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Seenivasan S, Nagpal A, Thomas D, Sacks G. Trends (2014-2018) in the healthiness of packaged food purchases of Australian consumers before and after the introduction of voluntary Health Star Rating nutrition labels. Public Health Nutr 2024:1-24. [PMID: 38602098 DOI: 10.1017/s1368980024000892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
OBJECTIVE To evaluate the trends in the healthiness of packaged food purchases of Australian consumers before and after the introduction of the Health Star Rating (HSR) nutrition labels. DESIGN Panel data analysis and difference-in-differences analysis. SETTING The Australian Government endorsed HSR nutrition labels for voluntary implementation on packaged foods in June 2014. We analyse the packaged food purchases of households across all major supermarkets before (January 2014 to June 2014) and after (June 2014 - Dec 2018) the introduction of HSR. PARTICIPANTS 6284 members of a panel of households across Australia reporting their grocery purchases to a market research company (Nielsen Homescan Panel). RESULTS The healthiness of household food purchases exhibited a U-shaped trend - decreasing from 2014 to 2017, and then increasing from 2018, corresponding to the time when a higher proportion of products were HSR-labelled. Households that purchased a higher proportion of HSR-labelled products had healthier household purchases overall. Further, the healthiness of households' category-specific food purchases was positively associated with the proportion of HSR labelled products in categories where HSR was adopted, relative to control categories where HSR was not adopted. CONCLUSIONS In Australia, once a substantial number of packaged food products adopted the voluntary HSR summary indicator, we observed an increasing trend in the healthiness of household food purchases. Widespread adoption of a nutrition summary indicator, such as HSR, on packaged food is likely to be beneficial for population health.
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Affiliation(s)
| | - Anish Nagpal
- Department of Management and Marketing, University of Melbourne, Parkville, Australia
| | - Dominic Thomas
- Monash Business School, Monash University, Clayton, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition, Deakin University, Burwood, Australia
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Bennett R, Keeble M, Zorbas C, Sacks G, Driessen C, Grigsby-Duffy L, Adams J, Burgoine T, Backholer K. The potential influence of the digital food retail environment on health: A systematic scoping review of the literature. Obes Rev 2024; 25:e13671. [PMID: 38104965 DOI: 10.1111/obr.13671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 10/01/2023] [Accepted: 11/03/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION The digital food retail environment (defined in this study as a digital platform, app or website where food can be purchased by individuals for personal consumption) is an emerging component of the wider food system. We aimed to systematically search and review the literature to understand the potential influence of the digital food retail environment on population diets and health. METHODS Four databases (across health, business, and marketing) and grey literature were searched using terms relating to "food and beverages," "digital," and "purchasing." Identified studies were included if they examined any aspect of the digital food retail environment where outcomes were examined with a health-related focus and were published before September 2023. All study designs were included (quantitative, qualitative, observational, and experimental). Reviews and conference abstracts were excluded. RESULTS We identified 21,382 studies, of which 57 articles were eligible for inclusion. Of the 57 included studies, 30 studies examined online grocery retail, 22 examined online food delivery platforms, and five examined meal kit subscription services. Of the 30 studies examining online grocery retail, six studies reported that customers believed they purchased fewer unhealthy food and beverages when shopping online, compared with shopping in-store. Nevertheless, customers also reported that their ability to choose healthy foods and beverages was reduced when shopping online due to difficulty in product comparison. Studies that examined online food delivery platforms primarily found that they promoted unhealthy foods and beverages more often than healthy options, through extensive use of marketing practices such as price discounts and images, and that unhealthy food offerings on these platforms dominate. Meal kit subscription services offered mostly healthy meals, with studies suggesting that these types of services may help individuals alleviate some of their "mental load" and stress related to cooking meals for their families. CONCLUSIONS The literature describing the digital food retail environment was found to be diverse, with different aspects having potential to impact health in different ways. Some evidence suggests that online grocery retail and meal kit subscription services may have positive population dietary impacts, whereas online food delivery platforms appear likely to promote unhealthy food purchasing. However, the current evidence base is fragmented, with many knowledge gaps. Further research is required to understand the influence of the digital food retail environment on population diets and how these environments can be designed to support healthy food choices.
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Affiliation(s)
- Rebecca Bennett
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Matthew Keeble
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Christina Zorbas
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Christine Driessen
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Lily Grigsby-Duffy
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Jean Adams
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Thomas Burgoine
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
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Thanekar U, Sacks G, Ruffini O, Reeve B, Blake MR. Local government stakeholders' perceptions of potential policy actions to influence both climate change and healthy eating in Victoria: A qualitative study. Health Promot J Austr 2024. [PMID: 38373299 DOI: 10.1002/hpja.848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 02/21/2024] Open
Abstract
ISSUE ADDRESSED Climate change is a defining public health issue of the 21st century. Food systems are drivers of diet-related disease burden, and account for 30% of global greenhouse gas emissions. Local governments play a crucial role in improving both the healthiness and environmental sustainability of food systems, but the potential for their actions to simultaneously address these two issues is unclear. This study aimed to explore the perceptions of Australian local government stakeholders regarding policy actions simultaneously addressing healthy eating and climate change, and the influences on policy adoption. METHODS We conducted 11 in-depth semi-structured interviews with stakeholders from four local governments in Victoria, Australia. Data were analysed using reflexive thematic analysis. We applied Multiple Streams Theory (MST) 'problem', 'politics and 'policy' domains to explain policy adoption influences at the local government level. RESULTS Key influences on local government action aligned with MST elements of 'problem' (e.g., local government's existing risk reports as drivers for climate change action), 'policy' (e.g., budgetary constraints) and 'politics' (e.g., local government executive agenda). We found limited evidence of coherent policy action in the areas of community gardens, food procurement and urban land use. CONCLUSION Barriers to further action, such as resource constraints and competing priorities, could be overcome by better tailoring policy action areas to community needs, with the help of external partnerships and local government executive support. SO WHAT?: This study demonstrates that Victorian local stakeholders believe they are well-positioned to implement feasible and coherent interventions that address both healthy eating and climate.
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Affiliation(s)
- Urvi Thanekar
- Sustainable Health Network, Deakin University, Melbourne, Victoria, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Institute for Health Transformation, Deakin University, Melbpurne, Victoria, Australia
| | - Oriana Ruffini
- Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Institute for Health Transformation, Deakin University, Melbpurne, Victoria, Australia
| | - Belinda Reeve
- The University of Sydney Law School, Sydney, New South Wales, Australia
| | - Miranda R Blake
- Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Institute for Health Transformation, Deakin University, Melbpurne, Victoria, Australia
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Reeve E, Bell C, Sacks G, Mounsey S, Waqa G, Peeters A, Thow AM. Lessons for strengthening policymaking for obesity and diet-related noncommunicable disease prevention: A narrative synthesis of policy literature from the Western Pacific Region. Obes Rev 2024; 25:e13651. [PMID: 37905309 DOI: 10.1111/obr.13651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 05/28/2023] [Accepted: 09/09/2023] [Indexed: 11/02/2023]
Abstract
Obesity and diet-related noncommunicable diseases (NCDs) have a profound impact on individuals, households, health care systems, and economies in low- and middle- income countries (LMICs), with the Western Pacific Region experiencing some of the highest impacts. Governments have committed to improving population diets; however, implementation challenges limit effective policy action. We undertook meta-narrative synthesis of the academic literature and used theories of policymaking and implementation to synthesize current knowledge of issues affecting the adoption and implementation of policies to prevent obesity and diet-related NCDs in LMICs in the Western Pacific Region. We found that political leadership and management of food and nutrition policies often diluted following policy adoption, and that nutrition and health advocates find it difficult to enforce policy compliance from actors outside their sectors. Opportunities for strengthening implementation of food and nutrition policies in the Western Pacific include (1) improved and earlier engagement between health policymakers and implementing agencies; (2) focusing on the need for increased accountability from governments, including through effective engagement and organization of actor networks, knowledge sharing, and in highlighting where stronger action is required; and (3) identifying and building the strategic capacities of policy actors in framing, advocacy, coalition-building, knowledge translation, and leadership.
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Affiliation(s)
- Erica Reeve
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Colin Bell
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Sarah Mounsey
- Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Gade Waqa
- Pacific Research Centre for Prevention of Obesity and Non-Communicable Disease (C-POND), Fiji National University, Suva, Fiji
| | - Anna Peeters
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Anne Marie Thow
- Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
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Soares Guimarães J, Pauzé E, Potvin Kent M, Barquera S, Jáuregui A, Sacks G, Vanderlee L, Hammond D. The relationship between parent's self-reported exposure to food marketing and child and parental purchasing and consumption outcomes in five countries: findings from the International Food Policy Study. J Nutr Sci 2023; 12:e123. [PMID: 38155804 PMCID: PMC10753451 DOI: 10.1017/jns.2023.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 08/29/2023] [Accepted: 09/21/2023] [Indexed: 12/30/2023] Open
Abstract
Food and beverage marketing influences children's food preferences and dietary intake. Children's diets are also heavily influenced by their family environment. The aim of this study was to assess the relationship between parent's self-reported exposure to unhealthy food marketing and a range of outcomes related to children's desire for and intake of unhealthy foods and beverages. The study also sought to examine whether these outcomes varied across different countries. The analysed data are from the International Food Policy Study and were collected in 2018 using an online survey. The sample included 5764 parents of children under 18, living in Australia, Canada, Mexico, the United Kingdom, or the United States. Binary logistic regressions assessed the link between the number of parental exposure locations and children's requests for and parental purchases of unhealthy foods. Generalized ordinal regression gauged the relationship between the number of exposure locations and children's consumption of such items. Interaction terms tested if these associations varied by country. Parental exposure to unhealthy food marketing was positively associated with parents reporting child purchase requests and purchase outcomes; and differed by country. Increased parental exposure to unhealthy food marketing was associated with slightly lower odds of children's weekly consumption of unhealthy foods, and this association varied by country. In conclusion, parental report of a greater range of food marketing exposure was associated with a range of outcomes that would increase children's exposure to unhealthy food products or their marketing. Governments should consider developing more comprehensive restrictions on the marketing of unhealthy foods.
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Affiliation(s)
| | - Elise Pauzé
- School of Interdisciplinary Health Sciences, University of Ottawa, Ottawa, Canada
| | - Monique Potvin Kent
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Simón Barquera
- Center for Nutrition and Health Research, INSP, Cuernavaca, Mexico
| | | | - Gary Sacks
- School of Health and Social Development, Deakin University, Victoria, Australia
| | - Lana Vanderlee
- School of Nutrition, Université of Laval, Quebec City, Canada
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
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Vanderlee L, Sacks G. Recommended nutrition-related practices for online food delivery companies. Public Health Nutr 2023; 26:3343-3348. [PMID: 37944996 PMCID: PMC10755444 DOI: 10.1017/s1368980023002495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023]
Affiliation(s)
- Lana Vanderlee
- École de Nutrition, Centre NUTRISS (Nutrition, Santé et Société), Institute of Nutrition and Functional Foods (INAF), Université Laval, 2440 Boulevard Hochelaga, Quebec, QCG1V 0A6, Canada
| | - Gary Sacks
- Deakin University, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, Geelong, VIC, Australia
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Robinson E, Chan J, O’Hearn M, Mozaffarian D, Sacks G. A comparative analysis of nutrition-related assessment criteria and associated nutrition performance scores of food companies across three prominent corporate sustainability assessment tools. Public Health Nutr 2023; 26:2677-2690. [PMID: 37869983 PMCID: PMC10755394 DOI: 10.1017/s1368980023002215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/16/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE Corporate sustainability assessment tools are increasingly used to evaluate company performance on environmental, social and governance (ESG) criteria. Given the growing burden of diet-related disease and nutrition-related business risks, it is important to understand the scope of nutrition-related ESG data currently available. This study aimed to compare the nutrition-related assessment criteria and associated food company performance across three prominent assessment tools. DESIGN Key attributes and assessment criteria of two civil society-led and one commercially available corporate sustainability assessment tools were extracted and compared for the year 2021. Company performance scores for twenty-five major food and beverage manufacturers using these three tools were analysed by nutrition domain: 'Product Portfolio', 'Labelling', 'Marketing', 'Accessibility and Affordability', 'Governance and Reporting', 'Stakeholder Engagement' and 'Employee Health'. To enable comparison between tools, company performance scores were assigned to categories of low (score = 0-25 % score or D), moderately low (25-50 % or C), moderately high (50-75 % or B) and high (75-100 % or A). SETTING Global. PARTICIPANTS N/A. RESULTS The tools covered similar nutrition domains; however, there was heterogeneity in the assessment criteria used to evaluate each domain. When applied to assess the performance of twenty-five major food and beverage manufacturers, a median nutrition-related performance score of moderately low or low was observed across all tools. The highest scoring domain was 'Governance and Reporting', and the lowest scoring domains were 'Product Portfolio' and 'Accessibility and Affordability'. CONCLUSIONS Greater standardisation of the nutrition-related criteria against which food companies are assessed is needed as part of efforts to drive improvements in food company practices.
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Affiliation(s)
- Ella Robinson
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Melbourne3125, Australia
| | - Jasmine Chan
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Melbourne3125, Australia
| | - Meghan O’Hearn
- Mozaffarian Research Group, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Dariush Mozaffarian
- Mozaffarian Research Group, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Melbourne3125, Australia
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O'Hearn M, Reedy J, Robinson E, Economos C, Wong JB, Sacks G, Mozaffarian D. Landscape analysis of environmental, social and governance (ESG) investing metrics for consumer nutrition and health in the food and beverage sector. BMJ Nutr Prev Health 2023; 6:139-152. [PMID: 38264364 PMCID: PMC10800242 DOI: 10.1136/bmjnph-2022-000600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 06/30/2023] [Indexed: 01/25/2024] Open
Abstract
Introduction The private sector plays a critical role in influencing food choices and health outcomes of consumers. Among private sector actors, investors are a powerful yet underutilised stakeholder for driving scalable public health impact. There are systems to facilitate investors' involvement, notably environmental, social and governance (ESG) investing, which is well placed to include an assessment of business risks to social well-being. However, nutrition efforts within the ESG agenda (ESG-Nutrition) are nascent. We aimed to critically assess the strength of existing ESG-Nutrition metrics to advance the science of measuring business impacts on consumer nutrition and health. Methods ESG-Nutrition metrics were extracted from eight ESG frameworks and categorised across four domains: product portfolio healthfulness; product distribution and equity; product marketing and labelling; and nutrition-related governance. The strength of each metric was evaluated and scored 1-3 (best), independently by two researchers, based on six attributes: materiality, objectivity, alignment, activity, resolution and verifiability. The total score (range 6-18) and intercorrelation for each attribute was calculated. Results Across 529 metrics, most related to product marketing and labelling (n=230, 43.5%), followed by product healthfulness (n=126, 23.8%), nutrition-related governance (n=108, 20.4%) and product distribution and equity (n=65, 12.3%). Across all metrics, average total score was 10.94 (1.58), with average attribute scoring highest for verifiability (mean: 2.36 (SD: 0.57)), objectivity (2.11 (0.61)) and materiality (2.01 (0.68)) and lowest for activity (1.83 (0.74)), alignment (1.37 (0.67)) and resolution (1.26 (0.65)). Most intercorrelations were null, suggesting attributes were measuring distinct characteristics of each metric. Significant heterogeneity across domains and frameworks was also observed. Conclusions This research identifies a range of nutrition-related metrics used in ESG frameworks with respect to food companies, but with substantial heterogeneity in relevant nutrition domains covered and strength of each metric. Efforts are required to improve the quality of metrics across frameworks, establish standardised reporting and align these with investor priorities.
