Mark Lawrence

• PhD
• Professor at Deakin University

Objective Ultra-processed beverages (UPBs) have known adverse impacts on health, but their impact on the environment is not well understood across different environmental indicators. This study aimed to quantify the environmental impacts of water-based UPBs and bottled waters sold in Australia and assess the impacts of various scenarios which may r...

The World Health Organization ExpandNet framework for scaling up contains key recommendations to support the scaling of health interventions globally. Despite being widely used, it is not known how the framework informs intervention scale-up nor how ‘successful’ scale-up is defined. Using data from the Scaling Up InTErventions’ study, this paper as...

Growing evidence suggests that diets high in ultra-processed foods (UPFs) are harming human and planetary health. UPFs therefore pose a complex regulatory challenge, yet, to date, little research has systematically assessed how governments have responded to UPFs in national food policies. Here we analyse data from the NOURISHING database to assess...

Background/aim Building on the evidence for multifaceted effects of different nutrients, foods and dietary patterns is a new priority for nutrition science. This review aims to describe the causal pathways and biological mechanisms that elucidate the associations between different nutrition exposures (nutrients, foods and dietary patterns) and heal...

Background: The importance of the international food regulatory system to global health, is often overlooked. There are calls to reform this system to promote healthy and sustainable food systems centred on the Codex Alimentarius Commission (Codex), the United Nation's (UN's) standard-setting body. Yet this presents a significant political challeng...

Achieving sustainable Australian food and land systems requires the rapid implementation and scaling up of a broad suite of solutions to meet the Sustainable Development Goals (SDGs). Decision-making frameworks are needed to identify suitable indicators and prioritise solutions at national scales to inform sustainability transitions. Using a knowle...

Our aim was to conduct an umbrella review of evidence from meta-analyses of observational studies investigating the link between sugar-sweetened beverage consumption and human health outcomes. Using predefined evidence classification criteria, we evaluated evidence from 47 meta-analyses encompassing 22,055,269 individuals. Overall, 79% of these ana...

The Codex Alimentarius Commission (Codex) has a substantial influence over the structure and operation of food systems by setting international standards that affect the composition, structure and labelling of food. Despite the dual mandates of Codex to protect public health and ensure fair practices in food trade, food systems are increasingly unh...

The rise of multi-stakeholder institutions (MIs) involving the ultra-processed food (UPF) industry has raised concerns among food and public health scholars, especially with regards to enhancing the legitimacy and influence of transnational food corporations in global food governance (GFG) spaces. However, few studies have investigated the governan...

A range of metrics have been developed and used to measure components of dietary patterns (e.g., adequacy, quality, diversity). However, no existing dietary metric simultaneously captures the three key dimensions of sustainable healthy diets recommended by the Food and Agriculture Organization of the United Nations and the World Health Organization...

Objective To evaluate the existing meta-analytic evidence of associations between exposure to ultra-processed foods, as defined by the Nova food classification system, and adverse health outcomes. Design Systematic umbrella review of existing meta-analyses. Data sources MEDLINE, PsycINFO, Embase, and the Cochrane Database of Systematic Reviews, a...

Background A major challenge to transforming food systems to promote human health and sustainable development is the global rise in the manufacture and consumption of ultra-processed foods (UPFs). A key driver of this dietary transition is the globalization of UPF corporations, and their organized corporate political activity (CPA) intended to coun...

Objective Despite commitment by many countries to promote food system transformation, Australia has yet to adopt a national food policy. This study aimed to evaluate Australian Federal Government’s (AFG) food policies and policy actions potential to promote healthy and sustainable food systems. Design This study is a desk-based policy mapping foll...

In recent decades, multi-stakeholder institutions (MIs) involving the ultra-processed food (UPF) industry have presented themselves as "part of the solution" to addressing malnutrition and other food systems sustainability challenges. This has raised concerns for many health and global food governance (GFG) scholars; however, few studies have inves...

