Healthy Food Environment Research Articles

Benchmarking public policies to create healthy food environments compared to best practice: the Healthy Food Environment Policy Index in Guatemala

BackgroundBenchmarking the implementation of healthy food environment public policies against international best practices may accelerate the government response to prevent obesity and non-communicable diseases (NCDs) in the countries. The aim of the study was to determine the extent of food environment policy implementation in Guatemala and to identify and prioritize actions for the government to accelerate their implementation.MethodsThe INFORMAS Healthy Food Environment Policy Index (Food-EPI from the International Network for Food and Obesity/NCDs Research, Monitoring and Action Support) was used. Evidence of implementation for 50 good practice indicators within the seven food policies and six infrastructure support domains was compiled, and subsequently validated by Guatemalan government officials. A national civil society expert panel on public health and nutrition performed an online assessment of the implementation of healthy food environment policies against best international practices. The level of agreement among evaluators was measured using the Gwet second order agreement coefficient (AC2). The expert panel recommended actions for each indicator during on-site workshops and those actions were prioritized by importance and achievability.ResultsThe expert panel rated implementation at zero for 26% of the indicators, very low for 28% of indicators, low for 42%, and medium for 4% of indicators (none were rated high). Indicators at medium implementation were related to the use of evidence for developing policies and ingredient list/nutrition information panels on packaged foods. Seventy-seven actions were recommended prioritizing the top 10 for immediate action. The Gwet AC2 was 0.73 (95% CI 0.67–0.80), indicating a good concordance among experts.ConclusionsIn the Food-EPI of Guatemala, almost all indicators of good practice had a low or less level of implementation. The expert panel proposed 12 priority actions to accelerate policy implementation to tackle obesity and NCDs in the country.

Ultra-Processed Foods Elicit Higher Approach Motivation Than Unprocessed and Minimally Processed Foods

BackgroundUltra-processed foods (UPF) are becoming extensively available in the food environments. UPF are industrial formulations that are designed to maximize palatability and consumption through a combination of calorie-dense ingredients and chemical additives. UPFs are also aggressively marketed, which may make them more attractive than unprocessed/minimally processed foods (UMPF). Since consumers' purchase decisions are guided by food-evoked emotions, we aimed to provide evidence that UPF visual cues trigger higher emotional responses and approach motivation than UMPF visual cues, with potential impacts on individuals' intention to consume the UPF over the UMPF.MethodsParticipants (n = 174; 144 women; mean age = 20.7 years; standard deviation = 4.35) performed two tasks. In the first task, 16 pictures of foods (8 UPF and 8 UMPF), and 74 pictures from other affective categories, were presented. After viewing each picture, the participants rated it along two basic dimensions of emotion through the Self-Assessment Manikin scale: pleasantness and arousal. In the second task, the participants viewed the same food pictures, and they rated their intention to consume the foods depicted in the pictures. Each picture was plotted in terms of its mean pleasantness and arousal ratings in a Cartesian plane, which resulted in an affective space.ResultsPictures of UPF and UMPF were positioned in the upper arm of the boomerang-shaped affective space that represents approach motivation. Pictures containing UPF triggered higher approach motivation and intention to consume than pictures containing UMPF. We also found a stronger association between emotional responses and intention to consume UPF relative to UMPF.ConclusionThese results shed new light on the role of ultra-processed foods evoked emotions that contribute to less healthy and sustainable food environments.

No new fast-food outlets allowed! Evaluating the effect of planning policy on the local food environment in the North East of England

