Strengthening of accountability systems to create healthy food environments and reduce global obesity

Abstract

To achieve WHO's target to halt the rise in obesity and diabetes, dramatic actions are needed to improve the healthiness of food environments. Substantial debate surrounds who is responsible for delivering eff ective actions and what, specifi cally, these actions should entail. Arguments are often reduced to a debate between individual and collective responsibilities, and between hard regulatory or fi scal interventions and soft voluntary, education-based approaches. Genuine progress lies beyond the impasse of these entrenched dichotomies. We argue for a strengthening of accountability systems across all actors to substantially improve performance on obesity reduction. In view of the industry opposition and government reluctance to regulate for healthier food environments, quasiregulatory approaches might achieve progress. A four step accountability framework (take the account, share the account, hold to account, and respond to the account) is proposed. The framework identifi es multiple levers for change, including quasiregulatory and other approaches that involve government-specifi ed and government-monitored progress of private sector performance, government procurement mechanisms, improved transparency, monitoring of actions, and management of confl icts of interest. Strengthened accountability systems would support government leadership and stewardship, constrain the infl uence of private sector actors with major confl icts of interest on public policy development, and reinforce the engagement of civil society in creating demand for healthy food environments and in monitoring progress towards obesity action objectives.

Constructing a Hierarchical Agribusiness Framework in Chinese Belt and Road Initiatives under Uncertainty

“…Thus, the government must ensure safety among the procedures of each food item that is produced, and then encourage the population to select healthy foods to prevent the negative impacts on the environment and to increase the public's health and welfare [54]. By establishing relevant regulations (C6), the government can require food suppliers to meet standards and maintain quality from raw materials to the end product [55]. Furthermore, developing sustainable label certification (C7) through government approval will increase the credibility of sustainable food as well as promote customers' confidence in selection and competition in the market [56].…”

Obesidade e políticas públicas: concepções e estratégias adotadas pelo governo brasileiro

“…Obesity's growing prevalence has been attributed to various biopsychosocial processes, where the "environment" (political, economic, social, cultural), and not only individuals and their choices, occupies a strategic place in the analysis of the problem and proposed interventions 4,5,6,7,8 . Meanwhile, important challenges lie in understanding how these multiple factors interact.…”

Childhood Obesity Prevention: Does Policy Meet Research? Evidence-Based Reflections upon the Spanish Case

“…Here we tap into four of them. First, the controversial understanding of obesity itself; [5][6][7] second, the pressure posed by the utterly competitive food industry; [6][7][8][9] third, the very own human nature in biological, psychological, cultural, and social terms; [7][8][9][10][11] and fourth, the current scientific evidence hierarchy and the difficulty to translate it into actual policy [5][6][7][8][9][10][11][12][13][14] which will be the main focus of this paper. In the first Lancet's Obesity Series published in 2011, the globalization of food systems that led to overconsumption, an expectable outcome of market economies, was posed as the main factor responsible for the increasing burden of obesity.…”

“…Notwithstanding that, tackling obesity demands broader, more specific actions than the ones used in these cases, as food is indispensable to life and, anthropologically, its connotations for human beings go beyond nutrition and acquire a psychological, social and cultural meaning (among others) that cannot be overlooked. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] All the previous considered, one might think that enough evidence to tackle obesity is not yet available. However, a quick search on PubMed with the words "obesity prevention" indicates just the opposite.…”

“…From the late nineties, the emergence of evidence-based medicine overflowed the clinical field and policymakers were also required to found their work on sound data. [4][5][6][7][8][9][10][11][12][13][14] The need for evidence-based policy is difficult to argue. However, the actual development of evidence-based policies is certainly challenged by a poor fit between atomized academic research, rigid evaluation standards, and the complex needs of policymakers.…”