23 results
An analysis of the transformative potential of Australia’s national food policies and policy actions to promote healthy and sustainable food systems
- Patricia Ribeiro de Melo, Phillip Baker, Priscila Pereira Machado, Elly Howse, Scott Slater, Mark Lawrence
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- Journal:
- Public Health Nutrition / Volume 27 / Issue 1 / 2024
- Published online by Cambridge University Press:
- 20 February 2024, e75
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Objective:
Despite commitment by many countries to promote food system transformation, Australia has yet to adopt a national food policy. This study aimed to evaluate Australian Federal Government’s (AFG) food policies and policy actions potential to promote healthy and sustainable food systems.
Design:This study is a desk-based policy mapping followed by a theoretically guided evaluation of policy actions. This involved three steps: (1) identification of government departments and agencies that could influence Australia’s food system; (2) identification of food policies and policy actions within these departments and (3) use of a conceptual framework to evaluate policy actions’ potential of changing the food system as adjust (first-order change), reform (second-order change) or transform (third-order change).
Setting:Australia.
Participants:None.
Results:Twenty-four food policies and sixty-two policy actions were identified across eight AFG departments and the Food Regulation System and evaluated based on the order of change they represented. Most policies were led by individual departments, reflecting the absence of a joined-up approach to food policy in Australia. Most policy actions (n 25/ 56·5 %) were evaluated as having adjust potential, whereas no transformative policy action was identified.
Conclusions:These findings suggest that Australia is likely to proceed incrementally towards achieving food system change through adjustments and reforms but lacking transformative impact. To promote transformative change, all three orders of change must be strategically implemented in a coherent and coordinated matter. A comprehensive national food policy and a national coordinating body are needed to ensure a cohesive approach to policy.
For deep networks, the whole equals the sum of the parts
- Philip J. Kellman, Nicholas Baker, Patrick Garrigan, Austin Phillips, Hongjing Lu
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- Journal:
- Behavioral and Brain Sciences / Volume 46 / 2023
- Published online by Cambridge University Press:
- 06 December 2023, e396
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Deep convolutional networks exceed humans in sensitivity to local image properties, but unlike biological vision systems, do not discover and encode abstract relations that capture important properties of objects and events in the world. Coupling network architectures with additional machinery for encoding abstract relations will make deep networks better models of human abilities and more versatile and capable artificial devices.
From harmful nutrients to ultra-processed foods: exploring shifts in ‘foods to limit’ terminology used in national food-based dietary guidelines
- Kim Anastasiou, Patricia Ribeiro De Melo, Scott Slater, Gilly A Hendrie, Michalis Hadjikakou, Phillip K Baker, Mark Andrew Lawrence
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- Journal:
- Public Health Nutrition / Volume 26 / Issue 11 / November 2023
- Published online by Cambridge University Press:
- 02 December 2022, pp. 2539-2550
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Objective:
The choice of terms used to describe ‘foods to limit’ (FTL) in food-based dietary guidelines (FBDG) can impact public understanding, policy translation and research applicability. The choice of terms in FBDG has been influenced by available science, values, beliefs and historical events. This study aimed to analyse the terms used and definitions given to FTL in FBDG around the world, including changes over time and regional differences.
Design:A review of terms used to describe FTL and their definitions in all current and past FBDG for adults was conducted, using a search strategy informed by the FAO FBDG website. Data from 148 guidelines (96 countries) were extracted into a pre-defined table and terms were organised by the categories ‘nutrient-based’, ‘food examples’ or ‘processing-related’.
Setting:National FBDG from all world regions.
Participants:None.
Results:Nutrient-based terms (e.g. high-fat foods) were the most frequently used type of term in both current and past dietary guidelines (91 %, 85 %, respectively). However, food examples (e.g. cakes) and processing-related terms (e.g. ultra-processed foods) have increased in use over the past 20 years and are now often used in conjunction with nutrient-based terms. Regional differences were only observed for processing-related terms.
Conclusion:Diverse, and often poorly defined, terms are used to describe FTL in FBDG. Policymakers should ensure that FTL terms have clear definitions and can be integrated with other disciplines and understood by consumers. This may facilitate the inclusion of the most contemporary and potentially impactful terminology in nutrition research and policies.
