Benchmarking food environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government.

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Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Benchmarking Food Environments:
Experts’ Assessments of Policy Gaps
and
Priorities for the New Zealand Government
Swinburn, B., Dominick, C.H., and Vandevijvere, S.
University of Auckland
New Zealand
2014

Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Benchmarking Food Environments: Experts’ assessments of policy gaps and priorities for the New Zealand
Government
July 2014
Suggested citation: Swinburn, B., Dominick, C.H. and Vandevijvere, S.
Benchmarking Food Environments: Experts’ assessments of policy gaps and priorities for the New Zealand
Government, Auckland: University of Auckland. 2014
ISBN 978-0-473-29309-3 (Online)
ISBN 978-0-473-29283-6 (Print)
Published in July 2014 by University of Auckland
Copyleft: The freedom to copy and share the work with others.
Contact details:
Professor Boyd Swinburn
Professor of Population Nutrition and Global Health
University of Auckland
Private Bag, 92019, Auckland
New Zealand
Email: Boyd.Swinburn@auckland.ac.nz
Further information on INFORMAS and the Food-EPI is available at: www.informas.org
Special Issue: INFORMAS (International Network for Food and Obesity/non-communicable diseases, Research,
Monitoring and Action Support): rationale, framework and approach. Obesity Reviews, Volume 14, Issue Supplement
S1, 1-164.
©

Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Executive Summary
New Zealand has an unacceptably high prevalence of overweight and obesity. Two in three adults and one in three
children are overweight or obese. Diet-related non-communicable diseases (NCDs), such as diabetes, cardiovascular
diseases and many cancers are the biggest cause of death and ill-health in New Zealand and they are preventable.
Effective government policies and actions are essential to increase the healthiness of food environments1 and
to reduce these very high levels of obesity, NCDs, and their related inequalities. Internationally, there is wide
recognition of this major public health issue. It is critical that the New Zealand Government implements preventive
policies and actions to match the magnitude of the burden that unhealthy diets are creating. Monitoring the
degree of implementation of the policies and actions recommended by the World Health Organisation (WHO) is an
important part of ensuring progress towards better nutritional health for New Zealanders.
Approach
This report presents the results of a study, using the Food Environments Policy Index (Food-EPI), which assessed the
New Zealand Government’s level of implementation of policies and infrastructure support against international
best practice for improving the healthiness of food environments. The Food-EPI is an initiative of INFORMAS
(International Network for Food and Obesity / NCDs Research, Monitoring and Action Support) and was conducted
in New Zealand with an Expert Panel of over 50 independent public health experts and representatives from medical
associations and non-governmental organisations (NGOs).
The Expert Panel rated the extent of implementation of policies on food environments and infrastructure support
systems by the New Zealand Government against international best practice. They also identied and prioritised
actions needed to address critical gaps in government policies and infrastructure support. These priority actions are
needed to improve the healthiness of food environments as these environments are major drivers of unhealthy diets
and obesity.
Assessment results
The assessment of the implementation levels of priority policies and infrastructure support showed some areas
of strength. New Zealand and Australia have set the international benchmark in one area by applying a nutrient
proling system to prevent unhealthy foods carrying health claims. New Zealand is also at world standard, along
with many other high income countries, in requiring nutrition information panels on packaged foods, having good
monitoring systems for NCDs and their risk factors, and having high levels of transparency in policy development
and access to government information. Several other initiatives are underway such as reducing trans fats in foods,
implementing food-based dietary guidelines, developing systems-based actions with communities (Healthy Families
NZ), and establishing an interpretive front-of-pack labelling system (Health Star Ratings).
However, of major concern was the high number of food policies which were rated as having ‘very little, if any,
implementation’. This was especially apparent in the areas of reducing the marketing of unhealthy foods to children,
using scal policies to support healthy food choices, supporting local communities to limit the density of unhealthy
food outlets in their communities (for example, around schools and early childhood education (ECE) services), and
ensuring that trade and investment agreements do not negatively affect population nutrition and health.
An enormous gap in New Zealand is the lack of a comprehensive national action plan to address unhealthy food
environments and to reduce obesity and NCDs. The Healthy Eating Healthy Action implementation plan was
prematurely terminated along with its funding and evaluation in 2010 and no plans have been announced to replace
it. New Zealand will be expected to report to WHO in 2015 that it has a fully funded, comprehensive plan to reduce
NCDs. This must be the highest priority for action.
1 Food environments are dened as the collective physical, economic, policy and socio-cultural surroundings, opportunities and conditions
that inuence people’s food and beverage choices and nutritional status. New Zealand’s high levels of obesity and diet-related NCDs are
related to the food environments in which New Zealanders live. Unhealthy food environments lead to unhealthy diets and excess energy
intake which have detrimental consequences on morbidity and mortality. Dietary risk factors (high salt intake, high saturated fat intake
and low fruit and vegetable intake) and excess energy intake (high body mass index) account for 11.4% of health loss in New Zealand.

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Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
New Zealand will also be expected to report on progress on reducing marketing of unhealthy food products to
children and the reduction of saturated fatty acids in the food supply because these are two of the 25 core indicators
in the WHO NCD Monitoring Framework. The absence of government action in protecting children from commercial
exploitation will not be considered acceptable progress for a high income, high capacity country with one of the
highest rates of childhood obesity in the world.
Priority recommendations
The Expert Panel recommended 34 actions, prioritising 7 for immediate action. They are to:
1. Implement a comprehensive national action plan for obesity and NCD prevention.
2. Set priorities in Statements of Intent and set targets for
a. reducing childhood and adolescent obesity
b. reducing salt, sugar and saturated fat intake
c. food composition (salt and saturated fat) in key food groups
3. Increase funding for population nutrition promotion, doubling it to at least $70m/year.
4. Reduce the promotion of unhealthy foods to children and adolescents by
a. restricting the marketing of unhealthy foods to children and adolescents through broadcast and non-
broadcast media.
b. ensuring schools and ECE services are free from commercial promotion of unhealthy foods.
5. Ensure that foods provided in or sold by schools and ECE services meet dietary guidelines.
6. Implement the front-of-pack Health Star Rating labelling system.
7. Introduce an excise tax of at least 20% on sugar-sweetened beverages.
The New Zealand Government is strongly urged to act on these recommendations to improve the diets of New
Zealanders, reduce health care costs and bring New Zealand towards the progressive, innovative and world leader of
public health that it can be.

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Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Acknowledgements
Many people have contributed to the development of this report. First, the authors would like to acknowledge the
New Zealand Expert Panel who participated in the Food-EPI pilot study (November 2013), the rating workshops for
this report (April/May 2014), the identication and prioritisation of the actions, and the critique of this report.
The authors would like to thank the National Heart Foundation for funding the Food-EPI workshops and the
University of Auckland, Faculty of Medical and Health Sciences for other related support.
The authors would also like to thank the government ofcials who spent time answering ofcial information requests
and checking completeness of the evidence on the extent of implementation of policies to create healthy food
environments.
INFORMAS is the International Network for Food and Obesity / non-communicable diseases (NCDs) Research,
Monitoring and Action Support. The authors wish to thank all founding members of the network for their
contributions to the development of the Healthy Food Environment Policy Index (Food-EPI). These members include (in
alphabetical order): Simon Barquera (Mexican National Institute of Public Health, Mexico), Sharon Friel (Australian
National University, Australia), Corinna Hawkes (World Cancer Research Fund, UK), Bridget Kelly (University of
Wollongong, Australia), Shiriki Kumanyika (University of Pennsylvania, USA), Mary L’Abbe (University of Toronto,
Canada), Amanda Lee (Queensland University of Technology, Australia), Tim Lobstein (World Obesity Federation,
UK), Jixiang Ma (Centers for Disease Control, China), Justin Macmullan (Consumers International, UK), Sailesh
Mohan (Public Health Foundation, India), Carlos Monteiro (University of Sao Paulo, Brazil), Bruce Neal (George
Institute for Global Health, Australia), Mike Rayner (University of Oxford, UK), Gary Sacks (Deakin University,
Australia), David Sanders (University of the Western Cape, South Africa), Wendy Snowdon (The Pacic Research
Center for the Prevention of Obesity and Non-Communicable Diseases, Fiji), Chris Walker (Global Alliance for
Improved Nutrition, Switzerland). Advice in the development phase of the Food-EPI was also obtained from Janice
Albert (Food and Agricultural Organisation of the United Nations) and Francesco Branca and Godfrey Xuereb (World
Health Organisation).
We would also like to thank Anandita Devi for her work as research assistant in this project.

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Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Table of Contents
1. Why do we need to improve New Zealand’s food environments? .......................................................................... 8
Who can help improve the healthiness of food environments and population diets? ................................ 8
2. How was the level of implementation level of government policies and infrastructure support assessed? ....10
Who conducted the assessment? ........................................................................................................................10
What tool was used to measure the level of implementation? ......................................................................10
What processes were used to rate the level of implementation? ..................................................................11
3. How were the recommended actions identied and prioritised? ...........................................................................12
4. How well is the New Zealand Government performing compared with international best practice? .............. 13
5. Which actions did the Expert Panel prioritise for implementation by the New Zealand Government? ............15
Implement a comprehensive national action plan for obesity and NCD prevention .................................15
Increase population nutrition promotion at least $70M per year ................................................................15
Set targets for reducing obesity, reducing salt, saturated fat and sugar intakes,
modifying food composition (salt and saturated fat) ......................................................................................17
Restrict the marketing of unhealthy foods to children and adolescents through all media ......................17
Ensure schools and ECE services provide or sell foods which meet food and nutrition guidelines .........17
Implement the front-of-pack Health Star Rating labelling system .................................................................18
Introduce an excise tax of at least 20% on sugar-sweetened beverages .....................................................18
6. Conclusions .....................................................................................................................................................................19
7. References .......................................................................................................................................................................20
8. Appendix 1: Research approach and methods.........................................................................................................22
Methods overview .................................................................................................................................................22
Development of the Healthy Food Environment Policy Index (Food-EPI) ....................................................... 23
Piloting and rening the Food-EPI tool and process.........................................................................................23
Baseline study – rating the levels of implementation in New Zealand .........................................................23
Identifying and prioritising actions for implementation in New Zealand ....................................................24
9. Appendix 2: Evidence summary provided to the Expert Panel ...............................................................................25
10. Appendix 3: List of good practice statements and experts’ ratings ...................................................................... 77
11. Appendix 4: Recommended actions prioritised by the Expert Panel ......................................................................83
12. Appendix 5: List of New Zealand Experts ...................................................................................................................89

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Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Figures
Figure 1: Food environments’ components and the main inuences on those environments .................................... 9
Figure 2: Components and domains of the ‘Healthy Food Environment Policy Index’ (Food-EPI) ..............................11
Figure 3: Level of implementation of food environment policies and infrastructure support by the
New Zealand Government ...................................................................................................................................14
Figure 4: Process for assessing the policies and actions of governments for creating healthy
food environments .................................................................................................................................................22
Tables
Table 1: Top four Infrastructure Support actions – ranked by score ............................................................................16
Table 2: Top six Policy actions – ranked by score ............................................................................................................16
Table 3: Criteria for prioritising the recommended actions: Importance and Achievability .................................... 24
Table 4: Level of implementation for each policy and infrastructure support good practice statement:
New Zealand 2014 ................................................................................................................................................77
Table 5: Recommended infrastructure support actions prioritised by the Expert Panel ........................................... 83
Table 6: Recommended policy actions prioritised by the Expert Panel ........................................................................86

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Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
1. Why do we need to improve
New Zealand’s food environments?
New Zealand has very high levels of obesity with adults having the third highest rate of obesity within OECD
countries, behind the United States and Mexico (1). Overall, in 2012, nearly two thirds of New Zealand adults were
either overweight (34%) or obese (31%) with higher rates for Māori adults (48%) and Pacic adults (68%), and in
those with greatest levels of deprivation (2). New Zealand children also have high rates of obesity, their rates are
higher than those for children in Australia and in almost all Western European countries (1). In 2012, 11.1% of
children aged 2 to 14 years were obese which had increased from 8.4% in 2006 (2).
Unhealthy diets and excess energy intake are modiable factors that contribute to disease and disability in New
Zealand.2 Recent analysis shows that, collectively, dietary risk factors (high salt intake, high saturated fat intake,
low vegetable and fruit intake) and excess energy intake (high body mass index, BMI) account for 11.4% of health
loss in New Zealand (3). This is greater than the estimated 9.1% of health loss from tobacco use. The main diet-
related diseases include cardiovascular diseases, diabetes and many cancers. These diseases are the main killers
of New Zealanders (3, 4) and the health costs they incur are rising rapidly. For example, it has been calculated
that overweight and obesity directly cost the health system $624M or 4.4% of New Zealand’s total health care
expenditure in 2006, in addition to $225 million in lost productivity (calculated using the Human Capital Approach)
(5). The health care costs and lost productivity are now probably about $1 billion annually.
Currently, food environments3 in New Zealand are characterised by highly accessible and heavily promoted energy-
dense, often nutrient-poor, food products with high levels of salt, saturated fats and sugars. These environments are
major drivers of unhealthy diets and energy overconsumption (6, 7) and are shaped by governmental, food industry
and societal mechanisms (Figure 1).
Who can help improve the healthiness of food environments and population diets?
National governments and the food industry are the two major stakeholders groups with the greatest capacity to
modify food environments and population diets. Effective government policies and actions are essential to increase
the healthiness of food environments and to reduce obesity, diet-related non-communicable diseases (NCDs), and
their related inequalities (8).
Despite wide recognition of this major public health issue internationally, slow and insufcient action by governments
and the food industry to improve food environments continues to fuel rising levels of obesity and diet-related NCDs.
This is in part due to the pressure of the food industry on governments (9-11) as well as other factors, such as the
challenges of providing robust evidence on policy effectiveness before its introduction and competition for resources
between prevention efforts and health services delivery (12).
However, some governments internationally have demonstrated leadership and taken action to improve food
environments, and these can serve as best practice exemplars or benchmarks for other countries. (The evidence
summary, Appendix 2, lists examples of best practice internationally and related references.)
2 Low physical activity is also an important modiable risk contributing to health loss in New Zealand, however, the focus of this report is
food environments, population diets and diet-related NCDs.
3 Food environments are dened as the collective physical, economic, policy and socio-cultural surroundings, opportunities and conditions
that inuence people’s food and beverage choices and nutritional status and they include things as such as food composition, food
labelling, food promotion, food prices, food provision in schools and other settings, food availability and trade policies affecting food
availability, price and quality.

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Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Figure 1: Food environments’ components and the main inuences on those environments
This report presents the results of an assessment by New Zealand experts of the level of implementation of
government policies and infrastructure support considered good practice for improving food environments and
population diets. Recommendations for government actions needed to address the gaps in policy and infrastructure
support to reduce obesity and diet-related NCDs were also identied and prioritised.
Food environments
1. Physical (availability, quality,
promotion)
2. Economic (costs)
3. Policy (‘rules’)
4. Socio-cultural (norms,
beliefs)
Government
Products (1), Placement (1),
Price (2), Promotion (1, 4)
Individual factors
(e.g., preferences, attitudes , habits, income)
Regulations and laws (1, 3), fiscal
policies (2), health promotion (4)
Diets
(dietary patterns, quality and quantity)
Food industry
Society Traditional cuisines (1,4), cultural &
religious values and practices (3,4)

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Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
2. How was the level of implementation of
government policies and infrastructure
support assessed?
Who conducted the assessment?
The study is an initiative of INFORMAS (International
Network for Food and Obesity / NCDs Research,
Monitoring and Action Support) (7) and it was
conducted with a New Zealand-based Expert Panel of
independent public health experts and representatives
from medical associations and non-governmental
organisations (NGOs).
INFORMAS was recently founded by universities
and global NGOs to monitor and benchmark food
environments, government policies and private sector
actions and practices in order to reduce obesity and
diet-related NCDs and their related inequalities.
INFORMAS aims to complement existing monitoring
efforts of the World Health Organization (WHO), such
as the global NCD monitoring framework, which does
not focus on food environment and policy indicators
(13). (Refer to Appendix 1 for a more detailed
description of INFORMAS’s aims and objectives.)
What tool was used to measure the level of
implementation?
An index developed by INFORMAS (called the ‘Healthy
Food Environment Policy Index’ [Food-EPI]) was used
to assess the extent of implementation by government
of good practice policies and infrastructure support
in New Zealand. The Food-EPI tool and process were
designed to answer the question – How much progress
has the government made towards good practice
in improving food environments and implementing
obesity/NCDs prevention policies and actions? (14,15)
The Food-EPI was developed to monitor and
benchmark governments’ policies and actions on
creating healthier food environments. It is consistent
with, and supportive of, the list of proposed policy
options and actions for Member States included in
the WHO’s Global Action Plan for the Prevention and
Control of Non-Communicable Diseases (2013–2020)
(13) and the World Cancer Research Fund (WCRF)
International NOURISHING Food Policy Framework
for Healthy Diets (8, 16). The Food-EPI tool comprises
a ‘policy’ component with seven domains on specic
aspects of food environments and an ‘infrastructure
support’ component originally with seven domains
(subsequently reduced to six) to strengthen obesity and
NCD prevention systems. Good practice indicators
contained in these domains encompass policies and
infrastructure support necessary to improve the
healthiness of food environments and to help prevent
obesity and diet-related NCDs (Figure 2).
The Food-EPI tool and process have been through
several phases of development including an initial
development based on a review of policy documents,
subsequent revision by a group of international
experts, from low, middle and high income countries,
(14) and pilot testing in New Zealand in 2013 (15).
The rened tool was used in the baseline assessment
of New Zealand’s policies and infrastructure support
in relation to international best practice (refer to
Appendix 1 for more detail).

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Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
What processes were used to rate the level
of implementation?
The processes used to rate the extent of
implementation of policies and infrastructure support
in New Zealand (more fully described in Appendix
1) involved 52 members of the Expert Panel (listed
in Appendix 5) rating the New Zealand Government
against international best practice benchmarks
of policies and actions for creating healthier food
environments. The Expert Panel’s ratings were
informed by extensive documented evidence, validated
by government ofcials, of current implementation
in New Zealand (refer to Appendix 2 for the
evidence summary). A week before participating in
the workshops, the experts were provided with the
documented evidence with examples of international
best practice benchmarks.
Figure 2: Components and domains of the ‘Healthy Food Environment Policy Index’ (Food-EPI)
The Expert Panel rated a total of 42 indicators (19
of which related to policy and 23 of which related
to infrastructure support) using likert scales (1 to 5)
within a workshop setting. Before rating each indicator,
the evidence on the extent of implementation in New
Zealand and the international benchmarks were shown
to the Expert Panel in a PowerPoint presentation, with
opportunities for discussion and clarication. The
mean rating for each indicator was used to categorise
the level of implementation as ‘high’, ‘medium’, ‘low’
or ‘very little, if any’. (Refer to Appendix 3 for a list of
all the indicators.)
Government
Healthy
Food
Environment
Policy Index
(Food-EPI)
POLICIES
INFRASTRUCTURE
SUPPORT
Food COMPOSITION
Food LABELLING
Food PROMOTION
Food PROVISION
Food RETAIL
Food PRICES
Food TRADE AND INVESTMENT
Leadership
Governance
Monitoring and intelligence
Funding and resources
Platforms for interaction
Health-in-all policies
INDEX COMPONENTS DOMAINS INDICATORS
GOOD PRACTICE /
BENCHMARK
STATEMENTS
Government Healthy Food Environment Policy Index (Food-EPI)

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Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
3.How were the recommended actions
identied and prioritised?
4 Hence the scores obtained for the Policy actions are not able to be compared with those for the Infrastructure Support actions and vice
versa.
Concrete actions were proposed by the Expert Panel
after assessing the ‘implementation gap’ from the
rating distributions for each good practice indicator.
Actions were recommended for 34 of the 42 good
practice indicators. These actions were identied as
having the potential, in concert with other actions,
to improve the healthiness of food environments and
population nutrition and reduce obesity and diet-
related NCDs in New Zealand. (Refer to Appendix 4
for the list of recommended actions and related good
practice statements).
The actions were prioritised in a separate process after
the workshops. Experts participating in the workshops
(and others unable to attend the workshops) were
provided with the implementation rating results and
the recommended actions within an Excel spreadsheet
(sent by email). Policy and Infrastructure Support
actions were prioritised separately4.
The Expert Panel members were asked to prioritise the
importance of the each action (taking into account
the relative need, impact, effects on equity, and any
other positive and negative effects of the action)
within the group of 15 recommended policy actions by
allocating 75 points across the 15 actions. They were
also asked to prioritise the likely achievability of the
recommended actions (taking into account the relative
feasibility, acceptability, affordability, and efciency of
the action) by allocating another 75 points across the
15 actions. Expert Panel members were then asked
to prioritise the 19 infrastructure actions using the
same method. This meant allocating 95 points across
the 19 infrastructure actions, rst for importance and
then for achievability. Participants were given the
opportunity to differentially weight the importance
and achievability criteria. The weights chosen by each
expert were applied to their individual scores and their
scores for importance and achievability were summed.

13
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
4. How well is the New Zealand Government
performing compared with international
best practice?
Related to the lack of an overarching plan were the
relatively low levels of funding for population nutrition
promotion and the absence of formal interaction
platforms to co-ordinate action and maintain links
between the government and key stakeholders
working in this eld. Funding for population nutrition
promotion has reduced considerably over the past
seven years which means that it is currently insufcient
to improve food environments and population nutrition
and to reduce obesity and diet related NCDs. For
example, funding in 2012/13, for population nutrition
promotion was $29 million compared with the
$67 million budget for the Healthy Eating Healthy
Action (HEHA) strategy in 2006/075. Funding of $29
million (0.21% of total vote health) is relatively small
compared with the health care costs attributable
to overweight and obesity. In 2006, this was $624
million, 4.4% of total health care expenditure (5).
Major implementation gaps were also identied within
government policy relating to the promotion, provision,
availability and relative pricing of unhealthy versus
healthy foods. Policies restricting the promotion of
unhealthy foods to children through broadcast and
non-broadcast media and within children’s settings
were areas that were rated as having very little, if any,
implementation. Similarly, results showed the lack of
policies aimed at making healthy food affordable and
accessible for the population through measures that
inuence the relative pricing of healthy and unhealthy
foods (17).
New Zealand rated well against international
benchmarks for several infrastructure support
indicators (Figure 3). These included having policies
and procedures in place for ensuring transparency in
the development of food policies; the public having
access to nutrition information and key documents;
and regular monitoring of body mass index (BMI) and
the prevalence of NCD risk factors and occurrence
rates for the main diet-related NCDs. New Zealand
also rated well for policies regulating the provision of
ingredient lists and nutrient declarations on packaged
foods and for those regulating health claims on
packaged foods.
However, over half (60%) of all the good practice
indicators were rated as having ‘low’ or ‘very little,
if any’ implementation compared with international
benchmarks. This was not spread evenly across
infrastructure support and policy indicators, with half
(48%) the infrastructure indicators and three-quarters
(74%) of the policy indicators rated as having ‘low’ or
‘very little, if any’ implementation in New Zealand.
Several critical gaps were identied relating to
government infrastructure support for obesity and
diet-related NCD prevention. These highlighted a lack
of government leadership. Obesity and population
diet are not included as health priorities and there
is no comprehensive and co-ordinated plan of action
to address food environments, obesity and diet-
related NCDs in New Zealand, despite the increasing
prevalence of overweight and obesity and diet-related
NCDs. To address the complexity of the multiple
inuences on population dietary behaviours and
health outcomes, a comprehensive plan is needed and
it should include a range of policy and programme
strategies at national and local levels and social
marketing for public awareness.
5 Note that the Healthy Eating Healthy Action budget included funding for physical activity initiatives.

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Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Food retail environments are increasingly considered
inuential in determining dietary behaviours and
health outcomes (20), however, ratings indicated
that there was very little, if any, policy relating to
community food environments (e.g., type, availability
and accessibility of food outlets) or consumer food
environments (e.g., in-store availability, prices,
promotion and nutritional quality of foods). For
example, there was little, if any, implementation of
policies which would allow local governments and
communities to make decisions about the density
of outlets selling unhealthy foods within their
communities, especially their proximity to schools and
early childhood education (ECE) services. Similarly,
there was little, if any, implementation of support
systems encouraging food stores to promote the in-
store availability of healthy food and limit the in-store
availability of unhealthy foods.
Assessing the health impacts of non-food policies
Assessing the health impacts of food policies
Systems based approach to obesity prevenon
Plaorms government and civil society
Plaorms government and food sector
Co-ordinaon mechanisms (naonal and local govt)
Research funding for obesity & NCD prevenon
Populaon nutrion promoon budget
Monitoring progress on reducing health inequalies
Evaluaon of major programmes
Monitoring NCD risk factors and prevalence
Monitoring Body Mass Index
Monitoring nutrion status and intakes
Monitoring food environments
Access to government informaon
Transparency for the public in the development of food policies
Use of evidence in food policies
Restricng commercial influence on policy development
Priories for reducing inequalies
Comprehensive implementaon plan linked to naonal needs
Food-based dietary guidelines implemented
Populaon intake targets established
Strong visible polical support
Protect regulatory capacity - nutrion
Trade agreement impacts assessed
In-store availability of healthy foods
Robust local government policies & zoning laws
Support and training systems (private companies)
Support and training systems (public sector sengs)
Policies in public sengs promote healthy food choices
Policies in schools / ECEs promote healthy food choices
Food-related income-support is for healthy foods
Exisng food subsidies favour healthy foods
Increase taxes on unhealthy foods
Reduce taxes on healthy foods
Restrict promoon of unhealthy foods to children (sengs)
Restrict promoon of unhealthy foods to children (media)
Menu board labelling
Front of pack labelling
Regulatory systems for health & nutrion claims
Ingredient lists / nutrient declaraons
Food composion targets
High
Medium
Low
Very lile
Level of Implementaon
Food Composion--------------------------------
Food Labelling-----------------------
Food Promoon
Food Prices-----------------------------------
Leadership------------------------------------
Food Trade & Investment------------
Food Retail----------------
Food Provision----
Health----------------------------
in-all-policies
Plaorms---------------
for Interacon
Funding & Resources-------------
Monitoring & Intelligence----------------
Governance-------
Food trade and investment agreements are an area
of increasing concern as these have the potential to
radically inuence the food supply within countries
(18, 19) and, therefore, which foods are available,
accessible and affordable for the population. There
was little, if any, implementation of policies which
ensured that international trade and investment
agreements are assessed for any direct and indirect
impacts on food environments and population
nutrition and health. Similarly, ratings indicated there
was very little, if any, adoption of measures to manage
foreign investment agreements and protect New
Zealand’s public health regulatory capacity to act to
protect and promote public health nutrition.
Figure 3: Level of implementation of food environment policies and infrastructure
support by the New Zealand Government

15
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
5. Which actions did the Expert Panel
prioritise for implementation by the New
Zealand Government?
Four infrastructure support actions and six policy actions (condensed to 7 recommendations) were identied
as having the highest priority for implementation by the New Zealand Government. In summary, these
recommendations are to:
1. Implement a comprehensive national action plan for obesity and NCD prevention.
2. Set priorities in Statements of Intent and set targets for
a. reducing childhood and adolescent obesity.
b. reducing salt, sugar and saturated fat intake.
c. food composition (salt and saturated fat) in key food groups.
3. Increase funding for population nutrition promotion, doubling it to at least $70m/year6.
4. Reduce the promotion of unhealthy foods to children and adolescents by
a. restricting the marketing of unhealthy foods to children and adolescents through broadcast and non-
broadcast media.
b. ensuring schools and ECE services are free from commercial promotion of unhealthy foods.
5. Ensure that foods provided in or sold by schools and ECE services meet dietary guidelines.
6. Implement the front-of-pack Health Star Rating labelling system.
7. Introduce an excise tax of at least 20% on sugar-sweetened beverages.
The top ranked policy and infrastructure support action recommendations are detailed further in Tables 1 and 2.
The full set of recommendations identied by the Expert Panel is listed in Appendix 4.
6 Approximately $67 million was allocated to the Healthy Eating Healthy Action strategy budget in 2008/09.
Implement a comprehensive national
action plan for obesity and NCD
prevention
Improving the healthiness of food environments and
reducing obesity and diet-related NCDs requires
integrated action by government across a number of
policy areas and infrastructure support systems. New
Zealand will need to report to WHO in 2015 about
whether it has a comprehensive national action plan
for NCDs in place. This should include targets relating
to obesity, nutrient intakes and food composition.
The availability, affordability, accessibility and
acceptability of foods are the critical determinants of
dietary intake and measures will need to be included
in the plan to increase these for healthy foods AND
decrease these for unhealthy foods.
New Zealand has previously shown leadership in this
area. For example, the Healthy Eating Healthy Action
(HEHA) strategy and its associated implementation
plan were comprehensive in their approach and had
actions to address the main drivers of unhealthy
diets and excessive energy intake. Action focused on
priority populations including Māori, Pacic peoples,
children and their families, and lower socioeconomic
groups. Implementation of priority programmes was
funded, as was an integrated research, evaluation and
monitoring component.
Increase population nutrition promotion
funding to at least $70M per year
Sufcient funding for policies, programmes and
their evaluation is also required. Current levels of
funding are only one twentieth of the health care
costs of overweight and obesity in 2006. Funding for
population nutrition promotion should be to least at
the level of previous HEHA funding.

