research is needed to understand the exact consequences for health and nutrition in the contexts of high-, middle- and low-income countries, as well as different population groups based on socioeconomic status, geographical location (urban or rural), ethnic background, gender and other characteristics.
More research should also facilitate the identification of a clearer link between digital food environments and the broader food system, including the dimensions of food access and affordability, as well as food safety, to improve the conceptual framework proposed here.
Even so, based on current knowledge, it is possible to derive some policy implications by identifying areas where advancements can be made. These include:
• the regulation of digital marketing of unhealthy foods and beverages to children;
• guidelines and/or codes of conduct for digital influencers sharing nutrition-related information on social media and participating in digital food marketing;
• health and nutrition literacy promotion to enable people to critically assess the information to which they are exposed through digital technology;
• increased overall digital literacy, so people can better understand how their lives are impacted by the digital technology that surrounds them; and
• consideration by governments of digital technology as platforms for health-promotion efforts, including nutrition and physical activity, in their policies and strategies to achieve national and global nutrition targets and goals.
CONCLUSION
Promoting healthy food environments is a crucial measure in addressing the multiple burden of nutritional problems, from undernutrition to obesity and NCDs. The existing approach to food environments has paid little heed to the increasing role of digital technology and the internet in daily life, and to the particularities of the digital world in influencing health and nutrition, even though the attention on digital food marketing has appropriately increased in recent years. In this article, we propose that a digital food environment has been created that augments the complexity and intensity of the effects of food environments on the health and nutrition status of individuals and populations. This is an emerging field of research and the exact consequences for health and nutrition in the different contexts of high-, middle- and low-income countries and different population groups, as well as the policy implications, need to be further investigated and discussed.
ACKNOWLEDGEMENTS
Miranda Thurston, Liv Elin Torheim and Laura Terragni provided advice and comments on earlier drafts of this article.
FUNDING
This research is fully funded by the Inland Norway University of Applied Sciences.
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ABSTRACT
There is substantial evidence of the need for efforts to drastically shift the food system to enable eating patterns consistent with human and planetary health. This will have implications for food production, processing, distribution and consumption. Eating patterns low in fruit, vegetables, whole grains, nuts and seeds and omega-3 fatty acids are contributing to morbidity and mortality around the world. This highlights the need for interventions to increase accessibility to foods that are currently under-consumed relative to recommendations.
However, some of those foods are not produced in sufficient quantity, while others are being consumed at an environmentally unsustainable rate. Consequently, food-based dietary guidelines, traditionally aimed at providing evidence-based recommendations for healthy eating, appear to be evolving towards a holistic approach that embraces the complexity of eating patterns, the roles they play in society and the factors that influence them, as well as environmental sustainability considerations. The recent update to Canada’s Food Guide has taken such an approach, providing an opportunity to consider the extent to which such food-based dietary guidelines can support strategies to transform the food system.
INTRODUCTION
Dietary risk factors, such as inadequate intake of fruit, vegetables, nuts and seeds, whole grains and omega-3 fatty acids and excessive intake of sodium, have been shown to be responsible for more deaths than any other risk factor (Afshin et al., 2019). At the same time, there is a growing body of literature documenting the non-trivial contribution
of eating patterns to climate change, biodiversity loss, water scarcity and deforestation (Friel et al., 2014; Willett et al., 2019). As we learn more about how influences in the outer rings of the social-ecological model (including foods and beverages offered in a range of settings) shape our eating patterns (Hawkes et al., 2013; Swinburn et al., 2013), the growing body of evidence has spurred efforts to transform the food system and the food environments within (Swinburn et al., 2013; Afshin et al., 2019; Willett et al., 2019).
In this context, it is relevant to consider food-based dietary guidelines (FBDGs) and the role they may play in influencing the food system. FBDGs are considered important in promoting healthy eating patterns among populations and placing nutrition concerns on national and regional agendas (WHO and FAO, 1998). We draw on Canada’s recently updated FBDGs (Health Canada, 2019a; 2019b) in considering whether such guidelines may support food-system transformation to enable healthy and sustainable eating patterns, defined as “diets with low environmental impacts which contribute to food and nutrition security and to healthy life for present and future generations” (FAO, 2010).