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The Impact of the COVID-19 Pandemic on Food Consumption Behavior: Based on the Perspective of Accounting Data of Chinese Food Enterprises and Economic Theory. Nutrients 2022; 14:nu14061206. [PMID: 35334868 PMCID: PMC8950524 DOI: 10.3390/nu14061206] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 02/24/2022] [Accepted: 03/09/2022] [Indexed: 01/27/2023] Open
Abstract
Since the outbreak of the COVID-19 pandemic, the rapid spread of COVID-19 around the world has become one of the main focuses of concern in almost every country, and governments have taken numerous measures to prevent/mitigate the spread of the disease. As an essential social determinant, COVID-19 has significantly impacted consumers’ food consumption behavior and healthy eating habits/behaviors. The purpose of this study is to analyze the impact of COVID-19 on food consumption behavior, and the main goal was to assess the possible problems (such as food waste and weight gain) caused by changes in food consumption behavior during the pandemic. Based on the accounting data of Chinese enterprises found in the China Stock Market and Accounting Research (CSMAR) database, this study uses economic theory and the translog function to conduct an average partial effect (APE) analysis of the pandemic, and finds that the COVID-19 pandemic has increased Chinese people’s overall food consumption, and the consumption of food from large food enterprises has increased even more (APE = 0.11 vs. APE = 0.31). This study suggests that food waste and weight gain in the Chinese population may be more severe during the pandemic, and it is necessary to enhance food management and weight management through multiple pathways.
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SOHAIB M, NAEEM M, ALI A, IQBAL S, AMJAD A, NAUMAN K, AHMAD S, RAZA M, SAAD BIN JUNAID M, UMAIR RIAZ M. Nutritional and safety evaluation of various liquid and powdered tea whiteners available in Pakistan. FOOD SCIENCE AND TECHNOLOGY 2022. [DOI: 10.1590/fst.04921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
| | | | - Ahmad ALI
- University of Veterinary & Animal Sciences, Pakistan
| | | | | | - Kashif NAUMAN
- University of Veterinary & Animal Sciences, Pakistan
| | - Shahzad AHMAD
- University of Veterinary & Animal Sciences, Pakistan
| | - Mohsin RAZA
- University of Veterinary & Animal Sciences, Pakistan
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Chavez‐Ugalde Y, Jago R, Toumpakari Z, Egan M, Cummins S, White M, Hulls P, De Vocht F. Conceptualizing the commercial determinants of dietary behaviors associated with obesity: A systematic review using principles from critical interpretative synthesis. Obes Sci Pract 2021; 7:473-486. [PMID: 34401205 PMCID: PMC8346378 DOI: 10.1002/osp4.507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 03/04/2021] [Accepted: 03/12/2021] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Unhealthy diet is an important preventable risk factor for overweight and obesity. Identifying the key drivers of an unhealthy diet is an important public health aim. "Big Food" has been identified as an influential factor shaping dietary behavior and obesity, and their practices have broadly been labeled as the "commercial determinants of obesity," but there is a lack of definitions and conceptualizations for these terms. This review aimed to synthesize literature on the commercial determinants of dietary behavior associated with obesity. It presents the development of an integrative definition and a conceptual framework involving potential influences on dietary behavior, and it examines the prevalence of certain narratives within papers that focus on children and adolescents. METHODS Four electronic databases (Ovid MEDLINE, PubMed, Web of Science, and Scopus) were searched up to December 2020. Eighty-one articles met the inclusion criteria: they were published in a peer-reviewed academic journal, described a practice from the food/beverage industry in relation to dietary behavior or obesity. Data were integrated using critical interpretative synthesis. RESULTS The commercial determinants of dietary behavior are conceptualized in terms of three corporate spheres of action-political and legal; production, processing and design; and marketing and preference shaping-which enable powerful food industry to successfully pursue their business, market, and political objectives. The most frequently reported sphere of action targeting children and adolescents was marketing and preference shaping. CONCLUSIONS In the included literature, the commercial determinants of dietary behavior associated with obesity have been conceptualized as being part of a complex system where corporate practices are enabled by power structures. The proposed framework can facilitate a structured identification and systematic study of the impact of specific aspects of food industry's strategies and increase opportunities for primary prevention by anticipating industry responses and by discouraging corporate practices that harm health.
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Affiliation(s)
- Yanaina Chavez‐Ugalde
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Russell Jago
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Centre for Exercise, Nutrition & Health Sciences, School for Policy StudiesUniversity of BristolBristolUK
- National Institute for Health Research Collaboration for Leadership, Applied Health Research and Care West (NIHR CLAHRC West)BristolUK
| | - Zoi Toumpakari
- Centre for Exercise, Nutrition & Health Sciences, School for Policy StudiesUniversity of BristolBristolUK
| | - Matt Egan
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Department of Public Health, Environments and SocietyLondon School of Hygiene and Tropical MedicineLondonUK
| | - Steven Cummins
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Department of Public Health, Environments and SocietyLondon School of Hygiene and Tropical MedicineLondonUK
| | - Martin White
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Centre for Diet and Activity Research (CEDAR) MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - Paige Hulls
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Frank De Vocht
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
- National Institute for Health Research Collaboration for Leadership, Applied Health Research and Care West (NIHR CLAHRC West)BristolUK
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Lauber K, Rutter H, Gilmore AB. Big food and the World Health Organization: a qualitative study of industry attempts to influence global-level non-communicable disease policy. BMJ Glob Health 2021; 6:e005216. [PMID: 34117011 PMCID: PMC8202098 DOI: 10.1136/bmjgh-2021-005216] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/08/2021] [Accepted: 04/25/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION There is an urgent need for effective action to address the over 10 million annual deaths attributable to unhealthy diets. Food industry interference with policies aimed at reducing non-communicable diseases (NCDs) is widely documented at the national level but remains under-researched at the global level. Thus, this study explores how ultra-processed food industry actors have attempted to influence NCD policy at WHO. METHODS A combination of inductive and deductive thematic coding of internal industry documents, academic literature and interviews with key informants from international organisations and global civil society was used to identify action-based strategies ultra-processed food industry actors employ to influence global-level policy. RESULTS Ultra-processed food industry actors have attempted to influence WHO and its policies through three main action-based strategies: coalition management, involvement in policy formulation, and information management. Coalition management includes the creation and use of overt alliances between corporations-business associations-and more covert science-focused and policy-focused intermediaries, the hiring of former WHO staff and attempted co-option of civil society organisations. Industry involvement in policy formulation is operationalised largely through the lobbying of Member States to support industry positions, and business associations gaining access to WHO through formal consultations and hearings. Information management involves funding and disseminating research favourable to commercial interests, and challenging unfavourable evidence. CONCLUSION We provide novel insights into how ultra-processed food industry actors shape global-level NCD policy and identify a clear need to guard against commercial interference to advance NCD policy. In their approach, the political behaviour of multinational food corporations bears similarities to that of the tobacco industry. Increased awareness of, and safeguarding against, commercial interference at the national as well as the global level have the potential to strengthen the crucial work of WHO.