16
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Table 1: Top four Infrastructure Support actions – ranked by score
1. To demonstrate a national commitment, the NZ Government:
• Prioritises improving nutrition and reducing childhood obesity by:
–Including clear support for these priorities in the government Statements of Intent (especially for the
Ministry of Health (MoH)).
–Setting a target to reduce the prevalence of childhood and adolescent obesity (for example, by 5% over
the next six years) as part of the Better Public Service challenge targets.
2. To ensure that sufcient resources are available to improve population nutrition, the NZ Government:
• Increases funding for population nutrition promotion to at least $70M per year (equivalent to about 10%
of the health care costs of overweight/obesity and on a par with previous investments in prevention).
3. To convert its commitments to WHO’s Global Action Plan to Reduce NCDs into the national context, the NZ
Government:
• Develops, funds and implements a comprehensive national action plan to prevent NCDs.
4. To demonstrate commitment and to measure progress, the NZ Government:
• Species clear targets for the reduction of salt, sugar and saturated fat intake of the population based on
WHO recommendations and the global NCD action plan (e.g., salt intake 5g/day, saturated fat intake less
than 10% of energy, and free sugar less than 10% of energy).
Table 2: Top six Policy actions – ranked by score
1. To improve food composition, the NZ Government:
• Sets sodium targets for the food groups which are major contributors to sodium intake, based on
international best practice targets.
• Establishes a food standard to minimise the unhealthy fatty acid content of commercial deep frying fats.
• Examines other opportunities to reduce the amount of salt, sugar and saturated fat in foods and
beverages.
2. To reduce unhealthy food promotion to children, the NZ Government:
• Introduces regulations to restrict the marketing of unhealthy foods, as dened by the nutrient proling
scoring criterion, to children and adolescents (e.g., younger than 16 years) through:
– broadcast media, with initial priorities for restriction of advertising through television, and
– non-broadcast media, with initial priorities for restriction of advertising through sports sponsorship, food
packaging and point of sale advertising.
3. To reduce unhealthy food promotion to children, the NZ Government:
• Implements policies to ensure that schools and early childhood education and care services, are free of
commercial promotion of unhealthy foods, as dened by the MoH Food and Beverage Classication System
4. To ensure that children’s settings provide healthy food, the NZ Government:
• Enacts policies that ensure schools and early childhood education and care services provide or sell
foods which meet the food and nutrition guidelines as outlined in the Food and Beverage Classication
System.
5. To improve food labelling (consumer-friendly nutrition quality labels), the NZ Government.
• Endorses the Health Star rating system for implementation from 2014 on a voluntary basis with provision
to move to regulations if there is not wide coverage within 2 years.
6. To discourage the consumption of unhealthy foods and beverages, the NZ Government:
• Introduces a signicant (at least 20%) excise tax on sugar-sweetened beverages; and explores how the tax
revenue could be applied to create healthy food environments and promote healthy diets.

17
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Set targets for reducing obesity, reducing
salt, saturated fat and sugar intakes,
modifying food composition (salt and
saturated fat)
Setting targets is increasingly seen as an effective
way of focusing and mobilising resources to address
public health issues. However, although the New
Zealand Government uses Statements of Intent and
setting targets as policy mechanisms, it has not
developed targets for obesity, food composition or
population intakes of salt, sugar, and saturated fats.
Internationally, several countries include targets for
obesity and NCDs in their national action plans.
For example, South Africa’s strategic plan for the
prevention and control of NCDs has a target for
reducing the percentage of people who are obese
and/or overweight by 10% by 2020 and reducing
premature mortality from NCDs of those aged
under 60 years by at least 25% (21). The Brazilian
Strategic Action Plan for Confronting NCDs 2011-
2022 also species national targets, such as halving
the prevalence of obesity in children and adolescents
by 2022 and halting the rise in obesity in adults (22).
Many countries have set population intake targets
for salt and reformulation targets for sodium in food
products. For example, Argentina and South Africa
have specied, in law, mandatory maximum levels of
sodium in a range of food categories (23). The UK salt
reduction programme, initiated in 2003/04 has led
to reductions in the salt content of many processed
foods and a signicant (15%) reduction in urinary
sodium levels (24). The World Health Organisation’s
NCD action plan also species a target to reduce
population salt intake to 5g/day (25).
Restrict the marketing of unhealthy foods
to children and adolescents through all
media
Restricting the high levels of marketing of unhealthy
foods to children and adolescents is another critical
action to begin addressing increasing levels of obesity
in New Zealand’s children and adolescents. Children’s
food preferences, purchase requests, and consumption
patterns are inuenced by food marketing (e.g., (26-
28)). Self-regulation by industry has not led to any
reduction in the exposure of children to unhealthy
food marketing. Experts consider restricting marketing
through broadcast and non-broadcast media as well
as removing commercial promotion of unhealthy
foods in schools and ECE services settings particularly
important. Internationally, a range of countries and
regions have restricted marketing of unhealthy foods
to children and adolescents. For example, in 1980,
Quebec banned all advertising to children under the
age of 13. In South Korea, television advertising of
specic categories of food is prohibited between 5 and
7pm and before, during, and after other children’s
programmes. In this instance, children are dened as
those aged under 18 years. The restriction also applies
to advertising targeting children (e.g., where free
toys are included). In Ireland, advertising and other
forms of commercial promotion of unhealthy foods (as
dened by a nutrient proling model) are prohibited
during children’s television and radio programmes
(that is, where over 50% of the audience is aged
under 18 years). Laws also prohibit food advertising to
children under 15 years that features celebrities (23).
Other countries such as Spain, Chile, Peru and Brazil
have passed legislation to restrict food advertising to
children.
Ensure schools and ECE services provide
or sell foods which meet food and nutrition
guidelines
Making sure healthy food choices are available within
school and ECE services is also a priority identied by
the Expert Panel. They consider that the government
should enact policies that ensured schools and ECE
services provide or sell foods which meet the food and
nutrition guidelines as outlined in the New Zealand
Food and Beverage Classication System.

18
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Implement the front-of-pack Health Star
Rating labelling system
To better inform consumers about the healthiness
of packaged foods, the Expert Panel prioritised the
introduction of the Health Star Rating system that
has been introduced into Australia. This follows other
countries such as the United Kingdom and Ecuador
who have introduced an interpretive, evidence-based
front of pack labelling system. New Zealand has since
announced that it will introduce the Health Star Rating
system but on a voluntary basis. The Expert Panel
recommended that New Zealand follow Australia’s
lead in making it mandatory if there is not widespread
uptake by industry.
Introduce an excise tax of at least 20% on
sugar-sweetened beverages
Discouraging consumption of sugar-sweetened
beverages by increasing the price through an excise
tax was also prioritised by the experts. Research
has shown that such a tax is likely to improve health
and probably reduce health inequalities (29). A 20%
tax on carbonated drinks was estimated to reduce
daily energy intakes by 0.2% (20kJ/day) and avert
or postpone 67 (95% CI, 60 to 73) deaths from
cardiovascular disease, diabetes and diet-related
cancers, which equates to 0.2% of all deaths in
New Zealand per year. Other research showed that
increasing the price of sugar sweetened beverages
led to a signicant reduction in purchases of those
beverages but did not signicantly affect purchases
in other beverage or snack food categories (30). A
tax on sugar sweetened beverages with the funding
used for health promotion was also recommended by
the New Zealand Beverage Guidance Panel in their
six-point policy brief (31). A range of other countries
globally (e.g., Mexico, Tonga, France, Hungary, French
Polynesia) introduced taxes on sugar-sweetened
beverages and several use the revenue for improving
population health (e.g., Mexico, Hungary, French
Polynesia) (23) .

19
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
6. Conclusions
Effective government policies and actions are essential
to increase the healthiness of food environments and
to reduce the high levels of obesity, diet-related NCDs,
and their related inequalities (8). Internationally, there
is wide recognition of this major public health issue
and New Zealand is lagging behind other nations in
implementing policies to improve food environments
and reduce levels of obesity and diet-related NCDs.
New Zealand has set the international benchmark
in one area by applying a nutrient proling system
to prevent unhealthy foods carrying health claims.
New Zealand is also at world standard in other
areas such as nutrition information panels and
monitoring systems for NCDs and their risk factors.
Several initiatives are showing good progress, such
as reducing trans fats in foods, and others, such as
the Health Star Rating system and community-based
efforts (for example, Healthy Families NZ) although
currently rated at a low level of implementation, will
be implemented in the near future.
Of major concern were the large gaps in
implementation, especially the lack of a comprehensive
plan and specic regulatory or scal policies, for
instance, the restriction of marketing of unhealthy
foods to children and taxes on sugar sweetened
beverages. The Healthy Eating Healthy Action plan
was prematurely terminated along with its funding
and evaluation in 2010 and no plans have been
announced to replace it. New Zealand will be expected
to report to the WHO in 2015 that it has a fully
funded, comprehensive plan for NCDs. This must be
the highest priority for action.
In addition, New Zealand will be expected to report on
progress on reducing the marketing of unhealthy food
products to children because this is one of the 25 core
indicators in WHO NCD Monitoring Framework. The
lack of government action in protecting children from
this commercial exploitation will not be considered
acceptable for a high income, high capacity country
with one of the highest rates of childhood obesity in
the world.
New Zealand has an excellent opportunity to take
the prevention of obesity and diet-related NCDs
seriously and invest in highly cost-effective policies
and programs to become a leader in the eld. It will
require a much greater government effort than has
recently been evident. The top priority actions are
recommended by the Expert Panel for immediate
implementation but all 34 recommended actions are
achievable with sufcient government commitment.
The Food-EPI will be conducted every three years
towards the end of each government’s term of ofce
to measure progress made towards improving food
environments over that term. The Expert Panel hopes
that substantial progress will be made by 2017 to
bring New Zealand towards the progressive, innovative
and world leader in public health that it can be.
“Let me remind you. Not one single country has managed to turn around its obesity
epidemic in all age groups. This is not a failure of individual will-power. This is a failure of
political will to take on big business”
Dr Margaret Chan, Director General, World Health Organisation, June 2013

20
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
7. References
1. OECD. OECD Obesity Update 2014. OECD Directorate for Employment, Labour and Social Affairs, 2014.
2. Ministry of Health. New Zealand Health Survey: Annual update of key ndings 2012/13. Wellington:
Ministry of Health, 2013.
3. Ministry of Health. New Zealand Burden of Diseases, Injuries and Risk Factors Study, 2006–2016.
Wellington: Ministry of Health, 2013.
4. Ministry of Health. Mortality and Demographic Data 2010. Wellington: Ministry of Health, 2013.
5. Lal A, Moodie M, Ashton T, Siahpush M, Swinburn B. Health care and lost productivity costs of overweight
and obesity in New Zealand. AustNZJPublic Health. 2012;36(6):550-6.
6. Swinburn BA, Sacks G, Hall KD, McPherson K, Finegood DT, Moodie ML, et al. Obesity The global obesity
pandemic: shaped by global drivers and local environments. Lancet. 2011;378(9793):804-14.
7. Swinburn B, Sacks G, Vandevijvere S, Kumanyika S, Lobstein T, Neal B, et al. INFORMAS (International
Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support):
overview and key principles. Obes Rev. 2013 Oct;14 Suppl 1:1-12.
8. Hawkes C, Jewell J, Allen K. A food policy package for healthy diets and the prevention of obesity and diet-
related non-communicable diseases: the NOURISHING framework. Obes Rev. 2013 Nov;14 Suppl 2:159-68.
9. Fraser B. Latin American countries crack down on junk food. Lancet. 2013 Aug 3;382(9890):385-6.
10. Moodie R, Stuckler D, Monteiro C, Sheron N, Neal B, Thamarangsi T, et al. Prots and pandemics:
prevention of harmful effects of tobacco, alcohol and ultra-processed food and drink industries. Lancet.
2013;380 (9867):670-679.
11. Stuckler D, McKee M, Ebrahim S, Basu S. Manufacturing Epidemics: The Role of Global Producers in
Increased Consumption of Unhealthy Commodities Including Processed Foods, Alcohol, and Tobacco. PLoS
Med. 2012;9(6):e1001235.
12. International Association for the Study of Obesity (IASO). The prevention of obesity and NCDs: challenges
and opportunities for governments. IASO policy brieng 2014 [10/01/2014]. Available from: http://www.
iaso.org/site_media/uploads/iaso_preventingobesitybrieng.pdf.
13. World Health Organisation. Follow-up to the Political Declaration of the High-level Meeting of the General
Assembly on the Prevention and Control of Non-communicable Diseases. Draft resolution proposed by the
delegations. Sixty-sixth World Health Assembly Agenda item 13. Geneva: World Health Organisation, 2013.
14. Swinburn B, Vandevijvere S, Kraak V, Sacks G, Snowdon W, Hawkes C, et al. Monitoring and benchmarking
government policies and actions to improve the healthiness of food environments: a proposed Government
Healthy Food Environment Policy Index. Obes Rev. 2013 Oct;14 Suppl 1:24-37.
15. Vandevijvere S, Swinburn B, for INFORMAS. First test of the Government Healthy Food Environment Policy
Index (Food-EPI) to reduce obesity and diet-related NCDs. Submitted.
16. World Cancer Research Fund. WCRF International Food Policy Framework for Healthy Diets: NOURISHING
London: World Cander Research Fund; 2013 [06/01/2014]. Available from: http://www.wcrf.org/policy_
public_affairs/nourishing_framework/#about.
17. Lee A, Mhurchu CN, Sacks G, Swinburn B, Snowdon W, Vandevijvere S, et al. Monitoring the price and
affordability of foods and diets globally. Obes Rev. 2013 Oct;14 Suppl 1:82-95.

21
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18. Friel S, Gleeson D, Thow AM, Labonte R, Stuckler D, Kay A, et al. A new generation of trade policy:
potential risks to diet-related health from the trans pacic partnership agreement. Global Health. 2013 Oct
16;9(1):46.
19. Friel S, Hattersley L, Snowdon W, Thow AM, Lobstein T, Sanders D, et al. Monitoring the impacts of trade
agreements on food environments. Obes Rev. 2013 Oct;14 Suppl 1:120-34.
20. Ni Mhurchu C, Vandevijvere S, Waterlander W, Thornton LE, Kelly B, Cameron AJ, et al. Monitoring the
availability of healthy and unhealthy foods and non-alcoholic beverages in community and consumer retail
food environments globally. Obes Rev. 2013 Oct;14 Suppl 1:108-19.
21. Department of Health. Strategic Plan for the Prevention and Control of Non-Communicable Diseases 2013-
17. Department of Health, 2013 Contract No.: RP06/2013.
22. Ministry of Health Brazil. Health Surveillance Secretariat. Health situation analysis department. Strategic
action plan to tackle non-communicable diseases in Brazil 2011-2022. Ministry of Health Brazil, 2011.
23. World Cancer Research Fund. WCRF International Food Policy Framework for Healthy Diets: NOURISHING
2014 [12/06/2014]. Available from: http://www.wcrf.org/policy_public_affairs/nourishing_framework/
food_marketing_advertising.
24. He FJ, Brinsden HC, Macgregor GA. Salt reduction in the United Kingdom: a successful experiment in public
health. J Hum Hypertens. 2014;28(6):345-52.
25. World Health Organisation. Global action plan for the prevention and control of noncommunicable diseases
2013-2020. Geneva, Switzerland: World Health Organization, 2013.
26. Cairns G, Angus K, Hastings G, Caraher M. Systematic reviews of the evidence on the nature, extent and
effects of food marketing to children. A retrospective summary. Appetite. 2013 Mar;62:209-15.
27. Cairns G, Angus K, Hastings G. The extent, nature and effects of food promotion to children: a review of the
evidence to December 2008. Geneva: World Health Organization, 2009.
28. Hastings G, McDermott L, Angus K, Stead M, Thomson T. The extent, nature and effects of food promotion
to children: a review of the evidence. Technical Paper prepared for the World Health Organization. Geneva:
World Health Organization, 2007.
29. Ni Mhurchu C, Eyles H, Genc M, Blakely T. Twenty percent tax on zzy drinks could save lives and generate
millions in revenue for health programmes in New Zealand. N Z Med J. 2014 Feb 14;127(1389):92-5.
30. Waterlander WE, Ni Mhurchu C, Steenhuis IHM. Effects of a price increase on purchases of sugar
sweetened beverages. Results from a randomized controlled trial. Appetite. 2014;78C:32-9.
31. New Zealand Beverage Guidance Panel. Policy Brief: Options to Reduce Sugar Sweetened Beverage (SSB)
Consumption in New Zealand. 2014. Available from: http://www.zz.org.nz/sites/zz.org.nz/les/A4%20
Policy%20Update%20Ofce%20print.pdf
32. World Health Organisation. Monitoring the building blocks of health systems: a handbook of indicators and
their measurement strategies. Geneva: World Health Organisation; 2010.

22
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
8. Appendix 1:
Research approach and methods
The International Network for Food and Obesity/NCDs
Research, Monitoring and Action Support (INFORMAS)
(7) was recently founded to monitor and benchmark
food environments, government policies and private
sector actions and practices globally.
INFORMAS aims to:
1. Develop a global network of public-interest
organisations and researchers to monitor,
benchmark and support efforts to create healthy
food environments and reduce obesity, non-
communicable diseases (NCDs) and their related
inequalities;
2. Collect, collate and analyse data on public
and private sector policies and actions, food
environments, population diets, obesity and NCDs:
3. Compare and communicate the progress on
improving food environments against good
practice benchmarks between countries and over
time;
4. Use the results to strengthen public health efforts,
particularly by supporting the translation of
relevant evidence into public and private sector
actions.
INFORMAS complements existing monitoring efforts
of the World Health Organization (WHO), such
as the global NCD monitoring framework, which
does not focus on food environment indicators (13).
INFORMAS produces evidence that is highly policy-
relevant in order to help increase the accountability
of governments and the private sector through the
provision of regular direct evidence on their levels
of action or inaction and the healthiness of food
environments.
Methods overview
The purpose of the Healthy Food Environment Policy
Index (Food-EPI) tool and process is to monitor and
benchmark public sector (national government)
policies and actions. It aims to answer the overarching
question – How much progress have governments
made towards good practice in improving food
environments and implementing obesity/NCD
prevention policies and actions?
A mixed methods design was used to obtain the
ratings of the level of implementation of good practice
policies and infrastructure support and to identify
and prioritise actions. The methods used to obtain
the rating followed the steps outlined in Figure 4
with the exception of weighting the scores outlined in
step 6. Unweighted rating results are presented as
appropriate weights for the good practice domains
and their indicators are in development.
In New Zealand, an Expert Panel was formed by
invitations being sent to a wide range of independent
public health experts and representatives from medical
associations and NGOs.
Figure 4: Process for assessing the policies and actions of governments for creating healthy
food environments
1.
Analyse
context
2.
Collect
relevant
inform-
ation
3.
Evidence-
ground
the
policies
and
actions
4.
Validate
evidence
with
govern-
ment
officials
5.
Rate
govern-
ment
policies
and
actions
6.
Weight,
sum and
calculate
Food-EPI
scores
7.
Qualify,
comment
&
recomm-
end
8.
Translate
results for
govern-
ment &
stake-
holders
Process driven by existing or formed ‘national coalition’
of informed public health non-government organisations and researchers

23
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Development of the Healthy Food
Environment Policy Index (Food-EPI)
The Food-EPI was based on a review of the evidence
and policy documents and revised by a group of
international experts, including experts from low,
middle and high income countries as well as senior
representatives from the World Health Organisation
(WHO) and the Food and Agriculture Organisation
(FAO). Evidence-based or expert committee
reports from international agencies such as WHO
and FAO, national government agencies, non-
governmental organisations, professional societies
and expert advisory groups were reviewed for their
recommendations for improving food environments
and population diets (14). The WHO approach to
strengthening healthy systems (32) was adapted
for incorporation into the infrastructure support
component of the tool. The structure of the Food-EPI
tool is provided in the body of the report (Figure 2) and
the process that was used to implement the tool in
New Zealand is outlined below.
Piloting and rening the Food-EPI tool and
process
The Food-EPI tool and processes were pilot tested
and revised for New Zealand and international
implementation in 2013. The main elements of the
piloting process were to:
• Collect evidence on the extent of government
implementation of different policies and
infrastructure support systems in New Zealand
and validated with government ofcials.
• Present the evidence to informed independent
public health experts and NGO representatives in
a workshop setting.
• Ask experts participating in the workshop to
rate the performance of their government on the
good practice statements covering the policy and
infrastructure support domains.
• Ask experts participating in the workshop to
evaluate.
- The level of difculty of rating each indicator.
- The appropriateness and completeness of the
evidence presented.
For the pilot study, two whole-day workshops were
convened. Thirty-nine independent public health
experts and NGO representatives rated the good
practice statements within the 7 policy and 7
infrastructure support domains. The difculty of rating
the indicators and the comprehensiveness of the
evidence base was also assessed by the experts. Based
on their assessments and comments and the inter-
rater reliability scores (overall score of 0.85, CI=0.81-
0.88), the main changes to the Food-EPI tool included
strengthening the leadership domain, removing the
workforce development domain (because professional
training was mainly outside the government
jurisdiction), strengthening the equity focus, and
adding community-based programs and government
funding for research on obesity and NCD prevention
as good practice indicators. The modied tool and the
revised good practice statements and evidence were
used in the baseline study in April-May 2014.
Baseline study – rating the levels of
implementation in New Zealand
Similar to the pilot study, two workshops were
convened to obtain ratings for the level of
implementation for each good practice indicator.
Prior to the rating workshops, the experts were
provided with a written summary of New Zealand
evidence on the extent of implementation of good
practice policies and infrastructure support and
international benchmarks for each indicator. The
evidence summary was compiled from policy
documents and budgets retrieved from websites and
through ofcial information requests. The evidence
was comprehensively documented and returned to
government ofcials to verify its completeness and
accuracy. International best practice exemplars were
extracted from the World Cancer Research Funding
NOURISHING framework and from other sources
detailed in Appendix 2.
Fifty-two New Zealand-based public health experts and
representatives from medical associations and NGOs
independently scored the degree of implementation
of policy and infrastructure support in New Zealand
against international best practice. A total of 42
indicators were rated using likert scales (1 to 5)
comprising 19 policy indicators and 23 infrastructure
support indicators (refer to Appendix 3 for a full list of
the statements).
Before rating each indicator, the evidence and
international benchmarks were briey summarised
in a PowerPoint presentation with opportunities
for comment and clarication. Experts in the
Auckland and Wellington workshops were able to
comment on the evidence and benchmarks before
rating the indicator. They also provided feedback
on the completeness and accuracy of the evidence
document. The evidence document was revised where
inaccuracies were noted. Representatives from the
Ministry of Health and/or the Ministry of Primary
Industries were present as observers and were invited
to make comments on any of the evidence presented.

24
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
The mean rating for each indicator was used
to determine an overall percentage level of
implementation. These ratings were then categorised
into High, Medium, Low, or Very Little, if any levels
of implementation based on the following cut-points:
>75% = High; 51 to 75% = Medium; 26 to 50% = Low;
<25% = Very little, if any.
Identifying and prioritising actions for
implementation in New Zealand
Concrete actions were identied in the workshops’
plenary discussions after all the indicators had been
rated. Experts participating in the workshops were
presented with the distribution of the rating score for
each indicator. They discussed the need for any action
in relation to the indicator and, if they considered there
was a need, identied actions required to improve food
environments and population nutrition and reduce
NCDs in New Zealand.
Actions were proposed for 34 of the 42 good practice
indicators. These 34 actions were identied as having
the potential, in concert with other actions, to help
improve food environments and population nutrition
and reduce obesity and diet-related NCDs in New
Zealand. (Refer to Appendix 4 for a complete list of
indicators and their related actions).
The 15 recommended policy actions and 19
recommended infrastructure support actions were
prioritised in a separate process. Experts who
participated in the workshops (and others unable to
attend the workshop) were provided with the summary
results of the ratings on the implementation gaps and
the recommended actions within an Excel spreadsheet
(sent by email). They were asked to complete
and return the spreadsheets with their individual
prioritisation scores. Policy and Infrastructure support
actions were prioritised separately.
Within the set of 15 recommended policy actions,
the experts were asked to prioritise the importance
of the action (taking into account the relative need,
impact, effects on equity, other positive and negative
effects of the action) by allocating 75 points across
the 15 actions (Refer to Table 3 for a description of
the criteria). They were also asked to prioritise the
likely achievability of the 15 policy actions (taking
into account the relative feasibility, acceptability,
affordability and efciency of the action) by allocating
75 points across the actions. The experts were then
asked to prioritise the 19 infrastructure actions.
This meant allocating a 95 points across the 19
infrastructure actions, rst for importance and then for
achievability.
Table 3: Criteria for prioritising the recommended actions: Importance and Achievability
Importance Achievability
Need
The size of the implementation gap
Feasibility
How easy or hard the action is to implement
Impact
The effectiveness of the action on improving food
environments and diets (including reach and effect
size)
Acceptability
The level of support from key stakeholders including
government, the public, public health, and industry
Equity
Progressive / regressive effects on reducing food/
diet-related health inequalities
Affordability
The cost of implementing the action
Other positive effects
(e.g., on protecting rights of children and consumers)
Efciency
The cost-effectiveness of the action
Other negative effects
(e.g., regressive effects on household income,
infringement of personal liberties)

25
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Denitions
Benchmark: A standard or point of reference against which aspects of food environments or policies can be assessed and
compared.
Civil society: The aggregate of non-governmental organizations, institutions and individuals that manifest interests and will
of citizens (academia, professional organizations, public-interest NGOs and citizens)
Diet-related non-communicable diseases (NCDs): Type 2 diabetes, cardiovascular diseases and nutrition-related cancers,
excluding micronutrient deciencies, undernutrition, stunting, osteoporosis, mental health and gastrointestinal diseases
Food environments: The collective physical, economic, policy and sociocultural surroundings, opportunities and conditions
that inuence people’s food and beverage choices and nutritional status
Government: National and local government, including councils, district health boards and public health units
Government-funded settings: Government departments and agencies, publicly funded schools, publicly funded early
childhood education services, elderly homes, hospitals and prisons
Government implementation: refers to the intentions and plans of the government, government funding for implementation
of actions undertaken by non-governmental organisations, and actions and policies implemented by the government.
Healthy foods: Foods recommended in national food-based dietary guidelines, dietary guidelines or food-based standards
Healthy food environments: Environments in which the foods, beverages and meals that contribute to a population diet
meeting national dietary guidelines are widely available, affordably priced and widely promoted
Nutrients of concern: salt, fat, saturated fat, trans fat, added sugar
Platforms: Formal government mechanisms (e.g. standing committees, ad hoc committees, advisory groups, taskforces,
boards, joint appointments) for interaction on particular issues
Population nutrition promotion: The investments in population promotion of healthy eating and healthy food environments
for the prevention of obesity and diet-related NCDs, excluding all one-on-one promotion (primary care, antenatal services,
maternal and child nursing services etc.), food safety, micronutrient deciencies (e.g. folate fortication) and undernutrition
Unhealthy foods: processed foods or non-alcoholic beverages high in saturated fats, trans fats, added sugars, and/or salt
Important information
If ‘foods’ are mentioned, it means ‘foods and non-alcoholic beverages’. Alcohol is excluded from the framework.
The time frame is the last three years (governing period), although the monitoring domain needs to take a longer view (5
years).
Text in italic in the tables serves as background information only.
Abbreviations
ASA: Advertising Standards Authority; DHB: District Health Board; ECE Early Childhood Education; ERO Education Review
Ofce; FIG: Food Industry Group; FSANZ: Food Standards Australia New Zealand; GRAS: Generally recognized as safe;
GST: Goods and Services Tax; HeartSafe: Sodium Advisory & Food Evaluation; HBC: Heartbeat Challenge; HEHA: Healthy
Eating Healthy Action; HPA: Health Promotion Agency; HPS: Health Promoting Schools; HSR: Health Star Rating; INFORMAS:
International Network for Food and Obesity/NCDs Research, Monitoring and Action Support; MBIE: Ministry of Business,
Innovation and Employment; MFAT: Ministry of Foreign Affairs and Trade; MoH: Ministry of Health; MPI: Ministry for Primary
Industries; NAG: National Administration Guideline; NCDs: Non-communicable diseases; NHF: National Heart Foundation;
NHMRC: National Health and Medical Research Council; NIP: Nutrition Information Panel; NPSC: Nutrient Proling Scoring
Criterion; NZFSA: New Zealand Food Safety Authority; NZFCD: New Zealand Food Composition Database; SD: Standard
Deviation; SNAP: Supplemental Nutrition Assistance Program; SPEAR: Social Policy Evaluation and Research; SSC: State
Services Commission; WIC: Special Supplemental Nutrition Program for Women, Infants, and Children; WHO: World Health
Organisation; WTO: World Trade Organization
Acknowledgements
The INFORMAS coordination team acknowledges the nancial support from the National Heart Foundation New Zealand
for holding the rating workshops (grant number 1580), and the NGO representatives, academics and public health experts
in New Zealand participating in the rating workshops. The authors acknowledge the government ofcials who spent precious
time answering ofcial information requests and checking completeness of the evidence on the extent of implementation of
policies.
9. Appendix 2: Evidence summary provided
to the Expert Panel
New Zealand Healthy Food Environment Policy Index (Food-Epi): Evidence for Raters Distributed to Participants in the
Food-Epi Workshops held in Auckland and Wellington in 2014

26
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Evidence collected for the good practice statements within the 7 FOOD POLICY domains
(as at 29/04/2014)
1 FOOD COMPOSITION: There are government systems implemented to ensure that, where practicable,
processed foods minimise the energy density and the nutrients of concern
Q2 COMP 1: Food composition targets/standards have been established by the government for the content
of the nutrients of concern in certain foods or food groups if they are major contributors to population intakes of
these nutrients of concern (trans fats and added sugars in processed foods, salt in bread, saturated fat in commercial
frying fats)
Evidence:
• There are no food composition targets specied by the Ministry of Health (MoH) or the Ministry for Primary Industries
(MPI) for the nutrients of concern.
• Major contributors to New Zealand sodium intakes are: bread (26%), processed meats (10%), and sauces (6%). Mean
(SD) sodium contents of these processed foods are: 447 (125) mg/100 g, 1,169 (444) mg/100 g, and 1,046 (1,235)
mg/100 g, respectively. Food categories with the lowest percentage of products meeting corresponding UK Food
Standards Agency targets are: sausages/hot dogs and sliced meat (0%); salami/cured meat (2%); liquid meal-based
sauces (4%); and multigrain bread (14%). Mean sodium contents of NZ products were found to be higher than for similar
products in the UK. These data were collected over a one-month period between December 2010 and January 2011 in
New Zealand. Key opportunities identied for sodium reduction were: white bread, sausages and hot dogs, and salami/
cured meat[1].
• There are a range of initiatives in New Zealand aimed at reducing levels of salt (mainly) and saturated fats in processed
foods and reducing portion sizes: The National Heart Foundation (NHF)’s food reformulation programme (HeartSafe
(Sodium Advisory & Food Evaluation)) was developed in 2010 to facilitate industry-led, cross-category sodium reduction in
New Zealand, based on voluntary collaboration between food companies, industry bodies and the government. HeartSafe
is coordinated by the NHF, under a contract from the MoH. It aims to support food companies to reduce salt levels in
packaged food products (particularly lower-cost high-volume packaged foods). Reformulation work largely focuses on
salt reduction. Some of the more recent categories have other factors included (e.g. pies - saturated fat, soups – portion
size). The programme involves the setting of best practice sodium guidelines for packaged foods, in partnership with
the food industry and then supports and encourages food companies to reduce sodium levels to these guidelines. The
objective of the programme is to achieve at least 80% of the market share (by sales volume) to meet the targets. In 2007,
the NHF started the voluntary strategy, rst with bread manufacturers. It aimed to reduce the sodium content of bread,
particularly low cost and high volume breads, to less than 450mg/100g[2]. Currently bread companies are exploring the
feasibility of a 400mg guideline (personal communication Dave Monro, NHF). The best practice guidelines for sodium
reduction in a range of food products (for bread, breakfast cereals, processed meats, savoury pies) and current industry
commitments for sodium and saturated fat reduction in foods within HeartSAFE can be found online on the website
of the NHF [3]. The NHF is also in the process of setting new sodium reduction guidelines for cheese, butter/oil based
spreads and soups. These guidelines are largely to encourage reformulation in outlier products as a number of the bigger
companies have done work in these categories to bring sodium levels down (personal communication Dave Monro, NHF).
Currently in the majority of categories where guidelines have been set, over 80% of the volume market share met the
sodium targets (personal communication Dave Monro, NHF). The reformulation work has been carried out in the absence
of any consumer awareness campaign. This “behind the scenes” approach was implemented in order to minimise risk
to market leading companies who owften do not want to communicate to their customers that iconic brands have been
reformulated. It also avoids cross-over with the NHF’s Tick signposting programme and avoids consumer confusion that
the NHF is endorsing less healthy foods (e.g. processed meats, white bread) that have lowered levels of salt. The approach
aimed to prioritise categories based on highest sodium contribution and targeted high volume, low cost foods (including
private label products). Despite this programme being on a voluntary basis the effect of the programme on the New
Zealand food supply has been signicant, with over 210 tonnes of salt per annum removed from the food categories that
have been targeted (personal communication Dave Monro, NHF).

