk factors such as high consumption of processed meat this approach quantifies contributions of diet-related risks to the NCD burden. Evidence on whole dietary patterns supports WHO and GBD findings and raises concerns about potential adverse health effects of foods with high levels of industrial processing. Implied shifts toward plant foods and away from animal foods (excepting fish and seafood), and for changes in food production systems have direct relevance to the sustainability agenda.
Letter to the Editor
Publisher: Cambridge University Press (CUP)
Date: 05-2007
Rethinking the translation of nutrition evidence into public health practice
Publisher: Elsevier BV
Date: 06-2017
Who has a beef with reducing red and processed meat consumption? A media framing analysis
Publisher: Cambridge University Press (CUP)
Date: 30-09-2022
DOI: 10.1017/S1368980021004092
Abstract: Diets high in red and processed meat (RPM) contribute substantially to environmental degradation, greenhouse gas emissions and the global burden of chronic disease. High-profile reports have called for significant global RPM reduction, especially in high-income settings. Despite this, policy attention and political priority for the issue are low. The study used a theoretically guided framing analysis to identify frames used by various interest groups in relation to reducing RPM in online news media articles published in the months around the release of four high-profile reports by authoritative organisations that included a focus on the impacts of high RPM production and/or consumption. Four major RPM producing and consuming countries – USA, United Kingdom, Australia and New Zealand. None. Hundred and fifty news media articles were included. Articles reported the views of academics, policymakers, industry representatives and the article authors themselves. RPM reduction was remarkably polarising. Industry frequently framed RPM reduction as part of a ‘Vegan Agenda’ or as advocated by an elite minority. Reducing RPM was also depicted as an infringement on personal choice and traditional values. Many interest groups attempted to discredit the reports by citing a lack of consensus on the evidence, or that only certain forms of farming and processing were harmful. Academics and nutrition experts were more likely to be cited in articles that were aligned with the findings of the reports. The polarisation of RPM reduction has led to a binary conflict between pro- and anti-meat reduction actors. This ision may diminish the extent to which political leaders will prioritise this in policy agendas. Using nuanced and context-dependent messaging could ensure the narratives around meat are less conflicting and more effective in addressing health and environmental harms associated with RPM.
The need for particular scrutiny of claims made by researchers associated with ultra-processed food manufacturers
Publisher: Cambridge University Press (CUP)
Date: 20-02-2023
Building global alliances for public health nutrition training
Publisher: Oxford University Press (OUP)
Date: 05-2009
DOI: 10.1111/J.1753-4887.2009.00162.X
Abstract: The purpose of this paper is to present a review of opportunities and challenges for future progress in building intercountry, regional, and global alliances for public health nutrition training. Drawing on experiences from developing, implementing, and evaluating public health nutrition training in Australasia, Europe, and the Middle East, suggestions are provided for building a network of global training activities. Opportunities are described in areas such as standardization of course competencies and registration schemes, resource sharing, student and trainer exchange programs, and professional development. Challenges are identified and options presented for building global alliances in public health nutrition training into the future.
Conceptualising the policy practice and behavioural research relationship
Publisher: Springer Science and Business Media LLC
Date: 2008
An accountability framework to promote healthy food environments
Publisher: Cambridge University Press (CUP)
Date: 25-02-2014
DOI: 10.1017/S1368980014000093
Abstract: To review the available literature on accountability frameworks to construct a framework that is relevant to voluntary partnerships between government and food industry stakeholders. Between November 2012 and May 2013, a desk review of ten databases was conducted to identify principles, conceptual frameworks, underlying theories, and strengths and limitations of existing accountability frameworks for institutional performance to construct a new framework relevant to promoting healthy food environments. Food policy contexts within high-income countries to address obesity and diet-related non-communicable diseases. Eligible resources ( n 26) were reviewed and the guiding principles of fifteen interdisciplinary frameworks were used to construct a new accountability framework. Strengths included shared principles across existing frameworks, such as trust, inclusivity, transparency and verification government leadership and good governance public deliberations independent bodies recognizing compliance and performance achievements remedial actions to improve accountability systems and capacity to manage conflicts of interest and settle disputes. Limitations of the three-step frameworks and ‘mutual accountability’ approach were an explicit absence of an empowered authority to hold all stakeholders to account for their performance. We propose a four-step accountability framework to guide government and food industry engagement to address unhealthy food environments as part of a broader government-led strategy to address obesity and diet-related non-communicable diseases. An independent body develops clear objectives, a governance process and performance standards for all stakeholders to address unhealthy food environments. The empowered body takes account (assessment), shares the account (communication), holds to account (enforcement) and responds to the account (improvements).
Identifying effective interventions to promote consumption of protein-rich foods from lower ecological footprint sources: A systematic literature review
Publisher: Public Library of Science (PLoS)
Date: 16-03-2022
DOI: 10.1371/JOURNAL.PGPH.0000209
Abstract: Addressing overconsumption of protein-rich foods from high ecological footprint sources can have positive impacts on health such as reduction of non-communicable disease risk and protecting the natural environment. With the increased attention towards development of ecologically sustainable diets, this systematic review aimed to critically review literature on effectiveness of those interventions aiming to promote protein-rich foods from lower ecological footprint sources. Five electronic databases (Medline, Web of Science, Scopus, Embase and Global Health) were searched for articles published up to January 2021. Quantitative studies were eligible for inclusion if they reported on actual or intended consumption of protein-rich animal-derived and/or plant-based foods purchase, or selection of meat lant-based diet in real or virtual environments. We assessed 140 full-text articles for eligibility of which 51 were included in this review. The results were narratively synthesised. Included studies were categorised into in idual level behaviour change interventions (n = 33) which included education, counselling and self-monitoring, and micro-environmental/structural behaviour change interventions (n = 18) which included menu manipulation, choice architecture and multicomponent approaches. Half of in idual level interventions (52%) aimed to reduce red rocessed meat intake among people with current ast chronic conditions which reduced meat intake in the short term. The majority of micro-environmental studies focused on increasing plant-based diet in dining facilities, leading to positive dietary changes. These findings point to a clear gap in the current evidence base for interventions that promote plant-based diet in the general population.
Building environmentally sustainable food systems on informed citizen choices: evidence from Australia
Publisher: Informa UK Limited
Date: 28-02-2014
Monitoring the health-related labelling of foods and non-alcoholic beverages in retail settings
Publisher: Wiley
Date: 17-09-2013
DOI: 10.1111/OBR.12077
Abstract: Food labelling on food packaging has the potential to have both positive and negative effects on diets. Monitoring different aspects of food labelling would help to identify priority policy options to help people make healthier food choices. A taxonomy of the elements of health-related food labelling is proposed. A systematic review of studies that assessed the nature and extent of health-related food labelling has been conducted to identify approaches to monitoring food labelling. A step-wise approach has been developed for independently assessing the nature and extent of health-related food labelling in different countries and over time. Procedures for s ling the food supply, and collecting and analysing data are proposed, as well as quantifiable measurement indicators and benchmarks for health-related food labelling.
Generating political commitment for ending malnutrition in all its forms: A system dynamics approach for strengthening nutrition actor networks
Publisher: Wiley
Date: 27-06-2019
DOI: 10.1111/OBR.12871
Abstract: Generating political commitment for ending all forms of malnutrition represents a key challenge for the global nutrition community. Without commitment, the policies, programs, and resources needed to improve nutrition are unlikely to be adopted, effectively implemented, nor sustained. One essential driver of commitment is nutrition actor network (NAN) effectiveness, the web of in iduals and organizations operating within a given country who share a common interest in improving nutrition and who act collectively to do so. To inform new thinking and action towards strengthening NAN effectiveness, we use a systems dynamics theoretical approach and literature review to build initial causal loop diagrams (CLDs) of political commitment and NAN effectiveness and a qualitative group model building (GMB) method involving an expert workshop to strengthen model validity. First, a "nutrition commitment system" CLD demonstrates how five interrelated forms of commitment-rhetorical, institutional, operational, embedded, and system-wide-can dynamically reinforce or diminish one another over time. Second, we present CLDs demonstrating factors shaping NAN effectiveness organized into three categories: actor features, resources, and capacities framing strategies, evidence, and norms and institutional, political, and societal contexts. Together, these models generate hypotheses on how political commitment and NAN effectiveness could be strengthened in future and may provide potential starting points for country-specific conversations for doing so.
