Priorización de políticas alimentarias en España mediante el Índice Food-EPI de entornos alimentarios saludables: panel de expertos

e202309076

Autores/as

  • Elisa Pineda Centre for Health Economics & Policy Innovation (CHEPI); Imperial College Business School. Londres. Reino Unido. / School of Public Health; Imperial College London. Londres. Reino Unido.
  • Cristina Bouzas CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN); Instituto de Salud Carlos III (ISCIII). Madrid. España. / Grupo de Investigación en Nutrición Comunitaria y Estrés Oxidativo-IUNICS; Universidad de las Islas Baleares. Palma de Mallorca. España. / Fundación Instituto de Investigación Sanitaria de las Illes Balears (IDISBA). Palma de Mallorca. España.
  • Marta Arroyo Departamento de Farmacia y Ciencias de los Alimentos; Grupo de Investigación BIOMICs, Microfluidics & BIOMICs Cluster; Facultad de Farmacia; Universidad del País Vasco (UPV/EHU). Vitoria-Gasteiz. España.
  • J. Alfredo Martínez Cardiometabolics Precision Nutrition Program; IMDEA Food; CEI UAM + CSIC. Madrid. España.
  • Josep A. Tur CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN); Instituto de Salud Carlos III (ISCIII). Madrid. España. / Grupo de Investigación en Nutrición Comunitaria y Estrés Oxidativo-IUNICS; Universidad de las Islas Baleares. Palma de Mallorca. España. / Fundación Instituto de Investigación Sanitaria de las Illes Balears (IDISBA). Palma de Mallorca. España.

Palabras clave:

Entornos alimentarios, Obesidad, Política de Salud Pública, Food-EPI, España

Resumen

FUNDAMENTOS // La conducta alimentaria de los individuos y las influencias ejercidas desde el entorno alimentario es un elemento clave para promover y facilitar el acceso a alimentos saludables. Sin embargo, el conocimiento sobre la implementación de políticas sobre entornos alimentarios saludables en España es escaso. El objetivo de este trabajo fue identificar y evaluar el nivel de implementación de políticas alimentarias en España, así como priorizar acciones necesarias para crear entornos alimentarios saludables, con la ayuda por un panel de personas expertas.
MÉTODOS // Se creó un panel de personas del mundo académico y la Administración expertas en salud pública, nutrición, políticas alimentarias o de salud, que evaluaron el nivel de implementación de políticas alimentarias en España durante 2018-2020, identificando y priorizando acciones concretas, utilizando el Índice de Políticas Ambientales de Alimentos de Entornos Alimentarios Saludables (Food-EPI). Se consideraron seis dominios para entornos alimentarios y seis dominios de infraestructura alimentaria. La confiabilidad entre evaluadores se midió utilizando AgreeStat 2015.6.2 a través de Gwet AC2. Se utilizó la calificación media de los indicadores. Se aplicó el método Delphi.
RESULTADOS // Las acciones políticas necesarias en alimentación saludable en España se consideraron bajas (58%) en composición, etiquetado, promoción y precios de los alimentos, y muy bajas (25%) en comercio minorista de alimentos. Las acciones prioritarias necesarias de apoyo a las infraestructuras alimentarias saludables se consideraron de importancia media (52%) para liderazgo y monitorización, y de importancia baja (48%) en gobernanza, financiación y plataformas.
CONCLUSIONES // España muestra un gran potencial para crear entornos alimentarios saludables, con una necesidad baja o muy baja de políticas de implementación de entornos alimentarios saludables, y media o baja de apoyo a infraestructuras alimentarias saludables.

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Citas

Djojosoeparto SK, Vandevijvere S, Harrington JM, Poelman MP, on behalf of the JPI-HDHL Policy Evaluation Network. The Healthy Food Environment Policy Index (Food-EPI): European Union. An assessment of EU-level policies influencing food environments and priority actions to create healthy food environments in the EU. The Netherlands: Utrecht, Utrecht University, 2021.

Swinburn B, Sacks G, Vandevijvere S, Kumanyika S, Lobstein T, Neal B, Barquera S, Friel S, Hawkes C, Kelly B et al. INFORMAS (International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support): overview and key principles. Obes Rev 2013; 14(S1): 1-12.

FAO. Influencing food environments for healthy diets. Rome: Food and Agriculture Organization of the United Nations, 2016.

Hilmers A, Hilmers DC, Dave J. Neighborhood disparities in access to healthy foods and their effects on environmental justice. Am J Public Health 2012; 102(9): 1644-1654.

Royo-Bordonada MA, Rodríguez-Artalejo F, Bes-Rstrollo M, Fernández-Escobar C, González CA, Rivas F, Martínez-González MA, Quiles J, Bueno-Cavamillas A, Navarrete-Muñoz AM et al. Políticas alimentarias para prevenir la obesidad y las principales enfermedades no transmisibes en España: querer es poder. Gac Sanit 2019; 33(6): 584-592.