27
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Food
category
Contribution
to sodium
intake[4]
Target set and timeframe Outcomes
Bread 25.7% Bread pilot project started in 2007
(Project Target 450: 450 mg/100g)
• Over 80% market share of category meet
target.
• 150 tonnes of salt removed from food
supply over one year period as result of bread
companies reformulating down from levels
around 500-600mg.
• Industry exploring the viability of going below
450mg as the new target. This has been done
already in some leading stock keeping units (e.g.
largest selling white bread in NZ at 410mg).
Processed
Meats
10.3% HeartSAFE target set in 2010 with
the timeframe of the end of 2013
(targets: sausages 800 mg/100g,
bacon and ham 1200 mg/100g)
• Currently 69% market share meets the
guidelines. By March 2014 it will rise to over
80% of market share meeting the targets.
• 34 tonnes of salt removed from the food
supply per annum.
• Reductions of around a third in some high
volume stock keeping units.
• Processed meat progress particularly pleasing
in light of research conducted in 2010 - 2011
that showed levels in NZ higher than UK and
Australia.
Breakfast
Cereals
5.8% HeartSAFE target set in 2010 with
the timeframe of the end of 2014
(targets: Puffed Rice & Corn Flakes
600 mg/100g, Oat based Muesli
& Porridge 200 mg/100g, biscuits
300mg/100g, and others 400
mg/100g)
• Over 80% market share of category meet
targets.
• 19 tonnes of salt per annum removed from the
food supply based on the change in levels from
2006-2007 to 2013.
• Large companies had reformulation in train
prior to setting targets; HeartSAFE targets have
been more effective in supporting change in
private label and smaller companies.
• Major reformulation activity has centred on
cornake and rice bubble- styled cereals, with
some products having sodium levels reduced by
a third.
Butter/
margarine
(Proposed)
3.8% HeartSAFE guideline setting/
industry roundtable in Feb 2014 (no
target on website yet)
Savoury
pies
3.1% HeartSAFE target set in 2012
-timeframe for sodium in March
2014 and saturated fat in November
2014)
Target for sodium: 400 mg/100g by
2014 and 350 mg/100g by 2016
Target for saturated fat: mince/steak
5 g/100 g by 2014, while Mince &
Cheese/Steak & Cheese 5 g/100g
by 2016
• Around 40% market share meet targets.
• One supplier who produces more than 12 million
pies annually has reduced the salt levels by
around 40 percent across its pie range to meet
the target.
• 10 tonnes of salt re moved per annum from
this category.
Cheese 2.8% HeartSAFE guideline setting/
industry roundtable Feb 2014 (no
target on website yet)
Soups 1.7% HeartSAFE guideline set Feb 2014
with timeframe of Feb 2016 ( wet
soups: 290mg/100g; dry soups:
300mg/100g).

28
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
• The Chip Group initiative aims to improve the nutritional quality of deep-fried chips served by New Zealand foodservice by
reducing fat (total and saturated) and salt content. It is funded by both food industry and the MoH, approximately 50%
from industry and 50% from government (85000 NZD per annum from MoH) (personal communication Glenda Gourley,
Chairperson The Chip Group). The NHF provides support to the Chip group through expertise, resources and time. The
Chip Group sets Industry Standards that are scientically robust and achievable, including chip size, serving size, cooking
oil temperature, salt addition, and oil type [5]. The standards for deep-frying are: Maximum 28% saturated fat, max 3%
linolenic acid and max 1% trans fat. The Chip Group oil logo, for use on approved oil packaging and point-of-sale, was
developed in 2010. There are currently 11 registered approved oils – including blends and new variety oils - marketed by
Bakels, Integro (division of Goodman Fielder), Cookright, Peerless, NZ Sugar/Wilmar. The Chip Group runs the Best Chip
Shop Competition every second year to nd the best of the best operators. Only one gets the Grand National title and six
are awarded as regional winners. If their chips were under 9% fats they receive a highly commended award.
• Food Standards Australia New Zealand (FSANZ) concluded based on reviews of the status of trans fats in the New Zealand
and Australian food supply in 2007 and 2009 that regulatory intervention and targets were not required and that national
non-regulatory approaches to further reduce the levels of trans fats in the Australia and New Zealand food supply
would be the most appropriate action for risk management. This was, because average total trans fat intakes from both
ruminant and manufactured sources in New Zealand were below the World Health Organization (WHO) population goal of
contributing less than1% to total energy intake. The survey report indicated as well that the quick service restaurants (19
participating) and their stakeholders made positive changes resulting in lower trans fat products. These results were self-
reported. The 2009 review report and supporting documents (including survey reports of progress of voluntary initiatives,
Round table on Trans Fats in the Quick Service Restaurant Industry) are available on the FSANZ website[6].
International or national good/best practice:
1. In Argentina in 2013, the government adopted a law on mandatory maximum levels of sodium permitted in meat
products and their derivatives, breads and farinaceous products, soups, seasoning mixes and tinned foods (law
no. 26.905 on Maximum Levels of Sodium Consumption). Large companies have to meet the sodium targets by
December 2014, small and medium sized companies by June 2015. Infringements by producers and importers may
be sanctioned, the most severe penalties being nes of up to one million pesos, in case of repeat infringements up
to ten million pesos, and the closing of the business for up to ve years[7]
2. In 2013, the South African Department of Health adopted targets for salt reduction in 13 food categories by means
of regulation (Foodstuffs, Cosmetics and Disinfectants Act). There is a stepped approach with food manufacturers
given until June 2016 to meet one set of category-based targets and another three years until June 2019 to meet
the next[7]
3. The UK salt reduction programme was a successful comprehensive voluntary approach [8]; The approach was
voluntary, but with threat of legislation. Since the salt reduction programme started in 2003/2004, signicant
progress has been made as demonstrated by the reductions in salt content in many processed foods and a 15%
reduction in 24-h urinary sodium over 7 years (from 9.5 to 8.1 g per day, P<0.05). In March 2006 the Food Standards
Agency published the original voluntary salt reduction targets for 85 categories of foods. The updated reduction
targets for 2010-2012[9] and those for 2017[10] can be found online.
4. In 2009, New York City established voluntary salt guidelines for various restaurant and store-bought foods. In
2010, this city initiative evolved into the National Salt Reduction Initiative that encouraged nationwide partnerships
among food manufacturers and restaurants involving more than 100 city and state health authorities to reduce
excess sodium by 25% in packaged and restaurant foods and by 20% among the population by 2014.The National
Salt Reduction Initiative has worked with the food industry to establish salt reduction targets for 62 packaged foods
and 25 restaurant food categories for 2012 and 2014 [11, 12].
5. In Denmark a law introduced in 2003 prohibits the sale of products containing trans fats, a move that effectively
bans its use in products destined for sale on the Danish market[7]
6. In New York City, trans fats were banned in chain restaurant meals to less than 0.5 g per serving in 2006. The
pre- and post- trans fat monitoring showed substantial declines compared to other US cities where no bans or
legislation was enacted to establish mandatory food labeling standards[13].

29
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
2 FOOD LABELLING: There is a regulatory system implemented by the government for consumer-oriented
labelling on food packaging and menu boards in restaurants to enable consumers to easily make informed food choices and
to prevent misleading claims
Q3 LABEL1: Ingredient lists and nutrient declarations in line with Codex recommendations are present on the
labels of all packaged foods
Evidence:
• New Zealand meets CODEX standards and regulation is in place to ensure compliance. The MPI manages New Zealand’s
participation in Codex and sets strategic priorities which ensure that Codex standards have the widest possible
application.
• The labelling regulation is outlined in the Australia New Zealand Food Standards Code [14, 15]. The MPI is responsible for
implementation of the Food Standards Code, which has been in force since 2002. Previously there were 2 separate codes:
a regular one and one combined with the AU code, which were agreed in 1995 and have been in force since 1996. Labels
must include among others the ingredient list. Ingredients must be declared in the statement of ingredients in descending
order of ingoing weight.
• The nutritional information panel (NIP) must be set out specically as shown below and is required on most packaged
food products.
• Where average quantities or minimum/maximum quantities are given this must be indicated in the NIP (standard
example shown below)
• In 2009, Australian and New Zealand food regulation ministers agreed to a comprehensive independent review of
food labelling law and policy. An expert panel, chaired by Dr Neal Blewett, undertook the review and the panel’s nal
report, called Labelling Logic, was publicly released on 28 January 2011 and included 61 recommendations[16]. The
role of food labels in communicating preventative health messages and informing healthy food purchasing decisions by
consumers was a key focus of Labelling Logic. The Legislative and Governance Forum on Food Regulation provided a
detailed response to the recommendations from the Labelling Logic report [17]. Under policy drivers of food labelling it
was recommended in Labelling Logic that the Food Standards Australia New Zealand Act 1991 be amended to include a
denition of public health to the effect that: ‘Public Health is the organised response by society to protect and promote
health, and to prevent illness, injury and disability’ (recommendation 1). To address this, in the rst instance a Ministerial
Policy Guideline will be developed detailing the expectations of FSANZ in relation to the role of food standards in
supporting public health objectives.
• Currently, FSANZ is undertaking a number of projects arising from the Legislative and Governance Forum on Food
Regulation response to Labelling Logic [18].One of the projects relates to Recommendation 13, which states that
mandatory declaration of all trans fats above an agreed threshold be introduced in the NIP if manufactured trans fats
have not been phased out of the food supply by January 2013. FSANZ has been asked to provide technical evaluation
and advice to the Forum on this issue.Further progress will be provided on an indicated online web page[19].
Other projects include providing technical advice on:
• recommendation 14 - declaration of total and naturally occurring ber content to be considered as a mandatory
requirement in the NIP
• recommendation 26 – that the energy content be displayed on the labels of all alcoholic beverages consistent with the
requirements for other foods. FSANZ has been requested to undertake a cost benet analysis for this recommendation
• providing technical advice on recommendation 12 - where sugars, fats or vegetable oils are added as separate
ingredients in a food, the terms ‘added sugars’ and ‘added fats’ and/or ‘added vegetable oils’ be used in the ingredient
list as the generic term, followed by a bracketed list (e.g., added sugars (fructose, glucose syrup, honey), added fats (palm
oil, milk fat) or added vegetable oils (sunower oil, palm oil);

30
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Over the next 12 months FSANZ will start work on:
• considering removal of the mandatory requirement for the ‘per serve’ column in the NIP unless a daily intake claim is
made in response to recommendation 17;
International or national good/best practice:
1. In a range of countries around the world, including New Zealand, producers and retailers are required by law to
provide a nutrient list on pre-packaged food products (with limited exceptions), even in the absence of a nutrition
or health claim. The rules dene which nutrients must be listed and on what basis (e.g. per 100g/per serving). [7]
2. In Finland national legislation regarding the compulsory use of warning labels on high-salt foods has been in
place since 1993. The legislation is applied to all the food categories that make a substantial contribution to
the salt intake of the Finnish population. Foods that are high in salt are required to carry a “high salt content”
warning. A “high salt content” must be labelled, if the salt content is more than 1.3% in bread, 1.8% in sausages,
1.4% in cheese, 2.0% in butter, and 1.7% in breakfast cereals or crisp bread. [7]
3. In 2012, the Chilean government approved a “Law of Food Labeling and Advertising” which included a provision
for the development of “warning labels” on foods high in energy, sugar, saturated fat and sodium. In 2013, the
government issued a further statement dening the products to which the warning label applies. It also denes
the criteria for the presentation and location of the warning. Although the rules have been adopted, the warning
labels have not yet been implemented. [7]
4. The US Food and Drug Administration has proposed updates to the Nutrition Facts label on food packages[20]
to reect the latest scientic information, including the link between diet and chronic diseases such as obesity
and heart disease. The proposed label also would replace out-of-date serving sizes to better align with how
much people really eat, and it would feature a fresh design to highlight key parts of the label such as calories
and serving sizes. Information on the amount of added sugars would be included on the label, serving size
requirements to reect the amounts people currently eat would be updated, and “dual column” labels would be
presented to indicate both “per serving” and “per package” calorie and nutrition information.
5. The US Food and Drug Administration made disclosures of trans fats mandatory on the ‘Nutrition Facts’ panel[21,
22]. In November 2013, the Food and Drug Administration issued a Federal Register notice with its preliminary
determination that trans fats are no longer “generally recognized as safe”.
2 FOOD LABELLING: There is a regulatory system implemented by the government for consumer-oriented
labelling on food packaging and menu boards in restaurants to enable consumers to easily make informed food choices and
to prevent misleading claims
Q4 LABEL2: Robust, evidence-based regulatory systems are in place for approving/reviewing claims on foods,
so that consumers are protected against unsubstantiated and misleading nutrition and health claims
Evidence:
• A new food standard to regulate nutrition content claims and health claims on food labels and in advertisements
became law on 18 January 2013. From this date food businesses in Australia and New Zealand have three years to meet
the requirements of the new Standard (Standard 1.2.7 - Nutrition, Health and Related Claims [23]). Food businesses
wanting to make general level health claims will be able to base their claims on one of the more than 200 pre-approved
food-health relationships in the Standard or self-substantiate a food-health relationship in accordance with detailed
requirements set out in the Standard. Standard 1.2.7 requires a person to notify FSANZ of a relationship between a food
or property of food and a health effect (food-health relationship) which has been established by a process of systematic
review. Notication must be made before making a general level health claim based on the food-health relationship. High
level health claims (referring to a serious disease or a biomarker of a serious disease) must be based on a food-health
relationship pre-approved by FSANZ. There are currently 13 pre-approved food-health relationships for high level health
claims listed in the Standard. For example: Diets high in calcium may reduce the risk of osteoporosis in people 65 years
and over. An example of a biomarker health claim is: Phytosterols may reduce blood cholesterol.
• Health claims will only be permitted on foods that meet the nutrient proling scoring criterion (NPSC)[24]. Final Score =
baseline points (based on average energy, saturated fat, total sugar and sodium content per 100 g or 100ml) – (fruit and
vegetable points) – (protein points) – (bre points). An online calculator is available to help food businesses determine a
food’s nutrient proling score[25]. New Zealand is one of the few countries having a nutrient proling scheme in place.
• A Health Claims Scientic Advisory Group has been established to provide scientic and technical advice to FSANZ,
when requested by FSANZ, in relation to: health claims; and matters relevant to Standard 1.2.7- Nutrition, Health and
Related Claims. The role of the High Level Health Claims Committee is to consider and provide recommendations to
FSANZ in relation to draft high level health claim variations and/or the application or proposals that resulted in that draft
variation.

31
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
• A nutrition content claim that meets the conditions to use the descriptor diet must not use another descriptor that
directly or indirectly refers to slimming or a synonym for slimming. A nutrition content claim using the descriptor diet is
a comparative claim if it meets the conditions for making that claim by having at least 40% less energy than the same
quantity of reference food. Although nutrition content claims need to meet certain criteria set out in the Standard, there
are no generalized nutritional criteria that restrict their use on “unhealthy” foods. The NPSC does not apply to nutrition
content claims.
• The MPI will undertake a baseline survey this year, identifying claims which are currently made on food products
available on the domestic market. This information will be used to identify areas which require additional guidance
information, to remind industry on the transitional process and associated deadlines, develop regulatory tools with
regard to the interpretation of the Standard and to also evaluate the impact of Standard in the future (response MPI to
ofcial information request).
• Other MPI work programme activities associated with Standard 1.2.7 include: provision of consumer and industry
information on the Standard, liaison with industry on the development of dossiers and the development of internal
procedures to assess dossiers.
• The enforcement mechanism specic to this Standard is under development. However, it is likely to be similar to that of
other legislative requirements, where non-compliances of a public health concern are treated as issues for priority action
by Food Act Ofcers. With regard to self-substantiated claims, MPI plans to review all dossiers associated with the initial
notications from New Zealand food manufacturers. MPI will then establish criteria for selecting dossiers associated with
notications. Dossiers will contain commercially sensitive information and therefore will not be available in the public
domain. Industry will hold these dossiers. MPI, as the regulatory body, has access to these dossiers, so that compliance
can be assessed against Standard 1.2.7. (response MPI to ofcial information request)
• Laws that protect the consumer in NZ include the fair trading act and the consumer guarantees act[26]. It is stated that
‘goods must meet the guarantees of acceptable quality, and matching description’. The Ministry of Consumer Affairs
prepared a consumer guide to explain the consumer’s rights related to the guarantees act[27].
International or national good/best practice:
1. A law (Standard 1.2.7)[23, 24] approved in 2013 regulates the use of nutrition content and health claims on
food labels and in advertisements in Australia and New Zealand. Health claims must be based on pre-approved
food-health relationships or self-substantiated according to government requirements. Health claims are only
permitted on foods that meet nutritional criteria, as dened by a nutrient proling model. Few countries have such
a nutrient proling model in place. Although nutrition content claims need to meet certain criteria set out in the
Standard, there are no generalized nutritional criteria that restrict their use on “unhealthy” foods.
2. Regulation 1924/2006 establishes EU-wide rules on the use of specied nutrient content and comparative
claims (i.e. levels of fat for a low fat claim). Nutrition claims can only be used on foods dened as “healthy” by a
nutrient prole (nutrient prole not yet dened). This regulation applies in Iceland and Norway as members of the
European Free Trade Agreement participating in the European single market[7].

32
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
2 FOOD LABELLING: There is a regulatory system implemented by the government for consumer-oriented
labelling on food packaging and menu boards in restaurants to enable consumers to easily make informed food choices and
to prevent misleading claims
Q5 LABEL3: A single, consistent, interpretive, evidence-informed front-of-pack supplementary nutrition
information system, which readily allows consumers to assess a product’s healthiness, is applied to all packaged
foods.
Evidence:
• There is currently no mandatory or voluntary front-of-pack labelling system implemented by the government in NZ.
• The Blewett labelling logic report[16], commissioned by the Australian and New Zealand food regulation ministers,
contained several recommendations related to front-of-pack nutrition labelling:
Recommendation 50: That an interpretative front-of-pack labelling system be developed that is reective of a
comprehensive Nutrition Policy and agreed public health priorities.
Recommendation 51: That a multiple trafc lights front-of-pack labelling system be introduced. Such a system has to be
voluntary in the rst instance, except where general or high level health claims are made or equivalent endorsements/
trade names/marks appear on the label, in which case it should be mandatory.
Recommendation 52: That government advice and support be provided to producers adopting the multiple trafc lights
system and that its introduction be accompanied by comprehensive consumer education to explain and support the
system.
Recommendation 53: That on-going monitoring and evaluation of the multiple trafc lights system be undertaken to
assess industry compliance and the effectiveness of the system in improving the food supply and inuencing consumers’
food choices.
Recommendation 50 was supported by the government and the others are on hold dependent on the outcome of
recommendation 50[17].
• Under the leadership of the MPI an expert advisory group, composed of industry, government and public health
stakeholders, has been working on development of a voluntary approach to front-of-pack labelling in NZ. On 14/06/2013
the Health Star Rating (HSR) system was approved by Australian government [28]. The preferred implementation option
at this stage is a voluntary system, subject to consistent and widespread uptake of the system by industry. If, following
evaluation after two years, a voluntary implementation is found to be unsuccessful, a mandatory approach will be
considered. In the meantime, the Calculator for the HSR system has been approved and consumer research has been
done. In June 2014 the Legislative and Governance Forum on Food Regulation will consider the HSR label design, and
any processes to address anomalies that may be identied within the HSR calculator[29]. An example of the health star
rating label is printed below. New Zealand intends to align as much as possible with what is happening in Australia and
has supported a voluntary interpretive FOPL system. The trafc light system is not being considered in New Zealand or
Australia. Research in New Zealand has shown however that Māori populations prefer the multiple trafc light labelling
system, but the research did not yet take into account the HSR system [30]. New Zealand is still working through any
areas of difference from the proposed Australian system, in particular the proposed exemptions.
Research to study the health star rating system in isolation, looking at how this system might be perceived and
understood in New Zealand, has been announced in November 2013[31].
International or national good/best practice:
1. In the UK a new consistent system of front-of-pack food labelling has been introduced: A combination of colour
coding and nutritional information is used to show how much fat, salt and sugar and how many calories are
in each product. It is estimated that about 60% of foods will be covered by the system because it will remain
voluntary. In 2013, the government published national guidance for voluntary ‘trafc light’ labelling for use on
the front of pre-packaged products. The label uses green, amber and red to identify whether products contain low,
medium or high levels of energy, fat, saturated fat, salt and sugar.
2. In Ecuador, mandatory multiple trafc light front-of-pack labelling has been approved by government, but not yet
implemented. A regulation of the Ministry of Health published in 2013 will require packaged foods to carry “trafc
light” labels with red, orange and green signals in Ecuador [7].
3. Australia is in the nal stages of implementing a Health Star Rating system which will be voluntary but become
mandatory if insufcient uptake by industry.

33
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
2 FOOD LABELLING: There is a regulatory system implemented by the government for consumer-oriented
labelling on food packaging and menu boards in restaurants to enable consumers to easily make informed food choices and
to prevent misleading claims
Q6 LABEL4: A consistent, single, simple, clearly-visible system of labelling the menu boards of all quick service
restaurants (i.e. fast food chains) is applied by the government, which allows consumers to interpret the nutrient
quality and energy content of foods and meals on sale
Evidence:
• The Labelling logic report[16], commissioned by Australian and New Zealand food regulation ministers, recommended
that declaration of energy content of standardised food items on the menu/menu boards or in close proximity to the
food display or menu should be mandatory in chain food service outlets and on vending machines. Further, information
equivalent to that provided by the Nutrition Information Panel (NIP) should be available in a readily accessible form
in chain food service outlets (recommendation 18). Chain food service outlets across Australia and New Zealand
should be encouraged to display the multiple trafc lights system on menus/menu boards. Such a system should be
mandatory where general or high level health claims are made or equivalent endorsements/trade names/marks are used
(recommendation 54).
• There is no government-initiated mandatory or voluntary labelling of foods and meals in any restaurants or outlets across
New Zealand. In some chains voluntary information is available.
• The government is supportive of the voluntary industry-led initiatives currently being implemented and will consider the
evaluation of these initiatives prior to considering regulatory measures of this nature being adopted through the Food
Standards Code [17].
International or national good/best practice:
1. Since 2010, in South Korea, the Special Act on Safety Control of Children’s Dietary Life has required all chain
restaurants with 100 or more establishments to display nutrient information on menus including energy, total
sugars, protein, saturated fat and sodium on menus from 2010[7].
2. In the UK as part of the government’s Responsibility Deal, 49 companies/retailers have agreed to provide calorie
information on menus and display boards. Although voluntary, the label must follow a standard government
model[7].
3. In the US the Patient Protection and Affordable Care Act (2010) requires that all chain restaurants with 20 or
more establishments display energy information on menus. The Food and Drug Administration has yet to issue
the implementing rules. Four states (e.g. California), ve countries (e.g. King County, Washington State) and three
municipalities (e.g. New York City) already have regulations requiring chain restaurants (often chains with more
than a given number of outlets) to display calorie information on menu and display boards. These regulations will
be pre-empted by the national law once implemented[7].
4. Australia has mandated kJ menu board labelling for chain fast food outlets in New South Wales, South Australia
and Australian Central Territory.

34
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
3 FOOD PROMOTION: There is a comprehensive policy implemented by the government to reduce the impact
(exposure and power) of promotion of unhealthy foods to children (<16years) across all media
Q7 PROMO1: Effective policies are implemented by the government to restrict exposure and power of promotion
of unhealthy foods to children through all forms of media, including broadcast (TV, radio) and non-broadcast media (e.g.
Internet, social media, point-of-purchase, product placement, packaging, sponsorship, outdoor advertising)
Evidence:
• There are no government regulations in place to restrict unhealthy food promotion to children through TV, radio, internet,
social media, packaging, product placement, magazines, outdoor advertising, sponsorship and point-of-purchase. If food
marketing to children via the media were to become regulated other than through the current self-regulatory regime,
the Ministry for Culture and Heritage would be likely to be the Ministry responsible for regulation because it is currently
the department responsible for media regulation. There is no Ministry of Broadcasting in New Zealand (only a Minister).
The extent to which other departments may be involved in regulation would depend on the nature of any food marketing
regulatory regime.
• There is industry self-regulation of food marketing in NZ. Advertising rules are governed by the Advertising Standards
Authority (ASA), which is an industry body. ASA has a number of codes, two of which are relevant to food advertising
to children. ASA, aiming to self-regulate advertising in NZ, established a new code in 2010: the Children’s Code for
Advertising Food 2010. All advertisements for food and beverages that inuence children, whether contained in children’s
media or otherwise, shall adhere to the Principles and Guidelines set out in this Code. This Code denes the age of a
child as under 14 in line with the Children, Young Persons and their Families Act 1989 and aligns with the Broadcasting
Standards Authority denition of a child [32]. It is stated that: “Food and Nutrition Guidelines” are the current version of
the Food and Nutrition Guidelines for Healthy Children (aged 2-12 years) of the Ministry of Health. Food advertisements
should not undermine the food and nutrition policies of Government, the Ministry of Health Food and Nutrition
Guidelines nor the health and wellbeing of children. Advertisements for nutritious foods important for a healthy diet
are encouraged to help increase the consumption of such foods. However, advertisements should not encourage over-
consumption of any food. Children’s viewing times are determined by the individual television broadcasters. Another
code, the Code for Advertising Food, applies to food advertising to persons 14 years and over. Advertisers are required to
exercise a particular duty of care for food advertisements directed at young people aged 14 to 17 years of age [33]. Also
relevant to TV advertising is the NZ Television Broadcasters code: getting it right for children (this covers the main free-
to-air broadcasters) [34]. There are policies included on: 1. No Advertising in Pre-school Television Programming Times,
2. Limited Advertising in School-age Children’s Television Programming Times, 3. Compliance with Television Advertising
Codes of Practice, 4. Separation of Programmes and Advertising, 5. Repetition, 6. Programme Issues, 7. Sponsorships and
8. 0900 Numbers and Text Responses. In 2008 a new advertising classication – CF (Children’s Food) was introduced, to
be applied during school-age children’s programming times only. It is based on the NZ food and beverage classication
system. Evidence suggests that there was no decline in children’s exposure to advertising of unhealthy food between
1997 and 2006 [35], based on content analysis of free-to-air television advertising to children [36, 37].

