Expert opinion survey on Israel's food system: implications for food and health policies

BACKGROUND

While there has been increasing global recognition and impetus for action to transform food systems towards greater food security, sustainability and better health outcomes, Israel has only recently begun to focus on the diverse challenges of its food system and its potential for transformation.

METHODS

An expert opinion survey (n = 50) on Israel's food system was conducted as part of a larger study on the systemic features of Israel's food system transition to understand its policy gaps and find strategies towards a healthy and sustainable food system. The survey ranks the relevance and importance of food system challenges and policy preferences. Policy implications are then examined by identifying potential priorities, gaps and dissensus.

RESULTS

The survey finds that there is a majority agreement (76%) that Israel's food policies are lacking or severely lacking. Respondents relate strongly to both concepts of nutritional security (90% think that access to nutritious food is relevant or highly relevant) and national food security (more than 80% perceive food security as part of national security). Respondents overwhelmingly recognize the benefits of Israeli agriculture with 60-90% agreeing or strongly agreeing that it benefits food security, economic value and national identity. Top-ranked problems include overall systemic problems such as the lack of national goals, strategic planning, and integrated policymaking across ministries, and specific ones such as food waste, costly farming inputs, and food affordability. The most preferred policy actions include establishing a national strategy for food and agriculture, making food affordable for vulnerable households, and incentivising sustainable farming methods. The key policy gaps include the lack of resilience in agriculture and the food system, insufficient data and knowledge for policy action, inadequate attention to the regulation of the food industry for better health and inadequate food policy attention for minority groups.

CONCLUSIONS

Building on this study's findings, further policy research and implementation areas to be covered include government responsibility for universal food security, strategic systemic policies for food systems, prevention and preparedness for future crises, and promoting resilience. The way forward may best be through an inter-ministerial committee with the responsibility, budgets, mandate and executive authority to plan data-driven policies for a sustainable food system for Israel's future.

Policy approaches to nutrition-focused food banking in industrialized countries: a scoping review

OBJECTIVE

This review aims to synthesize the literature describing policy approaches to nutrition-focused food banking in industrialized countries, spanning the period 2000 to October 2021.

BACKGROUND

The charitable food system provides food assistance to increasing numbers of people experiencing food insecurity in industrialized countries. Calls to improve the nutrition quality of foods provided by foods banks, pantries, and shelves have increased, yet little is known about the challenges faced when initiating policy in this setting.

METHODS

A protocol based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews Guidelines was developed and registered with Open Science Framework. Four electronic databases (MEDLINE [Ovid], Global Health, ProQuest, and Scopus) were searched for peer-reviewed articles published in English. A gray literature search was conducted using Google Advanced Search.

RESULTS

Of 642 peer-reviewed articles screened, 15 were eligible for inclusion. In addition, 24 gray literature documents were included. These 39 papers were assessed against the Iron Triangle of Hunger Relief and the Campbell et al framework of organizational factors. Six themes were identified: (1) there is a moral imperative to take action to ensure the provision of appropriate and nutritious food for vulnerable clients; (2) nutrition policies are unlikely to be formalized; (3) the unpredictability of donated food is a barrier to providing healthy foods; (4) reliance on donations affects the sector's willingness to reduce the unhealthy inventory for fear of losing donors, and the challenges of managing donor relationships were emphasized; (5) organizational capacity (volunteer workforce, executive leadership support) must be considered; (6) the existing measure of success is a weight-based metric that does not support food banks' prioritizing of healthy foods. These, and other characteristics, were incorporated into an adapted framework.

CONCLUSION

There is a need and opportunity for nutrition-focused food banking. A priority action area is the adoption of an outcome metric that is based on nutritional quality, to reorient the charitable food system.

Tailored Informational Interventions for Reducing Surplus and Waste of Fruits and Vegetables in a Food Market: A Pilot Study

This pilot study explored the effectiveness of tailored informational interventions to reduce the surplus and waste of fruits and vegetables at the distribution level in Chile. Stalls from a fresh food market were randomized to intervention (n = 5 selling fruits, n = 5 selling vegetables) or control (n = 4 selling fruits, n = 4 selling vegetables) groups. The causes of surplus and waste were estimated by questionnaires. Surplus, avoidable waste, and unavoidable waste were measured using direct quantification before and after the intervention, and were expressed relative to the initial stock. Before the intervention, the surplus was (median [25th-75th percentile]) 46.2% [33.3-51.2] for fruits and 51.5% [41.3-55.0] for vegetables; avoidable waste was 0.1% [0.0-0.8] for fruits and 1.8% [0.7-5.3] for vegetables; and unavoidable waste was 0.0% [0.0-1.0] for fruits and 0.0% [0.0-1.3] for vegetables. Planning and storage represented the main causes explaining surplus and waste. After the intervention, the intervention group decreased the surplus of fruits compared to the control group (-17.8% [-29.0--11.0] vs. 5.8% [-0.6-7.8], respectively; p = 0.016), without other differences. In conclusion, tailored informational interventions based on the causes of surplus and waste may reduce the surplus of fruits in a fresh food market. Interventions might also include management strategies for the surplus to improve grocers' business operations.