Residential urban food environment profiles and diet outcomes among adults in Brooklyn, New York: a cross-sectional study
- Roger Figueroa, Katherine Baker, Joel Capellan, Laura C Pinheiro, Laura Burd, Jane Lim, Reah Chiong, Relicious Eboh, Erica Phillips
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- Journal:
- Public Health Nutrition / Volume 26 / Issue 4 / April 2023
- Published online by Cambridge University Press:
- 17 November 2022, pp. 877-885
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Objective:
To assess the clustering properties of residential urban food environment indicators across neighbourhoods and to determine if clustering profiles are associated with diet outcomes among adults in Brooklyn, New York.
Design:Cross-sectional.
Setting:Five neighbourhoods in Brooklyn, New York.
Participants:Survey data (n 1493) were collected among adults in Brooklyn, New York between April 2019 and September 2019. Data for food environment indicators (fast-food restaurants, bodegas, supermarkets, farmer’s markets, community kitchens, Supplemental Nutrition Assistance Program application centres, food pantries) were drawn from New York databases. Latent profile analysis (LPA) was used to identify individuals’ food access-related profiles, based on food environments measured by the availability of each outlet within each participant’s 800-m buffer. Profile memberships were associated with dietary outcomes using mixed linear regression.
Results:LPA identified four residential urban food environment profiles (with significant high clusters ranging from 17 to 57 across profiles): limited/low food access, (n 587), bodega-dense (n 140), food swamp (n 254) and high food access (n 512) profiles. Diet outcomes were not statistically different across identified profiles. Only participants in the limited/low food access profile were more likely to consume sugar-sweetened beverages (SSB) than those in the bodega-dense profile (b = 0·44, P < 0·05) in adjusted models.
Conclusions:Individuals in limited and low food access neighbourhoods are vulnerable to consuming significant amounts of SSB compared with those in bodega-dense communities. Further research is warranted to elucidate strategies to improve fruit and vegetable consumption while reducing SSB intake within residential urban food environments.
Global trends in added sugars and non-nutritive sweetener use in the packaged food supply: drivers and implications for public health
- Cherie Russell, Phillip Baker, Carley Grimes, Rebecca Lindberg, Mark A Lawrence
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- Journal:
- Public Health Nutrition / Volume 26 / Issue 5 / May 2023
- Published online by Cambridge University Press:
- 28 July 2022, pp. 952-964
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Objective:
The health implications of excessive added sugar intakes have led to national policy actions to limit their consumption. Subsequently, non-nutritive sweeteners (NNS) may be used to maintain product sweetness. We aimed to assess trends in quantities of added sugars and NNS sold in packaged food and beverages worldwide, and the association between these trends and the number of national policy actions across regions to reduce added sugar consumption.
Design:(i) Longitudinal analysis of Euromonitor sales data (2007–2019) to assess the quantity of added sugars (kg) and NNS (g) sold in packaged foods and beverages globally, across regions, and across country income categories; (ii) policy-mapping of policy actions targeting added sugar consumption globally from the NOURISHING database; and (iii) Spearman’s correlations to assess the association between national policy actions across regions and changes in added sugar/NNS sales.
Setting:Worldwide.
Participants:Not applicable.
Results:Per capita volumes of NNS from beverage sales increased globally (36 %). Added sugars from beverage sales decreased in high-income countries (22 %) but increased in upper-middle-income countries (UMIC) and lower-middle-income countries (LMIC) (13–40 %). Added sugars from packaged food sales increased globally (9 %). Regions with more policy actions had a significant increase in NNS quantities from beverage sales (r = 0·68, P = 0·04). The sweetness of the packaged food supply (the sweetness of each NNS and added sugar, relative to sucrose, multiplied by sales volume) increased over time.
Conclusions:The increasing use of NNS to sweeten beverages globally, and in packaged food in UMIC and LMIC, may have health and dietary implications in the future. Their use as a substitute for added sugar should be considered in public health nutrition policymaking.
