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2.
Nutrients ; 12(3)2020 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-32110864

RESUMO

The objective of this study was to estimate, from an obesity prevention perspective, the cost-effectiveness of two potential policies that increase the price of alcohol in Australia: a volumetric tax applied to all alcohol (Intervention 1) and a minimum unit floor price (Intervention 2). Estimated changes in alcoholic drink consumption and corresponding changes in energy intake were calculated using the 2011-12 Australian Health Survey data, published price elasticities, and nutrition information. The incremental changes in body mass index (BMI), BMI-related disease outcomes, healthcare costs, and Health Adjusted Life Years (HALYs) were estimated using a validated model. Costs associated with each intervention were estimated for government and industry. Both interventions were estimated to lead to reductions in mean alcohol consumption (Intervention 1: 20.7% (95% Uncertainty Interval (UI): 20.2% to 21.1%); Intervention 2: 9.2% (95% UI: 8.9% to 9.6%); reductions in mean population body weight (Intervention 1: 0.9 kg (95% UI: 0.84 to 0.96); Intervention 2: 0.45 kg (95% UI: 0.42 to 0.48)); HALYs gained (Intervention 1: 566,648 (95% UI: 497,431 to 647,262); Intervention 2: 317,653 (95% UI: 276,334 to 361,573)); and healthcare cost savings (Intervention 1: $5.8 billion (B) (95% UI: $5.1B to $6.6B); Intervention 2: $3.3B (95% UI: $2.9B to $3.7B)). Intervention costs were estimated as $24M for Intervention 1 and $30M for Intervention 2. Both interventions were dominant, resulting in health gains and cost savings. Increasing the price of alcohol is likely to be cost-effective from an obesity prevention perspective in the Australian context, provided consumers substitute alcoholic beverages with low or no kilojoule alternatives.

3.
Nutrients ; 12(3)2020 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-32121199

RESUMO

Over one third of Australians' daily energy intake is from discretionary foods and drinks. While many health promotion efforts seek to limit discretionary food intake, the population health impact of reductions in the consumption of different types of discretionary foods (e.g., sugar-sweetened beverages (SSBs), confectionery, sweet biscuits) has not been quantified. This study estimated the potential reductions in body weight, obesity-related disease incidence, and healthcare cost savings associated with consumption of one less serving per week of different discretionary foods. Reductions in the different types of discretionary food were modelled individually to estimate the impact on energy consumption and population body weight by 5-year age and sex groups. It was assumed that one serving of discretionary food each week was replaced with either a serving of fruit or popcorn, and a serving (375 mL) of SSBs was replaced with coffee, tea, or milk. Proportional multi-state multiple-cohort Markov modelling estimated likely resultant health adjusted life years (HALYs) gained and healthcare costs saved over the lifetime of the 2010 Australian population. A reduction of one serving of SSBs (375 mL) had the greatest potential impact in terms of weight reduction, particularly in ages 19-24 years (mean 0.31 kg, 95% UI: 0.23 kg to 0.37 kg) and overall healthcare cost savings of AUD 793.4 million (95% UI: 589.1 M to 976.1 M). A decrease of one serving of sweet biscuits had the second largest potential impact on weight change overall, with healthcare cost savings of $640.7 M (95% CI: $402.6 M to $885.8 M) and the largest potential weight reduction amongst those aged 75 years and over (mean 0.21 kg, 95% UI: 0.14 kg to 0.27 kg). The results demonstrate that small reductions in discretionary food consumption are likely to have substantial health benefits at the population level. Moreover, the study highlights that policy responses to improve population diets may need to be tailored to target different types of foods for different population groups.

4.
Artigo em Inglês | MEDLINE | ID: mdl-32092853

RESUMO

Obesity prevalence is inequitably distributed across geographic areas. Food environments may contribute to health disparities, yet little is known about how food environments are evolving over time and how this may influence dietary intake and weight. This study aimed to analyse intra-city variation in density and healthiness of food outlets between 2008 and 2016 in Melbourne, Australia. Food outlet data were classified by location, type and healthiness. Local government areas (LGAs) were classified into four groups representing distance from the central business district. Residential population estimates for each LGA were used to calculate the density of food outlets per 10,000 residents. Linear mixed models were fitted to estimate the mean density and ratio of 'healthy' to 'unhealthy' food outlets and food outlet 'types' by LGA group over time. The number of food outlets increased at a faster rate than the residential population, driven by an increasing density of both 'unhealthy' and 'healthy' outlets. Across all years, ratios of 'unhealthy' to 'healthy' outlets were highest in LGAs located in designated Growth Areas. Melbourne's metropolitan food environment is saturated by 'unhealthy' and 'less healthy' food outlets, relative to 'healthy' ones. Melbourne's urban growth areas had the least healthy food environments.

