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 sampling 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/political 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.
Highlights
MethodsThis paper presents a case study of nutrition policy actions to reduce added sugar consumption in Australia
Current policy actions to reduce added sugar consumption Fifteen examples of implemented policy actions relating to public health nutrition in Australia were retrieved from the NOURISHING database
Though we found sixty-three policy actions in Australia to reduce added sugar consumption, most were voluntary, and all targeted the food environment and behaviour change as opposed to the food supply
Summary
This paper presents a case study of nutrition policy actions to reduce added sugar consumption in Australia. In which the learnings from the subject under study provide insights to other settings and contexts[38], are a commonly used method to analyse complex, multivariable topics involving human participants[39]. The methods and results of this study have been reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist[42]. Sampling and recruitment Participants were individuals involved in decision making, or with knowledge and expertise in public health and nutrition policy, including members of national food regulation bodies, food industry groups (growers, millers, manufacturers and industry representative bodies), public health and nutrition organisations, government departments, and academics. Snowball sampling was used to identify participants, including from submissions to FSANZ consultations regarding NNS and individuals known to the researchers
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