Healthy Food Environments

Food environments are “the physical, economic, political and sociocultural context in which consumers engage with the food system to make their decisions about acquiring, preparing and consuming food”^[2]HLPE, 2017.  http://www.fao.org/3/i7846e/I7846E.pdf

Currently, many food environments make it easier to prefer and purchase nutrient-poor, energy-dense foods rather than foods that fit better in healthy and sustainable dietary patterns. Today, every fourth person has an income insufficient for acquiring a healthy diet.^[3]Hirvonen, K. et al. 2020..https://doi.org/10.1016/S2214-109X(19)30447- 4; SOFI 2020 http://www.fao.org/publications/sofi/2020/en/ Current food systems have other shortcomings such as issues of animal welfare, equity, justice and unfairness that are exacerbated by how food environments are shaped today. Food deserts and swamps, as well as the demand for convenience drive increasing consumption of unhealthy and/or unsustainable diets. Certain vulnerable populations, including people from low socio-economic backgrounds, children, elderly, or women and girls also disproportionately suffer from food insecurity and inadequate nutrition. Even where sustainable and healthy options are accessible and affordable, marketing, advertising and promotion favor options that are difficult to be integrated into the daily lives of people. Thus, changing dietary patterns can not be considered as sole responsibility of consumers. Consumer behaviour is influenced by a myriad of complex and inter-linked societal, environmental, and individual factors, many of which drive behaviour automatically, even unconsciously. Food for healthy and sustainable dietary patterns for all can only be achieved in healthy food environments, enabled by coherent policies at all scales of governance, transparency and accountability for consumers who are active agents of change.

This solution cluster will promote ‘healthy food environments’ that make healthy and sustainable consumption patterns ‘normal’ and effortless. Being the crucial interface between food producers and consumers, healthy food environments have significant leverage. They can help consumers adopt behaviours that are good for them. Healthy food environments also give important signals upstream – to food business operators, food processors, primary producers, research and innovation to work towards ever more affordable products supporting healthy and sustainable dietary patterns. The solutions will work because 

• Dietary guidelines for People and Planet will be tailored to national and sub-national contexts but based on scientific evidence
• Coherent, consistent and inclusive policies will work together creating conditions for healthy food environments
• Transparency will ensure a level playing field for businesses, and trust and certainty for people

1. Develop and implement national Dietary Guidelines for People and Planet as the backbone for coherent food-system policy to create healthy food environments, taking into account the different realities worldwide.
DGPPs will provide evidence-based recommendations for what constitutes a healthy and sustainable diet in a national context and local realities1. They can become core to a suite of integrated policies to guide food system transformation towards healthy, sustainable and equitable food environments. DGPPs can guide not only nutrition and education programmes or communication campaigns, but go beyond to inform policies, programmes and stakeholder actions throughout food systems such as:
• Institutional or public procurement, rules for green investment, or social protection initiatives
• Trade agreements and fiscal measures such as government subsidies and taxes
• Investment into research and innovation, urban planning or private sector actions.
Such demand interventions are most effective if implemented through the right package of policies, covering policies from production to consumption of food, with broad consensus and participation by the public ensuring that nobody falls through the net and all can benefit.
2. Food environment actors make healthy and sustainable diets the easiest and most available, accessible, affordable and desirable option
The right for food extends to the right food supporting healthy and sustainable dietary patterns. When people get food e.g. in markets, food stalls, restaurants or canteens, the information and foods they see first and the foods they can afford are consistent with health and sustainability recommendations such as DGPPs, no matter what income they or their country have. Solutions include but are not limited to:
• Local food markets, informal vendors, supermarkets, cantines, online or other vendors – all fulfill high health and sustainability criteria (environmental, social and economic), everywhere, from long or short supply chains.
• Food business associations and operators have developed Codes of conduct on responsible food business and marketing practices and made publicly available, operating under the principle of ‘no harm.
• Healthy food environments, supported by smart regulations, offer a variety of sustainably sourced foods that enable adequate nutrition, avoiding adverse health effects.
3. Global conversation on healthy food environments to provide clarity, capacity and shift norms
There is currently no comprehensive or standard framework for assessing food environments for both health and sustainability at the national level. There is no method on how to account for food impacts in other parts of the world, or how to manage trade-offs. The solutions in this cluster will:
• Fostering a global dialogue to provide guidance to countries to define healthy and sustainable dietary patterns and support shifting of social norms including a greater appreciation for sustainability, good standards of animal welfare, as well as valuing food as a source of life-sustaining nutrients20,19 . Demand is generated21 for food conducive to healthy and sustainable dietary patterns.
• Form a coalition of countries to create a mechanism providing evidence for decision makers, fostering accountability, empowering civil society to drive change.
• Facilitate the creation of national food system hubs and provision of advice and guidelines to underpin policy options, funds to pilot innovative approaches, and information to build support for change in different country contexts

