by Silvia Monetti
The ongoing epidemic
In this article, we saw that obesity and overweight have become global threats to public health: they are no longer a problem exclusive to high-income countries, but are present worldwide. Obesity is even becoming one of the most frequently diagnosed chronic diseases in many countries, affecting all age groups and especially children. So far, no country has been able to stop the epidemic; obesity and overweight rates are expected to rise, which increasingly affects future societies’ public health (individuals’ quality of life and life expectancy) and economies (higher health-care expenditures in the short- and long-term).
Prevention is crucial, as food preferences can be learned and unlearned. Policies to promote a healthy nutrition should act on many different dimensions: not only on the biological mechanisms regulating food preferences, but also on the built environment, social and cultural norms influencing learning patterns, marketing, education, working times and free time activities (sport, time spent watching television and playing videogames), transportation, eating habits and the overall food system.
Four mechanisms for effective food policies
The task is challenging: lots of data are required to design effective measures and numerous players and sectors need to coordinate themselves, including national and local governments, private companies, and civil society actors. An interesting article in The Lancet identifies four mechanisms through which food policies may effectively influence eating habits:
- by providing enabling environments for learning healthy preferences;
- by overcoming barriers hindering the expression of healthy preferences – healthy foods, for example, tend to be more expensive than less healthy alternatives;
- by encouraging people to reconsider their unhealthy preferences – for instance by changing price, availability and presentation of healthier foods to encourage consumers to choose them;
- by stimulating positive responses at the food system level: taxing a certain (unhealthy) ingredient can lead to a reformulation of the products containing it.
Let’s see some examples of these mechanisms at work.
Schools are particularly significant environments for children and adolescences. Nutrition education is important, but knowledge alone might not be sufficient for lasting change. Food policies to promote healthy diets include the provision of fruits and vegetables as free snacks or in school lunches, school gardening, the introduction of vegetarian meals or vegetarian days, changes in the presentation of food. Policies for prevention should involve also children’s families and promote physical activity. Multicomponent interventions are the most effective ones.
By affecting individuals’ preferences, economic measures such as food taxes and subsidies can potentially reduce (or improve) the consumption of targeted foods and drinks. In the short-term, and in combination with measures to raise awareness, they can lead consumers to reassess their preferences at the point-of-purchase. Over time, by reducing (or increasing) the exposure to certain foods, they can determine long-lasting changes in eating habits and food preferences. If taxes target foods that can be reformulated, their potential of instilling food-systems feedbacks increase. A tax on soft drinks in Mexico, introduced in 2014, has already induced a 12% decrease in the selling of the targeted goods. It is extremely important that taxes and subsidies are well designed. For example, healthier and cheaper foods that can substitute the taxed ones need to be available – otherwise, consumers will just buy more of other non-targeted, less healthy foods.
Nutrient lists can be difficult to comprehend; such labels are useful especially for people already willing to consume healthy foods and looking for this information. Labels displaying foods’ calories or nutrient content with different colours or simple words are easier to understand but, still, their effectiveness depends much on consumers’ preferences and intentions, purchasing occasion, food type etc. Nonetheless, labelling of calories or other nutrients can determine responses at the food system’s level: for example, mandatory trans fat labelling in South Korea and the USA have led to the reformulation of certain food products, with an improvement of their nutritional quality. Nutrition labelling can thus serve as an incentive for food producers and retailers to change their offer.
Adopting a comprehensive approach
Integrated policies to prevent obesity and promote healthy diets and lifestyles are urgently needed at the local, national and global level. Measures include restrictions in the marketing of food aimed at children, regulation of food nutritional quality and availability in schools, nutrition labelling, food taxes and subsidies, public-private partnerships, information and awareness campaigns, the adoption of comprehensive health-in-all-policies approaches. Involving all food system’s actors is crucial. Recently, Mars food advised to consume some of its products only occasionally, due to a high salt, sugar or fat content.
What do you think?