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Gaucher-Holm A, Chan J, Sacks G, Vaillancourt C, Vergeer L, Potvin Kent M, Olstad DL, Vanderlee L. Food and beverage manufacturing and retailing company policies and commitments to improve the healthfulness of Canadian food environments. BMC Public Health 2024; 24:2419. [PMID: 39237999 PMCID: PMC11375943 DOI: 10.1186/s12889-024-19864-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 08/23/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND Food and beverage companies play a central role in shaping the healthfulness of food environments. METHODS The BIA-Obesity tool was used to evaluate and benchmark the specificity, comprehensiveness and transparency of the food environment-related policies and commitments of leading food and beverage manufacturing and retailing companies in Canada. Policies and commitments related to the healthfulness of food environments within 6 action areas were assessed: 1) corporate nutrition strategy; 2) product (re)formulation; 3) nutrition information and labelling; 4) product and brand promotion; 5) product accessibility; and 6) disclosure of relationships with external organizations. Data were collected from publicly available sources, and companies were invited to supplement and validate information collected by the research team. Each company was then assigned a score out of 100 for each action area, and an overall BIA-Obesity score out of 100. RESULTS Overall BIA-Obesity scores for manufacturers ranged from 18 to 75 out of 100 (median = 49), while scores for retailers ranged from 21 to 25 (median = 22). Scores were highest within the product (re)formulation (median = 60) followed by the corporate nutrition strategy (median = 59) domain for manufacturers, while retailers performed best within the corporate nutrition strategy (median = 53), followed by the disclosure of relationships with external organizations (median = 47) domain. Companies within both sectors performed worst within the product accessibility domain (medians = 8 and 0 for manufacturers and retailers, respectively). CONCLUSIONS This study highlights important limitations to self-regulatory approaches of the food and beverage industry to improve the healthfulness of food environments. Although some companies had specific, comprehensive, and transparent policies and commitments to address the healthfulness of food environments in Canada, most fell short of recommended best-practice. Additional mandatory government policies and regulations may be warranted to effectively transform Canadian food environments to promote healthier diets and prevent related non-communicable diseases.
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Affiliation(s)
- Alexa Gaucher-Holm
- École de nutrition, Centre NUTRISS (Nutrition, santé et société), Institut sur la nutrition et les aliments fonctionnels, Université Laval, 2425 Rue de L'Agriculture, Québec City, QC, G1V 0A6, Canada
| | - Jasmine Chan
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation (IHT), Deakin University, Geelong, VIC, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation (IHT), Deakin University, Geelong, VIC, Australia
| | - Caroline Vaillancourt
- École de nutrition, Centre NUTRISS (Nutrition, santé et société), Institut sur la nutrition et les aliments fonctionnels, Université Laval, 2425 Rue de L'Agriculture, Québec City, QC, G1V 0A6, Canada
| | - Laura Vergeer
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Monique Potvin Kent
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Lana Vanderlee
- École de nutrition, Centre NUTRISS (Nutrition, santé et société), Institut sur la nutrition et les aliments fonctionnels, Université Laval, 2425 Rue de L'Agriculture, Québec City, QC, G1V 0A6, Canada.
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Le Bouthillier M, Veilleux S, Loignon J, Turcotte M, Trudel L, Provencher V. Knowledge mobilization between the food industry and public health nutrition scientists: findings from a case study. BMC Nutr 2024; 10:81. [PMID: 38845063 PMCID: PMC11155086 DOI: 10.1186/s40795-024-00889-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 05/28/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Improving the nutritional quality of the food supply increases access to nutritious foods, which improves dietary habits and population health. Yet, knowledge mobilization initiatives between public health nutrition researchers and food industries are often not adequately considered and understood. This study explored what elements related to this specific context need to be recognized so that researchers can better mobilize nutrition science knowledge with the food industry to promote the nutritional improvement of food products. METHOD A case study qualitative approach was selected to answer the research question, using semi-structured interviews as the data collection technique. Québec baking industry actors were shown a mock-up of an online mobilization platform sharing the results of the Food Quality Observatory that describes the nutritional quality of breads offered in Québec, Canada. They were asked to think aloud as they explored the web platform and were interviewed. Two coders analyzed the data using an inductive approach and thematic content analysis, starting with individual open coding, and then put forward their analyses and drafted the final themes. RESULTS The final data consisted of 10 semi-structured interviews conducted between October 2019 and August 2020. Four main themes were identified: the industry's context, the knowledge mobilization initiative, the product-related matters stemming from the information shared and the motivation within the industry. Within each theme, sub-themes were highlighted and related to the industries' motivation to improve their products' nutritional quality. This study also specified key considerations for changes to the sodium and fiber content in bread. CONCLUSION Other steps beyond using simple language and a website format could be taken to better mobilize scientific knowledge with food industries, such as providing more consumer information, using an integrated knowledge mobilization approach that includes a consideration of ethics, working with communication professionals, collaborating with food science experts, and providing resources to act on shared information. Legislation such as the front-of-pack regulations could accelerate the pace of collaboration between researchers and industry. Overall, establishing a prior relationship with industries could help gain a better understanding of the themes highlighted in this study. Future research could build on this case study to provide more insights and solidify these findings. CLASSIFICATION CODES Public Health, Public Private, Policy Making, Research Institutions, Use of Knowledge.
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Affiliation(s)
- Marie Le Bouthillier
- Centre NUTRISS-Nutrition, Santé et Société, Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada
- École de Nutrition, Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada
| | - Sophie Veilleux
- Centre NUTRISS-Nutrition, Santé et Société, Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada
- Faculté des sciences de l'administration, Université Laval, Quebec, QC, G1V 0A6, Canada
- Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada
| | - Jeanne Loignon
- Centre NUTRISS-Nutrition, Santé et Société, Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada
- Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada
| | - Mylène Turcotte
- Centre NUTRISS-Nutrition, Santé et Société, Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada
| | - Laurélie Trudel
- Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada
| | - Véronique Provencher
- Centre NUTRISS-Nutrition, Santé et Société, Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada.