35
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
International or national good/best practice:
1. Norway and Sweden banned all food advertising targeting children aged younger than 12 years since 1990
2. Quebec has banned all advertising to children under the age of 13 since 1980[38]
3. In Ireland advertising and other forms of commercial communication of unhealthy foods, as dened by a nutrient
proling model, are prohibited during children’s TV and radio programmes where over 50% of audience are
under-18. Content rules also apply to commercial communications for unhealthy foods broadcast outside of
children’s programmes but which are directed at children. The 2005 Children’s Advertising Code states that food
advertising to children under the age of 15 must not feature celebrities [7].
4. In South Korea TV advertising is prohibited for specic categories of food before, during and after programmes
shown between 5-7pm and during other children’s programmes. Children are dened as younger than 18 years
of age. The restriction also applies to communication that is assumed to target children (e.g. where free toys are
included). The regulation of TV advertisements also applies to the Internet [7].
5. In November 2006, following an extended period of analysis and consultation, Ofcom, an independent
communications regulator in the UK, announced a ban on television advertising of products high in fat, salt
or sugar during children’s airtime and around programmes with a disproportionately high child audience.
Advertising of unhealthy foods, as dened by a nutrient proling model, is prohibited during TV and radio
programmes that have 20% more viewers under 16 years old relative to the general viewing population (includes
sponsorship of TV programmes). Ofcom’s principal aim was to reduce the exposure of children to advertising
of unhealthy foods. Unhealthy products were dened by reference to a nutrient proling model developed by
the Food Standards Agency (FSA). The nal phase came into force on 1 January 2009, when all advertising for
products high in fat, salt or sugar (HFSS) was banned from children’s channels (terrestrial as well as cable and
satellite channels). In the UK, the data show a 51% reduction in exposure (impacts) to TV advertisements high
in fats, sugars or salt during the period 2007–2010 for children aged 5–9 years, and a reduction of 23% for
children aged 10–15 years in a wide segment of TV programming. While the number of HFSS advertisements
(spots) shown during children’s programming fell from 0.3 m in Q1 2005 to virtually zero in 2009, the numbers
of advertisements for HFSS foods shown in non-child programming (but still seen by children) rose in the same
period[39].
6. In 2013, the “Promoting Healthy Food for Children Act” was passed into law in Peru. The law includes a range of
provisions designed to discouraged unhealthy diets, including food advertising. The law states that advertising
that is directed to children and adolescents under 16 years old and is disseminated through any format or media,
should not stimulate the consumption of food and non-alcoholic drinks, with “trans” fat, high content of sugar,
sodium and saturated fats. The law requires implementing regulations in order to be applied[7].
7. Conanda (National Council for the Rights of Children and Adolescents), a government agency attached to the
Department of Human Rights of Brazil, has passed a resolution, with the force of law, banning advertising
towards children in Brazil. Although there is uncertainty as to how this resolution will be enforced, it marks a
landmark shift in Brazil for marketing to children. The resolution states that “the practice of directing advertising
and marketing communication to children with the intention of persuading them to consume any product or
service” is abusive and, therefore, illegal as per the Consumer Defence Code. With the resolution, starting
immediately, the following methods of marketing to children is considered prohibited: print ads, television,
commercials, radio sports, banners and sites, packaging, promotions, merchandising, actions on shows, and
point-of-sale presentations directed at children[40].

36
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
3 FOOD PROMOTION: There is a comprehensive policy implemented by the government to reduce the impact
(exposure and power) of promotion of unhealthy foods to children (<16years) across all media
Q8 PROMO2: Effective policies are implemented by the government to ensure that unhealthy foods are not
commercially promoted to children in settings where children gather (e.g. preschools, schools, sport and cultural
events)
Evidence:
• No such policy in place in New Zealand, for any of the settings
• There are guidelines on the Ministry of Education’s website for schools to develop policies relating to the food
environment in their school[41]. Within the section ‘developing a food and nutrition policy framework’ the following
recommendation is included: ‘It is recommended to critically review the promotion of foods and beverages to children
and young people including through sponsored curriculum materials, advertisements, fundraisers, and sponsorship’.
International or national good/best practice:
1. In 2007, the state of Maine in the US passed a law prohibiting brand-specic advertising of certain unhealthy
foods and beverages on school grounds, at any time. The ban applies to “foods of minimum nutritional value” as
dened by federal law[7].
2. In 2011 the Spanish Parliament approved a Law on Nutrition and Food Safety, which stated that kindergartens
and schools should be free from advertising. Implementation, which is reportedly not enforced, is at the discretion
of regional authorities[7].
3. Conanda (National Council for the Rights of Children and Adolescents), a government agency attached to the
Department of Human Rights of Brazil, has passed a resolution, with the force of law, banning advertising
towards children in Brazil. The text of the resolution also considers abusive any advertising and market
communication in day care centres and nurseries, as well as elementary schools, including advertising on school
uniforms and classroom material[40].
4 FOOD PRICES: Food pricing policies (e.g., taxes and subsidies) are aligned with health outcomes by helping to
make the healthy eating choices the easier, cheaper choices
Q9 PRICES1: Taxes on healthy foods are minimised to encourage healthy food choices where possible (e.g. low or no
sales tax, excise, value-added or import duties on fruit and vegetables)
Evidence:
• Goods and services tax (GST) applies equally to all foods in NZ. There is no reduction of taxes on healthy foods in NZ,
never actively considered by the government due to complexity and potential revenue shortfall. The current government
policy is not in favour of introducing exemptions.
International or national good/best practice:
1. GST exemption exists for basic foods (including fresh fruits and vegetables) in Australia
2. In Tonga in 2013, as part of a broader package of scal measures, import duties were lowered from 20% to 5% for
imported fresh, tinned or frozen sh in order to increase affordability and promote healthier diets[7].
3. All unprocessed food stuffs are zero-rated value-added tax in the UK. A range of unhealthy foods have standard-
rated value-added tax[42]

37
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
4 FOOD PRICES: Food pricing policies (e.g., taxes and subsidies) are aligned with health outcomes by helping to
make the healthy eating choices the easier, cheaper choices
Q10 PRICES2: Taxes on unhealthy foods (e.g. sugar-sweetened beverages, foods high in nutrients of concern)
are in place to discourage unhealthy food choices where possible, and these taxes are reinvested to improve
population health
Evidence:
• No increase of taxes on unhealthy foods in NZ. The current government policy is not in favour of introducing taxes on
specic foods.
International or national good/best practice:
1. In December 2013, the Mexican legislature passed two new taxes as part of the national strategy for the
prevention of overweight, obesity and diabetes. An excise duty of 1 peso ($0.80) per litre applies to sugary drinks.
Sugary drinks are dened under the new law as all drinks with added sugar, excluding milks or yoghurts. This
is expected to increase the price of sugary drinks by around 10%. An ad valorem excise duty of 8% applies to
foods with high caloric density, dened as equal to or more than 275 calories per 100 grams. The food product
categories that are affected by the tax include chips and snacks; confectionary; chocolate and cacao based
products; puddings; peanut and hazelnut butters. The taxes entered into force on 1 January 2014[7]. The aim is for
the revenue of taxes to be reinvested in population health, namely providing safe drinking water in schools.
2. In France in 2012, the government introduced an excise duty on drinks with added sugar and articial sweeteners,
including sodas, fruit drinks, avoured waters and ‘light’ drinks. The tax is around 11 euro cents per 1.5 litres of
soda and used to raise revenue for the general budget[7].
3. In French Polynesia a domestic excise duty on sweetened drinks, beer, confectionary and ice cream has been in
place since 2002. The tax aims to raise funds for prevention-oriented health programmes, as well as discourage
consumption. The tax is around $0.44 per litre on domestically-produced drinks[7].
4. In Hungary a “public health tax” adopted in 2012 is applied on the salt, sugar and caffeine content of various
categories of ready-to-eat foods, including soft drinks (both sugar- and articially-sweetened), energy drinks,
pre-packaged sugar-sweetened products. The tax is applied at varying rates. Soft drinks, for example, are taxed at
$0.24 per litre, and other sweetened products at $0.47 per litre[7].
5. In Tonga, as of 2013, soft drinks containing sugar or sweeteners are taxed at $0.50 per litre. Animal fat products
(e.g. lard and drippings) are taxed at $1 per kilogram[7].

38
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
4 FOOD PRICES: Food pricing policies (e.g., taxes and subsidies) are aligned with health outcomes by helping to
make the healthy eating choices the easier, cheaper choices
Q11 PRICES3: The intent of existing subsidies on foods, including infrastructure funding support (e.g. research and
development, supporting markets or transport systems), is to favour healthy rather than unhealthy foods
Evidence:
• Subsidies on foods in New Zealand, compared to other countries (e.g. agricultural subsidies in the United States), are
quite small. In the US In addition to making grains cheap, subsidies have led to an articially low cost of meat (corn and
soy are the central constituents of animal feed) and allowed the food industry to inexpensively sweeten a variety of foods
with high fructose corn syrup.
• The National Science Challenge on high value nutrition drives functional food development towards foods on which
health claims can be made. In the recent request for proposals it was written that the objective of this science challenge
is to develop high-value foods with validated health benets to drive economic growth. Health targets are to be identied
that are amenable to a science evidence-based food solution to drive economic growth. Protable high-value food
products are to be produced and marketed, backed by scientically validated health claims. The major aim of all the 10
National Science Challenges is to identify big science-based issues for New Zealand that, if addressed, will contribute
signicantly to the wellbeing of the nation, including through economic growth[43].
• Councils can approve and encourage applications for farmers markets on Council owned land, remove any stall fees and
charges at farmers markets, regional councils can ensure appropriate transport links are available to markets and other
fruit and vegetable outlets, cycle pathways, lighting etc. for night markets (personal communication Sarah Stevenson
Public Health Service Tauranga). Councils usually support farmers markets by land allocation and bus routes. Support
for farmers markets is quite common by NZ Councils. To our knowledge, no councils to date boost support for fresh fruits
and vegetables at produce markets, by such measures as providing free stall space.
International or national good/best practice:
1. In Singapore as part of the Healthier Hawker programme, manufacturers are able to tap into non-health related
government funding for productivity and innovation to improve logistics and efciency in supply of healthier oils
and healthier staples, with a view to making prices competitive [7].
2. The New York City Health Department District Public Health Ofces distribute ‘Health Bucks’ to farmers’ markets.
When customers use income support (e.g. Food Stamps) to purchase food at famers’ markets, they receive $2
back in ‘Health Bucks’, which can then be used to purchase fresh fruits and vegetables[7].

39
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
4 FOOD PRICES: Food pricing policies (e.g., taxes and subsidies) are aligned with health outcomes by helping to
make the healthy eating choices the easier, cheaper choices
Q12 PRICES4: The government ensures that food-related income support programs are for healthy foods
Evidence:
• Food-related income support is not tied to criteria related to the nutritional quality of foods in New Zealand
• KickStart Breakfast is the only school breakfast programme of its kind within New Zealand. Sanitarium provides the
Weet-Bix, Fonterra the Anchor milk and it’s the school that is responsible for delivering the programme. There are no
nutrition requirements set for this programme by the Ministry of Social Development, any decisions around nutritional
requirements are matters for the individual schools (info on nutritional requirements retrieved through ofcial information
request). The Prime Minister announced, as part of Government’s commitment to optimal outcomes for children and
young people, funding of $9.5 million over the next ve years, to expand Fonterra and Sanitarium’s KickStart Breakfast
programme. KickStart Breakfast, now in its fth year, currently provides breakfasts of Anchor Milk and Weet-Bix twice a
week to children in more than 570 decile one to four schools around New Zealand (At 1 July 2013, there were about 1016
decile 1-4 schools in NZ). This amounts to 48,000 breakfasts every week, with almost 5 million breakfasts served to date.
The Government support will initially enable Fonterra and Sanitarium to extend the current programme from two days a
week to ve days a week for the schools that currently participate and offer the KickStart Breakfast programme to any
other decile one to decile four schools.
• The Government funds the Fruit in Schools programme, which all decile one and two primary and intermediate schools
are able to opt into. In 2012, around 480 decile one and two schools participated, seeing around 96,806 children
receiving one piece of fruit per day. At July 2013, there were about 521 decile 1-2 schools in NZ.
• There are special needs grants to beneciaries on a case-by-case basis. The Ministry of Social Development, through
Work and Income, can provide recoverable or non-recoverable nancial assistance to people to meet an immediate need
for essential items such as food, health costs, power and other costs. These payments are available to any person as long
as they meet the income and asset test, and they are unable to meet the cost from any other source. This form of support
is not tied to any nutritional requirements.
International or national good/best practice:
1. In 2009, the U.S. Department of Agriculture’s implemented revisions to the Special Supplemental Nutrition
Program for Women, Infants, and Children (WIC) to improve the composition and quantities of WIC-provided
foods from a health perspective. The revisions include: Increase the dollar amount for purchases of fruits and
vegetables, expand whole-grain options, allow for yoghurt as a partial milk substitute, allow parents of older
infants to buy fresh produce instead of jarred infant food and give states and local WIC agencies more exibility
in meeting the nutritional and cultural needs of WIC participants[7]
2. The WIC Farmers’ Market Nutrition Program (FMNP) is associated with the Special Supplemental Nutrition
Program for Women, Infants and Children, popularly known as WIC. The WIC FMNP was established by Congress
in 1992, to provide fresh, unprepared, locally grown fruits and vegetables to WIC participants, and to expand
the awareness, use of, and sales at farmers’ markets. Women, infants (over 4 months old) and children that
have been certied to receive WIC program benets or who are on a waiting list for WIC certication are eligible
to participate in the WIC FMNP. State agencies may serve some or all of these categories. A variety of fresh,
nutritious, unprepared, locally grown fruits, vegetables and herbs may be purchased with FMNP coupons. State
agencies can limit sales to specic foods grown within State borders to encourage FMNP recipients to support the
farmers in their own States[44].
3. The Senior Farmers’ Market Nutrition Program (SFMNP) awards grants to States, U.S. Territories, and federally
recognized Indian tribal governments to provide low-income seniors with coupons that can be exchanged
for eligible foods (fruits, vegetables, honey, and fresh-cut herbs) at farmers’ markets, roadside stands, and
community-supported agriculture programs[45].
4. In 2012, the USDA piloted a “Healthy Incentives Pilot” as part of the Supplemental Nutrition Assistance Program
(SNAP, formerly “food stamps”).
5. Participants received an incentive of 30 cents per US$ spent on targeted fruit and vegetables (transferred back
onto their SNAP card)[7].
6. The New York City Health Department District Public Health Ofces distribute ‘Health Bucks’ to farmers’ markets.
When customers use income support (e.g. Food Stamps) to purchase food at famers’ markets, they receive $2
back in ‘Health Bucks’, which can then be used to purchase fresh fruits and vegetables[7].

40
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
5 FOOD PROVISION: The government ensures that there are healthy food service policies implemented in
government-funded settings to ensure that food provision encourages healthy food choices, and the government actively
encourages and supports private companies to implement similar policies
Q13 PROV1: The government ensures that there are clear, consistent policies (including nutrition standards)
implemented in schools and early childhood education services for food service activities (canteens, food at events,
fundraising, promotions, vending machines etc.) to provide and promote healthy food choices
Evidence:
• The National Administration Guidelines (NAG) for school administration set out statements of desirable principles of
conduct or administration for specied personnel or bodies. The NAG 5 [46] states that each board of trustees is required
to promote healthy food and nutrition for all students. From June 2008 to February 2009 there was an additional clause
that schools should only sell healthy food on their premises. The Education Review Ofce (ERO) evaluated schools ability
to meet this requirement [47]. In February 2009, the National Government removed the Directive that school canteens
sell healthy food to the children in their care. There is now no minimum nutritional standard for school canteens in
New Zealand. Currently, a school board of trustees is obliged to comply with the requirement to “promote healthy food
and nutrition for all students” in its school. The responsibility for complying with that requirement rests with the board
of trustees, not with ERO or the Ministry of Education. ERO does not have any powers other than its ability to publish
reports, and any powers of ‘enforcement’ would be through the Ministry. Where a school board fails to comply with its
legal obligations to any signicant extent, the Ministry can consider an intervention under Part 7A of the Education Act
1989. As part of ERO’s general education review process, which is described in ERO’s publication Framework for School
Reviews, ERO uses the Guidelines of Board Assurance Statement and Self-Audit Checklists in which a board is asked to
attest to comply with a considerable number of legal obligations in six areas – Board Administration, Curriculum, Health,
Safety and Welfare, Personnel, Financial, and Asset Management – before ERO’s review of the school commences.
ERO then does not review those matters attested to, but takes that attestation on trust. ERO does however check on
items related in particular to student safety because they have a potentially high impact on student achievement. The
compliance obligation to meet the NAG 5 requirement for food and nutrition rests with the board of trustees. If a parent
of a student had concerns about the school’s response to the NAG 5 requirement, then the parent would take their
concern directly to the board. Prior to the removal of the directive, in June 2008 and January 2009 ERO completed two
national reports on the NAG 5 requirements, and published these on its website but has not reported on NAG 5 since
that time. (Personal communication Marc Canning Education Review Ofce).
• The Early Childhood Education (ECE) Services Regulations 2008 mention: 46 Health and safety practices standard:
general is the standard that requires every licensed service provider to whom this regulation applies to take all
reasonable steps to promote the good health and safety of children enrolled in the service
• There are guidelines on the Ministry of Education’s website for schools to develop policies related to the food environment
in their school[41].
• The Children’s Commissioner published Guidelines for School Food Programmes: Best Practice Guidance For Your School
(February 2014)[48]. The guideline principles are that school food programmes should be child-centred, inclusive, and
nutritionally sound, take a whole-school approach, sustainable and evidence-based. The guidelines include examples of
successful school food programmes in appendix 1 of that document.
International or national good/best practice:
1. In Australia ve states or territories have implemented mandatory standards in schools based on either the
national voluntary guidelines or nutrient and food criteria dened by the state. ‘Red category’ foods are either
completely banned in schools or heavily restricted.
2. In 2006, the Latvian government implemented legislation that prohibited the sale/availability of soft drinks, drinks
with added colours, sweeteners, preservatives and caffeine on all school premises. Food served in educational
institutions, hospitals and long-term social care institutions may not exceed 1.25g of salt per 100g of food
product; sh products may contain up to 1.5g of salt per 100g of product [7].
3. England and Scotland have mandatory nutritional standards for school food, that also apply to food provided in
schools other than school lunches. These standards apply to all state schools and restrict foods high in fat, salt
and sugar, as well as low quality reformed or reconstituted foods[7].
4. As part of the Public Health Act (2004) in France, there is a ban on vending machines in all schools. Fruit and
bottled water are made available[7].
5. Brazil has one of the largest school feeding programs in the world. Not only nutrition standards are set, but
also the law requires schools to buy locally grown or manufactured products, supporting small farmers and
stimulating the local economy. The law, approved in 2001, requires that 70% of the food served to children in
school meal programs be unprocessed and another law, approved in 2009, that 30% of the program budget
should be used to purchase fresh foods directly from family farms and their cooperatives.

41
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
5 FOOD PROVISION: The government ensures that there are healthy food service policies implemented in
government-funded settings to ensure that food provision encourages healthy food choices, and the government actively
encourages and supports private companies to implement similar policies
Q14 PROV2: The government ensures that there are clear, consistent policies in other public sector settings
for food service activities (canteens, food at events, fundraising, promotions, vending machines, public procurement
standards etc.) to provide and promote healthy food choices
Evidence:
• Overall, the government does not specify any requirements for consistent policies across public sector settings in NZ or
for specic public sector settings in particular.
• Nearly all District Health Boards (DHBs) do have healthy eating guidelines. Most DHBs also have policies and apply a
set of criteria to DHB owned and operated staff cafes and stocking vending machines and add a nutrition clause in new
contracts. A list of non-exhaustive examples follows. The Auckland District Health Board applies the following criteria to
DHB owned and operated staff cafes and stocking vending machines: no sugar sweetened beverages, no confectionary
or snack foods exceeding 800 kJ per packet and no deep fried foods. This applies for vendors leasing space at DHB as
well and a nutrition clause is included in the contracts for new vendors. The clause is tailored to the type of vendor and
focuses on limiting portion sizes and ensuring that vegetables, fruits and whole grains dominate the menus. The same
applies for contracts with NGO providers. The Northland DHB healthy food policy species that the healthy food options
in cafeterias must be promoted by methods such as: placing these products at eye level, subsidizing healthier options by
increasing the price of less healthy items, highlighting the healthier options etc. All vending machines must adhere to the
Northland DHB beverage guidelines. Red beverages (sugar-sweetened beverages) are not permitted to be sold. In terms
of processed and packaged foods, at least 50% of the items for sale must meet the better choice nutrition criteria (<800
kJ per packet, <1.5 g/100g saturated fat and <450mg/100g sodium). Confectionary items (including sugar-free ones) are
excluded from the better choice criteria such as lollies, marshmallows, liquorice, chocolate, carob or chewing gum. Before
the start of any new catering contract, the contractor shall provide Lakes DHB contractor manager with a nutritional
analysis of all hot and cold foods they intend to provide, using the Crop and Food Database. In Wairarapa DHB vending
machines are not permitted on the premises.
• A working group has been established with representatives from the three metro Auckland DHBs and Auckland Regional
Public Health Service including dieticians, food service managers and public health specialists. This Group is working
on a set of agreed nutrition criteria with the intention that these will be consistently applied across the three DHBs and
will also be promoted to other public sector settings e.g. Auckland Council, tertiary institutions etc. Removal of sugar
sweetened beverages is a key component of this work and there is also a focus on limiting portion sizes and ensuring
vegetables, fruit and wholegrain foods dominate the menu.
• The Department of Corrections states that meals provided to prisoners are in line with the guidelines for food and
nutrition set by the MoH. The Department’s prison operations manual sets out performance standards surrounding
catering, menus and responsibilities relating to prisoners with health issues, such as diabetes (personal communication
Department of Corrections). In 2008-2009 Regional Public Health Wellington undertook a review of the Corrections
menu[49], following a request from the Department of Corrections, to assess whether prison menus meets the minimum
nutritional requirements set out by the Ministry of Health, and Corrections are considering a review again this year. It
was found that overall; these menus provide an adequate variety of food in appropriate amounts for both males and
females. Energy intake would be suitable to meet the needs of sedentary prisoners. The overall recommendations for
further improvements to the menu to ensure nutrient adequacy are listed in the report[49] .
• All rest homes and aged residential care facilities are certied and audited to ensure they provide safe, appropriate care
for their residents and meet the standards set out in the Health and Disability Services (Safety) Act 2001[50]. Overall,
there are 50 standards and 101 criteria within the standards that can be used for the audits. It is stated that food,
uid and nutritional needs of consumers are provided in line with recognized nutritional guidelines appropriate for the
consumer group.
International or national good/best practice:
1. In 2007, New York City (NYC) began developing a nutrition policy for all foods purchased, served, or contracted
for by City agencies[51]. A Food Procurement Workgroup was created with representatives from all City agencies
that engaged in food purchasing or service, and the NYC Health Department served as technical advisor. The NYC
Standards for Meals/Snacks Purchased and Served (Standards) became a citywide policy in 2008. The rst of its
kind, the Standards apply to more than 3000 programs run by 12 City agencies. New York City has an Executive
Order setting nutritional standards for all food purchased or served by city agencies, which applies to prisons,
hospitals and senior care centres.
2. Vending machines dispensing crisps, chocolate and sugary drinks are prohibited in National Health Service
hospitals in Wales. Guidance issued by the Welsh government denes what is allowed and not allowed, and has
liaised with major vending providers to nd ways to introduce healthier food and drink options[7].
3. In 2008, the Scottish government issued guidelines to National Health Service chief executives on the provision
of competitively priced fruit and vegetables in hospital settings and the removal of all soft drinks with a sugar
content greater than 0.5g per 100ml (pure fruit juice is exempt)[7].
4. Los Angeles county has used health impact assessments relating to healthy food to inform public procurement bid
specications[7].

42
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
5 FOOD PROVISION: The government ensures that there are healthy food service policies implemented in
government-funded settings to ensure that food provision encourages healthy food choices, and the government actively
encourages and supports private companies to implement similar policies
Q15 PROV3: The government ensures that there are good support and training systems to help schools and
other public sector organisations and their caterers meet the healthy food service policies and guidelines
Evidence:
Support and training systems for schools and early childhood education (ECE) services
• The Ministry of Education has developed resources [52] in consultation with the MoH to assist schools and ECE services
in their focus on this area: ‘Food and Nutrition for Healthy Condent Kids’ guidelines (2007) [41] and ‘Food and Nutrition
for Healthy Condent Kids’ toolkit containing some resources to support the guidelines. These guidelines are supported
by the MoH’s food and beverage classication system. These have not been updated by MoH since 2007 but are still
available for use. The ‘Food and Nutrition for Healthy Condent Kids’ guidelines are still very much used by schools
and considered the key nutrition source for schools (statement from the Ministry of Education). The Food and Beverage
Classication System (FBCS) is now managed by the NHF (rebranded as Fuelled4life) and is a collaborative initiative
that involves the education, health and food industry sectors working together to make it easier to have healthier food in
schools and early childhood education (ECE) services in NZ. This is voluntary [53, 54]. Fuelled4life includes food buyers
guides for schools and ECE services.
• Also available at http://healthylifestyles.tki.org.nz are case studies from schools around New Zealand successfully
working to improve nutrition, physical activity levels and general wellbeing[41].
• There are guidelines on the Ministry of Education’s website for schools to develop policies relating to the food
environment in their school[41].
• The Children’s Commissioner published Guidelines for School Food Programmes in 2014: Best Practice Guidance For Your
School (February 2014)[48].
• The Healthy Heart Award is an established, free programme coordinated by the NHF and partially funded by the MoH.
It assists ECE services to create an environment promoting healthy eating and physical activity to under 5s and their
families. There are three award levels[55].
• HEART START Toitoi Manawa is a free curriculum-linked programme, partially funded by the MoH. It is offered to
all schools across New Zealand. The programme ts with schools existing work and helps build a heart healthy
environment[56].
• The NHF has several other resources available for schools and ECE services on the website related to ECE menu
development and school canteen menu development.
• Another training program from the NHF is the HEAT nutrition training course, a level 3 unit standard qualication in
nutrition available for food preparers. The course is ideal for chefs, caterers, teachers, menu planners, supervisors and
students with an interest in catering[57].
Health Promoting Schools (HPS) is an approach (initiative of MoH) where the whole school community works together to
address the health and wellbeing of students, staff and their community. The initiative is broader than nutrition only (e.g. sun-
safe and smoke-free schools, kiwi sport, fruit in schools, 5+ A Day School Competition) and it is funded by the MoH. The HPS
National Strategic Framework supports school communities to identify and address their prioritised health needs and take
actions that utilise their strengths and build capability. The framework empowers school communities to develop solutions for
their own transformation in partnership with health, education and social services. The inquiry-based approach is outcomes
focused and sustainable as it builds on what schools already do and integrates the actions and outcomes into schools’ plan-
ning and reporting mechanisms. Many schools have joined HPS over the years. In 2009, around 67% of schools were part of
the programme. There is a goal for HPS to have75% of decile 1-4 schools included by 2014. They are supported by advisors
from public health units, district health boards or local government, who are contracted by the MoH to support HPS. The
December 2013 database shows that: 474 decile 1-4 schools (out of 1016), 126 decile 5-7 schools, 54 decile 8-10 schools
are adopting the HPS framework in New Zealand . The December 2013 database shows that 37% of schools engaged in HPS
undertake nutrition-related work. The December 2013 biannual survey shows 52.36 FTEs spread across 178 staff are working
on HPS framework across the country (information received trough Janet Chen, Senior Portfolio Manager, MoH). An overview
of the themes and activities covered by HPS in relation to nutrition is printed below.

43
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Key areas: Activities
Partnerships across health, education and social
services
Enviro-schools, Fruit in Schools, 5+ a Day, Heart Foundation,
Cancer Society.
Government priorities:
• Healthy eating
• Physical activity
• Rheumatic Fever
• Mental health
• Smokefree
Hear start, Milk in Schools, Fruit in Schools, KidsCan, 5+ a Day,
Food for Thought, Food stuffs, Fonterra and Sanitarium Breakfast
Clubs
Plans and charter Nutrition/ Water only Policy review as part of review cycle.
Resulting plans for change.
Student engagement • Student involvement in building, planting and maintaining
gardens and using produce
• Cultural festivals and healthy eating options
Family/whānau engagement • Parent involvement in building, planting and maintaining
gardens and using produce
• Breakfast Club
• Cultural festivals and healthy eating options.
Individual and school community knowledge, skills,
attitudes and behaviours
Cooking(developed NCEA programme Chch), Nutrition lessons/
workshops for students and parents
Oral health
Matariki celebrations
Physical, social and cultural environment Gardens- herb, garden to plate, seed to plate, plant to plate.
Planting orchard
Keeping chickens/ bees
Worm farms
School policies
Healthy eating and nutrition policy
Healthy lunches
Tuck shop
Water only

44
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Support and training systems for other settings
• Heartbeat Challenge (HBC) is a workplace health and wellbeing programme which focuses on strengthening the
environment that supports and improves health for all employees. The programme framework enables and empowers
employees to help drive the programme and contribute to the content. Emphasis is placed on encouraging environmental
change within the workplace such as in the provision of healthy food options in cafeterias, encouraging incidental
exercise, providing bike racks, shower facilities, supporting smoking cessation programmes and harm reduction
from alcohol and other drugs. Workplaces that meet the Heartbeat Challenge criteria (factories, disability support
services, government departments, call centres, rest homes, local councils and district health boards) are supported
by a Workplace Health Promoter to work towards a Heartbeat Challenge Award. This is attained by achieving a set
number of changes in each of the chronic disease risk factor elements. The award is renewed every two years to ensure
sustainability. Heartbeat Challenge was originally developed by the NHF. Since 2003 HBC has been further developed
and delivered by the Auckland regional public health service and is funded by the MoH. HBC is active in over 110
workplaces in the wider Auckland Region [58].
• The Health Promotion Agency (HPA) recently developed a guide to providing healthier beverage options for
workplaces[59] . These guidelines explain how to improve the range of beverages available to staff in workplaces. They
are designed to help gain the support of management and staff to improve the quality of available beverages as part
of workplace health, safety and wellness responsibilities. These guidelines are for workplaces looking to take steps to
improve the health and wellbeing of employees. The guidelines can be used to improve the quality of beverages supplied
in vending machines, cafeterias and at staff functions.
• For the development of a workplace healthy eating programme or policy, the following toolkits may be useful: WorkWell
for Healthy Eating Toolkit[60], Auckland Regional Public Health Service Heartbeat Challenge[61], the sample workplace
food and nutrition policy template from The Heart Foundation[62]. The Well@Work initiative initiated as part of the
Healthy Eating Healthy Action (HEHA) and Mission-On initiatives developed tools for workplaces to use to create healthy
workplaces and focused on healthy eating and physical activity within workplaces.
International or national good/best practice:
1. In May 2009, President Obama tasked the Ofce of Personnel Management with developing wellness best
practices and a plan for the federal workforce. In addition, the White House Ofces of Management and Budget
and Health Reform began working with federal agencies to provide healthier food choices to federal employees.
This effort to improve food choices at federal facilities was led by the U.S. General Services Administration (GSA).
Health and Human services (HHS) and USDA joined the effort in late 2009. In 2010, CDC formed the federal
food service guidelines team (HHS (CDC, FDA, NIH, ASA, ASPE), GSA, and USDA), which translated the Dietary
Guidelines for Americans and evidence-based sustainability recommendations into institutional food service
practices to create the HHS and GSA Health and Sustainability Guidelines for Federal Concessions and Vending
Operations HHS/GSA Guidelines, released in March, 2011. The goal of the HHS/GSA Guidelines is to assist in
increasing healthy food and beverage choices and sustainable practices wherever people buy or are served
food[63].
2. Many New South Wales public schools provide a canteen service for their students. School canteens can be run by
Parents and Citizens’ Associations, by schools themselves or leased to private companies. The Fresh Tastes NSW
Healthy School Canteen Strategy requires all NSW government schools to provide a healthy, nutritious canteen
menu in line with the Australian Dietary Guidelines for Children and Adolescents. The Canteen Menu Planning
Guide with Communication Kit, the Fresh Tastes Tool Kit, the Fresh Ideas for a Healthy School Canteen recipe le
and the ‘Come into my Canteen’ DVD have been developed to assist schools in implementing the Strategy[64].