Ni Mhurchu C, Vandevijvere S, Waterlander W, Thornton LE, Kelly B, Cameron AJ, Snowdon W, Swinburn B, INFORMAS. Monitoring the availability of healthy and unhealthy foods and non-alcoholic beverages in community and consumer retail food environments globally. Obes Rev 2013; 14 (S1): 108-119.

Laar A. The role of food environment policies in making unhealthy foods unattractive and healthy foods available in Africa. EClin Med 2021; 36: 100908.

WHO. European Food and Nutrition Action Plan 2015-2020. Denmark: WHO European Region, 2014.

Hawkes C, Jewell J, Allen K. A food policy package for healthy diets and the prevention of obesity and diet-related non-communicable diseases: the NOURISHING framework. Obes Rev 2013; 14(S2): 159-168.

Harrington JM LC, Twohig CH, Vandevijvere S, for the Food-EPI project team. Policies for tackling obesity and creating healthier food environments in Ireland: Food-EPI 2020. Current policies & priority actions. Ireland: Cork, School of Public Health, University College Cork, 2020.

Backholer K, Beauchamp A, Ball K, Turrell G, Martin J, Woods J, Peeters A. A framework for evaluating the impact of obesity prevention strategies on socioeconomic inequalities in weight. Am J Public Health 2014; 104(10): e43-50.

Breda J, Castro LSN, Whiting S, Williams J, Jewell J, Engesveen K, Wickramasinghe K. Towards better nutrition in Europe: Evaluating progress and defining future directions. Food Policy 2020; 96: 101887.

Madureira Lima J, Rayner M, Breda J, Jewell J. The European Food Regulatory Environment Index: a tool to monitor progress in implementing food environment policies. Eur J Public Health 2021; 32(2): 261-266.

Hub OE. Countries that have implemented taxes on sugar-sweetened beverages (SSBs) 2021. https://www.obesityevidencehub.org.au/collections/prevention/countries-that-have-implemented-taxes-on-sugar-sweetened-beverages-ssbs (acceso: 07 Agosto 2022).

Vandevijvere S, Swinburn B, for the International Network for Food and Obesity/non-communicable diseases (NCDs) Research, Monitoring and Action Support (INFORMAS). Towards global benchmarking of food environments and policies to reduce obesity and diet-related non-communicable diseases: design and methods for nation-wide surveys. BMJ Open 2014; 4(5): e005339.

EUR-Lex. Consolidated version of the Treaty on the Functioning of the European Union – PART THREE: UNION POLICIES AND INTERNAL ACTIONS – TITLE XIV: PUBLIC HEALTH – Article 168 (ex Article 152 TEC). 2008; 115(9.5): 122-124.

Kwon J, Reeve E, Mann D, Swinburn B, Sacks G. Benchmarking for accountability on obesity prevention: evaluation of the Healthy Food Environment Policy Index (Food-EPI) in Australia. Public Health Nutr 2022; 25(2): 488-497.

Mackay S, Gerritsen S, Sing F, Vandevijvere S, Swinburn B. Implementing healthy food environment policies in New Zealand: nine years of inaction. Health Res Policy Sust 2022; 20(1): 8.

Vandevijvere S, Mackay S, Swinburn B. Measuring and stimulating progress on implementing widely recommended food environment policies: The New Zealand case study. Health Res Policy Syst. 2018; 16(1): 3.

Yamaguchi M, Nomura M, Arai Y, Vandevijvere S, Swinburn B, Nishi N. An assessment of implementation gaps and priority recommendations on food environment policies: the healthy Food Environment Policy Index in Japan. Public Health Nutr 2022; 25(6): 1720-1732.

Ng SH, Swinburn B, Kelly B, Vandevijvere S, Yeatmen H, Ismail MN, Karupaiah T. Extent of implementation of food environment policies by the Malaysian Government: gaps and priority recommendations. Public Health Nutr 2018; 21(18): 3395-3406.

Vandevijvere S, Barquera S, Cáceres G, Corvalan C, Karupaiah T, Kroker-Lobos MF. L’Abbé M, Ng SH, Phulkerd S, Ramirez-Zea M et al. An 11-country study to benchmark the implementation of recommended nutrition policies by national governments using the Healthy Food Environment Policy Index, 2015-2018. Obes Rev 2019; 20 (Suppl. 2): 57-66.

Vanderlee L, Goorang S, Karbasy K, Vandevijvere S, L’Abbé MR. Policies to create healthier Food Environments in Canada: Experts’ evaluation and prioritized actions using the Healthy Food Environment Policy Index (Food-EPI). Int J Environ Res Public Health 2019; 16(22): 4473.

Nieto C, Rodríguez E, Sánchez-Bazán K, Tolentino-Mayo L, Carriedo-Lutzenkirchen A, Vandevijvere S, Barquera S. The INFORMAS healthy food environmemnt policy index (Food-EPI) in Mexico: An assessment of implementation gaps and priority recommendations. Obes Rev 2019; 20 (Suppl.2): 67-77.