- École de Nutrition, Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada.
- Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada.
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Carducci B, Dominguez G, Kidd E, Oh C, Jain R, Khan A, Bhutta ZA. Promoting healthy school food environments and nutrition in Canada: a systematic review of interventions, policies, and programs. Nutr Rev 2024:nuae030. [PMID: 38767979 DOI: 10.1093/nutrit/nuae030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024] Open
Abstract
CONTEXT The school food environment is a critical interface for child and adolescent nutrition, and there is a need to understand existing literature on Canadian school food environments to identify equity gaps and opportunities, and empower decision-makers to plan for future action. OBJECTIVE Literature on Canadian school food and nutrition interventions, policies, programs, and their effects on diets and nutritional status are synthesized and appraised in this systematic review. DATA SOURCES A search strategy was developed for each database used (Medline, Embase, PsycINFO, ERIC, Cochrane Collaboration, Canadian Electronic Library, BiblioMap), with a combination of free text and controlled vocabulary, for articles published from 1990 to 2021. Unpublished data and grey literature were also searched. DATA EXTRACTION Quantitative and qualitative studies with an observational or intervention study design, reviews, or program evaluations conducted in Canadian schools with participants aged 5-19.9 years were included. Key study characteristics and risk of bias were extracted independently by 2 investigators using a standardized tool. DATA ANALYSIS A total of 298 articles were included (n = 192 peer reviewed and 106 from the grey literature), which were mostly conducted in Ontario (n = 52), British Columbia (n = 43), and Nova Scotia (n = 28). Twenty-four interventions, 5 nonevaluated programs, and 1 policy involved Indigenous populations. Overall, 86 articles measured and reported on effectiveness outcomes, including dietary intake; anthropometry; knowledge, attitudes, and practices; and physical activity. The literature remains largely heterogenous and primarily focused on nutrition education programs that use subjective assessments to infer changes in nutrition. A key facilitator to implementation and sustainability was community engagement, whereas key barriers were staff capacity, access to resources and funding, and consistent leadership. CONCLUSIONS This review provides insight into Canadian school food and nutrition interventions, programs, and policies and uncovers important evidence gaps that require careful examination for future evaluations. Governments must create supportive environments that optimize nutrition for children and adolescents through equitable policies and programs. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022303255.
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Affiliation(s)
- Bianca Carducci
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
- Department of Nutritional Sciences, University of Toronto, Faculty of Medicine, University of Toronto, Medical Sciences Building, Toronto, ON, Canada
| | - Georgia Dominguez
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
| | - Emily Kidd
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
| | - Christina Oh
- Western University, Schulich School of Medicine and Dentistry, London, ON, Canada
| | - Reena Jain
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
| | - Amira Khan
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
- Department of Nutritional Sciences, University of Toronto, Faculty of Medicine, University of Toronto, Medical Sciences Building, Toronto, ON, Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
- Department of Nutritional Sciences, University of Toronto, Faculty of Medicine, University of Toronto, Medical Sciences Building, Toronto, ON, Canada
- Centre of Excellence in Women, and Child Health, Aga Khan University, Karachi, Pakistan
- Dalla Lana School of Public, Health University of Toronto Health Sciences Building, Toronto, ON, Canada
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Robitaille MC, Mialon M, Moubarac JC. The bio-food industry's corporate political activity during Health Canada's revision of Canada's food guide. Health Promot Chronic Dis Prev Can 2023; 43:485-498. [PMID: 38117474 PMCID: PMC10824156 DOI: 10.24095/hpcdp.43.12.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
INTRODUCTION We analyzed the bio-food industry's corporate political activity (CPA) during the revisions of Canada's food guide between 2016 and 2019. METHODS We undertook a content analysis of the websites of 11 bio-food industry organizations and of the briefs that 10 of them submitted to the Canadian House of Commons Standing Committee on Health, as part of this Committee's review of the food guide. Data were classified according to an existing conceptual framework. RESULTS We identified 366 examples of CPA used by the bio-food industry during and immediately after the development of the food guide. Most of the industry actors opposed the guide's recommendations. The most common CPA strategies were information management (n = 197), used to create and disseminate information in industry's favour, and discursive strategies (n = 108), used to defend food products and promote the industry's position regarding the food guide. Influencing public policy (n = 40), by gaining indirect access to policy makers (e.g. through lobbying) and becoming active in government decision-making, as well as coalition management (n = 21), by establishing relationships with opinion leaders and health organizations, were also common strategies. CONCLUSION Bio-food industry actors used many different CPA strategies during the revisions of the food guide. It is important to continue to document the bio-food industry's CPA to understand whether and how this is shaping public policy development in Canada and elsewhere.