The environment in which we live impacts on our health. The food available to us in our environment is likely to influence what we eat and subsequently our weight. The use of planning policy can be one way for both local and national government to help shape a healthy environment. In England there are three main types of planning policy used to promote a healthy food environment: 1) restricting new fast-food outlets near schools; 2) restricting new fast-food outlets if the density of existing outlets has surpassed a certain threshold of all retail outlets, 3) restricting new fast-food outlets if childhood obesity rates are above a certain threshold. In 2015, Gateshead council, a local authority in the North East of England implemented all three types of guidance. We utilise a longitudinal administrative dataset, the Food Standards Agency Food Hygiene Rating Scheme Data, covering the period 2012–2019 on all premises selling or preparing food in Great Britain. To analyse the impact of employing all three types of planning guidance on the density, proportion, and number of fast-food outlets in Gateshead, we employ a propensity score matching difference-in-difference approach. We match small geographical areas in Gateshead (lower super output areas) to other local authorities in the North East with similar demographic characteristics that did not implement planning guidance. Results show a reduction in density of fast-food outlets by 12.45 per 100,000 of the population and a 13.88% decrease in the proportion of fast-food outlets in Gateshead compared to other similar local authorities in the North East. There was a marginally significant reduction in the number of restaurants which became insignificant after controlling for population density. These results suggest that a multi-pronged planning approach significantly changed the proportion and density of fast-food outlets in the food environment in the short term (4 years).

The Healthy Food Environment Policy Index in Poland: Implementation Gaps and Actions for Improvement.

Background: Poland is facing the growing problem of overweight and obesity in the population, which makes it necessary to conduct a thorough assessment of the existing food environment policies. The aims of the study were: (1) to depict the strength of healthy food environment policies in Poland and identify implementation policies and infrastructure support gaps; (2) to identify and prioritise improvement policies, taking into account their importance, achievability and equity. Methods: We used the Healthy Food Environment Policy Index (Food-EPI). An experts’ panel rated Polish policies and infrastructure compared to international best practices and developed a list of recommended improvement actions addressing both components. Results: eight of the twenty-two policy and four of the twenty-two infrastructure indicators achieved the “no/very weak policy” result. Another four policy and five infrastructure indicators were considered “weak”. Another seven and eight indicators, respectively, were assessed as “moderate”. Among the identified actions, the highest priority was given to a food labelling system and training for persons involved in nutrition in schools. Conclusions: The Polish healthy food environment has been assessed as very weak or weak in most aspects. The infrastructure was assessed as slightly better compared to the policies domain, with more indicators receiving the “moderate” score.

Assessment of a New England Public University’s Adherence to the Partnership for a Healthier America’s Healthier Campus Initiative

ObjectivesUniversity dining halls are understudied food environments that affect the diet quality of college students. This study assessed dining hall offerings at a large public university using the Partnership for a Healthier America’s Healthier Campus Initiative (PAHA), criteria for healthier campus food environments. MethodsWe evaluated breakfast, lunch, and dinner using spring cycle menus (16 weeks in 2019 and 4 in 2021) from two full-service dining halls totaling 29 meals in 2019, and 84 meals in 2021 to determine adherence with PAHA criteria for availability of: 1) wellness meals (defined as including whole grains, lean protein, low-fat dairy, fruits and vegetables), 2) 35 fruits, 35 vegetables, and 32 100% whole grain products, 3) ≤4 fried food options at a time, 4) 33 desserts with <150 kcals, labelled as healthier 5) healthier food identification at point of presentation, and 6) marketing strategies promoting healthy options. To assess validity of the cycle menu data, evaluators also completed 7 in-person visits to match the cycle menus to the dining hall’s physical displays. An “all-day” menu (ADM) was also collected from both years to evaluate static items available. ResultsAll spring 2019 and spring 2021 cycle menus consistently met PAHA criteria for fried foods, but 0% of cycle menus during either period met the other 5 criteria. In 2019, wellness meals and fruits, vegetable, and whole grain criteria were met when the ADM was included in the analysis; in 2021, the wellness meals was met when salad and sandwich bars offerings in the ADM were included. Cycle menus were consistent with what evaluators observed in-person. Even with the ADM, dining hall menus did not meet criteria for desserts or marketing of healthier options. ConclusionsCompared against guidance for healthy campus food environments, dining halls at a large public university largely met limited fried food criteria but did not meet other criteria. While increasing whole grains, fruits, vegetables, lean meat, and low-fat dairy in cycle menus may have budgetary and/or logistical constraints, it may be feasible for dining halls to clearly label and promote healthier foods at point-of-purchase through signage. Funding SourcesURI College of Health Sciences Undergraduate Research Award, April 2021.

