What policies are available & how to maximize impact: dietCorinna HawkesHead of Policy and Public Affairs

World Cancer Research Fund International

World Cancer Congress 2014, Melbourne, December 3-6 2014

Relevant WHO NCD Targets

• 0% increase in obesity/diabetes

• 30% reduction in salt/sodium intake

• 25% reduction in premature mortality from NCDs

www.wcrf.org/NOURISHING

What policies are available to improve diets?

Our “implemented” policy database: 222 actions in 75 countries

Denmark’s

trans fat ban

Netherlands’ free

school fruit

programme

South Africa’s

mandatory salt

reduction targets

Hungary’s public

health tax

USA’s Healthy

Incentives PilotMexico’s sugary

drinks taxEcuador’s

mandatory

traffic light labelBrazil’s school

health education

programme

South Korea’s

food advertising

restrictionsSingapore’s

Healthier Hawker

ProgrammeAustralia’s

voluntary “Health

Star Rating”

labelling system

Slovenia’s

school nutrition

law

How do these policies have impact?

1. Providing an environment for the young to learn healthy

food preferences

2. Overcoming barriers to expressing healthy

preferences

3. Encouraging people to re-evaluate unhealthy

preferences

E.g. many school fruit

schemes found to be

effective(a)

(a) 4 systematic reviews - da Sa & Lock, 2008; Van Cauwenberghe et al, 2010; Evans et al, 2012; USDA, 2012

(b) 1 systematic review – Waters et al, 2013; RCTs in >8 countries; James et al, 2004; Sichieri et al, 2009; Amaro et al, 2006; Gentile et al 2009; Francis et al, 2010; Bjelland et al, 2011; Lerner-Geva et al 2014; Ribeiro & Alves,

2013

(c) 2 systematic reviews – Black et al, 2012; An et al, 2013; evaluations in 4 countries – Andreyeva et al, 2012; Sturm et al, 2013; McFadden et al, 2014; Bartlett et al, 2014

(d) Smed and Jensen, 2013 (Denmark); Hungarian National Institute for Health Development, 2013; Instituto Nacional de Salud Pública, Mexico, 2014

E.g. targeted

subsidies for

healthier alternatives

found to work(c)

E.g. taxes found to

reduce spending in

3 countries (sat fat,

snacks, soda)(d)

✓✗

E.g. nutrition education in

schools can be effective

for soda, snacks, high-fat

foods, veg(b)

Undermining

influences

through the life

course

✓

Reinforcing

influences

through the life

course

Undermining

influences

through the life

course

✗

E.g. nutrition education in

schools can be effective

for soda, snacks, high-fat

foods, veg

4. By stimulating a

food systems

response

E.g. nutrition labelling

E.g. trans fats law;

salt targets

E.g. harnessing the

food supply chain

E.g. many school fruit

schemes found to be

effective

E.g. taxes found to

reduce spending in

3 countries (sat fat,

snacks, soda)

E.g. targeted

subsidies for

healthier alternatives

found to work

Next question:

how to maximise impact in populations?

Policies with impact

are those which:1. Provide an environment for the

young to learn healthy food preferences

2. Overcome barriers to people to

expressing healthy preferences

3. Encourage people to re-evaluate

unhealthy preferences

4. Stimulate a food systems response

1. Design policies tailored to the problem & the population

Coffee chain in New York City: Reduced calories

purchased by higher income, more educated, higher-

calorie consuming patrons, who previously

underestimated the amount of calories in food items

Fast food chain in Baltimore and Philadelphia: No

impact on calorie intake among frequent fast food

consumers Sources: Bollinger et al, 2010;

Elbel et al, 2013

2. Design comprehensive policies

Advertising of high fat, sugar, salt foods

eliminated in children’s airtime

Advertising of high fat, sugar, salt foods

seen by children increased in family airtime

Sources: Ofcom, 2010; Adams et al, 2012; Boyland et al, 2014

www.wcrf.org/NOURISHING

3. Design a package of policies

for mutually reinforcing impact

For further information

@wcrfintfacebook.com/wcrfint

www.wcrf.org

Corinna HawkesHead of Policy and Public Affairs

c.hawkes@wcrf.org