Policy implementation and priorities to create healthy food environments using the Healthy Food Environment Policy Index (Food-EPI): A pooled level analysis across eleven European countries

Background: Food environments have been recognised as highly influential on population diets. Government policies have great potential to create healthy food environments to promote healthy diets. This study aimed to evaluate food environment policy implementation in European countries and identify priority actions for governments to create healthy food environments. Methods: The Healthy Food Environment Policy Index (Food-EPI) was used to evaluate the level of food environment policy and infrastructure support implementation in Estonia, Finland, Germany, Ireland, Italy, the Netherlands, Norway, Poland, Portugal, Slovenia, and Spain in 20192021. Evidence of implementation of food environment policies was compiled in each country and validated by government officials. National experts evaluated the implementation of policies and identified priority recommendations. Findings: Finland had the highest proportion (32%, n = 7/22) of policies shaping food environments with a high level of implementation. Slovenia and Poland had the highest proportion of policies rated at very low implementation (42%, n = 10/24 and 36%, n = 9/25 respectively). Policies regarding food provision, promotion, retail, funding, monitoring, and health in all policies were identified as the most important gaps across the European countries. Experts recommended immediate action on setting standards for nutrients of concern in processed foods, improvement of school food environments, fruit and vegetable subsidies, unhealthy food and beverage taxation, and restrictions on unhealthy food marketing to children. Interpretation: Immediate implementation of policies and infrastructure support that prioritize action towards healthy food environments is urgently required to tackle the burden of obesity and diet-related non-communicable diseases in Europe. Funding: This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 774548 and from the Joint Programming Initiative A Healthy Diet for a Healthy Life. (c) 2022 The Author(s

The Healthy Food Environment Policy Index: Nederland. Een beoordeling van rijksoverheidsbeleid met betrekking tot de voedselomgeving in Nederland en beleidsaanbevelingen voor het creëren van een gezonde voedselomgeving

Overweight, obesity and diet-related non-communicable diseases have risen dramatically in the past decennia, caused by changes in dietary and physical activity patterns. The current food environment (e.g. easy availability of energy-dense, fat- and sugar-rich, and ultra-processed foods) is one of the key factors contributing to this public health problem. Government policies have the potential to improve these food environments, making a healthy choice easier. As part of the Policy Evaluation Network, Work Package 1 (https://www.jpi-pen.eu/) researchers examined national government policy on food environments in the Dutch context. The researchers asked 28 independent Dutch experts at universities, local authorities, and health and civil society organisations to make assessments based on 22 policy indicators referencing national government policy on the creation of a healthy food environment, divided into six categories: food composition, labelling, provision, pricing, marketing and retail. The experts also looked at 24 indicators referencing policy support domains, divided into the categories of leadership, governance, monitoring, funding, platforms for interaction, and health-in-all policies. The research was based on the Healthy Food Environment Policy Index (Food-EPI), an internationally standardised food policy assessment tool. Compared to international best practice, the Dutch Government is missing opportunities to ensure a healthy food environment, meaning an environment in which it's easy for people to make healthy food choices. The research calls for 29 specific actions reflecting more ambitious national government policies to support healthy food choices among the Dutch population

How can national government policies improve food environments in the Netherlands?

Objectives: Government policies are essential to create food environments that support healthy diets. The aims of this study were 1) to benchmark the implementation of Dutch government policies influencing food environments, and 2) to identify and prioritize actions to improve food environments in the Netherlands. Methods: The Healthy Food Environment Policy Index (Food-EPI) was applied. The Food-EPI includes 46 indicators of food environment policy and infrastructure support. Independent experts (n = 28) rated the extent of implementation on these indicators against international best practices, and formulated and prioritized policy and infrastructure support actions to improve food environments. Results: Most policy indicators were rated as having a low (50%) or very low (41%) level of implementation. Most infrastructure support indicators were rated as having a fair (42%) or medium (42%) level of implementation. 18 policy and 11 infrastructure support actions were recommended by experts to improve food environments in the Netherlands. Conclusion: There is large potential for the Dutch national government to strengthen its policy action and infrastructure support in order to improve the healthiness of food environments in the Netherlands

The Healthy Food Environment Policy Index: Nederland. Een beoordeling van rijksoverheidsbeleid met betrekking tot de voedselomgeving in Nederland en beleidsaanbevelingen voor het creëren van een gezonde voedselomgeving

Overweight, obesity and diet-related non-communicable diseases have risen dramatically in the past decennia, caused by changes in dietary and physical activity patterns. The current food environment (e.g. easy availability of energy-dense, fat- and sugar-rich, and ultra-processed foods) is one of the key factors contributing to this public health problem. Government policies have the potential to improve these food environments, making a healthy choice easier. As part of the Policy Evaluation Network, Work Package 1 (https://www.jpi-pen.eu/) researchers examined national government policy on food environments in the Dutch context. The researchers asked 28 independent Dutch experts at universities, local authorities, and health and civil society organisations to make assessments based on 22 policy indicators referencing national government policy on the creation of a healthy food environment, divided into six categories: food composition, labelling, provision, pricing, marketing and retail. The experts also looked at 24 indicators referencing policy support domains, divided into the categories of leadership, governance, monitoring, funding, platforms for interaction, and health-in-all policies. The research was based on the Healthy Food Environment Policy Index (Food-EPI), an internationally standardised food policy assessment tool. Compared to international best practice, the Dutch Government is missing opportunities to ensure a healthy food environment, meaning an environment in which it's easy for people to make healthy food choices. The research calls for 29 specific actions reflecting more ambitious national government policies to support healthy food choices among the Dutch population

How can National Government Policies Improve Food Environments in the Netherlands?