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Affiliation(s)
- Marie-Chantal Robitaille
- Department of Nutrition, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
- Centre de recherche en santé publique, Université de Montréal, Montréal, Quebec, Canada
| | - Mélissa Mialon
- Trinity Business School, Trinity College Dublin, Dublin, Ireland
| | - Jean-Claude Moubarac
- Department of Nutrition, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
- Centre de recherche en santé publique, Université de Montréal, Montréal, Quebec, Canada
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Hamel V, Hennessy M, Mialon M, Moubarac JC. Interactions Between Nutrition Professionals and Industry: A Scoping Review. Int J Health Policy Manag 2023; 12:7626. [PMID: 38618820 PMCID: PMC10590255 DOI: 10.34172/ijhpm.2023.7626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 07/31/2023] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND In recent years, interactions between nutrition professionals (NPs) and the food industry, such as sponsorship arrangements, have raised concerns, particularly as these may negatively impact the trustworthiness and credibility of the nutrition profession. This study aimed to map the literature and identify knowledge gaps regarding interactions between NPs and industry. We sought to examine the nature of such interactions and NPs perspectives about these, as well as the risks and solutions. METHODS We conducted a scoping review according to a pre-registered protocol, searching eight electronic databases and grey literature sources in March 2021 to identify documents for inclusion. Two independent reviewers screened citations for inclusion and conducted data extraction. Quantitative and qualitative syntheses were conducted. RESULTS We identified 115 documents for analysis, published between 1980 to 2021, with a majority from the United States (n=59, 51%). Only 32% (n=37) were empirical studies. The food industry was the most frequent industry type discussed (n=91, 79%). We identified 32 types of interactions between NPs and industry, such as continuing education provided by industry and sponsorship of professional bodies and health and nutrition organizations. The financial survival of nutrition organizations and continuing education access for NPs were the most frequently cited advantages of industry-NPs interactions. On the other hand, undermining public trust, NPs credibility and public health nutrition recommendations were pointed out as risks of these interactions. Following a code of ethics, policies, or guidelines was the most frequently proposed solution for managing these interactions. CONCLUSION Despite the increasing attention given to this issue, few empirical papers have been published to date. There is a need for more research to better and systematically document industry interactions with NPs and the impacts associated with these, as well as more research on effective management strategies. Registry Name and Number: Interactions between nutrition professionals and industry actors: A scoping review protocol. doi:10.17605/OSF.IO/Q6PUA.
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Affiliation(s)
- Virginie Hamel
- Department of Nutrition, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Centre de recherche en Santé publique, Montreal, QC, Canada
| | - Marita Hennessy
- College of Medicine and Health, University College Cork, Cork, Ireland
| | - Mélissa Mialon
- Trinity Business School, Trinity College Dublin, Dublin, Ireland
| | - Jean-Claude Moubarac
- Department of Nutrition, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Centre de recherche en Santé publique, Montreal, QC, Canada
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Ulucanlar S, Lauber K, Fabbri A, Hawkins B, Mialon M, Hancock L, Tangcharoensathien V, Gilmore AB. Corporate Political Activity: Taxonomies and Model of Corporate Influence on Public Policy. Int J Health Policy Manag 2023; 12:7292. [PMID: 37579378 PMCID: PMC10462073 DOI: 10.34172/ijhpm.2023.7292] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 04/19/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Non-communicable diseases (NCDs) kill 41 million people a year. The products and services of unhealthy commodity industries (UCIs) such as tobacco, alcohol, ultra-processed foods and beverages and gambling are responsible for much of this health burden. While effective public health policies are available to address this, UCIs have consistently sought to stop governments and global organisations adopting such policies through what is known as corporate political activity (CPA). We aimed to contribute to the study of CPA and development of effective counter-measures by formulating a model and evidence-informed taxonomies of UCI political activity. METHODS We used five complementary methods: critical interpretive synthesis of the conceptual CPA literature; brief interviews; expert co-author knowledge; stakeholder workshops; testing against the literature. RESULTS We found 11 original conceptualisations of CPA; four had been used by other researchers and reported in 24 additional review papers. Combining an interpretive synthesis of all these papers and feedback from users, we developed two taxonomies - one on framing strategies and one on action strategies. The former identified three frames (policy actors, problem, and solutions) and the latter six strategies (access and influence policy-making, use the law, manufacture support for industry, shape evidence to manufacture doubt, displace, and usurp public health, manage reputations to industry's advantage). We also offer an analysis of the strengths and weaknesses of UCI strategies and a model that situates industry CPA in the wider social, political, and economic context. CONCLUSION Our work confirms the similarity of CPA across UCIs and demonstrates its extensive and multi-faceted nature, the disproportionate power of corporations in policy spaces and the unacceptable conflicts of interest that characterise their engagement with policy-making. We suggest that industry CPA is recognised as a corruption of democracy, not an element of participatory democracy. Our taxonomies and model provide a starting point for developing effective solutions.
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Affiliation(s)
- Selda Ulucanlar
- Tobacco Control Research Group (TCRG), Department for Health, University of Bath, Bath, UK
| | - Kathrin Lauber
- School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Alice Fabbri
- Tobacco Control Research Group (TCRG), Department for Health, University of Bath, Bath, UK
| | - Ben Hawkins
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Melissa Mialon
- Trinity Business School, Trinity College Dublin, Dublin, Ireland
| | - Linda Hancock
- Alfred Deakin Institute, Deakin University, Melbourne, VIC, Australia
| | | | - Anna B. Gilmore
- Tobacco Control Research Group (TCRG), Department for Health, University of Bath, Bath, UK
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Padilla-Moseley J, Sivakumar B, Flexner N, Grajeda R, Gamble B, Blanco-Metzler A, Arcand J. Factors Impacting the Uptake of Research into Dietary Sodium Reduction Policies in Five Latin American Countries: A Qualitative Study. Curr Dev Nutr 2023; 7:100073. [PMID: 37180848 PMCID: PMC10126926 DOI: 10.1016/j.cdnut.2023.100073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/06/2023] [Accepted: 03/14/2023] [Indexed: 04/04/2023] Open
Abstract
Background Diets high in sodium are a risk factor for cardiovascular disease (CVD). Latin American countries (LAC) consume more than double the recommended sodium levels. Research uptake in dietary sodium reduction policies has been inconsistent in LAC, and the factors impacting research uptake are largely unknown. This study aimed to describe the barriers and facilitators to the uptake of research into sodium reduction policies from a funded research consortium with 5 LAC (Argentina, Brazil, Costa Rica, Paraguay, and Peru). Methods A qualitative case study included 5 researchers and 4 Ministry of Health officers from the funded consortium. Dimensions from Trostle's framework of actors, content, context, and process and relative advantages from the Diffusion of Innovation informed the semi-structured interview guide and analysis. One-on-one interviews were completed from November 2019 to January 2020. The participants validated transcripts, coded, and analyzed using NVivo software. Results Key barriers to policy advancements included 1) conflicts of interest from the food industry and some government actors; 2) government turnover resulting in policy and personnel changes; 3) a lack of human and financial resources; and 4) and communication gaps among key actors. Key facilitators to policy advancement included: 1) the content and quality of health economic, food supply, and qualitative data; 2) support, technical assistance, and alliances with the government, non-governmental organizations, and international experts; and 3) researchers enhanced skillsets facilitated with communication and dissemination with policymakers. Conclusion Researchers and policymakers are faced with several barriers and facilitators on research uptake in policies and programs in LAC; these factors should be addressed and leveraged to advance sodium reduction policy development. Future LAC studies can draw from the insights and lessons learned from this case study and apply the results to future efforts on policy nutrition to promote healthy eating and reduce CVD risk.
