Opinion: Ireland's policies to ensure we eat healthily are inconsistent and not comparable to best practice

The importance of a good diet for health and wellbeing is recognised as a priority area by governments across the world. Poor diet is responsible for an enormous burden of suffering and premature deaths globally. In Ireland, as in other developed countries, the impact of poor diet on the burden of non-communicable disease is immense.

Poor diet is the single biggest risk factor for non-communicable diseases, exceeding the combined effects of tobacco, alcohol and physical inactivity. This highlights the urgent need for effective population level programmes to promote healthier diets globally and in wealthy developed countries such as Ireland. 

Health education strategies are of 'limited' effect

In the past, efforts to tackle obesity and promote healthier diets relied heavily on health education strategies and counselling interventions in clinical settings. Unfortunately, these programmes assume a high level of individual effort, such as a high level of control over dietary choices, and are of limited effectiveness. To address these priorities, many countries, including Ireland, have introduced policies to improve the food and nutrition habits of the population with the ultimate aim of improving population health and reducing the burden of disease. However, these policies are often inconsistent with each other and not comparable to international best practice. 

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RTÉ Brainstorm podcast looks at if what we eat as children affects our future health

It is now clearly understood that to prevent diet related chronic disease, we need to understand and address the "foodscape" the wide range of interconnected factors such as food production, processing, marketing and distribution, that characterise our  food system and largely determine our dietary intakes.  We need to implement coherent policies that are considered 'best practice’ against international standards. 

What we found

Our Food EPI Ireland report identified existing Irish Government policies and actions to improve the food environment and a panel of Irish public health nutrition experts assessed progress on implementing these policies against recognised best practice in other countries. They then identified policy gaps and specific actions that would be needed to address these gaps. In the final step, the panel prioritised these actions as recommendations for Government to act on. 

While experts identified that the supports available to support policy implementation were on par with international best practice, the high number of food environment policies which were rated by the expert panel as being poor compared to best practice were of concern. These included:

· the need for greater emphasis on reducing the marketing of unhealthy foods to children on social media,

· limited use of financial policies to support healthy food choices e.g. policies to make healthier foods cheaper,

· limited support for communities to limit availability and accessibility of unhealthy food outlets, for example limiting the number of fast food outlets in residential neighbourhoods or imposing zoning limits on the types of food outlets that can be located near schools;

· limited support for private companies to promote healthy foods in their workplaces

· provision of income support programs for healthy foods for example government schemes which provide discounts on specific foods for those in receipt of welfare payments

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From RTÉ Radio 1's CountryWide, food writer Joanna Blythman on a 2019 Lancet report which calls for a comprehensive shift in how the world eats

Four areas were identified by the panel as being areas of particular concern.  These included

· a lack of government action on the introduction of targets for out-of-home meals, for example improving the nutritional quality of foods purchased out of home. 

· failure to restrict the promotion of unhealthy foods to children on food packaging

· no discernible progress towards establishing public sector procurement standards for food service activities to provide and promote healthy food choices,

· failure to implement policies that encourage availability of outlets selling nutritious foods.

The expert panel were asked to consider the areas where there were gaps and poor policy implementation and to identify and prioritise areas for Government action. 

What we need to do now

The government is strongly urged to act on the recommended priority actions, to improve the health outcomes of Irish citizens, with particular focus on those in disadvantaged or vulnerable groups. The top five policy recommendations were:

School food policies

Making sure healthy food choices are available within schools is a priority identified by the expert panel. They considered that the government should implement nutrition standards for all schools and tuck shops and to provide the support for promotion of healthy food choices in the school environment

Income support

Establish a cross-governmental group to monitor and evaluate food-related income support programmes for vulnerable population groups.

Healthy Food Subsidies (supports)

Ringfence revenue from tax on unhealthy foods to improve public health initiatives and provide healthy food subsidies targeted at disadvantaged groups in the community.

Zoning laws

Introduce zoning legislation "No Fry Zones" to prohibit the placement of unhealthy food outlets within 400m of primary and secondary schools.

Public sector food choices

Introduce a comprehensive policy on nutrition standards for food and beverage provision in public sector.

Government needs to do more

The current health status of people living in Ireland, lifestyle factors and inequalities in health outcomes must be urgently addressed through food environment reform. The food environment is greatly shaped by the policy environment, and policy action is needed by government to create healthier food environments.

Ireland has an excellent opportunity to improve the diets of the Irish population, prevent obesity and diet-related diseases and the associated rising healthcare costs by investing in highly cost-effective policies and programmes, which have had demonstrated success in a number of countries. This will clearly require a much greater government effort than has been evident to bring Ireland in line with international standards for a healthy food environment.

The views expressed here are those of the author and do not represent or reflect the views of RTÉ