An analysis on current food regulations for and inspection challenges of street food: Case of Florida

This study reviews current food safety regulations of food trucks and discusses possible inspection challenges and reasons for gaps between food safety regulations and practices. To be able to assess current food regulations at the state level, the Florida Department of Health (FDOH) was selected and their current materials and documents, publicly available on the DOH website, were briefly examined. This paper highlights possible reasons for safety risks and gaps between theory and application. Food regulations, inspection challenges, mobility of trucks, vendors’ personal hygiene, undocumented illnesses, temperature violations, and unlicensed trucks can be listed as potential gaps and safety risks. Regardless of the level of strict inspection facilities offered to the vendors, there are still incomplete and unsatisfactory results displayed in the county health department (CHD) webpages as open data. This review article shows that even though the United States Department of Agriculture (USDA), the Food and Drug Administration (FDA), and local health departments control safety regulations, street food operations still face great challenges and public health issues in Florida, as well as in many states in the United States.     

National men's health policies in Ireland and Australia: what are the challenges associated with transitioning from development to implementation?

The recent publication of national men's health policies in Ireland and Australia marks the first attempts by state governments anywhere in the world to target men as a specific population group for the strategic planning of health. The impetus for policy action in both countries can be traced to an increasing concern about sex differences in health status between men and women; a growing awareness of the need for a more gender-specific approach to health policy; and an expanding men's health field at a research, advocacy and community/voluntary level. This paper will describe the background to men's health policy development in Ireland and Australia; outline the aims, methodologies and key principles used for policy development; and highlight the principal priorities for policy action. It will pay particular attention to the challenges associated with transitioning from policy development to implementation, and reflect on some of the key lessons learned to date.     

Connecting food,well-being and environmental sustainability: towards an integrative public health nutrition

Modern society has no shortage of human nutrition science, nor interventions designed to improve the way we eat. Yet nutrition science, and the models, approaches and interventions derived from this, is apparently delivering diminishing returns in terms of population weight gain, unhealthy eating patterns and the obesity ‘epidemic’. We draw on a range of literature(s) to argue that public health nutritionists in affluent societies face an ingenuity gap – a series of complex and inter-connected challenges which are neither fully recognised nor easily amenable to resolution through conventional thinking and practice. Four such challenges are: nutritionism; economism; consumerism and individualism. We use an integrative framework to explain their significance for public health nutrition, where they exert a combined and compounding influence. In addition to these problems, insights from other disciplines show that ‘modern’ society and some of its key characteristics are linked to increasing environmental threats. The latter undermine food security and the sustainability of society itself, and possess global impact. For public health nutrition to be situated in and responsive to this broader context, the discipline will need a better understanding of the relationship between modern society, food choice and environmental sustainability. As ‘healthy eating’ may not be an achievable goal within the present social, economic and cultural system, public health nutrition has a unique and vital role to play in shaping change for the future.     

A great or heinous idea?: Why food waste diversion renders policy discussants apoplectic

Comprehensive agri-food policy includes food waste reduction as an important policy goal. Food bank donor indemnification is codified in law in several countries to support the charitable food sector. Other policy instruments to address waste reduction have emerged recently, among them tax measures to incentivize private sector action. These have been increasingly linked to the discourse on hunger in many jurisdictions. We asked 17 Canadian food insecurity policy entrepreneurs to comment on a vignette scenario featuring a hypothetical proposal for food waste diversion as a policy response to household food insecurity; the polarization in responses – ‘Not human garburators,’ vs. ‘everyone wins’ – was remarkable. This case of an unexpected divergence in the response to a policy idea in the food insecurity realm provides an opportunity to understand fundamental differences in societal perspectives that might be relevant to public health more generally. In particular we address the parallel humanist and ecological imperatives at work in contemporary public health practice. It appears that objections to food waste diversion for human consumption could be crystallized in terms of Mary Douglas’s theory of morality within particular worldviews. From a humanist viewpoint, the proposal was an indignity; for those with an ecological worldview, it was sensible and pragmatic. Public health has embraced ecosystem thinking and takes for granted that its ecological approach is sensitive to humanist perspectives but the two worldviews may differ and humanist ideals of dignity may raise moral rancor when considered in the context of ecological good.     

