Current food systems are failing to guide children towards healthy diets. This paper presents a tool to identify the actions needed to reorient food systems to become more child-centred from a nutrition perspective. To connect the dots between children's lives, their food environments and food supply systems, the tool takes a childcentred, food systems approach. Comprising six methodological steps, the tool starts by measuring and understanding children's realities and then working back up into the system to identify how food environments and supply systems could make relevant foods more or less available, affordable, appealing and aspirational in the contexts of children's lives. The paper spells out the mix of methods needed to make this assessment, gives examples of the data and studies already available and type of insights they provide, and discusses the methodological challenges and gaps. It presents a worked example that shows how following these steps in sequence enables the identification of a package of actions that can act coherently to reorient food systems in the way most likely to have impact on child malnutrition.

Background The first 1000 days in a child’s life, from conception to age two, are a critical period for establishing a child’s health and development. One important element is the diet that children receive during this time. Dietary intake of infants in the UK has been shown to be high in sugar and salt, with overall energy intakes exceeding recommendations by the time they are two years of age. Commercial infant food, which forms approximately 40–60% of infants’ dietary intake, was identified in 2011 as the main contributor to sugar intake for infants aged 4–9 months in the United Kingdom. Further, evidence demonstrates inconsistencies between national recommendations on infant feeding and some of these products in terms of the type available, their nutritional value and product labelling and marketing. Given their role in infants’ diets, it is important to understand parental perceptions of these products and why they are chosen. Methods The study comprised the first phase of an in-depth, longitudinal qualitative study which explored parents’ experiences of introducing solid foods to their infants over the first year of feeding. 62 parents/ carers were recruited to this phase when their infants were four-six months old. Data collection involved semi-structured interviews and a photo-elicitation exercise. Data from interview transcripts which focused on the purchase and use of packaged purees and commercial snacks were analysed thematically. Results Parents/ carers drew on a range of reasons for buying both packaged purees and commercial snacks for their infants. These included anxiety over food preparation, food safety, convenience, cost effectiveness, the pull of brand eco-systems for packaged purees, and the way in which commercial snacks provide opportunities for safe development of motor skills, keep infants occupied, and allow them to take part in family rituals. Conclusion In considering the use of packaged products as a food source for infants in public health nutrition policy, it is important to understand the broad range of factors that shape parents decisions ranging from the way that products are advertised and perceived, to the non-nutritive roles that they play.

People engaged in weight loss or weight loss maintenance (weight management) often regain weight long term. Unsupportive food environments are one of the myriad challenges people face when working towards a healthier weight. This systematic review explores how the food environment influences people engaged in weight management and the policy implications. Nine electronic databases (CINAHL, Medline, PsycINFO, Academic Search Complete, Embase, Ovid Emcare, PubMed, Open Grey, and BASE) were searched systematically in May 2020 to synthesize the qualitative evidence. Eligible studies were conducted with adults (18+) in highincome countries, available in English and published 2010-2020 with a substantial qualitative element and reference to food environments. Data were analyzed using a thematic synthesis approach. Quality assessment using the Critical Appraisal Skills Programme was undertaken. We identified 26 studies of 679 individuals reporting on weight management experiences with reference to the food environment. Limitations of the included studies included a lack of detail regarding socioeconomic status and ethnicity in many studies. The analysis revealed that food environments undermine efforts at weight management, consistently making purchasing and consumption of healthier food more difficult, particularly for those on a low income. For weight management to be more successful, concurrent actions to reshape food environments are necessary.

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