45
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
5 FOOD PROVISION: The government ensures that there are healthy food service policies implemented in
government-funded settings to ensure that food provision encourages healthy food choices, and the government actively
encourages and supports private companies to implement similar policies
Q16 PROV4: Government actively encourages and supports private companies to provide and promote healthy foods
and meals in their workplaces
Evidence:
• The Health Promotion Agency (HPA) recently developed a guide to providing healthier beverage options for
workplaces[59] . These guidelines explain how to improve the range of beverages available to staff in workplaces. They
are designed to help gain the support of management and staff to improve the quality of available beverages as part
of workplace health, safety and wellness responsibilities. These guidelines are for workplaces looking to take steps to
improve the health and wellbeing of employees. The guidelines can be used to improve the quality of beverages supplied
in vending machines, cafeterias and at staff functions.
• For the development of a workplace healthy eating programme or policy, the following toolkits may be useful: WorkWell
for Healthy Eating Toolkit[60], Auckland Regional Public Health Service Heartbeat Challenge[61], the sample workplace
food and nutrition policy template from The Heart Foundation[62]. In New Zealand local public health service units
oversee the WorkWell programme, including a focus on healthy eating, and provide toolkits for companies to use. Under
the WorkWell programme The Public Health Unit Toi Te Ora is currently working with 23 businesses who have identied
healthy eating as a priority. Each of these businesses is currently implementing their relevant action plans. The smaller
businesses have tended to opt for the development of a generic wellbeing policy rather than a specic healthy eating
policy. However, the policies of each of the 23 businesses have a commitment to healthy eating. Toi Te Ora provides
support to the workplaces in the development on their healthy eating action plans, ensuring they consider actions across
organisational, environmental and individual levels.
There is a healthy eating toolkit which provides examples and suppor t material.
There are currently 41 businesses enrolled in Workwell in that area covering a total of 11321 employees. Workwell targets
businesses employing high numbers of Māori, Pacic and low skilled staff.
International or national good/best practice:
1. Government funding for health promotion (including nutrition) in workplaces has been made available along with
guides and tools to promote health and wellbeing in the workplace as part of the National Partnership Agreement
on Preventive Health in Australia[65].
2. The UK responsibility deal includes collective pledges on health at work, which set out the specic actions that
partners agree to take in support of the core commitments. One of the pledges is on healthier staff restaurants,
with 165 signatories to date[66]

46
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
6 FOOD RETAIL: The government has the power to implement policies and programs to support the availability of
healthy foods and limit the availability of unhealthy foods in communities (outlet density and locations) and in-store (product
placement)
Q17 RETAIL1: Zoning laws and policies are robust enough and are being used, where needed, by local
governments to place limits on the density or placement of quick serve restaurants or other outlets selling mainly
unhealthy foods in communities
Evidence:
• Zones have a set of rules (e.g. permitted activity lists) that are reective of their anticipated land use, so for a commercial
zone retailing, commercial enterprises, takeaways etc. are all permitted activities that can be undertaken without need
for Council consent. Permitted activities for each zone are set by the District Council through the District plans. Council
does not regulate the type of commercial activity unless it is impacted by other regulations such as the Hazardous
Substances legislation that limits the amount and type of some goods that can be stored. Council does have the ability
to regulate other activities using bylaws / policies such as the Trading in Public Places Bylaw. This is primarily to regulate
temporary mobile vendors to keep them out of commercial zones so they do not impact on the trading of the existing,
lawfully established businesses.
• Historically, the public health role of the Councils focused on sanitation and food safety and the control of infectious
diseases by having a healthy physical environment. However, the Health Act 1956 imposes on Councils a general duty to
improve, promote and protect public health. Councils bylaw making power is covered in the Local Government Act 2002.
A territorial authority may make bylaws for its district for 1 or more of the following purposes: (b) protecting, promoting,
and maintaining public health and safety. The four well-beings (social, economic, environmental and cultural) as a
purpose of local government have recently been removed from the Local Government Act however.
• No NZ Council has specic rules for regulating the number and location of food outlets. If a Council was to develop a
policy on this it would need to undertake a process using the Special Consultative Procedure under the Local Government
Act 2002. Alternatively there could be new “takeaway” rules developed to be given effect through the District Plan which
would require a Plan Change Process under the Resource Management Act 1991. Both involve considerable research and
consultation. The real difference between the 2 processes is that Council’s decisions on Plan Changes can be appealed
to the Environment Court which can drag the process out considerably. Policy decisions developed under the Local
Government Act can’t be appealed but the process can be challenged to a Judicial Review to see if the process followed
was sufciently robust.
• In 2009 regional public health (Wellington region) funded research to examine the food environment of Eastern Porirua.
This work quantied the poor availability of healthy and affordable foods and high density of unhealthy food outlets
within this region. Presentations were made to the Porirua City Council to raise awareness and potential solutions
including zoning policies and community markets to promote fruit and vegetable availability. Since this time, a monthly
summer market has been commenced.
In 2012 the public health dietician wrote submissions for each of councils long term plans (upper hut, lower hutt,
wellington, porirua and kapiti), including raising awareness on increase in healthy food availability and access through
development and maintenance of community markets and gardens and mapping density of food outlets especially in
more deprived areas, work on solutions to improve access to healthier and more affordable foods and explore regulation
or incentives to restrict fast food outlets near schools and limit density within neighbourhoods.
• The Auckland Public Health Unit has made submissions on a cap for density of fast food outlets to the draft plan of the
Council. No New Zealand councils expressed interest in pursuing work around zoning policies to date.
International or national good/best practice:
1. In 2008, the Los Angeles City Council, in the United States (USA), approved a 1-year moratorium on the
opening of new fast food establishments in several south Los Angeles neighbourhoods with high fast
food density and high obesity[67].
2. In Detroit, USA, the zoning code prohibits the building of fast food restaurants within 500 ft. of all
elementary, junior and senior high schools[67].
3. In South Korea the Act establishes ‘Green Food Zones’, banning the sale of fast foods and soda within
200 metres of schools. The law was implemented in 2009-2010[68].

47
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
6 FOOD RETAIL: The government has the power to implement policies and programs to support the availability of
healthy foods and limit the availability of unhealthy foods in communities (outlet density and locations) and in-store (product
placement)
Q18 RETAIL2: There are existing support systems to encourage food stores to promote the in-store availability
of healthy foods and to limit the in-store availability of unhealthy foods
Evidence:
• Toolkit developed by Toi Te Ora- Public Health Service in Tauranga[69] with options for local government regarding
ways they can assist in improving the food security of their communities through supporting improvements in healthy
food access and the environment through advocacy, support, planning and policy. This toolkit contains a collection of
possible strategies, advocacy opportunities and policies targeting local government action to improve their community’s
food security. The toolkit is divided into four main sections that represent the four spheres of inuence to improve food
security: Collaboration, Community Capacity, Supportive Environments and Advocacy. Through the toolkit councils are
encouraged to take practical steps to encourage and facilitate farmers markets.
• Toi Te Ora- Public Health Service in Tauranga has done some work with fruit and vegetable retailers to increase fruit
and vegetable sales by offering a weekly ordering system that offers customers convenience and good value, it is called
“Kai@The Right Price”. This was originally a Waikato public health unit initiative that has been implemented across
three locations (Western Heights in Rotorua, Mangakino and Opotiki). Once a vendor agrees to be involved, support is
provided over a 13 week trial period, a communications strategy is developed and the advertisement of the project is
funded. T-shirts and aprons for the staff to promote the initiative in store, eco-bags to package the produce, ordering of
resources to include with the produce (including recipes and tips what to do with the produce), evaluation of the trial and
any other support required are funded. Funding is obtained to support the roll out of 2 new Kai@The Right Price projects
with businesses per nancial year[70]. The aim is to trial the programme in Whakatane this year and then to support
Food Policy councils to undertake it in the future.
• Taranaki DHB: During 2006-2009 a pink feet food retailer project took place within a dened geographical community
with a focus on healthy school lunches. Pink feet led the customers to the healthy choices which were highlighted with
shelf-talkers, in one outlet. This expanded to 3-4 outlets. During 2012-2013, in another community, green feet was
organised. The green Feet project is a collaborative project between the Taranaki DHB Public Health Unit and local food
retailer 4 Square 45, and is currently running within the small coastal community of Opunake.
The Green Feet project uses social marketing techniques to promote healthier lunchbox items for children. Green Feet run
along the oor; bypassing isles containing unhealthy food choices and leading people to the healthier food choices.
Shelf-talkers also point out food choices. The feet and the shelf-talkers lead the customers to the green, healthy choices.
Cheap and easy recipes were readily available. This project included supermarket tours and label reading, budget
cooking demonstrations and taste-testing and remains in place.
• The Tairawhiti DHB has worked with one shopping area to promote low fat milk, whole grain bread and increased
consumption vegetables and fruits. They are planning “Tips on chips” workshops with local food outlets in the next 6
months.
International or national good/best practice:
1. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) requires WIC authorised
stores to stock certain healthier products (e.g. wholegrain bread)[7].
2. In England’s responsibility deal, although voluntary, the government sets clear expectations for retailers, for
example to remove prominently displayed sweets and chocolate from checkouts or setting up a scheme that would
have given customers rewards for buying healthy food such as fruit and vegetables
3. The Change4Life Convenience Stores programme is a partnership between the UK Department of Health and the
Association of Convenience Stores to increase the availability of fresh fruit and vegetables in convenience stores
in deprived, urban areas in England with poor existing retail access to fresh fruits and vegetables [7]. It was
introduced in 2008 and aimed to increase retail access to fresh fruit and vegetables in deprived, urban areas by
providing existing convenience stores with a range of support and branded point-of-sale materials and equipment.

48
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
7 FOOD TRADE AND INVESTMENT: The government ensures that trade and investment agreements
protect food sovereignty, favour healthy food environments, are linked with domestic health and agricultural policies in ways
that are consistent with health objectives, and do not promote unhealthy food environments
Q19 TRADE1: The direct and indirect impacts of international trade and investment agreements on food
environments and population nutrition and health are assessed and considered
Evidence:
• A list of all New Zealand’s trade agreements (both in force and under negotiation) can be found online [71]. Trade
agreements between two or more countries can be known as either a Free Trade Agreement (FTA), Closer Economic
Partnership (CEP), or Strategic Economic Partnership (SEP). International trade accounts for around two-thirds of New
Zealand’s total economic activity. The site includes useful information on each of the agreements, including form of the
agreement, countries involved and time since entry into force. Trade agreements often cover: Trade in Goods (Market
Access, Rules of Origin, Customs Procedures, Chapters on institutional and legal matters, Trade Remedies, Sanitary and
Phytosanitary Measures, Technical Barriers to Trade), Trade in Services (Market Access, Movement of Natural Persons),
Investment, Intellectual Property, Government Procurement, Competition and Consumer Policy, Cooperation, Trade and
Labour and Trade and Environment. On the site the full text of each concluded agreement can be found, as well as the
National Interest Analysis for each agreement[71]. Both the statement of intent 2013-2016[72] and the annual report[73]
of the Ministry of Trade and Foreign Affairs do not include any assessment of the impact of trade agreements on food
environments, population nutrition or national nutrition and health policies. For the trade agreements in force, a search
for the key words ‘nutrition’, and ‘food’ in the text of the agreement as well as any national interest analysis for the
agreement did not deliver any relevant results. We found no evidence available from public sources from the Ministry of
Foreign Affairs and Trade (MFAT) or MoH or MPI, the Ministry of Business, Innovation and Employment (MBIE), treasury
or other relevant government agencies that potential impacts on nutrition and health are assessed in the negotiation
of agreements (other than relying on the standard WTO clauses which have a very high bar for evidence of negative
impacts on health).
• Information on stated purposes of legislative proposals relating to food was sought from examining the Food Bill,
introduced in 2010. This states among other things that the purpose of the act is to achieve the safety and suitability
of food for sale and provide for risk-based measures that minimise and manage risks to public health; and protect and
promote public health’( cl 4). While a reference to protecting and promoting public health is positive, there is little in the
act that would implement this aspect of the Act’s purpose in a broad way going beyond traditional food safety concerns.
For instance, the Bill states the primary duty of persons who trade in food is to ‘ensure that it is safe and suitable’.
Concepts of safe and suitable are dened in the Bill, but in rather limited ways. It is also to be noted that a report on
submissions to the Food Bill is due in May 2014 [74].
International or national good/best practice:
1. European commission launches online public consultation on provisions and investor protection in
Transatlantic Trade and Investment Partnership[75]
2. There has been very little systematic monitoring of the impacts of trade agreements from any
perspective, and nothing from a food environment/obesity perspective. There is some ex-post evidence
of the direct impacts of the North American Free Trade Agreement (NAFTA) agreement on agricultural
and food product imports/exports between US and Mexico, as well as indirect impacts on Mexico’s
food industry and domestic agricultural production. The ow of several key products between the
United States and Mexico was plotted over the 14-year NAFTA period (1994-2008). Directly and
indirectly, the United States has exported increasing amounts of corn, soybeans, sugar, snack foods,
and meat products into Mexico over the last two decades. Facilitated by NAFTA, these exports are one
important way in which US agriculture and trade policy inuences Mexico’s food system. Because of
signicant US agribusiness investment in Mexico across the full spectrum of the latter’s food supply
chain, from production and processing to distribution and retail, the Mexican food system increasingly
looks like the industrialized food system of the United States[76].

49
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
7 FOOD TRADE AND INVESTMENT: The government ensures that trade and investment agreements
protect food sovereignty, favour healthy food environments, are linked with domestic health and agricultural policies in ways
that are consistent with health objectives, and do not promote unhealthy food environments
Q20 TRADE2: The government adopts measures to manage investment and protect their regulatory capacity
with respect to public health nutrition.
Evidence:
• International investment agreements have the potential to restrict a country’s regulatory capacity with respect to public
health nutrition. A range of proactive measures have been proposed to manage investment and protect public health
nutrition regulatory capacity. For NZ it is uncertain whether trade negotiations include evaluation on whether granting
incentives that lower production costs may jeopardize public health by making unhealthy products more affordable, no
assurance that investment contracts do not tie the hands of regulators in ways likely to undermine health, no introduction
of a clarication that a foreign investor cannot legitimately expect the host country not to issue nutrition measures and
no clarication of terms and general exceptions and the meaning of indirect expropriation and of fair and equitable
treatment.
International or national good/best practice:
1. Ghana has set standards to limit the level of fats in beef, pork, mutton and poultry in response to rising imports
of low quality meat following liberalization of trade. The relevant standards establish maximum percentage fat
content for de-boned carcasses/cuts for beef (<25%), pork (<25%) and mutton (<25% or <30% where back fat is
not removed), and maximum percentage fat content for dressed poultry and/or poultry parts (<15%)[7].
2. Pacic Island countries have been innovative in developing trade-related policy approaches to create a
less obesogenic food environment. Taxation-based approaches that affect pricing in the region include
increased import and excise tariffs on sugared beverages and other high-sugar products, monosodium
glutamate, and palm oil and lowered tariffs on fruits and vegetables. The bans on high-fat turkey tails
and mutton aps highlight the politics, trade agreements and donor inuences that can be signicant
barriers to the pursuit of policy options. Countries that are not signatories to trade agreements may
have more policy space for innovative action. However, potential effectiveness and practicality require
consideration. The health sector’s active engagement in the negotiation of trade agreements is a key
way to support healthier trade in the region[77].

50
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Evidence collected for the good practice statements within the 7 INFRASTRUCTURE
SUPPORT domains (as at 29/04/2014)
8 LEADERSHIP: The political leadership ensures that there is strong support for the vision, planning,
communication, implementation and evaluation of policies and actions to create healthy food environments, improve
population nutrition, and reduce diet-related inequalities
Q21 LEAD1: There is strong, visible, political support (at the Head of State / Cabinet level) for improving food
environments, population nutrition, diet-related NCDs and their related inequalities
Evidence:
• The statements of intent of the Ministry of Health are available online and provided on a yearly basis [78-83]. Nutrition
does not gure at all in the latest statement of intent [78] and is not part of the latest health targets 2013/2014 either
[84]. The current health targets are: shorter stays in emergency departments, improved access to elective surgery, shorter
waits for cancer treatments, increased immunization, better help for smokers to quit and more heart and diabetes checks.
In the latest statement of intent, the only item that is mentioned under impact 7 (The public is supported to manage
their health and maintain their independence) is ‘develop policy options for incentives for self-care, healthy lifestyles and
responsible use of health services; and provide operational policy and technical advice on nutrition and physical issues’.
The only preventative measures covered are: increasing immunisation, better support for youth mental health services
and more smoking reduction programmes [78].
• The New Zealand Government adopted the voluntary global NCD action plan from the World Health Organization,
including 9 targets and 25 indicators for reducing premature mortality due to non-communicable diseases by 25% by
2025.
• The Health Promotion Agency (HPA) has an overall function to lead and support activities to: promote health and
wellbeing and encourage healthy lifestyles, prevent disease, illness and injury, enable environments which support health,
wellbeing and healthy lifestyles, and reduce personal, social and economic harm. The HPA undertakes work on a wide
range of health issues, including: alcohol, gambling harm, health education, immunisation, mental health, nutrition and
physical activity, sun safety and tobacco[85]. In the statement of intent it is specically stated that HPA will specically
contribute to the health targets of: increased immunisation, better help for smokers to quit and more heart and diabetes
checks. Nutrition does not gure as a priority in the statement of intent. Until recently, HPA’s nutrition and physical
activity work has focused on increasing breakfast eating among school aged children and some activities to support this
work will continue into 2013/14. They will also be undertaking new work to improve infant and maternal nutrition and
physical activity. Appropriate impact measures for the new work will be developed during 2013/14 as HPA’s contribution
to improving infant and maternal nutrition and physical activity is further dened.
• In 2012 the Health and Independence Report[86] (the Director-General of Health’s Annual Report on the State of
Public Health) was published as part of the Ministry’s Annual Report for the Year Ended 30 June 2012. The Health and
Independence Report provides an overview of the current state of public health in three main sections: health status,
factors that inuence New Zealanders’ health and health system performance.
• Media releases[87] and news items[88] from the MoH were investigated for the period 2012 and 2013 and 2014 (until
01/04/2014). Of the 60 media releases by the MoH [87], 1 was on the results of the Health Survey, 1 was about cancer
statistics for NZ, 1 was about release of new food and nutrition guidelines, 1 was about physical activity guidelines for
elderly, 1 was on the systematic assessment of health loss for New Zealand and 1 was about vitamin D and sun exposure.
Of the 66 news items published by the MoH [88], there was one news item about the new food and nutrition guidelines
for young people and one on the healthy survey results 2012-2013. On the website of Health Minister Tony Ryall [89]
speeches, releases, features and newsletters were searched for the period 2012-2013-2014 (until 01/04/2013).
• Of the 365 items posted, there were 6 on the Healthy Families New Zealand programme, 1 on the Energize project, 1
on the fruit in schools initiative, 3 items on infant and maternal nutrition, 2 items on the promotion of physical activity,
2 items on diabetes and heart disease with prevention focus, 1 item on world health day, 1 item on reporting progress
towards the national health targets, 1 item on extra money for school kids’ preventative health and 1 speech for the
Cardiac Society containing few lines on support for prevention. A search for the key words ‘nutrition’ and ‘obesity’ on
the government website www.beehive.govt.nz for 2012-2014 (until 01/04/2013) resulted in 78 items. Of those, only
the following were somewhat relevant: Under 5 Energize off to a rolling start, Healthy Families: $1.46 million to give
South Auckland families a healthy start , $1.1M giving young families a healthy start, Healthy Families NZ: texting
Auckland mums for a healthy start, 2011/12 NZ Health Survey regional data released , New food health labelling
a win for consumers and exporters , Launch of the revised Code of Practice for the Marketing of Infant Formula in
New Zealand, New food health labelling a win for consumers and exporters, Exercise still the best medicine – green
prescriptions increase, 2011/12 NZ Health Survey regional data released, Breakfast programme part of the solution,
Green Prescriptions going global, Massey University College of Health Opening, Opening of RNZCGP Quality Symposium,
Opening Australia New Zealand Obesity Society (ANZOS) Annual Scientic Meeting: preventative actions by government

51
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
mentioned, Minister commends Milk for Schools programme, Decision paves the way for innovative foods for health: new
trans-Tasman rules for health and nutrition claims on food labels, Minister welcomes Pacic Health Chart Book: including
call for better preventative actions, Health equity – in search of Narnia, Board appointed for new Health Promotion
Agency.
• As part of the theme of the auditor general Ofce’s work in 2012/13 – Our future needs – is the public sector ready?
–a performance audit to understand the public sector’s approach to combating child obesity was carried out. The
performance audit intended to concentrate on the Ministries of Health and Education and Sport New Zealand
(formally SPARC), because historically these three agencies had a leadership role that focused on physical activity and
nutrition[90]. It was found that the Ministry of Education and Sport New Zealand no longer focused on obesity to the
extent they had in the past. The Ministry is considering how its current range of health promotion-based programmes
can be complemented by introducing an emphasis on interventions that target critical periods of human development
to achieve the greatest effect. For example, the Ministry said that it might implement an obesity prevention programme
with, for example, a strong emphasis on maternal and infant services. This would mean supporting women to achieve
a healthy weight during and after pregnancy, and a focus on child nutrition in the rst few years to potentially prevent
obesity developing in childhood and later in life. In the meantime, the Ministry is continuing with its range of existing
interventions and Health Target initiatives, such as screening people for type II diabetes[90].
• The New Zealand Government has announced the Healthy Families New Zealand (HFNZ) programme, which is a
community-based programme in 10 more deprived communities in New Zealand. HFNZ will support local leaders to
implement voluntary initiatives that encourage families to live healthy, active lives.
• The public health bill aims to update New Zealand’s fragmented and outdated legislation for public health, and is
the primary public health statute. It aims to replace the Health Act 1956 and the Tuberculosis Act 1948[91, 92]. It
is important to note that it has been stalled since 2006/07. The bill continues the traditional public health focus on
communicable disease control (such as tuberculosis and HIV/AIDs) and environmental health (such as sewerage and
insanitary dwellings). The bill includes new guideline provisions aimed at reducing risks of non-communicable disease
(risk factors such as those that can lead to diabetes). The Bill provides for the Director-General of Health to issue non-
binding codes of practice or guidelines about NCD risk factors. Guidelines could, for example, be issued on the location
of vending machines in venues frequented by children. The Bill provides for statements about goods, substances or
services that comply with these codes or guidelines to be included in any promotional or communication material and
the Bill permits regulations to be made that would reduce or assist in reducing risk factors associated with NCDs. The
Bill provides for a ‘legislative review and report back’ to the House of Representatives three years after enactment,
on possible further measures to address NCDs[91, 92]. The Public Health Bill states: ‘Reducing the impact of non-
communicable diseases in the population requires intervention at a number of levels, as well as co-ordinated efforts
across key sectors and settings that can support outcomes such as improved nutrition and physical activity. Legislation
alone is not the answer, but, as experience with tobacco control has shown, appropriate legislative provisions can support
effective public health action in a way that also reduces inequalities.’ The Bill includes principles and provisions for the
making of codes or guidelines to address non-communicable disease risk factors. The Director-General will be able to
make non-binding codes and guidelines to promote public health, for example, in relation to:
• exposure to, or access or use by, the public generally or specic groups in respect of products and services relevant
to non-communicable disease risk factors
• matters relevant to the advertising, sponsorship, or marketing (direct or indirect) of products and services with an
impact on non-communicable disease risk factors
• performance, composition, contents, additives, design and construction of goods or services or processes that
impact on non-communicable disease risk factors.
The Bill requires the Minister of Health to report to the House of Representatives on options and proposals for addressing
non-communicable disease issues within 3 years from enactment (with an option to extend this period).
International or national good/best practice:
1. on a city level: Michael Bloomberg (New York)
2. on a state level: David Davis Victoria Melbourne for the implementation of the Healthy Together Victoria systems-
based approach
3. Michelle Obama
4. South Africa’s strategic plan for the prevention and control of non-communicable diseases includes a target on
reducing the percentage of people who are obese and/or overweight by 10% by 2020 and reduce by at least 25%
the relative premature mortality (under 60 years of age) from non-communicable diseases by 2020[93]
5. The Brazilian Strategic Action Plan for Confronting NCDs in Brazil, 2011-2022 species national targets, including:
reduction of the prevalence of obesity in children 5-9 years old from 16.6 % to 8.0 % in boys and from 11.8% to
5.1 % in girls between 2008 and 2022, reduction of the prevalence of obesity in male adolescents 10-19 years old
from 5.9 % to 3.2 % and in female adolescents from 4.0 % to 2.7 % between 2008 and 2022, halting the rise of
obesity in adults, increasing adequate consumption of fruits and vegetables, from 18.2% to 24.3 % between 2010
and 2022 and reduction of the average salt intake of 12 g to 5 g, between 2010 and 2022[94].

52
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
8 LEADERSHIP: The political leadership ensures that there is strong support for the vision, planning,
communication, implementation and evaluation of policies and actions to create healthy food environments, improve
population nutrition, and reduce diet-related inequalities
Q22 LEAD2: Clear population intake targets have been established by the government for the nutrients of
concern to meet WHO and national recommended dietary intake levels
Evidence:
• There are no intake targets specied by the Ministry of Health (MoH) or the Ministry for Primary Industries (MPI) for the
nutrients of concern. The National Heart Foundation (NHF) specied in 2010 that meeting the upper recommended level
of sodium intake (2300 mg/day) requires a one-third reduction in sodium consumed from both manufactured or pre-
prepared food and discretionary salt added at the table or during cooking [2].
• New Zealand adopted the voluntary non-communicable diseases (NCD) action plan and global monitoring framework of
the World Health Organisation in May 2013, including a target to reduce population salt intake to 5 g of salt per person
per day. The Ministry of Health is looking at the implications of the NCD resolution, including New Zealand’s reporting
obligations to the WHO, and will ensure it is ready to report to the WHO from 2016 onwards. The Ministry will continue
to work with key stakeholders and partners, and support effective strategies and actions to address the burden of NCDs
in New Zealand (response of MoH to ofcial information request).
• The adequate intake and upper intake level of sodium, including some recommendations and advice for the public to
decrease sodium intakes, have been updated by MoH for 2-18 year olds in July 2012 [95], for 0-2 year olds in December
2012 [96], for adults in 2003 [97], for the elderly in January 2013 [98], and for pregnant and lactating women in 2006
[99]. Adequate intake and upper intake level of fats, saturated fatty acids and added sugar were also specied in the
dietary guidelines for the specic age groups, and some practical advice for the public to reduce intakes was included as
well [95, 97]. It was specied that the sum of saturated and trans fat intakes should be lower than 10% of energy [95, 99].
International or national good/best practice:
1. The “Strategic Action Plan for Confronting NCDs in Brazil, 2011-2022 species a target of increasing adequate
consumption of fruits and vegetables, from 18.2% to 24.3 % between 2010 and 2022 and reduction of the average
salt intake of 12 g to 5 g, between 2010 and 2022[94].
2. Health Canada established a multi-stakeholder Sodium Working Group, which agreed a Sodium Reduction
Strategy for Canada in July 2010. The Strategy sets an interim goal of reducing daily sodium intake from 3400 mg
to 2300 mg by the year 2016[7].
3. On January 23, 2014 the Dutch Ministry of Health, Welfare and Sport signed an agreement with trade
organisations representing food manufacturers, supermarkets, hotel, restaurant and caterers to lower the levels
of salt, saturated fat and calories in food products. Under the agreement, the aim is to reduce the mean salt
intake from 9g to a maximum of 6g a day by 2020[7].
4. The South African plan for the prevention and control of non-communicable diseases includes a target
on reducing mean population intake of salt to <5 grams per day by 2020[93]

53
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
8 LEADERSHIP: The political leadership ensures that there is strong support for the vision, planning,
communication, implementation and evaluation of policies and actions to create healthy food environments, improve
population nutrition, and reduce diet-related inequalities
Q23 LEAD3: Clear, interpretive, evidence-informed food-based dietary guidelines have been established and
implemented
Evidence:
• There have no healthy visual food guides been developed and implemented in New Zealand. The NHF developed a
‘Healthy Heart’ visual food guide [98]. There are food-based dietary guidelines[100] available for adults (updated
February 2013), breastfeeding mothers (updated February 2013), for babies and toddlers (updated April 2013) and
for older people (updated August 2012), all based on the Ministry of Health food and nutrition guidelines. There is an
existing food and beverage classication system[54] developed by the Ministry of Health in 2007 and now rebranded as
Fuelled4life by the NHF.
• The contracts with the Ministry of Health include a clause that all messages have to be in line with the food and nutrition
guidelines of the MoH.
• The Ministry of Health is currently translating the food-based dietary guidelines into a set of short statements for the
public.
International or national good/best practice:
1. The Australian Dietary Guidelines use the best available scientic evidence to provide information on the types
and amounts of foods, food groups and dietary patterns that aim to: promote health and wellbeing, reduce
the risk of diet-related conditions and reduce the risk of chronic disease. The Guidelines are for use by health
professionals, policy makers, educators, food manufacturers, food retailers and researchers. They have recently
been updated [101].
2. Brazil has issued new dietary guidelines in 2014. Brazilian health ofcials designed the guidelines to help protect
against undernutrition, which is already declining sharply in Brazil, but also to prevent the health consequences of
overweight and obesity, which are sharply increasing in that country. The guidelines are remarkable in that they
are based on foods that Brazilians of all social classes eat every day, and consider the social, cultural, economic
and environmental implications of food choices. There are three golden rules: •Make foods and freshly prepared
dishes and meals the basis of your diet, •Be sure oils, fats, sugar and salt are used in moderation in culinary
preparations, and •Limit the intake of ready-to-consume products and avoid those that are ultra-processed[102].

