While many international policy campaigns to encourage healthier diets have been put in place, few have been evaluated for their impact in changing actual behavior. A new report presented at the 5th Annual European Public Health Conference on Nov. 8 suggests more and better evidence of the effectiveness of healthy eating policies needs to be collected, and should be considered as an integral part of all policies.
The report was derived from the EATWELL project (Interventions to Promote Healthy Eating Habits: Evaluation and Recommendations) that was launched in April 2009 and will conclude in March 2013. Funded by the European Commission under Framework Programme 7, its primary objective was to improve nutrition policy in the EU and Member States by providing scientifically sound evidence on the effectiveness of past interventions.
This EU-funded project looked at 111 national-level interventions, and used validated and advanced quantitative evaluation models conducted fresh analysis of secondary data bases. This showed, for example, that the UK Food Standards Agency’s salt campaign in 2004 resulted in a 10% reduction of salt intake on average in the UK population, with young women demonstrating the biggest behavior changes toward reduced salt intake. The initiative combined an advertising awareness campaign, to inform the public of the health issues of consuming too much salt, and working with the food industry to encourage reformulation to reduce salt in food products.
Similarly, a project analysis of the 5-a-day fruit and vegetables campaign in the UK, which started in 2003 and encouraged the increase in fruit and vegetable consumption through social marketing, found a significant increase in fruit and vegetable intakes between 0.2 and 0.7 portions per day especially in the lower- and middle-income classes.
“We used secondary data to carry out our own analyses of these initiatives. Continued evaluation of finished, ongoing and new interventions is necessary to form an even better picture of the impact of policies on actual eating behavior", said project coordinator Professor Bruce Traill of the University of Reading.
Based on the evaluations of the 111 interventions and an online survey of more than 3,000 interviews with European citizens, gauging public acceptance of healthy eating interventions, the project has made several proposals to aid in the development of future policies to encourage healthier eating.
Of the analyzed policies, 82 support informed choice by providing information or education, such as nutrition labeling and advertising controls. These policies have small but positive effects on healthy eating. They are relatively cheap, generally cost-effective and accepted by the public. For example, incorporating key success factors of commercial marketing into public information campaigns and investing in longer term campaigns could encourage healthier behavior. “However, it’s also important to take into account here that informed choice does not necessarily equal making a healthier choice; many factors influence what people ultimately choose to eat," Traill said.
The remaining policies seek to change the market environment and are those which change the choice set facing consumers either by enhancing the availability of healthier foods, restricting the availability of less healthy foods or nutrients, or changing relative prices of food through taxes and subsidies. These measures have the potential to bring about substantial changes in food choices and offset the social costs of unhealthy diets.
Evidence of effectiveness is lacking in many cases owing to the short time span since the introduction of some of the measures, but when evaluated, they were found to be cost effective, but with the down side that the public finds them intrusive and are less likely to accept them. “Fiscal interventions to promote healthy eating are highly cost-effective. The precise nature of any tax should be informed by the careful evaluation of recent measures in Denmark, France, Finland and Hungary, while the revenues generated should be used on other cost-effective measures to encourage healthier diets," Traill said.
