Phillip Baker

• BSc, PGDipHSc, MHSc, PhD
• ARC Future Fellow / Sydney Horizon Fellow at The University of Sydney

Introduction Generating country-level political commitment will be critical to driving forward action throughout the United Nations Decade of Action on Nutrition (2016–2025). In this review of the empirical nutrition policy literature, we ask: what factors generate, sustain and constrain political commitment for nutrition, how and under what circum...

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 inappropriate marketing and aggressive promotion of breastmilk substitutes (BMS) undermines breastfeeding and harms child and maternal health in all country contexts. Although a global milk formula 'sales boom' is reportedly underway, few studies have investigated its dynamics and determinants. This study takes two steps. First, it describes tr...

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...

Despite increasing evidence about the value and importance of breastfeeding, less than half of the world's infants and young children (aged 0–36 months) are breastfed as recommended. This Series paper examines the social, political, and economic reasons for this problem. First, this paper highlights the power of the commercial milk formula (CMF) in...

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: 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...

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...

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...

Background The exploitative marketing of commercial milk formula (CMF) reduces breastfeeding, and harms child and maternal health globally. Yet forty years after the International Code of Marketing of Breast-Milk Substitutes (The Code) was adopted by WHO member states, many countries are still to fully implement its provisions into national law. Fu...

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 In recent decades there has been a global rise in consumption of ultra-processed foods (UPFs) to the detriment of population health and the environment. Large corporations that have focused heavily on low-cost manufacturing and extensive marketing of UPFs to maximise profits have driven this dietary transition. The same corporations clai...

Background The role of ultra-processed food (UPF) manufacturers in driving unhealthy diets is coming under increasing scrutiny. While many of the strategies used by UPF corporations to push for and maintain high levels of UPF consumption are well documented, there has been limited analysis of how the UPF industry has evolved over time. This study a...

Incomplete understanding of the multiple mechanisms underlying the link between ultra-processed foods and cardiometabolic health should not be an excuse for inaction argue Mathilde Touvier and colleagues

Background In recent decades there has been a global rise in consumption of ultra-processed foods (UPFs) to the detriment of population health and the environment. Large corporations that have focused heavily on low-cost manufacturing and extensive marketing of UPFs to maximise profits have driven this dietary transition. The same corporations clai...

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,...

The recent involvement of Nestlé in the Africa Food Prize reinforces the presence of the ultra-processed food industry in the continent and invites us to reflect on the implications this may have for Africa’s sustainable food systems agenda.

Review Article Formula milk companies and allergy healthcare professionals in India

India is a low-middle income country with a population of 1.4 billion and home to one quarter of the world's children. Exclusive breastfeeding until 6 months and continued breastfeeding until at least 2 years as per global recommendations are common practice. The Indian government and associated organisations have strived to protect breastfeeding,...

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...

A global transition towards diets increasingly dominated by ultra-processed foods (UPFs) has occurred in recent decades to the detriment of public health and the environment. This study aimed to examine long-term trends in the structure and market dynamics of the global UPF manufacturing industry as part of broader efforts to understand the drivers...

Breast milk substitute (BMS) marketing harms breastfeeding and public health. To control BMS marketing, the Member States of the World Health Organization is called upon to adopt all provisions of the International Code of Marketing of Breastmilk Substitutes (the Code) into national law. In 2017, Thailand adopted many provisions of the Code through...

Background Evidence is mounting that the ultra - processed food industry seeks to influence food and nutrition policies in ways that support market growth and protect against regulatory threats, often at the expense of public health. However, few studies have explored how this occurs in lower - middle income countries. We aimed to explore if and ho...

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...

In this Series paper, we examine how mother and baby attributes at the individual level interact with breastfeeding determinants at other levels, how these interactions drive breastfeeding outcomes, and what policies and interventions are necessary to achieve optimal breastfeeding. About one in three neonates in low-income and middle-income countri...

Despite proven benefits, less than half of infants and young children globally are breastfed in accordance with the recommendations of WHO. In comparison, commercial milk formula (CMF) sales have increased to about US$55 billion annually, with more infants and young children receiving formula products than ever. This Series paper describes the CMF...

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...

Background The market and non-market activities of the food and beverage industry contribute to unhealthy and unsustainable dietary patterns, increasingly in low-income and middle-income countries (LMICs). We aimed to describe how The Coca-Cola Company (TCCC), as the world market leader in the sugar-sweetened beverage sector, operationalises their...

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...

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...

Background Baby food marketing undermines breastfeeding by influencing women’s attitudes and decision-making favourably toward commercial baby food. This study aimed to explore the effects of various baby food marketing techniques on Thai mothers’ opinions about commercial milk formulas (CMF) and commercial complementary foods (CCF) and their infan...

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...

Objective The mother-child breastfeeding dyad is a powerful force for achieving healthy, secure and sustainable food systems. However, food systems reports exclude breastfeeding and mother’s milk. To help correct this omission and give breastfeeding women greater visibility in food systems dialogue and action, we illustrate how to estimate mother’s...

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...

Objective: To report on the prevalence of different types of breast-milk substitutes (BMS) marketing and the compliance of such marketing with the "Control of Marketing of Infant and Young Child Food Act 2017" (The Act) and the "International Code of Marketing of Breastmilk Substitutes (WHO Code)" in Thailand. Design: Cross-sectional quantitativ...

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...

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...

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 The East Asia region is facing an increasing burden of overweight, obesity and related noncommunicable diseases, resulting from an ongoing nutrition transition. This study aimed to document the growing burden of overweight and obesity, and the accompanying dietary shifts, in the East Asia region and describe the policy responses to this....