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Affiliation(s)
- Kathrin Lauber
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Anna B Gilmore
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
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Montiel I, Cuervo-Cazurra A, Park J, Antolín-López R, Husted BW. Implementing the United Nations' Sustainable Development Goals in international business. JOURNAL OF INTERNATIONAL BUSINESS STUDIES 2021; 52:999-1030. [PMID: 34054154 PMCID: PMC8144281 DOI: 10.1057/s41267-021-00445-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/08/2021] [Accepted: 04/10/2021] [Indexed: 06/02/2023]
Abstract
Building on the concept of externalities, we propose an explanation of how multinationals can contribute to the enactment of the United Nations' Sustainable Development Goals as part of their ordinary investments. First, we suggest grouping the 17 Sustainable Development Goals into six categories based on whether they increase positive externalities - knowledge, wealth, or health - or reduce negative externalities - the overuse of natural resources, harm to social cohesion, or overconsumption. Second, we propose placing these categories within an extended value chain to facilitate their implementation. Third, we argue that multinationals' internal investments in host-country subsidiaries to improve their competitiveness contribute to addressing externalities in host-country communities, while external investments in host communities to solve underdevelopment generate competitiveness externalities on host-country subsidiaries.
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Affiliation(s)
- Ivan Montiel
- Zicklin School of Business, Baruch College, The City University of New York, 55 Lexington Ave at 24th Street, New York, NY 10010 USA
| | - Alvaro Cuervo-Cazurra
- D’Amore-McKim School of Business, Northeastern University, 313 Hayden Hall, 360 Huntington Avenue, Boston, MA 02115 USA
| | - Junghoon Park
- Zicklin School of Business, Baruch College, The City University of New York, 55 Lexington Ave at 24th Street, New York, NY 10010 USA
| | - Raquel Antolín-López
- Department of Economics and Business Administration, University of Almeria, Ctra. Sacramento s/n, 04120 La Cañada de San Urbano, Almería Spain
| | - Bryan W. Husted
- EGADE Business School, Tecnológico de Monterrey, Eugenio Garza Lagüera & Rufino Tamayo, Valle Oriente, 66269 San Pedro Garza García, Nuevo León Mexico
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Ultra-processed food targets bone quality via endochondral ossification. Bone Res 2021; 9:14. [PMID: 33637698 PMCID: PMC7910299 DOI: 10.1038/s41413-020-00127-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 10/11/2020] [Accepted: 11/01/2020] [Indexed: 01/31/2023] Open
Abstract
Ultra-processed foods have known negative implications for health; however, their effect on skeletal development has never been explored. Here, we show that young rats fed ultra-processed food rich in fat and sugar suffer from growth retardation due to lesions in their tibial growth plates. The bone mineral density decreases significantly, and the structural parameters of the bone deteriorate, presenting a sieve-like appearance in the cortices and poor trabecular parameters in long bones and vertebrae. This results in inferior mechanical performance of the entire bone with a high fracture risk. RNA sequence analysis of the growth plates demonstrated an imbalance in extracellular matrix formation and degradation and impairment of proliferation, differentiation and mineralization processes. Our findings highlight, for the first time, the severe impact of consuming ultra-processed foods on the growing skeleton. This pathology extends far beyond that explained by the known metabolic effects, highlighting bone as a new target for studies of modern diets.
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Vergeer L, Vanderlee L, Sacks G, Robinson E, Mackay S, Young L, Mulligan C, L'Abbé MR. The Development and Application of a Tool for Quantifying the Strength of Voluntary Actions and Commitments of Major Canadian Food Companies to Improve the Nutritional Quality of Their Products. Curr Dev Nutr 2020; 4:nzaa151. [PMID: 33134791 PMCID: PMC7580911 DOI: 10.1093/cdn/nzaa151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Canada's food supply is high in nutrients of public health concern, contributing to poor diet quality and increased noncommunicable disease risk. Food companies shape the healthfulness of the food supply, yet little is known about companies' voluntary actions and commitments concerning product (re)formulation. OBJECTIVE This study aimed to develop and apply a tool for quantifying the strength of voluntary actions and commitments of major food companies in Canada to improve the healthfulness of their products. METHODS Twenty-two top packaged food and beverage companies were selected based on Canadian market share. Recent actions and/or commitments to reduce energy/portion sizes, sodium, saturated fat, trans fat, and sugars were identified from company websites and public documents, verified by company representatives (where possible), and scored based on breadth of application across the product portfolio, magnitude(s) of reduction, measurability, nutritional significance, national/global applicability, and transparency using the Food Company Reformulation scoring tool. Companies offering beverages only (n = 4) were not assessed for sodium, saturated fat, or trans fat (re)formulation. RESULTS Seventeen of 22 companies reported reductions and/or commitments concerning sodium (72.2%, n = 13/18), trans fat (61.1%, n = 11/18), sugars (59.1%, n = 13/22), saturated fat (55.6%, n = 10/18), and/or energy/portion sizes (50.0%, n = 11/22). Scores ranged from 0/155 to 122/155 for food companies (median = 49/155) and 0/65 to 42/65 for beverage companies (median = 17/65). Companies generally performed best for sodium reduction (median = 21/32; range = 0-32) and poorest for energy/portion-size reductions (median = 2/30; range = 0-24). Multinational companies had significantly higher total scores than domestic companies (P = 0.004). Higher total scores were associated with greater market shares in the beverage manufacturing sector (P = 0.04), but not packaged food (P = 0.50). CONCLUSIONS Many of Canada's leading food companies report limited or no action to reduce nutrients of concern in their products, suggesting a need for government intervention and strengthened accountability mechanisms to encourage alignment of reformulation efforts with government and expert recommendations.