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Affiliation(s)
| | - Bridve Sivakumar
- Faculty of Health Sciences, Ontario Tech University, Oshawa ON, Canada
| | - Nadia Flexner
- Department of Nutritional Sciences, University of Toronto, 1 King’s College Circle, Toronto, Ontario, Canada
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, United States of America
| | - Ruben Grajeda
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, United States of America
| | - Brenda Gamble
- Faculty of Health Sciences, Ontario Tech University, Oshawa ON, Canada
| | - Adriana Blanco-Metzler
- Costa Rican Institute of Research and Teaching in Nutrition and Health, Tres Ríos, Costa Rica Costa Rica
| | - JoAnne Arcand
- Faculty of Health Sciences, Ontario Tech University, Oshawa ON, Canada
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Rampalli KK, Blake CE, Frongillo EA, Montoya J. Why understanding food choice is crucial to transform food systems for human and planetary health. BMJ Glob Health 2023; 8:bmjgh-2022-010876. [PMID: 37137535 PMCID: PMC10163507 DOI: 10.1136/bmjgh-2022-010876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 04/11/2023] [Indexed: 05/05/2023] Open
Abstract
What, how and why people eat has long been understood to be important for human health, but until recently, has not been recognised as an essential facet of climate change and its effects on planetary health. The global climate change and diet-related health crises occurring are connected to food systems, food environments and consumer food choices. Calls to transform food systems for human and planetary health highlight the importance of understanding individual food choice. Understanding what, how and why people eat the way they do is crucial to successful food systems transformations that achieve both human and planetary health goals. Little is known about how food choice relates to climate. To clarify potential paths for action, we propose that individual food choice relates to climate change through three key mechanisms. First, the sum of individual food choices influences the supply and demand of foods produced and sold in the marketplace. Second, individual food decisions affect type and quantity of food waste at the retail and household level. Third, individual food choices serve as a symbolic expression of concern for human and planetary health, which can individually and collectively stimulate social movements and behaviour change. To meet the dietary needs of the 2050 global population projection of 10 billion, food systems must transform. Understanding what, how and why people eat the way they do, as well as the mechanisms by which these choices affect climate change, is essential for designing actions conducive to the protection of both human and planetary health.
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Affiliation(s)
- Krystal K Rampalli
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
| | - Christine E Blake
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
| | - Joseph Montoya
- Department of Environmental Health Sciences, University of South Carolina, Columbia, SC, USA
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Jawad A, Mulligan C, Savona N, L'Abbé MR. Qualitative analysis of front-of package labeling policy interactions between stakeholders and Health Canada. Front Public Health 2023; 11:982908. [PMID: 37089483 PMCID: PMC10115994 DOI: 10.3389/fpubh.2023.982908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 03/10/2023] [Indexed: 04/08/2023] Open
Abstract
Background Front-of-package labelling regulations proposed by Health Canada in their Healthy Eating Strategy (2016) were finally passed in 2022, but remain unimplemented. This study analyzed interactions that occurred between stakeholders and government related to this policy proposal to identify key themes and policy implications. Methods A qualitative framework analysis was conducted on publicly available documents for stakeholder correspondences related to front-of-package that occurred between 2016 and 2019 in Health Canada's Meetings and Correspondence on Healthy Eating database. Five sequential steps were applied: familiarization, identifying a thematic framework, indexing, charting, and mapping and interpretation. A complex systems (i.e., a dynamic system with multiple interconnecting components) lens was incorporated in the final step to deepen the analysis. Results Hundred and seventy-three documents were included, the majority from industry stakeholders (n = 108, 62.4%). Three overarching themes were identified: industry trying to control the agenda and resist regulation; questioning the evidence supporting the policy and its impact on the agri-food industry; and dismissing the need and effectiveness of the policy. Incorporating a complex system lens found industry and non-industry stakeholders held markedly different perspectives on how cohesive the system defined by the front-of-package labelling policy was, and the policy impact on its stability. Economic and opportunity costs were the main trade-offs, and symbol misinterpretation considered an unintended consequence by industry. Finally, some stakeholders argued for wider policy scope incorporating more products, while others requested a narrower approach through exemptions. Conclusion Interactions with industry stakeholders on health food policy proposals require careful consideration, given it may suit their interests to generate delays and policy discordance. Explicitly setting out the principles of engagement and actively encouraging non-industry stakeholder representation provides a more balanced approach to policy consultation and development.