5.
Soc Sci Med ; 246: 112757, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31927475

RESUMO

The health and economic burden associated with overweight and obesity warrants comprehensive policy action; however, to date, there has been limited policy progress globally. This study sought to advance obesity prevention policy research and practice by applying theories of the policy process to study decision-making processes involved in the adoption of the contentious LiveLighter® social marketing campaign by the Victorian government in Australia. Through analysis of documents and interviews with policy makers, this qualitative study aimed to gain a better understanding of the dynamic influences on policy decision-making. Multiple theories of the policy process were used to elucidate policy drivers and Causal Loop Diagramming methods were used to illustrate the LiveLighter® policy decision-making systems. Findings highlighted a number of key influences including: various external events, evidence of the problem and intervention effectiveness, resistance from various stakeholders and the political capabilities of central policy makers. The policy systems map provided insight into the difficulties experienced by policy actors in achieving policy change, as well as to develop a conceptual framework for identifying potential leverage points to influence future obesity prevention policy decisions. Together the findings can inform future advocacy efforts for improving the implementation of obesity prevention policy action.

6.
Artigo em Inglês | MEDLINE | ID: mdl-31999857

RESUMO

ISSUE ADDRESSED: Healthy Together Victoria (HTV) was a large-scale intervention that adopted a systems approach to prevention. It established the capability of an inexperienced workforce by cultivating their understanding of systems theories, tools and practice. This paper explores how this capacity was developed and what helped and hindered the process. METHODS: This qualitative research included 31 primary semi-structured interviews that focused on participants' understanding of systems thinking. Deductive thematic analysis was undertaken. A workforce development framework informed the coding that was used to create a causal loop diagram. RESULTS: The findings display the multiple influencers on capacity-building. Practice change was enabled with training-although it lacked coordination and participation was limited. Yet, the systems approach was strengthened with governance arrangements, policies, funding, team support and leadership that empowered practitioners to trial systems methods. Capacity-building was hindered by HTV's unspecified theory that made it harder for novice practitioners to grasp. Funding cuts due to political changes reduced the initiative's duration and prompted resignations, causing the newfound experience to exit the workforce. CONCLUSION: Capacity-building for systems practice requires a holistic approach of simultaneous, complimentary actions that address the individual and environmental influences of workforce development, especially the drivers of organisational culture that facilitate new practice. SO WHAT?: Effective training methods should specifically teach skills and knowledge that help practitioners to implement systems thinking. The workforce development requirements of other contributors also need to be considered, in addition to the policies, opportunities and resources that embed practice change.

7.
Obes Rev ; 21(2): e12941, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31802612

RESUMO

There is strong support across multiple sectors for the implementation of policies to create healthier food environments as part of comprehensive strategies to address obesity and improve population diets. The existing evidence base describing food retail environments and their relationship with health outcomes is limited in several respects. This systematic review examines the current evidence regarding food retail environments in Australia, including associations with diet and people with obesity, and socioeconomic and geographic disparities. Three databases were searched and independently screened. Studies were included if they were undertaken in Australia and objectively measured the food retail environment. Sixty papers were included. The broad range of methodological approaches used across studies limited the ability to synthesize the evidence and draw conclusions. Results indicated that there is some evidence that disparities exist in food retail environments across measures of socioeconomic position and geographic area in parts of Australia. Overall, there were inconsistent findings regarding the association between the healthiness of food retail environments and diet or people with obesity. Findings support previous calls for standardized tools and measures for monitoring the healthiness of food retail environments. This is imperative to inform evidence-based policy and evaluation in this critical component of recommended obesity prevention strategies.