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Affiliation(s)
- Meghan O'Hearn
- Food Systems for the Future Institute, Chicago, Illinois, USA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Julia Reedy
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Ella Robinson
- Global Centre for Preventive Health and Nutrition, Deakin University, Burwood, Victoria, Australia
| | - Christina Economos
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - John B Wong
- Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA
- Tufts Medical Center, Institute for Clinical Research and Health Policy Studies, Boston, Massachusetts, USA
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition, Deakin University, Burwood, Victoria, Australia
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
- Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA
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Huse O, Backholer K, Nguyen P, Calibo A, Guirindola M, Desnacido JP, Sacks G, Bell AC, Peeters A, Angeles-Agdeppa I, Ananthapavan J. A comparative analysis of the cost-utility of the Philippine tax on sweetened beverages as proposed and as implemented. Lancet Reg Health West Pac 2023; 41:100912. [PMID: 37780636 PMCID: PMC10534259 DOI: 10.1016/j.lanwpc.2023.100912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 09/01/2023] [Accepted: 09/10/2023] [Indexed: 10/03/2023]
Abstract
Background In response to increasing overweight and obesity, the Philippine government introduced a tax on sweetened beverages (SBs) in 2018. Evidence suggests that the beverage industry influenced the final tax design, making it more favourable for industry than the initially proposed bill. This study aimed to compare the relative health and economic benefits of the proposed SB tax with the implemented SB tax. Methods Philippine dietary consumption data were combined with price elasticity data from Mexico and data from Australia adapted to the Philippine context to estimate reductions in SB purchases and changes in body mass index (BMI) following the implementation of the tax. A multi-state, multiple-cohort Markov model was used to estimate the change in health-adjusted life years (HALYs) due to reduction in the epidemiology of obesity-related diseases, healthcare cost savings and government taxation revenue, resulting from both the proposed and implemented tax policies, over the lifetime of the 2018 Philippine population. Findings The proposed and implemented taxes were modelled to be dominant (cost-saving and improving health). Intervention costs were modelled to be PHP305.2 million (M) (approximately US$6M). Compared to the proposed tax, the implemented tax was modelled to result in a 43.0% smaller reduction in targeted beverage intake (51.1 ml/person/day vs. 89.7 ml/person/day), a 43.5% smaller reduction in BMI (0.35 kg/m2 vs. 0.62 kg/m2), 39.7% fewer HALYs gained (2,503,118 vs. 4,149,030), 39.9% fewer healthcare cost savings (PHP16.4 billion (B) vs. PHP27.3B), and 27.7% less government taxation revenue (PHP426.3B vs. PHP589.4B). Interpretation While the implemented tax in the Philippines will benefit population health, it is likely to yield less benefit than the proposed tax. The influence of the food and beverage industry on policy processes has the potential to lessen the benefits of population NCD prevention policies. Funding OH was supported to conduct this research by an Australian Government Research Training Program Stipend Scholarship. The funding body had no role in data collection and analysis, or manuscript preparation.
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Affiliation(s)
- Oliver Huse
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Kathryn Backholer
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Phuong Nguyen
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
- Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Anthony Calibo
- Child Health Division, Department of Health, Medical Specialist IV, Disease Prevention and Control Bureau, Manila (2011-2020), Philippines
- Institute of Pediatrics and Child Health, St. Luke's Medical Center, Quezon City, Philippines
| | - Mildred Guirindola
- Department of Science and Technology, Food and Nutrition Research Institute, Manila, Philippines
| | - Josie P. Desnacido
- Department of Science and Technology, Food and Nutrition Research Institute, Manila, Philippines
| | - Gary Sacks
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Andrew Colin Bell
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Anna Peeters
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Imelda Angeles-Agdeppa
- Department of Science and Technology, Food and Nutrition Research Institute, Manila, Philippines
| | - Jaithri Ananthapavan
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
- Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
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Jones A, Shahid M, Morelli G, Howes K, Riesenberg D, Sievert K, Pettigrew S, Sacks G. Chocolate unicorns and smiling teddy biscuits: analysis of the use of child-directed marketing on the packages of Australian foods. Public Health Nutr 2023; 26:3291-3302. [PMID: 37962247 PMCID: PMC10755390 DOI: 10.1017/s136898002300215x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 09/08/2023] [Accepted: 09/20/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVE The use of food packaging as a vehicle for marketing to children is under investigated. Our objective was to determine the prevalence and types of child-directed promotional techniques used on food packaging in Australia. DESIGN Based on existing literature and regulations, we developed a framework to classify on-pack child-directed promotional techniques involving the use of characters and other elements that appeal to children. We analysed the packaging of all products in eight food categories available for sale from supermarkets in 2019 and recorded the use of child-directed promotions on pack. We assessed the number and proportion of products displaying child-directed promotional techniques overall and assessed the healthiness of products using child-directed promotions against four indicators of healthiness to provide summary data overall and for the manufacturers who most frequently employed child-targeted strategies. SETTING Data were collected from the FoodSwitch database in Sydney, Australia. RESULTS 901/8006 (11·3 %) products displayed one or more child-directed on-pack element. Most frequent was on foods for infants and young children (n 315), confectionery (n 283), snack foods (n 172) and dairy (n 168). Personified characters were the most commonly used element (n 512). Products using child-directed promotional techniques scored poorly on all four indicators of healthiness: mean health star rating 2·34 (out of 5); 81 % ultra-processed and 6·1 % and 4·5 % products eligible to market to children under Western Pacific and Mexican nutrient profiling schemes, respectively. CONCLUSIONS Australian children are targeted by promotional techniques on the packaging of unhealthy food products. Stronger regulation of these techniques is warranted to protect children's health.
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Affiliation(s)
- Alexandra Jones
- The George Institute for Global Health, University of New South Wales, UNSW, Sydney, Australia
| | - Maria Shahid
- The George Institute for Global Health, University of New South Wales, UNSW, Sydney, Australia
| | - Georgia Morelli
- The George Institute for Global Health, University of New South Wales, UNSW, Sydney, Australia
| | - Kylie Howes
- The George Institute for Global Health, University of New South Wales, UNSW, Sydney, Australia
| | - Devorah Riesenberg
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Katherine Sievert
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, UNSW, Sydney, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
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Wood B, Robinson E, Baker P, Paraje G, Mialon M, van Tulleken C, Sacks G. What is the purpose of ultra-processed food? An exploratory analysis of the financialisation of ultra-processed food corporations and implications for public health. Global Health 2023; 19:85. [PMID: 37957671 PMCID: PMC10644600 DOI: 10.1186/s12992-023-00990-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/08/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND In recent decades there has been a global rise in consumption of ultra-processed foods (UPFs) to the detriment of population health and the environment. Large corporations that have focused heavily on low-cost manufacturing and extensive marketing of UPFs to maximise profits have driven this dietary transition. The same corporations claim to serve the interests of multiple 'stakeholders', and that they are contributing to sustainable development. This paper aimed to test these claims by examining the degree to which UPF corporations have become 'financialised', focusing on the extent to which they have prioritised the financial interests of their shareholders relative to other actors, as well as the role that various types of investors have played in influencing their governance. Findings were used to inform discussion on policy responses to improve the healthiness of population diets. METHODS We adopted an exploratory research design using multiple methods. We conducted quantitative analysis of the financial data of U.S. listed food and agricultural corporations between 1962 and 2021, share ownership data of a selection of UPF corporations, and proxy voting data of a selection of investors between 2012 and 2022. We also conducted targeted narrative reviews using structured and branching searches of academic and grey literature. RESULTS Since the 1980s, corporations that depend heavily on manufacturing and marketing UPFs to generate profits have been increasingly transferring money to their shareholders relative to their total revenue, and at a level considerably higher than other food and agricultural sectors. In recent years, large hedge fund managers have had a substantial influence on the governance of major UPF corporations in their pursuit of maximising short-term returns. In comparison, shareholders seeking to take steps to improve population diets have had limited influence, in part because large asset managers mostly oppose public health-related shareholder proposals. CONCLUSIONS The operationalisation of 'shareholder primacy' by major UPF corporations has driven inequity and undermines their claims that they are creating 'value' for diverse actors. Measures that protect population diets and food systems from the extractive forces of financialisation are likely needed as part of efforts to improve the healthiness of population diets.
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Affiliation(s)
- Benjamin Wood
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Australia.
| | - Ella Robinson
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Phillip Baker
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Guillermo Paraje
- Business School, Universidad Adolfo Ibañez, Santiago de Chile, Chile
| | - Mélissa Mialon
- Trinity Business School, Trinity College, Dublin, Ireland
| | | | - Gary Sacks
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Australia
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Essman M, Burgoine T, Cameron A, Jones A, Potvin Kent M, Polden M, Robinson E, Sacks G, Smith RD, Vanderlee L, White C, White M, Hammond D, Adams J. A multi-country comparison of jurisdictions with and without mandatory nutrition labelling policies in restaurants: analysis of behaviours associated with menu labelling in the 2019 International Food Policy Study. Public Health Nutr 2023; 26:2595-2606. [PMID: 37661595 PMCID: PMC10641604 DOI: 10.1017/s1368980023001775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 07/06/2023] [Accepted: 08/04/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE To examine differences in noticing and use of nutrition information comparing jurisdictions with and without mandatory menu labelling policies and examine differences among sociodemographic groups. DESIGN Cross-sectional data from the International Food Policy Study (IFPS) online survey. SETTING IFPS participants from Australia, Canada, Mexico, United Kingdom and USA in 2019. PARTICIPANTS Adults aged 18-99; n 19 393. RESULTS Participants in jurisdictions with mandatory policies were significantly more likely to notice and use nutrition information, order something different, eat less of their order and change restaurants compared to jurisdictions without policies. For noticed nutrition information, the differences between policy groups were greatest comparing older to younger age groups and comparing high education (difference of 10·7 %, 95 % CI 8·9, 12·6) to low education (difference of 4·1 %, 95 % CI 1·8, 6·3). For used nutrition information, differences were greatest comparing high education (difference of 4·9 %, 95 % CI 3·5, 6·4) to low education (difference of 1·8 %, 95 % CI 0·2, 3·5). Mandatory labelling was associated with an increase in ordering something different among the majority ethnicity group and a decrease among the minority ethnicity group. For changed restaurant visited, differences were greater for medium and high education compared to low education, and differences were greater for higher compared to lower income adequacy. CONCLUSIONS Participants living in jurisdictions with mandatory nutrition information in restaurants were more likely to report noticing and using nutrition information, as well as greater efforts to modify their consumption. However, the magnitudes of these differences were relatively small.
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Affiliation(s)
- Michael Essman
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Thomas Burgoine
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Adrian Cameron
- Institute for Health Transformation, Deakin University, Burwood, Australia
| | - Andrew Jones
- School of Psychology, Liverpool John Moore’s University, Liverpool, UK
| | - Monique Potvin Kent
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Megan Polden
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - Eric Robinson
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - Gary Sacks
- Institute for Health Transformation, Deakin University, Burwood, Australia
| | | | - Lana Vanderlee
- School of Nutrition, Centre Nutrition, santé et société (NUTRISS), INAF, Université Laval, Québec, Canada
| | - Christine White
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Martin White
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Jean Adams
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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Wood B, Lacy-Nichols J, Sacks G. Taking on the Corporate Determinants of Ill-health and Health Inequity: A Scoping Review of Actions to Address Excessive Corporate Power to Protect and Promote the Public's Health. Int J Health Policy Manag 2023; 12:7304. [PMID: 38618808 PMCID: PMC10590241 DOI: 10.34172/ijhpm.2023.7304] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 08/18/2023] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND In many sectors of the economy, for-profit business corporations hold excessive power relative to some governments and civil society. These power imbalances have been recognised as important contributors to many pressing and complex societal challenges, including unhealthy diets, climate change, and widening socio-economic inequalities, and thus pose a major barrier to efforts to improve public health and health equity. In this paper, we reviewed potential actions for addressing excessive corporate power. METHODS We conducted a scoping review of diverse literature (using Scopus, Web of Science, HeinOnline, and EBSCO databases), along with expanded searches, to identify state and collective actions with the potential to address excessive corporate power. Actions were thematically classified into overarching strategic objectives, guided by Meagher's '3Ds' heuristic, which classifies actions to curb corporate power into three groups: dispersion, democratisation, and dissolution. Based on the actions identified, we proposed two additional strategic objectives: reform and democratise the global governance of corporations, and strengthen countervailing power structures. RESULTS We identified 178 documents that collectively cover a broad range of actions to address excessive corporate power. In total, 18 interrelated strategies were identified, along with several examples in which aspects of these strategies have been implemented. CONCLUSION The proposed framework sheds light on how a diverse set of strategies and actions that seek to address excessive corporate power can work synergistically to change the regulatory context in which corporations operate, so that broader societal goals, including health and equity, are given much greater prominence and consideration vis-à-vis powerful corporate interests.
