Aotearoa New Zealand’s unhealthy food environment needs more policy action

A new report reveals the troubling state of New Zealand’s food environment due to inaction from successive Governments and calls for this to change. Food environments influence the food we buy and eat, so are a key intervention area for improving population nutrition and diet-related health conditions. Food policies can improve food environments by making healthier foods and drinks more available, affordable, accessible and widely promoted, so have the potential to address inequities in health.

 

INFORMAS (the International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support), based at the University of Auckland, has been monitoring NZ’s food environments since 2014. Our first comprehensive assessment from 2014 to 2017¹ concluded that the food environment in NZ is largely unhealthy. Since then, there have been a few government and food company policies, commitments and actions aimed towards improvement of NZ diets. But have these made an impact on the food environment? Our second assessment from 2018 to 2021² shows these had minimal impact on the food environment, though a few government initiatives have the potential for long-term improvements. We call for an overarching Food and Nutrition Strategy for Aotearoa, and recommend that policies be mandatory for substantial and enduring change to food environments. Many other countries are implementing innovative food policy with NZ is falling behind. In this blog we discuss the healthiness of the NZ food environment according to the INFORMAS framework. Methods and detailed results are outlined here. This latest INFORMAS assessment rated the implementation of healthy food polices by government, the impact of the Advertising Standards Authority (ASA) Children and Young People’s Advertising (CYPA) Code on exposure to marketing, and food industry commitments.

The extent of Public sector policies and actions were rated by public health expert panels in 2014, 2017 and 2020³ against international benchmarks. Over the last nine years most of the 47 measures have not improved at all and it is worrying that each government, left or right, is doing so little about obesity and healthy eating. Though NZ does do well with labelling and health claims and some infrastructure support strategies like the NZ Health Survey. One positive recent initiative is Ka Ora Ka Ako, which provides free healthy school lunches for over 200,000 school children.

University of Auckland researchers analysed the composition of our food supply using the comprehensive Nutritrack database, an annual survey of the packaged food supply in NZ supermarkets. In 2018, we found over two-thirds (69%) of packaged foods were ultra-processed and only two-fifths (41%) of products would qualify for a Health Star Rating of 3.5 or more⁴. A deep-dive into the availability of single-serve beverages found four out of five (79%) drinks were sugar-sweetened despite more sugar-free/low sugar beverages on the market⁵. A recent study of the fast-food supply found what we all expected; a lot of products were high in energy and sodium⁶. What surprised us was just how unhealthy some of the meal combos were, with some providing more calories and sodium than recommended for a whole day.

Front of pack food labelling can assist consumers to choose healthier options. But in 2019, only one-quarter of packaged foods displayed the Health Star Rating, and in 2018 the HSR was more likely to be displayed on healthier products. We were impressed that almost all supermarket private label products displayed a HSR regardless of product healthiness⁷. And some good news for those shopping on a budget – our analysis of supermarket branded products (private labels) compared to similar branded label products found that there was little difference in sodium and sugar content and that for most food categories the private labels were cheaper.

Food marketing in NZ is governed by the industry-led ASA CYPA Code, effective since October 2017. Our studies found children were regularly exposed to unhealthy food and beverage marketing in many different mediums, both before and after the code came into effect. An in-depth study of complaints made to the ASA⁸ shows it is not an effective, transparent or accountable regulatory system, with vague definitions that create loopholes. A coalition of public health organisations and experts are so concerned about the lack of control on junk food marketing that we formed an alliance to advocate for legislation in this area which you can sign up to add support. We looked at the commitments and marketing practices of the top 26 packaged foods and beverage companies, supermarkets and quick-service restaurants. Children are still exposed to the marketing of these companies even when companies commit to the ASA CYPA Code.

The implementation of policies requires support, and in the Food Retail domain we found that the introduction of Food and Drinks Guidelines to Auckland Council-owned centres in 2016 was more effective when centres were supported by local health promotion organisations.

Small changes to the in-store supermarket environment have the potential to reach most New Zealanders.  Supermarkets have been working hard to improve their supermarket brand labelling and products as mentioned above and have mostly met their commitments to display fresh food on the cover pages of their flyers. Supermarkets could go further by reducing the prominence of junk food displayed in store. Only two in five end-of-aisle promotions and island bins were free of junk food, and one in three supermarkets did not even have one checkout that was free of junk food.

What still needs to be done to improve food environments?

The public health expert panels emphasised the need for mandatory policies related to restricting food marketing, a substantial tax on sugary drinks, mandatory health star ratings and food reformulation targets. Self-regulation of nutrition policies is shown to be ineffective⁹. More than 50 countries have introduced a levy on sugar-sweetened beverages, and it is so common and backed by solid evidence, that it is hard to imagine why New Zealand would not do the same¹⁰. Recent research from our team found 45 countries now have mandatory regulation to restrict marketing to children. While countries have been slow to adopt mandatory front-of-pack labelling and food reformulation targets^11,12, these are effective in some countries in steering consumers toward healthier choices, and encouraging product reformulation¹³. Action needs to be informed by a comprehensive food systems and nutrition strategy and supported by infrastructure actions. Some good news – planning is underway to develop the methodology for an updated national nutrition survey, though funding still needs to be secured for the data collection and analysis.

Actions prioritised by the expert panel for implementation by the New Zealand Government to improve the healthiness of New Zealand food environments

Additionally, the Government needs to ensure regular monitoring of food environments. At the moment this only happens when researchers receive funding from ad hoc grants. Thank you to the Heart Foundation of NZ and Health Research Council for funding the INFORMAS food environment surveys to date.

*Author details: All authors are with the School of Population Health, The University of Auckland

Acknowledgements: The authors thank Prof Boyd Swinburn for reviewing this blog.\