8.
Obes Rev ; 21(1): e12948, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31633289

RESUMO

Policies to restrict unhealthy food and beverage price promotions have been recommended, as part of a broader strategy to reduce obesity, but little evidence underpins such recommendations. We aimed to synthesize the literature on the prevalence of healthy and unhealthy food and beverage price promotions and their potential influence on purchasing behaviour. Eight scientific databases (covering health, business, and marketing) and grey literature were systematically searched using search terms related to "food and beverage price promotions" up until July 2019. Articles were included if they examined prevalence of, and/or consumer response to, food and non-alcoholic beverage price promotions, from a nutritional perspective. Of the 16 included studies, eight examined the prevalence of price promotions and eight examined the potential influence of price promotions on purchasing behaviour. Seven of the "prevalence" studies found that price promotions were more common for unhealthy foods and beverages. Seven "influence" studies found a greater proportion of price-promoted purchases were for unhealthy compared with healthy products. Policies that reduce the prevalence and/or influence of price promotions on unhealthy foods and beverages may shift consumer purchasing away from unhealthy foods and beverages. Empirical studies are required to better understand how consumers and industry may respond to such policies.

9.
Int J Obes (Lond) ; 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31792336

RESUMO

BACKGROUND: Restricting price promotions on unhealthy foods and beverages has been identified by governments as a promising approach for improving population diets. Using a limited societal perspective, this study assessed the potential cost-effectiveness of mandatory restrictions on price promotions for sugar-sweetened beverages (SSBs) in Australia. METHODS: Australian dietary consumption data, together with UK data on the SSB sales uplift associated with price promotions, were used to estimate reductions in SSB purchases and consequent changes in body mass index following the intervention. A multi-state, multiple-cohort Markov model was used to estimate the obesity-related health and cost impacts over the lifetime of the 2010 Australian population. Costs included passing legislation, assisting retailer implementation, and compliance monitoring. RESULTS: The intervention was estimated to result in a mean change in daily energy intake of -12.52 kJ (95% Uncertainty Interval, UI: -15.91 to -9.58) per person, which translated to a mean body weight change of -0.11 kg (95%UI: -0.14 to -0.08) per person. Total Health Adjusted Life Years gained were estimated at 34,260 (95%UI: 24,922-45,504). Estimated costs were AUD17.0 million, with estimated healthcare cost savings of AUD376.0 million. The intervention was considered dominant (cost-saving and health promoting). The intervention remained cost-effective if retailers reduced average non-discounted SSB prices in response to the intervention by less than 5.36%. CONCLUSIONS: Restricting price promotions on SSBs is likely to be highly cost-effective, although its impact would depend on how industry and shoppers respond. Although Australian data are used, these results are likely to be transferable and highly relevant to the UK context. Policies for restricting price promotions should be considered as part of a comprehensive obesity prevention strategy.

10.
Artigo em Inglês | MEDLINE | ID: mdl-31861344

RESUMO

The study provides direct evidence of the goals of food-industry-driven public relations (PR) campaigns. Two PR requests for proposals created for The Coca-Cola Company (Coke) were analysed. One campaign related to the 2016 Rio Olympic Games, the other related to the 2013-2014 Movement is Happiness campaign. Supplementary data were obtained from a search of business literature. The study found that Coke specifically targeted teenagers and their mothers as part of the two PR campaigns. Furthermore, Coke was explicit in its intentions to build allies, particularly with key media organisations, and to marginalise opposition. This study highlights how PR campaigns by large food companies can be used as vehicles for marketing to children, and for corporate political activity. Given the potential threats posed to populations' health, the use of PR agencies by food companies warrants heightened scrutiny from the public-health community, and governments should explore policy action in this area.

11.
Public Health Res Pract ; 29(3)2019 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-31569204

RESUMO

OBJECTIVE: To explore the incidence of the 'revolving door' phenomenon, whereby individuals move between positions in government and positions in the Australian alcohol, food and gambling industries. METHODS: This exploratory study was composed of two substudies: 1) an analysis of existing Australian Government Register of Lobbyists databases and related social network content; and 2) a series of 28 in-depth semistructured interviews with key informants discussing industry tactics for influencing policy, of which 15 interviewees explicitly discussed the revolving door phenomenon. RESULTS: More than one-third of people registered on the Australian Government Register of Lobbyists were previously government representatives. We report on several examples of government employees going on to work directly for alcohol, food or gambling industries, some taking employment directly related to their previous employment in government. Key informants highlight the potential risks this poses to good governance. CONCLUSION: This study suggests that the revolving door that sees people move between roles in the Australian Government and alcohol, food and gambling industries is commonplace, creating a range of ethical and moral problems, and posing a risk to public health.

