Achieving Food System Transformation: Insights From A Retrospective Review of Nutrition Policy (In)Action in High-Income Countries

Background: Comprehensive nutrition policies are required urgently to help transform food systems to more equitably deliver healthy, sustainable diets. Methods: Literature was searched systematically for nutrition policies of the then 34 Organisation for Economic Co-operation and Development (OECD) members as part of a scoping study. Recently, results were re-analysed, against the NOURISHING framework. Results: Twenty-three nutrition policy documents were identified for 19 jurisdictions. Most policy actions focused on the behaviour change communication domain: all (100%) promoted consumption of ‘healthy’ choices. In the food environment domain, most policies included food labelling (84%), product reformulation (68%), providing healthy foods in public institutions (89%, mainly schools), and restricting food advertising (53%), largely through voluntary codes. Relatively few economic tools were being applied. There was very little focus on reducing consumption of ‘unhealthy’ food or drinks. Not all nutrition policy actions identified were covered by the NOURISHING framework. Conclusion: The NOURISHING framework could be expanded to more comprehensively encompass the health and sustainability dimensions of food systems, eg, by detailing optimum governance arrangements. As recently as seven years ago, half of the most developed economies globally did not have a publicly available nutrition policy. Existing policies were dominated by conventional nutrition education approaches, while policy actions targeting food environments, and regulatory and legislative reforms, were rare. This is consistent with a neo-liberal approach centring individual responsibility. No examples of the multi-strategy, inter-sectoral, coordinated, evidence-based policies required to drive systemic transformation were identified. Therefore, it is not surprising that rates of obesity and diet-related conditions have continued to rise in these jurisdictions, nor that governments are currently off-track to deliver the systemic transformation required to meet relevant global health and sustainable development goals.