Abstract

Food environment policies play a critical role in shaping food choices, diets, and health outcomes. This study endeavored to characterize and evaluate the current food environment policies in Canada using the Healthy Food Environment Policy Index (Food-EPI) to compare policies in place or under development in Canada as of 1 January 2017 to the most promising practices internationally. Evidence of policy implementation from the federal, provincial, and territorial governments was collated and verified by government stakeholders for 47 good practice indicators across 13 policy and infrastructure support domains. Canadian policies were rated by 71 experts from across Canada, and an aggregate score of national and subnational policies was created. Potential policy actions were identified and prioritized. Canadian governments scored ‘high’ compared to best practices for 3 indicators, ‘moderate’ for 14 indicators, ‘low’ for 25 indicators, and ‘very little or none’ for 4 indicators. Six policy and eight infrastructure support actions were prioritized as the most important and achievable. The Food-EPI identified some progress and considerable gaps in policy implementation in Canada, and highlights a particular need for greater attention to prioritized policies that can help to shift to a health-promoting food environment.

Highlights

  • It is well established that food choices are heavily influenced by the food environment within which they are made [1]

  • 84% of participants agreed or strongly agreed that they had increased their knowledge of food environments and related food and nutrition policy, 86% had increased their knowledge of current best practice and international government actions, and 73% had made new connections in the area of food environments

  • The current patchwork of policies across provinces and territories that are implemented in some policy domains represent inherent inequities in exposure to less healthy food environments between Canadians living in different jurisdictions, which are likely contributing to disparities in diet quality and rates of obesity and non-communicable diseases (NCDs) between provinces and regions [35]

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Summary

Introduction

It is well established that food choices are heavily influenced by the food environment within which they are made [1]. The food environment, broadly defined as the physical, economic, political, and sociocultural factors that influence dietary choices, is closely related to diet [2]. The types and quality of foods in the food supply, the cost, and the marketing of foods all play critical roles in shaping food choices, with an ultimate influence on overall health [3]. Current food environments are largely not conducive to supporting healthier eating behaviors [1,4]: Nutrition-related risk factors are the greatest contributor to disability-adjusted life years and mortality worldwide [5]. Overall diet quality in Canada is poor, with few Canadians meeting recommendations for fruit and vegetable consumption and sodium intake [6,7,8]

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