12.
BMC Public Health ; 19(1): 1296, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31615458

RESUMO

BACKGROUND: As part of efforts to address high levels of overweight and obesity, the provision of nutrition information (e.g., through nutrition labels and nutrition claims) on food packages has increasingly become an important policy option. This study aimed to assess the influence of nutrition claims relating to fat, sugar, and energy content on product packaging on several aspects of food choices to understand how they contribute to the prevention of overweight and obesity. METHODS: A systematic literature review was conducted using the online databases EBSCOhost Global Health, EBSCOhost Medline, ScienceDirect, Scopus, PsycINFO and Embase. Studies were included if they measured the influence of nutrition claims relating to fat, sugar, and energy content on outcomes related to body weight, and were published between January 2003 and April 2018. RESULTS: Eleven studies were included in the review. Results showed that nutrition claims can influence the knowledge of consumers with respect to perceived healthfulness of products, as well as expected and experienced tastiness of food products - making food products with nutrition claims seem healthier and less tasty. Nutrition claims can make the appropriate portion size appear to be larger and lead to an underestimation of the energy content of food products. Nutrition claims can also influence food purchase intentions, moderated by the perceived healthfulness of the relevant food products and the health consciousness of individuals. Nutrition claims were also found to have an impact on food purchases, to influence 'consumption guilt' (i.e., feeling of guilt associated with eating), and to increase consumption, moderated by the weight status of individuals. These influences were shown to vary depending on the type of claim and food carrying the claim. CONCLUSIONS: There is evidence that, while nutrition claims may lead some consumers to improve their nutrition knowledge and select healthier options, it may also lead consumers to increase food consumption and overall energy intake. This may run counter to efforts to address overweight and obesity.


Assuntos
Ingestão de Energia , Rotulagem de Alimentos , Preferências Alimentares , Valor Nutritivo , Gorduras na Dieta , Açúcares da Dieta , Humanos
13.
Global Health ; 15(1): 56, 2019 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-31551086

RESUMO

BACKGROUND: Sugar sweetened beverages (SSB) are a major source of sugar in the diet. Although trends in consumption vary across regions, in many countries, particularly LMICs, their consumption continues to increase. In response, a growing number of governments have introduced a tax on SSBs. SSB manufacturers have opposed such taxes, disputing the role that SSBs play in diet-related diseases and the effectiveness of SSB taxation, and alleging major economic impacts. Given the importance of evidence to effective regulation of products harmful to human health, we scrutinised industry submissions to the South African government's consultation on a proposed SSB tax and examined their use of evidence. RESULTS: Corporate submissions were underpinned by several strategies involving the misrepresentation of evidence. First, references were used in a misleading way, providing false support for key claims. Second, raw data, which represented a pliable, alternative evidence base to peer reviewed studies, was misused to dispute both the premise of targeting sugar for special attention and the impact of SSB taxes on SSB consumption. Third, purposively selected evidence was used in conjunction with other techniques, such as selective quoting from studies and omitting important qualifying information, to promote an alternative evidential narrative to that supported by the weight of peer-reviewed research. Fourth, a range of mutually enforcing techniques that inflated the effects of SSB taxation on jobs, public revenue generation, and gross domestic product, was used to exaggerate the economic impact of the tax. This "hyperbolic accounting" included rounding up figures in original sources, double counting, and skipping steps in economic modelling. CONCLUSIONS: Our research raises fundamental questions concerning the bona fides of industry information in the context of government efforts to combat diet-related diseases. The beverage industry's claims against SSB taxation rest on a complex interplay of techniques, that appear to be grounded in evidence, but which do not observe widely accepted approaches to the use of either scientific or economic evidence. These techniques are similar, but not identical, to those used by tobacco companies and highlight the problems of introducing evidence-based policies aimed at managing the market environment for unhealthful commodities.


