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Objective: To progress nutrition policy change and develop more effective advocates, it is useful to consider real-world factors and practical experiences of past advocacy efforts to determine the key barriers to and enablers of nutrition policy change. The present review aimed to identify and synthesize the enablers of and barriers to public policy change within the field of nutrition. Design: Electronic databases were searched systematically for studies examining policy making in public health nutrition. An interpretive synthesis was undertaken. Setting: International, national, state and local government jurisdictions within high-income, democratic countries. Results: Sixty-three studies were selected for inclusion. Numerous themes were identified explaining the barriers to and enablers of policy change, all of which fell under the overarching category of 'political will', underpinned by a second major category, 'public will'. Sub-themes, including pressure from industry, neoliberal ideology, use of emotions and values, and being visible, were prevalent in describing links between public will, political will and policy change. Conclusions: The frustration around lack of public policy change in nutrition frequently stems from a belief that policy making is a rational process in which evidence is used to assess the relative costs and benefits of options. The findings from the present review confirm that evidence is only one component of influencing policy change. For policy change to occur there needs to be the political will, and often the public will, for the proposed policy problem and solution. The review presents a suite of enablers which can assist health professionals to influence political and public will in future advocacy efforts.

Objective: Food insecurity is the limited or uncertain availability or access to nutritionally adequate, culturally appropriate and safe foods. Food insecurity may result in inadequate dietary intakes, overweight or obesity and the development of chronic disease. Internationally, few studies have focused on the range of potential health outcomes related to food insecurity among adults residing in disadvantaged locations and no such Australian studies exist. The objective of the present study was to investigate associations between food insecurity, sociodemographic and health factors and dietary intakes among adults residing in disadvantaged urban areas. Design: Data were collected by mail survey (n 505, 53 % response rate), which ascertained information about food security status, demographic characteristics (such as age, gender, household income, education) fruit and vegetable intakes, takeaway and meat consumption, general health, depression and chronic disease. Results: Approximately one in four households (25 %) was food insecure. Food insecurity was associated with lower household income, poorer general health, increased health-care utilisation and depression. These associations remained after adjustment for age, gender and household income. Conclusions: Food insecurity is prevalent in urbanised disadvantaged areas in developed countries such as Australia. Low-income households are at high risk of experiencing food insecurity. Food insecurity may result in significant health burdens among the population, and this may be concentrated in socio-economically disadvantaged suburbs.

Findings from the current review add depth and scope to quantitative literature and can guide ongoing theory, interventions and policy development in food environment research. There is a need to investigate contextual influences within food environments as well as individual and household socio-economic characteristics that contribute to the differing use of and views towards local food environments. Greater emphasis on how individual and environmental factors interact in the food environment field will be key to developing stronger understanding of how environments can support and promote healthier food choices.

Aim:  To identify food insecurity and examine its association with socio‐demographic factors in a group of newly arrived refugees. Methods:  Structured questionnaire based around the same question asked during the National Nutrition Survey (1995). The questionnaire was administered to a service‐based sample of clients accessing early intervention services. Fifty‐one individuals who were newly arrived refugees, resident in Australia for less than 12 months and who were receiving torture and trauma counselling. Results:  Thirty‐six individuals (71% of sample) reported running out of food. This percentage was much greater than the 5.2% recorded across all social and economic groups in the 1995 National Nutrition Survey. The most common reasons for running out of food were related to large household bills, late welfare payments, poor household skills, sending money ‘home’, transport issues and poor budgeting skills. Conclusion:  Food insecurity in refugees in Perth, Western Australia is comparable to the rates of food insecurity found in this population in other parts of the developed world. There are, however, significant ramifications for the development of intervention strategies as well as policy implications. For refugees, focusing on community food security strategies will assist in building community capacity, facilitate the retention of cultural integrity, restore and maintain dignity, and will be instrumental in ensuring both short‐ and long‐term health.