Healthy food procurement and nutrition standards in public facilities: evidence synthesis and consensus policy recommendations

Raine, Kim D.; Atkey, Kayla; Olstad, Dana Lee; Ferdinands, Alexa R.; Beaulieu, Denis; Buhler, Susan; Campbell, Norm R.C.; Cook, Brian; L’Abbé, Mary R.; Lederer, Ashley; Mowat, David L.; Maharaj, Joshna; Nykiforuk, Candace I. J.; Shelley, Jacob; Street, Jackie

doi:10.24095/hpcdp.38.1.03

Cited by 27 publications

(36 citation statements)

References 47 publications

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“…Such interventions should be initiated early in pregnancy and continue throughout the pregnancy, as major short-and long-term health consequences for both the mother and the child are likely. • Develop and implement national diabetes plans as well as regional strategies promoting local partnerships with communities and stakeholders [38] • Governments should support the implementation of interdisciplinary care teams, with special regard to the involvement of pharmacists [39] • Improve the transparency of product ingredients using mandatory simple and intuitive nutrition or menu labelling [40] • Set up government food benefit programmes to incentivise the purchase of fruit and vegetables [41] • Support the certification of digital devices and apps to improve access to evidencebased health information [42] • Use narrative and visual messages to improve diabetes awareness [43] • Support interpretative nutrition labelling, like traffic lights, to decrease SSB sales [41] • Strengthen the framing of diabetes as a problem to be tackled on the societal level [44] • Raise taxes on unhealthy products (and consider the liability for adverse health effects of food and beverage products) and reinvest the money in local infrastructure (outdoor gyms and playgrounds) [45] Pregnant women and young families • Screen high-risk groups (elevated risk due to family history, increased BMI) for early detection of GDM [46] as a precondition for lifestyle change • Give advice regarding healthy eating and set activity targets during pregnancy [47,48] • Give advice regarding the benefits of breastfeeding [49] • Employ multimedia communication strategies to increase the widespread knowledge of diabetes risk during pregnancy [50,51] Children and adolescents…”

Section: Pregnant Women and Young Familiesmentioning

confidence: 99%

What should governments be doing to prevent diabetes throughout the life course?

et al. 2019

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Health systems and governments are increasingly required to implement measures that target at-risk populations to prevent noncommunicable diseases. In this review we lay out what governments should be doing to prevent diabetes throughout the life course. The following four target groups were used to structure the specific recommendations: (1) pregnant women and young families, (2) children and adolescents, (3) working age population, and (4) the elderly. The evidence to date supports the effectiveness of some known government policy measures, such as sugar taxes and regulatory measures in the (pre-)school setting for children and adolescents. Many of these appear to be more effective if they are part of a bundle of strategies and if they are supplemented by communication strategies. Although there is a current focus on strategies that target the individual, governments can make use of evidence-based population-level prevention strategies. More research and continuous evaluation of the overall and subgroup-specific effectiveness of policy strategies using high-quality longitudinal studies are needed.

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Section: Pregnant Women and Young Familiesmentioning

confidence: 99%

What should governments be doing to prevent diabetes throughout the life course?

et al. 2019

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“…Governments, industry task forces, and public health experts in Australia [69], Canada [70], the United Kingdom [71], and the United States of America (USA) [72,73] issued recommendations for healthy food procurement and nutrition standards for various food service settings. However, there are few explicit recommendations for transnational chain restaurants with quantitative nutrient targets and specified timelines to improve the healthfulness of offerings.…”

Section: Resultsmentioning

confidence: 99%

Progress Evaluation for Transnational Restaurant Chains to Reformulate Products and Standardize Portions to Meet Healthy Dietary Guidelines and Reduce Obesity and Non-Communicable Disease Risks, 2000–2018: A Scoping and Systematic Review to Inform Policy