The effects of an apparent breach of therapeutic regulations on consumers: the Pan Pharmaceuticals recall
Publisher: Informa UK Limited
Date: 09-2008
Balancing the benefits and risks of public-private partnerships to address the global double burden of malnutrition
Publisher: Cambridge University Press (CUP)
Date: 13-10-2012
DOI: 10.1017/S1368980011002060
Abstract: Transnational food, beverage and restaurant companies, and their corporate foundations, may be potential collaborators to help address complex public health nutrition challenges. While UN system guidelines are available for private-sector engagement, non-governmental organizations (NGO) have limited guidelines to navigate erse opportunities and challenges presented by partnering with these companies through public–private partnerships (PPP) to address the global double burden of malnutrition. We conducted a search of electronic databases, UN system websites and grey literature to identify resources about partnerships used to address the global double burden of malnutrition. A narrative summary provides a synthesis of the interdisciplinary literature identified. We describe partnership opportunities, benefits and challenges and tools and approaches to help NGO engage with the private sector to address global public health nutrition challenges. PPP benefits include: raising the visibility of nutrition and health on policy agendas mobilizing funds and advocating for research strengthening food-system processes and delivery systems facilitating technology transfer and expanding access to medications, vaccines, healthy food and beverage products, and nutrition assistance during humanitarian crises. PPP challenges include: balancing private commercial interests with public health interests managing conflicts of interest ensuring that co-branded activities support healthy products and healthy eating environments complying with ethical codes of conduct assessing partnership compatibility and evaluating partnership outcomes. NGO should adopt a systematic and transparent approach using available tools and processes to maximize benefits and minimize risks of partnering with transnational food, beverage and restaurant companies to effectively target the global double burden of malnutrition.
Aligning evidence generation and use across health, development, and environment
Publisher: Elsevier BV
Date: 08-2019
Perceptions of nutrition transition problems: a qualitative study of Vietnamese health and education professionals
Publisher: Informa UK Limited
Date: 29-11-2016
Policy and politics.
Publisher: Routledge
Date: 04-08-2007
Kitchens and Pantries—Helping or Hindering? The Perspectives of Emergency Food Users in Victoria, Australia
Publisher: Informa UK Limited
Date: 24-06-2016
Integrating Environmental Sustainability Considerations into Food and Nutrition Policies: Insights from Australia’s National Food Plan
Publisher: Frontiers Media SA
Date: 17-09-2015
Opportunities and challenges in developing a whole-of-government national food and nutrition policy: lessons from Australia’s National Food Plan
Publisher: Cambridge University Press (CUP)
Date: 15-06-2015
DOI: 10.1017/S1368980015001834
Abstract: The present article tracks the development of the Australian National Food Plan as a ‘whole of government’ food policy that aimed to integrate elements of nutrition and sustainability alongside economic objectives. The article uses policy analysis to explore the processes of consultation and stakeholder involvement in the development of the National Food Plan, focusing on actors from the sectors of industry, civil society and government. Existing documentation and submissions to the Plan were used as data sources. Models of health policy analysis and policy streams were employed to analyse policy development processes. Australia. Australian food policy stakeholders. The development of the Plan was influenced by powerful industry groups and stakeholder engagement by the lead ministry favoured the involvement of actors representing the food and agriculture industries. Public health nutrition and civil society relied on traditional methods of policy influence, and the public health nutrition movement failed to develop a unified cross-sector alliance, while the private sector engaged in different ways and presented a united front. The National Food Plan failed to deliver an integrated food policy for Australia. Nutrition and sustainability were effectively sidelined due to the focus on global food production and positioning Australia as a food ‘superpower’ that could take advantage of the anticipated ‘dining boom’ as incomes rose in the Asia-Pacific region. New forms of industry influence are emerging in the food policy arena and public health nutrition will need to adopt new approaches to influencing public policy.
From harmful nutrients to ultra-processed foods: exploring shifts in ‘foods to limit’ terminology used in national food-based dietary guidelines
Publisher: Cambridge University Press (CUP)
Date: 02-12-2022
DOI: 10.1017/S1368980022002580
Abstract: The choice of terms used to describe ‘foods to limit’ (FTL) in food-based dietary guidelines (FBDG) can impact public understanding, policy translation and research applicability. The choice of terms in FBDG has been influenced by available science, values, beliefs and historical events. This study aimed to analyse the terms used and definitions given to FTL in FBDG around the world, including changes over time and regional differences. A review of terms used to describe FTL and their definitions in all current and past FBDG for adults was conducted, using a search strategy informed by the FAO FBDG website. Data from 148 guidelines (96 countries) were extracted into a pre-defined table and terms were organised by the categories ‘nutrient-based’, ‘food ex les’ or ‘processing-related’. National FBDG from all world regions. None. Nutrient-based terms (e.g. high-fat foods) were the most frequently used type of term in both current and past dietary guidelines (91 %, 85 %, respectively). However, food ex les (e.g. cakes) and processing-related terms (e.g. ultra-processed foods) have increased in use over the past 20 years and are now often used in conjunction with nutrient-based terms. Regional differences were only observed for processing-related terms. Diverse, and often poorly defined, terms are used to describe FTL in FBDG. Policymakers should ensure that FTL terms have clear definitions and can be integrated with other disciplines and understood by consumers. This may facilitate the inclusion of the most contemporary and potentially impactful terminology in nutrition research and policies.
Public health nutrition and sustainability
Publisher: Cambridge University Press (CUP)
Date: 09-2015
Analysing the use of the Australian Health Star Rating system by level of food processing
Publisher: Springer Science and Business Media LLC
Date: 12-2018
Public Health Nutrition
Publisher: Routledge
Date: 04-08-2020
Modelling the Food Availability and Environmental Impacts of a Shift Towards Consumption of Healthy Dietary Patterns in Australia
Publisher: MDPI AG
Date: 12-12-2019
DOI: 10.3390/SU11247124
Abstract: Dietary change has been suggested as a key strategy to maintain food security, improve health and reduce environmental impacts in the face of rising populations, resource scarcity and climate change impacts, particularly in developed countries. This paper presents findings from a quantitative modelling analysis of food availability and environmental implications of shifting the current average Australian dietary pattern to one of two alternative, healthy dietary patterns, the ‘healthy mixed diet’, with a mixture of animal and plant foods, and the ‘healthy plant-based diet’, with only plant foods. Both were constructed in accordance with the Australian Dietary Guideline recommendations, and four sustainability principles: Avoiding over-consumption, reducing intake of discretionary foods, reducing animal products, and reducing food waste. It was assumed that all food was provided domestically where possible, and export of foods only occurred when there was a surplus to domestic requirements. The authors compared the impacts of each dietary pattern on direct food availability, water use, land use, greenhouse gas emissions, fuel and energy use and fertiliser use. The plant-based diet had the best overall environmental and direct food availability outcomes, however had key vulnerabilities in terms of fertiliser and cropping land availability. For the agricultural sector overall, changes in diet had little effect on environmental impact due to the amount and nature of Australian exports, indicating that changes to production methods are also necessary. Likewise, changing diets had little effect on the existing environmentally intensive Australian economy, indicating that changes to other sectors are also necessary.
Mechanisms of scaling up: combining a realist perspective and systems analysis to understand successfully scaled interventions
Publisher: Springer Science and Business Media LLC
Date: 22-03-2021
DOI: 10.1186/S12966-021-01103-0
Abstract: Sustainable shifts in population behaviours require system-level implementation and embeddedness of large-scale health interventions. This paper aims to understand how different contexts of scaling up interventions affect mechanisms to produce intended and unintended scale up outcomes. A mixed method study combining a realist perspective and systems analysis (causal loop diagrams) of scaled-up physical activity and/or nutrition interventions implemented at a state/national level in Australia (2010–18). The study involved four distinct phases: Phase 1 expert consultation, database and grey literature searches to identify scaled-up interventions Phase 2 generating initial Context-Mechanism-Outcome configurations (CMOs) from the WHO ExpandNet framework for scaling up Phase 3 testing and refining CMOs via online surveys and realist interviews with academics, government and non-government organisations (NGOs) involved in scale up of selected interventions ( Phase 1 ) and Phase 4 generating cross-case mid-range theories represented in systems models of scaling up validated by member checking. Descriptive statistics were reported for online survey data and realist analysis for interview data. Seven interventions were analysed, targeting nutrition ( n = 1), physical activity (n = 1), or a combination ( n = 5). Twenty-six participants completed surveys 19 completed interviews. Sixty-three CMO pathways underpinned successful scale up, reflecting 36 scale up contexts, 8 key outcomes linked via 53 commonly occurring mechanisms. All five WHO framework domains were represented in the systems models. Most CMO pathways included ‘intervention attributes’ and led to outcomes ‘community sustainability/embeddedness’ and ‘stakeholder buy-in erceived value’. Irrespective of interventions being scaled in similar contexts (e.g., having political favourability) mechanisms still led to both intended and unintended scale up outcomes (e.g., increased or reduced sustainability). This paper provides the first evidence for mechanisms underpinning outcomes required for successful scale up of state or nationally delivered interventions. Our findings challenge current prerequisites for effective scaling suggesting other conditions may be necessary. Future scale up approaches that plan for complexity and encourage iterative adaptation throughout, may enhance scale up outcomes. Current linear, context-to-outcome depictions of scale up oversimplify what is a clearly a complex interaction between perceptions, worldviews and goals of those involved. Mechanisms identified in this study could potentially be leveraged during future scale up efforts, to positively influence intervention scalability and sustainability.
