Belgian nutrition policy expert Laurence Doughan has spent 25 years fighting for healthier food environments. From Nutri-Score to influencer marketing, she says public health is facing actors with bigger budgets, better data and far greater reach. Yet all is not lost. Small changes matter, and even small improvements in our food system can make a difference. EuroHealthNet’s Ruth Thomas uncovers the story.
A few years ago, my dad became convinced he needed more peanuts in his diet. These days, his latest food hobby is cheese.
“I’ve been told I need more calcium,” he says. “I don’t really like cheese, but I know it’s good for me.”
How does he know this? Well, in the same way he decided he needed to eat more peanuts: a dietitian told him.
He ate large amounts of peanuts that they started affecting his health. Eventually, it turned out he had a mild allergy.
Then there was the flapjack. A dense, oat-based British treat made with butter, sugar and syrup, it left him ill. My dad, who has coeliac disease, had long assumed oats were safe. After all, that’s what he’d been told and what he’d read in leaflets.
What he hadn’t realised was that “oats are gluten-free” comes with an asterisk. Some are contaminated during processing, others are not. Some are safe for people with coeliac disease, others are not.
But surely, that’s the point, isn’t it?
Food education isn’t always easy to access or understand. Nutrition advice can be fragmented. Whether it’s fancy marketing campaigns promising “new and improved” and “all-natural” foods, or the familiar mantras from health professionals like eat more fibre, get more calcium, cut down on fat, avoid sugar. The messages themselves aren’t necessarily wrong, but they rarely come with context.
How much is enough? What’s the alternative?
At some point you realise the places where we all buy food are a sensory circus. A place where industry dominates, not health, a stage of actors all vying for our attention.
The battle for your basket
Those are the places Belgian nutrition policy expert Laurence Doughan has spent the past 25 years trying to improve.
Working within Belgium’s Federal Public Service of Public Health, she helps shape healthier food environments through dietary guidelines, nutrition policy and consumer information. But it’s not easy.
I first came across Laurence at a policy dialogue held in the European Parliament by EuroHealthNet, FEAST and EAT. What struck me wasn’t simply just her passion for helping shape healthier food environments, but her willingness to challenge those holding the power. When the topic on public health vs the public purse came up, she asked the tough questions to the fiscal policymaker in the room. It showed that food policy is rarely just about what’s on the plate. Why? Well, it’s also about power, priorities and who gets to shape the choices we make.
What drives her?
“Human connection,” she tells me. “I enjoy listening to others and educating people on why healthy eating is important. But I also like to learn from people too. When there’s a mutual exchange, it’s very enriching.”
Nutritional food should serve everyone, not just those who can afford it. Yet from her perspective, that mission is far from straightforward.
“We are always behind,” she says, referring to public health authorities,
“Our budgets are not comparable. Food companies invest enormous amounts in marketing.”
Public health, by contrast, is split. Short funding cycles, limited reach, and health messages that rarely travel as far as the products they’re trying to compete with.
But even that feels like an understatement once you look at how food companies now reach consumers. It goes beyond traditional lobbying. Packaging, placement, apps, influencers and targeted advertising all sit alongside systems built on behavioural data most people never see.
The data advantage
“Digital marketing is now highly personalised. Retail and data companies know a lot about consumer behaviour and sell that data.”
Industry sits on vast behavioural datasets, from loyalty card records to real-time online browsing habits, that public health authorities simply can’t match. Increasingly, that data is used to shape what we, as consumers, buy. But the imbalance goes beyond data. It’s visible in food labelling policy too.
Nutri-Score, a front-of-pack nutritional label that grades food from A to E based on nutritional quality, was designed to simplify decisions in an environment overloaded with competing signals. It’s been adopted or recommended in several European countries, including France and Belgium, but remains voluntary across much of the EU.
“In Belgium, we are lucky that some retailers are quite supportive,” Laurence says. “But there is significant lobbying pressure against tools like Nutri-Score.”
“So, for now, it is also a moral and political movement rather than a fully enforceable system.”
Small nudges, big stakes
Change can happen, but as usual it’s slow and uneven.
In Belgium, some supermarket apps have trialled loyalty incentives that encourage healthier food choices, including around 10% off fruit and vegetables. Meanwhile in the UK, some food manufacturers are removing cartoon characters and other child-focussed imagery from packaging to make unhealthy products less appealing to children.