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Affiliation(s)
- Laura Vergeer
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lana Vanderlee
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- École de Nutrition, Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels, Université Laval, Pavillon des Services, Quebec City, Quebec, Canada
| | - Gary Sacks
- Global Obesity Centre (GLOBE), Deakin University, Burwood, Victoria, Australia
| | - Ella Robinson
- Global Obesity Centre (GLOBE), Deakin University, Burwood, Victoria, Australia
| | - Sally Mackay
- Department of Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Grafton, Auckland, New Zealand
| | - Leanne Young
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Grafton, Auckland, New Zealand
| | - Christine Mulligan
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mary R L'Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Lauber K, Ralston R, Mialon M, Carriedo A, Gilmore AB. Non-communicable disease governance in the era of the sustainable development goals: a qualitative analysis of food industry framing in WHO consultations. Global Health 2020; 16:76. [PMID: 32847604 PMCID: PMC7448499 DOI: 10.1186/s12992-020-00611-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 08/19/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The UN system's shift towards multistakeholder governance, now embedded in the Sustainable Development Goals (SDGs), invites a broad range of actors, including the private sector, to the policymaking table. Although the tobacco industry is formally excluded from engagement, this approach provides opportunities for other unhealthy commodity industries to influence the World Health Organization's (WHO's) non-communicable disease (NCD) agenda. Focusing on the food industry, this research maps which actors engaged with WHO consultations, and critically examines actors' policy and governance preferences as well as the framing they employ to promote these preferences in the global context. METHODS All written responses from food industry actors to publicly available NCD-relevant WHO consultations held between September 2015 and September 2018 were identified, totalling forty-five responses across five consultations. A qualitative frame analysis was conducted to identify policy positions expressed by respondents, as well as arguments and frames used to do so. RESULTS Though no individual companies responded to the consultations, the majority of participating business associations had some of the largest multinational food corporations as members. Respondents overarchingly promoted non-statutory approaches and opposed statutory regulation and conflict of interest safeguards. To this purpose, they framed the food industry as a legitimate and necessary partner in policymaking, differentiating themselves from the tobacco industry and referencing a history of successful collaboration, while also invoking multistakeholder norms and good governance principles to portray collaboration as required. Respondents contrasted this with the limits of WHO's mandate, portraying it as out of step with the SDGs and framing NCD decision-making as a matter of national sovereignty. CONCLUSION We observed that the UN's call for partnerships to support the SDGs is invoked to defend corporate access to NCD policy. This highlights the need for more cautious approaches which are mindful of the commercial determinants of health. Systematic opposition to regulation and to governance approaches which may compromise commercial actors' insider role in global health by food industry actors shown here, and the strategic use of the Sustainable Development agenda to this purpose, raises questions about the value of collaboration from the perspective of international health agencies such as WHO.
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Affiliation(s)
- Kathrin Lauber
- Tobacco Control Research Group, University of Bath, Bath, UK.
- SPECTRUM Consortium, Edinburgh, UK.
| | - Rob Ralston
- Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Mélissa Mialon
- School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Anna B Gilmore
- Tobacco Control Research Group, University of Bath, Bath, UK
- SPECTRUM Consortium, Edinburgh, UK
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Athavale P, Hoeft K, Dalal RM, Bondre AP, Mukherjee P, Sokal-Gutierrez K. A qualitative assessment of barriers and facilitators to implementing recommended infant nutrition practices in Mumbai, India. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2020; 39:7. [PMID: 32718334 PMCID: PMC7385866 DOI: 10.1186/s41043-020-00215-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 03/25/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Childhood malnutrition has been a longstanding crisis in Mumbai, India. Despite national IYCF (Infant Young Child Feeding) guidelines to promote best practices for infant/toddler feeding, nearly one-third of children under age five are stunted or underweight. To improve child nutrition, interventions should address the cultural, social, and environmental influences on infant feeding practices. This study is an in-depth qualitative assessment of family barriers and facilitators to implementing recommended nutrition practices in two Mumbai slum communities, within the context of an existing nutrition education-based intervention by a local non-governmental non-profit organization. METHODS The population was purposively sampled to represent a variety of household demographics. Data were collected through 33 in-depth semi-structured interviews with caregivers (mothers and paternal grandmothers) of children age 0-2 years. Transcripts were translated and transcribed, and analyzed using qualitative analysis procedures and software. RESULTS A complex set of barriers and facilitators influence mothers'/caregivers' infant-toddler feeding practices. Most infants were fed complementary foods and non-nutritious processed snacks, counter to IYCF recommendations. Key barriers included: lack of nutrition knowledge and experience, receiving conflicting messages from different sources, limited social support, and poor self-efficacy for maternal decision-making. Key facilitators included: professional nutrition guidance, personal self-efficacy and empowerment, and family support. Interventions to improve child nutrition should address mothers'/caregivers' key barriers and facilitators to recommended infant-toddler feeding practices. CONCLUSIONS Nutrition interventions should prioritize standard messaging across healthcare providers, engage all family members, target prevention of early introduction of sugary and non-nutritious processed foods, and strengthen maternal self-efficacy for following IYCF recommended guidelines.
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Affiliation(s)
| | - Kristin Hoeft
- Department of Preventive & Restorative Dental Sciences and Center to Address Children’s Oral Health, University of California, San Francisco, USA
| | - Rupal M. Dalal
- Foundation for Mother & Child Health, 93/C Kamgar Nagar, SG Barve Marg, Kurla East, Mumbai, Maharashtra 400024 India
| | - Ameya P. Bondre
- New Horizons Health and Research Foundation (NHF), Unit No 10, Techniplex II, Veer Savarkar Flyover Bridge, Off S V Road, Opposite Hotel Grand Sarovar, Goregaon West, Mumbai, 400062 India
| | - Piyasree Mukherjee
- Foundation for Mother & Child Health, 93/C Kamgar Nagar, SG Barve Marg, Kurla East, Mumbai, Maharashtra 400024 India
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Processed Baobab (Adansonia digitata L.) Food Products in Malawi: From Poor Men’s to Premium-Priced Specialty Food? FORESTS 2020. [DOI: 10.3390/f11060698] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The baobab tree (Adansonia digitata L.) is an important source of non-timber forest products in sub-Saharan Africa. Its fruits contain high amounts of vitamin C, calcium, and dietary fibre. In addition, other parts of the tree are traditionally used for human consumption, particularly during lean seasons. In line with the increasing demand for natural, healthy, and nutritious food products, the baobab has great potential to contribute to human nutrition and rural livelihoods. In Malawi, where demand for baobab has substantially increased within the last decade, baobab fruits are being processed into a variety of food and non-food products, such as fruit juice, ice-lollies, sweets, and cosmetics. Yet, information on the sociodemographic background and quality preferences of baobab consumers is scanty. The current study, therefore, aimed to (1) map the diversity of baobab products available in Malawi; (2) determine consumer segments and their preferences for the most common baobab food products; and (3) examine the contribution of major attributes of processed baobab food products on their price. We employed a mixed-methods approach including the analysis of 132 baobab products and a survey of 141 consumers in formal and informal retail outlets, adopting multistage and purposive sampling. Qualitative and quantitative data were analysed using cluster analysis, cross tabulation, and hedonic regression. Results pointed to two distinct consumer segments for baobab food products, largely following the formal–informal product divide currently existing in Malawi. Both segments clearly differed with regard to preferred product attributes. We also showed that extrinsic product attributes such as packaging quality, labelling, conformity with food standards, or health claims provided distinct differentiation potential for baobab food manufacturers. In addition to providing empirical evidence for the transition of baobab food products into higher-value market segments, our results can help food processing enterprises to improve the composition and marketing of their baobab products.
