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National food strategy needed to fix poor health and obesity epidemic
Food-EPI 2020: Benchmarking food environments
The third New Zealand Healthy Food Environment Policy Index (Food-EPI) was conducted in February to May 2020 by an Expert Panel of over 50 independent and government public health experts. It used an evidence-based approach to benchmark policies and actions of the Government against international best practice for creating healthier food environments. Progress since 2014 and 2017 was assessed.
Diet-related non-communicable diseases (NCDs) are the biggest preventable cause of death and ill-health in New Zealand. These are related to the food environments in which New Zealanders live. Unhealthy food environments lead to unhealthy diets and excess energy intake which have consequences in levels of morbidity and mortality.
Government has a critical role to play in creating healthier food environments. Food policies are a powerful tool to increase wellbeing (including mental health) and health equity, including honouring the rights of Māori to the protection of health under the Treaty of Waitangi. Existing government policies, such as the Child and Youth Wellbeing Strategy, would address the need to improve children’s nutrition and reduce health inequities more effectively by improving the food environments that perpetuate inequity.
This study is an initiative of INFORMAS (the International Network for Food and Obesity/non-communicable diseases (NCDs) Research, Monitoring and Action Support) which aims to monitor and benchmark food environments and policies globally to increase the accountability of governments and the food industry for their actions to reduce obesity and NCDs.
Implementation of policies
The level of implementation has not improved since 2017 (40 indicators unchanged, 6 worse, 1 better), showing that the Government has made no progress compared to international best practice since the last Food-EPI assessment. This was according to the Expert Panel who rated the extent of implementation of policies on food environments and infrastructure support by the New Zealand Government against international best practice.
The New Zealand Government is performing well when compared to international best practice, in preventing unhealthy foods from carrying health claims; providing nutrition information panels on packaged foods; transparency in policy development processes; providing access to information for the public; and monitoring prevalence of NCDs and their risk factors and inequalities.
Gaps were identified in:
- healthy food policies in schools;
- fiscal policies to support healthy food choices;
- implementation of restrictions on unhealthy food marketing to children;
- support for communities to limit the density of unhealthy food outlets (for example, around schools); and
- ensuring that trade and investment agreements do not negatively affect population nutrition and health.
Additionally, infrastructure gaps were identified in:
- government leadership for obesity and NCD prevention and
- regular monitoring of adult and childhood nutrition status and population intakes.
Top priorities for improving the healthiness of food environments
The Expert Panel recommended 39 concrete actions to improve the healthiness of New Zealand food environments. Eight policy actions and 14 infrastructure support actions were considered high priority and then ranked by the Expert Panel for importance and achievability.
The 13 recommendations prioritised for immediate action can be grouped into four main areas: Food Systems and Nutrition Strategy; Infrastructure; People’s capacity; Healthier Food Environments. These actions would collectively result in positive outcomes for environmental sustainability, economic prosperity, improved health and increased equity.
The Expert Panel was very clear that for any progress to be made, there needs to be clear leadership, and the development of a multi-sectoral National Food Systems and Nutrition Strategy guided by a Scientific Committee. The experts expressed concern about the extent of food insecurity exposed by the Covid-19 crisis, prioritising the policy action of ensuring households receive an adequate income to enable autonomy to make healthy food choices. Also of major concern was the need for another national nutrition survey, with the previous Child and Adult Nutrition Surveys conducted 18 and 12 years ago respectively. Major policy decisions are being made in the absence of evidence about the nutrition status and food consumption patterns of the population.
The Expert Panel called for a mandatory approach to be adopted in all policy areas, as previous voluntary approaches have proven to be ineffective as they are not enforceable and therefore not implemented or adhered to. The Expert Panel called for a mandatory approach to:
New Zealand has an excellent opportunity to take the prevention of obesity and diet-related NCDs seriously. If the New Zealand Government invests in the highly cost-effective policies and programs recommended by WHO we could meet the standard of those countries currently leading the world on food policies for health and wellbeing
- marketing of unhealthy food to children
- Health Star Ratings labelling
- healthy food policies in schools and early learning services
- a levy on sugary drinks, and
- maximum levels of sodium and sugar in key food groups.
Figure: Actions prioritised by the Expert Panel for Government to improve the healthiness of New Zealand food environments
Mackay, S., Sing, F; Gerritsen, S.; Swinburn, B. Benchmarking Food Environments 2020: Progress by the New Zealand Government on implementing recommended food environment policies & priority recommendations, Auckland: The University of Auckland, 2020