54
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
8 LEADERSHIP: The political leadership ensures that there is strong support for the vision, planning,
communication, implementation and evaluation of policies and actions to create healthy food environments, improve
population nutrition, and reduce diet-related inequalities
Q24 LEAD4: There is a comprehensive, transparent, up-to-date implementation plan (including priority policy
and program strategies, social marketing for public awareness and threat of legislation for voluntary approaches)
linked to national needs and priorities, to improve food environments, reduce the intake of the nutrients of concern to
meet WHO and national recommended dietary intake levels, and reduce diet-related NCDs
Evidence:
• There is currently no such plan in NZ. The previous comprehensive plan (Healthy Eating Healthy Action strategic
framework, developed in 2003) has been abandoned.
• The New Zealand Food Safety Authority had a Nutrition Strategy 2009-12 with its associated work programme included
the intention of reducing sodium intake in the diet and improving the nutritional quality of fat in the food supply
International or national good/best practice:
1. The previous Healthy Eating Health Action New Zealand strategic framework was a comprehensive plan
with priorities on lower socio-economic groups, children, young people and their families, environments,
communication and workforce [103]. The strategy and associated implementation plan was a comprehensive
approach to achieving its goals of improving nutrition, increasing physical activit y and reducing obesity.
It incorporated a series of objectives and actions aimed at building healthy public policy; creating supportive
environments; strengthening community action; developing personal skills; reorienting health services; monitoring
environments and the population, researching underlying issues and evaluating policies and programmes;
communicating HEHA messages; and addressing workforce capacity and capability.
2. One of the rst tools that the UK Food Standards Agency devised to help prompt discussions with the food
industry in the UK on salt reduction was the salt model. This was a theoretical model which demonstrated one way
in which the 6g intake target could be achieved through both reductions in levels of salt in foods and consumers’
discretionary intake of salt[104]. A clear salt reduction strategy and action framework (including public health
campaigns) were developed by the UK Food Standards Agency which included the threat of legislation in case the
voluntary approach would not be successful[8]

55
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
8 LEADERSHIP: The political leadership ensures that there is strong support for the vision, planning,
communication, implementation and evaluation of policies and actions to create healthy food environments, improve
population nutrition, and reduce diet-related inequalities
Q25 LEAD5: Government priorities have been established to reduce inequalities in relation to diet,
nutrition, obesity and NCDs
Evidence:
• The New Zealand Public Health and Disability Act 2000, which the statement of intent refers to[78] sets the strategic
direction and goals for health and disability services in New Zealand, including improving the health of Māori and other
specic population groups.
• Protecting vulnerable children is stated as a government priority in the latest statement of intent[78]. In addition,
delivering better health services for Māori and the Pacic community is mentioned. To achieve this the Ministry will
administer and monitor the Māori Provider Development Scheme to develop more accessible and effective Māori health
and disability service providers and the Māori Health Innovation Fund (Te Ao Auahatanga Hauora Māori) to support
innovation in health services for Māori and administer and monitor the Pacic Provider Development Scheme to achieve
Government’s goals for viable Pacic provider infrastructure.
• Government and the Ministry of Health have made it a key priority to reduce the health inequalities that affect Māori
through the updated Māori health strategy and action plan[105].
• There is a good institutionalisation of the Treaty of Waitangi within central and local government (e.g. certain provisions
included in the Local Government Act)
• The MoH reports the estimates derived from health surveys and nutrition surveys by four subpopulation groups including
age group, gender, ethnic group and an area level deprivation index [106, 107]. Similarly, estimates derived from other
data types (e.g. mortality) are presented by these subpopulation groups.
• The contracts between MoH and NGOs or other institutions include a section on Māori Health and state: “An overarching
aim of the health and disability sector is the improvement of Māori health outcomes and the reduction of Māori health
inequalities. You must comply with any: a) Māori specic service requirements, b) Māori specic quality requirements
and c) Māori specic monitoring requirements”. In addition, the provider quality specications for public health services
include specic requirements for Māori:” C1 Services meet needs of Māori, C2 Māori participation at all levels of
strategic and service planning, development and implementation within organisation at governance, management and
service delivery levels, C3: support for Māori accessing services”. In the specic contract between the Ministry of Health
and Agencies for Nutrition Action the rst clause is on Māori Health: “you must comply with any Māori specic service
requirements, Māori specic quality requirements and Māori specic monitoring requirements contained in the Service
specications to this agreement”.
• There were more than 300 contracts funded from the budget of MoH over the past ve years related to nutrition and
physical activity. The Ministry has not examined every single contract (extensive work involved), but considered it unlikely
that an explicit objective to reduce health-related inequalities would have been included as part of contracts, as an
outcome, rather than an input, it is unlikely to have been explicitly contracted for. However, programmes developed over
the period were clearly designed with the intentions of meeting the diverse needs of New Zealand population. Contracts
were undertaken with Māori NGOs (for example Autaki Kaipaipa – smoking cessation, Rangatahi physical activity
programmes and Māori public health leadership). Programmes were also contracted with a focus on improving health
outcomes of Pacic peoples living in low decile areas. The Government funded Fruit in schools targets decile 1 and 2
primary and intermediate schools (answer MoH on ofcial information request).
• It has been announced that the Healthy Families NZ will be carried out specically in lower income communities: East
Cape; Far North District; Invercargill City; Lower Hutt City; Rotorua District; Whanganui District; Manukau Ward;
Manurewa-Papakura Ward; Spreydon-Heathcote Ward; and Waitakere Ward. The 10 communities come from areas with
higher-than-average rates of preventable chronic diseases (such as diabetes), higher-than-average rates of risk factors for
these diseases (such as smoking), and/or high levels of deprivation. The 10 communities are geographically spread and
are a mixture of urban and rural areas, so the healthy families NZ programme will be able to provide valuable evidence
on what works for a diverse range of communities[108].
• The Science Challenges have a strong focus on reducing health inequalities.
International or national good/best practice:
1. No benchmarks have been collected so far for this statement. The Healthy Eating – Healthy Action: Oranga Kai –
Oranga Pumau strategy prioritised Māori, Pacic peoples, children and lower income groups.

56
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
9 GOVERNANCE: Governments have structures in place to ensure transparency and accountability, and
encourage broad community participation and inclusion when formulating and implementing policies and actions to create
healthy food environments, improve population nutrition, and reduce diet-related inequalities
Q26 GOVER1: There are robust procedures to restrict commercial inuences on the development of policies
related to food environments where they have conicts of interest with improving population nutrition
Evidence:
• New Zealand is No 1 ranking in Transparency International’s Corruption Perceptions Index 2013, together with Denmark,
obtaining a score of 91% on a total of 177 countries included [109]. The last report on New Zealand’s national integrity
system was published in 2003[110] and acknowledged that New Zealand scores very highly by international standards
in terms of the absence of public sector corruption (dened as the misuse of public power for private gain). However,
the instruments used to measure corruption are not well suited to exploring more subtle issues of quality of governance.
Some emergent ndings of the 2013 survey were published [111] prior to the nal report. The nal report includes two
recommendations that relate more broadly to government systems including to 3. Strengthen the transparency, integrity
and accountability systems, of Parliament, the political executive (cabinet) and local government.4 Strengthen the role of
the permanent public sector with respect to public procurement, integrity and accountability systems, and public policy
processes.
• There are legal expectations with regard to lobbying and commercial inuences, contained in legislation including the
Crimes Act[112], Electoral Act[113], Secret Commissions Act[114] and others (communication Leo Stothart State Services
Commission (SSC)). New Zealand does not have a legislated lobbying regime.There are no lobbying registers available
in New Zealand. Before Parliament was the Lobbying Disclosure Bill which seeks to regulate lobbying in New Zealand.
The following link contains information on the Bill including submissions made to Select Committee[115]. This has been
rejected.
• Submissions from stakeholders to policy documents are generally publically disclosed in New Zealand.
• The State Services Commission (SSC) in New Zealand has published Best Practice Guidelines for Departments Responsible
for Regulatory Processes with Signicant Commercial Implications [116]. They cover the development and operation of
a regulatory process. They also include specic references to principles around stakeholder relationship management
and departmental dealings with former staff who may be employed by, or from, stakeholders. CSS has the power to set
minimum standards of conduct for many of the agencies which make up the State Services, and to apply those standards
by way of a code or codes of conduct.
• A discussion document was prepared in 2005 to identify integrity provisions which may already be in place, and explore
whether setting additional standards may contribute to increased trust in government and condence in the State
Services [117].
• Representatives of the processed foods industry and their lobby group (New Zealand Food and Grocery Council) sit
on key government committees or boards (e.g. food labelling committee, Health Promotion New Zealand) who make
decisions on food policy and public health nutrition. Appointments of members to sit on working groups, committees,
advisory groups and standing committees are made in accordance with any relevant legislation, the body’s terms of
reference and the State Services Commission’s Board Appointment and Induction Guidelines. The precise appointment
process adopted will depend on a number of factors (intended duration, complexity of work, need for specialist skills, level
of public interest in the subject matter etc.) (response MoH to ofcial information request).According to MPI the process
for selecting members for a particular group is usually outlined in the terms of reference (or equivalent document) for
that group. The working group on front-of-pack labelling in New Zealand mainly includes industry members, and only one
academic specialised in public health nutrition policy.
• Within the WHO compliance Panel all panel members on appointment sign a conict of interest declaration from to
declare whether or not they have any actual or potential nancial, professional or personal conicts of interest, and if so,
the details of these actual or potential conicts of interest. A conict of interest register is kept for current members and
conict of interest is a standard agenda item when the compliance panel is considering complaints. The procedure for
dealing with conicts of interest is outlined in the compliance panel’s terms of reference[118]. Members must perform
their functions in good faith, honestly and impartially and avoid situations that might compromise their integrity or
otherwise lead to conicts of interest. When members believe they have a conict of interest on a complaint, they must
declare that conict of interest and the chair will decide what that person can contribute to the discussion and/or activity
around the consideration of that complaint.
International or national good/best practice:
1. To our knowledge, there are currently no governments restricting participation of the food industry during
development of policies

57
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
9 GOVERNANCE: Governments have structures in place to ensure transparency and accountability, and
encourage broad community participation and inclusion when formulating and implementing policies and actions to create
healthy food environments, improve population nutrition, and reduce diet-related inequalities
Q27 GOVER2: Policies and procedures are implemented for using evidence in the development of food policies
Evidence:
• A recent report by Sir Peter Gluckman[119], requested by government to improve decision-making, found that there is a
wide and rather inconsistent range of practices and attitudes with respect to understanding and application of robust
evidence for policy formation and the evaluation of policy implementation across government agencies. The variability
suggests that a more systematic approach would be desirable. The key recommendations from the report include:
Develop a standard set of protocols across government regarding obtaining expert scientic advice; 2. Extend the use of
Departmental Science Advisors (DSAs) more broadly across government; 3. Use the community of DSAs and the Chief
Science Advisor to assist central agencies with longer-term planning, risk assessment and evaluation; 4. Improve and
make more explicit the use of government funds for research to assist policy formation; 5. Provide greater transparency
regarding the use of research-informed data (or its absence) with respect to complex and controversial areas of decision-
making where the public is directly or indirectly consulted.
• In 1999 the SSC reviewed the quality of policy advice within the Public Sector and identied areas for improvement. The
SSC produced advice for central government agencies on the basis of this review which included advice about the use
of accurate information/evidence and steps to ensure its availability when needed [120]. A more recent document was
produced in 2008 by the SSC on measuring [121].
• The policy advice produced by a number of government agencies including the MoH is regularly reviewed by The NZ
Institute of Economic Research[122]
• FSANZ includes evidence in their regulatory impact assessments
International or national good/best practice:
1. No benchmarks have been collected so far for this statement
9 GOVERNANCE: Governments have structures in place to ensure transparency and accountability, and
encourage broad community participation and inclusion when formulating and implementing policies and actions to create
healthy food environments, improve population nutrition, and reduce diet-related inequalities
Q28 GOVER3: Policies and procedures are implemented for ensuring transparency in the development of food
policies
Evidence:
• The State Services Commission (SSC) reviews each government department each year on performance and these reports
are available online through the SSC website. The latest review report for the MoH and for MPI can be found online[123].
FSANZ publishes all material related to processes and outcomes online. Public consultation on standards is possible at
several occasions. Submissions from stakeholders are publically disclosed.
• According to the latest report from Transparency International [111] there is a high level of scal transparency in NZ
at the level of international best practice, scoring 93 out of 100 on the open budget index 2012 and being ranked rst
among 100 countries.
International or national good/best practice:
1. New Zealand is No 1 ranking in Transparency International’s Corruption Perceptions Index 2013, together with
Denmark, obtaining a score of 91% on a total of 177 countries included [109].

58
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
9 GOVERNANCE: Governments have structures in place to ensure transparency and accountability, and
encourage broad community participation and inclusion when formulating and implementing policies and actions to create
healthy food environments, improve population nutrition, and reduce diet-related inequalities
Q29 GOVER4: The government ensures access to comprehensive nutrition information and key documents
(e.g. budget documents, annual performance reviews and health indicators) for the public
Evidence:
• Key budget documents (e.g. Vote Health), annual performance reviews of the different government departments and
reports on nutrition guidelines and survey results are available for download online through the library of the MoH. In
addition in NZ the public can request specic information through the Ofcial Information Act.
• Through the ofcial information act 1982, information on budgets spent on population nutrition promotion by MoH, MPI,
the Health Promotion Agency and DHBs and PHUs were easily obtained.
• The general approach is that information formally generated by the MoH is published on the web. Decisions about
work programmes and funded priorities are published through the Ministry’s statement of intent and output plan, both
of which are on the web. Decisions about publication of material on the web or through publications are usually made
by business unit producing that information, but there are no formal policies covering what is published (information
obtained from MoH through ofcial information request). MPI publishes most reports on its website. In cases where
reports are withheld from publication, it is because of commercial or other sensitivities.
International or national good/best practice:
1. New Zealand ranks rst on the Social Progress Index, second on the component of access to basic knowledge, and
seventh on the component of access to information and communications[124]
10 MONITORING AND INTELLIGENCE: The government’s monitoring and intelligence systems
(surveillance, evaluation, research and reporting) are comprehensive and regular enough to assess the status of food
environments, population nutrition and diet-related NCDs and their inequalities, and to measure progress on achieving the
goals of nutrition and health plans
Q30 MONIT1: Monitoring systems, implemented by the government, are in place to regularly monitor food
environments (especially for food composition for nutrients of concern, food promotion to children, and nutritional
quality of food in schools and other public sector settings), against codes/guidelines/standards/targets.
Evidence:
Food composition
• Levels of sodium in foods were assessed in the 2003/04 New Zealand Total Diet Survey [125] and the one in 2009
[126], funded by the MPI. This survey is carried out approximately every ve years and monitors concentration levels in
foods and dietary intake of contaminants and some key elements (including sodium) from a simulated NZ diet for key
population groups. The survey has been undertaken 7 times since the rst study in the mid-1970s. The most recent study
was in 2009. The rst 5 were carried out by the MoH, but when the NZFSA was established in 2002, responsibility for the
survey was transferred. The survey is now the responsibility of MPI. The 2009 Total Diet Study consisted of 123 foods and
represented those foods most commonly consumed in New Zealand. The next Total Diet Study is planned to go into the
eld in 2014 (personal communication Jenny Reid MPI).
• In 2009, Food Standards Australia New Zealand (FSANZ) found that trans fat levels in foods decreased and trans fat
intakes from manufactured sources decreased in Australia and NZ by 25-45% or 0.1% of energy since 2007[127, 128].
MPI is currently repeating a similar survey on trans fats in foods and the results will become publically available late
2014 or early 2015 (personal communication Jenny Reid MPI).
• National surveys on commercial frying fats[129], funded by MoH, were conducted in 1999, 2007 and 2011. Tallow/
hydrogenated fat use reduced from 87% (1999) to 64% (2007, 2011). Palm increased in 2007 survey and decreased
somewhat in 2011 survey. Saturated fat (as % of total fat) signicantly decreased from 53% (1999, 2007) to 49% (2011)
(personal communication Judith Morley-John).
• The New Zealand Institute for Plant & Food Research Limited and the MoH jointly own the New Zealand Food
Composition Database (NZFCD) which is a comprehensive collection of nutrient data in New Zealand. It contains nutrient
information on more than 2600 foods. The nutrients sodium, fat, saturated fat, trans fatty acids, sugars and total bre
are included. Accredited laboratories in New Zealand and Australia are used to analyse these nutrients in the foods.
The output products of the NZFCD are available in three forms: New Zealand Food les, the concise New Zealand food
composition tables and New Zealand food composition data for Nutrition Information Panel. An updated version of the
New Zealand FOODles is released regularly and a new edition of the Concise New Zealand Food Composition Tables is

59
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
published every 2-3 years. Approximately 65 Food Records are updated annually as new foods or replacements for foods
with values older than 10 years old or sourced from other databases [130]. There are two versions of the data les in
the New Zealand FOODles 2012: 1. A standard version that contains information for 76 components of >2600 foods.
Because the list of core components has changed over time, some foods do not have data for all 76 components.2. An
unabridged version that contains information for 342 food components of > 2600 foods listed in the standard version.
Most foods do not have data for all 342 components[131]. The following food groups are included: bakery products,
alcoholic beverages, non-alcoholic beverages, breakfast cereals, cereals and pseudo-cereals, dairy, eggs, fast foods,
fats and oils, nshes, fruits, meats, meat products, miscellaneous, nuts and seeds, recipes, sauces and condiments,
shellshes, snack foods, soups, sugar, confectionary and sweet spreads, vegetables, and infant formulas and baby
foods[131].
• The Nutritrack database, funded partly by MPI and by grants from the Health Research Council, currently contains
the nutritional content of more than 16,000 packaged and fast foods (from major fast food outlets with ≥20 stores
nationwide).[1, 132] From 2013, photographs of foods are being collected, and recently, a smartphone application,
FoodSwitch, was launched to help consumers make healthier food choices, but also allowing them to contribute new
products to the database. The app has been downloaded more than 28,000 times and users crowdsourced more than
5,000 new products.
• The Manufactured Food Database was discontinued mid-June 2012. However, a contract to supply a new food
composition database has been awarded to the University of Auckland. The database will contain ingredient data
and Nutrition Information Panel (NIP) data for manufactured foods regulated under the Australia New Zealand Food
Standard Code. MPIs interest in the composition of foods is mainly from a safety point of view, but it means there will be
a searchable database with package, nutrient, and ingredient information entered. It is important to note that nutrition
information panel data might be wrong in some cases.
Food promotion
• No monitoring of food promotion in place in New Zealand. Some research has been done in the area, but not nation-wide
and not across all types of media.
Food provision
• Both in 2007 and 2009 a School and Early Childhood Education (ECE) Services Food and Nutrition Environment Survey
was organised in a representative sample of Schools and ECE across New Zealand[133]. Those surveys aimed to collect
information on key baseline indicators, follow-up indicators and experiences of key stakeholders in relation to the
implementation of Healthy Eating Healthy Action (HEHA) and Mission-On initiatives within school and ECE services. The
initial 2007 Survey aimed to collect baseline information on the availability, supply and sale of food and beverage types
and described the prevalence and content of food and nutrition policies and procedures in schools and ECE services. The
survey was repeated in 2009. The survey was funded and managed by the MoH.
• No monitoring of food environments in other public sector settings by the NZ Government.
International or national good/best practice:
1. The Food Standards Australia New Zealand regularly conducts a Total Diet Survey which reports on sodium levels
in foods. Sodium levels were identied in the surveys in 2003/04 and 2009 and it is anticipated that they will be in
the 2014 survey[134]. A separate review of trans fatty acids in Australian and New Zealand population diets was
conducted in 2007 and 2009 and is planned for 2014 [127].
2. The UK regularly monitors sodium levels in foods against the Food Standards Agency targets[135].
3. Many countries do have food composition databases available[136]
4. Currently no country has a comprehensive program to monitor food marketing, to our knowledge. Most countries’
policies are reactive, and are based on consumer complaints rather than active monitoring.
5. Australia has good data on food promotion through different media, mostly funded through the New South Wales
government, and some other state governments in Queensland and South Australia. But it is ad hoc and not a
monitoring system, and nor is it linked to enforcement of policies.
6. Previously as part of HEHA monitoring and evaluation in New Zealand, a method was developed and tested which
aimed to monitor advertising of higher fat, salt and sugar products / foods and lower fat, salt sugar products /
foods on television.
7. In England in October 2005, the School Food Trust (‘the Trust’; now called the Children’s Food Trust) was
established to provide independent support and advice to schools, caterers, manufacturers and others on
improving the standard of school meals. They perform annual surveys, including the latest information on
how many children are having school meals in England, how much they cost and how they’re being provided.
Each year a survey of local authorities in England is conducted to collect data on take up of school lunches and
to nd out about factors affecting take up. The survey also gathers contextual information about school lunch
provision.[137]

60
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
10 MONITORING AND INTELLIGENCE: The government’s monitoring and intelligence systems
(surveillance, evaluation, research and reporting) are comprehensive and regular enough to assess the status of food
environments, population nutrition and diet-related NCDs and their inequalities, and to measure progress on achieving the
goals of nutrition and health plans
Q31 MONIT2: There is regular monitoring of adult and childhood nutrition status and population intakes
against specied intake targets or recommended daily intake levels
Evidence:
• The latest nation-wide adult nutrition survey was carried out from October 2008-October 2009 (4721 adults aged 15+
years participated) [138]. Results were presented separately for Pacic people (n=757) and Māori people (n=1040)
[106]. The results included information on energy and macronutrient intake, dietary habits, measured body mass
index, measured waist circumference, blood pressure, cholesterol and diabetes [107]. In the latest national nutrition
survey sodium intake was not estimated due to concerns about the reliability of sodium data in the NZFCD. The survey
included separate estimates for sucrose, fructose, lactose and total sugar intake, as well as for saturated and total
fat intake. No estimate was provided for intake of trans fats. The latest nation-wide survey on children was conducted
in 2002. The former survey was performed in 1997 and no new separate nutrition surveys will be organised in the
future. From April 2011, the Health Survey and the various other surveys (including the Adult and Child Nutrition
Surveys, Tobacco, Alcohol and Drug Use Surveys, Te Rau Hinengaro – the New Zealand Mental Health Survey, and the
Oral Health Survey) were integrated into a single survey, which is now in continuous operation. Each year, the survey
collects data from a representative sample of about 13000 adults and 4000 children. The survey contains some core
questions and measurements that are repeated each year, as well as a series of modules that change each year. The
core questions and measurements cover all key health domains, including health status, long term conditions, health
risks and behaviours, health service utilisation and socio-demographic factors. The core measurements of the New
Zealand Health Survey include self-reported fruit and vegetable intake (adults) and self-reported fruit and vegetable
intake, breakfast consumption, zzy drink consumption and fast food consumption among children. Planning for future
modules is currently underway. Key health domains that yet to be covered in a module are mental health, oral health,
nutrition and physical activity. The tentative plan is to include a nutrition module for both adults and children in 2017/18
to coincide with another round of biomedical testing. The scope and frequency of any future nutrition module has yet to
be determined.
• The Food and Nutrition Monitoring report was published in 2006, which covered information from a range of sources
about the food supply in New Zealand [139]. In addition, a national survey of physical activity, sedentary behaviours and
dietary habits in 5–24 year-olds was organised in New Zealand[140]. The Survey was commissioned by SPARC together
with the Ministries of Health, Education and Youth Development to support the Mission-On initiative. Face-to-face
interviews with follow-up telephone calls were conducted with a nationally representative sample of 2503 participants
from September 2008 to May 2009. As part of an evaluation of iodine fortication, MPI undertook a survey using 24-hour
urine samples in which sodium intake was measured as well for 300 adults in Dunedin and Wellington[141].
International or national good/best practice:
• The National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the
health and nutritional status of adults and children in the United States. The survey is unique in that it combines
interviews and physical examinations[142]. The NHANES program began in the early 1960s and has been
conducted as a series of surveys focusing on different population groups or health topics. In 1999, the survey
became a continuous program that has a changing focus on a variety of health and nutrition measurements to
meet emerging needs. The survey examines a nationally representative sample of about 5,000 persons each year.
These persons are located in counties across the country, 15 of which are visited each year.
• Other countries (Japan, US, The Netherlands) also have continuous surveys in place

61
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
10 MONITORING AND INTELLIGENCE: The government’s monitoring and intelligence systems
(surveillance, evaluation, research and reporting) are comprehensive and regular enough to assess the status of food
environments, population nutrition and diet-related NCDs and their inequalities, and to measure progress on achieving the
goals of nutrition and health plans
Q32 MONIT3: There is regular monitoring of adult and childhood overweight and obesity prevalence using
anthropometric measurements
Evidence:
• Both nutrition and health surveys contain information on obesity and overweight rates. Weight and height are measured.
The most recent update of the information from the New Zealand Health Survey was the 2012/13 update. The latest
New Zealand Health Survey was performed in 2011/2012 [143, 144] (4921 children aged from birth to 14 years and
12,488 adults aged 15 years and over). Prior to introduction of annual surveys, ve years surveys were conducted in
2006/07, 2002/03 and 1996/97. The questionnaire gathers information on key questions on nutrition, general health;
anthropometry, NCDs. The health surveys also measure waist circumference among children and adults. A report on
‘tracking the obesity epidemic’ was published by the MoH and included data from 4 national surveys up to 2003[145]
• The B4 School Check[146] is a nationwide programme offering a free health and development check for four year olds.
B4 School Checks were rolled out nationwide in September 2008. For 2011/12, the target across the country for B4
School Checks was 52,144 children. The B4 School Check includes the measurement of height and weight for recording in
the Well Child health book and B4 School Check database. The target was achieved. The Ministry of Health prepared a
document on the Access, Use and Disclosure Policy for B4 School Check Information System Users[147].
International or national good/best practice:
1. England’s National Child Measurement Programme was established in 2006 and aims to measure all children in
England in the rst (4-5 years) and last years (10-11 years) of primary school. In 2011-2012, 565,662 children at
reception and 491,118 children 10-11 years were measured[148].
10 MONITORING AND INTELLIGENCE: The government’s monitoring and intelligence systems
(surveillance, evaluation, research and reporting) are comprehensive and regular enough to assess the status of food
environments, population nutrition and diet-related NCDs and their inequalities, and to measure progress on achieving the
goals of nutrition and health plans
Q33 MONIT4: There is regular monitoring of the prevalence of NCD risk factors and occurrence rates (e.g.
prevalence, incidence, mortality) for the main diet-related NCDs
Evidence:
• NCD prevalence is measured in NZ health surveys [149, 150].
• Blood pressure is measured among adults in NZ health surveys[144], ‘Doctor-diagnosed’ Heart disease, stroke, diabetes,
asthma, arthritis, mental health conditions, chronic pain, high blood pressure, high blood cholesterol are self-reported.
• The Mortality Collection (MORT) classies the underlying cause of death for all deaths registered in New Zealand, and all
registerable stillbirths (foetal deaths), using the ICD-10-AM 6th Edition and the WHO Rules and Guidelines for Mortality
Coding. Deaths registered in New Zealand from 1988 onwards are held in the Mortality database[151]. The National
Minimum Dataset (NMDS) is a national collection of public and private hospital discharge information, including coded
clinical data for inpatients and day patients. Data has been submitted electronically in an agreed format by public
hospitals since 1993[152].
• The New Zealand Cancer Registry (NZCR) is a population-based register of all primary malignant diseases diagnosed in
New Zealand, excluding squamous and basal cell skin cancers[153].
• The New Zealand Burden of Disease, Injury and Risk Study 2006-2016 (NZBD)[154] is a systematic analysis of health
loss by cause for New Zealanders of all ages, both sexes and both major ethnic groups. It includes estimates of fatal and
nonfatal health losses from 217 diseases and injuries and 31 biological and behavioural risk factors. This information is
intended to support health policy and planning. It includes estimates of health loss due to diet and high BMI.
• There is a virtual national diabetes and cardiovascular disease register based on data from primary care.
International or national good/best practice:
1. NZ and most OECD countries: Have regular and robust prevalence data for the main diet-related NCDs and NCD
risk factors

62
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
10 MONITORING AND INTELLIGENCE: The government’s monitoring and intelligence systems
(surveillance, evaluation, research and reporting) are comprehensive and regular enough to assess the status of food
environments, population nutrition and diet-related NCDs and their inequalities, and to measure progress on achieving the
goals of nutrition and health plans
Q34 MONIT5: There is sufcient evaluation of major programs and policies to assess effectiveness and
contribution to achieving the goals of the nutrition and health plans
Evidence:
• No comprehensive nutrition and health plan exist in New Zealand. Previously The Healthy Eating Healthy Action Strategy,
( 2003)[155], its associated implementation plan[103] and the report on progress of implementation[156] set out the
programme of work. A comprehensive research, evaluation and monitoring framework was associated with the strategy.
However the strategy and many associated programmes were disestablished in 2009.
International or national good/best practice:
1. During 2007/2008 there was 7 million NZD foreseen in HEHA New Zealand for research, monitoring and
evaluation, both at national as well as at local level (a bit less than 10% of the total HEHA budget). During
previous years, this budget was a lower (3-4 million NZD)
2. National Institutes for Health (NIH) in the US provide funding for rapid assessments of natural experiments.
The funding establishes an accelerated review/award process to support time-sensitive research to evaluate a
new policy or program expected to inuence obesity related behaviours (e.g., dietary intake, physical activity, or
sedentary behaviour) and/or weight outcomes in an effort to prevent or reduce obesity[157].
10 MONITORING AND INTELLIGENCE: The government’s monitoring and intelligence systems
(surveillance, evaluation, research and reporting) are comprehensive and regular enough to assess the status of food
environments, population nutrition and diet-related NCDs and their inequalities, and to measure progress on achieving the
goals of nutrition and health plans
Q35 MONIT6: Progress towards reducing health inequalities and societal and economic determinants of
health are regularly monitored
Evidence:
• All Ministry of Health surveys (including the more recent nutrition and health surveys) report on estimates for different
population groups in particular by ethnicity (including Māori and Pacic peoples), by age, by sex and by NZDep).
• Ministry of Health contracts include a section on Māori Health and state: “An overarching aim of the health and
disability sector is the improvement of Māori health outcomes and the reduction of Māori health inequalities. You must
comply with any: a) Māori specic service requirements, b) Māori specic quality requirements and c) Māori specic
monitoring requirements.”
International or national good/best practice:
1. New Zealand: All Ministry of Health Surveys report estimates by subpopulations in particular by ethnicity
(including Māori and Pacic peoples), by age, by gender, and by NZDep

63
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
11 FUNDING AND RESOURCES: Sufcient funding is invested in ‘Population Nutrition Promotion’ to
create healthy food environments, improved population nutrition, reductions in obesity, diet-related NCDs and their related
inequalities
Q36 FUND1: The ‘Population Nutrition Promotion’ budget, as a proportion of total health spending and/or in
relation to the diet-related NCD burden is sufcient to reduce diet-related NCDs.
Evidence:
• Through the ofcial information act 1982, information on budgets spent on population nutrition promotion by MoH, MPI,
the Health Promotion Agency and DHBs and PHUs were easily obtained.
• The Health promotion agency budget was $1.1 million on population nutrition promotion in 2012/2013 (Info Health
Promotion Agency).
• MPI budget was $98000 in 2012/2013(0.113% of the Vote) for salt and energy reduction and the nutrition labelling
working group. This has not been included in the overall estimate as it is not considered to be part of population nutrition
promotion (monitoring and labelling are considered in other parts of the framework).
• The MoH budget was $24 million on population nutrition promotion (0.9% of vote health operational budget and 0.17%
of total vote health) compared to $67 million during 2008/09 HEHA period. The budget for physical activity is included
as well, as nutrition and physical activity could not be separated. Health care costs attributable to overweight and
obesity were estimated to be NZ$624m or 4.4% of New Zealand’s total health care expenditure in 2006. The costs of lost
productivity using the Friction Cost Approach were estimated to be NZ$98m and NZ$225m using the Human Capital
Approach. The combined costs of health care and lost productivity using the FCA were $784m and $911m using the
HCA[158].
• The spending of the Ministry of Education on Population Nutrition Promotion is difcult to retrieve and would be a huge
overestimation and has not been included either. They mainly develop a series of online resources on a website in view of
the administration guideline on health and physical education, they provide learning and facilitation for teachers in the
area of health and physical education and they provide funding for some networks and associations of teachers in the
areas of health & PE.
• The Ministry of Māori development (Te Puni Kokiri) does not have a specic budget allocation for nutrition promotion or
for the delivery of services aimed to prevent obesity and diet-related non-communicable diseases. Community groups
are supported through the Mara Kai programme to boost the level of involvement by Māori in community gardening
projects (including marae, schools and community organisations) to produce health, nancial and social benets.
Through the Mara Kai small one-off funding grants are available of up to $2000 for marae, kohanga reo, schools and
Māori communities to meet the set up and operational costs of gardens. A total of more than $500000 was allocated
for 278 Mara Kai in 2009/10 and a further $500000 was budgeted for 2010/11. To date the Māori Economic Task force
has supported the establishment of more than 460 Mara Kai, with more planned. The amount of funding for the Māra
kai programme for the year 2012/13 was $731,000. Under Te Puni Kokiri’s contestable funding, there are time-to-time
supported projects which promote sustainable communities in a general sense but not specically to encourage better
nutrition or obesity prevention. This funding has been excluded from the full gure.
• Contracts between MoH and DHBs were active during the time that the HEHA Strategy was being implemented with
each DHB receiving funding from the MOH to deliver a range of nutrition and physical activity (N&PA) services. When
HEHA funding was reduced after 2008/2009, N&PA health promotion services were no longer able to be funded unless
the understanding is that DHBs no longer delivered any N&PA health promotion services. However, some DHBs may still
fund some health promotion services using their baseline funding which they receive directly from the MOH. For 2012/13
this was about 4million dollars (including all DHBs).
• In summary, the total funding for population nutrition promotion was estimated at about 29 million dollars or 0.21% of
the total of vote health (while dietary risk factors account for 11.4% of health loss in NZ). In terms of comparison, 300
million dollars was spent during the Rugby World Cup by the government [142].
International or national good/best practice:
1. The budget of MoH was $67 million during 2008/09 HEHA period.