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Spires M, Berggreen-Clausen A, Kasujja FX, Delobelle P, Puoane T, Sanders D, Daivadanam M. Snapshots of Urban and Rural Food Environments: EPOCH-Based Mapping in a High-, Middle-, and Low-Income Country from a Non-Communicable Disease Perspective. Nutrients 2020; 12:E484. [PMID: 32075027 PMCID: PMC7071357 DOI: 10.3390/nu12020484] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 02/05/2020] [Accepted: 02/10/2020] [Indexed: 11/23/2022] Open
Abstract
A changing food environment is implicated as a primary contributor to the increasing levels of non-communicable diseases (NCDs). This study aimed to generate snapshots of selected external food environments to inform intervention strategies for NCD prevention in three countries: Uganda (low income), South Africa (middle income) and Sweden (high income), with one matched pair of urban-rural sites per country. Fifty formal and informal food retail outlets were assessed, and descriptive and comparative statistical analyses were performed. We found that formal food retail outlets in these countries had both positive and negative traits, as they were the main source of basic food items but also made unhealthy food items readily available. The Ugandan setting had predominantly informal outlets, while the Swedish setting had primarily formal outlets and South Africa had both, which fits broadly into the traditional (Uganda), mixed (South Africa) and modern (Sweden) conceptualized food systems. The promotion of unhealthy food products was high in all settings. Uganda had the highest in-community advertising, followed by South Africa and Sweden with the lowest, perhaps related to differences in regulation and implementation. The findings speak to the need to address contextual differences in NCD-related health interventions by incorporating strategies that address the food environment, and for a critical look at regulations that tackle key environment-related factors of food on a larger scale.
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Affiliation(s)
- Mark Spires
- School of Public Health, University of the Western Cape, Bellville 7535, South Africa; (M.S.); (P.D.); (T.P.)
- Centre for Food Policy, City, University of London, London EC1R 1UW, UK
| | | | - Francis Xavier Kasujja
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda;
| | - Peter Delobelle
- School of Public Health, University of the Western Cape, Bellville 7535, South Africa; (M.S.); (P.D.); (T.P.)
- Chronic Disease Initiative for Africa, University of Cape Town, Cape Town 7925, South Africa
- Department of Public Health, Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - Thandi Puoane
- School of Public Health, University of the Western Cape, Bellville 7535, South Africa; (M.S.); (P.D.); (T.P.)
| | - David Sanders
- School of Public Health, University of the Western Cape, Bellville 7535, South Africa; (M.S.); (P.D.); (T.P.)
| | - Meena Daivadanam
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, 75122 Uppsala, Sweden;
- Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden
- International Maternal and Child Health, Department of Women’s and Children’s Health, Uppsala University, 75237 Uppsala, Sweden
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Kraak VI, Rincón-Gallardo Patiño S, Sacks G. An accountability evaluation for the International Food & Beverage Alliance's Global Policy on Marketing Communications to Children to reduce obesity: A narrative review to inform policy. Obes Rev 2019; 20 Suppl 2:90-106. [PMID: 31034139 DOI: 10.1111/obr.12859] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 03/08/2019] [Accepted: 03/11/2019] [Indexed: 11/30/2022]
Abstract
United Nations (UN) organizations have urged governments to restrict the marketing of unhealthy food and nonalcoholic beverage products to children. This study conducted an accountability evaluation for the International Food & Beverage Alliance's (IFBA's) Global Policy on Marketing Communications to Children (Global Policy) compared with UN and other best-practice recommendations. We used the National Academy of Medicine's LEAD (ie, locate, evaluate, assemble evidence to inform decisions) framework to identify evidence (January 2004 to October 2018). We assigned a progress score (ie, none, limited, some, extensive) for five accountability steps. No progress was made to appoint an empowered body to evaluate IFBA's Global Policy. IFBA and the Access to Nutrition Foundation made some progress to take and share the account. Diverse actors made no progress to hold IFBA to account for nonadherence or to strengthen accountability structures for future compliance. IFBA could strengthen its Global Policy to align with best practices. UN organizations and other stakeholders should encourage IFBA firms to restrict the marketing of unhealthy foods and beverages to reduce children's obesity risk. This evaluation is relevant to all firms and industry associations that market products to children that undermine their diet and health.
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Affiliation(s)
- Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | | | - Gary Sacks
- Global Obesity Centre (GLOBE), Deakin University, Geelong, Victoria, Australia
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Nieto C, Rodríguez E, Sánchez-Bazán K, Tolentino-Mayo L, Carriedo-Lutzenkirchen A, Vandevijvere S, Barquera S. The INFORMAS healthy food environment policy index (Food-EPI) in Mexico: An assessment of implementation gaps and priority recommendations. Obes Rev 2019; 20 Suppl 2:67-77. [PMID: 30618143 DOI: 10.1111/obr.12814] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/09/2018] [Accepted: 10/26/2018] [Indexed: 11/28/2022]
Abstract
Mexico is one of the countries with the highest prevalence of obesity and recently declared a national epidemic of diabetes. Healthy food environments have the potential to improve the diet of the population and decrease the burden of disease. The aim of the study was to assess the efforts of the Mexican Government towards creating healthier food environments using the Healthy Food Environment Policy Index (Food-EPI). The tool was developed by the International Network for Food and Obesity/Non-communicable Diseases Research, Monitoring and Action Support (INFORMAS). Then, it was adapted to the Latin-American context and assessed the components of policy and infrastructure support. Actors from academia, civil society, government, and food industry assessed the level of implementation of food policies compared with international best practices. Actors were classified as (1) independents from academia and civil society (n = 36), (2) government (n = 28), and (3) industry (n = 6). The indicators with the highest percentage of implementation were those related to monitoring and intelligence. Those related to food retail were rated lowest. When stratified by type of actor, the government officials rated several indicators at a higher percentage of implementation compared with independent actors. None of the indicators were rated at high implementation. Government officials and independent actors agreed upon nine priority actions to improve the food environment in Mexico. These actions have the potential to improve government commitment and advocacy efforts to create healthier food environments.
