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Obesity and the future of food policies that promote healthy diets


Currently, an unhealthy diet is the largest modifiable factor in ill health and death globally. One of the important contributors to unhealthy diets is the pervasiveness of unhealthy food and drink in our daily food environments. Although efforts to build nutrition skills and education across communities are critical, they will be insufficient without substantial changes to the food environments themselves. Here, I discuss how we can improve our food environments by implementing a comprehensive, multilevel and multisetting approach. This approach needs to encompass the various policy contexts for improving population nutrition, from policy set by national governments to that introduced by local community organizations and food retailers. Clinicians can help implement and set healthy food policies across all our health-care settings, even in the absence of government action. To support a comprehensive suite of effective policies, we need to systematically develop and disseminate the evidence for the feasibility, effectiveness and sustainability of workable policies and to understand their role in the development of a healthier food system.

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Fig. 1: A socioecological model of drivers of food and beverage intake.
Fig. 2: Staged measurement of indicators of success for policies that promote a healthy food environment.
Fig. 3: Transforming our food environments to support healthy eating.


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The author acknowledges her appreciation of thoughtful feedback on this piece from K. Backholer, A. Cameron, M. Blake and T. Boelsen-Robinson.

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Correspondence to Anna Peeters.

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Food environments

The places where citizens purchase and/or consume food, which represent a range of settings that influence individual food choices.

Healthy food policies

Policies that affect the likelihood of a population purchasing and consuming more healthy food than unhealthy food.

Systems perspective

A perspective that considers the purchase and consumption of food as a consequence of an integrated system of multiple inter-related and interdependent parts.

Unhealthy dietary factors

Individual elements of characteristics of diet, such as types of foods or nutrients. Dietary factors associated with increased health risk include low fruit and vegetable intake and high salt, fat and sugar intake.

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Peeters, A. Obesity and the future of food policies that promote healthy diets. Nat Rev Endocrinol 14, 430–437 (2018).

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