How international efforts are reshaping our food environments

Creating a healthy and sustainable food system is a long and challenging task, but it is necessary for the wellbeing of people and the planet. Learning from past experiences is not about mere repetition but about adaptation, about harnessing the knowledge of the past to shape the innovations of the future. It is about recognising that change is not a sudden revolution but an evolutionary process, a delicate balance between preserving our food culture whilst simultaneously embracing sustainability.

It calls for a symphony of voices, experts, and stakeholders to come together, including farmers, scientists, policymakers, educators, and consumers to join forces, each contributing their unique expertise to orchestrate a successful transformation. Researcher and Assistant Professor Katarzyna Brukało, a clinical nutritionist and public health specialist from the Medical University of Silesia, Katowice, walks us through some leading examples of cross-collaboration from across Europe and illustrates why integrated, international efforts are vital to reshape our food environments.

Establishing a sustainable and healthy food system is a marathon, not a sprint. It can often be a long road, and change is time-consuming requiring strong cross-collaboration between sectors, including industry representatives, health professionals, educators, and ministries, to name but a few. Yet, to create and indeed shape effective international initiatives responsibly, it is important to learn from past experiences that have allowed for the exchange of experiences and the adaptation of validated practices.

But to ignite this change and foster a healthy food environment, we need to delve into the current reality of our food choices and ask ourselves, 'Where do we stand now?'.

Experts across Europe are carefully reviewing existing programmes and solutions, and this collective effort has found its way to the European stage through two landmark initiatives: the Joint Action in Nutrition and Physical Activity (JANPA) and the Joint Action on Health Equity Europe project (JAHEE). These initiatives are specifically focused on ensuring that all individuals have a fair and equal opportunity to attain their optimal health.

Sustainability in times of crisis: international cooperation is key

The global food system is facing a number of extreme challenges from climate change, obesity, through to food insecurity. We cannot underestimate how interconnected these challenges are and overcoming them requires a multifaceted approach. But why is international cooperation an essential factor when it comes to addressing these issues?

For societies to build a more sustainable and responsible food environment, international cooperation provides a clear answer, a strong platform for countries to share knowledge, expertise, and resources, enabling them to develop and implement effective solutions. Through collaboration, countries can break down barriers including understanding people's needs and wants, access to data, and having the ability to prioritise short-term needs over long-term sustainability. Through cross-collaboration, it is possible to adopt sustainable practices that promote environmental protection, food security, and nutrition for all.

In recent years, Europe, like much of the globe, has faced many crises, from the pandemic, the war in Ukraine, rising costs of living to soaring energy prices. Such crises have led us to rethink our food system structures. Yet, being able to provide nutritious, wholesome food during such times poses new challenges. In the Baltic region, there is a catering revolution happening. The 'Innovative Strategies for Public Catering: the Expansion of the Sustainable Public Meal Toolkit, StratKIT+' initiative helps to make the procurement and services of public catering more sustainable. The tools provide experience-based advice to local public authorities, public catering service providers, school canteens, and other public meal actors on how to move towards more sustainable public meals. It increases municipalities' adaptation to change in times of crisis. A developed crisis meal management plan, for example, will allow you to prepare for crisis situations and then implement sensible solutions instead of spontaneous and chaotic actions.

The impact of COVID-19

The COVID-19 pandemic's health effects have left a lasting impact on people worldwide, affecting both their mental and physical wellbeing. One of the most concerning consequences has been the significant increase in obesity and overweight among younger age groups, which can be attributed to various factors. The closure of schools and the cancellation of extracurricular activities led to a decline in physical activity for many children and young people. Financial constraints faced by families also made it challenging to access nutritious food options along with the widespread stress and anxiety as a result of the pandemic that took a toll on children and their families, potentially leading to unhealthy eating habits and weight gain.

Yet, despite the rise in excess body weight among children and adolescents, there was a silver lining. The pandemic offered a tremendous opportunity to support existing efforts to address this issue including the creation of the Best Re-MaP initiative, a Joint Action that aimed to implement proven nutrition best practices, and we, in Poland, participated in this initiative and implemented two activities.

But here in Poland, we are facing a growing epidemic of overweight and obesity in children and adolescents. According to a World Health Organization (WHO) report, 32% of Polish children aged 7-9 years are overweight or obese, placing Poland 8th among the surveyed countries in Europe. This is a major public health concern, as obesity can lead to a number of health problems, including heart disease, diabetes, and cancer.

However, the Polish government is taking steps to address this problem implementing a number of measures, such as a tax on sugary drinks (including 'zero' and energy drinks) and regulation on school and nursery nutrition, assessing what products are available in school shops and vending machines. However, such measures have not been enough to stem the tide of childhood obesity. create and indeed shape effective international initiatives responsibly, it is important to learn from past experiences that have allowed for the exchange of experiences and the adaptation of validated practices.

Government policies are crucial

Of course, governments across Europe play a key role in increasing healthy environments and encouraging healthier choices. Strong policies are needed to create effective solutions to obesity and diet-related diseases such as diabetes and heart disease and, in turn, promote healthy living environments. Monitoring the level and effectiveness of governmental policies is vital to ensuring progress towards better nutritional health.

A useful tool in assessing national policies affecting the food environment has been the FOOD-EPI. This tool identifies priority actions to create a healthy food environment in Europe and is used to measure the improvement of EU-level policies that target food environments in EU Member States.