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Affiliation(s)
- Aalaa Jawad
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Christine Mulligan
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Natalie Savona
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Mary R. L'Abbé
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
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Zorbas C, Jeyapalan D, Peeters A, Kapeke K, Sethi V, Murira Z, Gavaravarapu SM, Backholer K. World Children's Day 2022: power, policy, and children's rights to nutrition. Lancet 2022:S0140-6736(22)02352-2. [PMID: 36410363 DOI: 10.1016/s0140-6736(22)02352-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Christina Zorbas
- Deakin University, Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Geelong, VIC 3220, Australia.
| | - Dheepa Jeyapalan
- The Victorian Health Promotion Foundation (VicHealth), Melbourne, VIC, Australia
| | - Anna Peeters
- Deakin University, Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Geelong, VIC 3220, Australia
| | - Kevin Kapeke
- The Victorian Health Promotion Foundation (VicHealth), Melbourne, VIC, Australia
| | - Vani Sethi
- UNICEF Regional Office for South Asia, Kathmandu, Nepal
| | - Zivai Murira
- UNICEF Regional Office for South Asia, Kathmandu, Nepal
| | - SubbaRao M Gavaravarapu
- National Institute of Nutrition, Indian Council of Medical Research, Department of Health Research, Ministry of Health and Welfare, Government of India, Hyderabad, India
| | - Kathryn Backholer
- Deakin University, Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Geelong, VIC 3220, Australia
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Ramuscak AV, Ma DWL, Forbes LE, Duncan AM, Sadowski A, Haines J. Comparing the perceptions and opinions of the 2007 and 2019 Canada's food guides among parents of young children. Front Public Health 2022; 10:944648. [PMID: 36016900 PMCID: PMC9395618 DOI: 10.3389/fpubh.2022.944648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 07/19/2022] [Indexed: 01/21/2023] Open
Abstract
Background The Canada's Food Guide (CFG) is recognized as the most prominent authoritative guideline for healthy eating in Canada. In 2019, Health Canada released the latest iteration of the CFG with substantial changes to its messaging and format from the previous 2007 CFG. Objective This study compared the awareness, use, knowledge, and opinions of the 2007 and 2019 CFGs among parents with children aged 18 months to 5 years who are participants in a family-based intervention trial, the Guelph Family Health Study. Methods The sample consisted of 327 parents (59% women) who responded to questions about the 2007 CFG and 177 parents (60% women) who responded to questions about the 2019 CFG. Parents' awareness and knowledge of the 2007 and 2019 CFGs were compared using Pearson's Chi-Square, while parents' opinions of the two CFGs were compared using Wilcoxon Rank-Sum tests. To describe and provide context about how parents used the 2007 and 2019 CFG descriptive analysis was used. To analyze the open-answer comments parents provided for the 2007 and 2019 CFGs thematic coding was used. Results Awareness of the 2007 and 2019 CFGs was high with 94.5 and 90.4% of parents reported having heard about the 2007 and 2019 CFGs, respectively. Knowledge of the plate proportion recommendations in the 2019 CFG was significantly higher than knowledge of the recommended number of servings in the 2007 CFG with 93.4% of parents identifying the Vegetable and Fruit Plate Proportions in the 2019 CFG. Parents identified that the 2019 CFG was a helpful and trustworthy resource, and that it was easier to follow and understand, and more representative of their culture and traditional foods than the 2007 CFG. Conclusion Our results suggest that parents' knowledge of the 2019 CFG recommendations was higher than for the 2007 CFG recommendations. Parents also had more positive opinions about the 2019 CFG as compared to the 2007 CFG. Future research is needed to explore whether these higher levels knowledge of the 2019 CFG recommendation translate to healthier eating patterns among Canadian families.
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Affiliation(s)
- Alyssa V. Ramuscak
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada
| | - David W. L. Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Laura E. Forbes
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada
| | - Alison M. Duncan
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Adam Sadowski
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada
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Pettigrew S, Coyle D, McKenzie B, Vu D, Lim SC, Berasi K, Poowanasatien A, Suya I, Kowal P. A review of front-of-pack nutrition labelling in Southeast Asia: Industry interference, lessons learned, and future directions. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2022; 3:100017. [PMID: 37384259 PMCID: PMC10305914 DOI: 10.1016/j.lansea.2022.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Front-of-pack nutrition labelling is an evidence-based nutrition intervention that is recommended by the World Health Organization and other health agencies as an effective non-communicable disease prevention strategy. To date, the types of front-of-pack labels that have been identified as being most effective have yet to be implemented in Southeast Asia. This has been partly attributed to extensive industry interference in nutrition policy development and implementation. This paper outlines the current state of food labelling policy in the region, describes observed industry interference tactics, and provides recommendations for how governments in Southeast Asia can address this interference to deliver best-practice nutrition labelling to improve diets at the population level. The experiences of four focal countries - Malaysia, Thailand, the Philippines, and Viet Nam - are highlighted to provide insights into the range of industry tactics that are serving to prevent optimal food labelling policies from being developed and implemented. Funding This research was supported by the United Kingdom Global Better Health Programme, which is managed by the United Kingdom Foreign, Commonwealth and Development Office and supported by PricewaterhouseCoopers in Southeast Asia.
