Benchmarking government policies to enhance food environments in Asia

In recent decades, Asia has seen substantial economic growth and increased integration into global markets, leading to changes in lifestyles and diets. As a result, nutrition-related non-communicable diseases, including cancer, are increasing, posing a risk to health systems.

Improving food environments – including reducing the availability and affordability of ‘unhealthy food’ relative to healthy options – can enable better eating habits and enhance overall health. For instance, a recent study indicates that traffic-light labelling regulation in Sri Lanka helped consumers select lower-sugar beverages. A broad range of policies is essential to sustain healthy food settings and promote nutritious diets.

Food environment policies in the Asian region

SHAPE Asia is a collaborative network linking stakeholders across the Philippines, Malaysia, Indonesia, Thailand, and Sri Lanka to advocate for equitable food policies that enhance food environments throughout Asia.

While robust evidence emphasises the need for better food environment policies, their adoption in Asia remains gradual. Globally, many governments are either unaware of the issue or are preoccupied with other policies. Further, evidence suggests that industry actions hinder policymaking, impede progress, and dilute the quality of policy design. In this context, performance assessments serve as valuable tools to inform and encourage government initiatives.

Adopting the NOURISHING framework

The NOURISHING benchmarking tool, launched by World Cancer Research Fund International in 2023, evaluates government nutrition policies against international aspirational standards. Analysing food environments in 30 European countries with the tool revealed that even high-income nations often fall short of these standards. By comparing policy actions across countries against the tool, the study highlighted policy gaps, whether due to inaction or poor design.

Similar studies have assessed food environments worldwide, but no existing study evaluates the progress in food environment policies in Asia against global aspirational standards. To fill this gap, SHAPE Asia recently initiated an assessment of food environment policies in Asia using the NOURISHING tool, focusing on the first six dimensions:

• Nutrition label standards and regulations on the use of claims and implied claims on food
• Offer healthy food and set standards in public institutions and other specific settings
• Use economic tools to address food affordability and purchase incentives
• Restrict food advertising and other forms of commercial promotion
• Improve nutritional quality of the whole food supply
• Set incentives and rules to create a healthy retail and food service environment

Challenges and obstacles

SHAPE Asia has already evaluated the stakeholders and policies influencing food environments across the five participating countries. This foundational work positions us well to assess the thoroughness and quality of food environment policies in Asia and to validate them through available stakeholder networks.

One challenge we faced in conducting this study was assessing the different types of policies across the five countries, including legislation, regulation, and non-legislative policy instruments such as fiscal measures, strategies, and standards. Laws could be used to establish broad legal obligations, rights, and penalties, where regulations and secondary policies and guidelines could be used as part of implementation.

Applying the NOURISHING tool across these countries required knowledge of each country context to decide which measures were appropriate to include. Capturing these different types of instruments has allowed us to comprehensively reflect food environment policy in each of the countries. Conducting this work across the region highlights the challenges of benchmarking policy progress in a standardised way across countries.

Findings and next steps

Our work found that almost all countries have regulations covering the dimensions we assessed. However, these policy actions do not meet the highest aspirational standards described in the NOURISHING tool.

Preliminary findings show that all countries in SHAPE Asia have secondary policies on nutrition labels, and most countries use tools to address food affordability. Across all countries, legislation was strictest on improving the quality of the whole food supply, and it was weakest on setting incentives for healthy retail food environments.

Together, our analysis suggests that food environment-related policies in SHAPE Asia countries need focused attention to improve both quality and coverage.

We aim to leverage this analysis to develop knowledge products that inform Asian governments about the quality and scope of food environment policies, including an at-a-glance assessment to motivate governments to make progress. Additionally, we plan to produce policy briefs to guide governments in refining policy design and expanding coverage. Applying the NOURISHING benchmarking tool to highlight policy gaps will support our advocacy efforts and strengthen food environments.

The work being done through SHAPE Asia is a fantastic example of how World Cancer Research Fund International’s tools can be applied in different countries. Want to share an example of your own, or learn more about any of our resources? Contact policy@wcrf.org.