Public infrastructure for food and nutrition security in brazil: fufilling the constitutional commitment to the human right to adequate food

Food insecurity is a critical global problem with social and public health consequences. In Brazil, access to adequate food is a fundamental human right guaranteed under the country’s Constitution since 2010. As such, the State assumes the distinct and complementary obligations to respect, protect, promote and provide the Right to Adequate Food. The aim of this study is to present actions related to the “provision” dimension that have been developed as part of a network of public infrastructure strategies for food and nutrition security in Brazil. Through an exploratory, analytical literature review, the paper focuses on the operational designs and logistics of three main strategies: Food Banks, Community Kitchens, and Popular Restaurants. The Brazilian experience indicates that public actions are necessary, especially considering the urgency for those groups living with hunger and poverty. While similar programs can be found in other countries in South and North America, they are mostly offered by civil society organizations, and have not advanced toward public institutionalization. In fact, private programs are criticized for negating governments’ obligation and responsibility in this area. Brazil’s experience sheds light on public initiatives in meeting the State’s obligations towards the Right to Adequate Food.

A Game Theoretic Framework for Surplus Food Distribution in Smart Cities and Beyond

Food waste is currently a major challenge for the world. It is the precursor to several socioeconomic problems that are plaguing modern society. To counter and to, simultaneously, stand by the undernourished, surplus food redistribution has surfaced as a viable solution. Information and Communications Technology (ICT)-mediated food redistribution is a highly scalable approach and it percolates into the lives of the masses far better. Even if ICT is not brought into the picture, the presence of food surplus redistribution in developing countries such as India is scarce and is limited to only a few of the major cities. The discussion of a surplus food redistribution framework under strategic settings is a less discussed topic around the globe. This paper aims to address a surplus food redistribution framework under strategic settings, thereby facilitating a smoother exchange of surplus food in the smart cities of developing countries and beyond. As ICT is seamlessly available in smart cities, the paper aims to focus the framework in these cities. However, this can be extended beyond the smart cities to places with greater human involvement.

Food Waste and Nutrition Quality in the Context of Public Health: A Scoping Review

Food waste and nutrition are intrinsically linked in terms of environmental health and public health. Despite this, it is unknown whether these topics have been previously synthesized into a review. The aim was to identify the interdisciplinary parameters that exist in public health and nutrition literature in terms of food waste and plastic waste associated with food, and to identify how these parameters currently contribute to food sustainability messaging and interventions. A rapid scoping review was conducted. Data were mapped into concepts and synthesized in a narrative review. Four main concepts were identified: (1) food waste and diet quality, nutrient losses, and environmental health, (2) food waste reduction interventions and diet quality, (3) food banks/pantries and diet/nutritional quality, and (4) food and plastic waste messaging in nutrition or dietary guidelines. Food waste is associated with nutrient wastage, and interventions to reduce food waste can successfully address food sustainability and nutrition quality. Food redistribution systems do not currently address access to sustainably sourced foods that are also nutrient-dense for lower-income communities. Opportunities for future research and practice include aligning food waste, plastic waste, and nutrition priorities together and developing better food redistribution systems to limit wastage of high-quality foods.

Food Rescue Intervention Evaluations: A Systematic Review

Food rescue, the practice of gathering food that could otherwise be wasted and redirecting it for human consumption, represents a critical opportunity to improve food security and reduce waste. As global interest in reducing hunger and food waste grows, better insight is needed to assess and compare the effectiveness of different models of food rescue. We conducted a systematic review of peer-reviewed studies evaluating food rescue interventions with the aim of synthesizing findings and comparing methodologies. We searched PubMed, Academic Search Ultimate, and Science Citation Index for studies published worldwide, in English, through June 2019. Studies were included that: a) evaluated an existing or proposed food rescue intervention and, b) quantitatively or qualitatively measured the intervention impact. All nineteen included studies were observational and the intervention types ranged widely. The most commonly reported metric was the weight of food recovered. Few studies reported client outcome measures. The included studies suggested promising effects of food rescue interventions, including positive return on investment, decreased environmental burden, large quantities of food rescued and clients served, and high stakeholder satisfaction. Comparison across studies was challenging, however, due to inconsistent metrics and insufficiently detailed methodology. This review documents a need for additional evaluation of food rescue interventions and recommends a standardized methodology. Additional dialogue among key stakeholders is warranted to develop consistent, meaningful metrics to assess food rescue.