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Affiliation(s)
- Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, 1 King St Newtown NSW 2042, Sydney, Australia
| | - Daisy Coyle
- The George Institute for Global Health, University of New South Wales, 1 King St Newtown NSW 2042, Sydney, Australia
| | - Briar McKenzie
- The George Institute for Global Health, University of New South Wales, 1 King St Newtown NSW 2042, Sydney, Australia
| | - Duong Vu
- Alive & Thrive Southeast Asia, FHI 360, 7F, Opera Business Center, 60 Ly Thai To Street, Hanoi, Vietnam
| | - Shiang Cheng Lim
- RTI International Malaysia, Unit 5.2 & 5.3, Level 5, Nucleus Tower, Jalan PJU 7/6, Mutiara Damansara Petaling Jaya, Selangor, 47820, Malaysia
| | - Kyra Berasi
- Global Health Advocacy Incubator, 1400 I (Eye) Street NW, Suite 1200, Washington, DC 20005, USA
| | - Amphika Poowanasatien
- FHI360, Asia Pacific Regional Office, 19th Floor, Tower 3, Sindhorn Building, 130-132 Wireless Road, Kwaeng Lumpini, Khet Phatumwan, Bangkok 10330 Thailand
| | - Inthira Suya
- FHI360, Asia Pacific Regional Office, 19th Floor, Tower 3, Sindhorn Building, 130-132 Wireless Road, Kwaeng Lumpini, Khet Phatumwan, Bangkok 10330 Thailand
| | - Paul Kowal
- Better Health Programme Southeast Asia, 7 Straits View, Marina One, Singapore, 018936
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13
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Gaucher-Holm A, Mulligan C, L'Abbé MR, Potvin Kent M, Vanderlee L. Lobbying and nutrition policy in Canada: a quantitative descriptive study on stakeholder interactions with government officials in the context of Health Canada's Healthy Eating Strategy. Global Health 2022; 18:54. [PMID: 35619107 PMCID: PMC9137051 DOI: 10.1186/s12992-022-00842-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 05/02/2022] [Indexed: 11/25/2022] Open
Abstract
Background The political activities of industry stakeholders must be understood to safeguard the development and implementation of effective public health policies. Methods A quantitative descriptive study was performed using data from Canada’s Registry of Lobbyists to examine the frequency and governmental target of lobbying that occurred between various types of stakeholders (i.e., industry versus non-industry) and designated public office holders (DPOH) regarding Health Canada’s Healthy Eating Strategy, from September/2016 to January/2021. Initiatives of interest were revisions to Canada’s Food Guide, changes to the nutritional quality of the food supply, front-of-pack nutrition labelling and restrictions on food marketing to children. Results The majority of registrants (88%), and corporations and organizations (90%) represented in lobbying registrations had industry ties. Industry-affiliated stakeholders were responsible for 86% of communications with DPOH, interacting more frequently with DPOH of all ranks, compared to non-industry stakeholders. Most organizations and corporations explicitly registered to lobby on the topic of marketing to children (60%), followed by Canada’s Food Guide (48%), front-of-pack nutrition labelling (44%), and the nutritional quality of the food supply (23%). The food and beverage industry, particularly the dairy industry, was the most active, accounting for the greatest number of lobbying registrations and communications, followed by the media and communication industry. Conclusions Results suggest a strategic advantage of industry stakeholders in influencing Canadian policymakers. While some safeguards have been put in place, increased transparency would allow for a better understanding of industry discourse and help protect public health interests during the policy development process. Supplementary Information The online version contains supplementary material available at 10.1186/s12992-022-00842-4.
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Affiliation(s)
- Alexa Gaucher-Holm
- École de nutrition, Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 Bd Hochelaga, Québec, QC, G1V 0A6, Canada
| | - Christine Mulligan
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | - Mary R L'Abbé
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | - Monique Potvin Kent
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand, Ottawa, ON, K1G 5Z3, Canada
| | - Lana Vanderlee
- École de nutrition, Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 Bd Hochelaga, Québec, QC, G1V 0A6, Canada.
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14
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Vergeer L, Ahmed M, Vanderlee L, Mulligan C, Weippert M, Franco-Arellano B, Dickinson K, Bernstein JT, Labonté MÈ, L'Abbé MR. The relationship between voluntary product (re) formulation commitments and changes in the nutritional quality of products offered by the top packaged food and beverage companies in Canada from 2013 to 2017. BMC Public Health 2022; 22:271. [PMID: 35144589 PMCID: PMC8832833 DOI: 10.1186/s12889-022-12683-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 01/31/2022] [Indexed: 11/16/2022] Open
Abstract
Background Food companies shape Canada’s food supply through voluntary actions and commitments concerning product (re)formulation; however, the extent that these initiatives translate into actual improvements in nutritional quality is unclear. This study examined changes in the nutritional quality of products offered by the top 22 packaged food and beverage companies in Canada from 2013 to 2017, in relation to the strength of their product (re) formulation actions and commitments. Methods The Food Company Reformulation (FCR) scoring tool was used to quantify the strength of companies’ reported recent actions and commitments to reduce energy and nutrients of concern in their products, with higher scores signifying stronger voluntary actions/commitments. Nutritional information for products was sourced from the University of Toronto FLIP 2013 (n = 6490) and 2017 (n = 8277) databases (n = 4074 matched products). Changes in product healthfulness were assessed using the Health Star Rating (HSR) system (with higher HSRs denoting healthier products) and calories, sodium, saturated fat, trans fat, and total and free sugar levels per 100 g/mL. Generalized estimating equations examined changes in nutritional quality in relation to FCR scores. Results Overall, mean HSRs increased significantly for 5 companies’ product portfolios and were reduced in 1 company’s product portfolio. There were significant reductions in calories, sodium, saturated fat in 2 companies’ portfolios and increases in 4, 3, and 8 companies’ portfolios, respectively. Trans fats increased significantly in 2 companies’ portfolios. Total and free sugars decreased significantly in 4 and 5 companies’ portfolios, respectively, and increased in 1 company’s portfolio. There was little change in the healthfulness of matched products. Higher FCR scores were not associated with greater increases in HSRs, or reductions in calories or nutrient amounts. FCR scores were negatively associated with HSRs and positively associated with total and free sugars. No relationship was observed between FCR scores and calories, sodium, saturated fat or trans fat. Conclusions Reporting stronger voluntary product (re) formulation actions and commitments was not associated with greater improvements in the healthfulness of products offered by Canada’s leading packaged food and beverage companies from 2013 to 2017, suggesting a need for stronger industry initiatives or mandatory government interventions to improve the healthfulness of the food supply. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12683-2.
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Affiliation(s)
- Laura Vergeer
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Mavra Ahmed
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Lana Vanderlee
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada.,Centre nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels, École de nutrition, Université Laval, Pavillon des Services, 2440 boul. Hochelaga, Québec, Québec, G1V 0A6, Canada
| | - Christine Mulligan
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Madyson Weippert
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Beatriz Franco-Arellano
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada.,Faculty of Health Science, Ontario Tech University, 2000 Simcoe Street North, Oshawa, ON, L1G 0C5, Canada
| | - Kacie Dickinson
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada.,Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, G.P.O. Box 2100, Adelaide, SA, 5001, Australia
| | - Jodi T Bernstein
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Marie-Ève Labonté
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada.,Centre nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels, École de nutrition, Université Laval, Pavillon des Services, 2440 boul. Hochelaga, Québec, Québec, G1V 0A6, Canada
| | - Mary R L'Abbé
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada.