The shift in framing of food and beverage product reformulation in the United States from 1980 to 2015

Food and beverage product reformulation is a public health nutrition policy of recent prominence; it is a so-called ‘win-win’ policy, as unlike other nutrition policies, it has the potential to also benefit the food and beverage industry. However, reformulation has also been criticized as being driven by industry interests. In order to inform future policy debates about reformulation, we sought to investigate how and why reformulation became a public health initiative by conducting a framing analysis on 278 US newspaper articles from 1980 to 2015. Frames are aspects of text emphasizing a particular definition of a problem or solution, and they help shape policy discourses and the public policy agenda. Three primary frames of reformulation were identified: business, health, and political. Having multiple frames enables reformulation to assume different meanings in different contexts, which helps to explain how it has garnered broad support from multiple sectors. The political frame of reformulation, however, only grew in importance after 2001, to describe reformulations occurring in response to public health policy initiatives aimed at obesity and noncommunicable diseases. The increasing use of a political frame, and the events described in the articles, suggests that voluntary reformulation followed a growing threat of policy change and litigation facing the industry, a finding that provides important context to debates about voluntary reformulation initiatives. Future reformulation initiatives will need to reconcile and negotiate the varying frames and aims of reformulation in order to ensure they are a success from the public health perspective.     

Developing evidence-based recommendations in public health – incorporating the views of practitioners, service users and user representatives

Background  Guidance based on a systematic assessment of the evidence base has become a fundamental tool in the cycle of evidence‐based practice and policy internationally. The process of moving from the formal evidence base derived from research studies to the formation and agreement of recommendations is however acknowledged to be problematic, especially in public health; and the involvement of practitioners, service commissioners and service users in that process is both important and methodologically challenging. Aim  To test a structured process of developing evidence‐based recommendations in public health while involving a broad constituency of practitioners, service commissioners and service user representatives. Methods  As part of the development of national public health recommendations to promote and support breastfeeding in England, the methodological challenges of involving stakeholders were examined and addressed. There were three main stages: (i) an assessment of the formal evidence base (210 studies graded); (ii) electronic and fieldwork‐based consultation with practitioners, service commissioners and service user representatives (563 participants), and an in‐depth analytical consultation in three ‘diagonal slice’ workshops (89 participants); (iii) synthesis of the previous two stages. Results and conclusions  The process resulted in widely agreed recommendations together with suggestions for implementation. It was very positively evaluated by participants and those likely to use the recommendations. Service users had a strong voice throughout and participated actively. This mix of methods allowed a transparent, accountable process for formulating recommendations based on scientific, theoretical, practical and expert evidence, with the added potential to enhance implementation.     

Health concerns regarding consumption of irradiated food

Food irradiation is being promoted as a simple process that can be used to effectively and significantly reduce food-borne illnesses around the world. However, a thorough review of the literature reveals a paucity of adequate research conducted to specifically address health concerns that may directly result from the consumption of irradiated food. Consequently, there is considerable debate on the issue of health concerns from irradiated food among international agencies and between different nations. This report presents a critical review of scientific data and recommendations from different agencies and consumer groups. The objective of this review is to provide the scientific community and the general public with a balanced discussion on irradiated food from the viewpoint of an environmental or public health professional. As a result of this review, the authors conclude that current evidence does not exist to substantiate the support or unconditional endorsement of irradiation of food for consumption. In addition, consumers are entitled to their right of choice in the consumption of irradiated versus un-irradiated food. Different countries should further evaluate their local and global risks and benefits prior to developing and recommending national and international food irradiation policies.     

“同一健康”联合行动计划(2022-2026年)简介

联合国粮食及农业组织、联合国环境规划署、WHO和世界动物卫生组织近期联合发布 "同一健康"联合行动计划(2022-2026年)。这是四方组织首次就"同一健康"发布联合行动计划, 该计划以应对人类-动物-植物-环境中健康挑战为目标, 以"同一健康"、新发和再发人兽共患病、被忽视的热带病和媒传疾病、食品安全、抗生素耐药和环境6个方面的工作为重点。本文对该计划的背景、具体内容及其意义进行概括、翻译和总结, 帮助读者快速了解联合行动计划。     

A Community-Based Survey of Household Food Insecurity and Associated Sociodemographic Factors among 2–6 Years Old Children in the Southeast of Iran