The contribution of breastfeeding to a healthy, secure and sustainable food system for infants and young children: monitoring mothers’ milk production in the food surveillance system of Norway
- Julie P Smith, Britt Lande, Lars Johansson, Phillip Baker, Anne Bærug
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- Journal:
- Public Health Nutrition / Volume 25 / Issue 10 / October 2022
- Published online by Cambridge University Press:
- 04 July 2022, pp. 2693-2701
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Objective:
The mother–child breastfeeding dyad is a powerful force for achieving healthy, secure and sustainable food systems. However, food system reports exclude breastfeeding and mother’s milk. To help correct this omission and give breastfeeding women greater visibility in food systems dialogue and action, we illustrate how to estimate mother’s milk production and incorporate this into food surveillance systems, drawing on the pioneering experience of Norway to show the potential value of such analysis.
Design:The estimates use data on the proportion of children who are breastfed at each month of age (0–24 months), annual number of live births and assumptions on daily human milk intake at each month. New indicators for temporal and cross-country comparisons are considered.
Setting:It is assumed that a breastfeeding mother on average produces 306 l of milk during 24 months of lactation.
Participants:The annual number of live births is from Statistics Norway. Data for any breastfeeding at each month of age, between 0 and 24 months, are from official surveys in 1993, 1998–1999, 2006–2007, 2013 and 2018–2019.
Results:Estimated total milk production by Norwegian mothers increased from 8·2 to 10·1 million l per year between 1993 and 2018–2019. Annual per capita production increased from 69 to 91 l per child aged 0–24 months.
Conclusions:This study shows it is feasible and useful to include human milk production in food surveillance systems as an indicator of infant and young child food security and dietary quality. It also demonstrates significant potential for greater milk production.
Regulation of baby food marketing in Thailand: a NetCode analysis
- Nisachol Cetthakrikul, Matthew Kelly, Cathy Banwell, Phillip Baker, Julie Smith
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- Public Health Nutrition / Volume 25 / Issue 10 / October 2022
- Published online by Cambridge University Press:
- 23 June 2022, pp. 2680-2692
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Objective:
To report on the prevalence of different types of breast-milk substitutes (BMS) marketing and the compliance of such marketing with the ‘Control of Marketing of Infant and Young Child Food Act 2017’ (The Act) and the ‘International Code of Marketing of Breast-milk Substitutes (WHO Code)’ in Thailand.
Design:Cross-sectional quantitative study, guided by the WHO/UNICEF NetCode Periodic Assessment Protocol.
Setting:Health facilities and retail outlets in Bangkok, Thai media.
Participants:Mothers of 0–2-year-old children, health professionals, promotions at retail outlets and health facilities, product labels, marketing on television and the internet.
Results:Marketing to mothers was highly prevalent, mostly from electronic or digital media, while BMS companies provided items to health professionals to distribute to mothers. Promotional materials in health facilities displayed company brands or logos. At retail outlets, most promotions were price-related. Approximately two-fifths of labels contained nutrition or health claims. Television marketing was growing-up-milk (GUM) advertisements, while internet promotions were varied from price-related materials to product reviews. Most instances of non-compliant BMS marketing with the Act were advertisements to mothers, and most were infant formula. Most non-compliant BMS marketing with the WHO Code was mainly concerned GUM, which are not covered by the Act and appeared in the media.
Conclusions:BMS marketing does not fully comply with the Act or the WHO Code. The Thai government should conduct regular monitoring and enforcement activities, educate health professionals, and strengthen the Act’s provisions on the media and GUM to fully align with the WHO Code.
What are the benefits and risks of nutrition policy actions to reduce added sugar consumption? An Australian case study
- Cherie Russell, Phillip Baker, Carley Grimes, Mark Andrew Lawrence
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- Journal:
- Public Health Nutrition / Volume 25 / Issue 7 / July 2022
- Published online by Cambridge University Press:
- 24 January 2022, pp. 2025-2042
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Objective:
This study aimed to critically analyse Australia’s current and proposed policy actions to reduce added sugar consumption. Over-consumption of added sugar is a significant public health nutrition issue. The competing interests, values and beliefs among stakeholders mean they have disparate views regarding which policy actions are preferable to reduce added sugar consumption.