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Affiliation(s)
- Benjamin Wood
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Jennifer Lacy-Nichols
- Centre for Health Policy, The University of Melbourne School of Population and Global Health, Melbourne, VIC, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia
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14
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Heenan M, Jan S, Ralph M, Sacks G, Swinburn B, Shanthosh J. Priority setting for non-communicable disease prevention - Co-producing a regulatory agenda informing novel codes of practice in Australia. Soc Sci Med 2023; 333:116149. [PMID: 37573676 DOI: 10.1016/j.socscimed.2023.116149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 04/29/2023] [Accepted: 08/04/2023] [Indexed: 08/15/2023]
Abstract
There are a range of priority setting methods for non-communicable disease (NCDs) prevention. However, existing methods are often designed without detailed consideration of local context and political economy- critical success factors for implementation. In Australia, codes of practice under state government Public Health Acts could be used for NCD prevention. To inform the potential development of codes of practice under Public Health Acts, this study aimed to co-create a priority setting framework that accounts for local context and the prevailing regulatory agenda. A priority setting framework was co-produced by a multidisciplinary technical advisory group consisting of government representatives, public health lawyers and academic experts. It incorporated general prioritisation criteria (evidence, cost-effectiveness, equity, burden of disease) and local contextual criteria (legal compatibility, unmet-needs, political acceptability, structural and technical feasibility, community support). The framework was then applied in practice through surveys and policy dialogue workshops to discuss political economy factors. Policies were limited to nutrition, alcohol and physical activity risk factors. Through the prioritisation process, the most impactful, feasible and acceptable policies for NCD prevention via state government codes of practice were: restrictions on in-store placement of unhealthy products, enhancing data systems and capabilities for health surveillance and implementation monitoring, removal of unhealthy foods and drinks sold and supplied in public institutions, prohibition of marketing of unhealthy foods and drinks on assets controlled by government, and implementation of subsidies or grants to increase fruit and vegetable intake. The process illustrated that explicit consideration of local context, legal compatibility and the political economy had a substantial influence on the prioritised list of actions. The proposed priority setting framework is designed to be flexible and adaptable to varying contexts, can be embedded in government processes or utilised by researchers and practitioners to co-produce a regulatory agenda that is locally relevant.
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Affiliation(s)
- Maddie Heenan
- The George Institute for Global Health, University of New South Wales, Level 5/ 1 King St, Newtown, NSW, 2042, Australia; Australian Human Rights Institute, University of New South Wales, Sydney, NSW, 2052, Australia.
| | - Stephen Jan
- The George Institute for Global Health, University of New South Wales, Level 5/ 1 King St, Newtown, NSW, 2042, Australia.
| | - Martyn Ralph
- The George Institute for Global Health, University of New South Wales, Level 5/ 1 King St, Newtown, NSW, 2042, Australia.
| | - Gary Sacks
- Global Obesity Centre, Deakin University, Melbourne Burwood Campus, Burwood, VIC, 3125, Australia.
| | - Boyd Swinburn
- School of Population Health, University of Auckland, Auckland, 1010, New Zealand.
| | - Janani Shanthosh
- The George Institute for Global Health, University of New South Wales, Level 5/ 1 King St, Newtown, NSW, 2042, Australia; Australian Human Rights Institute, University of New South Wales, Sydney, NSW, 2052, Australia.
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15
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Hammond D, Acton RB, Rynard VL, White CM, Vanderlee L, Bhawra J, Reyes M, Jáuregui A, Adams J, Roberto CA, Sacks G, Thrasher JF. Awareness, use and understanding of nutrition labels among children and youth from six countries: findings from the 2019 - 2020 International Food Policy Study. Int J Behav Nutr Phys Act 2023; 20:55. [PMID: 37143053 PMCID: PMC10157591 DOI: 10.1186/s12966-023-01455-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 04/21/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Nutrition facts tables (NFTs) on pre-packaged foods are widely used but poorly understood by consumers. Several countries have implemented front-of-package labels (FOPLs) that provide simpler, easier to use nutrition information. In October 2020, Mexico revised its FOPL regulations to replace industry-based Guideline Daily Amount (GDA) FOPLs with 'Warning' FOPLs, which display stop signs on foods high in nutrients of concern, such as sugar and sodium. This study examined self-reported awareness, use, and understanding of NFTs and FOPLs among young people in six countries with different FOPLs, with an additional focus on changes before and after implementation of Mexico's FOPL warning policy. METHODS A 'natural experiment' was conducted using 'pre-post' national surveys in Mexico and five separate comparison countries: countries with no FOPL policy (Canada and the US), countries with voluntary FOPL policies (Traffic Lights in the UK and Health Star Ratings in Australia), and one country (Chile) with mandatory FOPL 'warnings' (like Mexico). Population-based surveys were conducted with 10 to 17-year-olds in 2019 (n = 10,823) and in 2020 (n = 11,713). Logistic regressions examined within- and between-countries changes in self-reported awareness, use, and understanding of NFTs and FOPLs. RESULTS Across countries, half to three quarters of respondents reported seeing NFTs 'often' or 'all the time', approximately one quarter reported using NFTs when deciding what to eat or buy, and one third reported NFTs were 'easy to understand', with few changes between 2019 and 2020. In 2020, awareness, use and self-reported understanding of the Warning FOPLs in Mexico were higher than for NFTs in all countries, and compared with GDA FOPLs in Mexico (p < .001). Mandated Warning FOPLs in Mexico and Chile had substantially higher levels of awareness, use, and understanding than the voluntary Traffic Lights in the UK and Health Star Ratings in Australia (p < .001 for all). CONCLUSIONS Mandated easy-to-understand FOPLs are associated with substantially greater levels of self-reported awareness, use and understanding at the population-level compared to NFT and GDA-based labeling systems.
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Affiliation(s)
- David Hammond
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Rachel B Acton
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Vicki L Rynard
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Christine M White
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Lana Vanderlee
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec City, QC, G1V 0A6, Canada
| | - Jasmin Bhawra
- School of Occupational and Public Health, Toronto Metropolitan University, 288 Church Street, Suite 300, ON, M5B 1Z5, Toronto, Canada
| | - Marcela Reyes
- Instituto de Nutrición Y Tecnología de los Alimentos (INTA), Universidad de Chile, Avda. El Líbano, 5524, Macul, Santiago, Chile
| | - Alejandra Jáuregui
- Center for Health and Nutrition Research, Instituto Nacional de Salud Pública, Av. Universidad 655 Col, Santa María Ahuacatitlán, 62100, Cuernavaca, Mexico
| | - Jean Adams
- Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Box 285, Cambridge, CB2 0QA, UK
| | - Christina A Roberto
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, 1121 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA
| | - Gary Sacks
- Global Obesity Centre, Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125, Australia
| | - James F Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, 921 Assembly St, Columbia, SC, 29208, USA
- Center for Population Health Research, Instituto Nacional de Salud Pública, Av. Universidad 655 Col, Santa María Ahuacatitlán, 62100, Cuernavaca, Mexico
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16
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Huse O, Schultz S, Boelsen‐Robinson T, Ananthapavan J, Peeters A, Sacks G, Blake MR. The implementation and effectiveness of outlet-level healthy food and beverage accreditation schemes: A systematic review. Obes Rev 2023; 24:e13556. [PMID: 36756666 PMCID: PMC10909553 DOI: 10.1111/obr.13556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/20/2022] [Accepted: 01/17/2023] [Indexed: 02/10/2023]
Abstract
Healthy food outlet accreditation schemes represent an avenue for incentivizing food retailers to promote healthy eating patterns by improving the healthiness of food environments. This systematic review aimed to (i) assess the impact of food outlet-level accreditation schemes on outlet practices and customer purchases and (ii) identify barriers and enablers to scheme implementation. Peer-reviewed and grey literature were systematically searched. Eligible studies related to outlet-level food and beverage accreditation schemes across any food retail setting. Findings were narratively synthesized by retailer type according to (i) scheme characteristics (governance, targeted products, support, and monitoring); (ii) scheme outcomes (rate of uptake, proportion of certified retailers, impact on purchasing, customer perspectives, and retailer perspectives); and (iii) barriers and enablers to implementation. From 21,943 records screened, 48 were included, covering 26 schemes. Most (18) targeted restaurants or convenience stores. Average uptake was 65% of all outlets approached to participate. Implementation of accreditation schemes was associated with healthier customer purchases in convenience stores, schools, and hospitals, but evidence from restaurants was mixed. Enablers of scheme implementation included support for implementation and maintenance, flexible scheme criteria, and motivated retail staff. Healthy food outlet accreditation schemes represent a promising mechanism for engaging retailers to improve the healthiness of food retail environments.
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Affiliation(s)
- Oliver Huse
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of HealthDeakin UniversityGeelongAustralia
| | - Sally Schultz
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of HealthDeakin UniversityGeelongAustralia
| | - Tara Boelsen‐Robinson
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of HealthDeakin UniversityGeelongAustralia
| | - Jaithri Ananthapavan
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of HealthDeakin UniversityGeelongAustralia
- Deakin Health Economics, Institute for Health Transformation, Faculty of HealthDeakin UniversityGeelongAustralia
| | - Anna Peeters
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of HealthDeakin UniversityGeelongAustralia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of HealthDeakin UniversityGeelongAustralia
| | - Miranda R. Blake
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of HealthDeakin UniversityGeelongAustralia
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Gaucher-Holm A, Wood B, Sacks G, Vanderlee L. The structure of the Canadian packaged food and non-alcoholic beverage manufacturing and grocery retailing sectors through a public health lens. Global Health 2023; 19:18. [PMID: 36906536 PMCID: PMC10008568 DOI: 10.1186/s12992-023-00917-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/28/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Corporate power has been recognized as an important influence on food environments and population health more broadly. Understanding the structure of national food and beverage markets can provide important insight into the power held by leading corporations. This study aimed to descriptively analyze the structure of the Canadian food and beverage manufacturing and grocery retailing sectors as of 2020/21. METHODS Packaged food manufacturers, non-alcoholic beverage manufacturers and grocery retailers with ≥ 1% market share in 2020/21 in Canada as per Euromonitor International were identified and characterized. Proportion of market share held by public vs private, multinational vs national, and foreign multinational companies was assessed for the 3 sectors. The concentration of 14 packaged food, 8 non-alcoholic beverage and 5 grocery retailing markets was assessed using the Herfindahl-Hirschman Index (HHI) and the four firm concentration ratio (CR4) (HHI > 1800 and CR4 > 60 suggest high market concentration). Company ownership structure was also assessed, including common ownership of public companies by three of the largest global asset managers using data from Refinitiv Eikon, a financial market database. RESULTS The Canadian non-alcoholic beverage manufacturing sector, and, to a lesser extent, the packaged food manufacturing sector were dominated by foreign multinational companies, in contrast with the grocery retailing sector which was dominated by national companies. Market concentration varied across sectors and markets but was substantially greater within the retailing (median CR4 = 84; median HHI = 2405) and non-alcoholic beverage sectors (median CR4 = 72; median HHI = 1995) compared to the packaged food sector (median CR4 = 51; median HHI = 932). There was considerable evidence of common ownership across sectors. Overall, the Vanguard Group Inc owned at least 1% of shares in 95% of publicly listed companies, Blackrock Institutional Trust Company 71%, and State Street Global Advisors (US) 43%. CONCLUSIONS The Canadian packaged food and non-alcoholic beverage manufacturing and grocery retailing sectors include several consolidated markets, with a high degree of common ownership by major investors. Findings suggest that a small number of large corporations, particularly in the retailing sector, have extensive power to influence Canadian food environments; their policies and practices warrant substantial attention as part of efforts to improve population diets in Canada.
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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, 2425 rue de l'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Benjamin Wood
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Lana Vanderlee
- École de nutrition, Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2425 rue de l'Agriculture, Québec, QC, G1V 0A6, Canada.
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18
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Zorbas C, Martino F, Heneghan T, Potter J, Chisholm M, Cameron AJ, Sacks G, Ananthapavan J, Backholer K. Perceptions towards unhealthy food sponsorship in junior sports in Victoria, Australia. Aust N Z J Public Health 2023; 47:100024. [PMID: 36907000 DOI: 10.1016/j.anzjph.2023.100024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 11/21/2022] [Accepted: 12/11/2022] [Indexed: 03/12/2023] Open
Abstract
OBJECTIVE To explore Victorian parents' and club officials' engagement with, and attitudes towards, the sponsorship of junior sports by unhealthy food and beverage companies. METHODS We conducted online surveys with 504 parents of children participating in junior sports and 16 semi-structured interviews with junior sports club officials (from clubs that accepted unhealthy food sponsorship) in Victoria, Australia. RESULTS Most parents were concerned about children's exposure to sponsorship by unhealthy local (58% extremely, very or moderately concerned) and large food companies (63%) in junior sports. The views of sporting club officials were grouped into four themes: (1) the existing funding challenges for junior sports, (2) how junior sports sponsorship is community dependent, (3) how the perceived risks of sponsorship by unhealthy food companies are low and (4) the need for high-level regulations and support to transition towards healthier junior sports sponsorship. CONCLUSIONS Transitioning towards healthier junior sports sponsorship may be hindered by insufficient funding models and low concern for such actions by community leaders. IMPLICATIONS FOR PUBLIC HEALTH Policy actions from higher-level sporting governing bodies and governments are likely to be necessary to reduce harmful junior sports sponsorship, alongside restrictions on the marketing of unhealthy foods through other media and settings.
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Affiliation(s)
- Christina Zorbas
- Deakin University, Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Geelong, Australia.
| | - Florentine Martino
- Deakin University, Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Geelong, Australia
| | - Tara Heneghan
- The Victorian Health Promotion Foundation (VicHealth), Australia
| | - Jane Potter
- The Victorian Health Promotion Foundation (VicHealth), Australia
| | - Melanie Chisholm
- The Victorian Health Promotion Foundation (VicHealth), Australia
| | - Adrian J Cameron
- Deakin University, Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Geelong, Australia
| | - Gary Sacks
- Deakin University, Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Geelong, Australia
| | - Jaithri Ananthapavan
- Deakin University, Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Geelong, Australia; Deakin University, Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Geelong, Australia
| | - Kathryn Backholer
- Deakin University, Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Geelong, Australia
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Huse O, Reeve E, Zambrano P, Bell C, Peeters A, Sacks G, Baker P, Backholer K. Understanding the corporate political activity of the ultra - processed food industry in East Asia: a Philippines case study. Global Health 2023; 19:16. [PMID: 36879312 PMCID: PMC9986662 DOI: 10.1186/s12992-023-00916-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 02/21/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Evidence is mounting that the ultra - processed food industry seeks to influence food and nutrition policies in ways that support market growth and protect against regulatory threats, often at the expense of public health. However, few studies have explored how this occurs in lower - middle income countries. We aimed to explore if and how the ultra - processed food industry seeks to influence food- and nutrition - related policy processes in the Philippines, a lower - middle income country in East Asia. METHODS Semi - structured key informant interviews were conducted with ten representatives from the Philippines government and non - government organisations closely involved with nutrition policy making in the Philippines. Interview schedules and data analysis were guided by the policy dystopia model, which we used to identify the instrumental and discursive strategies used by corporate actors to influence policy outcomes. RESULTS Informants were of the view that ultra - processed food companies in the Philippines sought to delay, prevent, water - down and circumvent implementation of globally recommended food and nutrition policies by engaging in a range of strategies. Discursive strategies included various tactics in which globally recommended policies were framed as being ineffective or highlighting potential unintended negative impacts. Instrumental strategies included: directly engaging with policymakers; promoting policies, such as industry - led codes and practices, as substitutes for mandatory regulations; presenting evidence and data that industry has generated themselves; and offering gifts and financial incentives to government individuals and agencies. CONCLUSIONS In the Philippines, the ultra - processed food industry engaged in overt activities designed to influence food and nutrition policy processes in their favour. A range of measures to minimise industry influence on policy processes should be introduced, to ensure that implemented food and nutrition policies align with best practice recommendations.
