Food Futures: A detailed study protocol for combining a food systems approach and public health nutrition

Global nutrition is in a state of crisis; 842 million people worldwide are undernourished, while simultaneously the number of overweight and obese individuals increased to 2.1 billion in 2013. Furthermore, the widespread of non-communicable disease is one of the biggest societal problems globally. Our highly commercialized food system promotes overconsumption of foods that are harmful for both public health and the environment and there is growing support for a closer look into this system to find sustainable solutions. This paper outlines a study protocol on innovative research combining systems approaches and public health nutrition. The aim of this research is twofold: 1) Develop a food systems approach for public health nutrition; 2) Examine the operation of the food system to inform the design of sustainable public health nutrition interventions. This programme of research is divided into three phases: A) Availability and affordability of food; B) Determinants of (healthy) food availability and affordability; and C) Food system intervention development. The proposed research is unique in that it combines established systems methods with public health by using New Zealand (NZ) case studies with a global perspective. Phase A forms the fundament of this research combining a series of smaller projects examining food availability, affordability and healthiness in NZ, within an international context. Phase B will use Global Value Chain Analysis (GVCA) to examine potatoes and potato products and identify different attributes of value, including both health and monetary values, as products move through the chain. Industrial processing mostly increases the monetary value of products, but simultaneously diminishes the nutritional value (e.g., whole potatoes versus potato crisps). The GVCA will give a detailed overview of how potatoes move along the food chain, how this relates to health and monetary value, who the key players are and how decisions are made. Finally, Phase C aims to combine Group Model Building methods with a Delphi Study design to explore power dimensions and identify sustainable food system public health interventions. The ultimate goal of this research is to reveal how public health can be integrated in the food system instead of having to work against it.