Design of a Laboratory-Cafeteria to Improve the Food Environment in the Faculty of Medicine in Mexicali

ObjectivesThe objective of this study is to create healthy menus and with this improve the food environment. These menus on top of being visually attractive and tasty, they address the recommendations of macronutrients, fiber, and fruits and vegetables a regular person who consumes 2000kcal must ingest daily according to the recommendations of the World Health Organization. MethodsTo design the laboratory-cafeteria to improve the food environment, we implemented the following: 1) the healthy menus were made using the software ESHA research food labeling software and the guidelines of food equivalents of Mexico. 2) Focus group was established to evaluate the food environment before we implement the laboratory-cafeteria which the participants, a total of 9, debated in an orderly fashion the before and after of the food environment and the service provided modulated by Author, this part of the study was evaluated using the Nvivo Software. 3) The participants also submitted two questionnaires on the first one they had to explain their eating habits and physical activity before and after our intervention and on the second one was a feedback of the service provided. ResultsThe project by name is La Cafe 1600, “la Café” is short for cafeteria and “1600” representing the total of calories that we provide between a breakfast of 400 kcal, two snacks of 300 kcal each and lunch with 600 kcal; the distribution of each menu is of 60% carbohydrates, 25% fat and 15% protein. The cost of each menu was established, the logo and name of the project was also registered. To evaluate the progress of the project we applied two questionnaires, the first one is to evaluate how the participants are eating, if they are eating healthy and if they practice and physical activity. The second one is to evaluate projects feedback in regards to the portion sizes, the flavor, the quantity, etc. ConclusionsThe intention of the project is to promote a healthy food environment provided by La Cafe 1600 with menus that are diverse, balanced, and healthy. To evaluate the impact that La Cafe 1600 could have in the Faculty’s community it requires the collaboration of all its members to ensure this project is a success. Funding SourcesFacultad de Medicina de Mexicali de la Universidad Autónoma de Baja California (UABC) and Consejo Nacional de Ciencia y Tecnología (CONACYT).

飲食店における健康を考慮した食品ロスの削減

【目的】食品ロス削減のために，飲食店で適量を超えた提供で食べきりを促進すると，客の過剰摂取により健康課題につながる可能性がある。本研究は，飲食店に着目し，健康も考慮した食品ロス削減に取り組む自治体の実態と具体的な取組内容を整理することを目的とした。

Culture of Healthy Eating and Food Environments, Policies, and Practices in Regional New Zealand Schools.

The school food environment plays an important role in shaping students’ dietary choices, which often influence future dietary behaviours. We surveyed primary and secondary schools in Hawke’s Bay, New Zealand, to measure the comprehensiveness and strength of food policies, describe the culture of food provision, and identify barriers to improving school food environments. Fifty-one schools were included in the final analysis, with 58.8% having a food policy, most of which used a generic template. Schools with food policies and those participating in the free and healthy lunch programme were more likely to have a strong culture around healthy eating. Common barriers to healthy eating were food outlets near school and resistance from students. Secondary schools reported facing more barriers to implementing healthy eating cultures, were more likely to use food as classroom rewards and to sell food to students, most of which was unhealthy. Hawke’s Bay schools participating in food provision programmes are successfully improving their food environments through improved culture and delivery of healthy food; however, more action is needed to strengthen the wording and guidance in food policies and reduce the provision of unhealthy food in schools before effective change can be achieved.

Food Environment Inequalities and Moderating Effects of Obesity on Their Relationships with COVID-19 in Chicago

The COVID-19 outbreak has raised challenges for people with health problems. Obesity is a global issue related to COVID-19. The Centers for Disease Control (CDC) finds that obesity worsens COVID-19 outcomes. As body mass index increases, the COVID-19 death risk increases. Additionally, due to different restriction policies, the pandemic has transformed our food environment. Thus, it is important to develop an antivirus-enabled paradigm to decrease the COVID-19 spreading rate in neighborhoods with obesity concerns and design a sustainable and healthy food environment. It is found that both COVID-19 and obesity inequalities are associated with food environment inequalities, but few studies have examined the moderating effects of obesity and food environment on COVID-19. According to the Chicago Department of Public Health, more than 30% of the Chicago adult population is obese. Additionally, Chicago has 340,676 COVID-19 cases during the period between 1 March 2020 and 26 November 2021. This study uses regression models to examine the moderating effects of obesity and food environment on COVID-19 in Chicago. Besides food environment factors, green spaces and transportation access are considered. The results show COVID-19 is concentrated in areas with a high obesity rate and low food access. A 1 percent increase in obesity rate is associated with a 2.83 percent increase in COVID-19 death rate in a community. Additionally, the moderating effects of obesity on the association between food environment and COVID-19 are shown in the results.

