Provision of healthy public food: leading by example

In 2017, an estimated 22% of all deaths and 15% disability-adjusted life-years (DALYs) globally were attributable to dietary risk factors, including high sodium sugar intake low consumption fruits vegetables, primarily through the promotion cardiovascular diseases. The scale this yearly burden—11 million 255 DALYs—positions nutrition at forefront global health agenda. Poor diet is also associated with lowered educational attainment productivity, propagating deprivation inequity for populations limited access healthy food drink options. Attempts improve nutritional quality consumed foods are hindered by multiple private sector interests disjointed public policy. Many sizeable potentially vulnerable heavily dependent on publicly provided food, schoolchildren, hospital care home patients staff, those working in other facilities. Unsurprisingly, meeting these demands requires considerable funding. England, free school meals, a resourced benefit which 1·4 children from low-income families eligible, cost around £600 2019. Given stakes, governments hold unique position responsibility: state should be adhere national international guidelines, policies support ideals. 2013 WHO Global Noncommunicable Disease Action Plan, key policy goal promoting was “Promote provision availability institutions schools, workplace”. Against backdrop, Framework guide countries developing or amending procurement service published Jan 12, 2021. guidance states that should, general, promote core principles diets: limit intake, increase whole grains, fruits, nuts, pulses, encourage unsaturated rather than saturated fats, ensure free, safe drinking water available. proposes considerations developing, implementing, monitoring policies. For instance, simply identifying priorities—eg, addressing childhood obesity—can selection school-based reduce sugars, salt. Similarly, mapping existing environment crucial identify non-overlapping future Monitoring evaluation steps, methods measure compliance, key. potential impacts optimised diverse substantial. Most obvious direct benefits produced malnutrition, reduction diet-related non-communicable These measures can therefore expenditure mitigate lost saving resources. A simulation low-sodium introduced County Los Angeles US$630 000 could saved each year reduced health-care costs. Additional might expected schools workplaces, given associations between improved outcomes workplace productivity. Public fresh, unprocessed sustainable producers has stimulate local economies, communities, influence wider practices. have already enacted polices South Korea, businesses banned selling classified as unhealthy based calorie, fat, content within 200 m designated schools. Singapore, government-organised events required offer plain default option, staple options must include grains. Numerous success stories notwithstanding, there still substantial room improvement, even high-income nations established recent furore over apparently nutritionally substandard meals schoolchildren England during COVID-19 pandemic reminder only robust implementation compliance allow. Cohesive action across society will burden disease, uniquely placed lead example.