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. 2022 Jun;25(6):1720-1732.
doi: 10.1017/S1368980021004900. Epub 2021 Dec 20.

An assessment of implementation gaps and priority recommendations on food environment policies: the Healthy Food Environment Policy Index in Japan

Miwa Yamaguchi  1 , Marika Nomura  1   2 , Yusuke Arai  3 , Stefanie Vandevijvere  4 , Boyd Swinburn  5 , Nobuo Nishi  1
Affiliations

An assessment of implementation gaps and priority recommendations on food environment policies: the Healthy Food Environment Policy Index in Japan

Miwa Yamaguchi et al. Public Health Nutr. 2022 Jun.

Abstract

Objective: The current study aimed to evaluate policies and actions for food environments by the Japanese Government using the Healthy Food Environment Policy Index (Food-EPI).

Design: Public health experts rated the extent of implementation of food environment-related Policy and the Infrastructure-support components, compared with international best practices. Subsequently, the experts proposed and prioritised future actions to address implementation gaps in an online workshop.

Setting: Japan.

Participants: A total of sixty-six experts rated policy implementation by the Japanese Government and twenty-three participated in the workshop on future actions.

Results: The implementations of regulations on unhealthy foods and non-alcoholic beverages were rated low in the domains of Food composition, Food labelling and Food promotion, Food prices and Food retail in the Policy component. The implementations of several domains in the Infrastructure-support component were, overall, rated at a higher level, specifically for monitoring and intelligence systems. Based on the rating, reducing health inequalities by supporting people, both economically and physically, was the highest priority for future actions in both components.

Conclusions: The current study found that Japan has a robust system for long-term monitoring of population health but lacks regulations on unhealthy foods and non-alcoholic beverages compared with international best practices. The current study confirmed the importance of continuous accumulation of evidence through national monitoring systems. Developing comprehensive regulations to restrict food marketing, sales and accessibility of unhealthy foods and non-alcoholic beverages is needed to improve the health of food environments in Japan.

Keywords: Food environments; Policy implementation; Priority actions; The Healthy Food Environment Policy Index.

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Figures

Fig. 1
Fig. 1
Components and domains of the Healthy Food Environment Policy Index (Food-EPI)
Fig. 2
Fig. 2
The protocol of the Healthy Food Environment Policy Index (Food-EPI) in Japan
Fig. 3
Fig. 3
Implementation level of indicators against international best practices in the Policy component and the Infrastructure-support component. COMP, Food composition; LABEL, Food labelling; PROMO, Food promotion; PRICES, Food prices; PROV, Food provision; RETAIL, Food retail; TRADE, Food trade and investment; LEAD, Leadership; GOVER, Governance; MONIT, Monitoring and intelligence; FUND, Funding and resources; PLATF, Platforms for interaction; HIAP, Health-in-all policies. The inter-rater reliability (IRR) and 95 % confidential interval (CI) was 0·44 (95 % CI: 0·38, 0·50) in overall, 0·65 (95 % CI: 0·58, 0·72) the Policy component and 0·44 (95 % CI: 0·36, 0·52) the Infrastructure-support component. The IRR in the academia group was 0·45 (95 % CI: 0·38, 0·53) and 0·49 (95 % CI: 0·41, 0·58) in the government experts
Fig. 4
Fig. 4
Priority of the importance and the achievability of policy actions in the Policy component
Fig. 5
Fig. 5
Priority of the importance and the achievability of policy actions in the Infrastructure-support component
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References

    1. World Health Organization (2018) Noncommunicable Diseases, Key Facts. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases (accessed May 2021).
    1. The Portal Site of Official Statistics of Japan: e-Stat & The Japanese Government Statistics (2020) The 2018 National Health and Nutrition Survey. https://www.e-stat.go.jp/stat-search/files?page=1&layout=datalist&toukei... (accessed May 2021).
    1. Ministry of Health, Labour and Welfare (2020) 2018 National Health and Nutrition Survey. https://www.mhlw.go.jp/content/000681199.pdf (accessed May 2021).
    1. World Health Organization (2016) Global Health Observatory (GHO) Data, Overweight and Obesity. https://www.who.int/gho/ncd/risk_factors/overweight_obesity/obesity_adul... (accessed May 2021).
    1. Director-General for Statistics, Information Policy and Policy Evaluation & Ministry of Health, Labour and Welfare, Japan (2018) Vital Statistics of Japan 2018. https://www.mhlw.go.jp/english/database/db-hw/dl/81-1a2en.pdf (accessed May 2021).

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