NOURISHING framework

Our policy framework to promote healthy diets & reduce obesity.

Our NOURISHING framework is an interactive tool designed to help policymakers worldwide to:

  • identify where action is needed to promote healthy diets, reduce obesity and other non-communicable diseases, including cancer
  • select and tailor options suitable for different populations
  • assess if approach is sufficiently comprehensive

By clicking on the links you will be able to discover examples of different policy actions that have been taken around the world.

Key to domains:

NOURISHING

  POLICY AREA EVIDENCE FOR POLICY AREA EXAMPLES OF POTENTIAL POLICY ACTIONS
N Nutrition label standards and regulations on the use of claims and implied claims on foods

The evidence suggests people who want to eat well use nutrient lists to choose healthier options. Interpretative labels help them when they find the labels hard to understand. Nutrition labels also create incentives for food manufacturers to reformulate their products, so helping populations more broadly by increasing the availability of foods of higher nutritional value.

Clear standards are also needed on the use of nutrient and health claims. Evidence shows these claims alter the perception people have of these products – making it essential that they do not mislead.

e.g. Nutrient lists on food packages; clearly visible ‘interpretive’ and calorie labels; menu, shelf labels; rules on nutrient & health claims

INFORMATION UPDATED 06/11/2014

O Offer healthy foods and set standards in public institutions and other specific settings

We know from the evidence that making fruits and vegetables available in schools increases consumption. There is also evidence that food standards to restrict availability have the effect of reducing consumption of the restricted foods.

For these actions to be effective for all children, they need to be sustained over time and accompanied by complementary behaviour change communication techniques, such as "modelling," school gardens, and communication to all stakeholders involved in the provision and consumption of school food. Worksites and healthcare also present strong potential for improved eating among adults.

e.g. Fruit and vegetable programmes; standards in education, work, health facilities; award schemes; choice architecture

INFORMATION UPDATED 06/11/2014

U Use economic tools to address food affordability and purchase incentives

Empirical estimates show that food prices influence, to a varying degree, how much food people buy. Targeted subsidies have been shown to help overcome affordability barriers to healthy foods for people on low incomes. Incentives, like financial rewards or price discounts, have also been shown to encourage people to switch to healthier options.

Emerging evidence from implemented taxes, as well as modelling studies, indicate the potential for effectiveness to reduce consumption. Given food choices are influenced by a whole host of factors, especially in modern, complex food markets, taxes must be designed very carefully to maximise effectiveness.

e.g. Targeted subsidies; price promotions at point of sale; unit pricing; health-related food taxes

INFORMATION UPDATED 06/11/2014

R Restrict food advertising and other forms of commercial promotion

There is clear evidence that the advertisements children see influence their food preferences and habits. There is also a lot of evidence that children and adolescents around the world are exposed to a whole host of other promotional techniques, whether it be on a billboard or through a phone or computer.

Emerging evidence shows that restrictions work to reduce children’s exposure of children to marketing, but this depends on the criteria used in the restrictions. Given the role played by parents and caregivers in what children eat, consideration is needed to how they are also influenced by promotional activities.

e.g. Restrict advertising to children that promotes unhealthy diets in all forms of media; sales promotions; packaging; sponsorship

INFORMATION UPDATED 06/11/2014

I Improve nutritional quality of the whole food supply

We are all influenced by the food that is available and affordable when we grow up, and the habits of the people around us. That’s why people in different countries and communities consume differently. We know that when the food supply changes, so does what people eat. This is why we need to improve the quality of the food supply. Evidence from salt reduction indicates that people’s tastes can change.

e.g. Reformulation to reduce salt and fats; elimination of transfats; reduce energy density of processed foods; portion size limits

INFORMATION UPDATED 06/11/2014

S Set incentives and rules to create a healthy retail and food service environment

The neighbourhood food environment – the retailers and other outlets where we buy our food – are the means through which people access the food supply. There is clear evidence that this environment influences the decisions we make about what we eat.

e.g. Incentives for shops to locate in underserved areas; planning restrictions on food outlets; in-store promotions

INFORMATION UPDATED 06/11/2014

H Harness the food supply chain and actions across sectors to ensure coherence with health

Policies within this category aim to harness the whole food system, and the sectors which influence it, to ensure coherence with healthy eating. This is because the food system, and the policies that affect it, influence our food environment.

What our food industry produces is in part a response to incentives in the supply chain. Sectors outside of health influence our ability to take policy action. Likewise, if governments implement policies contained in NOURISHING, they have repercussions upstream for the actors and activities in food systems. This wider relationship to the food supply chain presents an opportunity to support all the policies in NOURISHING with actions in the food supply chain.

e.g. Supply-chain incentives for production; public procurement through ‘short’ chains; health-in-all policies; governance structures for multi-sectoral engagement

INFORMATION UPDATED 06/11/2014

I Inform people about food and nutrition through public awareness

Awareness is one precursor to eating well. The evidence suggests that public campaigns can boost awareness. To influence consumption, they need to be sustained and use multiple channels.

e.g. Education about food-based dietary guidelines, mass media, social marketing; community and public information campaigns

INFORMATION UPDATED 06/11/2014

N Nutrition advice and counselling in health care settings

People with elevated risk factors for cancer and other non-communicable diseases – such as heavy bodyweight, high cholesterol or glucose intolerance –can benefit from advice provided by their health care provider. Such advice can also be given to people at low risk for prevention into the future.

There is potentially a wide range of mechanisms for integrating nutrition advice into primary care, including counseling, self-help materials and computer-tailored messages. Randomised controlled trials suggest they can be effective if carefully designed and well targeted. The most positive outcomes appear to be for people already at risk.

e.g. Nutrition advice for at-risk individuals; telephone advice and support; clinical guidelines for health professionals on effective interventions for nutrition

INFORMATION UPDATED 06/11/2014

G Give nutrition education and skills

The reason for nutrition education is to improve knowledge and the ability to put that knowledge into practice. Studies have demonstrated that nutrition knowledge and healthy dietary behaviour are positively correlated. Higher levels of general education have been found to increase the ability of individuals to obtain and understand the health-related information needed to develop health-promoting behaviours.

The evidence shows that interventions to provide education can be effective, but this depends on the pre-existing attitude, knowledge and habit strength of the targeted group. Education should thus be accompanied by changes in the food environments to effect longer-lasting change.

e.g. Nutrition, cooking/food production skills on education curricula; workplace health schemes; health literacy programmes

INFORMATION UPDATED 06/11/2014

 

Table last updated: 06/11/2014


Our NOURISHING framework is consistent with and supportive of the list of policy options included in the WHO’s Global Action Plan for the Prevention and Control of Non-Communicable Diseases (2013–2020).

Our NOURISHING framework is also consistent with and supports the work of INFORMAS (International Network for Food and Obesity/NCDs Research, Monitoring and Action Support). This global network aims to monitor, benchmark and support actions to create healthy food environments, including through actions governing labelling, provision of foods in specific settings, prices, advertising and promotion, composition across the food supply, retail provision, and trade between countries. It has also developed a Government Healthy Food Environment Policy Index (Food-EPI) to assess the extent of government policy implementation against international best practice.

We encourage you to use NOURISHING in your work. Please send any feedback to policy@wcrf.org, and acknowledge WCRF International as the originators. We are developing a process to keep you updated on NOURISHING. If you are interested in being updated (including updates to the website) please email your contact details to policy@wcrf.org with NOURISHING in the subject line.