Assuntos
Indústria Alimentícia , Política de Saúde , Pesquisa , Bebidas/economia , Açúcares da Dieta/economia , Humanos , África do Sul , Edulcorantes/economia , Impostos
14.
BMC Public Health ; 19(1): 1205, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31477071

RESUMO

BACKGROUND: Poor diet is a significant contributor to the burden of global disease. There are numerous policies available to address poor diets; however, these policies often require public support to encourage policy action. The current study aimed to understand the level of public support for a range of food policies and the factors associated with policy support. METHODS: An online survey measuring support for 13 food policies was completed by 19,857 adults in Australia, Canada, Mexico, the United Kingdom (UK) and the United States (US). The proportion of respondents that supported each policy was compared between countries, and the association between demographic characteristics and policy support was analysed using multivariate logistic regression. RESULTS: The level of support varied between policies, with the highest support for policies that provided incentives (e.g., price subsidies) or information (e.g., calorie labelling on menus), and the lowest support for those that imposed restrictions (e.g., restrictions on sponsorship of sport events). This pattern of support was similar in all countries, but the level differed, with Mexico generally recording the highest support across policies, and the US the lowest. Several demographic characteristics were associated with policy support; however, these relationships varied between countries. CONCLUSION: The results suggest that support for food policies is influenced by several factors related to the policy design, country, and individual demographic characteristics. Policymakers and advocates should consider these factors when developing and promoting policy options.


Assuntos
Política Nutricional , Opinião Pública , Adulto , Austrália , Canadá , Estudos Transversais , Feminino , Humanos , Masculino , México , Inquéritos e Questionários , Reino Unido , Estados Unidos
15.
Am J Public Health ; 109(10): 1434-1439, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31415196

RESUMO

Objectives. To examine the prevalence and magnitude of price promotions in a major Australian supermarket and how they differ between core (healthy) and discretionary (less healthy) food categories.Methods. Weekly online price data (regular retail price, discount price, and promotion type) on 1579 foods were collected for 1 year (April 2017 to April 2018) from the largest Australian supermarket chain. Products audited were classified according to Australian Dietary Guidelines definitions of core and discretionary foods and according to their Health Star Rating (a government-endorsed nutrient profiling scheme).Results. On average, 15.1% (95% confidence interval [CI] = 14.7%, 15.3%) of core foods and 28.8% (95% CI = 28.6%, 29.0%) of discretionary foods were price promoted during a given week. Average discounts were -15.4% (95% CI = -16.4, -14.4) for core products and -25.9% (95% CI = -26.8, -25.1) for discretionary products. The percentage of products on price promotion and the size of the discount were larger for products with a lower Health Star Rating (P < .05).Conclusions. Price promotions were more prevalent and greater in magnitude for discretionary foods than for core foods. Policies to reduce the prevalence and magnitude of price promotions on discretionary foods could improve the healthiness of food purchased from supermarkets.

16.
Obes Rev ; 20(11): 1542-1556, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31408577

RESUMO

Interventions for obesity prevention in early childhood (first 5 years of life) are likely to have a significant preventive health impact. This mapping review identified recommended policy options for the Australian Federal Government (AFG) by comparing countries with similar population, income, and language to Australia. Policies were mapped in six countries using two matrices. The first matrix examined policy context, describing obesity prevention governance. The second matrix examined policy content, compared with global recommendations. Policies were grouped into downstream (healthcare), midstream (lifestyle and settings), and upstream (determinants of health, including food and built environments). Results identified variance in obesity governance across the six countries including policy coherence, leadership, institutional drivers, and overlapping responsibility across different levels of government. While countries tended to have more downstream or midstream policies, upstream policies were more likely when countries had invested in system-wide approaches to obesity such as developing a national obesity strategy, having separate food/nutrition and physical activity plans, and a dedicated preventive health agency. This study recommends a range of initiatives for the AFG to strengthen policies for the prevention of obesity in early childhood, including prioritising the development of a national food/nutrition strategy.

17.
Obes Rev ; 20 Suppl 2: 78-89, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31317645

RESUMO

Addressing obesity and improving the diets of populations requires a comprehensive societal response. The need for broad-based action has led to a focus on accountability of the key factors that influence food environments, including the food and beverage industry. This paper describes the Business Impact Assessment-Obesity and population-level nutrition (BIA-Obesity) tool and process for benchmarking food and beverage company policies and practices related to obesity and population-level nutrition at the national level. The methods for BIA-Obesity draw largely from relevant components of the Access to Nutrition Index (ATNI), with specific assessment criteria developed for food and nonalcoholic beverage manufacturers, supermarkets, and chain restaurants, based on international recommendations and evidence of best practices related to each sector. The process for implementing the BIA-Obesity tool involves independent civil society organisations selecting the most prominent food and beverage companies in each country, engaging with the companies to understand their policies and practices, and assessing each company's policies and practices across six domains. The domains include: "corporate strategy," "product formulation," "nutrition labelling," "product and brand promotion," "product accessibility," and "relationships with other organisations." Assessment of company policies is based on their level of transparency, comprehensiveness, and specificity, with reference to best practice.