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Affiliation(s)
- Oliver Huse
- Global Centre for Preventative Health and Nutrition, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia.
| | - Erica Reeve
- Global Centre for Preventative Health and Nutrition, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Paul Zambrano
- Alive & Thrive Southeast Asia, FHI 360, Manila, Philippines
| | - Colin Bell
- Global Centre for Preventative Health and Nutrition, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Anna Peeters
- Global Centre for Preventative Health and Nutrition, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Gary Sacks
- Global Centre for Preventative Health and Nutrition, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Phillip Baker
- Faculty of Health, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Kathryn Backholer
- Global Centre for Preventative Health and Nutrition, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia
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20
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Yin E, Cameron AJ, Schultz S, White CM, Vanderlee L, Hammond D, Sacks G. Public Support for Nutrition-Related Actions by Food Companies in Australia: A Cross-Sectional Analysis of Findings from the 2020 International Food Policy Study. Int J Environ Res Public Health 2023; 20:4054. [PMID: 36901060 PMCID: PMC10002083 DOI: 10.3390/ijerph20054054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
Unhealthy food environments contribute to unhealthy population diets. In Australia, the government currently relies on voluntary food company actions (e.g., related to front-of-pack labelling, restricting promotion of unhealthy foods, and product formulation) as part of their efforts to improve population diets, despite evidence that such voluntary approaches are less effective than mandatory policies. This study aimed to understand public perceptions of potential food industry nutrition-related actions in Australia. An online survey was completed by 4289 Australians in 2020 as part of the International Food Policy Study. The level of public support was assessed for six different nutrition-related actions related to food labelling, food promotion, and product formulation. High levels of support were observed for all six company actions, with the highest support observed for displaying the Health Star Rating on all products (80.4%) and restricting children's exposure to online promotion of unhealthy food (76.8%). Findings suggest the Australian public is strongly supportive of food companies taking action to improve nutrition and the healthiness of food environments. However, given the limitations of the voluntary action from food companies, mandatory policy action by the Australian government is likely to be needed to ensure company practices align with public expectations.
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Affiliation(s)
- Ebony Yin
- Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, Deakin University, Burwood 3125, Australia
| | - Adrian J. Cameron
- Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, Deakin University, Burwood 3125, Australia
| | - Sally Schultz
- Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, Deakin University, Burwood 3125, Australia
| | - Christine M. White
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Lana Vanderlee
- School of Nutrition, Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec City, QC G1V 0A6, Canada
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Gary Sacks
- Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, Deakin University, Burwood 3125, Australia
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21
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Wood B, Sacks G. The influence of share buybacks on ill-health and health inequity: an exploratory analysis using a socio-ecological determinants of health lens. Global Health 2023; 19:3. [PMID: 36631805 PMCID: PMC9832402 DOI: 10.1186/s12992-023-00905-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 01/04/2023] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Share buybacks, when a corporation buys back its own shares, are recognised as having potentially harmful impacts on society. This includes by contributing to economic inequalities, and by impeding investments with the potential to protect and promote the welfare of various stakeholders. Share buybacks, however, have received minimal analytical attention in the public health literature. This paper aimed to explore the potential influence of share buybacks on population health and health inequity using a socio-ecological determinants of health lens. METHODS We conducted a descriptive analysis of share buybacks made by corporations listed on United States (US) stock exchanges between 1982 and 2021, using quantitative data sourced from Compustat. We examined annual trends in share buyback expenditure, including comparisons to dividend, net income, capital expenditure, and research and development expenditure data. We then purposively sampled a set of corporations to provide illustrative examples of how share buybacks potentially influence key socio-ecological determinants of health. The examples were: i) three COVID-19 vaccine manufacturers; ii) five of the world's largest fossil fuel corporations; and iii) US car manufacturer General Motors. For these, we conducted an analysis of data from Compustat, company reports and grey literature materials, focusing on key sources of profits and their allocation to share buybacks and particular investments. RESULTS US-listed corporations spent an estimated US$9.2 trillion in real terms on share buybacks between 2012 and 2021 (nearly 12 times more than from 1982 to 1991). The contribution of share buybacks to total shareholder 'returns' increased from 11% in 1982 to 55% in 2021, with expenditure on shareholder returns increasing considerably relative to capital, research and development expenditure over this period. The three examples illustrated how some corporations have prioritised the short-term financial interests of their shareholders, including via implementing large share buyback programs, over investments with considerable potential to protect and promote the public's health. CONCLUSION The potentially substantial impacts of share buybacks on health warrant increased research and policy attention. Arguably, more must be done to regulate share buybacks as part of efforts to address the corporate drivers of ill-health and inequity.
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Affiliation(s)
- Benjamin Wood
- Global Centre for Preventive Health and Nutrition, Deakin University, Institute for Health Transformation, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
| | - Gary Sacks
- grid.1021.20000 0001 0526 7079Global Centre for Preventive Health and Nutrition, Deakin University, Institute for Health Transformation, 221 Burwood Highway, Burwood, VIC 3125 Australia
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22
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Acton RB, Rynard VL, Adams J, Bhawra J, Cameron AJ, Contreras-Manzano A, Davis RE, Jáuregui A, Sacks G, Thrasher JF, Vanderlee L, White CM, Hammond D. Awareness, use and understanding of nutrition labels among adults from five countries: Findings from the 2018-2020 International Food Policy Study. Appetite 2023; 180:106311. [PMID: 36122623 DOI: 10.1016/j.appet.2022.106311] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/09/2022] [Accepted: 09/11/2022] [Indexed: 12/15/2022]
Abstract
Few studies have compared the effects of different front-of-package label (FOPL) systems in the 'real world'. This study assessed adults' awareness, use and understanding of nutrition facts labels (NFLs) and nationally implemented FOPLs such as Health Star Ratings (HSR), Traffic lights, and Guideline Daily Amounts (GDAs) in five countries, including before and after implementation of Mexico's warning FOPLs in 2020. Data were from the International Food Policy Study, an annual repeat cross-sectional study conducted in 2018-2020 among adults (N=64,032) in Australia, Canada, Mexico, the UK and the US. Self-reported awareness, use, and understanding of NFLs (in all five countries) and FOPLs (in Australia, Mexico, and UK) were assessed over time, between countries, and between NFLs and FOPLs. Most respondents in all countries reported seeing their country's NFLs (awareness) 'often' or 'all the time' across all three years, with one third to half of respondents using NFLs 'often' or 'all the time' (Australia: 43-45%; Canada: 47-50%; Mexico: 36-39%; UK: 32-34%; US: 47-49%), and approximately one half to two thirds finding NFLs 'easy' or 'very easy to understand' (56-57%; 67-69%; 51-54%; 48-51%; 70-71%). In 2020, awareness, use and self-reported understanding of the Warning FOPLs in Mexico were highest among all countries with a FOPL (p<0.001), whereas awareness and use were lowest for Australia's HSR (p<0.001). In countries with FOPLs, self-reported understanding was higher for FOPLs than NFLs, except for the GDA FOPL in Mexico. Only modest changes were observed over time. Warning FOPLs were associated with greater levels of self-reported awareness, use and understanding among adults compared to NFLs and GDA-based FOPLs. FOPLs implemented on a voluntary basis, such as Australia's HSR, may be less likely to be seen and used.
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Affiliation(s)
- Rachel B Acton
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada.
| | - Vicki L Rynard
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada.
| | - Jean Adams
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
| | - Jasmin Bhawra
- School of Occupational and Public Health, Faculty of Community Services, Toronto Metropolitan University, Toronto, Ontario, Canada.
| | - Adrian J Cameron
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Australia.
| | - Alejandra Contreras-Manzano
- Center for Health and Nutrition Research, Instituto Nacional de Salud Pública, Av. Universidad 655, Cuernavaca, Morelos, Zip code, 62100, Mexico.
| | - Rachel E Davis
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
| | - Alejandra Jáuregui
- Center for Health and Nutrition Research, Instituto Nacional de Salud Pública, Av. Universidad 655, Cuernavaca, Morelos, Zip code, 62100, Mexico.
| | - Gary Sacks
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Australia.
| | - James F Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
| | - Lana Vanderlee
- École de Nutrition, Centre de Nutrition, santé et société (NUTRISS), Université LavalQuébec, Québec, G1V 0A6, Canada.
| | - Christine M White
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada.
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada.
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23
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Huse O, Reeve E, Bell C, Sacks G, Baker P, Wood B, Backholer K. Strategies used by the soft drink industry to grow and sustain sales: a case-study of The Coca-Cola Company in East Asia. BMJ Glob Health 2022; 7:bmjgh-2022-010386. [PMID: 36593644 PMCID: PMC9730366 DOI: 10.1136/bmjgh-2022-010386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 11/10/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The market and non-market activities of the food and beverage industry contribute to unhealthy and unsustainable dietary patterns, increasingly in low-income and middle-income countries (LMICs). We aimed to describe how The Coca-Cola Company (TCCC), as the world market leader in the sugar-sweetened beverage sector, operationalises their activities in LMICs in East Asia, among the world's most highly populated yet under-researched countries, to illustrate the ways in which these activities may negatively influence health outcomes. METHODS We adopted a theoretically-guided qualitative research design and documentary analysis method. Data sources included: industry documents and web pages, marketing case studies obtained from the World Advertising Research Centre, media reports, global trade summaries and websites of industry associations. To guide data analysis, we synthesised a conceptual framework from existing commercial determinants of health literature, to describe ways in which the market and non-market activities of TCCC influence health. RESULTS TCCC leverages subsidiary companies and investments in international networks to expand its supply chains. The company engages in frequent political activities to minimise the implementation of nutrition policies that may impact profits. The company markets products, particularly on digital and mobile devices, often targeting children, adolescents and mothers, and undertakes public relations activities related to human rights, environmental sustainability and community and economic supports, and these public relations activities are often integrated into marketing campaigns. The identified activities of TCCC are frequently in direct contrast to efforts to improve the healthfulness of population diets in East Asia LMICs. CONCLUSIONS A public health analysis of the market and non-market activities of corporations active in unhealthy commodity industries needs to be broad in scope to cover the diverse set of strategies used to increase their market power and influence. Governments should consider a suite of policy options to attenuate these commercial determinants of unhealthy diets.
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Affiliation(s)
- Oliver Huse
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation. Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Erica Reeve
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation. Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Colin Bell
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation. Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation. Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Phillip Baker
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Victoria, Australia
| | - Benjamin Wood
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation. Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation. Faculty of Health, Deakin University, Geelong, Victoria, Australia
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24
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Robinson E, Parker C, Carey R, Foerster A, Blake MR, Sacks G. Integrating nutrition and obesity prevention considerations into institutional investment decisions regarding food companies: Australian investment sector perspectives. Global Health 2022; 18:93. [PMID: 36348484 PMCID: PMC9640902 DOI: 10.1186/s12992-022-00885-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 10/13/2022] [Accepted: 10/17/2022] [Indexed: 11/11/2022] Open
Abstract
Background: There is growing recognition that current food systems are both unhealthy and unsustainable, and are increasingly shifting toward the supply and marketing of unhealthy, ultra-processed foods and beverages. Large food companies hold substantial power within food systems and present a significant barrier to progress on addressing issues related to nutrition and obesity prevention. Institutional investors (such as pension funds) play a key role in influencing corporate governance and practices, and are increasingly incorporating environmental, social and governance (ESG) considerations within investment decisions. By considering nutrition and obesity prevention, institutional investors present a potential avenue for driving increased food industry accountability for their population health impact. This study investigated views of stakeholders in the Australian investment sector on the incorporation of nutrition and obesity prevention considerations within institutional investment decision-making regarding food companies. Methods: Fifteen in-depth, semi-structured interviews were conducted in 2020-21. Participants were predominantly Australian-based, and included representatives from asset management companies, superannuation funds, ESG advisory/consultancy firms, ESG research providers, and relevant advocacy groups. Interviews examined challenges and opportunities to the integration of nutrition and obesity prevention considerations within institutional investment decision-making. Interviews were analysed using deductive thematic analysis, informed by a theoretical change model. Results: Several participants reported that their institution factored nutrition and obesity prevention considerations into their investment decisions; however, attention to nutrition-related issues was limited, generally perceived as ‘niche’, and not yet institutionalised. Key challenges and opportunities were identified at the employee, investment organisation, investment sector, government and non-government levels. These challenges and opportunities centred around experience and knowledge, quality and availability of ESG data and benchmarks, importance of investor coalitions, and demonstration of financial risks related to nutrition and obesity. Conclusion: There are a range of steps that could be taken to help ensure more systematic and effective consideration of issues related to nutrition and obesity prevention within institutional investment decision-making in Australia, including: (1) improved nutrition-related reporting metrics and benchmarking criteria for food companies; (2) better articulation of the financial risks that unhealthy diets and obesity pose to investors; (3) enhanced investor advocacy on unhealthy diets and obesity through investor coalitions and; (4) detailed guidance for investors on how to address unhealthy diets and obesity. Better engagement between the Australian public health community, institutional investors and government regulators is critical to drive changed investor practice in this area. Supplementary Information The online version contains supplementary material available at 10.1186/s12992-022-00885-7.
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Affiliation(s)
- Ella Robinson
- grid.1021.20000 0001 0526 7079Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC Australia
| | - Christine Parker
- grid.1008.90000 0001 2179 088XMelbourne Law School, The University of Melbourne, Melbourne, VIC Australia
| | - Rachel Carey
- grid.1008.90000 0001 2179 088XSchool of Agriculture and Food, The University of Melbourne, Melbourne, VIC Australia
| | - Anita Foerster
- grid.1002.30000 0004 1936 7857Monash Business School, Monash University, Melbourne, VIC Australia
| | - Miranda R Blake
- grid.1021.20000 0001 0526 7079Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC Australia
| | - Gary Sacks
- grid.1021.20000 0001 0526 7079Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC Australia
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25
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Petre T, Bauman A, Sumithran P, Sacks G, Lobstein T, Le Roux C, Mullen C, Oldfield B. A better understanding of the science and reality of obesity is urgently needed. Public Health Res Pract 2022; 32:3232220. [PMID: 36220556 DOI: 10.17061/phrp3232220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
Efforts to prevent and treat obesity need to be grounded in science. A historical focus on individual responsibility has been ineffective in halting the rise in obesity prevalence. There needs to be a better understanding of environmental and biological drivers of weight gain to help reduce weight bias and stigma and identify more effective policies for action.