Unusual circumstances and complex challenges in folate debate
Publisher: Elsevier BV
Date: 02-2007
Formulating policy activities to promote healthy and sustainable diets
Publisher: Cambridge University Press (CUP)
Date: 18-08-2015
DOI: 10.1017/S1368980015002529
Abstract: To develop a policy formulation tool for strategically informing food and nutrition policy activities to promote healthy and sustainable diets (HSD). A policy formulation tool consisting of two complementary components was developed. First, a conceptual framework of the environment–public health nutrition relationship was constructed to characterise and conceptualise the food system problem. Second, an ‘Orders of Food Systems Change’ schema drawing on systems dynamics thinking was developed to identify, assess and propose policy options to redesign food systems. Food and nutrition policy activities to promote HSD have been politicised, fragmented and lacking a coherent conceptual and strategic focus to tackle complex food system challenges. The tool’s conceptual framework component comprises three integrated dimensions: (i) a structure built around the environment and public health nutrition relationship that is mediated via the food system (ii) internal mechanisms that operate through system dynamics and (iii) external interactions that frame its nature and a scope within ecological parameters. The accompanying schema is structured around three orders of change distinguished by contrasting ideological perspectives on the type and extent of change needed to ‘solve’ the HSD problem. The conceptual framework’s systems analysis of the environment–public health nutrition relationship sets out the food system challenges for HSD. The schema helps account for political realities in policy making and is a key link to operationalise the framework’s concepts to actions aimed at redesigning food systems. In combination they provide a policy formulation tool to strategically inform policy activities to redesign food systems and promote HSD.
Level of implementation of best practice policies for creating healthy food environments: assessment by state and non-state actors in Thailand
Publisher: Cambridge University Press (CUP)
Date: 13-09-2016
DOI: 10.1017/S1368980016002391
Abstract: To determine and compare the level of implementation of policies for healthy food environments in Thailand with reference to international best practice by state and non-state actors. Data on the current level of implementation of food environment policies were assessed independently using the adapted Healthy Food Environment Policy Index (Food-EPI) by two groups of actors. Concrete actions were proposed for Thai Government. A joint meeting between both groups was subsequently held to reach consensus on priority actions. Thailand. Thirty state actors and twenty-seven non-state actors. Level of policy implementation varied across different domains and actor groups. State actors rated implementation levels higher than non-state actors. Both state and non-state actors rated level of implementation of monitoring of BMI highest. Level of implementation of policies promoting in-store availability of healthy foods and policies increasing tax on unhealthy foods were rated lowest by state and non-state actors, respectively. Both groups reached consensus on eleven priority actions for implementation, focusing on food provision in public-sector settings, food composition, food promotion, leadership, monitoring and intelligence, and food trade. Although the implementation gaps identified and priority actions proposed varied between state and non-state actors, both groups achieved consensus on a comprehensive food policy package to be implemented by the Thai Government to improve the healthiness of food environments. This consensus is a platform for continued policy dialogue towards cross-sectoral policy coherence and effective actions to address the growing burden of non-communicable diseases and obesity in Thailand.
Dietitians Australia position statement on healthy and sustainable diets
Publisher: Wiley
Date: 02-2022
Abstract: It is the position of Dietitians Australia that to promote human and planetary health, a food system transformation is needed that enables the population to adopt healthy and sustainable diet‐related practices. A healthy and sustainable diet must (i) be nutritionally adequate, healthy and safe, (ii) have low environmental impact and be protective of natural resources and bio ersity, (iii) be culturally acceptable and (iv) be accessible, economically fair and affordable. Dietitians Australia acknowledges that it is critical to prioritise Indigenous knowledges in consultation, policy‐making and implementation processes to achieve these recommendations. In facilitating the uptake of healthy and sustainable diets, dietitians are contributing to the transformation of our current food system that is urgently required to nourish present and future generations within planetary boundaries. In developing this position statement, opportunities for future research have been identified including those to advance the professions' capacity to improve environmental sustainability outcomes across all areas of practice. To achieve a population‐level shift towards this diet, Dietitians Australia recommends: (i) the development of a National Food and Nutrition Strategy which honours Indigenous knowledges on food systems, (ii) the integration of sustainability principles in Australia's dietary guidelines, (iii) the reorientation of our food environment to prioritise access to healthy and sustainable foods, and (iv) investment in capacity building activities to equip the current and future nutrition and dietetics workforce.
Making nutrition guidelines fit for purpose
Publisher: BMJ
Date: 16-04-2019
DOI: 10.1136/BMJ.L1579
Concepts and guiding principles
Publisher: Routledge
Date: 04-08-2020
Reference standards and guidelines
Publisher: Routledge
Date: 04-08-2020
Communication of scientific uncertainty: international case studies on the development of folate and vitamin D Dietary Reference Values
Publisher: Cambridge University Press (CUP)
Date: 23-09-2014
DOI: 10.1017/S1368980014002006
Abstract: Transparent evidence-based decision making has been promoted worldwide to engender trust in science and policy making. Yet, little attention has been given to transparency implementation. The degree of transparency (focused on how uncertain evidence was handled) during the development of folate and vitamin D Dietary Reference Values was explored in three a priori defined areas: (i) value request (ii) evidence evaluation and (iii) final values. Qualitative case studies (semi-structured interviews and desk research). A common protocol was used for data collection, interview thematic analysis and reporting. Results were coordinated via cross-case synthesis. Australia and New Zealand, Netherlands, Nordic countries, Poland, Spain and UK. Twenty-one interviews were conducted in six case studies. Transparency of process was not universally observed across countries or areas of the recommendation setting process. Transparency practices were most commonly seen surrounding the request to develop reference values (e.g. access to risk manager/assessor problem formulation discussions) and evidence evaluation (e.g. disclosure of risk assessor data sourcing/evaluation protocols). Fewer transparency practices were observed to assist with handling uncertainty in the evidence base during the development of quantitative reference values. Implementation of transparency policies may be limited by a lack of dedicated resources and best practice procedures, particularly to assist with the latter stages of reference value development. Challenges remain regarding the best practice for transparently communicating the influence of uncertain evidence on the final reference values. Resolving this issue may assist the evolution of nutrition risk assessment and better inform the recommendation setting process.
Positioning food standards programmes to protect public health: current performance, future opportunities and necessary reforms
Publisher: Cambridge University Press (CUP)
Date: 28-02-2019
DOI: 10.1017/S1368980018003786
Abstract: To assess current performance and identify opportunities and reforms necessary for positioning a food standards programme to help protect public health against dietary risk factors. A case study design in which a food standards programme’s public health protection performance was analysed against an adapted Donabedian model for assessing health-care quality. The criteria were the food standards programme’s structure (governance arrangements and membership of its decision-making committees), process (decision-making tools, public engagement and transparency) and food standards outcomes, which provided the information base on which performance quality was inferred. The Australia and New Zealand food standards programme. The structure, process and outcomes of the Programme. The Programme’s structure and processes produce food standards outcomes that perform well in protecting public health from risks associated with nutrient intake excess or inadequacy. The Programme performs less well in protecting public health from the proliferation and marketing of ‘discretionary’ foods that can exacerbate dietary risks. Opportunities to set food standards to help protect public health against dietary risks are identified. The structures and decision-making processes used in food standards programmes need to be reformed so they are fit for purpose for helping combat dietary risks caused by dietary excess and imbalances. Priorities include reforming the risk analysis framework, including the nutrient profiling scoring criterion, by extending their nutrition science orientation from a nutrient (reductionist) paradigm to be more inclusive of a food/diet (holistic) paradigm.
Sustainable, resilient food systems for healthy diets: the transformation agenda
Publisher: Cambridge University Press (CUP)
Date: 13-08-2019
Re: Jones et al., Nutrients 2018, 10, 501
Publisher: MDPI AG
Date: 09-06-2018
DOI: 10.3390/NU10060746
Food fortification evidence and ethics
Publisher: Oxford University Press
Date: 10-01-2013
Profiling National Mandatory Folic Acid Fortification Policy Around the World
Publisher: Springer New York
Date: 2013
Dietary patterns, foods and nutrients: a descriptive analysis of the systematic reviews conducted to inform the Australian Dietary Guidelines
Publisher: Cambridge University Press (CUP)
Date: 11-08-2020
DOI: 10.1017/S0954422420000190
Abstract: Dietary guidelines should be underpinned by the best available evidence on relationships between diet and health, including evidence from nutrient-based, food-based and dietary patterns research. The primary aim of the present study was to analyse the systematic reviews conducted to inform the 2013 Australian Dietary Guidelines according to dietary exposure. The secondary aim was to analyse the reviews by health outcome, and design of included studies. To identify the systematic reviews, the dietary guidelines report was used as a starting point and relevant references were retrieved. The evidence report contained the data used in this analysis. Descriptive statistics were used to analyse reviews according to exposure, outcome, and design of included studies. A total of 143 systematic reviews were included in this analysis. Foods were the most common exposure (86·7 % of reviews), followed by nutrients (10·5 %) and dietary patterns (2·8 %). Chronic disease morbidity and/or mortality was the most common outcome (80·4 %), followed by chronic disease risk factors (19·6 %). Most reviews included evidence from cohort or nested case–control studies (92·3 %), many included evidence from case–control studies (61·5 %) and some included evidence from randomised controlled trials (28·7 %). These results reflect the research questions that were asked, the systematic review methods that were used, and the evidence that was available. In developing future iterations of the Australian Dietary Guidelines, there is an opportunity to review the latest evidence from dietary patterns research.