Phulkerd S, Vandevijvere S, Lawrence M, Tangcharoensathien V, Sacks G. Level of implementation of best practice policies for creating healthy food environments: assessment by state and non-state actors in Thailand. Public Health Nutr 2017; 20(3): 381-390.

Romaniuk P, Kaczmarek K, Brukalo K, Grochowska-Niedworok E, Lobczowska K, Banik A, Lusczynska A, Poelman M, Harrington JM, Vandevijvere S et al. The healthy Food Environment Policy Index in Poland: Implementation gaps and actions for improvement. Foods 2022; 11(11): 1648.

Zaçe D, Di Pilla A, Silano M, Carini E, Cacciatore P, Frisicale EM, Vandevijere S, Sassi F, Specchia ML. Implementation lev l of best practice policies by Italian Government for healthier food environment: Healthy Food Environment Policy Index (Food-EPI). Ann Ist Super Sanita 2022; 58(1): 55-66.

Djojosoeparto SK, Kamphuis CBM, Vandevijvere S, Poelman MP. How can National Government policies improve food environments in the Netherlands? Int J Public Health 2022; 67: 1604115.

Djojosoeparto SK, Kamphuis CBM, Vandevijvere S, Murrin C, Stanley I, Romaniuk P, Harrington JM, Poelman MP, PEN Consortium. Strength of EU- level food environment policies and priority recommendations to create healthy food environments. Eur J Public Health 2022; 32(3): 504-511.

Von Philipsborn P, Geffert K, Klinger C, Hebelstreit A, Stratil J, Rehfuess EA, PEN Consortium. Nutrition policies in Germany: A systematic assessment with the Food Environment Policy Index. Public Health Nutr 2022; 25(6): 1691-1700.

Pineda E, Bascunan J, Sassi F. Improving the school food environment for the prevention of childhood obesity: What works and what doesn’t. Obes Rev 2021; 22(2): e13176.

Brown H, Kirkman S, Albani V, Goffe L, Akhter N, Hollingsworth B, von Hinke S, Lake A. The impact of school exclusion zone planning guidance on the number and type of food outlets in an English local authority: A longitudinal analysis. Health Place 2021; 70: 102600.

Rosales Chavez JB, Bruening M, Royer MF, Ohri-Vachaspati P, Lee RE, Jehn M. Availability, variety and distribution of healthy and unhealthy foods and beverages sold at street food stands in Mexico City. Public Health Nutrition 2021; 24(17): 5577-5588

Reyes M, Garmendia ML, Olivares S, Aqueveque C, Zacarías I, Corvalán C. Development of the Chilean front-of-package food warning label. BMC Public Health 2019; 19(1): 906.

Popkin BM, Ng SW. Sugar-sweetened beverage taxes: Lessons to date and the future of taxation. PLOS Med 2021; 18(1): e1003412.

European Comission. https://food.ec.europa.eu/horizontal-topics/farm-fork-strategy_en (acceso: 8 Agosto 2022).

Europe WROf. Improving dietary intake and achieving food product improvement. UK: Chatham House, 2020.

Rippin HL, Hutchinson J, Jewell J, Breda JJ, Cade JE. Assessing diet in European populations using national dietary surveys. Proc Nutr Soc 2020; 79(4): 531-41.

Freiler A, Muntaner C, Shankardass K, Mah CL, Molnar A, Renahy E, O’Campo P. Glossary for the implementation of Health in All Policies (HiAP). J Epidemiol Comm Health 2013; 67(12): 1068-1072.

Sharma LL, Teret SP, Brownell KD. The Food Industry and Self-Regulation: Standards to Promote Success and to Avoid Public Health Failures. Am J Public Health 2010; 100(2): 240-246.

Rippin HL, Hutchinson J, Evans CEL, Jewell J, Breda JJ, Cade JE. National nutrition surveys in Europe: a review on the current status in the 53 countries of the WHO European region. Food Nutr Res 2018; 62: doi: https://dx.doi.org/10.29219/fnr.v62.1362

Laar A, Barnes A, Aryeetey R, Tandoh A, Bash K, Mensah K, Zotor F, Vandevijvere S, Michelle Holdsworth. Implementation of healthy food environment policies to prevent nutrition-related non-communicable diseases in Ghana: National experts’ assessment of government action. Food Policy 2020; 93: 101907.

Branca F, Lartey A, Oenema S, Aguayo V, Stordalen GA, Richardson R, Arvelo M, Afshin A. Transforming the food system to fight non-communicable diseases. BMJ 2019; 364: l296.

Foundation TF. Food Environment Policy Index (Food-Epi) for England. London: The Food Foundation, 2016.

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Publicado

15-09-2023

Cómo citar

1.
Pineda E, Bouzas C, Arroyo M, Martínez JA, Tur JA. Priorización de políticas alimentarias en España mediante el Índice Food-EPI de entornos alimentarios saludables: panel de expertos: e202309076. Rev Esp Salud Pública [Internet]. 15 de septiembre de 2023 [citado 5 de noviembre de 2024];97:14 páginas. Disponible en: https://ojs.sanidad.gob.es/index.php/resp/article/view/156

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