Kraak

Patiño

Renukuntla

et al. 2019

IJERPH

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Transnational restaurant chains sell food and beverage products in 75 to 139 countries worldwide linked to obesity and non-communicable diseases (NCDs). This study examined whether transnational restaurant chains reformulated products and standardized portions aligned with healthy dietary guidelines and criteria. Firstly, we describe the transnational restaurant industry structure and eating trends. Secondly, we summarize results from a scoping review of healthy dietary guidelines for restaurants. Thirdly, we describe a systematic review of five electronic databases (2000–2018) to identify studies on nutrient profile and portion size changes made by transnational restaurants over 18 years. We used Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, identified 179 records, and included 50 studies conducted in 30 countries across six regions. The scoping review found a few expert-recommended targets for restaurants to improve offerings, but no internationally accepted standard for portions or serving sizes. The systematic review results showed no standardized assessment methods or metrics to evaluate transnational chain restaurants’ practices to improve menu offerings. There was wide variation within and across countries, regions, firms, and chains to reduce energy, saturated and trans fats, sodium, and standardized portions. These results may inform future research and encourage transnational chain restaurants to offer healthy product profiles and standardized portions to reduce obesity and NCD risks worldwide.

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“…Governments should be committed to the promotion of healthy food environments for all citizens, allowing them to make healthier food choices. According to a recent review conducted by Raine et al [ 16 ], healthy food procurement policies can have a positive effect in several outcomes such as on improving food availability and on increasing sales and intake of healthy food options. In the school environment, the Portuguese Ministry of Education and the Ministry of Health have had a good collaboration experience.…”

Section: Resultsmentioning

confidence: 99%

A new interministerial strategy for the promotion of healthy eating in Portugal: implementation and initial results

Graça

Gregório

Sousa³

et al. 2018

Health Res Policy Sys

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ObjectiveTo describe the implementation, main intervention areas and initial results of the Integrated Strategy for the Promotion of Healthy Eating (EIPAS) in Portugal.MethodsEIPAS was published as a Law, in December of 2017, as a result of a collaboration between several ministries, including the Finance, Internal Affairs, Education, Health, Economy, Agriculture, and Sea Ministries, aiming at improving the dietary habits of the Portuguese population. The working group, led by the Ministry of Health, developed this strategy for over a year. The framework produced was based on WHO and European Commission recommendations as well as on relevant data from the last Portuguese dietary intake survey (2015/2016). EIPAS also reflects the results of a public hearing, including the food industry, among others, and the experience gathered, since 2012, through the National Programme for the Promotion of Healthy Eating. It considers the ‘health in all policies’ challenge set by WHO and has four different strategic areas, namely (1) creation of healthier food environments, (2) improvement of the quality and accessibility of healthy food choices for consumers, (3) promotion and development of literacy, in order to encourage healthy food choices, and (4) promotion of innovation and entrepreneurship. In order to achieve these goals, a set of 51 actions was established and assigned to the seven ministries involved.ResultsUnder the scope of this strategy, Portugal has already implemented several actions, including (1) definition of standards for food availability at all public healthcare institutions; (2) implementation of a sugar tax on sweetened beverages; (3) implementation of a voluntary agreement with the food industry sector for food reformulation (work in progress); (4) design of a proposal for an interpretative model of front-of-pack food labelling; (5) improvement of the nutritional quality of food aid programmes for low-income groups; and (6) regulation of marketing of unhealthy foods to children.ConclusionsFor the first time, Portugal has a nutrition policy based on the WHO concept of ‘health in all policies’ and on the national data on food intake. The implementing process of all 51 actions and the inherent complexities and difficulties found so far have made this process be an authentic political and social laboratory that deserves to be followed.

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Healthy food procurement and nutrition standards in public facilities: evidence synthesis and consensus policy recommendations

Abstract: Implementation of healthy food procurement policies can increase Canadians' access to healthier foods as part of a broader vision for food policy in Canada.

Cited by 27 publications

References 47 publications

What should governments be doing to prevent diabetes throughout the life course?

What should governments be doing to prevent diabetes throughout the life course?

Progress Evaluation for Transnational Restaurant Chains to Reformulate Products and Standardize Portions to Meet Healthy Dietary Guidelines and Reduce Obesity and Non-Communicable Disease Risks, 2000–2018: A Scoping and Systematic Review to Inform Policy

A new interministerial strategy for the promotion of healthy eating in Portugal: implementation and initial results

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