“We do see improvements in consumer behaviour,” Laurence says. “More A and B-rated products are being purchased, and increased consumption of fruit and vegetables.”
“But linking this directly to obesity or diabetes is not yet possible. These are long-term epidemiological questions.”
Still, early evidence suggests labels like Nutri-Score can influence what people buy, nudging consumers towards healthier choices.
A Belgian supermarket found that Nutri-Score shifts purchasing behaviour towards better-rated products in everyday shopping. In France, some retailers are already pushing manufacturers to adopt Nutri-Score, even using ‘name and shame’
tactics for those who refuse. If France moves towards mandatory labelling, it could create a domino effect across Europe.
Of course, the imbalance doesn’t just stop at food labelling, it extends into the wider food environment. Industry’s influence affects public health a “great deal” according to Laurence. “They often try to delay or undermine regulation.”
“The strategies are well known – denial, delay, and discrediting public health proposals.”
Even modest proposals, or ones that seem modest anyway, such as including nutritional information in advertising rather than banning ads outright, face resistance.
“It is extremely difficult,” she says. “Marketing evolves constantly, social media, influencers, personalised advertising.”
“Governments simply do not have the capacity to regulate all of it effectively.”
Supporting people, changing systems
Even when restrictions are introduced, they’re quickly bypassed. So, is affordability what pushes people towards the less healthy options?
“I am not fully convinced that healthy food is always more expensive. This is often overstated.”
“Cooking healthy food is not necessarily expensive, but it requires skills and education.”
“The real issue is food literacy. People need to know how to cook simple, healthy meals.”
In Belgium, 1 in 2 adults are overweight or obese, and 1 in 7 adolescents are affected. The figures point to a broad nutrition policy landscape marked by both ambition and constraint. Since, 2019 a voluntary approach has been in place, replacing earlier national plans that struggled to survive political instability.
Some progress is visible, particularly in hospital initiatives like the Baby-Friendly Hospital initiative, which now includes around a third of maternity hospitals. But overall, resources remain limited.
For Laurence, the answer doesn’t lie in more restriction, but in a shift in norms, where healthier food environments become the default.
“We need to promote healthy, sustainable, locally sourced food — not ban everything but shift norms.”
So, the question for public health is no longer simply whether information exists. It’s whether information can cut through the noise of industry at all. And increasingly, the uncomfortable answer is that it struggles to.
For all the debates over nutrition science, regulation and marketing, perhaps that’s what this comes down to - consumers shouldn’t need a degree in food chemistry to understand what they’re buying but instead need support in understanding their needs to lead a healthier life.
“Education is key when it comes to healthy living”, says Laurence. “School meals are crucial. High-quality public procurement can reduce inequalities. Social media influencers could also play a positive role in the future [in influencing people’s choices].”
Research shows that hands-on food education in schools doesn’t just teach children what’s healthy, it changes how they feel about food, with benefits that can last for years. Poor diets start early, and so intervention must start early too. And perhaps that’s where change needs to begin. Not by underestimating people, especially the younger generation, but by listening to them and learning.
Beyond personal responsibility
Throughout our conversation, what seemed to motivate Laurence was simply people, and the ability to listen and learn from each other. These aren’t new skills; they’re deeply human ones. Yet without the political will to challenge the influence of industry, even the strongest public health efforts can only go so far.
My dad’s story is a cautionary tale for all of us. He didn’t overconsume because he was careless, but because today’s food system asks consumers to navigate competing messages, marketing and nutrition advice with little to zero support.
The question isn’t whether people are making the right choices, but why the system makes those choices so difficult in the first place, who shapes our food choices, and whose interests are really at the heart (and health) of what we eat.
In focus
- Strengthen food literacy through practical nutrition education and cooking skills across the life course, starting in schools.
- Create healthier food environments by supporting clear nutrition labelling, healthier retail incentives, and evidence-based public health policies.
- Regulate food marketing more effectively to address personalised digital advertising and reduce industry influence on food choices.
- Invest in sustained public health communication so trusted, evidence-based nutrition advice can compete with commercial marketing.
- Put equity at the centre of nutrition policy by ensuring healthy food information and choices are accessible, affordable, and understandable for everyone.
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