Malnutrition remains a major public health issue in developing and transitional countries and food insecurity is a major indicator of the nutritional status in these societies. This research aimed to investigate the status of household food insecurity and sociodemographic factors affecting it among 2–6 years old children in an urban area in the southeast of Iran. A community-based survey was conducted from September to January 2018 on 421 children aged 2–6 years who were selected using stratified cluster random sampling. They lived in six different areas in an urban area in the southeast of Iran. Data was collected using the U.S. Department of Agriculture Food Security questionnaire and anthropometric measurements. Our study showed that the prevalence of food insecurity among children was 81.7% consisting of 2.6% with low food security, 9.2% with moderate food insecurity, and 69.9% with very low food security. The weight gain of those children who were in the low food security group, was 2.63 times lower than those children in the food security group. Moreover, the chance of weight gain in the low food security and in the moderate food insecurity groups was less as 1.91 and 1.41 times, respectively. Food insecurity in children aged 2–6 years is influenced by various sociodemographic factors including weight and height, mother’s education level, sanitation as access to water closet (WC). Policymakers should plan to improve the quality of life and health of the children through improving their food security.     

Researching the implementation of community mental health promotion programs

Understanding the process of program implementation plays a critical role in advancing research, practice and policy in mental health promotion. This paper focuses on the implementation of community mental health promotion and considers the challenges presented in implementing and evaluating complex, multifaceted interventions carried out in the context of dynamic community settings. The Rural Mental Health Project1–3 is presented as a case study to illustrate the practical and research challenges encountered in implementing and evaluating a community mental health promotion initiative. This case study highlights the factors that contributed to the successful implementation and evaluation of a community‐based intervention for rural communities on the border region in the Republic and Northern Ireland. Among the factors identified are: a partnership model of working; local co‐ordinating structures and consultation mechanisms; use of a structured planning model to guide program planning and implementation; mobilisation of cross‐community and inter‐agency support; and a comprehensive logic evaluation framework to assess the input, process, impact and outcomes of the project as it unfolded.     

我国居民膳食变迁与慢性病问题--基于宏观数据的分析

基于我国政府数据与联合国粮农组织食品平衡表数据，探讨了我国饮食的变化与慢性病的关系。数据表明，从1980—2011年我国居民人均食物提供的能量增长了1.47倍，蛋白质量增长了1.76倍，脂肪量增长了2.73倍。将我国人均食品占有情况与我国居民膳食指南以及国际上主要国家与地区进行比较表明，我国食品总量已经足够整个人群健康所需。基于健康视角进行了讨论并给出了一定的建议。     

Knowledge needs and the ‘savvy’ child: teenager perspectives on banning food marketing to children

Food marketing to children is a powerful factor in the health of young people. In Canada, one proposed measure to protect young people is to ban all food and beverage marketing to children under age 13. Since policy initiatives should consider the voices of those directly impacted, we conducted focus groups with teenagers aged 12–14 – precisely those individuals who would be directly impacted by, or just over, the age threshold proposed. The majority of teenagers consulted were opposed to a ban on food marketing, framing food marketing as a way to meet their consumer needs. Such perspectives mirror the arguments made by the food industry, and suggest that teenagers’ self-identification as consumers trump questions of ethics or public health. Even though teenagers argue that marketing is often misleading, they do not view regulation as a solution – a view troubled by the fact that many of the teenagers underestimated their own vulnerability to marketing. The research points to the need for a more complex understanding of how food marketing messages are understood by teenagers, for a more robust media literacy education, and for the need to engage – not ignore – young people when it comes to issues of public health.     

The Demise of Artificial Trans Fat: A History of a Public Health Achievement

Policy Points

• This article describes a strategic combination of research, advocacy, corporate campaigns, communications, grassroots mobilization, legislation, regulatory actions, and litigation against companies and government to secure a national policy to remove artificial trans fat from the US food system.
• Sharing lessons we learned can help inform policymakers, academics, policy practitioners, and students across disciplines. Some of our lessons are that system change means that all consumers benefit without the need for individual behavior change; research can both identify opportunities to improve health and support policy adoption; policy efforts can serve as public education campaigns; policy campaigns can drive marketplace changes; and engaging forward‐thinking companies can diffuse opposition to passing a policy.