Government policies are essential to create food environments that support healthy diets. The aims of this study were 1) to benchmark the implementation of Dutch government policies influencing food environments, and 2) to identify and prioritize actions to improve food environments in the Netherlands. The Healthy Food Environment Policy Index (Food-EPI) was applied. The Food-EPI includes 46 indicators of food environment policy and infrastructure support. Independent experts (n = 28) rated the extent of implementation on these indicators against international best practices, and formulated and prioritized policy and infrastructure support actions to improve food environments. Most policy indicators were rated as having a low (50%) or very low (41%) level of implementation. Most infrastructure support indicators were rated as having a fair (42%) or medium (42%) level of implementation. 18 policy and 11 infrastructure support actions were recommended by experts to improve food environments in the Netherlands. There is large potential for the Dutch national government to strengthen its policy action and infrastructure support in order to improve the healthiness of food environments in the&nbsp;Netherlands.</p

How can national government policies improve food environments in the Netherlands?

Objectives: Government policies are essential to create food environments that support healthy diets. The aims of this study were 1) to benchmark the implementation of Dutch government policies influencing food environments, and 2) to identify and prioritize actions to improve food environments in the Netherlands. Methods: The Healthy Food Environment Policy Index (Food-EPI) was applied. The Food-EPI includes 46 indicators of food environment policy and infrastructure support. Independent experts (n = 28) rated the extent of implementation on these indicators against international best practices, and formulated and prioritized policy and infrastructure support actions to improve food environments. Results: Most policy indicators were rated as having a low (50%) or very low (41%) level of implementation. Most infrastructure support indicators were rated as having a fair (42%) or medium (42%) level of implementation. 18 policy and 11 infrastructure support actions were recommended by experts to improve food environments in the Netherlands. Conclusion: There is large potential for the Dutch national government to strengthen its policy action and infrastructure support in order to improve the healthiness of food environments in the Netherlands

Strength of EU-level food environment policies and priority recommendations to create healthy food environments.

BACKGROUND: Food environments impact on diets, obesity and non-communicable diseases (NCDs). Government policies are essential to create healthy food environments. This study aimed to assess the strength of European Union (EU)-level policies, and identify and prioritize actions for the EU to create healthy food&nbsp;environments. METHODS: The Healthy Food Environment Policy Index (Food-EPI) was applied. The Food-EPI included 26 policy and 24 infrastructure support indicators. Independent experts (n = 31) rated the strength of EU-level policies and infrastructure support for each of these indicators (on a 5-point scale, from very weak to very strong) and identified and prioritized actions to improve food&nbsp;environments. RESULTS: For 65% of the 26 policy indicators, EU-level policies were rated as weak and for 23% as very weak. For 63% of the 24 infrastructure support indicators, EU-level policies were rated as moderate and for 33% as weak. The experts recommended 18 policy and 19 infrastructure support actions to the EU. The Top 5 prioritized policy actions included three actions in the food composition domain (e.g. setting mandatory food composition targets), one action in the food prices domain and one action in the food promotion domain. The Top 5 prioritized infrastructure support actions included three actions in the leadership domain (e.g. developing a high-level NCDs Prevention Strategy) and two actions in the monitoring&nbsp;domain. CONCLUSIONS: There is large potential for the EU to strengthen its policies and infrastructure support in order to improve food environments. This study specifies priority actions for the EU to create healthy food&nbsp;environments.</p

How can national government policies improve food environments in the Netherlands?

Objectives: Government policies are essential to create food environments that support healthy diets. The aims of this study were 1) to benchmark the implementation of Dutch government policies influencing food environments, and 2) to identify and prioritize actions to improve food environments in the Netherlands. Methods: The Healthy Food Environment Policy Index (Food-EPI) was applied. The Food-EPI includes 46 indicators of food environment policy and infrastructure support. Independent experts (n = 28) rated the extent of implementation on these indicators against international best practices, and formulated and prioritized policy and infrastructure support actions to improve food environments. Results: Most policy indicators were rated as having a low (50%) or very low (41%) level of implementation. Most infrastructure support indicators were rated as having a fair (42%) or medium (42%) level of implementation. 18 policy and 11 infrastructure support actions were recommended by experts to improve food environments in the Netherlands. Conclusion: There is large potential for the Dutch national government to strengthen its policy action and infrastructure support in order to improve the healthiness of food environments in the Netherlands