Definition
This Policy Instrument (PI) focuses on promoting and enabling access to healthy diets through interventions that encourage the availability and consumption of nutritious foods while reducing the presence and appeal of unhealthy options.
Rationale
Promoting and enabling access to healthy diets is essential to address the growing burden of malnutrition in all its forms, including undernutrition, micronutrient deficiencies, overweight, and diet-related non-communicable diseases. Dietary choices are strongly shaped by food environments; when nutritious foods are less available, affordable, or visible than energy-dense, nutrient-poor products, consumers are more likely to adopt unhealthy dietary patterns. Interventions that increase the availability, affordability, and desirability of nutritious foods, while reducing the presence and appeal of unhealthy options, can help shift consumption patterns toward healthier diets. Such measures are particularly important for protecting vulnerable populations, including children and low-income households, who are more exposed to unhealthy food environments and marketing practices. By influencing both the supply and demand of nutritious foods, these interventions contribute to improved nutrition outcomes, healthier populations, and more sustainable food systems.
Key interventions
Interventions should support the supply and demand of safe and nutritious foods as part of healthy diets. These interventions typically involve regulations and strategies aimed at influencing what food is offered and demanded in various settings, including fragile contexts.
1. Labeling and regulation:
- Nutritional standards: Implementing mandatory nutritional standards for foods available in schools, workplaces, and public institutions;
- Front of pack food labeling laws: Requiring clear front of pack labeling of food products to inform consumers about nutritional content and health impacts;
- Marketing restrictions: restrictions on marketing of food/beverages to children. Limiting advertising of unhealthy foods and restrictions on marketing of food/beverages to children.
2. Fiscal policy repurposing:
- Production and/or consumption incentives: Providing financial and tax incentives to producers and retailers to increase the availability and lower the cost of fruits, vegetables, and other nutritious foods by repurposing incentives on other commodities (e.g. staple foods or cash crops). Incentives to encourage consumers, particularly those in greatest vulnerability, to purchase safe and nutritious foods;
- Taxing unhealthy foods: Implementing taxes on sugary drinks, fast food, and other foods which should be consumed in moderation (or avoided).
3. Improving food access through public channels:
- Public procurement: Ensuring that government-funded programs (e.g., school lunches, hospital meals) prioritize healthy food options including fortified foods (staples and other);
- Cash assistance: To maximize the nutritional impact of cash assistance programs, a comprehensive assessment must be conducted to establish an adequate cash transfer value that allows households to make healthy food choices. Integrating cash transfers with Social and Behavior Change (SBC) initiatives is essential to enhance program effectiveness;
- Food vouchers: A form of assistance issued by governments or organizations that can be used like cash to purchase approved food items at designated retailers. They aim to ensure access to safe and nutritious foods that are under-consumed in the local diets, especially by population groups in situations of greatest vulnerability. When food vouchers are linked with nutrition education and counseling, they can contribute towards improved nutrition outcomes;
- In-kind food assistance: Ensuring the design and inclusion of nutritious foods (including fortified foods) into in-kind transfer helps ensure nutritional adequacy of household food assistance.
4. Support for local producers:
- Farm-to-table programs: Encouraging local sourcing of produce through initiatives that connect local farmers with consumers and institutions;
- Home grown school feeding programs: Aims to provide nutritious meals to schoolchildren by sourcing food locally from smallholder farmers.
5. Promotion of healthy diets:
- Food-based dietary guidelines: development of contextually appropriate food based dietary guidelines and support to their implementation, including influencing relevant policies;
- Consumer education and awareness: using different channels and tailoring messages to be contextually appropriate and reflecting specific requirements by age, gender, conditions and situations.
All consumers, but especially those in situations of vulnerability, including children and breastfeeding women and girls; small scale producers selling directly to consumers.
Overview
A substantial and growing body of evidence demonstrates that policies aimed at promoting access to healthy diets through shaping food environments have measurable effects on dietary behavior and nutrition outcomes. HLPE (2017) provides a global synthesis establishing that dietary choices are strongly determined by food environments, including the availability, affordability, and desirability of foods. Their assessment concludes that environments dominated by energy-dense, nutrient-poor foods are systematically associated with poorer dietary quality and rising burdens of malnutrition in all its forms. This conclusion is reinforced by the WHO (2016), which synthesizes evidence from fiscal policy interventions and finds that price signals significantly influence consumption patterns. Their systematic review indicates that a 10% increase in the price of sugar-sweetened beverages is associated with a reduction in consumption of approximately 10–12%, while subsidies for fruits and vegetables lead to measurable increases in their intake, particularly among low-income populations. In addition, the WHO (2022) review on food marketing demonstrates that exposure to marketing of unhealthy foods significantly shapes children’s preferences, purchase requests, and consumption patterns, with particularly strong effects among younger and socioeconomically vulnerable populations.
