Policy implementation and priorities to create healthy food environments using the Healthy Food Environment Policy Index (Food-EPI): A pooled level analysis across eleven European countries.

Background: Food environments have been recognised as highly influential on population diets. Government policies have great potential to create healthy food environments to promote healthy diets. This study aimed to evaluate food environment policy implementation in European countries and identify priority actions for governments to create healthy food environments. Methods: The Healthy Food Environment Policy Index (Food-EPI) was used to evaluate the level of food environment policy and infrastructure support implementation in Estonia, Finland, Germany, Ireland, Italy, the Netherlands, Norway, Poland, Portugal, Slovenia, and Spain in 2019-2021. Evidence of implementation of food environment policies was compiled in each country and validated by government officials. National experts evaluated the implementation of policies and identified priority recommendations. Findings: Finland had the highest proportion (32%, n = 7/22) of policies shaping food environments with a "high" level of implementation. Slovenia and Poland had the highest proportion of policies rated at very low implementation (42%, n = 10/24 and 36%, n = 9/25 respectively). Policies regarding food provision, promotion, retail, funding, monitoring, and health in all policies were identified as the most important gaps across the European countries. Experts recommended immediate action on setting standards for nutrients of concern in processed foods, improvement of school food environments, fruit and vegetable subsidies, unhealthy food and beverage taxation, and restrictions on unhealthy food marketing to children. Interpretation: Immediate implementation of policies and infrastructure support that prioritize action towards healthy food environments is urgently required to tackle the burden of obesity and diet-related non-communicable diseases in Europe. Funding: This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 774548 and from the Joint Programming Initiative "A Healthy Diet for a Healthy Life".

Changes in healthy food habits after transition to old age retirement.

BACKGROUND: Retirement is one of the major transitions in the life course. However, it is poorly understood how health behaviours, such as food habits, might change after retirement. This study aimed to examine whether healthy food habits change after the transition to old age retirement and whether socio-demographic or health-related factors explain the association between retirement, being continuously employed and healthy food habits at follow-up. METHODS: The data were derived from the Helsinki Health Study cohort on the staff of the City of Helsinki, Finland. The baseline questionnaire survey data were collected in 2000-02 and the follow-up in 2007. We included only participants who were aged 55-60 years at baseline and entered old age retirement during the follow-up (n = 1156, 76% women) or remained continuously employed (n = 1269, 79% women). Food habits from a food frequency questionnaire included eight items formed according to the Finnish and Nordic dietary recommendations. Logistic regression models were fitted to examine the associations between retirement, being continuously employed and healthy food habits at follow-up. RESULTS: Healthy food habits increased more among retired women than those continuously employed (P = 0.03). At follow-up retired women had healthier food habits than continuously employed women after adjusting for baseline food habits [OR = 1.36 (1.12-1.65)]. Among men, healthy food habits were unassociated with retirement. CONCLUSION: Transition to old age retirement is likely to have beneficial effects on food habits among women. This helps prevent major diseases and supports better public health among ageing people.