Food-Aid Quality Correlates Positively With Diet Quality of Food Pantry Users in the Leket Israel Food Bank Collaborative

Introduction: In many affluent countries, including Israel, networks of food banks and pantries have increasing responsibility to alleviate endemic poverty and food insecurity. While they may relieve acute hunger, their long-term influence on health and well-being is poorly understood.

Methods: An exploratory cross-sectional telephone survey assessed both adequacy and quality of food aid provided via food pantries in the Leket Israel food bank network, in relation to recipients' dietary needs and health. The quality of food baskets and recipient diets were given a Healthy Portions Score (HPS) to measure compliance with Government guidelines for a “Basic Healthy Food Basket,” and a Nutrient Density Score (NDS) to capture how well the food achieved the recommended dietary allowance (RDA) for vital macro and micronutrients. A total of 105 pantry users were surveyed from 16 pantries around the country.

Results: The basket HPS correlated positively and highly significantly with dietary quality (individual NDS) after adjusting for gender, marital status and country of birth (standardized β = 0.22, p = 0.03). Nearly half (46%) reported food insecurity with hunger. Two thirds were overweight or obese, and anemia, cardiovascular and metabolic disease were prevalent. The average food basket provides 30% of energy, 55% of protein, 50% of fiber, but only 33% or less of the household requirement for most minerals and vitamins. Only 60% of participants met their estimated energy requirements, and the intake of many essential micronutrients was well below the RDA. Fruits and vegetable portions contributed by Leket Israel correlated positively with the dietary quality (individual NDS) after adjustment for the same covariates (Standardized β = 0.20, p = 0.04).

Discussion: A structured telephone survey proved a feasible method to study the impact of food-aid quality on the nutrition and health of food pantry users in an affluent country. Food baskets with fruits, vegetables and higher quality nutrition were correlated with healthier diets among the recipients. Data correlating food-aid quality and recipient diet and health is essential to effective policy making.

The demographic and morbidity characteristics of a population receiving food support in Israel

BACKGROUND

Food supply to poor populations is a big challenge, particularly in periods of economic stress and in an era of chronic diseases epidemics. In Israel more than 4000 poor families are currently receiving food support. Many of the food support products given to the family have low nutrient values, therefore not appropriately ensuring food security of the population. The aim of the current study was to examine for the first time the demographic, nutritional and chronic diseases profiles of food support beneficiaries, so as to aid in planning future food support components in Israel. In addition, the study examined associations between levels of food insecurity status and selected morbidities among food support recipients.

METHODS

In 2016, 3000 families (classified as very poor) in 24 municipalities received food support in Israel from the "National Food Security Project" (NFSP), under the guidance of the National Food Security Council. The 400 new families who joined the program in 2016 were requested to complete a questionnaire regarding the demographic and health characteristics of their families. Three hundred sixty-two of them completed the questionnaire for a response rate of 90%. The current study includes these families only.

RESULTS

The disposable income per capita of the surveyed families was very low - less than NIS 1100 a month ($280). About half the families were working families and 40% of them were in debt. Of the 362 responding families, about 82% of them were food insecure, with more than half severely food-insecure; this, despite receiving food support. About one-third of the families had at least one member with anemia, and a quarter of the families had a member with hyperlipidemia. Hypertension is present in about 22% of the families, diabetes in 17%, and there is a 12% incidence of at least one family member with heart disease. These rates are markedly higher than those in the general population. Higher levels of food insecurity were associated with higher levels of hyperlipidemia, heart disease and hypertension.

DISCUSSION AND CONCLUSIONS

The nutrition and medical status of the population receiving food support is much worse than in the general population. There is a need to improve the nutritional value of food support; this could include greater emphasis on whole grains, fruits and vegetables. There is also a need for a nationwide education program to focus on healthy nutrition and to subsidize healthy foods. Many health and nutrition promotion models show that in order to effect changes in dietary habits and behaviors related to improving nutrition, there is a need for nutrition education (Kamp et al., J Nutr Educ Behav 42:72-82, 2010).