CO-CREATE's NOURISHING & MOVING policy indexes & country snapshots
Building on the existing NOURISHING (nutrition) and MOVING (physical activity) frameworks, two policy indexes have been developed that assess and compare national government policy action on nutrition and physical activity across Europe.
In Europe, overweight and obesity affect one in five adolescents. Overweight in adolescence is accompanied by a range of health consequences and risks which continue into adulthood (such as an increased likelihood of noncommunicable diseases), as well as having social and economic implications for the individual.
Research conducted as part of the CO-CREATE project aims to support improved government policy action in the areas of nutrition and physical activity. Building on the existing NOURISHING (nutrition) and MOVING (physical activity) frameworks, two policy indexes (see NOURISHING and MOVING) have been developed that assess and compare national government policy action on nutrition and physical activity across Europe. A set of country snapshots (see nutrition policy snapshots and physical activity policy snapshots) have also been produced that offer a closer look at the policy status in each of the 30 European countries included in the index.
The policy indexes are produced by assessing implemented policies across each area of the NOURISHING and MOVING frameworks against aspirational, evidence- based benchmarks or standards that assess policy design. The standards are aspirational in that they do not measure countries against current best practice – because we know that current best efforts to prevent NCDs are insufficient. The overall policy index results rate countries in five categories, from poor to excellent.
In the NOURISHING index results, four policy areas were assessed as having moderate or good policy design across most of the 30 countries: nutrition labelling, standards for healthy foods in schools and other public settings, setting nutrient limits or targets for the improvement and reformulation of food products, and policies to inform people on healthy eating.
The NOURISHING policy areas that are consistently rated as poor or fair are: restrictions on advertising and marketing of unhealthy foods to young people, as well as nutrition education and skills e.g in schools, and nutrition counselling in healthcare settings.
Finally, there is insufficient national government action across Europe on: using economic tools to address food affordability and purchase incentives, ensuring coherence between food supply chains and health, and setting incentives and rules to create a healthy retail and food service environment.
In the MOVING index results, three policy areas were assessed mostly as moderate or good: promoting physical activity in schools and the wider community, offering physical activity opportunities in the workplace (and training in physical activity promotion across multiple professions), and public communication policies which build behaviour change skills. In contrast, national government actions were assessed as poor or fair on the two MOVING policy areas that target the active environment, specifically: structures and surroundings which promote physical activity, and transport infrastructure and other opportunities that support active societies. Finally, there was least national government action taken on physical activity training, assessment and counselling in healthcare settings, with little to no focus on training for healthcare professionals in this area.
Potential applications of the Indexes
The indexes can serve as effective advocacy support tools, and provide insightful learnings to a series of actors, from young people to academia as to how European countries are performing in nutrition and physical activity policymaking.
Professor Knut-Inge Klepp, Executive Director at the Norwegian Institute of Public Health and lead project investigator of CO-CREATE says:
‘‘Policy actions that promote improved nutrition and physical activity are essential in turning the tide against rising childhood obesity rates. NOURISHING and MOVING are important policy tools which, through the NOURISHING & MOVING benchmarking tools and policy index, highlight where national governments need to do better in nutrition and physical activity policy design. They enable national governments to see how they compare to other European countries. This monitoring and accountability work is vital in improving population health.’’
Policymakers can utilise the policy design criteria to improve current policies (in particular, structural policies), to identify gaps at national levels, and identify opportunities for action at local and regional level.
Civil society, including youth groups, can identify weaknesses in the current policy status. These weaknesses can inform advocacy efforts to improve policy action by national governments to lower the current and future rates of overweight and obesity.
Researchers can compare higher-scoring and lower-scoring countries to identify how existing policies can be improved to meet aspirational standards. They can also identify where results could be supplemented by additional analyses at local level and in other specific settings.