Design:Semi-structured interviews using purposive, snowball sampling and policy mapping. Policy actions were classified by two frameworks: NOURISHING (e.g. behaviour change communication, food environment and food system) and the Orders of Change (e.g. first order: technical adjustments, second order: reforming the system, third order: transforming the system).
Setting:Australia.
Participants:Twenty-two stakeholders from the food industry, food regulation, government, public health groups and academia.
Results:All proposed and existing policy actions targeted the food environment/behaviour change; most were assessed as first-order changes, and reductionist (nutrient specific) in nature. Influences on policy actions included industry power, stakeholder fragmentation, government ideology/political will and public pressure. Few stakeholders considered potential risks of policy actions, particularly of non-nutritive sweetener substitution or opportunity costs for other policies.
Conclusions:Most of Australia’s policy actions to reduce added sugar consumption are reductionist. Preferencing nutrient specific, first-order policy actions could reflect the influence of vested interests, a historically dominant reductionist orientation to nutrition science and policy, and the perceived difficulty of pursuing second- or third-order changes. Pursuing only first-order policy actions could lead to ‘regrettable’ substitutions and creates an opportunity cost for more comprehensive policy aimed at adjusting the broader food system.
Who has a beef with reducing red and processed meat consumption? A media framing analysis
- Katherine Sievert, Mark Lawrence, Christine Parker, Cherie A Russell, Phillip Baker
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- Journal:
- Public Health Nutrition / Volume 25 / Issue 3 / March 2022
- Published online by Cambridge University Press:
- 30 September 2021, pp. 578-590
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Objective:
Diets high in red and processed meat (RPM) contribute substantially to environmental degradation, greenhouse gas emissions and the global burden of chronic disease. High-profile reports have called for significant global RPM reduction, especially in high-income settings. Despite this, policy attention and political priority for the issue are low.
Design:The study used a theoretically guided framing analysis to identify frames used by various interest groups in relation to reducing RPM in online news media articles published in the months around the release of four high-profile reports by authoritative organisations that included a focus on the impacts of high RPM production and/or consumption.
Setting:Four major RPM producing and consuming countries – USA, United Kingdom, Australia and New Zealand.
Participants:None.
Results:Hundred and fifty news media articles were included. Articles reported the views of academics, policymakers, industry representatives and the article authors themselves. RPM reduction was remarkably polarising. Industry frequently framed RPM reduction as part of a ‘Vegan Agenda’ or as advocated by an elite minority. Reducing RPM was also depicted as an infringement on personal choice and traditional values. Many interest groups attempted to discredit the reports by citing a lack of consensus on the evidence, or that only certain forms of farming and processing were harmful. Academics and nutrition experts were more likely to be cited in articles that were aligned with the findings of the reports.
Conclusions:The polarisation of RPM reduction has led to a binary conflict between pro- and anti-meat reduction actors. This division may diminish the extent to which political leaders will prioritise this in policy agendas. Using nuanced and context-dependent messaging could ensure the narratives around meat are less conflicting and more effective in addressing health and environmental harms associated with RPM.
The drivers, trends and dietary impacts of non-nutritive sweeteners in the food supply: a narrative review
- Cherie Russell, Carley Grimes, Phillip Baker, Katherine Sievert, Mark A. Lawrence
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- Journal:
- Nutrition Research Reviews / Volume 34 / Issue 2 / December 2021
- Published online by Cambridge University Press:
- 05 November 2020, pp. 185-208
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Poor diets, including excess added sugar consumption, contribute to the global burden of disease. Subsequently, many nutrition policies have been implemented to reduce added sugar intake and improve population health, including taxes, education, labelling and environmental interventions. A potential consequence of these policy actions is the substitution of added sugars with non-nutritive sweeteners (NNS) in a variety of foods and beverages. NNS are used to reduce the energy and sugar content of foods and beverages while maintaining their palatability. Evidence of the toxicological risks of NNS is inconsistent, though concerns have been raised over the potential substitution effects of ultra-processed foods containing NNS for whole foods. This review aimed to provide an overview of current NNS food supply and consumption patterns, assess added sugar-reduction policies and their impact on NNS, and determine the impact of NNS on food choice, energy intake and diet quality. NNS are widely available in a variety of products, though most commonly in carbonated beverages, dairy products, confectionery, table-top sweeteners and fruit drinks. However, the longitudinal trends of different product categories, and differences between geographies and economy-income levels, require further study. Few studies have examined NNS consumption trends globally, though an increase in NNS consumption in beverages has been observed in some regions. Research examining how the increased availability of low-sugar, NNS-containing products affects global dietary patterns is limited, particularly in terms of their potential substitution effects.