Our theory of change is that small-scale farming and localised traditional and indigenous peoples’ food systems can advance equitable livelihoods, nutritional wellbeing, ecosystem health and resilience to climate change. Applying this knowledge and using it can contribute to the design and management of sustainable food systems worldwide. Our aim is to connect traditional knowledge holders with contemporary scientific knowledge as equal partners through multicultural learning and exchange processes for the development of equitable livelihoods. The theory of change is based on centuries of knowledge and learning from indigenous peoples and the evidence that their food systems are sustainable, equitable, productive, and resilient at the same time. It then builds in the imperative of respecting and upholding the right to food and human rights and draws on the best that traditional and contemporary knowledge has to offer in ensuring dignified livelihoods and food security for all.

This cluster embraces a “leave no-one behind” approach and will contribute, specifically, to achieving SDGs 1, 2, 5, 10, 12 and 13 while its coalition building approach addresses SDG 17. The solution cluster is linked to ongoing global policy agendas led by the CFS, Conventional on Biological Diversity (CBD), United Nations Framework Convention on Climate Change (UNFCCC), and the United Nations Convention to Combat Desertification (UNCCD) and considers recommendations from the White/Wiphala Paper on Indigenous Peoples’ Food Systems.

Examples of ongoing efforts

• • “The Committee on World Food Security (CFS) has undertaken a policy process to produce Voluntary Guidelines on Food Systems and Nutrition (VGFSyN). The preparation of the VGFSyN is informed by the High Level Panel of Experts on Food Security and Nutrition’s (HLPE)17 Report on Nutrition and Food Systems, additional literature as well as an inclusive consultation process that took place between May and November 2019 which involved the participation of CFS stakeholders. The VGFSyN are expected to …. promote policy coherence, coordination and convergence across different domains. They provide science and evidence-based guidance to help countries and other relevant stakeholders operationalize ICN2’s Framework for Action recommendations in support of the progressive realization of the right to adequate food in the context of national food security, and other relevant rights, as applicable, including the right of everyone of the enjoyment of the highest attainable standard of physical and mental health, and to achieve the 2030 Agenda on Sustainable Development”.
  • FAO is revising the methodology to develop, revise and implement Food-based dietary guidelines to integrate a food systems approach and include sustainability considerations. FAO is supporting several countries in developing or revising their FBDGs with a broader perspective..
  • WHO list of healthy food environment related guidance documents and monitoring initiatives
  • INFORMAS (International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research, Monitoring and Action Support) is a global network of public-interest organisations and researchers that aims to monitor, benchmark and support public and private sector actions to increase healthy food environments and reduce obesity and NCDs and their related inequalities.
  • The NOURISHING and MOVING databases, maintained by the World Cancer Research Fund (WCRF) International, collect policy actions from around the world which are implemented on a national level, and which are currently in effect. All policy actions listed on the database have been verified by an in-country government expert. In select cases local policies have also been included as best practice examples. To source the policy actions, a specific search criteria and verification process is used.
    See https://policydatabase.wcrf.org/level_one?page=nourishing-level-one 
  • EU food business associations and operators have developed a voluntary Code of conduct on responsible food business and marketing practices. The Code defines a common aspirational path towards sustainable food systems addressing environmental, social, and economic sustainability, and covering food consumption patterns, internal processes and value chain/primary producers. The code invites businesses of all sizes active in production, trade, processing, promotion, distribution and serving of food, as well as any other food system stakeholders, to align with the common agenda of the code and to contribute with tangible actions to help achieve the objectives set out therein. Furthermore, individual businesses that want to show leadership and demonstrate front-runner ambitions to contribute to the aspirational objectives and targets are invited to make ambitious complementary commitments on sustainability topics that are relevant for them. 