In recent decades, multi-stakeholder institutions (MIs) involving the ultra-processed food (UPF) industry have presented themselves as "part of the solution" to addressing malnutrition and other food systems sustainability challenges. This has raised concerns for many health and global food governance (GFG) scholars; however, few studies have inves...

Background A major challenge to transforming food systems to promote human health and sustainable development is the global rise in the manufacture and consumption of ultra-processed foods (UPFs). A key driver of this dietary transition is the globalization of UPF corporations, and their organized corporate political activity (CPA) intended to coun...

The rise of ultra-processed foods (UPFs) in diets and associated harms to human and planetary health, has prompted calls for regulatory action. This challenges the approach of food regulatory systems that emphasize food safety risks over wider harms to population and ecological health and confronts the interests of a powerful UPF industry. To under...

Background Earth and all its inhabitants are threatened by a planetary crisis; including climate change, deforestation, biodiversity loss and pollution. Dietitians and nutrition professionals have a responsibility to lead transformational change in contemporary food and health systems to help mitigate this crisis. The study aims to develop a concep...

The sustainable transformation of food and land systems requires the rapid implementation and scaling up of a broad suite of solutions to meet the Sustainable Development Goals (SDGs). Decision-making frameworks are needed to identify suitable indicators and prioritise solutions at national scales. Using a knowledge co-production framework, we conv...

Background Ultra-processed foods (UPF) are associated with adverse health outcomes. This study aimed to analyse the national trends in retail sales, consumer expenditure and nutritional quality of UPFs in Thailand. Methods The study used data from the Euromonitor Passport database for analysis of retail sales and consumer expenditure, and from the...

Objective: To evaluate the existing meta-analytic evidence of associations between exposure to ultra-processed foods, as defined by the Nova food classification system, and adverse health outcomes. Design: Systematic umbrella review of existing meta-analyses. Data Sources: MEDLINE, PsycINFO, Embase, and the Cochrane Database of Systematic Reviews,...

[This corrects the article DOI: 10.3389/fnut.2023.1071356.].

Introduction This study aimed to assess the nutritional quality of food and beverage products in Thailand by comparing four different food classification systems: the nutrient profiling-based food classification systems by the Department of Health (DOH), the WHO South-East Asia Region (WHO SEA), the Healthier Choice Logo (HCL), and the food-process...

Using group model building we developed a series of causal loop diagrams identifying the environmental impacts of ultra-processed food (UPF) systems, and underlying system drivers, which was subsequently validated against the peer-reviewed literature. The final conceptual model displays the commercial, biological and social drivers of the UPF syste...

We aimed to understand the process of setting or varying food standards related to non-nutritive sweeteners (NNS) in Australia and New Zealand. Overconsumption of added sugars is a risk factor for non-communicable diseases. Limiting added sugar consumption is recommended by the World Health Organization. NNS are sweet substances with little to no e...

Nutrient Profiling Systems provide frameworks to assess the healthfulness of foods based on food composition and are intended as inputs into strategies to improve diets. Many Nutrient Profiling Systems are founded on a reductionist assumption that the healthfulness of foods is determined by the sum of their individual nutrients, with no considerati...

Unhealthy diets are a leading risk factor for non-communicable diseases and negatively impact environmental sustainability. Policy actions recommended to address dietary risk factors, such as restrictions on marketing and front-of-pack labelling, are informed by nutrition classification schemes (NCSs). Ultra-processed foods are associated with adve...

Many are calling for transformative food systems changes to promote population and planetary health. Yet there is a lack of research that considers whether current food policy frameworks and regulatory approaches are suited to tackle whole of food systems challenges. One such challenge is responding to the rise of ultra-processed foods (UPF) in hum...

Building on an extensive review of the literature and expert elicitation using group model building, we developed a series of causal loop diagrams identifying the environmental impacts of ultra-processed food (UPF) systems, and underlying system drivers. The final conceptual model displays the commercial, biological and social drivers of the UPF sy...

Modern nutrition science began approximately 100 years ago in the context of nutrient deficiency diseases. Nutrition research and policy activities were framed mostly within a reductionist paradigm in which foods were analysed as being a collection of their constituent nutrients. Today, nutrition problems extend to all forms of malnutrition as well...