Consumption of breast milk, formula and other non-human milk by children aged under 2 years: analysis of eighty-six low- and middle-income countries
- Paulo AR Neves, Aluísio JD Barros, Phillip Baker, Ellen Piwoz, Thiago M Santos, Giovanna Gatica-Domínguez, Juliana S Vaz, Nigel Rollins, Cesar G Victora
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- Journal:
- Public Health Nutrition / Volume 25 / Issue 3 / March 2022
- Published online by Cambridge University Press:
- 16 October 2020, pp. 680-688
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Objective:
To investigate the prevalence and socio-economic inequalities in breast milk, breast milk substitutes (BMS) and other non-human milk consumption, by children under 2 years in low- and middle-income countries (LMIC).
Design:We analysed the prevalence of continued breast-feeding at 1 and 2 years and frequency of formula and other non-human milk consumption by age in months. Indicators were estimated through 24-h dietary recall. Absolute and relative wealth indicators were used to describe within- and between-country socio-economic inequalities.
Setting:Nationally representative surveys from 2010 onwards from eighty-six LMIC.
Participants:394 977 children aged under 2 years.
Results:Breast-feeding declined sharply as children became older in all LMIC, especially in upper-middle-income countries. BMS consumption peaked at 6 months of age in low/lower-middle-income countries and at around 12 months in upper-middle-income countries. Irrespective of country, BMS consumption was higher in children from wealthier families, and breast-feeding in children from poorer families. Multilevel linear regression analysis showed that BMS consumption was positively associated with absolute income, and breast-feeding negatively associated. Findings for other non-human milk consumption were less straightforward. Unmeasured factors at country level explained a substantial proportion of overall variability in BMS consumption and breast-feeding.
Conclusions:Breast-feeding falls sharply as children become older, especially in wealthier families in upper-middle-income countries; this same group also consumes more BMS at any age. Country-level factors play an important role in explaining BMS consumption by all family wealth groups, suggesting that BMS marketing at national level might be partly responsible for the observed differences.
Have we compromised too much? A critical analysis of nutrition policy in Australia 2007–2018
- Brandon I, Phillip Baker, Mark Lawrence
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- Journal:
- Public Health Nutrition / Volume 24 / Issue 4 / March 2021
- Published online by Cambridge University Press:
- 28 September 2020, pp. 755-765
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Objective:
A comprehensive nutrition policy containing a broad package of cross-sector and synergistic policy actions is required to attenuate the systemic drivers of poor nutrition. The current study aims to critically analyse trends in the scope of federal nutrition policy actions in Australia between 2007 and 2018 by: (1) describing the changes in nutrition policy actions, benchmarked against an international best-practice policy framework and (2) investigating how and why the scope of these policy actions have changed over time by examining the decision-making processes that led to the establishment of Australia’s Healthy Food Partnership (the Partnership).
Design:Qualitative case study involving documentary analysis and key-informant interviews. Australian federal government documents (n 10) were analysed against the NOURISHING framework. Key informants (n 6) were interviewed and asked about the Partnership’s decision-making and establishment processes.
Setting:Australia.
Participants:Executive Committee (the Partnership’s governing body) and working group members.
Results:From 2007 to 2018, the scope of Australian national nutrition policy has fluctuated from evidence-informed recommendations for a comprehensive policy to the mostly discrete policy actions of the Partnership. Themes of ‘pragmatism and compromise’, ‘actor relationships and lobbying’ and ‘political context’ were critical drivers for establishing the Partnership.