Ultra-processed foods: a fit-for-purpose concept for nutrition policy activities to tackle unhealthy and unsustainable diets
Publisher: Cambridge University Press (CUP)
Date: 14-12-2023
DOI: 10.1017/S000711452200280X
Abstract: Modern nutrition science began approximately 100 years ago in the context of nutrient deficiency diseases. Nutrition research and policy activities were framed mostly within a reductionist paradigm in which foods were analysed as being a collection of their constituent nutrients. Today, nutrition problems extend to all forms of malnutrition as well as environmental sustainability considerations and are associated with food and dietary pattern exposures. In 2009, researchers investigating the nutrition transition in Brazil proposed that industrial food processing was a key determinant of nutrition problems. The NOVA food classification system which is based on the nature, extent and purposes of food processing was developed to operationalise this proposition. The ultra-processed food (UPF) concept within NOVA is receiving much attention in relation to nutrition research and policy activities. This commentary describes the UPF concept as being fit-for-purpose in providing guidance to inform policy activities to tackle unhealthy and unsustainable diets. There is now a substantial body of evidence linking UPF exposure with adverse population and planetary health outcomes. The UPF concept is increasingly being used in the development of food-based dietary guidelines and nutrition policy actions. It challenges many conventional nutrition research and policy activities as well as the political economy of the industrial food system. Inevitably, there are politicised debates associated with UPF and it is apparent a disproportionate number of articles claiming the concept is controversial originate from a small number of researchers with declared associations with UPF manufacturers. Prominent ex les of these claims are assessed.
The need to reshape global food processing: a call to the United Nations Food Systems Summit
Publisher: BMJ
Date: 07-2021
Policy change to create supportive environments for physical activity and healthy eating: which options are the most realistic for local government?
Publisher: Oxford University Press (OUP)
Date: 18-03-2011
Abstract: The objective is to identify and test regulatory options for creating supportive environments for physical activity and healthy eating among local governments in Victoria, Australia. A literature review identified nine potential areas for policy intervention at local government level, including the walking environment and food policy. Discussion documents were drafted which summarized the public health evidence and legal framework for change in each area. Levels of support for particular interventions were identified through semi-structured interviews conducted with key informants from local government. We conducted 11 key informant interviews and found support for policy intervention to create environments supportive of physical activity but little support for policy changes to promote healthy eating. Participants reported lack of relevance and competing priorities as reasons for not supporting particular interventions. Promoting healthy eating environments was not considered a priority for local government above food safety. There is a real opportunity for action to prevent obesity at local government level (e.g. mandate the promotion of healthy eating environments). For local government to have a role in the promotion of healthy food environments, regulatory change and suitable funding are required.
An analysis of potential barriers and enablers to regulating the television marketing of unhealthy foods to children at the state government level in Australia
Publisher: Springer Science and Business Media LLC
Date: 12-2012
DOI: 10.1186/1471-2458-12-1123
Abstract: In Australia there have been many calls for government action to halt the effects of unhealthy food marketing on children's health, yet implementation has not occurred. The attitudes of those involved in the policy-making process towards regulatory intervention governing unhealthy food marketing are not well understood. The objective of this research was to understand the perceptions of senior representatives from Australian state and territory governments, statutory authorities and non-government organisations regarding the feasibility of state-level government regulation of television marketing of unhealthy food to children in Australia. Data from in-depth semi-structured interviews with senior representatives from state and territory government departments, statutory authorities and non-government organisations (n=22) were analysed to determine participants' views about regulation of television marketing of unhealthy food to children at the state government level. Data were analysed using content and thematic analyses. Regulation of television marketing of unhealthy food to children was supported as a strategy for obesity prevention. Barriers to implementing regulation at the state level were: the perception that regulation of television advertising is a Commonwealth, not state/territory, responsibility the power of the food industry and the need for clear evidence that demonstrates the effectiveness of regulation. Evidence of community support for regulation was also cited as an important factor in determining feasibility. The regulation of unhealthy food marketing to children is perceived to be a feasible strategy for obesity prevention however barriers to implementation at the state level exist. Those involved in state-level policy making generally indicated a preference for Commonwealth-led regulation. This research suggests that implementation of regulation of the television marketing of unhealthy food to children should ideally occur under the direction of the Commonwealth government. However, given that regulation is technically feasible at the state level, in the absence of Commonwealth action, states/territories could act independently. The relevance of our findings is likely to extend beyond Australia as unhealthy food marketing to children is a global issue.
The political construction of public health nutrition problems: a framing analysis of parliamentary debates on junk-food marketing to children in Australia
Publisher: Cambridge University Press (CUP)
Date: 17-01-2020
DOI: 10.1017/S1368980019003628
Abstract: Junk-food marketing contributes significantly to childhood obesity, which in turn imposes major health and economic burdens. Despite this, political priority for addressing junk-food marketing has been weak in many countries. Competing interests, worldviews and beliefs of stakeholders involved with the issue contribute to this political inertia. An integral group of actors for driving policy change are parliamentarians, who ch ion policy and enact legislation. However, how parliamentarians interpret and portray (i.e. frame) the causes and solutions of public health nutrition problems is poorly understood. The present study aimed to understand how Australian parliamentarians from different political parties frame the problem of junk-food marketing. Framing analysis of transcripts from the Australian Government’s Parliamentary Hansard, involving development of a theoretical framework, data collection, coding transcripts and thematic synthesis of results. Australia. None. Parliamentarian framing generally reflected political party ideology. Liberal parliamentarians called for minimal government regulation and greater personal responsibility, reflecting the party’s core values of liberalism and neoliberalism. Greens parliamentarians framed the issue as systemic, highlighting the need for government intervention and reflecting the core party value of social justice. Labor parliamentarians used both frames at varying times. Parliamentarians’ framing was generally consistent with their party ideology, though subject to changes over time. This project provides insights into the role of framing and ideology in shaping public health policy responses and may inform communication strategies for nutrition advocates. Advocates might consider using frames that resonate with the ideologies of different political parties and adapting these over time.
Functional foods and health claims: a public health policy perspective
Publisher: Cambridge University Press (CUP)
Date: 06-1998
DOI: 10.1079/PHN19980013
Abstract: To propose a policy framework for the regulation of functional foods and health claims within a public health context. This article reviews the empirical evidence and public health principles associated with functional foods and health claims to analyse the issues, challenge the assumptions that have emerged and explore options for moving forward. Functional foods and health claims are among the more controversial and complex issues being debated by food regulators internationally. Proponents of functional foods and health claims state that functional foods may reduce health care expenditure and health claims are a legitimate nutrition education tool that will help them inform consumers of the health benefits of certain food products. Conversely, opponents of these developments respond that it is the total diet that is important for health, not so-called ‘magic bullets’. Moreover, they argue that health claims will enable manufacturers to indulge in marketing hyperbole and essentially blur the distinction between food and drugs. This topic provides a valuable case study of public policy in relation to food and health. The need to maintain a general prohibition on health claims while accommodating specific exemptions supported by scientific substantiation is recommended. Nutrition education and monitoring and evaluation are integral to the proposed regulatory framework. The intention of this policy position is to encourage research and development of innovative food products while avoiding an inappropriate medicalization of the general food supply.
Ultra-processed foods: a fit-for-purpose concept for nutrition policy activities to tackle unhealthy and unsustainable diets
Publisher: Cambridge University Press (CUP)
Date: 14-12-2023
DOI: 10.1017/S1368980022002117
Abstract: Modern nutrition science began approximately 100 years ago in the context of nutrient deficiency diseases. Nutrition research and policy activities were framed mostly within a reductionist paradigm in which foods were analysed as being a collection of their constituent nutrients. Today, nutrition problems extend to all forms of malnutrition as well as environmental sustainability considerations and are associated with food and dietary pattern exposures. In 2009, researchers investigating the nutrition transition in Brazil proposed that industrial food processing was a key determinant of nutrition problems. The NOVA food classification system which is based on the nature, extent and purposes of food processing was developed to operationalise this proposition. The ultra-processed food (UPF) concept within NOVA is receiving much attention in relation to nutrition research and policy activities. This commentary describes the UPF concept as being fit-for-purpose in providing guidance to inform policy activities to tackle unhealthy and unsustainable diets. There is now a substantial body of evidence linking UPF exposure with adverse population and planetary health outcomes. The UPF concept is increasingly being used in the development of food-based dietary guidelines and nutrition policy actions. It challenges many conventional nutrition research and policy activities as well as the political economy of the industrial food system. Inevitably, there are politicised debates associated with UPF and it is apparent a disproportionate number of articles claiming the concept is controversial originate from a small number of researchers with declared associations with UPF manufacturers. Prominent ex les of these claims are assessed.
