A systematic policy approach to changing the food system and physical activity environments to prevent obesity

Abstract

As obesity prevention becomes an increasing health priority in many countries, including Australia and New Zealand, the challenge that governments are now facing is how to adopt a systematic policy approach to increase healthy eating and regular physical activity. This article sets out a structure for systematically identifying areas for obesity prevention policy action across the food system and full range of physical activity environments. Areas amenable to policy intervention can be systematically identified by considering policy opportunities for each level of governance (local, state, national, international and organisational) in each sector of the food system (primary production, food processing, distribution, marketing, retail, catering and food service) and each sector that influences physical activity environments (infrastructure and planning, education, employment, transport, sport and recreation). Analysis grids are used to illustrate, in a structured fashion, the broad array of areas amenable to legal and regulatory intervention across all levels of governance and all relevant sectors. In the Australian context, potential regulatory policy intervention areas are widespread throughout the food system, e.g., land-use zoning (primary production within local government), food safety (food processing within state government), food labelling (retail within national government). Policy areas for influencing physical activity are predominantly local and state government responsibilities including, for example, walking and cycling environments (infrastructure and planning sector) and physical activity education in schools (education sector). The analysis structure presented in this article provides a tool to systematically identify policy gaps, barriers and opportunities for obesity prevention, as part of the process of developing and implementing a comprehensive obesity prevention strategy. It also serves to highlight the need for a coordinated approach to policy development and implementation across all levels of government in order to ensure complementary policy action.

Formulating policy activities to promote healthy and sustainable diets

“…Structurally, the framework's mapping of the food system within the environment-PHN relationship provides a point of reference to identify sectors and levels of governance that impact on the structure and operation of the food system. (57) It affirms the notion of identifying leverage points or strategic places to intervene within a system (20,58) . The framework highlights the need to recognise the nexus between food supply and food demand impacts on the operation of the food system and therefore the need for food policy activities to address these supply and demand components in a synchronised manner (59) .…”

How well do Australian shoppers understand energy terms on food labels?

“…those with twenty or more outlets in NSW or fifty or more nationally) to display the average energy content of standard food items, as well as the average adult daily recommended energy intake (8700 kJ), on menus (10) . While front-of-pack food labelling may be a potential strategy to assist consumers in selecting healthier food products (11,12) , poor nutrition knowledge and nutrition literacy may reduce the ability of some consumers to interpret the nutrition information provided, particularly for non-interpretive systems, such as percentage daily intake and energy labelling (3) . Health literacy refers to individuals' access to, understanding and use of information to make decisions relating to health (13) .…”

Prevention and Management of Non-Communicable Disease: The IOC Consensus Statement, Lausanne 2013

“…Despite global advocacy for a sound ''whole of government'' systems approach [30], the direct and indirect costs of NCD remain staggering and unsustainable due to the financial, political and structural complexity involved. The health care industry pushes government agencies for policies leading to change and the government pushes the health care industry to develop programs of prevention.…”