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Affiliation(s)
| | - Adrian Bauman
- School of Public Health and Charles Perkins Centre, University of Sydney, NSW, Australia
| | - Priya Sumithran
- University of Melbourne, Department of Medicine (St Vincent's) and Austin Health, Department of Endocrinology, VIC, Australia
| | - Gary Sacks
- Deakin University, Global Obesity Centre, Institute for Health Transformation, Geelong, Australia
| | - Tim Lobstein
- World Obesity Federation, London, UK; The Boden Initiative, University of Sydney, NSW, Australia
| | - Carel Le Roux
- Conway Institute, University College Dublin, Ireland
| | - Clare Mullen
- Health Consumers' Council WA, Perth, Australia; Weight Issues Network, Australia
| | - Brian Oldfield
- Department of Physiology, Monash University, Victoria, Australia
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26
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Wood B, Baker P, Sacks G. Conceptualising the Commercial Determinants of Health Using a Power Lens: A Review and Synthesis of Existing Frameworks. Int J Health Policy Manag 2022; 11:1251-1261. [PMID: 33619932 PMCID: PMC9808328 DOI: 10.34172/ijhpm.2021.05] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 01/16/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND There is increasing recognition that power imbalances that favour corporations, especially those active in unhealthy commodity industries, over other actors are central to the ways in which corporations influence population health. However, existing frameworks for analysing corporate strategies and practices that impact on health do not incorporate concepts of power in consistent ways. This paper aimed to review the ways in which corporate power has been incorporated into such frameworks, and to propose a revised framing of the commercial determinants of health (CDoH) that makes concepts of power explicit. METHODS We conducted a narrative review of frameworks that identify corporate strategies and practices and explain how these influence population health. Content analysis was conducted to identify explicit references to different qualities of power - its origins, nature, and manifestations. RESULTS Twenty-two frameworks were identified, five of which used theories of power. A wide range of contexts that shape, and are shaped by corporate power were discussed, as were a diversity of corporate, social and ecological outcomes. A variety of material and ideational sources of power was also covered. We proposed an integrated 'Corporate Power and Health' framework to inform analysis of the CDoH, organised around key questions on power set out by Foucault. The proposed framework draws from a number of well-established corporate power theories and synthesises key features of existing CDoH frameworks. CONCLUSION Public health advocates, researchers and policy-makers would likely be better placed to understand and address the CDoH by engaging with theories of power to a greater extent, and by explicitly incorporating concepts of corporate power in analyses of how the deployment of corporate strategies and practices influence population health.
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Affiliation(s)
- Benjamin Wood
- Global Obesity Centre, Deakin University, Geelong, VIC, Australia
| | - Phillip Baker
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Gary Sacks
- Global Obesity Centre, Deakin University, Geelong, VIC, Australia
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27
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Grigsby-Duffy L, Cameron AJ, Backholer K, Sacks G. Food industry perspectives on potential policies targeting unhealthy food and beverage price promotions in Australian supermarkets. BMC Public Health 2022; 22:1423. [PMID: 35883174 PMCID: PMC9322738 DOI: 10.1186/s12889-022-13812-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/11/2022] [Indexed: 12/04/2022] Open
Abstract
Current supermarket price promotions are likely to encourage unhealthy diets, leading some governments to recently endorse restrictions on price promotions for unhealthy food and beverages. However, little is known about the likely industry response to policy action in this area. The aim of this study was to understand how potential government policies targeting food and beverage price promotions in supermarkets are perceived by food industry stakeholders in Australia. Twelve semi-structured in-depth interviews were conducted with current and former employees of major food manufacturers and food retailers as well as other industry experts with experience related to price promotion practices in the Australian supermarket setting. Data were analysed deductively based on Lewin’s organisational change theories and inductively to highlight forces that might drive or restrain change. From an industry perspective, forces likely to create industry opposition to implementation of price promotion policy included: fear of losing competitive advantage; potential financial loss for food retailers and their suppliers; a perception that restrictions on price promotions for unhealthy products will not impact health; and a perception of increased financial cost to consumers. Forces perceived to drive implementation of a policy that would benefit public health included: mandatory regulation; extensive compliance monitoring; support for promoting healthy products; consumer education; and sufficient lead time and support from retailers for implementation. These forces, and the way in which they interact, need to be actively considered as part of efforts to change the healthiness of food and beverage price promotions in supermarkets.
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Affiliation(s)
- Lily Grigsby-Duffy
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC, 3220, Australia.
| | - Adrian J Cameron
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC, 3220, Australia
| | - Kathryn Backholer
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC, 3220, Australia
| | - Gary Sacks
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC, 3220, Australia
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28
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Wolfenden L, Hawe P, Rychetnik L, Sutherland R, Barnes C, Yoong S, Giles-Corti B, Mitchell J, Bauman A, Milat AJ, Chai LK, Mayfield S, Mastersson N, Freebairn L, Sacks G, Wilson A, Wright A, Wiggers J. A call to action: More collaborative implementation research is needed to prevent chronic disease. Aust N Z J Public Health 2022; 46:549-553. [PMID: 35735905 DOI: 10.1111/1753-6405.13270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Luke Wolfenden
- School of Medicine and Public Health, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, New Lambton, New South Wales.,The Australian Prevention Partnership Centre, Sax Institute, Sydney, New South Wales
| | - Penelope Hawe
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, New South Wales.,Sydney School of Public Health, University of Sydney, Sydney, New South Wales
| | - Lucie Rychetnik
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, New South Wales.,Sydney School of Public Health, University of Sydney, Sydney, New South Wales
| | - Rachel Sutherland
- School of Medicine and Public Health, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, New Lambton, New South Wales
| | - Courtney Barnes
- School of Medicine and Public Health, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, New Lambton, New South Wales
| | - Serene Yoong
- School of Medicine and Public Health, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, New Lambton, New South Wales.,Faculty Health, Arts and Design, Swinburne University of Technology, Victoria
| | - Billie Giles-Corti
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, New South Wales.,Centre for Urban Research, RMIT University, Melbourne, Victoria
| | - Jo Mitchell
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, New South Wales.,Centre for Population Health, New South Wales Ministry of Health, Sydney, New South Wales
| | - Adrian Bauman
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, New South Wales.,Sydney School of Public Health, University of Sydney, Sydney, New South Wales
| | - Andrew J Milat
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, New South Wales.,Centre for Epidemiology and Evidence, NSW Ministry of Health, Sydney, New South Wales
| | - Li Kheng Chai
- School of Exercise and Nutrition Science, Queensland University of Technology at the Centre for Children's Health Research (CCHR), South Brisbane, Queensland.,Health and Wellbeing Queensland, Queensland Government, Milton, Queensland
| | - Sara Mayfield
- Health and Wellbeing Queensland, Queensland Government, Milton, Queensland
| | - Nadia Mastersson
- The Commission on Excellence and Innovation in Health, Government of South Australia, Adelaide, South Australia
| | - Louise Freebairn
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, New South Wales.,Brain and Mind Centre, University of Sydney, Sydney, New South Wales
| | - Gary Sacks
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, New South Wales.,Deakin University, Global Obesity Centre, Institute for Health Transformation, Geelong, Victoria
| | - Andrew Wilson
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, New South Wales.,Sydney School of Public Health, University of Sydney, Sydney, New South Wales
| | - Annemarie Wright
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria.,Victorian Health Promotion Foundation, Melbourne, Victoria
| | - John Wiggers
- School of Medicine and Public Health, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, New Lambton, New South Wales
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29
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Hammond D, Vanderlee L, White CM, Acton RB, White M, Roberto CA, Cameron A, Sacks G, Kirkpatrick S, Dubin J, Adams J, Jauregui A, Thrasher JF. The Conceptual Framework for the International Food Policy Study: Evaluating the Population-Level Impact of Food Policy. J Nutr 2022; 152:1S-12S. [PMID: 35274695 PMCID: PMC9188864 DOI: 10.1093/jn/nxac042] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/16/2022] [Accepted: 02/20/2022] [Indexed: 11/14/2022] Open
Abstract
An unhealthy diet is among the leading global causes of death and disability. Globally, a range of policies are being implemented to support healthy food choices at a population level, including novel polices in the areas of food marketing, nutrition labeling, and taxation of less healthy foods. There is a need to evaluate and inform the implementation of these policies, including their impacts on marginalized population subgroups. The International Food Policy Study (IFPS) consists of repeated cross-sectional surveys conducted in 5 high- and upper-middle-income countries: Australia, Canada, Mexico, the United Kingdom, and the United States. In each country, approximately 4000 adults and 1200 children and youth (aged 10-17) were recruited from a global commercial panel to complete an online survey using consistent measures and methodologies across countries. The first annual IFPS surveys were conducted in 2017 with adults; annual surveys for young people aged 10-17 were launched in 2019 in the same countries, as well as in Chile. The design of the IFPS surveys creates a framework for evaluating "natural experiments" in food policies, including comparisons over time within countries implementing the policy and comparisons with countries in which the policy was not implemented. IFPS surveys have 3 primary areas of focus: 1) knowledge, attitudes, and beliefs associated with specific policies; 2) diet-related behaviors; and 3) dietary intake, including 24-hour dietary recalls for adults in 4 of the 5 countries. Surveys also assess food insecurity, income adequacy, sex and gender, race/ethnicity, and a range of other measures to assess trends among priority subgroups. Overall, the IFPS project has the potential to address important gaps in national monitoring surveys for dietary patterns, and to evaluate the impacts of novel food policies implemented in any of the 5 countries over the study period.
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Affiliation(s)
| | - Lana Vanderlee
- École de Nutrition, Centre Nutrition, santé et société (Centre NUTRISS), and Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
| | - Christine M White
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Rachel B Acton
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Martin White
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Christina A Roberto
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Adrian Cameron
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Gary Sacks
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Sharon Kirkpatrick
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Joel Dubin
- Department Statistics and Actuarial Science, University of Waterloo, Waterloo, Canada
| | - Jean Adams
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Alejandra Jauregui
- Centre for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | - James F Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Hock K, Barquera S, Corvalán C, Goodman S, Sacks G, Vanderlee L, White CM, White M, Hammond D. Awareness of and Participation in School Food Programs in Youth from Six Countries. J Nutr 2022; 152:85S-97S. [PMID: 35274730 PMCID: PMC9188863 DOI: 10.1093/jn/nxac052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/25/2022] [Accepted: 03/03/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND School-based meal programs can promote healthy dietary intake in youth. However, limited data exist regarding the impact of income-targeted school meal programs across countries, particularly among food-insecure youth. OBJECTIVES We examined self-reported awareness of and participation in free school meal programs, and associations with dietary intake in youth from 6 countries with differing national school meal policies. METHODS Data were collected through the 2019 International Food Policy Study Youth Survey, a cross-sectional survey of 10,565 youth aged 10-17 y from Australia, Canada, Chile, Mexico, the United Kingdom, and the United States. Regression models examined: 1) country differences in awareness of and participation in breakfast and lunch programs; and 2) associations between lunch program participation and intake of fruit and vegetables, and "less healthy" foods during the previous school lunch day. RESULTS Awareness of and participation in free breakfast and lunch programs varied across countries. Approximately half of USA and Chilean students participated in school lunch programs-the countries with the most comprehensive national policies-compared with one-fifth of students in the United Kingdom, and ∼5% in Australia, Canada, and Mexico (P < 0.001 for all contrasts). In the United States and Chile, more than two-thirds of youth with the highest level of food insecurity participated in lunch programs, compared with 45% in the United Kingdom, 27% in Canada, and ≤20% in Australia and Mexico. In all countries, youth reporting school lunch program participation were more likely to report fruit and vegetable intake during their previous school lunch (P < 0.001), and higher intake of "less healthy" food in all countries except the United States and Chile. CONCLUSIONS More comprehensive national policies were associated with greater participation in school meal programs, particularly among youth at greatest risk of food insecurity, as well as healthier dietary intake from school lunches.
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Affiliation(s)
- Karen Hock
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Camila Corvalán
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Samantha Goodman
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Gary Sacks
- Global Obesity Centre, Deakin University, Melbourne Burwood Campus, Burwood, Victoria, Australia
| | - Lana Vanderlee
- École de Nutrition, Centre Nutrition, santé et société (Centre NUTRISS), and Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
| | - Christine M White
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Martin White
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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Cameron AJ, Oostenbach LH, Dean S, Robinson E, White CM, Vanderlee L, Hammond D, Sacks G. Consumption Frequency and Purchase Locations of Foods Prepared Outside the Home in Australia: 2018 International Food Policy Study. J Nutr 2022; 152:76S-84S. [PMID: 35274693 PMCID: PMC9188859 DOI: 10.1093/jn/nxab437] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/17/2021] [Accepted: 01/17/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Foods prepared outside the home (e.g., fast-food chains, restaurants) represent increasing proportions of diets worldwide, and have been associated with higher energy intakes and BMIs. To improve the healthiness of population diets, it is important to understand patterns of consumption of these foods, and whether related policy measures are effective. OBJECTIVES This study aimed to identify the frequency and sources of consumption of foods prepared outside the home in Australia, and to understand the impact of nutrition information in restaurants on related food choices. METHODS Data were from a web-based survey (the International Food Policy Study) completed in 2018 by Australian adults aged ≥18 years (n = 4103). The number of meals prepared outside the home, their purchase locations, and the extent to which nutrition information was noticed and influenced purchasing decisions were each analyzed by sociodemographic characteristics and BMI, with linear models also adjusted for sex, age group, education, ethnicity, and BMI. RESULTS An average of 2.73 (95% CI, 2.61-2.86) meals per week were prepared outside the home, with higher frequencies among men, younger ages, and more highly educated participants. A wide variety of sources for these foods was observed, with fast-food outlets being most common. Around one-quarter of all foods prepared outside the home were delivered. A small percentage (14.9%; 95% CI, 13.3%-16.7%) of participants reported noticing nutrition information, but among those who did, around half reported that it influenced their behavior. CONCLUSIONS Foods prepared outside the home are commonly purchased in Australia, particularly by young adults, from a variety of outlet types. While current menu energy labeling regulations may provide some population health benefit, a broader policy focus on foods prepared outside the home is needed as part of efforts to improve population diets.