A systematic policy approach to changing the food system and physical activity environments to prevent obesity
Publisher: Springer Science and Business Media LLC
Date: 05-06-2008
Evaluating intake levels of nutrients linked to non-communicable diseases in Australia using the novel combination of food processing and nutrient profiling metrics of the PAHO Nutrient Profile Model
Publisher: Springer Science and Business Media LLC
Date: 16-01-2022
DOI: 10.1007/S00394-021-02740-8
Abstract: To investigate intake levels of nutrients linked to non-communicable diseases in Australia using the novel combination of food processing and nutrient profiling metrics of the PAHO Nutrient Profile Model. Dietary intakes of 12,153 participants from the Australian Health Survey (2011-12) aged 2 + years were evaluated. Food items reported during a 24 h recall were classified using the NOVA system. The Pan-American Health Organization Nutrient Profile Model (PAHO NPM) was applied to identify processed and ultra-processed products with excessive content of critical nutrients. Differences in mean intakes and prevalence of excessive intakes of critical nutrients for groups of the population whose diets were made up of products with and without excessive content in critical nutrients were examined. The majority of Australians consumed daily at least three processed and ultra-processed products identified as excessive in critical nutrients according to the PAHO NPM. In iduals consuming these products had higher intakes of free sugars (β = 8.9), total fats (β = 11.0), saturated fats (β = 4.6), trans fats (β = 0.2), and sodium (β = 1788 for adolescents and adults β = 1769 for children 5-10 years β = 1319 for children aged < 5 years) (p ≤ 0.001 for all nutrients) than in iduals not consuming these foods. The prevalence of excessive intake of all critical nutrients also followed the same trend. The PAHO NPM has shown to be a relevant tool to predict intake levels of nutrients linked to non-communicable diseases in Australia and, therefore, could be used to inform policy actions aimed at increasing the healthiness of food environments.
Marketing ethics in context: The promotion of unhealthy foods and beverages to children
Publisher: Edward Elgar Publishing
Date: 26-06-2015
The significant influence of ‘Big Food’ over the design and implementation of the Health Star Rating system
Publisher: Wiley
Date: 31-07-2019
An evaluation of the reported sodium content of Australian food products
Publisher: Wiley
Date: 18-11-2008
A review of methods and tools to assess the implementation of government policies to create healthy food environments for preventing obesity and diet-related non-communicable diseases
Publisher: Springer Science and Business Media LLC
Date: 12-2016
Estimating the impact of mandatory folic acid fortification on the folic acid intake of Australian women of childbearing age
Publisher: Elsevier BV
Date: 10-2011
DOI: 10.1111/J.1753-6405.2011.00759.X
Abstract: The primary aim of this study was to estimate the impact of mandatory folic acid (FA) fortification of bread-making flour on the FA intake of Australian women of childbearing age (16-44 years). The secondary objective was to investigate the relationship between estimated FA intake and socio-economic status (SES) and age. Dietary modelling was used to estimate FA intake under four mandatory fortification scenarios--no supplement use, supplement use unrelated to FA intake, supplement use only among the highest consumers of bread, and increased supplement use. Data were obtained from the 1995 National Nutrition Survey for food intake patterns, the 2007 Victorian Population Health Survey for FA supplement use, and a marketplace survey. It is estimated that the National Health and Medical Research Council (NHMRC) recommendation for an additional 400 μg/day [DOSAGE ERROR CORRECTED] FA will be achieved by a minimum of 3.9, 25.4, 21.7 and 30% of the target population under scenarios 1-4, respectively. The FA upper level of intake is exceeded by a maximum of 0.1, 1.7, 6.1 and 4.1% of the target population for scenarios 1-4, respectively. Conclusions : Mandatory FA fortification is not sufficient for the NHMRC recommendations for minimum and maximum intakes to be met by all of the target population under a number of plausible behaviour scenarios. Targeted nutrition education c aigns are needed for SES and age sub-groups and research of this nature should be extended to other population groups. Monitoring and evaluation of this policy will be important to ensure appropriate FA intake.
Breastfeeding, first-food systems and corporate power: a case study on the market and political practices of the transnational baby food industry and public health resistance in the Philippines
Publisher: Springer Science and Business Media LLC
Date: 26-10-2021
DOI: 10.1186/S12992-021-00774-5
Abstract: The aggressive marketing of breastmilk substitutes (BMS) reduces breastfeeding, and harms child and maternal health globally. Yet forty years after the World Health Assembly adopted the International Code of Marketing of Breast-milk Substitutes (The Code), many countries are still to fully implement its provisions into national law. Furthermore, despite The Code, commercial milk formula (CMF) markets have markedly expanded. In this paper, we adopt the Philippines as a case study to understand the battle for national Code implementation. In particular, we investigate the market and political strategies used by the baby food industry to shape the country’s ‘first-food system’, and in doing so, promote and sustain CMF consumption. We further investigate how breastfeeding coalitions and advocates have resisted these strategies, and generated political commitment for a world-leading breastfeeding policy framework and protection law (the ‘Milk Code’). We used a case study design and process tracing method, drawing from documentary and interview data. The decline in breastfeeding in the Philippines in the mid-twentieth Century associated with intensive BMS marketing via health systems and consumer advertising. As regulations tightened, the industry more aggressively promoted CMFs for older infants and young children, thereby ‘marketing around’ the Milk Code. It established front groups to implement political strategies intended to weaken the country’s breastfeeding policy framework while also fostering a favourable image. This included lobbying government officials and international organizations, emphasising its economic importance and threats to foreign investment and trade, direct litigation against the government, messaging that framed marketing in terms of women’s choice and empowerment, and forging partnerships. A resurgence in breastfeeding from the mid-1980s onwards reflected strengthening political commitment for a national breastfeeding policy framework and Milk Code, resulting in-turn, from collective actions by breastfeeding coalitions, advocates and mothers. The Philippines illustrates the continuing battle for worldwide Code implementation, and in particular, how the baby food industry uses and adapts its market and political practices to promote and sustain CMF markets. Our results demonstrate that this industry’s political practices require much greater scrutiny. Furthermore, that mobilizing breastfeeding coalitions, advocacy groups and mothers is crucial to continually strengthen and protect national breastfeeding policy frameworks and Code implementation.
Using the Hierarchies of Evidence Applied to Lifestyle Medicine (HEALM) Approach to Assess the Strength of Evidence on Associations between Dietary Patterns and All-Cause Mortality
Publisher: MDPI AG
Date: 17-10-2022
DOI: 10.3390/NU14204340
Abstract: Dietary guidelines should be underpinned by high-quality evidence. Quality assessment methods that reflect traditional evidence hierarchies prioritise evidence from randomised controlled trials (RCTs). The Hierarchies of Evidence Applied to Lifestyle Medicine (HEALM) approach is an alternative quality assessment method for research questions that for practical and/or ethical reasons, cannot be answered using RCTs. The aim of this study was to investigate how the HEALM approach could be used to assess the strength of evidence on associations between dietary patterns and all-cause mortality (a research question that is difficult to answer using RCTs). Two data sources were used: an existing systematic review of dietary patterns and all-cause mortality that synthesised evidence from observational studies and an overview of reviews that was conducted to summarise relevant evidence from mechanistic and intervention studies. A set of four criteria were developed and used in the application of HEALM. Using different datasets in combination, the strength of evidence was rated as ‘Grade B: moderate/suggestive’ or ‘Grade C: insufficient/inconclusive’. HEALM is a novel approach for integrating and assessing the strength of evidence from mechanistic, intervention, and observational studies. Further research is needed to address the practical challenges that were identified in the application of HEALM.
Letters to the Editor
Publisher: Cambridge University Press (CUP)
Date: 08-2009
Evidence-informed health policy - the crucial role of advocacy
Publisher: Hindawi Limited
Date: 15-03-2012
Voluntary food fortification policy in Australia: did ‘formal’ stakeholder consultation influence the outcome?
Publisher: Oxford University Press (OUP)
Date: 07-02-2021
Abstract: This research aimed to understand how the policy was represented as a ‘problem’ in food regulatory decision-making in Australia, and the implications for public health nutrition engagement with policy development processes. Bacchi’s ‘what’s the problem represented to be?’ discourse analysis method was applied to a case study of voluntary food fortification policy (VFP) developed by the then Australia and New Zealand Food Regulation Ministerial Council (ANZFRMC) between 2002 and 2012. As a consultative process is a legislated aspect of food regulatory policy development in Australia, written stakeholder submissions contributed most of the key documents ascertained as relevant to the case. Four major categories of stakeholder were identified in the data citizen, public health, government and industry. Predictably, citizen, government and public health stakeholders primarily represented voluntary food fortification (VF) as a problem of public health, while industry stakeholders represented it as a problem of commercial benefit. This reflected expected differences regarding decision-making control and power over regulatory activity. However, at both the outset and conclusion of the policy process, the ANZFRMC represented the problem of VF as commercial benefit, suggesting that in this case, a period of ‘formal’ stakeholder consultation did not alter the outcome. This research indicates that in VFP, the policy debate was fought and won at the initial framing of the problem in the earliest stages of the policy process. Consequently, if public health nutritionists leave their participation in the process until formal consultation stages, the opportunity to influence policy may already be lost.