Modern nutrition science began approximately 100 years ago in the context of nutrient deficiency diseases. Nutrition research and policy activities were framed mostly within a reductionist paradigm in which foods were analysed as being a collection of their constituent nutrients. Today, nutrition problems extend to all forms of malnutrition as well...

Objective: The choice of terms used to describe 'foods to limit' (FTL) in food-based dietary guidelines (FBDGs) can impact public understanding, policy translation and research applicability. The choice of terms in FBDGs have been influenced by available science, values, beliefs and historical events. This study aimed to analyse the terms used and...

Food-based dietary guidelines (FBDGs) provide country-specific guidance on what constitutes a healthy diet. With increasing evidence for the synergy between human and planetary health, FBDGs have started to consider the environmental sustainability of food choices. However, the number of countries that discuss environmental sustainability in their...

Comprehensive metrics that provide a measure of dietary patterns at global and national levels are needed to inform and assess the effectiveness of policy actions that promote sustainable healthy diets. In 2019, the Food and Agriculture Organization of the United Nations and the World Health Organization reported 16 guiding principles of sustainabl...

Population ageing and climate change are issues of global concern. Subsequently, the need for healthy and sustainable food systems to meet the increasing demands for health and aged care is evident. This review aimed to systematically identify studies reporting new or innovative foods, drinks and snack products in health and aged care, and describe...

Dietary guidelines should be underpinned by high-quality evidence. Quality assessment methods that reflect traditional evidence hierarchies prioritise evidence from randomised controlled trials (RCTs). The Hierarchies of Evidence Applied to Lifestyle Medicine (HEALM) approach is an alternative quality assessment method for research questions that f...

Background Sustainable diets, as a concept, was the status quo of human existence from time immemorial. Modern agriculture and industrial food systems of the 20th century had displaced the notion, until the alarming consequences of unsustainable food production and consumption started manifesting as harm to both human and ecosystem health. Scope a...

Multiple reports from international organisations and expert groups call for reductions in production and consumption of red and processed meat (RPM) to attenuate associated health and environmental harms. Policymakers have given limited attention to the issue and public discourse on the topic is contentious. The framing of RPM as a policy issue by...

Background While moderate amounts of meat have nutritional benefits, diets high in meat are contributing to adverse health and environmental outcomes, including environmental degradation, high greenhouse gas emissions, and the increasing the global burden of chronic disease. Authoritative organisations have repeatedly called for significant reducti...

Objective The health implications of excessive added sugar intakes have led to national policy actions to limit their consumption. Subsequently, non-nutritive sweeteners (NNS) may be used to maintain product sweetness. We aimed to assess trends in quantities of added sugars and NNS sold in packaged food and beverages worldwide, and the association...

Background Policy makers are increasingly using nutrition classification schemes (NCSs) to assess a food's health potential for informing nutrition policy actions. However, there is wide variability among the NCSs implemented and no standard benchmark against which their contrasting assessments can be validated. Objective This study aimed to compa...

Minimising environmental impacts and prioritising the production of nutritious foods are essential qualities of a sustainable food system. Ultra-processed foods (UFPs) are potentially counterproductive to these objectives. This review aims to summarise the magnitude and types of environmental impacts resulting from each stage of the UPF supply chai...

Purpose To investigate intake levels of nutrients linked to non-communicable diseases in Australia using the novel combination of food processing and nutrient profiling metrics of the PAHO Nutrient Profile Model. Methods Dietary intakes of 12,153 participants from the Australian Health Survey (2011–12) aged 2 + years were evaluated. Food items rep...

The use of dietary pattern assessment methods has increased over time. However, data from individual studies can be difficult to compare and synthesize when the dietary pattern assessment methods, and the dietary patterns that are identified are not described sufficiently. The aims of this systematic review were to analyze the application and repor...

