Jose Brambila-Macias

Policy interventions to promote healthy eating: A review of what works, what does not, and what is promising

Unhealthy diets can lead to various diseases, which in turn can translate into a bigger burden for the state in the form of health services and lost production. Obesity alone has enormous costs and claims thousands of lives every year. Although diet quality in the European Union has improved across countries, it still falls well short of conformity with the World Health Organization dietary guidelines. In this review, we classify types of policy interventions addressing healthy eating and identify through a literature review what specific policy interventions are better suited to improve diets. Policy interventions are classified into two broad categories: information measures and measures targeting the market environment. Using this classification, we summarize a number of previous systematic reviews, academic papers, and institutional reports and draw some conclusions about their effectiveness. Of the information measures, policy interventions aimed at reducing or banning unhealthy food advertisements generally have had a weak positive effect on improving diets, while public information campaigns have been successful in raising awareness of unhealthy eating but have failed to translate the message into action. Nutritional labeling allows for informed choice. However, informed choice is not necessarily healthier; knowing or being able to read and interpret nutritional labeling on food purchased does not necessarily result in consumption of healthier foods. Interventions targeting the market environment, such as fiscal measures and nutrient, food, and diet standards, are rarer and generally more effective, though more intrusive. Overall, we conclude that measures to support informed choice have a mixed and limited record of success. On the other hand, measures to target the market environment are more intrusive but may be more effective.

AN EVALUATION OF THE UK FOOD STANDARDS AGENCY'S SALT CAMPAIGN

Excessive salt intake is linked to cardiovascular disease and several other health problems around the world. The UK Food Standards Agency initiated a campaign at the end of 2004 to reduce salt intake in the population. There is disagreement over whether the campaign was effective in curbing salt intake or not. We provide fresh evidence on the impact of the campaign, by using data on spot urinary sodium readings and socio-demographic variables from the Health Survey for England over 2003-2007 and combining it with food price information from the Expenditure and Food Survey. Aggregating the data into a pseudo-panel, we estimate fixed effects models to examine the trend in salt intake over the period and to deduce the heterogeneous effects of the policy on the intake of socio-demographic groups. Our results are consistent with a previous hypothesis that the campaign reduced salt intakes by approximately 10%. The impact is shown to be stronger among women than among men. Older cohorts of men show a larger response to the salt campaign compared to younger cohorts, while among women, younger cohorts respond more strongly than older cohorts.

Assessment of evaluations made to healthy eating policies in Europe: A review within the EATWELL Project

OBJECTIVE To identify and assess healthy eating policies at national level which have been evaluated in terms of their impact on awareness of healthy eating, food consumption, health outcome or cost/benefit. DESIGN Review of policy documents and their evaluations when available. SETTING European Member States. SUBJECTS One hundred and twenty-one policy documents revised, 107 retained. RESULTS Of the 107 selected interventions, twenty-two had been evaluated for their impact on awareness or knowledge and twenty-seven for their impact on consumption. Furthermore sixteen interventions provided an evaluation of health impact, while three actions specifically measured any cost/benefit ratio. The indicators used in these evaluations were in most cases not comparable. Evaluation was more often found for public information campaigns, regulation of meals at schools/canteens and nutrition education programmes. CONCLUSIONS The study highlights the need not only to develop harmonized and verifiable procedures but also indicators for measuring effectiveness and success and for comparing between interventions and countries. EU policies are recommended to provide a set of indicators that may be measured consistently and regularly in all countries. Furthermore, public information campaigns should be accompanied by other interventions, as evaluations may show an impact on awareness and intention, but rarely on consumption patterns and health outcome.

Interventions to promote healthy eating habits: evaluation and recommendations.

Although in several EU Member States many public interventions have been running for the prevention and/or management of obesity and other nutrition‐related health conditions, few have yet been formally evaluated. The multidisciplinary team of the EATWELL project will gather benchmark data on healthy eating interventions in EU Member States and review existing information on the effectiveness of interventions using a three‐stage procedure (i) Assessment of the interventions impact on consumer attitudes, consumer behaviour and diets; (ii) The impact of the change in diets on obesity and health and (iii) The value attached by society to these changes, measured in life years gained, cost savings and quality‐adjusted life years. Where evaluations have been inadequate, EATWELL will gather secondary data and analyse them with a multidisciplinary approach incorporating models from the psychology and economics disciplines. Particular attention will be paid to lessons that can be learned from private sector that are transferable to the healthy eating campaigns in the public sector. Through consumer surveys and workshops with other stakeholders, EATWELL will assess the acceptability of the range of potential interventions. Armed with scientific quantitative evaluations of policy interventions and their acceptability to stakeholders, EATWELL expects to recommend more appropriate interventions for Member States and the EU, providing a one‐stop guide to methods and measures in interventions evaluation, and outline data collection priorities for the future.

Cross-border bank lending versus FDI in Africa's growth story

We investigate the relative long run growth impact of each of the two main types of Africas private capital inflows, namely Foreign Direct Investment (FDI) and Cross-Border Bank Lending (CROSSBANK). In addition to controlling for some factors (e.g. financial reforms and trade openness), we isolate the outcomes for four groups: (1) all the African economies; (2) all the African economies except the SANE (South Africa, Algeria, Nigeria and Egypt), which are considered Africas growth dynamos; (3) natural resource countries, which include some of the SANE and (4) countries without a sizeable hydrocarbon endowment. Our evidence suggests that both FDI and CROSSBANK exert a positive impact on African countries as a whole; an interesting comparison is that consistently, the former has a larger impact than the latter. Moreover, the effect of CROSSBANK becomes negative when the sample is restricted to oil countries. Also, financial reforms have a positive impact on economic growth in nonoil countries, while they have no growth effect on oil countries. The importance of trade openness as a driver of economic growth is confirmed for all African countries.

Finance-growth nexus: evidence from a top global reformer

In the last two decades, Egypt has experienced two waves of ambitious economic reforms. During the same period, the economy has boomed and the stock market has skyrocketed. In this article, we develop a simple endogenous growth model and estimate multivariate vector autoregressive models in order to investigate the linkages between economic reforms, stock market and economic growth in Egypt. The channels through which the stock market may affect the Egyptian economic activity are also examined. Our results show unidirectional causality running from stock market development to economic growth through the level of investment. Furthermore, there is evidence that the reforms launched by the Egyptian government impact directly on the liquidity of the stock market, which in turn increases the incentives for investment and boosts further economic growth.