Meat production and consumption for a healthy and sustainable Australian food system: Policy options and political dimensions
Publisher: Elsevier BV
Date: 09-2022
Understanding the Political Challenge of Red and Processed Meat Reduction for Healthy and Sustainable Food Systems: A Narrative Review of the Literature
Publisher: Maad Rayan Publishing Company
Date: 02-12-2020
Abstract: Background: Diets high in red and processed meat (RPM) contribute substantially to environmental degradation, greenhouse gas (GHG) emissions, and the global burden of chronic disease. Recent high-profile reports from international expert bodies have called for a significant reduction in global dietary meat intake, particularly RPM, especially in high-income settings, while acknowledging the importance of animal-sourced foods to population nutrition in many lower-income countries. However, this presents a major yet under-investigated political challenge given strong cultural preferences for meat and the economic importance and power of the meat industry. Methods: A theoretically-guided narrative review was undertaken. The theoretical framework used to guide the review considered the interests, ideas and institutions that constitute food systems in relation to meat reduction and the instrumental, discursive and structural forms of power that actors deploy in relation to others within the food system. Results: High production and consumption levels of RPM are promoted and sustained by a number of factors. Actors with an interest in RPM included business and industry groups, governments, intergovernmental organisations, and civil society. Asymmetries of power between these actors exist, with institutional barriers recognised in the form of government-industry dependence, trade agreement conflicts, and policy incoherence. Industry lobbying, shaping of evidence and knowledge, and highly concentrated markets are key issues. Furthermore, prevailing ideologies like carnism and neoliberalism present embedded difficulties for RPM reduction. The literature noted the power of actors to resist meat reduction efforts exists in varying forms, including the use of lobbying, shaping of evidence and knowledge, and highly concentrated markets. Conclusion: There are a number of political challenges related to RPM reduction that contribute to policy inertia, and hence are likely to impede the transformation of food systems. Research on policy efforts to reduce RPM production and consumption should incorporate the role of power and political feasibility.
Ultra-processed food and adverse health outcomes
Publisher: BMJ
Date: 29-05-2019
DOI: 10.1136/BMJ.L2289
Progress towards Achieving the Recommendations of the Commission on Ending Childhood Obesity: A Comprehensive Review and Analysis of Current Policies, Actions and Implementation Gaps in Thailand
Publisher: MDPI AG
Date: 03-06-2021
DOI: 10.3390/NU13061927
Abstract: Despite a significant commitment to tackling childhood overweight and obesity, questions remain about the progress the Thai Government has made in implementing childhood obesity prevention policies and actions. This study aimed to review and assess the implementation of the government’s policies and actions for childhood obesity prevention in Thailand compared with the recommendations of the Commission on Ending Childhood Obesity and to identify the implementation gaps. Policy data were collected from governmental and NGO websites and publications and via direct contact with government officials. Stakeholder meetings were held to seek further information and advice on implementation gaps and to give recommendations. The analysis of each policy was conducted against pre-determined criteria formulated from literature assessments and stakeholder consultations. The policies and actions that were implemented by the Government were consistent with 33 broad policy actions and 55 specific policy actions. Preconception and pregnancy care was the policy area that was most implemented. Six broad policy actions were assessed as ‘high’ performance, these were: sugar-sweetened beverage taxation, nutrient labeling, nutrition guidance for preconception and pregnancy care, the International Code of Marketing of Breast-milk Substitutes, regulatory measures for supporting maternal breastfeeding, and regulations on the marketing of complementary foods and beverages. Policy coherence and monitoring and evaluation (M& E) were identified as major implementation gaps. Increasing the effectiveness of childhood obesity prevention in Thailand will require national immediate attention towards building infrastructure to enhance coherence among the policies and to put in place M& E mechanisms for each policy.
A Q methodology study of stakeholders’ views about accountability for promoting healthy food environments in England through the Responsibility Deal Food Network
Publisher: Elsevier BV
Date: 12-2014
Ultra-Processed Foods and Health Outcomes: A Narrative Review
Publisher: MDPI AG
Date: 30-06-2020
DOI: 10.3390/NU12071955
Abstract: The nutrition literature and authoritative reports increasingly recognise the concept of ultra-processed foods (UPF), as a descriptor of unhealthy diets. UPFs are now prevalent in diets worldwide. This review aims to identify and appraise the studies on healthy participants that investigated associations between levels of UPF consumption and health outcomes. This involved a systematic search for extant literature integration and interpretation of findings from erse study types, populations, health outcomes and dietary assessments and quality appraisal. Of 43 studies reviewed, 37 found dietary UPF exposure associated with at least one adverse health outcome. Among adults, these included overweight, obesity and cardio-metabolic risks cancer, type-2 diabetes and cardiovascular diseases irritable bowel syndrome, depression and frailty conditions and all-cause mortality. Among children and adolescents, these included cardio-metabolic risks and asthma. No study reported an association between UPF and beneficial health outcomes. Most findings were derived from observational studies and evidence of plausible biological mechanisms to increase confidence in the veracity of these observed associations is steadily evolving. There is now a considerable body of evidence supporting the use of UPFs as a scientific concept to assess the ‘healthiness’ of foods within the context of dietary patterns and to help inform the development of dietary guidelines and nutrition policy actions.
The Role of Policy in Preventing Childhood Obesity
Publisher: Wiley
Date: 23-04-2010
Towards healthy and sustainable food consumption: an Australian case study
Publisher: Cambridge University Press (CUP)
Date: 13-06-2013
DOI: 10.1017/S1368980013001523
Abstract: To articulate a healthy and sustainable (H& S) diet outline key health and environmental sustainability principles that can be applied in the selection of foods for inclusion in such a diet and describe a methodology with which to assess the availability and affordability of a H& S food basket. We synthesized publically available evidence on the environmental impact of different foods from academic, government, industry and non-government sources and constructed a hypothetical H& S equivalent of the typical Australian diet. Based on this, we constructed a weekly H& S food basket for a household of two adults and two children. Australia. Australian populations. The H& S diet is based on three overarching principles: (i) any food that is consumed above a person's energy requirement represents an avoidable environmental burden in the form of greenhouse gas emissions, use of natural resources and pressure on bio ersity (ii) reducing the consumption of discretionary food choices, which are energy-dense and highly processed and packaged, reduces both the risk of dietary imbalances and the use of environmental resources and (iii) a diet comprising less animal- and more plant-derived foods delivers both health and ecological benefits. We have focused on the articulation of a H& S diet not to facilitate ‘policy drift’ to focus on in idual dietary choice, but rather to provide evidence to extend dietary guideline recommendations so as to integrate environmental considerations within the scope of food and health policy advice in Australia and elsewhere.
A call to action to reshape evidence synthesis and use for nutrition policy
Publisher: John Wiley & Sons, Ltd
Date: 21-11-2016
Promoting healthy and sustainable diets: barriers and enablers for successful policy activities in Australia
Publisher: Oxford University Press (OUP)
Date: 05-03-2021
Abstract: Consumption of healthy and sustainable diets (HSD) provides opportunities to co-benefit human health and adapt to and mitigate climate change. Despite robust evidence and policy recommendations from authoritative groups to reorientate the food system to favour consumption of HSD there has been limited policy action. This study investigated potential barriers and enablers for successful HSD policies in Australia. A review of HSD policy recommendations and of current Australian policies was undertaken. Results from the reviews informed a Delphi study, which investigated Australian stakeholder opinions on the effectiveness of HSD policy recommendations and barriers and enablers to creating successful HSD policies. Nine participants completed two Delphi iterations. A lack of consensus was reached on the effectiveness of policy recommendations. Consensus was reached on the effect of five barriers and three enablers. Key barriers were: the complex nature of the food system, competing interests of stakeholders, pressure from industry, government silos and lack of political will. Key enablers were: building relationships with key stakeholders across multiple disciplines and sectors, understanding the policy making process and developing a clear and coherent solution. Most of the identified barriers fall under the broad category of lack of political will. Interrelationships between barriers are likely worsening the impact of inadequate political will. There is a need to act on the identified barriers and enablers to secure the HSD policies that are required. Interactions between barriers may present an opportunity to address them simultaneously.