Conclusion:The narrowing of Australian nutrition policy reflects a response to political expediency and compromise. This political dynamic highlights a dilemma facing nutrition policy advocates: should (and if so, how) a balance be sought between the aspirational but possibly unrealistic goals, and the limited but likely deliverable outcomes during policy-making processes? These findings have relevance for developing a future comprehensive national nutrition policy.
The political construction of public health nutrition problems: a framing analysis of parliamentary debates on junk-food marketing to children in Australia
- Cherie Russell, Mark Lawrence, Katherine Cullerton, Phillip Baker
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- Public Health Nutrition / Volume 23 / Issue 11 / August 2020
- Published online by Cambridge University Press:
- 17 January 2020, pp. 2041-2052
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Objective:
Junk-food marketing contributes significantly to childhood obesity, which in turn imposes major health and economic burdens. Despite this, political priority for addressing junk-food marketing has been weak in many countries. Competing interests, worldviews and beliefs of stakeholders involved with the issue contribute to this political inertia. An integral group of actors for driving policy change are parliamentarians, who champion policy and enact legislation. However, how parliamentarians interpret and portray (i.e. frame) the causes and solutions of public health nutrition problems is poorly understood. The present study aimed to understand how Australian parliamentarians from different political parties frame the problem of junk-food marketing.
Design:Framing analysis of transcripts from the Australian Government’s Parliamentary Hansard, involving development of a theoretical framework, data collection, coding transcripts and thematic synthesis of results.
Settings:Australia.
Participants:None.
Results:Parliamentarian framing generally reflected political party ideology. Liberal parliamentarians called for minimal government regulation and greater personal responsibility, reflecting the party’s core values of liberalism and neoliberalism. Greens parliamentarians framed the issue as systemic, highlighting the need for government intervention and reflecting the core party value of social justice. Labor parliamentarians used both frames at varying times.
Conclusions:Parliamentarians’ framing was generally consistent with their party ideology, though subject to changes over time. This project provides insights into the role of framing and ideology in shaping public health policy responses and may inform communication strategies for nutrition advocates. Advocates might consider using frames that resonate with the ideologies of different political parties and adapting these over time.
An exposé of the realpolitik of trade negotiations: implications for population nutrition
- Sharon Friel, Phillip Baker, Anne-Marie Thow, Deborah Gleeson, Belinda Townsend, Ashley Schram
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- Journal:
- Public Health Nutrition / Volume 22 / Issue 16 / November 2019
- Published online by Cambridge University Press:
- 23 August 2019, pp. 3083-3091
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Objective:
To explore the formal and informal ways in which different actors involved in shaping trade agreements pursue their interests and understand the interactions with nutrition, in order to improve coherence between trade and nutrition policy goals.
Design:The paper draws on empirical evidence from Australian key informant interviews that explore the underlying political dimensions of trade agreements that act as barriers or facilitators to getting nutrition objectives on trade agendas.
Setting:Countries experiencing greater availability and access to diets full of energy-dense and nutrient-poor foods through increased imports, greater foreign direct investment and increasing constraints on national health policy space as a result of trade agreements.
Participants:Interviews took place with Australian government officials, industry, public-interest non-government organizations and academics.
Results:The analysis reveals the formal and informal mechanisms and structures that different policy actors use both inside and outside trade negotiations to pursue their interests. The analysis also identifies the discourses used by the different actors, as they attempt to influence trade agreements in ways that support or undermine nutrition-related goals.
Conclusions:Moving forward requires policy makers, researchers and health advocates to use various strategies including: reframing the role of trade agreements to include health outcomes; reforming the process to allow greater access and voice to health arguments and stakeholders; establishing cross-government partners through accountable committees; and building circles of consensus and coalitions of sympathetic public-interest actors.
