Abstract
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.
Highlights
Overweight, obesity and diet-related chronic diseases are a major public health challenge globally [1, 2]
After a brainstorm with the research team we developed a long list of relevant Dutch organizations in the field of food and nutrition, public health, obesity, and/or diet-related chronic diseases, i.e., academia, health organizations, health professional associations, non-governmental organizations, and local governments
The 28 experts that participated in this study were working in academia, health organizations/health professional associations, non-governmental organizations (NGO’s) and local governments, and specialised in food, nutrition, public health, obesity and/or dietrelated chronic diseases (Supplementary Material S5)
Summary
Overweight, obesity and diet-related chronic diseases are a major public health challenge globally [1, 2]. In the Netherlands, approximately 50% of the adult population is overweight [3, 4]. An unhealthy diet is an important determinant of overweight, obesity and diet-related chronic diseases [5, 6]. Unhealthy diets are not merely the result of individual decisions, but strongly influenced by the food environment [7–9]. The food environment can be defined as the physical (e.g., food availability, marketing), economic (food prices), policy and sociocultural surroundings, opportunities and conditions that influence people’s food choices and nutritional status [9]. Over the past few decades, the availability and marketing of ultra-processed, high-fat and sugar-rich products increased, and prices of these products have decreased relatively to healthier foods [8–10].
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