Evidence from selected countries
Chile: In 2016, Chile implemented a law mandating front-of-package warning labels, restricting marketing, and banning the sale of products high in calories, sodium, sugar, or saturated fat in schools. Evidence presented by Taillie et al. (2021) indicates that, following the implementation of the first phase of the law, there were significant reductions in the overall purchases of calories, sugar, saturated fat, and sodium, relative to a counterfactual scenario in which the law had not been introduced. This case illustrates the effectiveness of combined regulatory approaches in influencing both consumer behaviour and supply-side responses.
Mexico: In 2014, Mexico implemented a national excise tax on sugar-sweetened beverages. Colchero et al. (2016) analysed short-term changes in the purchase of sugar-sweetened beverages following one year of the tax’s implementation. The study found that the average monthly volume of taxed beverages purchased was 6 percent lower in 2014 than expected in the absence of the tax. Moreover, the reductions intensified over time, reaching a 12 percent decline by December 2014. These findings provide evidence that fiscal measures can effectively reduce the consumption of unhealthy products.
Brazil: Brazil’s Solidarity Kitchens Programme (Cozinhas Solidárias) is a community-based food security intervention designed to improve access to healthy meals among populations experiencing severe food insecurity and social vulnerability. The programme supports community kitchens through federal financing, public food procurement, and partnerships with civil society organizations (Madruga et al.,2024).
References
Economic Impact
- Increased Costs: Policies can be costly to implement and sustain. These costs might be passed on to consumers, who may simply shift to cheaper alternatives or adapt their consumption behaviours without impact on the overall healthfulness;
- Economic Inequality: Taxes on unhealthy foods can disproportionately affect low-income populations who may rely on cheaper, calorie-dense options for their daily caloric intake.
Implementation Challenges
- Regulatory Compliance: Ensuring compliance with nutritional standards and labeling laws can be challenging, especially in regions with limited regulatory capacity or resources;
- Monitoring and Enforcement: Effective monitoring and enforcement require significant resources and infrastructure, which may not be available in all areas.
Limited Scope
- Supply and Demand: Increasing the availability of safe and nutritious foods does not automatically translate to increased consumption if there is no alignment with consumers’ demand and preferences. This will require combined efforts to improve supply and demand (i.e. coordination, co-location of efforts, etc).
Potential for Unintended Consequences
- Market Distortions: Interventions like subsidies and taxes can create market distortions, potentially leading to unintended economic consequences, such as reduced profitability for small farmers or local businesses;
- Product Reformulation: Companies might reformulate products in ways that meet regulatory standards, but introduce other health concerns, such as replacing added sugar with artificial sweeteners.
Limited Reach
- Urban-Rural Divide: strategies such as public procurement or food vouchers might be more effectively implemented in urban areas, leaving rural populations with less access to the benefits of such interventions;
- Small and Informal Markets: In many regions, a significant portion of food is sold through informal markets that are harder to regulate and monitor;
- Sustainability: strategies in support of the supply and demand of healthy diets often require ongoing political will and funding, which can fluctuate with changes in government or economic conditions.
Consumer Autonomy
- Pushback on dietary recommendations that focus on moderation: consumers might resist recommendations on moderation (or avoidance) of unhealthy foods, especially if they feel that their personal choice is being restricted.
SDG 3 - Good health and well-being
- Target 3.4 - By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
The FAO's Right to Food Guidelines
FAO’s School Food and Nutrition
CFS Voluntary Guidelines on Food Systems and Nutrition (VGFSyN)
Global Strategy on Diet, Physical Activity and Health
The UN Sustainable Development Goals (SDGs)
UNICEF Guidance on the prevention of overweight and obesity in childhood
WHO Implementing nutrition labelling policies: a review of contextual factors
UNICEF Front-of-Pack Nutrition Labelling: A ‘How-to’ Guide for Countries
WHO Guideline: Implementing policies to restrict food marketing: a review of contextual factors