Sustainable, resilient food systems for healthy diets: the transformation agenda
- Mark Andrew Lawrence, Phillip Ian Baker, Claire Elizabeth Pulker, Christina Mary Pollard
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- Public Health Nutrition / Volume 22 / Issue 16 / November 2019
- Published online by Cambridge University Press:
- 13 August 2019, pp. 2916-2920
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Trade and nutrition policy coherence: a framing analysis and Australian case study
- Phillip Baker, Sharon Friel, Deborah Gleeson, Anne-Marie Thow, Ronald Labonte
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- Public Health Nutrition / Volume 22 / Issue 12 / August 2019
- Published online by Cambridge University Press:
- 21 May 2019, pp. 2329-2337
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Objective:
Maximising synergies and minimising conflicts (i.e. building policy coherence) between trade and nutrition policy is an important objective. One understudied driver of policy coherence is the alignment in the frames, discourses and values of actors involved in the respective sectors. In the present analysis, we aim to understand how such actors interpret (i.e. ‘frame’) nutrition and the implications for building trade–nutrition policy coherence.
Design:We adopted a qualitative single case study design, drawing on key informant interviews with those involved in trade policy.
Setting:We focused on the Australian trade policy sub-system, which has historically emphasised achieving market growth and export opportunities for Australian food producers.
Participants:Nineteen key informants involved in trade policy spanning the government, civil society, business and academic sectors.
Results:Nutrition had low ‘salience’ in Australian trade policy for several reasons. First, it was not a domestic political priority in Australia nor among its trading partners; few advocacy groups were advocating for nutrition in trade policy. Second, a ‘productivist’ policy paradigm in the food and trade policy sectors strongly emphasised market growth, export opportunities and deregulation over nutrition and other social objectives. Third, few opportunities existed for health advocates to influence trade policy, largely because of limited consultation processes. Fourth, the complexity of nutrition and its inter-linkages with trade presented difficulties for developing a ‘broader discourse’ for engaging the public and political leaders on the topic.
Conclusions:Overcoming these ‘ideational challenges’ is likely to be important to building greater coherence between trade and nutrition policy going forward.
Global trends and patterns of commercial milk-based formula sales: is an unprecedented infant and young child feeding transition underway?
- Phillip Baker, Julie Smith, Libby Salmon, Sharon Friel, George Kent, Alessandro Iellamo, JP Dadhich, Mary J Renfrew
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- Journal:
- Public Health Nutrition / Volume 19 / Issue 14 / October 2016
- Published online by Cambridge University Press:
- 23 May 2016, pp. 2540-2550
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Objective
The marketing of infant/child milk-based formulas (MF) contributes to suboptimal breast-feeding and adversely affects child and maternal health outcomes globally. However, little is known about recent changes in MF markets. The present study describes contemporary trends and patterns of MF sales at the global, regional and country levels.
DesignDescriptive statistics of trends and patterns in MF sales volume per infant/child for the years 2008–2013 and projections to 2018, using industry-sourced data.
SettingEighty countries categorized by country income bracket, for developing countries by region, and in countries with the largest infant/child populations.
SubjectsMF categories included total (for ages 0–36 months), infant (0–6 months), follow-up (7–12 months), toddler (13–36 months) and special (0–6 months).
ResultsIn 2008–2013 world total MF sales grew by 40·8 % from 5·5 to 7·8 kg per infant/child/year, a figure predicted to increase to 10·8 kg by 2018. Growth was most rapid in East Asia particularly in China, Indonesia, Thailand and Vietnam and was led by the infant and follow-up formula categories. Sales volume per infant/child was positively associated with country income level although with wide variability between countries.
