Prioritising Indicators for Large-scale Monitoring and Assessment of Food Environments for Public Health

Abstract

This study aimed to prioritise key indicators for monitoring and assessing the healthiness of food environments, including at the country level. We conducted a literature review and engaged a consortium of researchers from the International Network for Food environments Research, Monitoring and Action Support (INFORMAS) as part of a prioritisation process. We identified 375 existing indicators that had been used to measure food environments. Researchers were consulted on priorities and implementation considerations through a series of interviews, focus groups and an online survey. Sixteen indicators were short-listed for prioritisation, and five indicators were identified as key priorities: proportion of packaged food and drinks products classified as unhealthy; frequency of exposure to unhealthy food promotion; price of a healthy diet and the price of the current diet as a proportion of income; proportion of schools in which unhealthy foods are provided or available for sale regularly; and application of back of package and front of package food labelling. This study lays the groundwork for standardised and scalable food environment monitoring that can drive policy action to support healthier food environments globally. Future areas for inquiry include tools to classify healthy foods and outlets, which could be adapted across policy areas, and the establishment of evidence-informed benchmarks for assessment of each indicator.