ContextFor many decades, partially hydrogenated vegetable oil (PHO), the primary source of artificial trans fat in the American diet, was used widely in processed and restaurant foods. In the early 1990s, studies linked the consumption of artificial trans fat with heart disease. This article details how research and advocacy led to eliminating artificial trans fat from the US food supply.MethodsWe synthesized published studies of the health impact of trans fat, the legislative history of state and local trans fat bills, the Food and Drug Administration''s (FDA) regulatory docket on trans fat labeling and its declaration that PHOs are no longer Generally Recognized as Safe (GRAS), and our own files, which included strategy documents, notes from meetings with the FDA staff, correspondence between advocates and the FDA, fact sheets, press releases, news clips, and other materials.FindingsThis history of trans fat provides insights into policy strategy and advocacy best practices that resulted in the removal of trans fat from food in the United States, preventing an estimated 50,000 premature deaths a year. The lessons we learned are that system change benefits all consumers without the need for individual behavior change; research can both identify opportunities to improve health through policy and support policy adoption; policy campaigns can serve as public education campaigns; policy can drive changes to products and the marketplace; and engaging forward‐thinking companies can help diffuse opposition to passing a policy. Securing this policy required the persistence of scientists and health advocates in first discovering the risks and then using the science to secure policies to mitigate the identified harm.ConclusionsAn understanding of the tactics used to help attain the targeted policies and how challenges were addressed (such as through communications, leveraging an expanding research base and expert reports, showing that a national policy was feasible through voluntary corporate changes and state and local policy, and litigation against companies and government agencies) may provide a model for scientists, students, advocates, and policymakers. We hope this account will inform efforts to address other public health challenges, such as the current threats of excessive exposure to sodium and added sugars, which persist in the US food system.     

Blueprint for a deliberative public forum on biobanking policy: were theoretical principles achievable in practice?

Background: Public deliberation is recommended for obtaining citizen input to policy development when policies involve contested ethical dimensions, diverse perspectives on how to trade‐off competing public interests and low public awareness of these perspectives. Several norms have been proposed for the design of deliberative methods. Evidence is scarce regarding whether such norms are achievable in practice. Purpose: This paper refers to principles of deliberative democracy theory to describe a deliberative public forum on biobanking. Practical challenges and contextual facilitators of achieving deliberative ideals are discussed, along with factors that influenced use of the forum output in policy development. Method: The forum ran for 4 days over two weekends in Perth, Western Australia. Key methodological features were socio‐demographic stratification to randomly recruit a mini‐public of citizens for discursive representation, provision of information inclusive of diverse perspectives and framed for difference, provision of a fair way for reasoning and collective decision making and adoption of processes to achieve publicity, accountability and independence from undue institutional influence. Results: Most design principles were achieved in practice, with the fundamental exception of representativeness. Factors influencing these outcomes, and the use of deliberated outputs to develop policy, included institutional characteristics, the design involvement of deliberative experts and quality of the outputs when compared to other consultation methods. Conclusions: Public deliberations can achieve design ideals and influence (ethics‐based) public health policy. The representation of ‘hard to reach’ citizens and their views needs further consideration, particularly as this relates to the procedural legitimacy of ethical analyses and the just inclusion of deliberative citizen advice within the broader policy‐making process.     

Reshaping Food Policy and Governance to Incentivize and Empower Disadvantaged Groups for Improving Nutrition

The coronavirus disease 2019 (COVID-19) pandemic has exacerbated global malnutrition challenges, disrupted food supply chains, and left poor and vulnerable people unable to produce and access safe and affordable food, especially in developing countries. Food policy and governance are currently malfunctioning, despite their recognized roles in improving food security and public nutrition in many local and national contexts. This article reviews existing food policies and governance with implications for disadvantaged groups in the food systems, particularly smallholder farmers, women, and small- and medium-sized enterprises (SMEs), highlighting the importance of reshaping food policies and governance. To end malnutrition in the post-COVID era, multiple sectors, including health, agriculture, social protection, education, and infrastructure, must make greater collaborative efforts to develop and implement food and nutrition policies. Several recommendations for reshaping food policy interventions and governance are summarized.     

Encouraging big food to do the right thing for children’s health: a case study on using research to improve marketing of sugary cereals

Addressing concerns about unhealthy food marketing to children, food companies pledge to advertise only ‘healthier dietary choices’ in ‘child-directed media’. However, public health advocates question whether the food industry will voluntarily improve their child-targeted marketing practices in a meaningful way. In this paper, we evaluate progress made by manufacturers of one food category – ready-to-eat breakfast cereals – in promoting nutritious choices to children, and the potential role of scientific research to influence corporate behavior. Beginning in 2008, researchers at the Rudd Center for Food Policy & Obesity conducted a series of studies to evaluate child-targeted marketing by cereal companies using a variety of research methods. We aimed to understand the extent and impact of cereal marketing to children; disseminate these findings to parents, the media, the public health community, policy-makers, and industry representatives; and encourage cereal companies to shift child-targeted marketing toward the more nutritious products in their portfolios. A follow-up analysis in 2012 demonstrated some improvements in the nutritional quality and marketing of child-targeted cereals, although child-targeted cereals remain the least healthy products in company portfolios. This analysis provides a case study of the potential for success, as well as the limitations, of a public health strategy to incent food companies to voluntarily improve child-targeted marketing practices through strategic research and communications.     