64
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
11 FUNDING AND RESOURCES: Sufcient funding is invested in ‘Population Nutrition Promotion’ to
create healthy food environments, improved population nutrition, reductions in obesity, diet-related NCDs and their related
inequalities
Q37 FUND2: Government funded research is targeted for improving food environments, reducing obesity, NCDs and
their related inequalities
Evidence:
• All funding recipients of 2012 and 2013 funding from the Marsden Fund and the Health Research Council New Zealand
were evaluated. For Marsden, both in 2012 (total budget=$54,960,000) and 2013 (total budget=$58,965,214) there was
no funding for projects related to population nutrition or prevention of obesity and non-communicable diseases. For the
Health Research Council, in 2012 11.4% (total budget=$69,960,192) and in 2013 10.6% (total budget=$70,964,459) was
spent on population nutrition and/or prevention of obesity and non-communicable diseases.
• The funding programmes from MPI relate to Agriculture, Forestry, Environment and Natural Resources, Biosecurity and
animal welfare and are not considered relevant.
International or national good/best practice:
1. In January 2009, recent funds allocated by major medical research funding bodies to obesity in children were
investigated in Australia. Websites from the National Health and Medical Research Council (NHMRC), Australian
Research Council, Diabetes Australia Research Trust and National Heart Foundation (NHF) were explored to
identify outcomes of funding rounds since 2005. A limitation of the approach is that fellowship, scholarship and
travel grants were not included. Of the total 2809 project grants of NHMRC funded since 2005, just 0.5% (almost
$7 million) were directed towards childhood obesity[159]. The NHMRC’s December 2008 statement indicated that
33 (total $18 040 675) of 688 (total $355 872 646) project grants funded for 2009 were related to obesity [160].
2. NZ: In 2012, 11.4% of the HRC’s total budget of $70M and, in 2013, 10.6% of the HRC’s total budget of $71M
was spent on population nutrition and/or prevention of obesity and non-communicable diseases

65
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
12 PLATFORMS FOR INTERACTION: There are coordination platforms and opportunities for synergies
across government departments, levels of government, and other sectors (NGOs, private sector, and academia) such that
policies and actions in food and nutrition are coherent, efcient and effective in improving food environments, population
nutrition, diet-related NCDs and their related inequalities
Q38 PLATF1: There are robust coordination mechanisms across departments and levels of government
(national and local)) to ensure policy coherence, alignment, and integration of food, obesity and diet-related NCD
prevention policies across governments
Evidence:
• Delivering better public services within tight nancial constraints is one of the Government’s four priorities for this term.
The Better Public Services (BPS) programme aims to increase alignment of policy by working across agencies. Changes
are also being made to core State sector legislation which places obligations of stewardship on chief executives of State
sector agencies to look to the long term interests of the Crown and departments. This statement from The Treasury
elaborates on some of the changes being made to facilitate policy alignment[161].
• In the Statement of Intent 2012-2015 of the Minister of Health the following paragraph is included: ‘The health and
wellbeing of a population require coordinated action across government. Children’s health, for example, is inuenced
by their household’s living conditions, income and education levels. As well as fostering collaboration across the health
sector, the Ministry of Health works collaboratively with other government agencies to implement the government’s
agenda. This involves nding better ways to organise integrated and streamlined public services, in order to deliver more
effective, accessible and convenient services for New Zealanders.
• There used to be a memorandum of understanding between Sparc, MoH and Ministry of Education as part of the
Mission-On initiative which was supported at ministerial, agency and implementation levels. The arrangement
was disestablished with Mission-On and HEHA...There are no formal or mandated links between health and other
departments relating specically to nutrition and physical activity.
• The Government set 10 challenging results for the public sector to achieve over the next ve years. There are 10 result
actions within ve areas (none of which relate to nutrition or obesity) which are collective responsibility to be achieved
over the next 5 years[162].
• The Government has set 10 challenging results for the public sector to achieve over the next ve years. There are 10
result actions within ve areas (nothing in this space) which are collective responsibility to be achieved over the next 5
years[162].
• The Social Policy Evaluation and Research (SPEaR) Committee is a cross-agency group established by the New Zealand
Government in 2001 to oversee the government’s investment in social policy research and evaluation. “We use our
unique cross-agency mandate to monitor social research and evaluation activity. We work to strengthen connections
between public, private and tertiary sector providers and users of information. We do this to increase the capacity and
capability of the social sector to deliver evidence-informed advice in a timely manner. We advocate for the provision of
social research and evaluation to decision makers. SPEaR was established with 17 member agencies.” The committee was
supported by the SPEaR Secretariat[163] but has not had a chair since 2010.
• Whānau Ora is an inclusive interagency approach to providing health and social services to build the capacity of all New
Zealand families in need. It empowers whānau as a whole rather than focusing separately on individual family members
and their problems[164].
International or national good/best practice:
1. The ministerial, agency and operational cross-sectorial teams supporting the Mission-On initiative during HEHA
and the associated memorandums of understanding can be considered a good practice example

66
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
12 PLATFORMS FOR INTERACTION: There are coordination platforms and opportunities for synergies
across government departments, levels of government, and other sectors (NGOs, private sector, and academia) such that
policies and actions in food and nutrition are coherent, efcient and effective in improving food environments, population
nutrition, diet-related NCDs and their related inequalities
Q39 PLATF2: There are formal platforms between government and the commercial food sector to implement
healthy food policies
Evidence:
• The Front of Pack Labelling advisory group was established to provide advice on an approach to voluntary interpretive
front of pack labelling in New Zealand. This committee has wide representation and includes the commercial food sector.
• A NZ food industry group (FIG) arose out of the formation of the Food Industry Accord, which was launched in 2004 by
the former Minister of Health. Membership is voluntary and members believe in the principle of industry self-regulation.
Nothing on salt, fat or sugar reduction was included in the latest FIG annual report of 2011-2012 [165, 166]. The Chip
Group™ is made up of a range of players in the food service industry, such as potato growers, chip manufacturers, oil
suppliers, equipment suppliers and media. The group is supported by The Ministry of Health. The overriding goal is to
improve the nutritional status of deep-fried chips served by New Zealand foodservice by reducing fat (total and saturated)
and salt content[167]. The Chip group is funded by both government (50%) and industry (50%).
• In 2007, the National Heart Foundation (NHF), under a contract from MoH, started a voluntary strategy with bread
manufacturers. It aimed to reduce the sodium content of bread, particularly low cost and high volume breads, to
less than 450mg/100g. Currently bread companies are exploring the feasibility of a 400mg guideline (personal
communication Dave Monro, NHF). The best practice guidelines for sodium reduction in a range of food products (for
bread, breakfast cereals, processed meats, savoury pies) and current industry commitments for sodium and saturated
fat reduction in foods within HeartSAFE[168] can be found online on the website of the NHF. However, this is a service
delivery approach rather than a direct engagement platform.
• An important document in the conicts of interest sphere is the Ofce of the Auditor-General’s ‘Managing conicts of
interest: Guidance for public entities [169]. In relation to conicts of interest, State servants are bound by the ‘Standards
of Integrity and Conduct’ (‘The Code’) which sets out the standards expected of State servants. The Code includes the
statement ‘we must ensure our actions are not affected by our personal interests or relationships.’ A breach of this (or
any aspect) of the Code may be grounds for disciplinary action[170].
• The SSC in New Zealand has published Best Practice Guidelines for Departments Responsible for Regulatory Processes
with Signicant Commercial Implications [116]. These guidelines cover a section on managing conict of interest issues
in different government departments as well. As a principle it is stated that Departments should have clear, effective
and robust processes in place for identifying and addressing potential conicts of interest[116]. Two useful resources
are the State Services Commission resource kit “Walking the Line: Managing Conicts of Interest” (published June
2003 and updated in 2005)[171] as well as an SSC report “Report for State Services Commissioner on Civil Aviation
Authority Policies Procedures and Practices Relating to Conicts of Interest and Conduct of Special Purpose Inspections
and Investigations” (published December 2003) that describes the application of these principles to an example of a
regulatory process.
• There are conict of interest registers available for senior management staff by each department. Board members
have duties under the Crown Entities act (much stricter for boards than committees). The conicts of interest are looked
after through the crown ownership unit at the treasury. HPA manages conicts of interest (declaration of interests was
received) in accordance with the provisions of the Crown Entities Act 2004 and advice provided to the state sector from
the Ofce of the Auditor General and the State Services Commission. Once board members are appointed, the following
HPA procedures apply: A register of interests, regularly updated, in accordance with policy. Identication and noting
of interests in preparing agenda Interest disclosure to be rst item at each meeting. Affected member leaves room for
discussion/decision (Ofcial Information Request Health Promotion Agency).
• The Treasury’s guideline for public private partnerships in New Zealand (2009) refers to public private initiatives as being
direct agreements between the crown and the private sector. The Ministry does not have any direct agreements with the
Private Sector for nutrition initiatives.
However, the Ministry has a small number of contracts with NGOs who have either memorandum of understandings or
other formal arrangements with the private sector; or the Ministry funds NGOs who also receive separate funding from
the private sector for different services. These are managed separately by the NGO. The two nutrition-related Ministry
funded joint public private initiatives are as follows:
• Chip Group: To improve the nutrient prole of food service deep-fried chips, including reductions in total fat, saturated
fatty acids, trans fatty acids and sodium (85000 NZD excluding GST annually)
• New Zealand Heart Foundation: Food for thought programme which takes children into supermarkets where they put
theory into action by purchasing food and then preparing a class lunch for their parents after a classroom session on
healthy eating and nutrition (100000 NZD excluding GST annually)

67
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
International or national good/best practice:
1. Consensus Action for Salt and Health (CASH) in the UK[172]
2. Australian Health Star Rating Advisory Committee has wide representation
3. New Zealand: Front of Pack Labelling advisory committee has wide representation
12 PLATFORMS FOR INTERACTION: There are coordination platforms and opportunities for synergies
across government departments, levels of government, and other sectors (NGOs, private sector, and academia) such that
policies and actions in food and nutrition are coherent, efcient and effective in improving food environments, population
nutrition, diet-related NCDs and their related inequalities
Q40 PLATF3: There are formal platforms for regular interactions between government and civil society on food
policies and other strategies to improve population nutrition
Evidence:
• MPI has had contracts with Otago University Nutrition Department for providing advice on a range of nutrition related
issues. They also had a range of academics on the Academy, which was disbanded earlier last year. The Academy was a
group of academics that met once a year and were able to be contacted during the year to provide advice on food safety
related issues. Three academics were considered nutrition experts. They also had academics as members of the Front of
Pack labelling working group. This group has just been reconvened and there are two nutrition academics in this group
(Information from MPI through the Ofcial Information Act request). A range of organisations is involved in consultations
for policies or standards, regular meetings with consumer groups and advisory groups etc.
• The MoH currently does not have any standing committees or formal platforms for dialogue between Government
ofcials and academia on general nutrition issues. Several advisory committees have been disestablished due to
restrictions on the budget. External advice is obtained on an individual project basis as and where necessary. For
example, the Ministry has: led the development of a consensus statement on vitamin D and sun exposure, a WHO code
of marketing of breast milk substitutes compliance panel, a joint project with the department of health and ageing
in Australia to review nutrient reference values, funded the health promotion agency to convene a technical advisory
group, including academics, to provide strategic advice to inform their nutrition and physical activity work programme
(Information from MoH through the Ofcial Information Act request). A list of all food-and nutrition related advisory
groups, working groups and committees over the last 5 years, including topics dealt with; list of conicts of interest
declared is attached as Annex 1. The only committees currently active are the WHO code compliance panel (meeting up
to four times a year) and the technical advisory group for the eating and activity guidelines (has met once in November
2013 and expected to meet up to four times a year).
• FSANZ encourages input of consumers through the consumer and health dialogue
• The National Health Committee (NHC) provides the Minister of Health with independent advice on a broad spectrum of
health and disability issues.
The NHC incorporates the Public Health Advisory Committee, which provides the Minister with public health advice.
• Some NGOs in NZ receive MoH funding, for example, the National Heart Foundation is funded to develop salt reduction
strategies with industry.
• MoH contracts with NGOs do not allow NGOs to spend their MoH funding on advocacy for healthy food environments
although the relevant clauses may be absent from contracts with smaller NGOs who receive the majority of their funding
from other sources. The contract between the Ministry of Health and Agencies for Nutrition Action was received for
the period June 2012-June 2015. Service requirements include: to support the facilitation of a nationally coordinated
approach to the implementation of public health prevention services, to support the implementation of evidence-based
nutrition and physical activity policies and programmes and to promote the building of healthy public policies that
enhance wellbeing and disease prevention related to nutrition, physical activity and healthy weight. The following clause
is included: “Neither of us may during or after this agreement either directly or indirectly criticise the other publicly,
without rst fully discussing the matters of concern with the other in good faith and in a co-operative and constructive
manner. Nothing in this clause prevents either of us from discussing any matters of concern with our respective staff,
subcontractors, agents or advisors. In the service specications under activities not funded by the Ministry of Health:
advocate for a comprehensive environmental approach to prevent obesity and encourage healthy eating and physical
activity”.
• Civil society is encouraged to participate in public submissions in certain aspects of food policy development (eg to
Parliamentary Inquiries, Select Committees)
International or national good/best practice:
1. In Brazil the National Council of Food and Nutrition Security (CONSEA) is a body made up of civil society and
government representatives, which advises the President’s ofce on matters involving food and nutrition security.
Through the presidential advisory body CONSEA, a cross-government, cross-sector, participatory instrument
for designing or suggesting, implementing and evaluating food and nutritional security policy, civil society has
been able to inuence policy directions more directly. CONSEA supported Congress to pass a bill obliging local
governments to buy at least 30 per cent of the food destined for school meals from small-scale farmers.

68
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
12 PLATFORMS FOR INTERACTION: There are coordination platforms and opportunities for synergies
across government departments, levels of government, and other sectors (NGOs, private sector, and academia) such that
policies and actions in food and nutrition are coherent, efcient and effective in improving food environments, population
nutrition, diet-related NCDs and their related inequalities
Q41 PLATF4: The government leads a broad, effective and sustainable systems-based approach with local
organisations to improve the healthiness of food environments at a national level
Evidence:
• The only program currently running in New Zealand is project Energize in the Waikato region[173]. Project Energize
began in 2005 and is funded by Waikato District Health Board. Partners in the project include Sport Waikato and AUT
University, University of Waikato, Waikato Institute of Technology, Sport and Recreation NZ, National Health Foundation.
Programme delivery partners are Māori and Pacic health providers Te Kohao Health, Te Korowai Hauora O Hauraki,
Nga Miro Health and South Waikato Pacic Islands Health Committee. A total of 44,000 primary and intermediate
schoolchildren are now part of Project Energize through 244 Waikato schools. Vital to the success of Project Energize
are the 27 “Energizers” who work with schools, teachers and parents, giving physical tness and nutritional advice and
helping implement health and tness programmes. The budget for the program Energize is increasing over the years
since 2004. Other areas are looking into implementing Energize. In New Zealand, a 2011 evaluation of Project Energize
(Waikato) found that ‘Energize’ children had: smaller waist circumferences and lower body-mass index than Waikato
children of the same age measured in 2004 and 2006, obesity rates three percent less than the national level and faster
running times over 550m compared to national data[174].
• The Government recently announced[108] it would launch a ‘healthy families NZ’ community-based programme, similar
to the Healthy together Victoria programme in Australia. Healthy Families New Zealand is a new initiative that aims to
improve people’s health where they live, learn, work and play in order to prevent chronic disease. The Ministry of Health
is leading the establishment of HFNZ communities in 10 locations across New Zealand. HFNZ will support local leaders
to implement voluntary initiatives that encourage families to live healthy, active lives. Through investment in community
partnerships and a skilled health promotion workforce, these communities will nd local solutions to local needs,
supporting healthy living. Activities will initially focus on the settings where people live, learn, work, and play. The 10
HFNZ communities come from areas with higher-than-average rates of preventable chronic diseases (such as diabetes),
higher-than-average rates of risk factors for these diseases (such as smoking), and/or high levels of deprivation. It is
expected that HFNZ communities will reach approximately 900,000 New Zealanders. The design for Healthy Families NZ
communities draws on evidence from the Be Active Eat Well pilot (Colac, Australia), EPODE pilots (France) and Project
Energize (New Zealand), which have been associated with a number of measurable improvements that will support the
health and wellbeing of children. The process for establishing HFNZ began with the release of a Registration of Interest
(ROI) process on 14 March 2014. The purpose of the ROI is to identify and short-list organisations who could act as Local
Lead Providers for the implementation of HFNZ in the communities selected. The funding for HFNZ will allow providers to:
• establish and build a local health promotion workforce
• support communities to nd local solutions to local needs
• roll out a range of programmes that provide skills and support for families to achieve better health
• support prevention partnerships within their communities (e.g. with government, non-government organisations,
businesses and community members)
• support health promoting early childhood services, schools, workplaces and communities
• tailor health messaging to local circumstances and needs
• contribute to research and evaluation.
International or national good/best practice:
1. Healthy Together Victoria[175] in Australia aims to improve people’s health where they live, learn, work and play.
It focuses on addressing the underlying causes of poor health in children’s settings, workplaces and communities
by encouraging healthy eating and physical activity, and reducing smoking and harmful alcohol use. Healthy
Together Victoria incorporates policies and strategies to support good health across Victoria, as well as locally-
led Healthy Together Communities. The initiative is jointly funded by the State Government of Victoria and the
Australian Government through the National Partnership Agreement on Preventive Health (NPAPH).

69
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
13 HEALTH IN ALL POLICIES: Processes are in place to ensure policy coherence and alignment, and that
population health impacts are explicitly considered in the development of government policies
Q42 HIAP1: There are processes in place to ensure that population nutrition, health outcomes and reducing
health inequalities are considered and prioritised in the development of all government policies relating to food
Evidence:
• FSANZ does not undertake health impact assessments. However, their standards development process (which is based
on the Codex risk analysis model) incorporates key elements, including assessment of issues (including health impacts, if
relevant) and consultation. Their process also includes a regulatory impact analysis, and a Regulation Impact Statement
(RIS) may be prepared to inform this process. Regulatory impact assessments usually compare several scenarios: no
regulation, voluntary regulation and mandatory regulation (1 or 2 different scenarios), but this is not considered a health
impact assessment.
• MPI performs safety assessments for agricultural policies
International or national good/best practice:
1. Republic of Slovenia assessed the health effects of agricultural policy at a national level[176]. The HIA has
basically followed a six-stage process: policy analysis; rapid appraisal workshops with stakeholders from a range
of backgrounds; review of research evidence relevant to the agricultural policy; analysis of Slovenian data for
key health-related indicators; a report on the ndings to a key cross-government group; and evaluation. The
experience in Slovenia shows that the HIA process has been a useful mechanism for raising broader public health
issues on the agricultural policy agenda, and it has already had positive results for policy formation[176].

70
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
13 HEALTH IN ALL POLICIES: Processes are in place to ensure policy coherence and alignment, and that
population health impacts are explicitly considered in the development of government policies
Q43 HIAP2: There are processes (e.g. health impact assessments) to assess and consider health impacts during the
development of other non-food policies
Evidence:
• Policy-level Health Impact Assessment (HIA) guidelines were published in 2004 by the Public Health Advisory Committee
(PHAC), a subcommittee of the National Health Committee [177]. The MoH released additional HIA guidelines in 2007
that provided greater focus on whānau ora (health and well-being for Māori, their families and communities)[178].
• The NZ Cabinet agreed in 2006 to establish a national HIA support unit within the MoH with four years of funding.
Since October 2012 there is no HIA support anymore at the MoH since both of the people working in that unit left and
were not replaced. Currently the central government is not anymore prioritizing HIA. HIA is much stronger at local
level in New Zealand but actions are slowing down due to lack of support from central government. Most DHB public
health units have undertaken HIAs. Reasons for this include permission given to them by the MoH through funding
contracts; allocation of staff and funding by DHB management; workforce development, resulting in a trained HIA staff
member in all public health units in 2009;[179] and the willingness of staff to take a new approach to protecting and
promoting public health. There appears to be increasing acceptance amongst public health staff that HIA is ‘business-
as-usual’. Local government has also been a key player in the development of HIA in NZ. Several HIAs have been led by
local government agencies and many other HIAs have involved strong collaboration between public health and local
government staff. It seems likely that the legislative requirement on local government to consider community well-being
has been an important motivator for them in adopting HIA. HIA values and processes appear to resonate with some local
government staff and politicians. Building support and leadership for HIA in local government is a continuing focus in
NZ. An evaluation of health impact assessments in New Zealand was performed in a report in 2010 [180]. An overview
of HIA in New Zealand to date can be found in the book chapter by Rob Quigley and Louise Signal[181]. In late 2011 47
HIAs were completed, or in progress in NZ, at the local level. They cover a wide range of health determinants at a range
of levels. All of the HIAs were voluntary as there is no legislative requirement for them to be undertaken. A ‘Learning by
Doing Fund’ provided nancial support to nearly half the HIAs undertaken in NZ. The fund, now ceased, likely increased
the number of HIAs that occurred, and may have ensured better quality. There is a now a substantial body of work in
NZ demonstrating the value of HIA at the local-level including how HIA can strengthen health, well-being and equity
in strategies, policies, programmes and plans. This work has included building HIA workforce capacity, increasing the
evidence about the impacts of policy on health, and evaluating the benets of HIA. Further there has been progress on
embedding HIA as ‘business-as-usual’ in public health and in some areas of local government. Progress has slowed since
2009 reecting reprioritization of resources by successive centre-right governments. For instance, efforts to provide a
legal framework for HIA under new public health legislation have stalled and the Learning by Doing Fund is no longer
available[181].
• Health in All Policies (HiAP) is dened as “an approach to public policies across sectors that systematically takes into
account the health implications of decisions, seeks synergies, and avoids harmful health impacts, in order to improve
population health and health equity.” There is nothing happening at central government level on this. A diversity of ways
of incorporating health and equity into urban planning was explored in a report in 2011 by the University of Auckland
nanced by the Ministry of Health. [182] Nobody was sent from the Ministry to the Health Promotion Conference in
Helsinki in June 2013 (topic=health in all policies). The only good local example is the health-in-all policies approach
from Canterbury launched in 2009. Christchurch City Council, Canterbury District Health Board, the Regional Council
(Environment Canterbury) and Pegasus Health work in this partnership to embed a health perspective within their
organisations. These four partner organisations operated a Steering Group [SG], with a Memorandum of Understanding
[MoU] and Terms of Reference [ToR] to oversee the project, and jointly funded a fulltime Project Ofcer. In addition,
Community and Public Health and the Christchurch City Council jointly funded a Public Health Specialist position to lead
the Health In All Policies approach. The focus is to educate and re-orientate the health and other sectors around a health
determinants focus. Evaluation of this HiAP is done at a regular basis.

71
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
International or national good/best practice:
1. Two initiatives with healthy public policy goals were recently implemented in Canada and are designed to better
coordinate public policies in multiple sectors of government activity so as to improve health outcomes[183].
Those initiatives are the strategies surrounding section 54 of Québec’s Public Health Act and ActNow British
Columbia (BC). ActNow BC, for its part, is aimed at coordinating all the provincial ministries, as well as various
municipal public agencies and private partners―that is, non-governmental organizations and corporations. This
initiative can thus best be described in terms of the concept of “whole-of-government.” ActNow BC is an initiative
that was publicly launched in 2006 by the ofce of the Premier of British Columbia. The intention was to take
advantage of the renown and the nature of the Olympic Games (which, in 2003, the City of Vancouver was chosen
to host), using them as a jumping off point and a catalyzer for efforts to meet certain public health objectives.
This initiative was thus conceived of as a government platform; that is, a grouping of principles and proposals
dening the framework of a public policy initiative, with targets having a limited time frame. The platform was
structured around three objectives. First, the overall goal was, through the platform, “to make BC the healthiest
jurisdiction to host the Winter Olympic and Paralympic Games”. Second, the initiative aimed more specically “to
inspire commitment to create a BC that makes the healthy lifestyle choice the easy choice for everyone”. Finally,
ActNow BC aimed to improve the health of British Columbians by encouraging, specically, “healthier eating,
increased physical activity, a healthy body weight, the reduction, cessation or avoidance of tobacco use, and
healthy choices in pregnancy”. In section 54 of QUÉBEC’S public health act which took effect in June 2002, the
government afrmed its desire to take into account, in its legislative process, the effects of all its public policies on
the population’s health and welfare. The initiative is conceived of in horizontal terms. Section 54, in fact, provides
a legal basis for the task of promoting healthy public policy, and its purpose is to prompt interministerial action
and responsibility for the purpose of establishing healthy public policies. The following provisions are included
in this section of the law: 1) The Minister is by virtue of his or her ofce the advisor of the Government on any
public health issue. The Minister shall give the other ministers any advice he or she considers advisable for health
promotion and the adoption of policies capable of fostering the enhancement of the health and welfare of the
population. 2) In the Minister’s capacity as government advisor, the Minister shall be consulted in relation to the
development of the measures provided for in an Act or regulation that could have signicant impact on the health
of the population (Québec, 2005)[183].
2. The South Australian HiAP model includes two key elements: central governance and accountability and a Health
Lens analysis process. The model captures the interactive and uid nature of the approach. Beginning with clear
governance and accountability it moves through a exible Health Lens analysis process, leading to improved
policy or social determinants of health outcomes. The governance structure provides a mandate for horizontal
collaboration and joined-up policy making, which underpins the HiAP work. The model seeks agreement on the
policy focus and utilises robust methods of assessment and analysis to explore the links between the policy
area and health and wellbeing of the population[184]. A background document and practical guide have been
published [185]. An overview is given in the Figure below.