Household Food Shopping Locations Beyond Residential Neighborhoods: An Exploratory Study Using a GPS-Based Household Survey

Understanding household food shopping locations is important as it could help policymakers develop effective place-based strategies to improve healthy eating and subsequently improve health conditions. Although a growing number of studies have examined food shopping patterns and their associations with food environment around home locations, evidence on food shopping locations relative to areas beyond residential neighborhoods remains scarce. We aimed to explore spatial dimensions of household food shopping locations relative to home, workplaces, and commuting routes. We defined three buffers to delineate potential food shopping geographies for home, workplaces, and commuting routes. We calculated home–grocery distances and work–grocery distances, and the percentage of grocery shopping locations falling inside each of the three aforementioned spatial units, respectively. Our findings suggest that people were more likely to visit food stores beyond immediate residential areas or workplace areas. They often bypassed the closest supermarkets near home or work, whereas they were more likely to shop along their commuting paths. Our findings provide an example of the uncertain geographic context problem in a context of food activities, highlighting that activity space is a more comprehensive measure for assessing food exposures and food shopping activities. Key Words: activity spaces, food shopping locations, healthy food environment, residential neighborhoods, workplace neighborhoods.

Historical redlining and food environments: A study of 102 urban areas in the United States.

Unhealthy food environments are disproportionally concentrated in neighborhoods with clustering of racial/ethnic minorities and poverty. This disparity has been blamed, in part, on market self-regulation. This explanation risks overlooking past and current practices of racial segregation that have created and reinforced the obstacles blocking investments from food retailers in marginalized neighborhoods. We fill this gap by investigating how the long-term ramifications of redlining, discriminatory housing practices enacted by federal Home Owner Lending Corporation (HOLC) in the 1930s, has evolved generations later to disproportionally exposing neighborhoods to unhealthy food environments. We overlaid historical redlining maps over 2010 food environment observations at the census tract level to identify areas with less healthy food environments and to assess the historical context of those areas. For 11,651 census tracts within 102 U.S. urban areas, we described the healthiness of food environments as measured by the modified retail food environment index (mRFEI). Using hurdle models with random effects, we further examined the association between redlining housing practice and food environments. The results indicate that historically redlined neighborhoods show a higher likelihood for unhealthy retail food environments even for census tracts with present-day economic and racial privilege. The current evidence shows how structural discrimination manifested by unjust housing practices and racial residential segregation fueled an uneven food environment where minority neighborhoods disproportionally bore the brunt of restrictive food access. It highlights an urgent need to ameliorate patterns of housing inequality as a fix to unequal food environments.

Using the Tools of Today to Advance the Life Course Interventions of Tomorrow.

Using the Tools of Today to Advance the Life Course Interventions of Tomorrow.

Measures of Perceived Neighborhood Food Environments and Dietary Habits: A Systematic Review of Methods and Associations.

Access to healthy food is a necessity for all people. However, there is still a lack of reviews on the assessment of respondent-based measures of neighborhood food environments (perceived food environments). The aim of this systematic review was to evaluate the measurement tools for perceived food environments by five dimensions of food access and to obtain the overview of their associations with dietary habits among people aged 18 years and older in middle- and high-income countries. Observational studies using perceived food environment measures were identified through a systematic review based on two databases for original studies published from 2010 to 2020. A total of 19 final studies were extracted from totally 2926 studies. Pertaining to the five dimensions of food access, 12 studies dealt with accessibility, 13 with availability, 6 with affordability, 10 with acceptability, 2 with accommodation, and 8 with a combination of two or more dimensions. Perceived healthy food environments were positively associated with healthy dietary habits in 17 studies, but 8 of them indicated statistically insignificant associations. In conclusion, this review found accessibility and availability to be major dimensions of perceived food environments. The relationship between healthy food environments and healthy diets is presumably positive and weak.