The health and ecological harms created and spread by firms active in many unhealthy commodity industries (UCIs) have received considerable attention from the public health community. However, less focus has been paid to analysing the distribution of wealth and income – important social and economic determinants of health – by these industries. Thi...

Background Recent studies show corporate political activity (CPA) can have detrimental impacts on health policy processes. The Control of Marketing Promotion of Infant and Young Child Food Act B.E. 2560 (the Act) was implemented in Thailand in 2017, but there have been no studies documenting CPA during its policy processes. Furthermore, the effects...

Background: Sugar-sweetened beverage (SSB) taxes are an effective public health policy intervention for improving nutrition and public health. Although implemented in over 50 jurisdictions worldwide, this intervention remains vastly underutilised, and in Australia political commitment for such a tax is low. The aim of this study is to understand t...

Background Many of the harms created by the global soft drink industry that directly influence human and planetary health are well documented. However, some of the ways in which the industry indirectly affects population health, via various socio-economic pathways, have received less attention. This paper aimed to analyse the extent to which market...

Food systems are increasingly being understood as driving various health and ecological crises and their transformation is recognised as a key opportunity for planetary health. First-food systems represent an underexplored aspect of this transformation. Despite breastfeeding representing the optimal source of infant nutrition, use of commercial mil...

Background Public health concerns relating to international investment liberalization have centred on the potential for investor-state dispute settlement (ISDS)-related regulatory chill. However, the broader political and economic dimensions that shape the relationship between the international investment regime and non-communicable disease (NCD) p...

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...

Commercial milk formula for pregnant women (CMF-PW) is an expensive, ultra-processed food with a high concentration of sugar, the consumption of which may be linked to negative health outcomes. However, CMF-PWs are promoted as beneficial for pregnant women and lactating mothers as well as their children. To date, little is known about the factors a...

Today’s food systems are contributing to multiple intersecting health and ecological crises. Many are now calling for transformative, or even radical, food systems change. Our starting assumption in this Special Issue is the broad claim that the transformative changes being called for in a global food system in crisis cannot – and ultimately will n...

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...

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: International food standards set by the Codex Alimentarius Commission (CAC), have become more prominent in international trade politics, since being referenced by various World Trade Organization (WTO) agreements. We examine how this impacts implementation of the World Health Organization (WHO) International Code of Marketing of Breast...

The UN Food Systems Summit is bold but controversial, with important implications for global food systems and public health. Alongside claims of corporate capture, many have noted insufficient attention paid to human rights and to rebalancing power in the food system. These issues speak to wider issues of participation and equity in the summit itse...

Background Previous analyses of trends in feeding indicators of children younger than 2 years have been limited to low-income and middle-income countries. We aimed to assess time trends in the consumption of different types of milk (breastmilk, formula, and animal milk) by children younger than 2 years from 2000 to 2019 at a global level. Methods...

Background: Ultra-processed food (UPF) and Ultra-processed beverage (UPB) consumption is associated with higher risks of numerous non-communicable diseases (NCDs). Yet global consumption of these products is rising due to profound changes in production, processing, manufacturing, marketing, retail, and consumption practices, alongside the growth of...

Background The detrimental impact of dominant corporations active in health-harming commodity industries is well recognised. However, to date, existing analyses of the ways in which corporations influence health have paid limited attention to corporate market power. Accordingly, the public health implications of concentrated market structures, the...

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...

Background: There is increasing recognition that power imbalances that favour corporations, especially those active in unhealthy commodity industries, over other actors are central to the ways in which corporations influence population health. However, existing frameworks for analysing corporate strategies and practices that impact on health do no...

Background In low- and middle-income countries (LMICs), low levels of formal maternal educational are positively associated with breastfeeding whereas the reverse is true among women with higher levels of formal education. As such, breastfeeding has helped to reduce health equity gaps between rich and poor children. Our paper examines trends in bre...

Transnational tobacco, alcohol and ultra-processed food corporations use the international trade regime to prevent policy action on non-communicable diseases (NCDs); i.e. to promote policy ‘non-decisions’. Understanding policy non-decisions can be assisted by identifying power operating in relevant decision-making spaces, but trade and health resea...

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...

Objective: Equity-oriented policy actions are a key public health principle. In this study, how equity and socioeconomic inequalities are represented in policy problematizations of population nutrition were examined. Data sources: We retrieved a purposive sample of government nutrition-policy documents (n = 18) from high-income nations. Data sy...

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 To investigate the prevalence and socio-economic inequalities in breast milk, breast milk substitutes (BMS) and other non-human milk consumption, by children under 2 years in low- and middle-income countries (LMIC). Design We analysed the prevalence of continued breast-feeding at 1 and 2 years and frequency of formula and other non-human...

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...

Effective government policies are crucial to creating healthy food environments. However, changing public policy is a slow and challenging process involving many competing factors. One cited factor is public opinion towards a proposed policy. This study aimed to systematically explore public opinion on regulatory nutrition policy issues in Australi...

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...

Background Consumption of breast milk substitutes (BMS) by children aged under six months in low and middle income countries (LMICs) is directly driven by country income and family wealth. Multi-country investigations on the consumption of BMS by older children (6-23 months) are lacking. Methods Using data from 86 nationally representative surveys...

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...

Background: In contrast with the ample literature on within- and between-country inequalities in breastfeeding practices, there are no multi-country analyses of socioeconomic disparities in breastmilk substitute (BMS) consumption in low- and middle-income countries (LMICs). Objective: This study aimed to investigate between- and within-country s...