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15
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Ares G, Velázquez AL, Vidal L, Curutchet MR, Varela P. The role of food packaging on children's diet: Insights for the design of comprehensive regulations to encourage healthier eating habits in childhood and beyond. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2021.104366] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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16
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Lauber K, Hunt D, Gilmore AB, Rutter H. Corporate political activity in the context of unhealthy food advertising restrictions across Transport for London: A qualitative case study. PLoS Med 2021; 18:e1003695. [PMID: 34473694 PMCID: PMC8412307 DOI: 10.1371/journal.pmed.1003695] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 06/14/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Diets with high proportions of foods high in fat, sugar, and/or salt (HFSS) contribute to malnutrition and rising rates of childhood obesity, with effects throughout the life course. Given compelling evidence on the detrimental impact HFSS advertising has on children's diets, the World Health Organization unequivocally supports the adoption of restrictions on HFSS marketing and advertising. In February 2019, the Greater London Authority introduced novel restrictions on HFSS advertising across Transport for London (TfL), one of the most valuable out-of-home advertising estates. In this study, we examined whether and how commercial actors attempted to influence the development of these advertising restrictions. METHODS AND FINDINGS Using requests under the Freedom of Information Act, we obtained industry responses to the London Food Strategy consultation, correspondence between officials and key industry actors, and information on meetings. We used an existing model of corporate political activity, the Policy Dystopia Model, to systematically analyse arguments and activities used to counter the policy. The majority of food and advertising industry consultation respondents opposed the proposed advertising restrictions, many promoting voluntary approaches instead. Industry actors who supported the policy were predominantly smaller businesses. To oppose the policy, industry respondents deployed a range of strategies. They exaggerated potential costs and underplayed potential benefits of the policy, for instance, warning of negative economic consequences and questioning the evidence underlying the proposal. Despite challenging the evidence for the policy, they offered little evidence in support of their own claims. Commercial actors had significant access to the policy process and officials through the consultation and numerous meetings, yet attempted to increase access, for example, in applying to join the London Child Obesity Taskforce and inviting its members to events. They also employed coalition management, engaging directly and through business associations to amplify their arguments. Some advertising industry actors also raised the potential of legal challenges. The key limitation of this study is that our data focused on industry-policymaker interactions; thus, our findings are unable to present a comprehensive picture of political activity. CONCLUSIONS In this study, we identified substantial opposition from food and advertising industry actors to the TfL advertising restrictions. We mapped arguments and activities used to oppose the policy, which might help other public authorities anticipate industry efforts to prevent similar restrictions in HFSS advertising. Given the potential consequences of commercial influence in these kinds of policy spaces, public bodies should consider how they engage with industry actors.
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Affiliation(s)
- Kathrin Lauber
- Department for Health, Tobacco Control Research Group, University of Bath, Bath, United Kingdom
- SPECTRUM Consortium (Shaping Public Health Policies to Reduce Inequalities and Harm), Edinburgh University, Edinburgh, United Kingdom
- * E-mail:
| | - Daniel Hunt
- Independent Researcher and Freelance Health Policy Consultant, Bath, United Kingdom
| | - Anna B. Gilmore
- Department for Health, Tobacco Control Research Group, University of Bath, Bath, United Kingdom
- SPECTRUM Consortium (Shaping Public Health Policies to Reduce Inequalities and Harm), Edinburgh University, Edinburgh, United Kingdom
| | - Harry Rutter
- SPECTRUM Consortium (Shaping Public Health Policies to Reduce Inequalities and Harm), Edinburgh University, Edinburgh, United Kingdom
- Department of Social and Policy Sciences, University of Bath, Bath, United Kingdom
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Lauber K, McGee D, Gilmore AB. Commercial use of evidence in public health policy: a critical assessment of food industry submissions to global-level consultations on non-communicable disease prevention. BMJ Glob Health 2021; 6:e006176. [PMID: 34426403 PMCID: PMC8383892 DOI: 10.1136/bmjgh-2021-006176] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 08/04/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Ultra-processed food industry (UPFI) actors have consistently opposed statutory regulation in health policy debates, including at the WHO. They do so most commonly with claims that regulatory policies do not work, will have negative consequences or that alternatives such as self-regulation work well or better. Underlying this are often assertions that industry is aligned with principles of evidence-based policymaking. In this study, we interrogate if this holds true by exploring the extent and quality of the evidence UPFI respondents employed to support claims around regulatory policy, and how they did this. METHODS First, we identified all submissions from organisations who overtly represent UPFI companies to consultations held by the WHO on non-communicable disease policy between 2016 and 2018. Second, we extracted all relevant factual claims made in these submissions and noted if any evidence was referenced in support. Third, we assessed the quality of evidence using independence from UPFI, nature, and publication route as indicators. Lastly, where peer-reviewed research was cited, we examined if the claims made could be justified by the source cited. RESULTS Across 26 included consultation responses, factual claims around regulation were made in 18, although only 10 referenced any evidence at all. Of all 114 claims made, 39 pieces of identifiable evidence were cited in support of 56 claims. Of the 39 distinct pieces of evidence, two-thirds were industry-funded or industry-linked, with only 16 externally peer-reviewed. Over half of industry-funded or industry-linked academic articles failed to declare a conflict of interest (COI). Overall, of only six claims which drew on peer-reviewed and independent research, none appropriately represented the source. DISCUSSION UPFI respondents made far-reaching claims which were rarely supported by high-quality, independent evidence. This indicates that there may be few, if any, benefits from consulting actors with such a clear COI.