Inter-sectoral action to support healthy and environmentally sustainable food behaviours: a study of sectoral knowledge, governance and implementation opportunities
Publisher: Springer Science and Business Media LLC
Date: 08-2017
Comparison of methodological quality between the 2007 and 2019 Canadian dietary guidelines
Publisher: Cambridge University Press (CUP)
Date: 17-06-2020
DOI: 10.1017/S1368980020000956
Abstract: With significant shifts in the dietary recommendations between the 2007 and 2019 Canadian dietary guidelines, such as promoting plant-based food intake, reducing highly processed food intake and advocating the practice of food skills, we compared their differences in guideline development methods. Two reviewers used twenty-five guided criteria to appraise the methods used to develop the most recent dietary guidelines against those outlined in the 2014 WHO Handbook for Guideline Development. Canada. 2007 and 2019 dietary guidelines. We found that the 2019 guidelines were more evidence-based and met 80 % (20/25) of the WHO criteria. For ex le, systematic reviews and health organisation authoritative reports, but not industry reports, constituted the evidence base for the dietary recommendations. However, recommendations on food sustainability and food skill practice were driven primarily by stakeholders’ interests. By contrast, less information was recorded about the process used to develop the 2007 guidelines, resulting in 24 % (6/25) consistency with the WHO standards. Our analysis suggests that a more transparent and evidence-based approach is used to develop the 2019 Canadian dietary guidelines and that method criteria should support further incorporation of nutrition priorities (food sustainability and food skills) in future dietary guideline development.
Food Politics: How the Food Industry Influences Nutrition and Health
Publisher: Wiley
Date: 07-11-2007
What are the benefits and risks of nutrition policy actions to reduce added sugar consumption? An Australian case study
Publisher: Cambridge University Press (CUP)
Date: 24-01-2022
DOI: 10.1017/S1368980022000234
Abstract: This study aimed to critically analyse Australia’s current and proposed policy actions to reduce added sugar consumption. Over-consumption of added sugar is a significant public health nutrition issue. The competing interests, values and beliefs among stakeholders mean they have disparate views regarding which policy actions are preferable to reduce added sugar consumption. Semi-structured interviews using purposive, snowball s ling and policy mapping. Policy actions were classified by two frameworks: NOURISHING (e.g. behaviour change communication, food environment and food system) and the Orders of Change (e.g. first order: technical adjustments, second order: reforming the system, third order: transforming the system). Australia. Twenty-two stakeholders from the food industry, food regulation, government, public health groups and academia. All proposed and existing policy actions targeted the food environment/behaviour change most were assessed as first-order changes, and reductionist (nutrient specific) in nature. Influences on policy actions included industry power, stakeholder fragmentation, government ideology olitical will and public pressure. Few stakeholders considered potential risks of policy actions, particularly of non-nutritive sweetener substitution or opportunity costs for other policies. Most of Australia’s policy actions to reduce added sugar consumption are reductionist. Preferencing nutrient specific, first-order policy actions could reflect the influence of vested interests, a historically dominant reductionist orientation to nutrition science and policy, and the perceived difficulty of pursuing second- or third-order changes. Pursuing only first-order policy actions could lead to ‘regrettable’ substitutions and creates an opportunity cost for more comprehensive policy aimed at adjusting the broader food system.
The Politics of Regulating Foods for Infants and Young Children: A Case Study on the Framing and Contestation of Codex Standard-Setting Processes on Breast-Milk Substitutes
Publisher: Maad Rayan Publishing Company
Date: 20-11-2021
Abstract: Background: Breastfeeding is important for the health and development of the child, and for maternal health, in all country contexts. However, global sales of breast-milk substitutes (BMS), including infant, follow-up and toddler formulas, have ‘boomed’ in recent decades. This raises the importance of international food standards established by the Codex Alimentarius Commission (Codex) on the safety, composition and labelling of BMS. Such standards appear to be strongly contested by governments, industry and civil society groups, yet few studies have investigated the politics of Codex standard-setting processes. The aim of this paper is to understand who participates in decision-making, and how actors frame and contest proposals to revise the Codex Standard on Follow-up Formula (FUF). Methods: We adopted a case study design involving two steps. First, we enumerated government, industry, civil society, and international organization stakeholders participating in standard-setting processes of the Codex Committee on Nutrition and Foods for Special Dietary Uses (CCNFSDU). Second, we conducted a framing analysis of stakeholder inputs during the FUF standard revision in CCNFSDU meetings. Publicly available online meeting reports (2015-2019) were retrieved, analyzed using a theoretical framework, and organized thematically. Results: High-income country (HIC) delegates greatly outnumbered those from other country income categories. Industry representation was higher compared with other observer categories. Member state delegations included more industry representation than civil society representation, and were occasionally the only member state delegates. Industry stakeholders framed arguments in terms of trade implications, science, and flexible standards. Civil society groups used public health, science, and pro-breastfeeding frames. Conclusion: Codex BMS standard-setting procedures are dominated by HICs and industry groups. Limited representation of civil society, and of low- and middle-income countries (LMICs), suggest actions are needed to substantially increase support for their involvement at Codex. Such representation may help to counteract power asymmetries and commercial influences on food standards for infants and young children.
An introduction to healthy and sustainable food systems
Publisher: Routledge
Date: 18-10-2019
The need for particular scrutiny of claims made by researchers associated with ultra-processed food manufacturers
Publisher: Cambridge University Press (CUP)
Date: 13-04-2023
Unhealthy food, integrated marketing communication and power: a critical analysis
Publisher: Informa UK Limited
Date: 24-01-2014
The Health Star Rating system – is its reductionist (nutrient) approach a benefit or risk for tackling dietary risk factors?
Publisher: The Sax Institute
Date: 03-2019
DOI: 10.17061/PHRP2911906
Abstract: The Australian Government's voluntary Health Star Rating (HSR) system has potential to provide a user-friendly approach to help shoppers choose healthier packaged food options. However, despite evidence that it is dietary imbalances and excesses that are the predominant causes of diet-related noncommunicable diseases and obesity, the star-rating system's design is based on a reductionist (nutrient) world view of nutrition science which is not a fit-for-purpose solution to the cause of the problem. As a result, the HSR system frequently is inadvertently contradicting Australian Dietary Guidelines (ADG) recommendations, and promoting the marketing of discretionary and ultraprocessed foods. This perspective article looks at how the HSR system could be reformed to complement the ADG and stresses the overriding priority is to position it within, and not be a distraction from, a comprehensive national nutrition policy if dietary risk factors are to be effectively tackled.
Evaluation of the implementation of the folate-neural tube defect health claim and its impact on the availability of folate-fortifed food in Australia
Publisher: Elsevier BV
Date: 08-2007
DOI: 10.1111/J.1467-842X.2006.TB00850.X
Abstract: To evaluate the implementation of the folate-neural tube defect (NTD) health claim and its impact on the availability of folate-fortified food in Australia. During late 2005, a survey was conducted in 16 supermarkets across all Australian capital cities to identify the use of the folate-NTD health claim on the labels of the 128 food products listed in food standard 1.1A.2: 'Transitional standard--Health claims' and the number of products fortified with folic acid. Seventy-nine per cent of existing listed food products were found and two of these were implementing the folate-NTD health claim. Forty-four per cent of these listed products, previously fortified with folic acid, were no longer fortified. One hundred and seventeen generally available food products were fortified with folic acid, predominantly breakfast cereals (73%). Twenty-seven per cent of these folate-fortified products were listed in the transitional standard. The health claim was not used widely to inform women of child-bearing age of the importance of periconceptional folate intake. The increased availability of folate-fortified products generally has occurred independently of the health claim. Deficiencies in the verification system of the tested regulatory framework are identified. The voluntary regulatory provisions for both folate fortification and the use of the health claim diminished the States' influence over their implementation of public health tools.
Enhancing evidence use in public health nutrition policymaking: theoretical insights from a New Zealand case study
Publisher: Springer Science and Business Media LLC
Date: 25-11-2016
Distinguishing Accountability From Responsibility: An Accountability Framework
Publisher: American Public Health Association
Date: 06-2014
Interpretive nutrient profiling algorithms are a limited tool for assessing the healthiness of countries' packaged food and beverage supplies, and the conclusions are not substantiated by the data
Publisher: Wiley
Date: 19-12-2020
DOI: 10.1111/OBR.12957
Does the Australian Health Star Rating System Encourage Added Sugar Reformulation? Trends in Sweetener Use in Australia
Publisher: MDPI AG
Date: 10-03-2021
DOI: 10.3390/NU13030898
Abstract: Dietary risk factors, including excess added sugar intake, are leading contributors to Australia’s burden of disease. An objective of the Australian Health Star Rating (HSR) system is to encourage the reformulation of packaged foods. Manufacturers may improve a product’s HSR by replacing added sugar with non-nutritive sweeteners (NNS). Concerns have been raised regarding the potential substitution effects of ultra-processed foods containing NNS for whole foods, and the long-term impact this may have on population health. The aim of this study was to determine whether the implementation of the HSR system has impacted the use of added sugars and NNS in the food supply. Four product categories were used: products with no added sweetener, products containing added sugar only, products containing NNS only, and products containing a combination of added sugar and NNS. Of 6477 newly released products analyzed displaying a HSR in Australia between 2014–2020, 63% contained added sugars. The proportion of new products sweetened with added sugars increased over time, while NNS use did not, despite a higher average and median HSR for products sweetened with NNS. These findings suggest that at the current time, the HSR system may not discourage the use of added sugars in new products or incentivize the reformulation of added sugar with NNS. As the health risks of NNS are questioned, increased reformulation of products with NNS to reduce the presence of added sugar in the food supply may not address broader health concerns. Instead, supporting the promotion of whole foods and drinks should be prioritized, as well as policy actions that reduce the proliferation and availability of UPFs.