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Affiliation(s)
- Adrian J Cameron
- School of Health and Social Development, Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Laura H Oostenbach
- Institute for Physical Activity and Nutrition Research (IPAN), Deakin University, Geelong, Australia
| | - Sarah Dean
- School of Health and Social Development, Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Ella Robinson
- School of Health and Social Development, Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Christine M White
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Lana Vanderlee
- École de Nutrition, Centre Nutrition, santé et société (Centre NUTRISS), and Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Gary Sacks
- School of Health and Social Development, Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia
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Cameron AJ, Brown A, Orellana L, Marshall J, Charlton E, Ngan WW, Ananthapavan J, Isaacs J, Blake M, Sacks G. Change in the Healthiness of Foods Sold in an Australian Supermarket Chain Following Implementation of a Shelf Tag Intervention Based on the Health Star Rating System. Nutrients 2022; 14:nu14122394. [PMID: 35745125 PMCID: PMC9229209 DOI: 10.3390/nu14122394] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/07/2022] [Accepted: 06/07/2022] [Indexed: 12/10/2022] Open
Abstract
Introduction: Most people in Australia buy most of their food in supermarkets. Marketing techniques promoting healthy foods in supermarkets can be important to encourage healthy eating at a population level. Shelf tags that highlight the healthiness of products have been identified as one such promising initiative. The aim of this study was to assess changes in the healthiness of foods sold in an Australian supermarket chain following implementation of a shelf tag intervention based on the Australian Health Star Rating (HSR) system. Methods: A controlled, non-randomised trial was undertaken in seven supermarkets (intervention: n = 3; control: n = 4) of a single chain in Victoria, Australia, over 12 weeks (4 weeks baseline, 8 weeks intervention period) between August and November 2015. The intervention involved provision of a shelf tag indicating the HSR of all packaged products that scored 4.5 or 5 stars (‘high-HSR products’) using the Australian HSR system. Posters indicating the healthiness of fresh fruits and vegetables (not eligible for an HSR rating, as they are not packaged) were also installed. Weekly per store sales data were provided by the retailer. In an intention-to-treat analysis (with intervention status of individual products based on their eligibility to be tagged), the proportion (%) of all ‘high-HSR’ packaged food sold and the volume of key nutrients (saturated fat, total fat, sodium, total sugar, protein, carbohydrates and energy) per 100 g sold were assessed. Difference-in-difference analyses were conducted to determine the difference between intervention and control stores in terms of mean outcomes between baseline and intervention periods. Customer exit surveys (n = 304) were conducted to evaluate awareness and use of the shelf tags and posters. Results: The proportion of ‘high-HSR products’ sold increased in the intervention period compared to the baseline period in each of the three intervention stores (average increase of 0.49%, 95% CI: −0.02, 0.99), compared to a decrease of −0.15% (−0.46, 0.15) in control stores (p = 0.034). The overall increase in intervention compared to control stores (difference-in-difference) of 0.64% represents an 8.2% increase in the sales of ‘high-HSR products’. Sales of total sugar, total fat, saturated fat, carbohydrates, sodium, protein and total energy in packaged food all decreased significantly more in intervention stores compared to control stores. Sales of fresh fruits and vegetables decreased in intervention stores compared to control stores. Customer surveys found that 34.4% noticed the shelf tags. Of those who noticed the tags, 58% believed the shelf tags influenced their purchases. Conclusions: With this study, we found that the use of shelf tags that highlight the healthiest packaged foods in a supermarket setting showed promise as a mechanism to improve the healthiness of purchases. Opportunities to scale up the intervention warrant exploration, with further research needed to assess the potential impact of the intervention on overall population diets over the longer term.
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Affiliation(s)
- Adrian J. Cameron
- Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, VIC 3220, Australia; (J.M.); (E.C.); (W.W.N.); (J.A.); (J.I.); (M.B.); (G.S.)
- Correspondence: ; Tel.: +61-39-2517-741
| | - Amy Brown
- City of Greater Bendigo Council, Bendigo, VIC 3550, Australia;
| | - Liliana Orellana
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, VIC 3550, Australia;
| | - Josephine Marshall
- Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, VIC 3220, Australia; (J.M.); (E.C.); (W.W.N.); (J.A.); (J.I.); (M.B.); (G.S.)
| | - Emma Charlton
- Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, VIC 3220, Australia; (J.M.); (E.C.); (W.W.N.); (J.A.); (J.I.); (M.B.); (G.S.)
| | - Winsfred W. Ngan
- Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, VIC 3220, Australia; (J.M.); (E.C.); (W.W.N.); (J.A.); (J.I.); (M.B.); (G.S.)
| | - Jaithri Ananthapavan
- Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, VIC 3220, Australia; (J.M.); (E.C.); (W.W.N.); (J.A.); (J.I.); (M.B.); (G.S.)
| | - Jasmine Isaacs
- Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, VIC 3220, Australia; (J.M.); (E.C.); (W.W.N.); (J.A.); (J.I.); (M.B.); (G.S.)
| | - Miranda Blake
- Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, VIC 3220, Australia; (J.M.); (E.C.); (W.W.N.); (J.A.); (J.I.); (M.B.); (G.S.)
| | - Gary Sacks
- Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, VIC 3220, Australia; (J.M.); (E.C.); (W.W.N.); (J.A.); (J.I.); (M.B.); (G.S.)
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Acton RB, Vanderlee L, Cameron AJ, Goodman S, Jáuregui A, Sacks G, White CM, White M, Hammond D. Self-Reported Impacts of the COVID-19 Pandemic on Diet-Related Behaviors and Food Security in 5 Countries: Results from the International Food Policy Study 2020. J Nutr 2022; 152:35S-46S. [PMID: 35274699 PMCID: PMC8992246 DOI: 10.1093/jn/nxac025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/08/2021] [Accepted: 01/28/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has impacted many aspects of daily life, including dietary intake; however, few studies have reported its impacts on dietary behaviors and food security across multiple countries. OBJECTIVES We examined self-reported impacts of COVID-19 on food behaviors, food security, and overall diet healthfulness in 5 countries. METHODS Adults aged 18-100 years (n = 20,554) in Australia, Canada, Mexico, the United Kingdom, and the United States completed an online survey in November and December 2020 as part of the International Food Policy Study, an annual, repeat cross-sectional survey. Survey measures assessed perceived impacts of the COVID-19 pandemic on eating food prepared away from home, having food delivered from a restaurant, and buying groceries online, as well as perceived food security and overall diet healthfulness. Regression models examined associations between each outcome and sociodemographic correlates. RESULTS Across all countries, 62% of respondents reported eating less food prepared away from home due to the pandemic, while 11% reported eating more. Some participants reported having less food delivered from a restaurant (35%) and buying fewer groceries online (17%), while other respondents reported more of each (19% and 25%, respectively). An average of 39% reported impacts on their food security, and 27% reported healthful changes to their overall diet. The largest changes for all outcomes were observed in Mexico. Participants who were younger, ethnic minorities, or had lower income adequacy tended to be more likely to report food-related changes in either direction; however, these relationships were often less pronounced among respondents in Mexico. CONCLUSIONS Respondents reported important changes in how they sourced their food during the pandemic, with trends suggesting shifts towards less food prepared away from home and more healthful diets overall. However, changes in diet and food behaviors occurred in both healthful and less healthful directions, suggesting that dietary responses to the pandemic were highly variable.
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Affiliation(s)
- Rachel B Acton
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Lana Vanderlee
- École de Nutrition, Centre Nutrition, santé et société (Centre NUTRISS), and Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
| | - Adrian J Cameron
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Samantha Goodman
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Alejandra Jáuregui
- Centre for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Gary Sacks
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Christine M White
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Martin White
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada,Address correspondence to DH (e-mail:)
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Van Dam I, Guillon E, Robinson E, Allais O, Sacks G, Vandevijvere S. Assessment of the Commitments and Performance of the European Food Industry to Improve Population Nutrition. Int J Public Health 2022; 67:1604116. [PMID: 35719734 PMCID: PMC9198223 DOI: 10.3389/ijph.2022.1604116] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/18/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: Food companies could play an important role in improving population diets, but often escape accountability through unspecific commitments. This study evaluated nutrition-related commitments and estimated performance of the largest packaged food and non-alcoholic beverage manufacturers, supermarkets and quick-service restaurants (QSR) in Europe. Methods: To quantitatively assess companies’ publicly available commitments in 2020, the “Business Impact Assessment on Obesity and Population Nutrition” was applied. The proportion of sales from ultra-processed and “unhealthy” food categories (product categories not-permitted to be marketed to children) and over time changes in the number of QSR transactions and QSR and supermarket outlets were calculated. Results: Company commitments fell short of best practice recommendations (median overall score of 21%, range: 1%–62%). Food and beverage companies generated 82% (15%–100%) and 58% (1%–100%) sales from ultra-processed and “unhealthy” products, respectively. The number of QSR outlets and transactions substantially increased in Europe since 2011, while QSR commitments to improve population nutrition remained limited. Conclusion: Whilst most companies made some nutrition-related commitments, they did not comply with best practice recommendations. A large proportion of sales was generated from ultra-processed/unhealthy products and QSR outlets increased. Government regulations are urgently needed.
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Affiliation(s)
- Iris Van Dam
- Sciensano, Service of Lifestyle and Chronic Diseases, Brussels, Belgium
- Université Paris-Saclay, INRAE, UR ALISS, Ivry-sur-Seine, France
- *Correspondence: Iris Van Dam,
| | - Emilie Guillon
- Alimentation & Santé, UniLaSalle Campus de Beauvais, Beauvais, France
| | - Ella Robinson
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Olivier Allais
- Université Paris-Saclay, INRAE, UR ALISS, Ivry-sur-Seine, France
| | - Gary Sacks
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
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Vanderlee L, Gómez-Donoso C, Acton RB, Goodman S, Kirkpatrick SI, Penney T, Roberto CA, Sacks G, White M, Hammond D. Meat-Reduced Dietary Practices and Efforts in 5 Countries: Analysis of Cross-Sectional Surveys in 2018 and 2019. J Nutr 2022; 152:57S-66S. [PMID: 35544274 PMCID: PMC9188860 DOI: 10.1093/jn/nxac057] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Diets that reduce reliance on animal-source foods are recommended in some contexts. OBJECTIVES This study aimed to compare proportions of respondents who reported following meat-reduced dietary practices (i.e., vegetarian, vegan, or pescatarian diets) and/or making efforts to reduce animal-source foods, and to examine sociodemographic correlates across 5 countries. METHODS Online surveys were conducted in November and December 2018 and 2019 with 41,607 adults from Australia (n = 7926), Canada (n = 8031), Mexico (n = 8110), the United Kingdom (n = 9129), and the United States (n = 8411) as part of the International Food Policy Study. Respondents were asked whether they would describe themselves as vegetarian, vegan, or pescatarian, and whether they had made efforts to consume less red meat, less of all meats, or less dairy in the past year. Logistic regressions examined differences in the likelihood of each behavior between countries and sociodemographic subgroups. RESULTS Approximately 1 in 10 respondents reported following a vegetarian, vegan, or pescatarian diet, ranging from 8.6% (Canada) to 11.7% (UK). In the past 12 months, the proportions of respondents who reported efforts to consume less red meat ranged from 34.5% (Australia) to 44.4% (Mexico), less of all meats ranged from 27.9% (US) to 35.2% (Mexico), and to consume less dairy ranged from 20.6% (UK) to 41.3% (Mexico). Respondents were more likely to report efforts to consume less animal-source products in 2019 compared to 2018 in most countries. Sociodemographic patterns varied by country; in general, women, those with higher education levels, and those in minority ethnic groups were more likely to report following meat-reduced dietary practices or efforts to consume fewer animal-source products. CONCLUSIONS Nearly half of respondents reported following a meat-reduced diet or efforts to reduce animal-source products, with differences between countries and population subgroups. Population-level approaches and policies that support meat reduction may further reduce consumption of animal-source products.
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Affiliation(s)
| | - Clara Gómez-Donoso
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
| | - Rachel B Acton
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Samantha Goodman
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | | | - Tarra Penney
- Faculty of Health, York University, Toronto, Canada
| | - Christina A Roberto
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Gary Sacks
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Martin White
- Centre for Diet and Activity Research, Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
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Contreras-Manzano A, Nieto C, Jáuregui A, Pérez Ferrer C, Vanderlee L, Barquera S, Sacks G, Adams J, Thrasher JF, Hammond D. Perceived Availability of Healthy and Unhealthy Foods in the Community, Work, and Higher Education Settings across Five Countries: Findings from the International Food Policy Study 2018. J Nutr 2022; 152:47S-56S. [PMID: 35544236 PMCID: PMC9188857 DOI: 10.1093/jn/nxac070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/11/2022] [Accepted: 03/15/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Food environments play a key role in dietary behavior and vary due to different contexts, regulations, and policies. OBJECTIVES This study aimed to characterize the perceived availability of healthy and unhealthy foods in 3 different settings in 5 countries. METHODS We analyzed data from the 2018 International Food Policy Study, a cross-sectional survey of adults (18-100 y, n = 22,824) from Australia, Canada, Mexico, the United Kingdom (UK), and the USA. Perceived availability of unhealthy (junk food and sugary drinks) and healthy foods (fruit or vegetables, healthy snacks, and water) in the community, workplace, and university settings were measured (i.e. not available, available for purchase, or available for free). Differences in perceived availability across countries were tested using adjusted multinomial logistic regression models. RESULTS Across countries, unhealthy foods were perceived as highly available in all settings; in university and work settings unhealthy foods were perceived as more available than healthy foods. Australia and Canada had the highest perceived availability of unhealthy foods (range 87.5-90.6% between categories), and the UK had the highest perceived availability of fruits and vegetables for purchase (89.3%) in the community. In university and work settings, Mexico had the highest perceived availability for purchase of unhealthy foods (range 69.9-84.9%). The USA and the UK had the highest perceived availability of fruits and vegetables for purchase (65.3-66.3%) or for free (21.2-22.8%) in the university. In the workplace, the UK had high perceived availability of fruits and vegetables for purchase (40.2%) or for free (18.5%), and the USA had the highest perceived availability of junk food for free (17.3%). CONCLUSIONS Across countries, unhealthy foods were perceived as highly available in all settings. Variability between countries may reflect differences in policies and regulations. Results underscore the need for the continuation and improvement of policy efforts to generate healthier food environments.
