Towards global benchmarking of food environments and policies to reduce obesity and diet-related non-communicable diseases : design and methods for nation-wide surveys

Introduction:&nbsp;Unhealthy diets are heavily driven by unhealthy food environments. The International Network for Food and Obesity/non-communicable diseases (NCDs) Research, Monitoring and Action Support (INFORMAS) has been established to reduce obesity, NCDs and their related inequalities globally. This paper describes the design and methods of the first-ever, comprehensive national survey on the healthiness of food environments and the public and private sector policies influencing them, as a first step towards global monitoring of food environments and policies. Methods and analysis: A package of 11 substudies has been identified: (1) food composition, labelling and promotion on food packages; (2) food prices, shelf space and placement of foods in different outlets (mainly supermarkets); (3) food provision in schools/early childhood education (ECE) services and outdoor food promotion around schools/ECE services; (4) density of and proximity to food outlets in communities; food promotion to children via (5) television, (6) magazines, (7) sport club sponsorships, and (8) internet and social media; (9) analysis of the impact of trade and investment agreements on food environments; (10) government policies and actions; and (11) private sector actions and practices. For the substudies on food prices, provision, promotion and retail, \u27environmental equity\u27 indicators have been developed to check progress towards reducing diet-related health inequalities. Indicators for these modules will be assessed by tertiles of area deprivation index or school deciles. International \u27best practice benchmarks\u27 will be identified, against which to compare progress of countries on improving the healthiness of their food environments and policies. Dissemination: This research is highly original due to the very \u27upstream\u27 approach being taken and its direct policy relevance. The detailed protocols will be offered to and adapted for countries of varying size and income in order to establish INFORMAS globally as a new monitoring initiative to reduce obesity and diet-related NCDs.</div

Final report : food@school resource pilot

It&rsquo;s Your Move! was a 3-year community-based obesity prevention project conducted in secondary schools across the Barwon-South West Region in Victoria. The project ran from 2005-2008, with five intervention schools from the East Geelong/ Bellarine Peninsula area as well as seven comparison schools.Children and adolescents spend a substantial amount of time in school; consequently schools have been identified as a key setting for influencing their nutrition behaviour [1]. In the face of increasing obesity levels among children and adolescents, it is essential that the school environment is conducive to encouraging healthy eating.The Food@School Resource was developed in response to baseline results from the It&rsquo;s your Move! project in order to facilitate the implementation of intervention strategies around creating whole-of-school healthy eating environments. Using the Health Promoting Schools Framework, teachers and students were involved in the development and implementation of a number of initiatives and environmental changes to their school around healthy eating. This process of engagement and collaboration ensured that the interventions complemented their existing structures and support e.g. curriculum, canteen and culture. The Food@School Resource is a document to help secondary schools through the process of developing a healthy eating policy.In order to ensure that the resource was valid beyond the confines of the It&rsquo;s Your Move! schools, the Department of Human Services funded a six-month pilot project. The Food@School Resource was pilot tested in six diverse secondary schools across both rural and metropolitan Victoria as well as being expertly reviewed by Home Economics Victoria.<br /

Creating healthy food environments through global benchmarking of government nutrition policies and food industry practices

Unhealthy processed food products are increasingly dominating over healthy foods, making food and nutrition environments unhealthier. Development and implementation of strong government healthy food policies is currently being circumvented in many countries by powerful food industry lobbying. In order to increase accountability of both governments and the private sector for their actions, and improve the healthiness of food environments, INFORMAS (the International Network for Food and Obesity/non-communicable diseases (NCDs) Research, Monitoring and Action Support) has recently been founded to systematically and comprehensively monitor food environments and policies in countries of varying size and income. This will enable INFORMAS to rank both governments and private sector companies globally according to their actions on food environments. Identification of those countries which have the healthiest food and nutrition policies and using them as international benchmarks against which national progress towards best practice can be assessed, should support reductions in global obesity and diet-related NCDs

The runaway weight gain train: too many accelerators, not enough brakes

Obesity seems to be perpetuated by a series of vicious cycles, which, in combination with increasingly obesogenic environments, accelerate weight gain and represent a major challenge for weight managemen

Changing risk behaviours for non-communicable disease in New Zealand working men - is workplace intervention effective?

Aims. To evaluate the effectiveness of a health promotionprogramme targeting dietary behaviours and physicalactivity among male hourly-paid workers and to exploredemographic and attitudinal influences on dietary patternsat baseline.Methods. A controlled field trial compared workers at oneintervention and one control worksite. The interventioncomprised nutrition displays in the cafeteria and monthly30-minute workshops for six months. Key outcomemeasures at six and twelve-months were self-reporteddietary and lifestyle behaviours, nutrition knowledge, bodymass index (BMI), waist circumference and blood pressure.Results. 132 men at the intervention site and 121 men at thecontrol site participated in the study and a high retention rate(94% at 6-months and 89% at 12-months) was achieved. Atbaseline, 40% of the total sample (253) were obese, 30% hadelevated blood pressure, 59% indicated an excessive fat intakeand 92% did not meet the recommended vegetable and fruitintake. The intervention reduced fat intake, increasedvegetable intake and physical activity, improved nutritionknowledge and reduced systolic blood pressure whencompared to the control site. There was no difference inchange in mean BMI or waist circumference. Reduction inBMI was associated with reduction in fat intake.Discussion. Low intensity workplace intervention cansignificantly improve reported health behaviours andnutrition knowledge although the impact on moreobjective measures of risk was variable. A longer durationor more intensive intervention may be required to achievefurther reduction in risk factors.<br /

Health-related quality of life is low in secondary school children in Fiji

The health and wellbeing of children in lower-income countries is the focus of much international effort, yet there has been very little direct measurement of this. Objective. The current objective was to study the health-related quality of life (HRQoL) in a general population of secondary school children in Fiji, a low middle-income country in the Pacific. Methods. Self-reported HRQoL was measured by the Pediatric Quality of Life Inventory 4.0 in 8947 school children (aged 12&ndash;18 years) from 18 secondary schools on Viti Levu, the main island of Fiji. HRQoL in Fiji was compared to that of school-aged children in 13 high- and upper middle-income countries. Results. The school children in Fiji had lower HRQoL than the children in the 13 comparison countries, with consistently lower physical, emotional, social, and school functioning and wellbeing. HRQoL was particularly low amongst girls and Indigenous Fijians. Conclusions. These findings raise concerns about the general functioning and wellbeing of school children in Fiji. The consistently low HRQoL across all core domains suggests pervasive underlying determinants. Investigation of the potential determinants in Fiji and validation of the current results in Fiji and other lower-income countries are important avenues for future research