New Standards for Public Food Procurement

While governments play a crucial role in promoting healthier living environments, public institutions, such as nurseries and schools, also hold the key to shaping the eating habits of children and adolescents. The meals served in these institutions should be nutritious, sustainable, and affordable, fostering healthy eating habits from an early age.

Recognising the significance of this role, Polish public institutions have implemented a new Best Re-MaP initiative, setting food procurement standards that meet this criteria. The government has also drafted a complete guide to facilitate the food procurement process, which follows the legal framework in Poland with a strong emphasis on quality and sustainability criteria. The manual is dedicated to authorising officers and those involved (and interested) in school and nursery nutrition.

The manual provides guidance on how to:

  • Select food suppliers that meet high standards for quality and sustainability.
  • Negotiate contracts with food suppliers to ensure that prices are fair and that the food meets the nutritional needs of children and adolescents.
  • Implement and monitor food procurement procedures to ensure that they are effective and efficient.

This Best Re-MaP activity is expected to have a significant impact on the health and wellbeing of Polish children and adolescents, as it promotes healthy eating in public institutions and supports a healthier future for the next generation.

Food sleuths: what's in the food we eat and how is it changing?

We've all faced the challenge of translating food labels while standing in the aisle of a supermarket. But why is it crucial to comprehend the intricacies of nutritional information?

Understanding the nutritional composition of commercially available foods – those produced, packaged, and sold for consumption, such as ready-to-eat meals – and how it evolves over time is essential for us to make informed food choices and achieve optimal health; and this was a key focus of the Joint Action Best-ReMaP initiative.

Of course, when it comes to understanding what food is available and its content, it can help us, as health professionals, to understand personalised nutrition, monitor health, and raise awareness of hidden nutrients such as unhealthy fats, sugars, and sodium often found in ultra-processed food products.

Fortunately, the standardisation of data collection and processing has enabled the  creation of a comprehensive European food database, the Food and Beverage Labels Explorer (FABLE), which provides valuable insights into the nutritional profiles of commercially available foods.

This database provides researchers with the ability to monitor the quality of food products over time and assess how the composition of products is changing and what impact such reformulation has on public health. It also delivers insights to understand how manufacturers are adapting to market demands, economic constraints, and consumer expectations.

However, it isn't just research that can benefit from a database such as this. FABLE is also a valuable tool for Member States and the European food market as a whole. It can help policymakers develop evidence-based policies to promote healthy eating and food reformulation. It can also help manufacturers understand consumer demands and adapt their products accordingly. So, how exactly does FABLE work? It can:

  • Identify unhealthy food categories: Policymakers can use FABLE to identify food categories that are high in unhealthy ingredients, such as salt, sugar, and saturated fat. They can then develop targeted policies to reduce these ingredients in food products.
  • Change tastes: Manufacturers can use FABLE to track how consumer preferences are changing over time. This information can help them develop new products that meet the needs of consumers.
  • Impact food choices: Researchers can use FABLE to study the impact of reformulation on public health. For example, they can track how changes in the nutritional composition of food products affect the prevalence of obesity and other chronic diseases.

With committed international cooperation, it is possible to successfully draw inspiration and adapt promising practices at the local or regional level - let's think globally, act locally and create socially responsible science. Together, we can create real and lasting change that, by creating a sustainable food system, will improve the health and wellbeing of our community.

Creating supportive environments

Beyond nutrition knowledge, fostering supportive environments that empower individuals to make informed food choices is paramount to optimising overall wellbeing and health.

The Finnish 'Smart Family' practice is prime example, an initiative that supports the creation of a sustainable food environment for children and adolescents. The practice is also based on international research and best practices, and it involves the whole family as well as healthcare professionals and teachers.

The 'Smart Family' practice approach supports children and adolescents with overweight or obesity and their families to create a supportive environment by working closely with GP clinical staff and teachers.


Together, stronger: think globally, act locally

A number of initiatives are already underway to promote sustainable food systems and responsible food environments, as mentioned throughout this article. These initiatives, although implemented at different times and in different places, complement each other and amplify their positive impact.

A sustainable food system is one that meets the needs of the present without compromising the ability of future generations to meet their own needs. It is a system that is environmentally friendly, economically viable, and socially just. With committed international cooperation, it is possible to successfully draw inspiration from and adapt promising practices at the local or regional level. Let's think globally and act locally to create socially responsible science, ensuring that scientific research is conducted in an ethical, transparent, and accountable manner, with the potential benefits and impacts clearly defined and communicated to the public. Only through this collaborative and responsible approach can we build a sustainable food system that nourishes both people and the planet.

By creating a sustainable food system, we can improve the health and wellbeing of our community. We can also reduce our impact on the environment and ensure that everyone has access to nutritious food.

Katarzyna Brukało
Research and Teaching Assistant Professor at Medical University of Silesia, Katowice

Katarzyna Brukało, PhD, MBA in healthcare, clinical dietitian and public health specialist, Department of Health Policy, Faculty of Public Health, Medical University of Silesia, Poland.
She serves as an expert for the European Federation of the Associations of Dietitians within the European Specialist Dietetic Network for Older Adults and the International Group of Urban Planning for Health Equity under the Academy of Territorial Development in the Leibniz Association.

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