The Formation of the Criteria, Rules and Regulations of the Sufficient and High-Quality Food According to the European Standards

Abstract. Introduction. Modern food systems face the challenge of supporting food choices that are consistent with a healthy and adequate diet. The vast majority of consumers of food products do not choose the principle of quality � the choice is made in favor of lower cost (low nutrient content), readiness of the product for consumption (high processing and trans fat content) or taste (high sugar, salt, etc.). At the same time, poor nutrition around the world is the number one risk factor for death and disability. Purpose. To study the criteria of the sufficient and high-quality food based on the norms and standards according to the European standards at different levels. Results. The article examines the indicators of calorie consumption per capita, daily calorie reserve per person, the minimum daily calorie requirement, inequality in calorie consumption per capita in the world. The key drivers of the impact of the level of nutrition on the quality of life have been identified: a healthy diet; unhealthy diet and lack of physical activity are the main global health risks, especially obesity; breastfeeding; balanced energy consumption; restriction of sugar consumption (up to 10%) and salt (up to 5 g per day). The WHO data and recommendations on ensuring a healthy diet for adults and children are summarized. The effective actions of politicians to create a healthy food environment have been identified, which should include three interrelated areas: building coherence in national policies and investment plans, including trade, food and agricultural policies; encouraging consumer demand for healthy food; promoting appropriate feeding practices for infants and young children; and tools for their implementation at the national level were systematized. WHO�s healthy eating policies and programs for national governments and related healthy eating policies and programs in Ukraine were described. Conclusions. A healthy diet from birth and throughout life prevents malnutrition in all its forms, as well as a number of non-communicable diseases. However, increased production and consumption of processed foods, rapid urbanization and lifestyle changes have led to changes in diets. People now consume significantly more foods high in energy, fat, sugar and salt / sodium. At the same time many people do not consume enough fruits, vegetables and whole grains, which contain the necessary fiber, vitamins and minerals for the human body. The required content of a varied, balanced and healthy diet varies depending on individual characteristics (age, gender, lifestyle and level of physical activity), cultural context, local products and eating habits. Along with this the basic principles of healthy nutrition remain unchanged.

Healthy Food Environments in Early Learning Services: An Analysis of Manager Survey Responses, Menus and Policies in Regional New Zealand Early Childhood Education and Care Centres.

Healthy food environments in early childhood play an important role in establishing health-promoting nutritional behaviours for later life. We surveyed Early Learning Services (ELS) in the Hawke’s Bay region of New Zealand and describe common barriers and facilitators to providing a healthy food environment, through descriptive survey analysis and thematic analysis of open-ended questions. We used a policy analysis tool to assess the strength and comprehensiveness of the individual centre’s nutrition policies and we report on the healthiness of menus provided daily in the centres. Sixty-two centres participated and 96.7% had policies on nutrition compared to 86.7% with policies on drinks. Of the 14 full policies provided for analysis, identified strengths were providing timelines for review and encouraging role modelling by teachers. The main weaknesses were communication with parents and staff, lack of nutrition training for staff and absence of policies for special occasion and fundraising food. With regard to practices in the ELS, food for celebrations was more likely to be healthy when provided by the centre rather than brought from home. Food used in fundraising was more likely to be unhealthy than healthy, though <20% of centres reported using food in fundraising. Only 40% of menus analysed met the national guidelines by not including any ‘red’ (unhealthy) items. Centre Managers considered the biggest barriers to improving food environments to be a lack of parental support and concerns about food-related choking. These results highlight the need for future focus in three areas: policies for water and milk-only, celebration and fundraising food; increased nutrition-focused professional learning and development for teachers; and communication between the centre and parents, as a crucial pathway to improved nutrition for children attending NZ early childhood education and care centres.

Factors Influencing Adolescents' Dietary Behaviors in the School and Home Environment in Addis Ababa, Ethiopia.

