The European Union's fight against obesity must avoid top-down half measures

Against a global backdrop of runaway inflation, food insecurity and rising obesity, the Biden administration has recently announced a major conference on hunger, nutrition and public health that it will host in late September. The conference comes in the aftermath of the Covid-19 pandemic, whose disproportionately harsh impact on people with diet-related diseases, such as obesity, exposed the interplay between dietary habits and health, as well as food security and supply chain vulnerabilities.

As such, this high-profile event will bring together a wide range of actors – including school groups, environmental associations and nonprofits tackling hunger – to address the complex socio-economic and environmental factors that impede healthy nutrition and physical activity while fueling diet-related diseases. The US’s multidisciplinary and nuanced approach to food-related public health issues notably contrasts with the more blunt, top-down intervention on obesity and unhealthy lifestyles emerging in Europe.

Critical EU decision on healthy food: Nutri-score or another nutritional labelling scheme?

With an estimated one in five deaths around the world attributable to unhealthy food choices, improving dietary habits has understandably emerged as a top priority for governments and public health agencies. However, one of the leading European solutions to this slow-burning public health crisis risks leading its citizens astray.

The EU is currently considering candidates to implement as a bloc-wide Front-of-Package (FOP) food labelling system – which are designed to tackle obesity by providing simple nutritional value information to shoppers – and the France-backed Nutri-Score system has emerged as a clear frontrunner. Using an A-to-E, green-to-red grading system, Nutri-Score evaluates a product’s supposed healthiness based on its sugar, sodium and fat content per 100g/ml serving.

The problem is that its flawed, reductive algorithm and arbitrary serving size fail to capture the broader healthiness of a product when consumed in proper portions as part of a balanced diet. This is how Mediterranean diet staples, like olive oil, receive “C” Nutri-Scores, while certain ultra-processed products, such as Chocapic cereal, receive a “green A.” The Italian Competition Authority (ICA) banned Nutri-score from Italian supermarkets in August for this misleading quality, which it has ruled risks giving consumers the false impression that high-scoring products can be healthily consumed in large quantities.

Supporting the ICA’s concerns on Nutri-score’s dubious scientific basis, a new study has found that existing research on its health impact fails to meet the European Food Safety Authority’s (EFSA) evidential standards for food health claims. The EU would therefore be wise to wait for additional studies before rushing into an ill-informed decision on a bloc-wide FOP.

Urban design and development interventions

Rather than imposing top-down, absolutist policies, the EU should approach obesity from a more multi-disciplinary and grassroots perspective. As eminent French doctor and nutritionist Jean-Michel Lecerf has argued, obesity is a “socio-economic problem, not an agri-food problem,” given that 20% of the population cannot afford healthy products, so solutions must tackle the root causes.

Urban design is one of the underlying factors that impacts public health by either connecting or cutting people off from healthy food sources and outdoor spaces, as a new World Health Organisation (WHO) Europe report has highlighted. By integrating urban design interventions in public health policy, governments can avoid patronising their citizens with directives on the “right” ways to eat and instead create opportunities for them to make healthier choices.

Mapping projects can help cities identify food deserts, as well as underused existing food outlets that could be mobilized to fill these gaps. Local governments can then lead economic development initiatives to attract fresh food shops to these underserved communities, including by incentivizing local businesses to sell healthy foods and converting abandoned spaces into local food production and retail sites.

In Copenhagen, the “Shifting Urban Diets” project combined neighbourhood-level mapping of the food ecosystem, analysis of its infrastructure’s influence on residents’ food choices, urban design improvements and the creation of new healthy food retailers to promote healthy diets. These types of projects play a crucial role in tackling food deserts and poverty, which is particularly urgent given the emerging cost-of-living crisis.

Beyond improving diets, cities can use urban design to encourage physical activity. For example, in Tbilisi, the city redesigned its car-focused streets to facilitate active travel and boost public health. The EU Commission already has a sustainable urban mobility capacity-building platform in place for cities, and this support should be expanded to roll out similar “healthy streets” initiatives across the bloc.

Education and skills-based approaches

While urban design and development initiatives provide physical and financial access to healthy foods, projects are also needed to build knowledge and skills. Educational projects on food growing and healthy meal preparation have a key role to play in tackling obesity by generating real interest in healthy food and empowering people.

The FoodE initiative, led by the University of Bologna with funding from EU Horizon 2020 programme, scales up grassroots, community-led urban food projects and offers a strong example to replicate. For example, the Cité Maraîchère vertical greenhouse – its project in Romainville, France – combines the provision of healthy, affordable and locally-produced food with educational workshops on sustainable food and food-related vocational training.

And in Lisbon, the city has promoted healthy eating by dedicating more of its public spaces to urban food growing, with an important educational component that teaches residents how to grow vegetables in urban community gardens, as well as the importance of healthy dietary choices. Moving forward, the EU should boost its financial and technical support of grassroots healthy food initiatives across the EU, targeting food deserts and areas with higher levels of obesity.

With both obesity and food insecurity on the rise, attempts to tackle these problems must recognise their multifaceted nature. By involving experts from a variety of relevant disciplines, the Biden Administration has demonstrated an encouragingly progressive vision on the problem. Instead of implementing misguided food policies that fail to empower and truly educate its citizens, the EU would do well to emulate the US approach by addressing the complex underlying drivers of unhealthy diets and obesity.

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Gary Cartwright

Gary Cartwright

Gary Cartwright is publishing editor and Brussels correspondent of EU Today.

An experienced journalist and author, he specialises in environment, energy, and defence.

He also has more than 10 years experience of working as a staff member in the EU institutions, working with political groups and MEPs in various policy areas.

In October 2021 POLITICO described Gary as "the busiest man in Brussels!"

He is a of member the Chartered Institute of Journalists, a professional association for journalists, the senior such body in the UK, and the oldest in the world having been founded in October 1884

Gary's most recent book WANTED MAN: THE STORY OF MUKHTAR ABLYAZOV: A Manual for Criminals on How to Avoid Punishment in the EU is currently available from Amazon

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