Allow a VAT exemption of 0% for all fresh fruit and vegetables, set mandatory food composition targets for all food categories, and restrict or ban the (online) marketing of foods high in saturated fat, trans fat, salt or added sugars to children and adolescents up to 19 years. These are just a few of the measures which the European Union (EU) could put forward to create healthy food environments in EU member states. The EU is missing out on opportunities to support member states to create food environments that make the healthy choice the easy choice. This is shown by research led by Utrecht University and Wageningen University & Research in the Netherlands. The research team recommends the EU to take immediate action.

Government policies are essential to create supportive food environments for making healthy choices. It is therefore an important tool in the fight against overweight, obesity and chronic diseases. And that is sorely needed, given the fact that in 2017 more than 50% of the adult population in the European Union (EU) was overweight of which 15% was obese. Individuals with obesity are more likely to develop chronic diseases such as cardiovascular diseases and type 2 diabetes, and to experience a more serious disease course when infected by COVID-19.

Assessment by independent experts 
Sanne Djojosoeparto and dr. Carlijn Kamphuis (Utrecht University) and dr. Maartje Poelman (Wageningen University and Research) led the study on EU-level policies influencing food environments. The study was carried out in collaboration with European partners within the JPI Policy Evaluation Network (https://www.jpi-pen.eu/). In their study, 29 international and independent food- and health experts assessed the strength of EU-level policies. The researchers first created an overview of EU-level policies. They summarized existing policies regarding food environments for 26 pre-specified policy indicators (e.g. on food composition, labelling, promotion, provision, retail and trade and investment) and another set of 24 indicators covering infrastructure support domains (related to leadership, governance, monitoring, funding, platforms for interaction and health-in-all-policies). Then, experts assessed for each of the indicators the strength of EU-level policies. The researchers used the Healthy Food Environment Policy Index (Food-EPI), an international standardized tool and process to assess policies influencing food environments.  

Few policies for healthy food environments 
For the majority of the 26 policy indicators, experts rated current policies as weak (65%) or very weak/non-existent (23%). For example, there are no or very weak EU-level policies to restrict unhealthy food promotion to children on packaging. Likewise, there are no policies to increase taxes or levies on unhealthy foods. Only policies with respect to ‘food composition targets for industrially processed foods’, ‘ingredient lists and nutrient declarations’ and ‘nutrition and health claims’ were rated to be of moderate strength.

EU infrastructure support was rated somewhat better. Experts rated 63% of the 24 indicators as moderate and ‘public access to nutrition information’ was rated strong by the experts. EU infrastructure support was assessed as weak on for example ‘clear population intake targets’, ‘a comprehensive implementation plan for nutrition’, and ‘priorities for reducing health inequalities or protecting vulnerable populations’.

Integrated and comprehensive approach to create healthy food environments
This study shows that the EU should take more ambitious measures to create food environments that make the healthy choice the easy choice. Experts came up with concrete actions how to do so. For example, the EU should develop a high-level EU Non-Communicable Diseases (NCDs) Prevention Strategy and harmonize the promotion of healthy diets with other issues of concern such as climate change. Also, the EU should require member states to implement restrictions or bans on the (online) marketing of foods high in saturated fat, trans fat, salt or added sugars to children and adolescents up to 19 years. Furthermore, the EU should set mandatory and ambitious food composition targets for added sugars, salt, and saturated fat for all food categories sold in EU member states.

Researcher Sanne Djojosoeparto says: “We would like to present this report to the European Commission so that they can improve their current policies. Already, the Farm to Fork Strategy includes some actions to improve food environments. However, our study shows that a more integrated and comprehensive approach is needed to stimulate and support EU member states in creating healthy food environments.”

Report

This research has been published on the 5th of March 2021 in a report: The Healthy Food Environment Policy Index (Food-EPI): European Union. An assessment of EU-level policies influencing food environments and priority actions to create healthy food environments in the EU. Utrecht, Universiteit Utrecht, 2021.
Djojosoeparto SK, Kamphuis CBM, Vandevijvere S, Harrington JM  and Poelman MP, on behalf of the JPI-HDHL Policy Evaluation Network.