‘Maximising shareholder value’: a detailed insight into the corporate political activity of the Australian food industry

Objective: To gain deeper insight into the corporate political activity (CPA) of the Australian food industry from a public health perspective. Methods: Fifteen interviews with a purposive sample of current and former policy makers, public health advocates and academics who have closely interacted with food industry representatives or observed food industry behaviours. Results: All participants reported having directly experienced the CPA of the food industry during their careers, with the ‘information and messaging’ and ‘constituency building’ strategies most prominent. Participants expressed concern that food industry CPA strategies resulted in weakened policy responses to addressing diet‐related disease. Conclusions: This study provides direct evidence of food industry practices that have the potential to shape public health‐related policies and programs in Australia in ways that favour business interests at the expense of population health. Implications for public health: This evidence can inform policy makers and public health advocates and be used to adopt measures to ensure that public interests are put at the forefront as part of the policy development and implementation process.     

Innovation and participation for healthy public policy: the first National Health Assembly in Thailand

Aim This paper aims to describe and disseminate the process and initial outcomes of the first National Health Assembly (NHA) in Thailand, as an innovative example of health policy making. Setting The first NHA, held in December 2008 in Bangkok, brought together over 1500 people from government agencies, academia, civil society, health professionals and the private sector to discuss key health issues and produce resolutions to guide policy making. It adapted the approach used at the World Health Assembly of the World Health Organization. Method Findings are derived from a literature review, document analysis, and the views and experiences of the authors, two of whom contributed to the organization of the NHA and two of whom were invited external observers. Results Fourteen agenda items were discussed and resolutions passed. Potential early impacts on policy making have included an increase in the 2010 public budget for Thailand’s universal health coverage scheme as total public expenditure has decreased; cabinet endorsement of proposed Strategies for Universal Access to Medicines for Thai People; and establishment of National Commissions on Health Impact Assessment and Trade and Health. Discussion The NHA was successful in bringing together various actors and sectors involved in the social production of health, including groups often marginalized in policy making. It provides an innovative model of how governments may be able to increase public participation and intersectoral collaboration that could be adapted in other contexts. Significant challenges remain in ensuring full participation of interested groups and in implementing, and monitoring the impact of, the resolutions passed.     

Healthier catering initiatives in London,UK: an effective tool for encouraging healthier consumption behaviour?

The increasing amount of ‘unhealthy’ food consumed outside the home is thought to be a major contributory factor to growing levels of obesity. To tackle the problem and promote changes in catering and consumption behaviour, initiatives designed to encourage out-of-home caterers to provide healthier menus or adopt healthier cooking practices have been developed. Such voluntary agreements, rather than legislation, are the UK government’s preferred strategy. This paper reports on and explores issues arising from an evaluation of one such initiative – the Healthier Catering Commitment, piloted with over 80 independent businesses in London in the UK. Analysis of data on take-up of the scheme, and interviews with businesses and those involved in assessing them against the scheme’s criteria, suggests the extent to which businesses are prepared to make changes to their catering practices. Operational barriers as well as aspects of the local trading environment are shown to impact on the level of business commitment to the initiative. In considering the degree to which the scheme’s criteria inform, widen or restrict consumer choice, the paper adds to the debate on effective strategies for encouraging behaviour change. It also comments on the extent to which voluntary agreements are likely to be an effective means of ensuring a healthier food environment, and the extent to which government intervention is justified in the interests of improving public health and tackling health inequalities.     

Grasping at straws: a recent history of health promotion in Canada

Despite Canada's reputation as a leader in the development of health promotion concepts, implementation of these concepts in the service of health has always been far from stellar. Much of this has to do with Canada's liberal political economy and the recent further ascendance of neo-liberal approaches to public policymaking. These developments have combined with longstanding biomedical and epidemiological traditions in health policy to inhibit health promotion approaches that incorporate the principles and themes of the Ottawa Charter. Additionally, the emergence in Canada of population health as a competing–and displacing–discourse to health policy has further eroded health promotion's profile and presence. There is increasing interest in the social determinants of health concept, yet government spending, media attention, and health sector activities lavished on ‘lifestyle’ approaches to health promotion and the emergence of the ‘obesity epidemic’ as a focus of public, media, and health sector attention serves to further reinforce this dreary picture.