  • Established in 2017, EIT Food is investing in innovative solutions that put consumers at the center of the transformation and increase the level of trust within the food system. To this end, EIT Food established an online platform called “FoodUnfolded®” to convey objective, scientific, easy to understand and relevant information about food to citizens. Learning more about our food and its origins. By bringing facts and stories to life, FoodUnfolded helps citizens navigate everyday food decisions through knowledge. Furthermore, EIT Food also runs a multi-country annual survey with more than 20,000 consumers to track the level of trust within the food system (TrustTracker). Findings of the TrustTracker is used in informing policy as well as investment and innovation decisions. In July 2021, EIT Food will be launching its free-access education module for medical professionals to increase their knowledge about the health and sustainability aspects of food consumption, empowering medical doctors as change agents in shift towards healthy and sustainable food.
  • FAO has launched a project to develop a best-practice Life Cycle Assessment approach to more accurately assess and compare the environmental and nutritional impacts of food items common to diets across the world. Uptake of the tool can assist in the design and promotion of robust policies that encourage healthy diets from sustainable food systems and enabling people to make better-informed food choices.
  • The Federation of European Nutrition Societies started a process establishing working groups  and concluded that environmental aspects should be included in the future conceptual framework for FBDG. Several more countries are now in the process to develop or review their dietary guidelines integrating sustainability including The Nordics (8 countries), Mexico and Costa Rica. 
  • Toolkits and approaches for consistent accountability mechanisms for the private sector are already being developed through a collaborative initiative from the Food Foundation and World Benchmarking Alliance. This includes metrics and methodologies covering nutritional, environmental and social inclusion topics in line with the existing benchmarks each organisation has developed at a global level (World Benchmarking Alliance) and national level (Food Foundation) and other specific benchmarks such as Access To Nutrition Initiative. Independent dialogue processes have already begun with representatives from lower-, middle-, and high-income countries keen to participate in sessions to further develop a consistent methodology adaptable to different national contexts.  The first version of this toolkit is due to be developed during 2021 and released in Q4 2021. The One Planet Network’s Sustainable Food Systems Programme has a core initiative that focuses on sustainable healthy diets, jointly led by FAO and UNEP and supported by others. The core initiative has been doing work on indicators of sustainable healthy diets, as well as communication activities in support of sustainable diets in the context of sustainable food systems.
  • Global diet quality project implemented by GALLUP and Harvard in collaboration with GAIN is ongoing, supported by EU DEVCO/ GIZ, Rockerfeller, USAID and SDC.
  • In order to help Members States halt and reverse the high prevalence of overweight and obesity, the Commission launched in 2020 the BestReMaP joint action on implementation of best practices in the area of nutrition. The work under the joint action, which is carried out by participating countries, includes several initiatives focusing on food reformulation, reducing aggressive marketing to children of foods high in fat, salt and sugar and public procurement of food in public institutions. The main objective of one of its key work packages is to contribute to the higher quality of foods procured by kindergartens and schools in the EU through the development of procurement tools such as a catalogue of selected healthy food products available on the market and by creating procurement templates, which will help institutions draft better catering contracts. 

• Chile has a number of relevant initiatives from the Ministry of Social Development and Family that are already underway, including: 1) Elige Vivir Sano’s Healthy Environments Fund (Fondo Promoción de Entornos Saludables) which helps implement and maintain farmers’ markets and healthy kiosks. 2) Elige Vivir Sano’s Healthy Deliveries (Pedidos Sanos), a mobile phone app which allows consumers to order fruits and vegetables from local markets with free delivery.  

• Several countries are taking steps towards the development of interpretative front of pack nutrition labelling such as the Nutriscore, that has demonstrated its effectiveness to guide consumers towards healthier food choices, and encourage food industry to reformulate their products. In addition, experiences from countries with long term use of front of pack nutrition labelling, such as the Keyhole, show that front of pack nutrition labelling has beneficial effects also when it comes to dietary advice in health care and in education on different levels, thereby not only as food labelling.
• In addtion there is the Global Action Network on Nutrition Labelling, launched by France, Australia and Chile in 2019, under the umbrella of the United Nation Decade of Action on Nutrition 2016-2025.