The politics of developing reference standards for nutrient intakes: the case of Australia and New Zealand
Publisher: Cambridge University Press (CUP)
Date: 09-2009
DOI: 10.1017/S136898000800459X
Abstract: Nutrient Reference Values (NRV) are evidence-based benchmarks for assessing the dietary adequacy of in iduals and population groups as well as informing public health nutrition policies and programmes. The present paper presents the findings of an analysis of the views of submitters to a draft document associated with the development of the 2006 NRV for Australia and New Zealand. The aim of the study was to explore how these views were reflected in the policy-making process and final policy document. The information necessary to fulfil this aim required access to stakeholder submissions to the NRV development process and this necessitated exploiting the provisions of the Commonwealth of Australia’s Freedom of Information (FOI) Act 1982. We understand that the present research represents the first time that an FOI request seeking information about a National Health and Medical Research Council food and nutrition policy process has been made and therefore is novel in its approach to public health nutrition policy analysis. The analysis of stakeholder submissions identified that stakeholders had particular concerns about the conduct of the review process and the future application of the nutrient values to policy and programmes. There is a lack of evidence that the majority of stakeholder comments were addressed in the final NRV document. Although these findings cannot be interpreted to assess the validity or otherwise of the set nutrient values, they do raise questions about the process for their development and the adequacy of the final document to reflect the views of key stakeholders.
Prioritizing policy interventions to improve diets? Will it work, can it happen, will it do harm?
Publisher: Oxford University Press (OUP)
Date: 18-02-2010
Front-of-package nutrition labels need to be assessed on their nutrition science rigour
Publisher: Cambridge University Press (CUP)
Date: 10-05-2018
Evidence Use in the Development of the Australian Dietary Guidelines: A Qualitative Study
Publisher: MDPI AG
Date: 23-10-2021
DOI: 10.3390/NU13113748
Abstract: Dietary guidelines are important nutrition policy reference standards that should be informed by the best available evidence. The types of evidence that are reviewed and the evidence review methods that are used have implications for evidence translation. The aim of this study was to explore perceived advantages, disadvantages, and practicalities associated with the synthesis and translation of evidence from nutrient-based, food-based, and dietary patterns research in dietary guideline development. A qualitative descriptive study was conducted. Twenty-two semi-structured interviews were conducted with people involved in the development of the 2013 Australian Dietary Guidelines (ADGs). Transcripts were analysed thematically. To inform future ADGs, there was support for reviewing evidence on a range of dietary exposures (including dietary patterns, foods and food groups, nutrients and food components, and eating occasions) and health outcomes, as well as evidence on environmental sustainability and equity. At the evidence synthesis stage, practicalities associated with planning the evidence review and conducting original systematic reviews were discussed. At the evidence translation stage, practicalities associated with integrating the evidence and consulting stakeholders were described. To ensure that the best available evidence is translated into future ADGs, evidence review methods should be selected based on the exposures and outcomes of interest.
Innovation in Healthy and Sustainable Food Product Development for Health and Aged Care: A Scoping Review
Publisher: MDPI AG
Date: 11-11-2022
Abstract: Population ageing and climate change are issues of global concern. Subsequently, the need for healthy and sustainable food systems to meet the increasing demands for health and aged care is evident. This review aimed to systematically identify studies reporting new or innovative foods, drinks and snack products in health and aged care, and describe health and environmental sustainability considerations where reported. Methods were guided by the Joanna Briggs Institute guidelines for scoping reviews and reported against the PRISMA-ScR guidelines. Eligible studies were conducted in an inpatient healthcare setting or aged care facility where a new or innovative food, drink or snack product was evaluated with outcomes of product use, acceptability, cost, appropriateness for the population, and clinical or environmental sustainability outcomes in the last decade. Three databases were searched using a replicable strategy, with five publications of four studies included in the final library. Product innovations were led at the facility level and included testing dewaxed brown rice, talbinah, and an apple ear juice fibre solution. Results suggest that food industry suppliers are operating in parallel with foodservices within hospital and aged care. Future intersection would be transformative for both industry sectors.
Ultra‐processed foods and the nutrition transition: Global, regional and national trends, food systems transformations and political economy drivers
Publisher: Wiley
Date: 06-08-2020
DOI: 10.1111/OBR.13126
Food Policy Development in the Australian State of Victoria: A Case Study of the Food Alliance
Publisher: Informa UK Limited
Date: 02-2013
Have we compromised too much? A critical analysis of nutrition policy in Australia 2007–2018
Publisher: Cambridge University Press (CUP)
Date: 28-09-2021
DOI: 10.1017/S1368980020003389
Abstract: A comprehensive nutrition policy containing a broad package of cross-sector and synergistic policy actions is required to attenuate the systemic drivers of poor nutrition. The current study aims to critically analyse trends in the scope of federal nutrition policy actions in Australia between 2007 and 2018 by: (1) describing the changes in nutrition policy actions, benchmarked against an international best-practice policy framework and (2) investigating how and why the scope of these policy actions have changed over time by examining the decision-making processes that led to the establishment of Australia’s Healthy Food Partnership (the Partnership). Qualitative case study involving documentary analysis and key-informant interviews. Australian federal government documents ( n 10) were analysed against the NOURISHING framework. Key informants ( n 6) were interviewed and asked about the Partnership’s decision-making and establishment processes. Australia. Executive Committee (the Partnership’s governing body) and working group members. From 2007 to 2018, the scope of Australian national nutrition policy has fluctuated from evidence-informed recommendations for a comprehensive policy to the mostly discrete policy actions of the Partnership. Themes of ‘pragmatism and compromise’, ‘actor relationships and lobbying’ and ‘political context’ were critical drivers for establishing the Partnership. The narrowing of Australian nutrition policy reflects a response to political expediency and compromise. This political dynamic highlights a dilemma facing nutrition policy advocates: should (and if so, how) a balance be sought between the aspirational but possibly unrealistic goals, and the limited but likely deliverable outcomes during policy-making processes? These findings have relevance for developing a future comprehensive national nutrition policy.
The potential of food regulation as a policy instrument for obesity prevention in developing countries
Publisher: Oxford University Press
Date: 09-09-2010
Healthy and environmentally sustainable food choices: Consumer responses to point-of-purchase actions
Publisher: Elsevier BV
Date: 06-2017
Evidence-informed process to identify policies that will promote a healthy food environment in the Pacific Islands
Publisher: Cambridge University Press (CUP)
Date: 03-03-2010
Evaluating Nutrient-Based Indices against Food- and Diet-Based Indices to Assess the Health Potential of Foods: How Does the Australian Health Star Rating System Perform after Five Years?
Publisher: MDPI AG
Date: 18-05-2020
DOI: 10.3390/NU12051463
Abstract: Nutrient-based indices are commonly used to assess the health potential of in idual foods for nutrition policy actions. This study aimed to evaluate the nutrient profile-informed Australian Health Star Rating (HSR), against NOVA and an index informed by the Australian Dietary Guidelines (ADGs), to determine the extent of alignment. All products displaying an HSR label in the Australian marketplace between June 2014 and June 2019 were extracted from the Mintel Global New Product Database, and classified into one of four NOVA categories, and either as an ADG five food group (FFG) food or discretionary food. Of 4451 products analysed, 76.5% were ultra-processed (UP) and 43% were discretionary. The median HSR of non-UP foods (4) was significantly higher than UP foods (3.5) (p 0.01), and the median HSR of FFG foods (4) was significantly higher than discretionary foods (2.5) (p 0.01). However, 73% of UP foods, and 52.8% of discretionary foods displayed an HSR ≥ 2.5. Results indicate the currently implemented HSR system is inadvertently providing a ‘health halo’ for almost ¾ of UP foods and ½ of discretionary foods displaying an HSR. Future research should investigate whether the HSR scheme can be reformed to avoid misalignment with food-and diet-based indices.
Still serving hot soup? Two hundred years of a charitable food sector in Australia: a narrative review
Publisher: Elsevier BV
Date: 08-2015
Abstract: Despite the importance of the charitable food sector for a proportion of the Australian population, there is uncertainty about its present and future contributions to wellbeing. This paper describes its nature and examines its scope for improving health and food security. The review, using systematic methods for public health research, identified peer-reviewed and grey literature relevant to Australian charitable food programs (2002 to 2012). Seventy publications met the criteria and informed this paper. The sector includes food banks, more than 3,000 community agencies and 800 school breakfast programs. It provides food for up to two million people annually. The scope extends beyond emergency food relief and includes case management, advocacy and other support. Weaknesses include a food supply that is sub-optimal, resource limitations and lack of evidence to evaluate or support their work towards food security. The sector supports people experiencing disadvantage and involves multiple organisations, working in a variety of settings, to provide food for up to 8% of the population. The limits on the sector's capacity to address food insecurity by itself must be acknowledged so that civil society, government and the food industry can support sufficient, nutritious and affordable food for all.
Letters to the Editor
Publisher: Cambridge University Press (CUP)
Date: 02-2009
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