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Affiliation(s)
| | - Claudia Nieto
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Alejandra Jáuregui
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Carolina Pérez Ferrer
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico,National Council for Science and Technology, Mexico City, Mexico
| | - Lana Vanderlee
- École de Nutrition, Centre Nutrition, santé et société (Centre NUTRISS), and Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Gary Sacks
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Burwood Victoria, Geelong, Australia
| | - Jean Adams
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - David Hammond
- School of Public Health and Sciences, University of Waterloo, Waterloo, Canada
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Nieto C, Jáuregui A, Contreras-Manzano A, Potvin Kent M, Sacks G, White CM, Pauzé E, Vanderlee L, Thrasher JF, Barquera S, Hammond D. Adults' Exposure to Unhealthy Food and Beverage Marketing: A Multi-Country Study in Australia, Canada, Mexico, the United Kingdom, and the United States. J Nutr 2022; 152:25S-34S. [PMID: 35544288 PMCID: PMC9188858 DOI: 10.1093/jn/nxab449] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/10/2021] [Accepted: 12/28/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Food marketing increases product appeal, purchasing, and consumption, using diverse strategies and locations to reach consumers. OBJECTIVES The aim of this study was to examine differences in adults' self-reported exposure to various marketing strategies (brand and licensed characters, celebrities, and sponsorship of sports and cultural events) and locations (television, radio, and digital media) across 5 countries: Australia, Canada, Mexico, the United Kingdom, and the United States. METHODS We analyzed cross-sectional survey data on self-reported exposure to food marketing strategies and locations collected in 2018 by the International Food Policy Study. Participants (n = 21,678) aged ≥18 years completed an online survey. Exposures to unhealthy food marketing strategies and locations in the prior 30 days were self-reported. Regression models examined differences in marketing exposure and locations across countries. RESULTS The average number of unhealthy food marketing strategies to which participants reported being exposed ranged from 0.5 in the United Kingdom to 2.3 in Mexico. Self-reported exposure to strategies across all countries was highest for brand characters (32%), followed by licensed characters (22%). In total, the reported mean exposure of marketing locations was 1.6 in the prior month. Television was the most prevalent location (44%), followed by digital marketing (32%). Adjusted models indicated that the odds of reporting exposure to marketing strategies and marketing locations were higher for Mexico compared to the rest of the countries. CONCLUSIONS Adults report a variety of exposures to unhealthy food marketing in all countries, but exposure was highest in Mexico. Special attention should be paid to regulating marketing strategies, such as brand characters and licensed characters, and locations, such as television and digital marketing.
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Affiliation(s)
- Claudia Nieto
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | | | | | - Monique Potvin Kent
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Gary Sacks
- Global Obesity Centre, Deakin University, Geelong, Australia
| | - Christine M White
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Elise Pauzé
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Lana Vanderlee
- École de Nutrition, Centre Nutrition, santé et société (Centre NUTRISS), and Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
| | - James F Thrasher
- Arnold School of Public Health, University of South Carolina, South Carolina, USA,Center for Population Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
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Barons KP, Mann D, Orellana L, Miller M, Pettigrew S, Sacks G. Nutrition-Related Information on Alcoholic Beverages in Victoria, Australia, 2021. Int J Environ Res Public Health 2022; 19:ijerph19084609. [PMID: 35457477 PMCID: PMC9030476 DOI: 10.3390/ijerph19084609] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/05/2022] [Accepted: 04/09/2022] [Indexed: 02/01/2023]
Abstract
Alcoholic beverages sold in Australia are largely exempt from requirements to display nutrition information on packages, unlike other food and beverages. However, alcoholic beverage manufacturers can provide nutrition-related information voluntarily. This study aimed to investigate the prevalence of nutrition-related information on packaged alcoholic beverages in Australia. An in-store audit of the largest alcohol retailer in Melbourne, Australia was conducted in July 2021. A systematic sampling method was used to assess the presence and format of nutrition information on 850 alcoholic beverages across 5 alcohol categories (wine (n = 200), beer (n = 200), spirits (n = 200), ready-to-drink beverages (n = 140) and ciders (n = 110)). Most products (n = 682, 80.2%) did not present nutrition-related information. Where information was presented (n = 168), it was most frequently on ready-to-drink beverages (n = 81, 57.9%) and least frequently on spirits (n = 9, 4.5%) and wines (n = 9, 4.5%). Nutrition information was most frequently in the format of a nutrition information panel (n = 150, 89.3%) and approximately half of labelled beverages (n = 86, 51.2%) included a nutrition content claim (e.g., ‘low in carbs’). Given limited voluntary implementation of nutrition labelling on alcoholic beverages in Australia and the substantial contribution of alcoholic beverages to energy intake, consideration of mandatory nutrition labelling, in a standardised format designed to maximise public health benefit, on alcoholic beverages is warranted.
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Affiliation(s)
| | - Davina Mann
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia;
| | - Liliana Orellana
- Biostatistics Unit, Deakin University, Geelong, VIC 3220, Australia;
| | - Mia Miller
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia; (M.M.); (S.P.)
- The Menzies School of Health Research, Charles Darwin University, Darwin, NT 0811, Australia
| | - Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia; (M.M.); (S.P.)
| | - Gary Sacks
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia;
- Correspondence:
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Acton RB, Vanderlee L, Adams J, Kirkpatrick SI, Pedraza LS, Sacks G, White CM, White M, Hammond D. Tax awareness and perceived cost of sugar-sweetened beverages in four countries between 2017 and 2019: findings from the international food policy study. Int J Behav Nutr Phys Act 2022; 19:38. [PMID: 35361251 PMCID: PMC8973878 DOI: 10.1186/s12966-022-01277-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 02/24/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The public health benefits of sugar-sweetened beverage (SSB) taxes often rely on, among other things, changes to consumer purchases. Thus, perceived cost of SSBs and signalling effects-via awareness of the tax-may impact the effectiveness of SSB taxes on consumer purchases. OBJECTIVE The study sought to examine perceived cost of SSBs, tax awareness, and changes in beverage purchasing over time and across four countries with and without SSB taxes. METHODS The study used data from the 2017, 2018 and 2019 waves of the International Food Policy Study. Annual cross-sectional online surveys were conducted in Australia, Mexico, UK and US, which captured perceived cost of SSBs relative to non-SSBs in all countries (with Australia as a no-tax comparator), and measures of tax awareness and participants' reported changes in beverage purchasing in response to SSB taxes in Mexico (tax implemented in 2014), UK (tax implemented in 2018) and US (subnational taxes since 2015). Logistic regression models evaluated the measures across years and socio-demographic groups. RESULTS Perceived cost of SSBs relative to non-SSBs was higher in Mexico (all three years) and the UK (2018 and 2019 following tax implementation) than Australia and the US. Tax awareness was higher in UK than Mexico, and decreased over time among Mexican respondents. Patterns of reported beverage purchasing changes in response to the tax were similar across Mexico, UK and US, with the largest changes reported by Mexican respondents. Respondents with characteristics corresponding to lower socioeconomic status were less likely to be aware of an SSB tax, but more likely to perceive SSBs to cost more than non-SSBs and report changes in purchasing in response to the tax, where there was one. CONCLUSIONS This study suggests that in countries where a national SSB tax was present (Mexico, UK), perceived cost of SSBs and tax awareness were higher compared to countries with no SSB tax (Australia) or subnational SSB taxes (US), respectively, and suggests that perceived cost and tax awareness represent distinct constructs. Improving the 'signalling effect' of existing SSB taxes may be warranted, particularly in tax settings where consumer behaviour change is a policy objective.
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Affiliation(s)
- Rachel B Acton
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada.
| | - Lana Vanderlee
- École de Nutrition, Centre de Nutrition, Santé Et Société (NUTRISS), Université Laval, 2425 rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Jean Adams
- Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, School of Clinical Medicine, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Box 285, Cambridge, CB2 0QQ, UK
| | - Sharon I Kirkpatrick
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | - Lilia S Pedraza
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Col. Santa María Ahuacatitlán, Cerrada los Pinos Y Caminera, Av. Universidad 655, C.P. 62100, Morelos, Mexico
| | - Gary Sacks
- Global Obesity Centre, Deakin University, Melbourne Burwood Campus, Burwood, VIC, 3125, Australia
| | - Christine M White
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | - Martin White
- Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, School of Clinical Medicine, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Box 285, Cambridge, CB2 0QQ, UK
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
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40
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Martino F, Ananthapavan J, Moodie M, Sacks G. Potential financial impact on television networks of a ban on alcohol advertising during sports broadcasts in Australia. Aust N Z J Public Health 2022; 46:463-468. [PMID: 35238438 DOI: 10.1111/1753-6405.13223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/01/2021] [Accepted: 01/01/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study aimed to assess the potential financial impacts on Australian television networks of a ban on alcohol advertising during sports broadcasts. METHODS We analysed television advertising data from Nielsen, a commercial market research company. The data included details of all advertisements (ads) for the 10 highest-spending alcohol brands on free-to-air television networks in the five largest capital cities in Australia over a 12-month period (November 2018-October 2019). We estimated alcohol advertising spend during sports broadcasts. Financial value per network was estimated using ad duration and total spend per channel. RESULTS There were 10,660 alcohol ads (average of 75 minutes per week) shown during sports broadcasts, amounting to A$14.4 million in revenue to television networks. Forty-five per cent of these ads were at children's viewing times. Channel Seven received the largest amount of alcohol advertising revenue (A$20.8 million), of which A$10.8 million (52.0%) was during sports broadcasts (0.5% of its total advertising revenue). CONCLUSIONS Alcohol advertising during sports broadcasts is pervasive but contributes a relatively small proportion of revenue for television networks. Implications for public health: A ban on alcohol advertising during sport broadcasts is unlikely to have major financial impacts on broadcasters, whilst the health and social benefits are potentially substantial.
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Affiliation(s)
- Florentine Martino
- Deakin University, Geelong, Australia, Global Obesity Centre, Institute for Health Transformation
| | - Jaithri Ananthapavan
- Deakin University, Geelong, Australia, Global Obesity Centre, Institute for Health Transformation.,Deakin University, Geelong, Australia, Deakin Health Economics, Institute for Health Transformation
| | - Marj Moodie
- Deakin University, Geelong, Australia, Global Obesity Centre, Institute for Health Transformation.,Deakin University, Geelong, Australia, Deakin Health Economics, Institute for Health Transformation
| | - Gary Sacks
- Deakin University, Geelong, Australia, Global Obesity Centre, Institute for Health Transformation
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Wood B, McCoy D, Baker P, Williams O, Sacks G. The double burden of maldistribution: a descriptive analysis of corporate wealth and income distribution in four unhealthy commodity industries. Critical Public Health 2021. [DOI: 10.1080/09581596.2021.2019681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - David McCoy
- Institute of Population Health Sciences, Queen Mary University London, UK
| | - Phil Baker
- Institute for Physical Activity and Nutrition, Deakin University, Australia
| | - Owain Williams
- School of Political Science and International Studies, University of Leeds, UK
| | - Gary Sacks
- Global Obesity Centre, Deakin University, Australia
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Sacks G, Kwon J, Vandevijvere S, Swinburn B. Benchmarking as a Public Health Strategy for Creating Healthy Food Environments: An Evaluation of the INFORMAS Initiative (2012-2020). Annu Rev Public Health 2021; 42:345-362. [PMID: 33351647 DOI: 10.1146/annurev-publhealth-100919-114442] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Diet-related noncommunicable diseases (NCDs) and obesity are the leading contributors to poor health worldwide. Efforts to improve population diets need to focus on creating healthy food environments. INFORMAS, established in 2012, is an international network that monitors and benchmarks food environments and related policies. By 2020, INFORMAS was active in 58 countries; national government policies were the most frequent aspect benchmarked. INFORMAS has resulted in the development and widespread application of standardized methods for assessing the characteristics of food environments. The activities of INFORMAS have contributed substantially to capacity building, advocacy, stakeholder engagement, and policy evaluation in relation to creating healthy food environments. Future efforts to benchmark food environments need to incorporate measurements related to environmental sustainability. For sustained impact, INFORMAS activities will need to be embedded within other existing monitoring initiatives. The most value will come from repeated assessments that help drive increased accountability for improving food environments.
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Affiliation(s)
- Gary Sacks
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Burwood, Victoria 3125, Australia; ,
| | - Janelle Kwon
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Burwood, Victoria 3125, Australia; ,
| | | | - Boyd Swinburn
- School of Population Health, The University of Auckland, St. Johns, Auckland 1072, New Zealand;
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Wood B, Baker P, Scrinis G, McCoy D, Williams O, Sacks G. Maximising the wealth of few at the expense of the health of many: a public health analysis of market power and corporate wealth and income distribution in the global soft drink market. Global Health 2021; 17:138. [PMID: 34857019 PMCID: PMC8641192 DOI: 10.1186/s12992-021-00781-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/22/2021] [Indexed: 12/13/2022] Open
Abstract
Background Many of the harms created by the global soft drink industry that directly influence human and planetary health are well documented. However, some of the ways in which the industry indirectly affects population health, via various socio-economic pathways, have received less attention. This paper aimed to analyse the extent to which market power and corporate wealth and income distribution in the global soft drink market negatively impact public health and health equity. In doing so, the paper sought to contribute to the development of a broad-based public health approach to market analysis. A range of dimensions (e.g., market concentration; financial performance; corporate wealth and income distribution) and indicators (e.g., Herfindahl Hirschman Index; earnings relative to the industry average; effective tax rates; and shareholder value ratios) were descriptively analysed. Empirical focus was placed on the two dominant global soft drink manufacturers. Results Coca-Cola Co, and, to a lesser extent, PepsiCo, operate across an extensive patchwork of highly concentrated markets. Both corporations control vast amounts of wealth and resources, and are able to allocate relatively large amounts of money to potentially harmful practices, such as extensive marketing of unhealthy products. Over recent decades, the proportion of wealth and income transferred by these firms to their shareholders has increased substantially; whereas the proportion of wealth and income redistributed by these two firms to the public via income taxes has considerably decreased. Meanwhile, the distribution of soft drink consumption is becoming increasingly skewed towards population groups in low and middle-income countries (LMICs). Conclusions Market power and corporate wealth and income distribution in the global soft drink market likely compound the market’s maldistribution of harms, and indirectly influence health by contributing to social and economic inequalities. Indeed, a ‘double burden of maldistribution’ pattern can be seen, wherein the wealth of the shareholders of the market’s dominant corporations, a group over-represented by a small and wealthy elite, is maximised largely at the expense of the welfare of LMICs and lower socioeconomic groups in high-income countries. If this pattern continues, the appropriate role of the global soft drink market as part of sustainable economic development will require rethinking. Supplementary Information The online version contains supplementary material available at 10.1186/s12992-021-00781-6.