72
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
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184. The South Australian Model of Health in All Policies [http://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/
health+reform/health+in+all+policies]
185. Government of South Australia: The South Australian approach to Health in All Policies: background and practical guide. version 2. 2011. [
http://www.sahealth.sa.gov.au/wps/wcm/connect/cb6fa18043aece9fb510fded1a914d95/HiAPBackgroundPracticalGuide-v2.pdf?MOD=AJ
PERES&CACHEID=cb6fa18043aece9fb510fded1a914d95]

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Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Domain Good practice statements: RATING %
category
Leadership:
The political leadership ensures that there is strong
support for the vision, planning, communication,
implementation and evaluation of policies and actions
to create healthy food environments, improve population
nutrition, and reduce diet-related inequalities
LEAD1: There is strong, visible, political support (at the Head of State / Cabinet level) for improving food
environments, population nutrition, diet-related NCDs and their related inequalities Low 35
LEAD2: Clear population intake targets have been established by the government for the nutrients of concern to
meet WHO and national recommended dietary intake levels Low 36
LEAD3: Clear, interpretive, evidence-informed food-based dietary guidelines have been established and
implemented Medium 63
LEAD4: There is a comprehensive, transparent, up-to-date implementation plan (including priority policy and
program strategies, social marketing for public awareness and threat of legislation for voluntary approaches)
linked to national needs and priorities, to improve food environments, reduce the intake of the nutrients of concern
to meet WHO and national recommended dietary intake levels, and reduce diet-related NCDs
Very little 24
LEAD5: Government priorities have been established to reduce inequalities in relation to diet, nutrition , obesity
and NCDs Medium 62
Governance:
Governments have structures in place to ensure
transparency and accountability, and encourage broad
community participation and inclusion when formulating
and implementing policies and actions to create healthy
food environments, improve population nutrition, and
reduce diet-related inequalities
GOVER1: There are robust procedures to restrict commercial inuences on the development of policies related to
food environments where they have conicts of interest with improving population nutrition Medium 51
GOVER2: Policies and procedures are implemented for using evidence in the development of food policies Medium 59
GOVER3: Policies and procedures are implemented for ensuring transparency in the development of food policies High 83
GOVER4: The government ensures access to comprehensive nutrition information and key documents (e.g. budget
documents, annual performance reviews and health indicators) for the public High 90
Appendix 3: List of good practice statements and experts’ ratings
Table 4: Level of implementation for each policy and infrastructure support good practice statement: New Zealand 2014

78
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Domain Good practice statements: RATING %
category
Monitoring & Intelligence:
The government’s monitoring and intelligence systems
(surveillance, evaluation, research and reporting) are
comprehensive and regular enough to assess the status of
food environments, population nutrition and diet-related
NCDs and their inequalities, and to measure progress on
achieving the goals of nutrition and health plans
MONIT1: Monitoring systems, implemented by the government, are in place to regularly monitor food
environments (especially for food composition for nutrients of concern, food promotion to children, and nutritional
quality of food in schools and other public sector settings), against codes/guidelines/standards/targets.
Medium 53
MONIT2: There is regular monitoring of adult and childhood nutrition status and population intakes against
specied intake targets or recommended daily intake levels. Medium 61
MONIT3: There is regular monitoring of adult and childhood overweight and obesity prevalence using
anthropometric measurements High 76
MONIT4: There is regular monitoring of the prevalence of NCD risk factors and occurrence rates (e.g. prevalence,
incidence, mortality) for the main diet-related NCDs High 86
MONIT5: There is sufcient evaluation of major programs and policies to assess effectiveness and contribution to
achieving the goals of the nutrition and health plans Low 36
MONIT6: Progress towards reducing health inequalities and social determinants of health are regularly monitored Medium 74

79
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Domain Good practice statements: RATING %
category
Funding & Resources:
Sufcient funding is invested in ‘Population Nutrition
Promotion’(estimated from the investments in
population promotion of healthy eating and healthy
food environments for the prevention of obesity and
diet-related NCDs, excluding all one-on-one promotion
(primary care, antenatal services, maternal and child
nursing services etc.), food safety, micronutrient
deciencies (e.g. folate fortication) and under-nutrition)
to create healthy food environments, improved population
nutrition, reductions in obesity, diet-related NCDs and
their related inequalities
FUND1: The ‘Population Nutrition Promotion’ budget, as a proportion of total health spending and/or in relation
to the diet-related NCD burden is sufcient to reduce diet-related NCDs Low 34
FUND2: Government funded research is targeted for improving food environments, reducing obesity, NCDs and
their related inequalities Medium 56
Platforms for Interaction:
There are coordination platforms and opportunities for
synergies across government departments, levels of
government, and other sectors (NGOs, private sector,
and academia) such that policies and actions in food and
nutrition are coherent, efcient and effective in improving
food environments, population nutrition, diet-related
NCDs and their related inequalities
PLATF1: There are robust coordination mechanisms across departments and levels of government (national and
local) to ensure policy coherence, alignment, and integration of food, obesity and diet-related NCD prevention
policies across governments
Low 37
PLATF2: There are formal platforms between government and the commercial food sector to implement healthy
food policies Low 47
PLATF3: There are formal platforms for regular interactions between government and civil society on food policies
and other strategies to improve population nutrition Low 41
PLATF4: The government leads a broad, effective and sustainable systems-based approach with local
organisations to improve the healthiness of food environments at a national level Low 43
Health-in-all-policies:
Processes are in place to ensure policy coherence and
alignment, and that population health impacts are
explicitly considered in the development of government
policies
HIAP1: There are processes in place to ensure that population nutrition, health outcomes and reducing health
inequalities are considered and prioritised in the development of all government policies relating to food Low 37
HIAP2: There are processes (e.g. health impact assessments) to assess and consider health impacts during the
development of other non-food policies Low 28

80
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Domain Good practice statements: RATING %
category
Food Composition:
There are government systems implemented to ensure
that, where practicable, processed foods minimise the
energy density and the nutrients of concern (salt, fat,
saturated fat, trans fat, added sugar)
COMP 1: Food composition targets/standards have been established by the government for the content of the
nutrients of concern in certain foods or food groups if they are major contributors to population intakes of these
nutrients of concern (trans fats and added sugars in processed foods, salt in bread, saturated fat in commercial
frying fats)
Medium 51
Food Labelling:
There is a regulatory system implemented by the
government for consumer-oriented labelling on food
packaging and menu boards in restaurants to enable
consumers to easily make informed food choices and to
prevent misleading claims
LABEL1: Ingredient lists and nutrient declarations in line with Codex recommendations are present on the labels
of all packaged foods High 86
LABEL2: Robust, evidence-based regulatory systems are in place for approving/reviewing claims on foods, so that
consumers are protected against unsubstantiated and misleading nutrition and health claims High 76
LABEL3: A single, consistent, interpretive, evidence-informed front-of-pack supplementary nutrition information
system, which readily allows consumers to assess a product’s healthiness, is applied to all packaged foods Low 43
LABEL4: A consistent, single, simple, clearly-visible system of labelling the menu boards of all quick service
restaurants (i.e. fast food chains) is applied by the government, which allows consumers to interpret the nutrient
quality and energy content of foods and meals on sale
Very little 25
Food Promotion:
There is a comprehensive policy implemented by the
government to reduce the impact (exposure and power)
of promotion of unhealthy foods to children (<16years)
across all media
PROMO1: Effective policies are implemented by the government to restrict exposure and power of promotion of
unhealthy foods to children through all forms of media, including broadcast (TV, radio) and non-broadcast media
(e.g. Internet, social media, point-of-purchase, product placement, packaging, sponsorship, outdoor advertising)
Very little 22
PROMO2: Effective policies are implemented by the government to ensure that unhealthy foods are not
commercially promoted to children in settings where children gather (e.g. preschools, schools, sport and cultural
events)
Very little 25

81
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Domain Good practice statements: RATING %
category
Food Prices:
Food pricing policies (e.g., taxes and subsidies) are
aligned with health outcomes by helping to make the
healthy eating choices the easier, cheaper choices
PRICES1: Taxes on healthy foods are minimised to encourage healthy food choices where possible (e.g. low or no
sales tax, excise, value-added or import duties on fruit and vegetables) Very little 22
PRICES2: Taxes on unhealthy foods (e.g. sugar-sweetened beverages, foods high in nutrients of concern) are in
place to discourage unhealthy food choices where possible, and these taxes are reinvested to improve population
health
Very little 22
PRICES3: The intent of existing subsidies on foods, including infrastructure funding support (e.g. research and
development, supporting markets or transport systems), is to favour healthy rather than unhealthy foods Very little 23
PRICES4: The government ensures that food-related income support programs are for healthy foods Low 42
Food Provision:
The government ensures that there are healthy food
service policies implemented in government-funded
settings to ensure that food provision encourages healthy
food choices, and the government actively encourages
and supports private companies to implement similar
policies
PROV1: The government ensures that there are clear, consistent policies (including nutrition standards)
implemented in schools and early childhood education services for food service activities (canteens, food at
events, fundraising, promotions, vending machines etc.) to provide and promote healthy food choices
Low 35
PROV2: The government ensures that there are clear, consistent policies in other public sector settings for food
service activities (canteens, food at events, fundraising, promotions, vending machines, public procurement
standards etc.) to provide and promote healthy food choices
Low 38
PROV3: The government ensures that there are good support and training systems to help schools and other
public sector organisations and their caterers meet the healthy food service policies and guidelines Medium 55
PROV4: Government actively encourages and supports private companies to provide and promote healthy foods
and meals in their workplaces Medium 52

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Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Domain Good practice statements: RATING %
category
Food Retail:
The government has the power to implement policies and
programs to support the availability of healthy foods and
limit the availability of unhealthy foods in communities
(outlet density and locations) and in-store (product
placement)
RETAIL1: Zoning laws and policies are robust enough and are being used, where needed, by local governments to
place limits on the density or placement of quick serve restaurants or other outlets selling mainly unhealthy foods
in communities
Very little 21
RETAIL2: There are existing support systems to encourage food stores to promote the in-store availability of
healthy foods and to limit the in-store availability of unhealthy foods Very little 23
Food Trade & Investment:
The government ensures that trade and investment
agreements protect food sovereignty, favour healthy
food environments, are linked with domestic health and
agricultural policies in ways that are consistent with
health objectives, and do not promote unhealthy food
environments
TRADE1: The direct and indirect impacts of international trade and investment agreements on food environments
and population nutrition and health are assessed and considered Very little 22
TRADE2: The government adopts measures to manage investment and protect their regulatory capacity with
respect to public health nutrition Very little 21

83
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Infrastructure support action Infrastructure support good practice statement Score
(rank)
1. To demonstrate a national commitment, the NZ Government prioritises improving
nutrition and reducing childhood obesity by:
• including clear support for these priorities in the government Statements of
Intent (especially for the Ministry of Health);
• setting a target to reduce the prevalence of childhood and adolescent obesity
(for example, by 5% over the next six years) as part of the Better Public Service
challenge targets
LEADERSHIP
LEAD1: There is strong, visible, political support (at the Head of State / Cabinet level) for
improving food environments, population nutrition, diet-related NCDs and their related
inequalities
390
(1)
2. To demonstrate commitment and to measure progress, the NZ Government
species clear targets for the reduction of salt, sugar and saturated fat intake of
the population based on WHO recommendations and the global NCD action plan
(e.g., salt intake 5g/day, saturated fat intake less than 10% of energy, and free sugar
less than 10% of energy)
LEAD2: Clear population intake targets have been established by the government for the
nutrients of concern to meet WHO and national recommended dietary intake levels
317
(4)
3. To ensure the consistency of policies and messages on healthy diets, the NZ
Government actively implements its food-based dietary guidelines including
translating and promoting them to the public and to professional groups, industry
groups, and relevant settings.
LEAD3: Clear, interpretive, evidence-informed food-based dietary guidelines have been
established and implemented
282
(10)
4. To convert its commitments to WHO’s Global Action Plan to Reduce Non-
Communicable Diseases (NCDs) into the New Zealand context, the NZ
Government develops, funds and implements a comprehensive national action plan
to prevent NCDs
LEAD4: There is a comprehensive, transparent, up-to-date implementation plan (including
priority policy and program strategies, social marketing for public awareness and threat
of legislation for voluntary approaches) linked to national needs and priorities, to improve
food environments, reduce the intake of the nutrients of concern to meet WHO and
national recommended dietary intake levels, and reduce diet-related NCDs
324
(3)
5. To articulate the high priority to reduce health inequalities, the NZ Government
embeds explicit objectives to reduce health inequalities throughout the
comprehensive plan.
LEAD5: Government priorities have been established to reduce inequalities in relation to
diet, nutrition , obesity and NCDs
302
(5)
Appendix 4: Recommended actions prioritised by the Expert Panel
The following tables list the recommended actions that were prioritised by the experts. Note that the actions for ‘Infrastructure Support’ and ‘Policies’ were prioritised separately.
As the number of actions differed between Infrastructure Support (19) and Policies (15), the scores cannot be compared across the two components. The scores provide the overall
ranking of the action statements within each component.
Table 5: Recommended infrastructure support actions prioritised by the Expert Panel

84
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Infrastructure support action Infrastructure support good practice statement Score
(rank)
6. To minimise direct conicts between commercial interests and the interests of
public health nutrition, the NZ Government strengthens its conict of interest
procedures to ensure that food industry representatives with direct conicts are not
included in setting food-related policy objectives and principles (this does not apply to
their participation in policy implementation).
GOVERNNANCE
GOVER1: There are robust procedures to restrict commercial inuences on the
development of policies related to food environments where they have conicts of interest
with improving population nutrition
298
(6)
7. To track progress towards healthier food environments and to inform action, the
NZ Government strengthens its monitoring of food environments by regularly:
• monitoring of marketing unhealthy foods to children through broadcast and non-
broadcast media; and
• monitoring the nutritional quality of foods provided and sold in schools and early
childhood education and care services.
MONITORING
MONIT1: Monitoring systems, implemented by the government, are in place to regularly
monitor food environments (especially for food composition for nutrients of concern, food
promotion to children, and nutritional quality of food in schools and other public sector
settings), against codes/guidelines/standards/targets.
292
(7)
8. To track progress towards healthier diets and to inform action, the NZ
Government ensures that there are comprehensive regular (e.g., ve yearly) food
consumption surveys for adults and children, so that food and nutrient intakes and
nutritional status can be assessed against nutritional and food-based guidelines and
targets.
MONIT2: There is regular monitoring of adult and childhood nutrition status and
population intakes against specied intake targets or recommended daily intake levels.
278
(12)
9. To track progress and to inform action at a local level, the NZ Government
institutes a system to deliver regular ‘ne-grained’ estimates of overweight and
obesity prevalence (especially for children and adolescents) at community levels for
use by local communities.
MONIT3: There is regular monitoring of adult and childhood overweight and obesity
prevalence using anthropometric measurements
228
(18)
10. To track progress on NCDs and their risk factors, the NZ Government continues
to invest in CVD and diabetes risk assessments and investigates the inclusion
of height and weight measurements and the use of the data for population
monitoring.
MONIT4: There is regular monitoring of the prevalence of NCD risk factors and occurrence
rates (e.g. prevalence, incidence, mortality) for the main diet-related NCDs
280
(11)
11. To ensure effectiveness and the efcient use of resources, the NZ Government
includes robust program evaluation in any major investment in improving
population nutrition with approximately 10% of program costs allocated for
evaluation including outcome measures
MONIT5: There is sufcient evaluation of major programs and policies to assess
effectiveness and contribution to achieving the goals of the nutrition and health plans
288
(8)

85
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Infrastructure support action Infrastructure support good practice statement Score
(rank)
12. To track progress and inform action on the underlying drivers of poor health
and health inequalities, the NZ Government funds regular monitoring reports on
the underlying societal and economic determinants of health and the related
progress on the reduction of health inequalities.
MONIT6: Progress towards reducing health inequalities and social determinants of health
are regularly monitored
288
(9)
13. To ensure that sufcient resources are available to improve population
nutrition, the NZ Government funding for population nutrition promotion is
increased to at least $70M per year (equivalent to about 10% of the health care
costs of overweight/obesity and on a par with previous investments in prevention).
FUNDING
FUND1: The ‘Population Nutrition Promotion’ budget, as a proportion of total health
spending and/or in relation to the diet-related NCD burden is sufcient to reduce diet-
related NCDs
339
(2)
14. To align research strategies with improving the healthiness of diets, the NZ
Government ensures that the Science Challenges on Healthier Lives, Aging Well, and
A Better Start have a strong focus on research to improve nutrition.
FUND2: Government funded research is targeted for improving food environments,
reducing obesity, NCDs and their related inequalities
232
(17)
15. To facilitate whole-of-government approaches to improving population nutrition
and obesity, the NZ Government establishes cross-government mechanisms
(national to local and between ministries) to co-ordinate food-related prevention
policies (e.g., through the introduction of a new Public Sector Challenge).
PLATFORMS FOR INTERACTION
PLATF1: There are robust coordination mechanisms across departments and levels of
government (national and local) to ensure policy coherence, alignment, and integration of
food, obesity and diet-related NCD prevention policies across governments
264
(14)
16. To maximise the input and value from civil society, the NZ Government ensures
there are formal platforms including a nutrition advisory committee and other
mechanisms for civil society organisations (e.g., NGOs, academia) to be involved
proactively in food policy and program development, implementation, and evaluation.
PLATF3: There are formal platforms for regular interactions between government and civil
society on food policies and other strategies to improve population nutrition
264
(15)
17. To maximise the impact of community-based programs for obesity prevention,
the NZ Government implements the Healthy Families NZ programme to at least the
level of comprehensiveness, coverage and depth as the Healthy Together Victoria
programme in Australia
PLATF4: The government leads a broad, effective and sustainable systems-based approach
with local organisations to improve the healthiness of food environments at a national level
273
(13)

86
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Infrastructure support action Infrastructure support good practice statement Score
(rank)
18. To ensure that food policies are compatible with the objectives of improving
population nutrition and reducing obesity and diet-related NCDs, the Ministry for
Primary Industries and the Ministry of Business, Innovation, and Employment assess
the wider health impact of food policies (not only from a safety point of view) on
long-term population health.
HEALTH-IN-ALL-POLICIES
HIAP1: There are processes in place to ensure that population nutrition, health outcomes
and reducing health inequalities are considered and prioritised in the development of all
government policies relating to food
246
(16)
19. To ensure that government policies in general are compatible with the
objectives of improving health, the NZ Government establishes a health impact
assessment (HIA) capacity, including funding for HIAs at the national and local level.
HIAP2: There are processes (e.g. health impact assessments) to assess and consider health
impacts during the development of other non-food policies
227
(19)
Policy action Policy good practice statement Score
(rank)
20. To improve food composition, the NZ Government:
• sets sodium targets for the food groups which are major contributors to sodium
intake, based on international best practice targets;
• establishes a food standard to minimise the unhealthy fatty acid content of
commercial deep frying fats;
• examines other opportunities to reduce the amount of salt, sugar and
saturated fat in foods and beverages.
FOOD COMPOSITION
COMP 1: Food composition targets/standards have been established by the government
for the content of the nutrients of concern in certain foods or food groups if they are major
contributors to population intakes of these nutrients of concern (trans fats and added
sugars in processed foods, salt in bread, saturated fat in commercial frying fats)
372
(1)
21. To improve food labelling (nutrient disclosure), the NZ Government:
• requires trans fats to be added in the nutrition information panel where they
exceed a particular level; and
• examines the potential for including ‘added sugars’ in the nutrition information
panel.
FOOD LABELLING
LABEL1: Ingredient lists and nutrient declarations in line with Codex recommendations
are present on the labels of all packaged foods
260
(10)
Table 6: Recommended policy actions prioritised by the Expert Panel

87
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Policy action Policy good practice statement Score
(rank)
22. To improve food labelling (preventing misleading claims), the NZ Government
investigates the application of the Nutrient Proling Scoring Criterion to restrict the
use of nutrient content claims on packaged unhealthy foods (especially ‘irrelevant
claims’ such as ‘no cholesterol’ claims on plant-based foods).
LABEL2: Robust, evidence-based regulatory systems are in place for approving/reviewing
claims on foods, so that consumers are protected against unsubstantiated and misleading
nutrition and health claims
278
(8)
23. To improve food labelling (consumer-friendly nutrition quality labels), the NZ
Government endorses the Health Star Rating system for implementation from
2014 on a voluntary basis with provision to move to regulations if there is not wide
coverage within 2 years
LABEL3: A single, consistent, interpretive, evidence-informed front-of-pack supplementary
nutrition information system, which readily allows consumers to assess a product’s
healthiness, is applied to all packaged foods
329
(5)
24. To improve food labelling (energy disclosure), the NZ Government requires all
quick service chain restaurants to display kJ labelling (per serve as sold) on their
menu boards.
LABEL4: A consistent, single, simple, clearly-visible system of labelling the menu boards
of all quick service restaurants (i.e. fast food chains) is applied by the government, which
allows consumers to interpret the nutrient quality and energy content of foods and meals
on sale
242
(12)
25. To reduce unhealthy food promotion to children, the NZ Government introduces
regulations to restrict the marketing of unhealthy foods, as dened by the nutrient
proling scoring criterion to children and adolescents (e.g., younger than 16 years)
through:
• broadcast media, with initial priorities for restriction of advertising through
television; and
• non-broadcast media, with initial priorities for restriction of advertising through
sports sponsorship, food packaging and point of sale advertising.
FOOD PROMOTION
PROMO1: Effective policies are implemented by the government to restrict exposure and
power of promotion of unhealthy foods to children through all forms of media, including
broadcast (TV, radio) and non-broadcast media (e.g. Internet, social media, point-of-
purchase, product placement, packaging, sponsorship, outdoor advertising)
364
(2)
26. To reduce unhealthy food promotion to children, the NZ Government implements
policies to ensure that schools and early childhood education and care services,
are free of commercial promotion of unhealthy foods, as dened by the MoH food
and beverage classication system
PROMO2: Effective policies are implemented by the government to ensure that unhealthy
foods are not commercially promoted to children in settings where children gather (e.g.
preschools, schools, sport and cultural events)
341
(3)
27. To discourage the consumption of unhealthy foods and beverages, the NZ
Government:
• introduces a signicant (at least 20%) excise tax on sugar-sweetened beverages;
and
• explores how the tax revenue could be applied to create healthy food environments
and promote healthy diets
FOOD PRICES
PRICES2: Taxes on unhealthy foods (e.g. sugar-sweetened beverages, foods high in
nutrients of concern) are in place to discourage unhealthy food choices where possible,
and these taxes are reinvested to improve population health
320
(6)

88
Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Policy action Policy good practice statement Score
(rank)
28. To ensure that taxpayer-funded food for children is healthy, the NZ Government
requires all programs involving subsidised or supplied food for children (e.g.,
school breakfast programs) to meet the food and nutrition guidelines as outlined in
the food and beverage classication system
PRICES4: The government ensures that food-related income support programs are for
healthy foods
270
(9)
29. To ensure that children’s settings provide healthy food, the NZ government
enacts policies that ensure schools and early childhood education and care
services provide or sell foods which meet the food and nutrition guidelines as
outlined in the food and beverage classication system
FOOD PROVISION
PROV1: The government ensures that there are clear, consistent policies (including
nutrition standards) implemented in schools and early childhood education services for
food service activities (canteens, food at events, fundraising, promotions, vending machines
etc.) to provide and promote healthy food choices
330
(4)
30. To show national leadership, the NZ government develops and implements
healthy food service policies throughout the public health sector (e.g. Ministry of
Health, hospitals, DHBs, Public Health Units).
PROV2: The government ensures that there are clear, consistent policies in other
public sector settings for food service activities (canteens, food at events, fundraising,
promotions, vending machines, public procurement standards etc.) to provide and promote
healthy food choices
284
(7)
31. To stimulate the uptake of healthy food service policies and actions, the
NZ Government provides support and training systems for children’s settings,
government sector and private sector workplaces (particularly small to medium
businesses).
PROV3: The government ensures that there are good support and training systems to help
schools and other public sector organisations and their caterers meet the healthy food
service policies and guidelines
236
(14)
32. To support local communities achieve healthy food environments for children,
the NZ Government reviews the adequacy of the current local government
legislation with a view to strengthening local governments’ authority to create
healthy food environments for children (e.g., ensuring ‘green food zones’ around
schools to minimise unhealthy food outlets and advertising.
FOOD RETAIL
RETAIL1: Zoning laws and policies are robust enough and are being used, where
needed, by local governments to place limits on the density or placement of quick serve
restaurants or other outlets selling mainly unhealthy foods in communities
254
(11)
33. To protect the health of New Zealanders, the NZ Government includes formal and
explicit population nutrition and health risk assessments as part of their national
interest analysis on trade and investment agreements
FOOD TRADE & INVESTMENT
TRADE1: The direct and indirect impacts of international trade and investment agreements
on food environments and population nutrition and health are assessed and considered
228
(15)
34. To avoid government exposure to being sued by transnational corporations, the
NZ Government ensures that specic and explicit provisions are included in trade
and investment agreements allowing the New Zealand Government to preserve its
regulatory capacity to protect and promote public health
TRADE2: The government adopts measures to manage investment and protect their
regulatory capacity with respect to public health nutrition
237
(13)

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Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
12. Appendix 5: List of New Zealand Experts
The following experts participated in the Food-EPI process at one or more of its stages: rating workshops; priority
setting for the policy and infrastructure support actions; and the review of the nal document. All took part on their
own behalf and were not formally representing their employing organisation or other organisations to which they
belong.
Title Surname First Name Organisation Location
Mr Asghar Joe Diabetes New Zealand Wellington
Dr Baddock Kate New Zealand Medical Association Auckland
Prof Blakely Tony University of Otago Dunedin
Prof Bonita Ruth The University of Auckland Auckland
Dr Butts Christine The New Zealand Institute for Plant & Food Research Ltd Palmerston North
Ms Chilcott Nicola Agencies for Nutrition Action Wellington
Assoc. Prof Coad Jane Massey University Palmerston North
Ms Connor Ellen ProCare Health Ltd Auckland
Ms Cook Lynley Pegasus Health Christchurch
Ms Cutler Liz NuDe Food Consultants Timaru
Mr Ehau Ter ry Te Rōpū Mate Huka ō Aotearoa Bay of Plenty
Ms Field Penny University of Otago Dunedin
Ms Fitzpatrick Jo Diabetes New Zealand Auckland
Dr Foliaki Sunia Massey University Wellington
Ms Funaki-Tahifote Ma Heart Foundation Auckland
Ms Gallagher Jenifer Eastern Bay Primary Health Alliance Whakatane
Ms Gorton Delvina Heart Foundation Auckland
Ms Gregan-Ford Carmel Kidney Health NZ Christchurch
Ms Head Marilyn The New Zealand Nurses Organisation Wellington
Prof Hoek Janet University of Otago Dunedin
Prof Jackson Rod The University of Auckland Auckland
Dr Jenkin Gabrielle University of Otago Wellington
Ms King Bronwen Pegasus Health (Charitable) Ltd Christchurch
Dr Krebs Jeremy Wellington Hospital Wellington
Mr Lindberg Warren Public Health Association of NZ Wellington
Ms Mackay Sally The University of Auckland Nelson
Prof Mann Jim University of Otago Dunedin
Ms Marshall Hereni Toi Tangata Auckland
Ms Matoe Leonie Te Hotu Manawa Māori Auckland
Dr McCool Judith University of Auckland Auckland
Ms McGregor Maggie Agencies for Nutrition Action Auckland
Ms McKerchar Christina University of Otago Christchurch
Ms McKey Anne Royal New Zealand Plunket Society Auckland
Dr McLean Rachael University of Otago Dunedin
Ms Morgan Melanie Te Rūnanga Ō Kirikiriroa Hamilton
Ms Muimuiheata Soana ProCare Health Ltd Auckland
Ms Ngatama Raetea Healthward Ltd Auckland
Prof Ni Mhurchu Cliona The University of Auckland Auckland
Ms Nitschke Julie Whanganui Regional Health Network Whanganui
Continued...

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Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government
Title Surname First Name Organisation Location
Ms Outhwaite Linda Nutritionwise Ltd Auckland
Ms Nahi Papatuanuku Hapai Te Hauora Tapui Auckland
Dr Parackal Sherly The University of Auckland Auckland
Dr Paterson Helen The Royal Australian and New Zealand College of
Obstetrics and Gynaecology
Wellington
Dr Pearson Jan Cancer Society of New Zealand Wellington
Dr Pega Frank University of Otago Wellington
Dr Peterson Mark New Zealand Medical Association Wellington
Ms Pollard Sue New Zealand Nutrition Foundation Auckland
Prof Poppitt Sally The University of Auckland Auckland
Ms Radford Tanya Te Awakairangi Health Network Lower Hutt
Ms Robinson Vicki Dietitians NZ Wellington
Ms Rolston Sharron Te Rūnanga Ō Kirikiriroa Hamilton
Ms Rout Julia Stroke Foundation of New Zealand Wellington
Prof Rush Elaine AUT University Auckland
Ms Ryan Louisa Heart Foundation Auckland
Prof Schoeld Grant AUT University Auckland
Dr Scott Ian Auckland PHO Auckland
Mr Simmons Geoff The Morgan Foundation Wellington
Dr Skeaff Sheila The Nutrition Society of New Zealand Dunedin
Dr Stuart Marise NZ Medical Students’ Association Wellington
Dr Sundborn Gerhard Le Va Auckland
Prof Taylor Barry University of Otago Dunedin
Assoc. Prof Taylor Rachael University of Otago Dunedin
Dr Te Morenga Lisa University of Otago Dunedin
Ms Tester Beth Kimi Hauora Wairau- Marlborough Primary Health
Organisation
Blenheim
Dr Tolley Hilary The University of Auckland Auckland
Dr Toomath Robyn Fight the Obesity Epidemic Auckland
Dr Utter Jennifer The University of Auckland Auckland
Dr Von Hurst Pamela Massey University Auckland
Dr Wall Clare University of Auckland Auckland
Dr Weber Janet Massey University Palmerston North
Dr Wham Carol Massey University Auckland
Mr White John The University of Otago Wellington

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Benchmarking Food Environments: Experts’ Assessments of Policy Gaps and Priorities for the New Zealand Government

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