Background Scaling up population health interventions is a context-orientated, dynamic and multi-stakeholder process; understanding its influences is essential to enhance future scaling efforts. Using physical activity and nutrition interventions in Australia as case examples, the aim of this paper is to identify core influences involved in scaling...

Addressing overconsumption of protein-rich foods from high ecological footprint sources can have positive impacts on health such as reduction of non-communicable disease risk and protecting the natural environment. With the increased attention towards development of ecologically sustainable diets, this systematic review aimed to critically review l...

Today's food systems are driving several intersecting public health and ecological crises of global concern. Acknowledging this, numerous major reports have made wide-ranging recommendations for achieving ‘transformative’ food systems change. However, no studies have yet analysed the transformative potential of these recommendations. Here we undert...

Nutrient Profiling Systems provide algorithms which are designed to assess the healthfulness of foods based on nutrient composition, and intended as a strategy to improve diets. Many Nutrient Profiling Systems are founded on a reductionist assumption that the healthfulness of foods is determined by the sum of their nutrients, with little considerat...

It is the position of Dietitians Australia that to promote human and planetary health, a food system transformation is needed that enables the population to adopt healthy and sustainable diet‐related practices. A healthy and sustainable diet must (i) be nutritionally adequate, healthy and safe, (ii) have low environmental impact and be protective o...

Objective This study aimed to critically analyse Australia’s current and proposed policy actions to reduce added sugar consumption. Over-consumption of added sugar is a significant public health nutrition issue. The competing interests, values and beliefs among stakeholders means they have disparate views regarding which policy actions are preferab...

Background: Breastfeeding is important for the health and development of the child, and for maternal health, in all country contexts. However, global sales of breast-milk substitutes (BMS), including infant, follow-up and toddler formulas, have 'boomed' in recent decades. This raises the importance of international food standards established by th...

Background The aggressive marketing of breastmilk substitutes (BMS) reduces breastfeeding, and harms child and maternal health globally. Yet forty years after the World Health Assembly adopted the International Code of Marketing of Breast-milk Substitutes (The Code), many countries are still to fully implement its provisions into national law. Furt...

Dietary guidelines are important nutrition policy reference standards that should be informed by the best available evidence. The types of evidence that are reviewed and the evidence review methods that are used have implications for evidence translation. The aim of this study was to explore perceived advantages, disadvantages, and practicalities a...

Balancing the adoption of environmentally sustainable food systems in Australian healthcare and aged care settings whilst meeting nutritional requirements has never been more critical. This scoping review aimed to identify: the major authoritative reports/guidelines related to healthy and environmentally sustainable food procurement and foodservice...

Objective Diets high in red and processed meat (RPM) contribute substantially to environmental degradation, greenhouse gas emissions, and the global burden of chronic disease. High-profile reports have called for significant global RPM reduction, especially in high-income settings. Despite this, policy attention and political priority for the issue...

Background Dietary guidelines should be informed by evidence from dietary patterns research. However, variation in the methods used to assess and report dietary patterns can make this type of evidence difficult to synthesise. The aim of this systematic review was to analyse the methods used to assess and report dietary patterns. Methods Literature...

Despite a significant commitment to tackling childhood overweight and obesity, questions remain about the progress the Thai Government has made in implementing childhood obesity prevention policies and actions. This study aimed to review and assess the implementation of the gov-ernment's policies and actions for childhood obesity prevention in Thai...

Background The global milk formula market has ‘boomed’ in recent decades, raising serious concerns for breastfeeding, and child and maternal health. Despite these developments, few studies have investigated the global expansion of the baby food industry, nor the market and political practices corporations have used to grow and sustain their markets...

Background Sustainable shifts in population behaviours require system-level implementation and embeddedness of large-scale health interventions. This paper aims to understand how different contexts of scaling up interventions affect mechanisms to produce intended and unintended scale up outcomes. Methods A mixed method study combining a realist pe...

Dietary risk factors, including excess added sugar intake, are leading contributors to Australia’s burden of disease. An objective of the Australian Health Star Rating (HSR) system is to encourage the reformulation of packaged foods. Manufacturers may improve a product’s HSR by replacing added sugar with non-nutritive sweeteners (NNS). Concerns hav...