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Affiliation(s)
- Claudia Nieto
- Centro de Investigación en Nutrición y Salud, Instituto Nacional De Salud Pública, Cuernavaca, Morelos, Mexico
| | - Estefania Rodríguez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional De Salud Pública, Cuernavaca, Morelos, Mexico
| | - Karina Sánchez-Bazán
- Centro de Investigación en Nutrición y Salud, Instituto Nacional De Salud Pública, Cuernavaca, Morelos, Mexico
| | - Lizbeth Tolentino-Mayo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional De Salud Pública, Cuernavaca, Morelos, Mexico
| | - Angela Carriedo-Lutzenkirchen
- Faculty of Public Health and Policy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional De Salud Pública, Cuernavaca, Morelos, Mexico
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The food environment in Latin America: a systematic review with a focus on environments relevant to obesity and related chronic diseases. Public Health Nutr 2019; 22:3447-3464. [PMID: 31666140 DOI: 10.1017/s1368980019002891] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Food environments may be contributing to the rapid increase in obesity occurring in most Latin American (LA) countries. The present study reviews literature from LA that (i) describes the food environment and policies targeting the food environment (FEP); and (ii) analytic studies that investigate associations between the FEP and dietary behaviours, overweight/obesity and obesity related chronic diseases. We focus on six dimensions of the FEP: food retail, provision, labelling, marketing, price and composition. DESIGN Systematic literature review. Three databases (Web of Science, SciELO, LILACS) were searched, from 1 January 1999 up to July 2017. Two authors independently selected the studies. A narrative synthesis was used to summarize, integrate and interpret findings. SETTING Studies conducted in LA countries. PARTICIPANTS The search yielded 2695 articles of which eighty-four met inclusion criteria. RESULTS Most studies were descriptive and came from Brazil (61 %), followed by Mexico (18 %) and Guatemala (6 %). Studies were focused primarily on retail/provision (n 27), marketing (n 16) and labelling (n 15). Consistent associations between availability of fruit and vegetable markets and higher consumption of fruits and vegetables were found in cross-sectional studies. Health claims in food packaging were prevalent and mostly misleading. There was widespread use of marketing strategies for unhealthy foods aimed at children. Food prices were lower for processed relative to fresh foods. Some studies documented high sodium in industrially processed foods. CONCLUSIONS Gaps in knowledge remain regarding policy evaluations, longitudinal food retail studies, impacts of food price on diet and effects of digital marketing on diet/health.
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Abstract
Recently, processed foods received negative images among consumers and experts regarding food-health imbalance. This stresses the importance of the food processing-nutrition interface and its relevance within the diet-health debates. In this review, we approach the related questions in a 3-fold way. Pointing out the distinguished role food processing has played in the development of the human condition and during its 1.7 million year old history, we show the function of food processing for the general design principles of food products. Secondly, a detailed analysis of consumer related design principles and processing reveals questions remaining from the historical transformation from basic cooking into advanced food technology. As a consequence, we analyze new and emerging technologies in relation to their contributions to food-health impacts. During the last 35 years, new and emerging food technologies have initiated a paradigm shift away from conventional process methodologies to gentler, non-thermal processing. Reducing the existing uncertainties in the assessment of impact of technology like "minimal processing," we propose the use of the newly established ISO standard for natural food ingredients as a "reference point." Finally, we assess the usefulness of recently proposed classification systems, e.g., NOVA classification, based on comprehensive insights of recently published nutritional analysis of those classifications. This paper calls for a radical change and worldwide adaptation of the key research and developmental areas tackling the grand challenges in our food systems.
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Affiliation(s)
- Dietrich Knorr
- Food Biotechnology and Food Process Engineering, Technical University Berlin, Berlin, Germany
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16
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Ferretti F, Mariani M. Sugar-sweetened beverage affordability and the prevalence of overweight and obesity in a cross section of countries. Global Health 2019; 15:30. [PMID: 30999931 PMCID: PMC6472017 DOI: 10.1186/s12992-019-0474-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 04/03/2019] [Indexed: 11/10/2022] Open
Abstract
Background A key component of ‘obesogenic environments’ is the ready availability of convenient, calorie-dense foods, in the form of hyper-palatable and relatively inexpensive ultra-processed products. Compelling evidence indicates that the regular consumption of soft drinks, specifically carbonated and non-carbonated sugar-sweetened beverages (SSBs), has a significant impact on the prevalence of overweight and obesity. However, to implement country-level effective prevention programmes we need to supplement this evidence with quantitative knowledge of the relationships between overweight/obesity and the main determinants of SSB consumption, notably SSB prices and consumers’ disposable income. Method Affordability considers the simultaneous effects of both price and disposable income on the buying decision. The purpose of this study was to investigate the effect of SSB affordability on the consumers’ purchasing behaviour and weight-related health outcomes. Our study was divided into three parts. First, we computed SSB consumption and affordability for approximately 150 countries worldwide. Second, we estimated a demand function for SSBs to assess the impact of affordability on consumption at the country level. Third, we used a multivariate regression model and country data on the prevalence of overweight and obesity to test the role of SSB affordability in the current obesity epidemic. Results The analysis reveals that SSB affordability: 1) showed both a large variability across countries and a clear tendency to increase substantially with the level of economic development; 2) played a key role in determining cross-country differences in the amount of soft drink consumed per capita; and 3) was significantly associated with the prevalence rates of both overweight and obesity. Specifically, we show that a 10 % increase in SSB affordability was associated, on average, with approximately 0.4 more overweight/obese adults per 100 inhabitants. Conclusions By controlling for the main possible confounding factors, our results clearly indicate that affordability is a major driver of purchasing behaviours and is significantly associated with the prevalence rates of both overweight and obesity. We thus suggest a fiscal approach to curb SSB consumption based on the effectiveness of ‘soda taxes’ to affect the long-term dynamic of SSB affordability. Electronic supplementary material The online version of this article (10.1186/s12992-019-0474-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Fabrizio Ferretti
- School of Social Sciences, Department of Communication and Economics, University of Modena and Reggio Emilia, Palazzo Dossetti, Viale Allegri, 9, 42121, Reggio Emilia, Italy.