BackgroundMalnutrition affects many adolescents in Ethiopia. Over one-third of adolescent girls and two-thirds of boys are thin. Overweight and obesity in Ethiopia is mostly a concern in urban populations of higher wealth quintiles. Urbanization and globalization of diets is shifting food environments. The objective of this study was to assess whether food environments in and around schools in urban Ethiopia influence dietary diversity, quality, BMI status or perceptions of adolescents.MethodsTwelve high schools were selected in Addis Ababa (private/government). From each school, 20 pupils aged 15–19 years were randomly selected (n = 217) and interviewed about assets in their households, their diets (categorized into 10 food groups of the Minimum Dietary Diversity, the Global Dietary Recommendations scores and four categories of the NOVA classification based on level of processing) and their use of pocket money. In addition, food environment audits were conducted within the school compound and a 0.5 km radius around each school and types of food outlets.ResultsOn average there were 436 food outlets and 246 food or drink advertisements around each school. The majority of the advertisements (89.9%) were of ultra-processed foods, mostly sugar-sweetened beverages (SSBs). Most were positioned on food outlets (89.1%). SSBs or sweets were visibly on display in 26.3% of the outlets and fresh fruits and vegetables in 17.9% of outlets. Dietary diversity of adolescents was poor with an average of 3.6 food groups out of 10 consumed in the last 24 h. Ultra-processed foods and beverages were consumed by 23.5% of adolescents. The majority of adolescents spent their pocket money on SSBs, sweets or fried foods. Our analysis found that higher assets in adolescents' households were associated with higher dietary diversity and consumption of healthy food groups. We found no association between the food environment and dietary indicators or the BMI-z-score.ConclusionWhile the school food environments investigated were not conducive with promoting healthy dietary behaviors, we cannot conclude that these environmental factors directly influence adolescents' diets. The pervasive advertising and availability of unhealthy foods and beverages requires policy action for healthy school food environments.

Citizen science in monitoring food environments: a qualitative collective case study of stakeholders\u2019 experiences during the Local Environment Action on Food project in Alberta, Canada

BackgroundCitizen science bears potential to build a comprehensive view of global food environments and create a broader discussion about how to improve them. Despite its potential, citizen science has not been fully utilised in food environment research. Thus, we sought to explore stakeholders’ experiences of the Local Environment Action on Food (LEAF) project, a community-based intervention that employs a citizen science approach to monitoring food environments.MethodsWe used a qualitative collective case study design to explore citizen science through the LEAF process in seven communities in Alberta, Canada. Data generating strategies included semi-structured interviews with citizen scientists (n = 26), document review of communities’ Mini Nutrition Report Cards (n = 7), and researcher observation. Data were analyzed in a multi-phase process, using Charmaz’s constant comparison analysis strategy.ResultsAnalysis revealed two main themes: relationship building and process factors. Communities used three interconnected strategies, engaging the right people, treading lightly, and reaching a consensus, to navigate the vital but challenging relationship building process. Process factors, which were influences on the LEAF process and relationship building, included the local context, flexibility in the LEAF process, and turnover among LEAF community groups.ConclusionCitizen science through the LEAF project supported the creation and application of food environment evidence: it enabled residents to collect and interpret local food environment data, develop realistic recommendations for change, and provided them with an evidence-based advocacy tool to support the implementation of these recommendations. We recommend a web application that enables independent community food environment assessments. Such a tool could stimulate and sustain citizen involvement in food environment efforts, helping to build the necessary evidence base and promote the creation of healthy food environments.

A review of food and nutrition communication and promotion in Ghana

Dietary perception, behavior, and nutritional status can all be influenced by exposure to information. Behavior change communication that is appropriately designed and implemented is critical for motivating optimal dietary behavior. On the other hand, inadvertent or deliberate misinformation can drive unhealthy dietary behaviors. As part of the process to develop food-based dietary guidelines (FBDGs) for Ghana, this rapid evidence review examined the nature, extent, sources, and medium of food and nutrition information dissemination and promotion in Ghana. PubMed, Cochrane, Google Scholar, and Open Access Theses Dissertations (OATD) databases were searched systematically using keywords to identify relevant peer-reviewed and grey literature. The review included 31 documents, after excluding 1,302 documents for ineligibility (based on irrelevant title, abstract, and duplicates). Limited reporting of undernutrition was found in print and electronic media. Unhealthy foods, including sugar-sweetened beverages, snacks, yogurt, instant noodles, candy/chocolate, and ice cream were frequently advertised through various communication media. Children are highly exposed to food advertisements, which target them. Promotional characters, animation, billboards, and front-of-store displays; product-branded books, and toys are common strategies for food marketing and advertisement in Ghana. The most frequently reported sources of health and nutrition information were television, radio, social media, health professionals, families, and friends. Children and adults experienced changes in food preferences and choices as a result of exposure to food advertised on television. The commonly used traditional media were radio and television; printed newspaper use has declined tremendously in the past decade. Social media use (particularly WhatsApp, Facebook, and YouTube) is highest in urban areas, and is growing rapidly; young adults are the most active users of social media platforms. Experts recommend regulation as a mitigation for nutrition miscommunication and inaccurate promotion. The current review highlights the need for regulation of food marketing, and advertisement to safeguard a healthy food environment in Ghana. Key words: advertisement, promotion, diet, regulation, social media, food, Ghana