18.
Curr Nutr Rep ; 8(3): 250-255, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31300982

RESUMO

PURPOSE OF REVIEW: The price of foods and beverages is a critical driver of food choice, particularly among families and households with limited food budgets. Policies targeting unhealthy food and beverage price promotions represent an untapped policy target for improving population diets and health. Here we review policy options for reducing the frequency and influence of price promotions on unhealthy foods and beverages (high in one or more of salt, sugar and saturated fat), and demonstrate their potential to complement other food policies and improve population diets. RECENT FINDINGS: Price promotions on unhealthy foods and beverages are ubiquitous in many settings globally and appear to be more common than price promotions for healthy food. Shoppers appear to be more responsive to price promotions on unhealthy foods and beverages compared to price promotions for healthier items, with evidence that discounts lead to impulse purchases, stockpiling and overconsumption. A range of policy options exist to reduce the influence of price promotions on unhealthy foods and beverages, but none have been tested in the real world, meaning the industry and consumer responses to such policies are unclear. Policies that reduce the prevalence and influence of unhealthy food and beverage price promotions should be considered as part of a comprehensive approach to improving population diets.

19.
Int J Public Health ; 64(8): 1147-1157, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31230118

RESUMO

OBJECTIVES: To benchmark comprehensiveness, specificity and transparency of the nutrition-related commitments of major food companies in New Zealand. METHODS: We applied the Business Impact Assessment on Obesity and Population Level Nutrition (BIA-Obesity). The largest 25 New Zealand companies in each of the packaged food (n = 15), non-alcoholic beverage (n = 2), supermarket (n = 2) and quick-service restaurant (n = 6) sectors were selected. Publicly available information on commitments was collected through an online search. Representatives from each company were asked to review and/or supplement the information collected. Commitments were then assessed, and recommendations made at the company and sector levels. RESULTS: Overall scores ranged from 0 to 75% across all companies with a median score of 38%. The best-performing domain was 'corporate nutrition strategy' (median score = 55%), and the worst-performing domain was 'product accessibility' (median score = 0%). Twelve out of 25 companies fully engaged with the process. CONCLUSIONS: The comprehensiveness, specificity and transparency of company commitments varied but were low overall. In the absence of strong industry commitments, government regulations, such as restrictions on unhealthy food marketing, are urgently needed. Future assessments should incorporate performance measures.


Assuntos
Benchmarking , Comércio/normas , Indústria Alimentícia , Marketing , Obesidade/prevenção & controle , Bebidas , Alimentos , Indústria Alimentícia/normas , Regulamentação Governamental , Humanos , Nova Zelândia , Estado Nutricional
20.
Aust N Z J Public Health ; 43(4): 355-365, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31141289

RESUMO

OBJECTIVE: The Health Star Rating (HSR) is a front-of-pack nutrition labelling system, implemented voluntarily in Australia and New Zealand since 2014. Our aim was to evaluate HSR's performance. METHOD: We used data from peer-reviewed publications and government-commissioned monitoring and evaluation, websites and communiqués to evaluate HSR's performance between June 2014 and October 2018 using the RE-AIM (Reach, Efficacy, Adoption, Implementation and Maintenance) framework. RESULTS: Thirty-three peer-reviewed publications, 21 government and three independent reports informed the assessment. Awareness and trust in HSR was increasing, though campaign reach remained low. Consumers liked, could understand and use the HSR logo, though effects on purchasing were largely unknown. The algorithm was the focus of a formal review. HSR was present on 20-28% of products but biased to those that scored better (HSR≥3.0). Necessary stakeholders were mostly engaged. CONCLUSIONS: A substantial body of work supports continuation and strengthening of HSR. Reasonable refinements to HSR's star graphic and algorithm, action to initiate mandatory implementation, and strengthened HSR governance present the clearest opportunities for improving public health impact. Implications for public health: Development and implementation of government-led front-of-pack nutrition labelling systems have the potential to improve public health, while engaging a diverse set of stakeholders.


Assuntos
Defesa do Consumidor , Rotulagem de Alimentos , Saúde Pública , Austrália , Programas Governamentais , Promoção da Saúde , Humanos , Política Nutricional , Valor Nutritivo
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