| | - Michele Mariani
- School of Social Sciences, Department of Communication and Economics, University of Modena and Reggio Emilia, Palazzo Dossetti, Viale Allegri, 9, 42121, Reggio Emilia, Italy
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17
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Bandy L, Adhikari V, Jebb S, Rayner M. The use of commercial food purchase data for public health nutrition research: A systematic review. PLoS One 2019; 14:e0210192. [PMID: 30615664 PMCID: PMC6322827 DOI: 10.1371/journal.pone.0210192] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 12/17/2018] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Traditional methods of dietary assessment have their limitations and commercial sources of food sales and purchase data are increasingly suggested as an additional source to measuring diet at the population level. However, the potential uses of food sales data are less well understood. The aim of this review is to establish how sales data on food and soft drink products from third-party companies have been used in public health nutrition research. METHODS A search of five electronic databases was conducted in February-March 2018 for studies published in peer-reviewed journals that had used food sales or purchase data from a commercial company to analyse trends and patterns in food purchases or in the nutritional composition of foods. Study quality was evaluated using the National Institutes of Health (NIH) Quality Assessment Tool for Cohort and Cross-Sectional Studies. RESULTS Of 2919 papers identified in the search, 68 were included. The selected studies used sales or purchase data from four companies: Euromonitor, GfK, Kantar and Nielsen. Sales and purchase data have been used to evaluate interventions, including the impact of the saturated fat tax in Denmark, the soft drink and junk food taxes in Mexico and supplemental nutrition programmes in the USA. They have also been used to identify trends in the nutrient composition of foods over time and patterns in food purchasing, including socio-demographic variations in purchasing. CONCLUSION Food sales and purchase data are a valuable tool for public health nutrition researchers and their use has increased markedly in the last four years, despite the cost of access, the lack of transparency on data-collection methods and restrictions on publication. The availability of product and brand-level sales data means they are particularly useful for assessing how changes by individual food companies can impact on diet and public health.
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Affiliation(s)
- Lauren Bandy
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Vyas Adhikari
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Susan Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Mike Rayner
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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18
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19
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Affiliation(s)
- José Miguel Aguilera
- Dept. of Chemical and Bioprocess Engineering; Pontificia Universidad Católica de Chile; Chile
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20
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Gibney MJ, Forde CG, Mullally D, Gibney ER. Ultra-processed foods in human health: a critical appraisal. Am J Clin Nutr 2017; 106:717-724. [PMID: 28793996 DOI: 10.3945/ajcn.117.160440] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 07/12/2017] [Indexed: 11/14/2022] Open
Abstract
The NOVA classification of foods proposes 4 categories: unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods and drinks (UPFDs). It is argued that the latter relies heavily on modifications to foods, resulting in enhanced amounts of salt, added sugar, and fat as well as the use of additives in an attempt to make this food category highly palatable. It further argues that controlling food processing, rather than examining nutrients, should be foremost in shaping nutrition policy. This commentary challenges many of the basic arguments of using the NOVA food classification system to examine the link between food and health. We believe that there is no evidence to uphold the view that UPFDs give rise to hyperpalatable foods associated with a quasi-addictive effect and that the prevailing European Union and US data fail to uphold the assertion that UPFDs, which dominate energy intake, give rise to dietary patterns that are low in micronutrients. With regard to the use of the NOVA food classification in the development of food-based dietary guidelines, we show that the very broad definition of UPFDs makes this impossible. Finally, the available evidence does not support the view that the globalization of food is the driver of increased intakes of UPFDs in low- to middle-income countries but rather that this is driven by small indigenous companies. On balance, therefore, there seems to be little advantage from the use of the NOVA classification compared with the current epidemiologic approach, which relies on the linkage of nutrient intakes to chronic disease with subsequent identification of foods that merit consideration in public health nutrition strategies.
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Affiliation(s)
- Michael J Gibney
- UCD Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Ciarán G Forde
- Clinical Nutrition Research Centre, A*STAR Singapore Institute for Clinical Sciences, and.,National University Health System, Centre for Translational Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Deirdre Mullally
- UCD Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Eileen R Gibney
- UCD Institute of Food and Health, University College Dublin, Dublin, Ireland;
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21
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Rush EC, Yan MR. Evolution not Revolution: Nutrition and Obesity. Nutrients 2017; 9:nu9050519. [PMID: 28531097 PMCID: PMC5452249 DOI: 10.3390/nu9050519] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 05/13/2017] [Accepted: 05/16/2017] [Indexed: 02/03/2023] Open
Abstract
The increasing prevalence of obesity over the course of life is a global health challenge because of its strong and positive association with significant health problems such as type 2 diabetes, cardiovascular disease, stroke, and some cancers. The complex causes and drivers of obesity include genetic factors, social, ecological and political influences, food production and supply, and dietary patterns. Public health messages and government food and activity guidelines have little impact; the retail food environment has many low-priced, nutrient-poor, but energy-dense products and there is a gap between what an individual knows and what they do. Public health and education services need legislation to mandate supportive environments and promote food literacy. Two New Zealand case studies of proof-of-principle of positive change are described: Project Energize and Under 5 Energize as exemplars of school environment change, and the development of the Nothing Else™ healthier snack bar as an example of working with the food industry. Changes in food literacy alongside food supply will contribute in the long term to positive effects on the future prevalence of obesity and the onset of non-communicable disease. More cross-disciplinary translational research to inform how to improve the food supply and food literacy will improve the health and wellbeing of the economy and the population.
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Affiliation(s)
- Elaine C Rush
- AUT Food Network, Auckland University of Technology, Auckland 1142, New Zealand.
| | - Mary R Yan
- AUT Food Network, Auckland University of Technology, Auckland 1142, New Zealand.
- Community and Social Sciences, Unitec Institute of Technology, Auckland 1025, New Zealand.
