Healthy Food Environment Scoping Review

Abstract

This work was conducted at the request of the Centre for Population Health at the NSW Ministry of Health, to inform implementation of the relevant strategic direction of the NSW Healthy Eating Active Living (HEAL) Strategy 2013–2018. It is not intended to be an exhaustive review but rather to provide an indication of the rationale for intervening and the potential effectiveness of a broad range of policy options. It is also intended to inform ongoing stakeholder consultation regarding action with respect to the food environment. This consultation will necessarily take account of other evidence of effectiveness including likely reach and population impact, as well as implementation issues such as sustainability of effects, feasibility, acceptability, equity, and other factors affectingplanning and investment decisions. It is noted that no single action contained within this evidence synthesis will in itself be sufficient to affect weight status substantially at the population level. A portfolio of interventions within the food environment, alongside action to increase physical activity and reduce sedentary behaviours, is required to halt the progress of obesity and prevent chronic disease. This sentiment has been expressed many times previously but also recently in the McKinsey paper by Dobbs et al (November 2014) relating to an economic analysis for obesity prevention: “Existing evidence indicates that no single intervention is likely to have a significant overall impact. A systemic, sustained portfolio of initiatives, delivered at scale, is needed to reverse the health burden.” Similarly, no individual sector in society can address obesity acting on its own — neither governments, retailers, consumer-goods companies, restaurants, employers, media organisations, educators, healthcare providers, or individuals.Achieving the full potential impact requires engagement from as many sectors as possible. Ideally such actions would be contained within an overarching National Nutrition Policy in Australia. Finally, we would like to echo another sentiment of the McKinsey Global Institute discussion paper, that “… our analysis is by no means complete. Rather we see our work [on a potential program to address obesity] as the equivalent of the maps used by 16th-century navigators. Some islands were missing and some islands were misshapen in these maps, but they were helpful to the sailors of the era. We are sure that we have missed some interventions and over- or underestimated the impact of others. But we hope our work to be a useful guide….”