Consumption of healthy and sustainable diets (HSD) provides opportunities to co-benefit human health and adapt to and mitigate climate change. Despite robust evidence and policy recommendations from authoritative groups to reorientate the food system to favour consumption of HSD there has been limited policy action. This study investigated potentia...

This research aimed to understand how the policy was represented as a ‘problem’ in food regulatory decision-making in Australia, and the implications for public health nutrition engagement with policy development processes. Bacchi’s ‘what’s the problem represented to be?’ discourse analysis method was applied to a case study of voluntary food forti...

Background: Diets high in red and processed meat (RPM) contribute substantially to environmental degradation, greenhouse gas (GHG) emissions, and the global burden of chronic disease. Recent high-profile reports from international expert bodies have called for a significant reduction in global dietary meat intake, particularly RPM, especially in h...

Background Healthy diets promote optimal growth and development and prevent malnutrition in all its forms, including undernutrition, obesity, and diet-related noncommunicable diseases (NCDs). Objective This background paper for the International Expert Consultation on Sustainable Healthy Diets characterizes healthy diets and their implications for...

This letter appeared in the Public Health Nutrition journal in response to Carlos Monteiro's first publication of the ultra-processed food concept, also in that journal.

Poor diets, including excess added sugar consumption, contribute to the global burden of disease. Subsequently, many nutrition policies have been implemented to reduce added sugar intake and improve population health, including taxes, education, labelling and environmental interventions. A potential consequence of these policy actions is the substi...

Objective: A comprehensive nutrition policy containing a broad package of cross-sector and synergistic policy actions is required to attenuate the systemic drivers of poor nutrition. The current study aims to critically analyse trends in the scope of federal nutrition policy actions in Australia between 2007 and 2018 by: (1) describing the changes...

Dietary guidelines should be underpinned by the best available evidence on relationships between diet and health, including evidence from nutrient-based, food-based, and dietary patterns research. The primary aim of this study was to analyse the systematic reviews conducted to inform the 2013 Australian Dietary Guidelines according to dietary expos...

Understanding the drivers and dynamics of global ultra‐processed food (UPF) consumption is essential, given the evidence linking these foods with adverse health outcomes. In this synthesis review, we take two steps. First, we quantify per capita volumes and trends in UPF sales, and ingredients (sweeteners, fats, sodium and cosmetic additives) suppl...

The nutrition literature and authoritative reports increasingly recognise the concept of ultra-processed foods (UPF), as a descriptor of unhealthy diets. UPFs are now prevalent in diets worldwide. This review aims to identify and appraise the studies on healthy participants that investigated associations between levels of UPF consumption and health...

Objective With significant shifts in the dietary recommendations between the 2007 and 2019 Canadian dietary guidelines, such as promoting plant-based food intake, reducing highly processed food intake and advocating the practice of food skills, we compared their differences in guideline development methods. Design Two reviewers used twenty-five gu...

Nutrient-based indices are commonly used to assess the health potential of individual foods for nutrition policy actions. This study aimed to evaluate the nutrient profile-informed Australian Health Star Rating (HSR), against NOVA and an index informed by the Australian Dietary Guidelines (ADGs), to determine the extent of alignment. All products d...

Objective Junk-food marketing contributes significantly to childhood obesity, which in turn imposes major health and economic burdens. Despite this, political priority for addressing junk-food marketing has been weak in many countries. Competing interests, worldviews and beliefs of stakeholders involved with the issue contribute to this political i...

Dietary change has been suggested as a key strategy to maintain food security, improve health and reduce environmental impacts in the face of rising populations, resource scarcity and climate change impacts, particularly in developed countries. This paper presents findings from a quantitative modelling analysis of food availability and environmenta...

Sustainable, resilient food systems for healthy diets: the transformation agenda - Volume 22 Issue 16 - Mark Andrew Lawrence, Phillip Ian Baker, Claire Elizabeth Pulker, Christina Mary Pollard