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Affiliation(s)
- Kathrin Lauber
- Department for Health, University of Bath, Bath, Somerset, UK
| | - Darragh McGee
- Department for Health, University of Bath, Bath, Somerset, UK
| | - Anna B Gilmore
- Department for Health, University of Bath, Bath, Somerset, UK
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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: 25] [Impact Index Per Article: 8.3] [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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Mulligan C, Jawad A, Kent MP, Vanderlee L, L'Abbé MR. Stakeholder interactions with the federal government related to Bill S-228 and marketing to kids in Canada: a quantitative descriptive study. CMAJ Open 2021; 9:E280-E287. [PMID: 33757965 PMCID: PMC8096395 DOI: 10.9778/cmajo.20200086] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Canadian federal restrictions on food marketing to children (children's marketing) were proposed in 2016 as Bill S-228, the Child Health Protection Act, which subsequently died on the parliamentary table. This study quantified the interactions (meetings, correspondence and lobbying) related to Bill S-228 and children's marketing by different stakeholders with the federal government. METHODS Interactions between all stakeholders and government related to children's marketing and Bill S-228 (Sept. 1, 2016-Sept. 30, 2019) were analyzed. These included the "Meetings and correspondence on healthy eating" database, detailing interactions between stakeholders and Health Canada related to nutrition policies; and Canada's Registry of Lobbyists, reporting activities of paid lobbyists. We categorized the interactions by stakeholder type (industry, nonindustry and mixed), and analyzed the number and type of interactions with different government offices. RESULTS We analyzed 139 meetings, 65 lobbying registrants, 215 lobbying registrations and 3418 communications related to children's marketing and Bill S-228. Most interactions were from industry stakeholders, including 84.2% of meetings (117/139), 81.5% of lobbying registrants (53/65), 83.3% of lobbying registrations (179/215) and 83.9% of communications (2866/3418). Most interactions (> 80%) in the highest-ranking government offices were by industry. INTERPRETATION Industry stakeholders interacted with government more often, more broadly and with higher ranking offices than nonindustry stakeholders on subjects related to children's marketing and Bill S-228. Although further research is needed to analyze the nature of the discourse around children's marketing, it is apparent that industry viewpoints were more prominent than those of nonindustry stakeholders.
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Affiliation(s)
- Christine Mulligan
- Department of Nutritional Sciences (Mulligan, L'Abbé), University of Toronto, Toronto, Ont.; Faculty of Public Health and Policy (Jawad), London School of Hygiene & Tropical Medicine, London, UK; School of Epidemiology and Public Health (Potvin Kent), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; School of Nutrition (Vanderlee), Université Laval, Québec, Que
| | - Aalaa Jawad
- Department of Nutritional Sciences (Mulligan, L'Abbé), University of Toronto, Toronto, Ont.; Faculty of Public Health and Policy (Jawad), London School of Hygiene & Tropical Medicine, London, UK; School of Epidemiology and Public Health (Potvin Kent), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; School of Nutrition (Vanderlee), Université Laval, Québec, Que
| | - Monique Potvin Kent
- Department of Nutritional Sciences (Mulligan, L'Abbé), University of Toronto, Toronto, Ont.; Faculty of Public Health and Policy (Jawad), London School of Hygiene & Tropical Medicine, London, UK; School of Epidemiology and Public Health (Potvin Kent), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; School of Nutrition (Vanderlee), Université Laval, Québec, Que
| | - Lana Vanderlee
- Department of Nutritional Sciences (Mulligan, L'Abbé), University of Toronto, Toronto, Ont.; Faculty of Public Health and Policy (Jawad), London School of Hygiene & Tropical Medicine, London, UK; School of Epidemiology and Public Health (Potvin Kent), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; School of Nutrition (Vanderlee), Université Laval, Québec, Que
| | - Mary R L'Abbé
- Department of Nutritional Sciences (Mulligan, L'Abbé), University of Toronto, Toronto, Ont.; Faculty of Public Health and Policy (Jawad), London School of Hygiene & Tropical Medicine, London, UK; School of Epidemiology and Public Health (Potvin Kent), Faculty of Medicine, University of Ottawa, Ottawa, Ont.; School of Nutrition (Vanderlee), Université Laval, Québec, Que.
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20
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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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Food Industry Donations to Academic Programs: A Cross-Sectional Examination of the Extent of Publicly Available Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051624. [PMID: 32138233 PMCID: PMC7084227 DOI: 10.3390/ijerph17051624] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/18/2020] [Accepted: 02/27/2020] [Indexed: 12/02/2022]
Abstract
No studies have documented the prevalence of the food industry’s funding of academic programs, which is problematic because such funding can create conflicts of interest in research and clinical practice. We aimed to quantify the publicly available information on the food industry’s donations to academic programs by documenting the amount of donations given over time, categorizing the types of academic programs that receive food industry donations, cataloguing the source of the donation information, and identifying any stated reasons for donations. Researchers cataloged online data from publicly available sources (e.g., official press releases, news articles, tax documents) on the food industry’s donations to academic programs from 2000 to 2016. Companies included 26 food and beverage corporations from the 2016 Fortune 500 list in the United States. Researchers recorded the: (1) monetary value of the donations; (2) years the donations were distributed; (3) the name and type of recipient; (4) source of donation information; and (5) reasons for donations. Adjusting for inflation, we identified $366 million in food industry donations (N = 3274) to academic programs. Universities received 45.2% (n = 1480) of donations but accounted for 67.9% of total dollars given in the sample. Community colleges, schools (i.e., preschool, elementary, middle, and high schools), and academic nonprofits, institutes, foundations, and research hospitals collectively received 54.8% of the donations, but made up less than one-third of the monetary value of donations. Half of the donations (49.0%) did not include a stated reason for the donation. In our sample, donations grew from $3 million in 2000 to $24 million in 2016. Food companies in our sample donated millions of dollars to universities and other academic programs but disclosed little information on the purpose of the donations. Achieving transparency in donation practices may only be possible if federal policies begin to require disclosures or if companies voluntarily disclose information.
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