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22
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Baker P, Friel S. Food systems transformations, ultra-processed food markets and the nutrition transition in Asia. Global Health 2016; 12:80. [PMID: 27912772 PMCID: PMC5135831 DOI: 10.1186/s12992-016-0223-3] [Citation(s) in RCA: 151] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 11/23/2016] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Attracted by their high economic growth rates, young and growing populations, and increasingly open markets, transnational food and beverage corporations (TFBCs) are targeting Asian markets with vigour. Simultaneously the consumption of ultra-processed foods high in fat, salt and glycaemic load is increasing in the region. Evidence demonstrates that TFBCs can leverage their market power to shape food systems in ways that alter the availability, price, nutritional quality, desirability and ultimately consumption of such foods. This paper describes recent changes in Asian food systems driven by TFBCs in the retail, manufacturing and food service sectors and considers the implications for population nutrition. METHOD Market data for each sector was sourced from Euromonitor International for four lower-middle income, three upper-middle income and five high-income Asian countries. Descriptive statistics were used to describe trends in ultra-processed food consumption (2000-2013), packaged food retail distribution channels (1999-2013), 'market transnationalization' defined as the market share held by TFBCs relative to domestic firms (2004-2013), and 'market concentration' defined as the market share and thus market power held by the four leading firms (2004-2013) in each market. RESULTS Ultra-processed food sales has increased rapidly in most middle-income countries. Carbonated soft drinks was the leading product category, in which Coca-Cola and PepsiCo had a regional oligopoly. Supermarkets, hypermarkets and convenience stores were becoming increasingly dominant as distribution channels for packaged foods throughout the region. Market concentration was increasing in the grocery retail sector in all countries. Food service sales are increasing in all countries led by McDonalds and Yum! Brands. However, in all three sectors TFBCs face strong competition from Asian firms. CONCLUSIONS Overall, the findings suggest that market forces are likely to be significant but variable drivers of Asia's nutrition transition. The carbonated soft drink market is the most highly concentrated and likely to be most harmful to population nutrition. The grocery retail sector is, in terms of increasing market concentration and thus market power, likely to be the most important driver of ongoing food systems change and ultra-processed food sales in the region. Given it's rapid growth, the food service sector will also contribute significantly to ongoing dietary change.
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Affiliation(s)
- Phillip Baker
- Health, Equity and Governance Group, School of Regulation and Global Governance (RegNet), Coombs Extension Building, Australian National University, Canberra, Australia
| | - Sharon Friel
- Health, Equity and Governance Group, School of Regulation and Global Governance (RegNet), Coombs Extension Building, Australian National University, Canberra, Australia
- Menzies Centre for Health Policy, Australian National University, Canberra, Australia
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23
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Leroy P, Réquillart V, Soler LG, Enderli G. An assessment of the potential health impacts of food reformulation. Eur J Clin Nutr 2015; 70:694-9. [PMID: 26669572 DOI: 10.1038/ejcn.2015.201] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 07/31/2015] [Accepted: 09/29/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Policies focused on food quality are intended to facilitate healthy choices by consumers, even those who are not fully informed about the links between food consumption and health. The goal of this paper is to evaluate the potential impact of such a food reformulation scenario on health outcomes. SUBJECTS/METHODS We first created reformulation scenarios adapted to the French characteristics of foods. After computing the changes in the nutrient intakes of representative consumers, we determined the health effects of these changes. To do so, we used the DIETRON health assessment model, which calculates the number of deaths avoided by changes in food and nutrient intakes. RESULTS Depending on the reformulation scenario, the total impact of reformulation varies between 2408 and 3597 avoided deaths per year, which amounts to a 3.7-5.5% reduction in mortality linked to diseases considered in the DIETRON model. The impacts are much higher for men than for women and much higher for low-income categories than for high-income categories. These differences result from the differences in consumption patterns and initial disease prevalence among the various income categories. CONCLUSIONS Even without any changes in consumers' behaviors, realistic food reformulation may have significant health outcomes.
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Affiliation(s)
- P Leroy
- INRA Aliss UR 1303, Ivry sur Seine, France
| | - V Réquillart
- Toulouse School of Economics (GREMAQ-INRA), Toulouse, France
| | - L-G Soler
- INRA Aliss UR 1303, Ivry sur Seine, France
| | - G Enderli
- INRA Aliss UR 1303, Ivry sur Seine, France
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24
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Jensen JD, Ronit K. Obesity, International Food and Beverage Industries, and Self-Regulation: The Fragmentation of Information Strategies. WORLD MEDICAL & HEALTH POLICY 2015. [DOI: 10.1002/wmh3.145] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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25
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Swinburn B, Kraak V, Rutter H, Vandevijvere S, Lobstein T, Sacks G, Gomes F, Marsh T, Magnusson R. Strengthening of accountability systems to create healthy food environments and reduce global obesity. Lancet 2015; 385:2534-45. [PMID: 25703108 DOI: 10.1016/s0140-6736(14)61747-5] [Citation(s) in RCA: 194] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
To achieve WHO's target to halt the rise in obesity and diabetes, dramatic actions are needed to improve the healthiness of food environments. Substantial debate surrounds who is responsible for delivering effective actions and what, specifically, these actions should entail. Arguments are often reduced to a debate between individual and collective responsibilities, and between hard regulatory or fiscal interventions and soft voluntary, education-based approaches. Genuine progress lies beyond the impasse of these entrenched dichotomies. We argue for a strengthening of accountability systems across all actors to substantially improve performance on obesity reduction. In view of the industry opposition and government reluctance to regulate for healthier food environments, quasiregulatory approaches might achieve progress. A four step accountability framework (take the account, share the account, hold to account, and respond to the account) is proposed. The framework identifies multiple levers for change, including quasiregulatory and other approaches that involve government-specified and government-monitored progress of private sector performance, government procurement mechanisms, improved transparency, monitoring of actions, and management of conflicts of interest. Strengthened accountability systems would support government leadership and stewardship, constrain the influence of private sector actors with major conflicts of interest on public policy development, and reinforce the engagement of civil society in creating demand for healthy food environments and in monitoring progress towards obesity action objectives.
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Affiliation(s)
- Boyd Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand; WHO Collaborating Centre for Obesity Prevention, Deakin University, Victoria, Australia.
| | - Vivica Kraak
- WHO Collaborating Centre for Obesity Prevention, Deakin University, Victoria, Australia; Department of Human Nutrition, Foods & Exercise, Virginia Tech, Blacksburg, VA, USA
| | - Harry Rutter
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Gary Sacks
- WHO Collaborating Centre for Obesity Prevention, Deakin University, Victoria, Australia
| | - Fabio Gomes
- National Cancer Institute of Brazil, Ministry of Health, Rio de Janeiro, Brazil
| | | | - Roger Magnusson
- Sydney Law School, University of Sydney, Sydney, NSW, Australia
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26
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Lobstein T, Jackson-Leach R, Moodie ML, Hall KD, Gortmaker SL, Swinburn BA, James WPT, Wang Y, McPherson K. Child and adolescent obesity: part of a bigger picture. Lancet 2015; 385:2510-20. [PMID: 25703114 PMCID: PMC4594797 DOI: 10.1016/s0140-6736(14)61746-3] [Citation(s) in RCA: 672] [Impact Index Per Article: 74.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The prevalence of childhood overweight and obesity has risen substantially worldwide in less than one generation. In the USA, the average weight of a child has risen by more than 5 kg within three decades, to a point where a third of the country's children are overweight or obese. Some low-income and middle-income countries have reported similar or more rapid rises in child obesity, despite continuing high levels of undernutrition. Nutrition policies to tackle child obesity need to promote healthy growth and household nutrition security and protect children from inducements to be inactive or to overconsume foods of poor nutritional quality. The promotion of energy-rich and nutrient-poor products will encourage rapid weight gain in early childhood and exacerbate risk factors for chronic disease in all children, especially those showing poor linear growth. Whereas much public health effort has been expended to restrict the adverse marketing of breastmilk substitutes, similar effort now needs to be expanded and strengthened to protect older children from increasingly sophisticated marketing of sedentary activities and energy-dense, nutrient-poor foods and beverages. To meet this challenge, the governance of food supply and food markets should be improved and commercial activities subordinated to protect and promote children's health.
