A narrative review of regulatory governance factors that shape food and nutrition policies

Abstract

Food composition, marketing restrictions, nutrition labeling, and taxation policies are recommended for preventing diet-related noncommunicable diseases. In view of the increasing but variable adoption of food policies globally, this narrative review examines the actors, regulatory frameworks, and institutional contexts that shape the development, design, and implementation of these policies. We found a diverse range of actors using various strategies, including advocacy, framing, and evidence generation to influence policy agendas. We identified diverse regulatory designs used in the formulation and implementation of the policies: command and control state regulation for taxes and menu labels, quasi-regulation for sodium reformulation, and co-regulation and industry self-regulation for food marketing policies. Quasi-regulation and industry self-regulation are critiqued for their voluntary nature, lack of independence from the industry, and absence of (or poor) monitoring and enforcement systems. The policy instrument design and implementation best practices highlighted in this review include clear policy goals and rigorous standards that are adequately monitored and enforced. Future research should examine how these combinations of regulatory governance factors influence policy outcomes.

The regulatory governance conditions that lead to food policies achieving improvements in population nutrition outcomes: a qualitative comparative analysis

“…Labelling, marketing, taxation and reformulation policies have gained significant policy attention at the global and national levels, hence we thought prudent and practical to focus on these. In 2019, we conducted a narrative review of international peer-reviewed and grey literature on regulatory governance of implemented food policies (n 73) and on policy outcomes (n 224) (13) . A year after the initial review, we conducted an additional literature search to identify any studies published between August 2019 and August 2020 followed by an additional grey literature search to fill gaps in policy cases that had insufficient information on one or more regulatory governance conditions.…”

“…The literature review identified the roles of actors, ideas, political contexts and evidence that shaped agenda setting, design and implementation of the policy cases included in this study (13) . In this analysis, we included policies that were already adopted thus our interest was less on the contextual factors that led to policy adoption and more on the factors that shaped how the policies were eventually designed.…”

“…In this analysis, we included policies that were already adopted thus our interest was less on the contextual factors that led to policy adoption and more on the factors that shaped how the policies were eventually designed. A key factor in the literature was the powerful role of the industry in shaping the design and implementation of policies in ways that reflect their interests and often in conflict with public health interests (13,26,27) . Based on this, we predict that the extent of high industry involvement may be one of the conditions that may influence food policy efficacy.…”

“…The literature review on the regulatory governance of instrument design revealed various approaches to designing food policies, including the use of best practices (13) . The factors included for instrument design were the extent to which the policy was designed following best practices based on the recommendations by international organisations such as the WHO (25) , International Network for Food and Obesity/Non-communicable Disease Research, Monitoring, and Action Support (INFORMAS) (29) and the World Cancer Research Fund International Nourishing framework (30) .…”

“…Research on regulatory governance of population nutrition policies shows that the agenda setting stage of food policies is shaped by powerful actors involved with the issue and how they frame the issues, and political contexts and existence of evidence (11)(12)(13) . The work of Magnusson and Reeve identified various shortcomings with the regulatory governance of the formulation and implementation stages of population nutrition policies (14)(15)(16)(17) .…”