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Affiliation(s)
- Benjamin Wood
- Global Obesity Centre, Deakin University, Geelong, Australia.
| | - Phil Baker
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Gyorgy Scrinis
- School of Agriculture and Food, University of Melbourne, Melbourne, Australia
| | - David McCoy
- Institute of Population Health Sciences, Queen Mary University London, London, UK
| | - Owain Williams
- School of Political Science and International Studies, University of Leeds, Leeds, UK
| | - Gary Sacks
- Global Obesity Centre, Deakin University, Geelong, Australia
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Reeve E, Thow AM, Huse O, Bell C, Peeters A, Sacks G. Policy-makers' perspectives on implementation of cross-sectoral nutrition policies, Western Pacific Region. Bull World Health Organ 2021; 99:865-873. [PMID: 34866682 PMCID: PMC8640684 DOI: 10.2471/blt.20.283366] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 02/07/2023] Open
Abstract
Implementation of effective cross-sectoral nutrition policies remains a challenge worldwide. By reviewing reports from World Health Organization meetings and consultations - convened for policy-makers representing Member States of the Western Pacific Region - we provide an insight into how national policy-makers and external actors can support different dimensions of nutrition policy implementation. Key insights of policy-makers attending food and nutrition-centred meetings include that country-level implementation of nutrition policy relies on strong policy design, organizational planning and governance mechanisms that promote collective responsibility across multiple sectors. Policy-makers responsible for implementing nutrition policies face major challenges resulting from limited capacity, both within and external to government, particularly in relation to monitoring and enforcement activities. Successful implementation of nutrition policy measures will require greater political will to provide the requisite resources and institutional structures to ensure sustained policy effectiveness. Nongovernmental partners, including international agencies and researchers, have an opportunity to support policy implementation by providing technical support to Member States to frame action on nutrition in a more compelling way. They can also help policy-makers to build the organizational and structural capacity to coordinate cross-sectoral policy. Improved policy design, planning and governance and strategic capacity-building, supported by external partners, can strengthen the sustained implementation of cross-sectoral nutrition policy and improve nutrition outcomes.
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Affiliation(s)
- Erica Reeve
- Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
| | - Anne-Marie Thow
- Menzies Centre for Health Policy, University of Sydney, Sydney, Australia
| | - Oliver Huse
- Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
| | - Colin Bell
- Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
| | - Anna Peeters
- Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
| | - Gary Sacks
- Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
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Mialon M, Vandevijvere S, Carriedo A, Bero L, Gomes F, Petticrew M, McKee M, Stuckler D, Sacks G. Mechanisms for addressing the influence of corporations on public health. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Manufacturers, such as producers of cigarettes, drugs or ultra-processed foods, influence health policy, research and practice. This influence is one of the main barriers against the implementation of public health policies around the world. Our goal was to identify existing mechanisms to limit this influence.
Methods
We conducted a scoping review in 2019. We searched five scientific databases: Web of Science Core Collection; BIOSIS; MEDLINE; Base; Scopus. Twenty-eight institutions and networks related to our research objective were also contacted to identify additional mechanisms and examples. In addition, we identified mechanisms and examples drawn from our collective experience. We have classified the mechanisms into two groups: those of international organizations and governments; those for universities, the media and civil society.
Results
Thirty-one publications were included in our review, including eight scientific articles. Nine mechanisms focused on several industries; while the other documents targeted specific industries. We identified 49 mechanisms that could help limit corporate influence in health policy, science and practice. For 41 of these mechanisms, we found examples, around the world, where they have been implemented. The main objectives of the mechanisms identified were to manage conflicts of interest and ethical issues, while increasing the transparency of public-private interactions. Mechanisms for governments (n = 17) and universities (n = 13) were most frequently identified, with fewer examples existing to protect the media and civil society.
Discussion
The development, implementation and monitoring of these mechanisms are essential to protect public health from industrial influence.
Key messages
We found 49 mechanisms that could help limit corporate influence in health policy, science and practice. There are fewer mechanisms to protect the media and civil society, than to protect governments and universities.
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Affiliation(s)
- M Mialon
- Trinity College Dublin, Dublin, Ireland
| | | | - A Carriedo
- World Public Health Nutrition Association, London, UK
| | - L Bero
- University of California San Francisco, San Francisco, USA
| | - F Gomes
- Pan American Health Organization, Washington, USA
| | | | | | | | - G Sacks
- Deakin University, Burwood, Australia
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Goodman S, Armendariz GC, Corkum A, Arellano L, Jáuregui A, Keeble M, Marshall J, Sacks G, Thrasher JF, Vanderlee L, White CM, Hammond D. Recall of government healthy eating campaigns by consumers in five countries. Public Health Nutr 2021; 24:3986-4000. [PMID: 33843564 PMCID: PMC10195272 DOI: 10.1017/s1368980021001415] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/11/2021] [Accepted: 03/25/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine awareness and recall of healthy eating public education campaigns in five countries. DESIGN Data were cross-sectional and collected as part of the 2018 International Food Policy Study. Respondents were asked whether they had seen government healthy eating campaigns in the past year; if yes (awareness), they were asked to describe the campaign. Open-ended descriptions were coded to indicate recall of specific campaigns. Logistic models regressed awareness of healthy eating campaigns on participant country, age, sex, ethnicity, education, income adequacy and BMI. Analyses were also stratified by country. SETTING Online surveys. PARTICIPANTS Participants were Nielsen panelists aged ≥18 years in Australia, Canada, Mexico, UK and the USA (n 22 463). RESULTS Odds of campaign awareness were higher in Mexico (50·9 %) than UK (18·2 %), Australia (17·9 %), the USA (13·0 %) and Canada (10·2 %) (P < 0·001). Awareness was also higher in UK and Australia v. Canada and the USA, and the USA v. Canada (P < 0·001). Overall, awareness was higher among males v. females and respondents with medium or high v. low education (P < 0·001 for all). Similar results were found in stratified models, although no sex difference was observed in Australia or UK (P > 0·05), and age was associated with campaign awareness in UK (P < 0·001). Common keywords in all countries included sugar/sugary drinks, fruits and vegetables, and physical activity. The top five campaigns recalled were Chécate, mídete, muévete (Mexico), PrevenIMSS (Mexico), Change4Life (UK), LiveLighter® (Australia), and Actívate, Vive Mejor (Mexico). CONCLUSIONS In Mexico, UK and Australia, comprehensive campaigns to promote healthy lifestyles appear to have achieved broad, population-level reach.
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Affiliation(s)
- Samantha Goodman
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, OntarioN2L 3G1, Canada
| | - Gabriela C Armendariz
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Adele Corkum
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, OntarioN2L 3G1, Canada
| | - Laura Arellano
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
- Nutrition and Food Sciences, Psychology Education and Health Department, Instituto Tecnológico y de Estudios Superiores de Occidente (ITESO), Tlaquepaque, Jalisco, Mexico
| | - Alejandra Jáuregui
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Matthew Keeble
- Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
| | - Josephine Marshall
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Gary Sacks
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Center for Population Health Research, Instituto Nacional de Salud Pública, Cuernavaca, MR, Mexico
| | - Lana Vanderlee
- École de Nutrition, Centre nutrition, Santé et Société (Centre NUTRISS) and Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC, Canada
| | - Christine M White
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, OntarioN2L 3G1, Canada
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, OntarioN2L 3G1, Canada
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Mialon M, Swinburn B, Allender S, Sacks G. Correction to: Systematic examination of publicly -available information reveals the diverse and extensive corporate political activity of the food industry in Australia. BMC Public Health 2021; 21:1172. [PMID: 34144698 PMCID: PMC8214272 DOI: 10.1186/s12889-021-10997-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Melissa Mialon
- World Health Organization Collaborating Centre for Obesity Prevention, Deakin University, Burwood, Victoria, Australia.
| | - Boyd Swinburn
- World Health Organization Collaborating Centre for Obesity Prevention, Deakin University, Burwood, Victoria, Australia.,School of Population Health, University of Auckland, Auckland, New Zealand
| | - Steven Allender
- World Health Organization Collaborating Centre for Obesity Prevention, Deakin University, Burwood, Victoria, Australia
| | - Gary Sacks
- World Health Organization Collaborating Centre for Obesity Prevention, Deakin University, Burwood, Victoria, Australia
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Gómez-Donoso C, Sacks G, Vanderlee L, Hammond D, White CM, Nieto C, Bes-Rastrollo M, Cameron AJ. Public support for healthy supermarket initiatives focused on product placement: a multi-country cross-sectional analysis of the 2018 International Food Policy Study. Int J Behav Nutr Phys Act 2021; 18:78. [PMID: 34127002 PMCID: PMC8201822 DOI: 10.1186/s12966-021-01149-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 06/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Food retail environments have an influential role in shaping purchasing behavior and could contribute to improving dietary patterns at a population level. However, little is known about the level of public support for different types of initiatives to encourage healthy food choices in supermarkets, and whether this varies across countries or context. The current study aimed to explore the level of support for three potential supermarket initiatives focused on product placement across five countries, and factors that may influence this support. METHODS A total of 22,264 adults from Australia, Canada, Mexico, the United Kingdom and the United States (US) provided information on support for three supermarket initiatives related to product placement (targeting product positioning: 'checkouts with only healthy products', 'fewer end-of-aisle displays containing unhealthy foods or soft drinks' or availability: 'more shelf space for fresh and healthier foods') as part of the online 2018 International Food Policy Study. The proportion of respondents that supported each initiative was assessed across countries, and multivariable logistic regression analyses were conducted to evaluate the influence of sociodemographic factors on support. RESULTS The initiative that received the highest support was 'more shelf space for fresh and healthier foods': 72.0% [95% CI 71.3-72.7], whereas 'checkouts with only healthy products' received the lowest support: 48.6% [95% CI 47.8-49.4]. The level of support differed between countries (p < 0.001 for all initiatives), with the US generally showing the lowest support and Mexico the highest. Noteworthy, in the overall sample, there was not much opposition to any of the initiatives (2.5-14.2%), whereas there was a large proportion of neutral responses (25.5-37.2%). Respondents who were older, female, highly educated, and those who reported having more nutrition knowledge tended to be more supportive, with several differences between countries and initiatives. CONCLUSIONS Most people in the assessed five countries showed a generally high level of support for three placement initiatives in supermarkets to encourage healthy food choices. Support varied by type of initiative (i.e., product positioning or availability) and was influenced by several factors related to country context and sociodemographic characteristics. This evidence could prompt and guide retailers and policy makers to take stronger action to promote healthy food choices in stores.
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Affiliation(s)
- Clara Gómez-Donoso
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
- Biomedical Research Centre Network on Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain
| | - Gary Sacks
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood VIC, Geelong, 3125, Australia
| | - Lana Vanderlee
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels, École de nutrition, Université Laval, Québec, Canada
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - Christine M White
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - Claudia Nieto
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
- Biomedical Research Centre Network on Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain
| | - Adrian J Cameron
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood VIC, Geelong, 3125, Australia.
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Clarke B, Kwon J, Swinburn B, Sacks G. Policy processes leading to the adoption of 'Jamie's Ministry of Food' programme in Victoria, Australia. Health Promot Int 2021; 37:6292205. [PMID: 34086910 DOI: 10.1093/heapro/daab079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study investigated the policy processes related to the 2012 adoption of the Jamie's Ministry of Food programme by the Victorian Government in Australia. The aim was to provide insight into obesity prevention policy change processes to help strengthen future health promotion action. State-level government policy processes were examined through key informant interviews and a review of relevant documentation. Data were analysed using the Multiple Streams Theory and the Advocacy Coalition Framework in order to understand influences on relevant policy processes and strategies used by policy advocates to facilitate policy adoption. We found that policy adoption was facilitated by dedicated national funding for preventive health at that time, the relatively small number of stakeholders involved in the policy development process and the anticipated support for the programme by the general public due to the association with celebrity chef, Jamie Oliver. We identified that policy brokers aligned the policy with decision-maker ideologies and broader government objectives, and proactively managed potential criticisms. Evidence of intervention effectiveness was not a major driver of policy adoption. We conclude that, iven the complexity of policy processes for obesity prevention, multiple, reinforcing strategies are likely to be needed to facilitate policy change. Support for the adoption of obesity prevention policies is likely to increase when framing of policy options aligns with decision-maker values and has broad public appeal.
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Affiliation(s)
- Brydie Clarke
- Deakin University, Geelong, Global Obesity Centre, Institute for Health Transformation, 75 Pigdons Road, Waurn Ponds, Victoria 3216, Australia
| | - Janelle Kwon
- Deakin University, Geelong, Global Obesity Centre, Institute for Health Transformation, 75 Pigdons Road, Waurn Ponds, Victoria 3216, Australia
| | - Boyd Swinburn
- School of Population Health, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Gary Sacks
- Deakin University, Geelong, Global Obesity Centre, Institute for Health Transformation, 75 Pigdons Road, Waurn Ponds, Victoria 3216, Australia
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Lo VYT, Sacks G, Gearon E, Bell C. Did imports of sweetened beverages to Pacific Island countries increase between 2000 and 2015? BMC Nutr 2021; 7:13. [PMID: 34011416 PMCID: PMC8135168 DOI: 10.1186/s40795-021-00416-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 03/02/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Nutrition-related chronic diseases are the major cause of illness and death in Pacific Island countries. Imports of sweetened beverages (SBs) are likely to be contributing but there is limited analysis of the quantities imported or the source countries of such beverages. The purpose of this study was to describe trends in the amount and types of SBs imported to Pacific Island countries and the impact of SB taxes on imports in Fiji and Tonga. METHODS A repository of official international trade statistics was used to collect data on the volume, dollar value and source countries of SBs exported to Pacific Island countries from 2000 to 2015. Corresponding population data was sourced from the Secretariat of the Pacific Community for per capita analyses. We also explored which countries earned the most from exporting SBs to the Pacific. Descriptive and regression analyses were used to describe trends over time for each country and for the region as a whole. RESULTS Imports of SBs to Pacific Island Countries from 2000 to 2015 increased by an average of 0.30 kg per person per year (p < 0.001). New Zealand and the USA were the largest income earners from SB exports to the Pacific over this period. The introduction of a tax did not impact the volume of SBs imported to Fiji. More data is needed to assess the impact of SBs tax on imports in Tonga. CONCLUSIONS Exports of SBs to Pacific Island countries are increasing. Both importing and exporting countries should consider the health implications of trade in these products.
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Affiliation(s)
- Veronica Yueh Torng Lo
- Australian Bureau of Statistics, National Data Acquisition Centre, Melbourne, Australia
- Deakin University, Institute for Health Transformation, Global Obesity Centre, Geelong, Australia
| | - Gary Sacks
- Deakin University, Institute for Health Transformation, Global Obesity Centre, Geelong, Australia
| | - Emma Gearon
- Deakin University, Institute for Health Transformation, Global Obesity Centre, Geelong, Australia
- Monash Department of Clinical Epidemiology, Cabrini Institute, Malvern, Australia
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Colin Bell
- Deakin University, Institute for Health Transformation, Global Obesity Centre, Geelong, Australia
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