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Affiliation(s)
- Tim Lobstein
- World Obesity Federation (formerly the International Association for the Study of Obesity), London, UK.
| | - Rachel Jackson-Leach
- World Obesity Federation (formerly the International Association for the Study of Obesity), London, UK
| | - Marjory L Moodie
- Deakin Health Economics, Deakin University, Melbourne, VIC, Australia
| | - Kevin D Hall
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Steven L Gortmaker
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
| | - Boyd A Swinburn
- WHO Collaborating Centre for Obesity Prevention Deakin University, Melbourne, VIC, Australia; School of Population Health, University of Auckland, New Zealand
| | - W Philip T James
- World Obesity Federation (formerly the International Association for the Study of Obesity), London, UK
| | - Youfa Wang
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, NY, USA
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27
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Abstract
Open discourse and tolerance between the food industry and public sector is limited. As a result, the public and private sectors are reluctant to collaborate on pressing nutritional issues. Those in the public sector have never heard what they could do to encourage a food company's transition towards healthier foods and beverages, whereas many in the private sector dismissed policies and actions initiated within the public sector. During my career, I have sought to engage the broadest possible stakeholder groups required to develop evidence-based policies and with the aim of improving public health. My recent experience in industry confirmed my view about the need for scientific exchange regardless of the disagreements about policy. Open discourse and partnering is essential if we are to tackle complex food and health issues and improve the global food system. Private-public engagement can provide faster and more sustainable results than government alone without impacting profits. Moreover, a high-quality product in smaller portions will have higher profit margins than a bargain-sized product of lower quality. The food industry and private sector must come together to implement innovative strategies to address urgent nutritional needs.
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Affiliation(s)
- D Yach
- The Vitality Institute, New York, NY, USA
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28
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Ng SW, Dunford E. Complexities and opportunities in monitoring and evaluating US and global changes by the food industry. Obes Rev 2013; 14 Suppl 2:29-41. [PMID: 24103006 DOI: 10.1111/obr.12095] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 08/14/2013] [Indexed: 11/29/2022]
Abstract
In developed nations and increasingly in the rest of the world, a large proportion of people's diets comes from manufactured food sources and food not produced at home. These types of products are constantly changing and have significant nutrition and health implications for the world's population. However, researchers, public health workers and policy makers face major complexities in understanding what these changes are and their relationships to diet and health outcomes. This paper will describe some of the complexities faced in monitoring and evaluating the nutritional composition of food products and what it means for population health. Importantly, no existing food composition database is able to keep up with the continuous reformulation and introductions and removals of packaged foods and food services. The paper will also discuss opportunities to improve and update the monitoring and evaluation of changes made by each of these key sectors of the modern food supply and how these changes can influence the nutrients purchased or consumed across the globe. The focus will be on the United States with some examples from other developed nations and a discussion of implications for low- and middle-income countries.
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Affiliation(s)
- S W Ng
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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29
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Moodie R, Stuckler D, Monteiro C, Sheron N, Neal B, Thamarangsi T, Lincoln P, Casswell S. Profits and pandemics: prevention of harmful effects of tobacco, alcohol, and ultra-processed food and drink industries. Lancet 2013; 381:670-9. [PMID: 23410611 DOI: 10.1016/s0140-6736(12)62089-3] [Citation(s) in RCA: 882] [Impact Index Per Article: 80.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The 2011 UN high-level meeting on non-communicable diseases (NCDs) called for multisectoral action including with the private sector and industry. However, through the sale and promotion of tobacco, alcohol, and ultra-processed food and drink (unhealthy commodities), transnational corporations are major drivers of global epidemics of NCDs. What role then should these industries have in NCD prevention and control? We emphasise the rise in sales of these unhealthy commodities in low-income and middle-income countries, and consider the common strategies that the transnational corporations use to undermine NCD prevention and control. We assess the effectiveness of self-regulation, public-private partnerships, and public regulation models of interaction with these industries and conclude that unhealthy commodity industries should have no role in the formation of national or international NCD policy. Despite the common reliance on industry self-regulation and public-private partnerships, there is no evidence of their effectiveness or safety. Public regulation and market intervention are the only evidence-based mechanisms to prevent harm caused by the unhealthy commodity industries.
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Affiliation(s)
- Rob Moodie
- Melbourne School of Population Health, University of Melbourne, Melbourne, VIC, Australia.
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Igumbor EU, Sanders D, Puoane TR, Tsolekile L, Schwarz C, Purdy C, Swart R, Durão S, Hawkes C. "Big food," the consumer food environment, health, and the policy response in South Africa. PLoS Med 2012; 9:e1001253. [PMID: 22802733 PMCID: PMC3389030 DOI: 10.1371/journal.pmed.1001253] [Citation(s) in RCA: 112] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
In an article that forms part of the PLoS Medicine series on Big Food, Corinna Hawkes and colleagues provide a perspective from South Africa on the rise of multinational and domestic food companies, and argue that government should act urgently through education about the health risks of unhealthy diets, regulation of Big Food, and support for healthy foods.
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Affiliation(s)
- Ehimario U Igumbor
- School of Public Health, University of the Western Cape, Bellville, South Africa.
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Abstract
In an article that forms part of the PLoS Medicine series on Big Food, guest editors David Stuckler and Marion Nestle lay out why more examination of the food industry is necessary, and offer three competing views on how public health professionals might engage with Big Food.
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Affiliation(s)
- David Stuckler
- Department of Sociology, University of Cambridge, Cambridge, United Kingdom.
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Abstract
The PLoS Medicine editors ask readers to join the debate about Big Food and introduce their new series examining the activities and influence of the food and beverage industry in the health arena.
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