Nutrition Policies in Europe: a Structure Review of Existing Measures
Interventions aimed at improving people’s diet have recently entered the policy agenda of most European countries. The EATWELL project1 has produced a classification of existing public policies targeted at affecting eating behaviour by distinguishing between those measures changing the market environment and those supporting more informed choice.
Policy actions supporting more informed choice
By far the largest numbers of measures adopted in the European Union are those intended to promote informed choice. Advertising controls included in this category are quite common in Europe (e.g. the French law on food advertising and the United Kingdom ban on advertising of unhealthy food to children) and are normally used to protect minors through restrictions on the timing and content of television advertising.
Public information and nutrition education campaigns are by far the most common healthy eating policies. They employ respectively social marketing and education tools (training, seminars, lectures, etc.) in order to improve knowledge and awareness about healthy eating. They might address people’s diet in general or focus on specific foods (e.g. the UK campaign to reduce salt intake or the 5-a-day campaigns promoting fruit and vegetables consumption). Within this category nutrition labelling is also included, however given the existence of EU regulation on labelling (Council Directive 90/496/EEC) only a few national labelling acts can be found (the most prominent ones are the ‘keyhole’ symbol adopted in Sweden, Norway and Denmark, and the heart symbol adopted in Finland).
Nutrition information on menus also affects consumers’ information. Yet, apart from some cases where the use of nutritional information on menus in restaurants or canteens is part of wider information or labelling programs (e.g. the case of the Portuguese Platform against Obesity, or the Swedish Keyhole), no specific interventions have been identified in Europe.
Policy actions aimed at changing the market environment
Within the policies that operate at market level, those regulating school meals (e.g. British and French ban on vending machines in schools, or provision of free fruit at school through the EU School Fruit Scheme) and government actions encouraging private sector commitment (e.g. the reduction of the trans-fat and salt content in processed foods in the UK through voluntary commitment) are the most common.
Fiscal measures (taxes or subsidies) designed to change the relative prices of healthy and unhealthy foods are probably the most debated nutritional intervention in Europe. In fact a number of European countries have recently adopted a tax on some kind of “unhealthy” food:
- Denmark on saturated fats,
- Hungary on foods high in salt and sugar,
- France on caloric soft drinks,
- Finland on sweets.
Among the interventions affecting the market, nutritionrelated standards are considered; however the Danish ban on artificial trans fats is the only mandatory standard on nutrient content of foods in Europe. Very few of the programs are also aimed at improving the availability of healthy food for disadvantaged consumers (two programs were identified in Scotland and Denmark).
Policy effectiveness and evaluation deficiencies
Consolidated and systematic healthy eating policy actions other than information campaigns are confined to a few cases in Scandinavian countries and the UK, with France as a newcomer. The Mediterranean countries have only a recent history of policy action, mostly limited to information and education measures. While some impact evaluations of nutrition policies in Europe exist, in most cases they suffer from important deficiencies (they are often confined to changes in attitudes rather than in behaviour, and they fail to account for confounding factors potentially affecting the impact).
Yet, existing evaluations suggests that nutrition labelling and advertising regulations to children generate a positive behavioural response2,3. The impact of information campaigns on attitudes and intentions is also significant, while the effects on behaviour are still rather limited4 and the body of evidence about fiscal measures suggest that small taxes result in small behavioural responses, but large taxes might have a substantial impact on consumption and health5,6.
BASED ON: Capacci S, Mazzocchi M, Shankar B, Brambila-Macias J, Verbeke W, Pérez-Cueto FJA, Kozioł-Kozakowska A et al. Policies to promote healthy
eating in Europe: a structured review of policies and their effectiveness. Nutrition Reviews 2012;70:188–200.
- European Union Seventh Framework Programme (FP7/2007–2013) EATWELL project (Grant Agreement No. 226713, http://www.eatwellproject.eu).
- Cowburn G, Stockley L Consumer understanding and use of nutrition labelling: a systematic review. Public Health Nutrition 2007;8:21-28.
- Dhar T, Baylis K Fast-food consumption and the ban on advertising targeting children: the Quebec experience. Journal of Marketing Research 2011;48:799-813.
- Pomerleau J, Lock K, Knai C, Mckee M Interventions designed to increase adult fruit and vegetable intake can be effective: A systematic review of the literature. Journal of Nutrition 2005;135:2486-2495.
- Mytton O, Gray A, Rayner M, Rutter H Could targeted food taxes improve health? Journal of Epidemiology and Community Health 2007;61:689.
- Fletcher JM, Frisvold D, Tefft N Can soft drink taxes reduce population weight? Contemporary Economic Policy 2010;28:23-35