ConclusionsA global infant and young child feeding (IYCF) transition towards diets higher in MF is underway and is expected to continue apace. The observed increase in MF sales raises serious concern for global child and maternal health, particularly in East Asia, and calls into question the efficacy of current regulatory regimes designed to protect and promote optimal IYCF. The observed changes have not been captured by existing IYCF monitoring systems.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. 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Depression and anxiety in cardiac rehabilitation patients: characteristics, treatment and outcome
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. 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Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. 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Rubenstein, Rosemary Radford Ruether, Markku Ruotsila, John E. Rybolt, Risto Saarinen, John Saillant, Juan Sanchez, Wagner Lopes Sanchez, Hugo N. Santos, Gerhard Sauter, Gloria L. Schaab, Sandra M. Schneiders, Quentin J. Schultze, Fernando F. Segovia, Turid Karlsen Seim, Carsten Selch Jensen, Alan P. F. Sell, Frank C. Senn, Kent Davis Sensenig, Damían Setton, Bal Krishna Sharma, Carolyn J. Sharp, Thomas Sheehan, N. Gerald Shenk, Christian Sheppard, Charles Sherlock, Tabona Shoko, Walter B. Shurden, Marguerite Shuster, B. Mark Sietsema, Batara Sihombing, Neil Silberman, Clodomiro Siller, Samuel Silva-Gotay, Heikki Silvet, John K. Simmons, Hagith Sivan, James C. Skedros, Abraham Smith, Ashley A. Smith, Ted A. Smith, Daud Soesilo, Pia Søltoft, Choan-Seng (C. S.) Song, Kathryn Spink, Bryan Spinks, Eric O. Springsted, Nicolas Standaert, Brian Stanley, Glen H. Stassen, Karel Steenbrink, Stephen J. Stein, Andrea Sterk, Gregory E. Sterling, Columba Stewart, Jacques Stewart, Robert B. Stewart, Cynthia Stokes Brown, Ken Stone, Anne Stott, Elizabeth Stuart, Monya Stubbs, Marjorie Hewitt Suchocki, David Kwang-sun Suh, Scott W. Sunquist, Keith Suter, Douglas Sweeney, Charles H. Talbert, Shawqi N. Talia, Elsa Tamez, Joseph B. Tamney, Jonathan Y. Tan, Yak-Hwee Tan, Kathryn Tanner, Feiya Tao, Elizabeth S. Tapia, Aquiline Tarimo, Claire Taylor, Mark Lewis Taylor, Bishop Abba Samuel Wolde Tekestebirhan, Eugene TeSelle, M. Thomas Thangaraj, David R. Thomas, Andrew Thornley, Scott Thumma, Marcelo Timotheo da Costa, George E. “Tink” Tinker, Ola Tjørhom, Karen Jo Torjesen, Iain R. Torrance, Fernando Torres-Londoño, Archbishop Demetrios [Trakatellis], Marit Trelstad, Christine Trevett, Phyllis Trible, Johannes Tromp, Paul Turner, Robert G. Tuttle, Archbishop Desmond Tutu, Peter Tyler, Anders Tyrberg, Justin Ukpong, Javier Ulloa, Camillus Umoh, Kristi Upson-Saia, Martina Urban, Monica Uribe, Elochukwu Eugene Uzukwu, Richard Vaggione, Gabriel Vahanian, Paul Valliere, T. J. Van Bavel, Steven Vanderputten, Peter Van der Veer, Huub Van de Sandt, Louis Van Tongeren, Luke A. Veronis, Noel Villalba, Ramón Vinke, Tim Vivian, David Voas, Elena Volkova, Katharina von Kellenbach, Elina Vuola, Timothy Wadkins, Elaine M. Wainwright, Randi Jones Walker, Dewey D. Wallace, Jerry Walls, Michael J. Walsh, Philip Walters, Janet Walton, Jonathan L. Walton, Wang Xiaochao, Patricia A. Ward, David Harrington Watt, Herold D. Weiss, Laurence L. Welborn, Sharon D. Welch, Timothy Wengert, Traci C. West, Merold Westphal, David Wetherell, Barbara Wheeler, Carolinne White, Jean-Paul Wiest, Frans Wijsen, Terry L. Wilder, Felix Wilfred, Rebecca Wilkin, Daniel H. Williams, D. Newell Williams, Michael A. Williams, Vincent L. Wimbush, Gabriele Winkler, Anders Winroth, Lauri Emílio Wirth, James A. Wiseman, Ebba Witt-Brattström, Teofil Wojciechowski, John Wolffe, Kenman L. Wong, Wong Wai Ching, Linda Woodhead, Wendy M. Wright, Rose Wu, Keith E. Yandell, Gale A. Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
-
- Book:
- The Cambridge Dictionary of Christianity
- Published online:
- 05 August 2012
- Print publication:
- 20 September 2010, pp xi-xliv
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