Nutrition and health-related information disclosure on pre-packaged food products from local retail shops in Accra

The prevalence of obesity and diet related non-communicable diseases (NCDs) are rapidly increasing in Africa. Consumption of pre-packaged foods is one of the main drivers of these NCDs. Pre-packaged foods tend to contain high levels of energy, fat, sugar, and salt, which are known risk factors for NCDs. Food labels can guide consumers to make informed healthy food choices. Therefore, it is important to analyze how health-related information is communicated on food labels. In Ghana, there is paucity of evidence on what health-related information is available to consumers of pre-packaged foods. This study describes health-related information on labelled pre-packaged foods sold in local retail shops in Accra. A cross-sectional survey and quantitative content analysis of food label information were employed in this study. Pre-packaged food labels photograph data were sourced from shops and content analyzed to describe their health-related information. Nutrition and health-related information were classified using the International Network for Food and Obesity/Non-Communicable Diseases Research, Monitoring and Action Support (INFORMAS) system. Three hundred and fifty-one (N=351) pre-packaged foods and non-alcoholic beverages were sampled, out of which 2.3% products were unlabelled. Out of 343 labelled products, 92% disclosed ingredient list information and 68.8% had nutrition declaration. Between the two nutrition labelling formats: Back-of-Pack (BOP) and Front of Pack (FOP), BOP was the dominant (87.3%) format. Various types of FOPs were identified however, Guidelines Daily Allowance (GDA) was the most common format. The study found that 18% of labelled pre-packaged foods carried nutrition claim and about 7% had a health claim. Most of the claims were written and the others were a combination of words, numbers, and pictures/symbols. This study has shown a high disclosure of health-related label information on pre-packaged food but information presentations on labels were not consistent. The insight gained from this study shows that the presentation of health-related label information does not meet the current recommendations of Codex and the benchmarks set out by INFORMAS in promoting a healthy food environment. Key words: Pre-packaged Foods, Food/Nutrition labels, health-related information, retail shops, Accra

Evaluation and prioritization of actions on food environments to address the double burden of malnutrition in Senegal: perspectives from a national expert panel.

To evaluate the extent of implementation of public policies aimed at creating healthy eating environments in Senegal compared to international best practice and identity priority actions to address the double burden of malnutrition. The Healthy Food Environment Policy Index (Food-EPI) was used by a local expert panel to assess the level of implementation of 43 good practice policy and infrastructure support indicators against international best practices using a Likert scale and identify priority actions to address the double burden of malnutrition in Senegal. Senegal, West Africa. A national group of independent experts from academia, civil society, non-governmental organizations and United Nations bodies (n =15) and a group of government experts from various ministries (n =16) participated in the study. Implementation of most indicators aimed at creating healthy eating environments were rated as "low" compared to best practice (31 on 43, or 72%). The Gwet AC2 inter-rater reliability was good at 0.75 (CI 0.70 - 0.80). In a prioritization workshop, experts identified forty-five actions, prioritizing ten as relatively most feasible and important and relatively most effective to reduce the double burden of malnutrition in Senegal (example: Develop and implement regional school menus based on local products (expand to 14 regions) and measure the extent of the promotion of unhealthy foods to children). Significant efforts remain to be made by Senegal to improve food environments. This project allowed to establish an agenda of priority actions for the government to transform food environments in Senegal to tackle the double burden of malnutrition.