Food policies or nutritional policies?

Food policies or nutritional policies? Is it necessary to distinguish between these concepts?

In this text, we reflect on the concept of nutritional policy and food policy. Are we using the terms "nutritional policies" and "food policies" imprecisely? Their indiscriminate use and as synonyms is becoming increasingly frequent.

Never before has there been so much discussion about food and nutrition policies as there is today. We can even say that we are living through a historic period in this area. But this historic moment, particularly the political recognition of the need to implement strategies in this area, is not the result of chance. It reflects the need to urgently intervene in a problem that is difficult to solve (the inadequate nutrition of the majority of the population) and, on the other hand, the accumulation of evidence suggesting the possibility of modifying population behaviors through environmental changes, whether legislative measures or measures in the field of education. It also reflects the economic impact of inadequate nutrition and the unsustainability of public health systems if food consumption patterns remain as they are now.

This perception of the need to consider the concept of political intervention in the area of food consumption has undergone an evolutionary process over time. The basis for the definition of the concept of food and nutrition policy that we present and reflect upon here is based on the definitions of two authors who conceptually marked the history of food and nutrition policies at the European and national levels. For the European context, we refer to Elisabeth Helsing , and at the national level, Gonçalves Ferreira , the father of food and nutrition policies and who was at the genesis of FCNAUP in the 1970s.

In 1978, Gonçalves Ferreira defined food and nutrition policy as "a set of measures aimed at making available to the population the various types of food that they need and ensuring their regular consumption by individuals, seeking to establish or maintain correct habits of rational eating throughout life," and Elisabeth Helsing, in 1997, defined it as "a concerted set of actions aimed at improving the nutritional status of populations ."

The first strategies in this area, many of which emerged in Europe after World War II in the 1940s, had the central objective of guaranteeing a sufficient food supply for the entire population and were therefore designated by many authors as "food policies". These were agricultural-based policies intended to increase the production of essential food items with added value for the production chain, such as milk or meat. Elizabeth Helsing, emphasizing the importance of "nutrition" and health, proposed a new designation for these early food and nutrition policies, which she called "quantitative nutritional policies".

In the 60s and 70s – A new paradigm in nutritional policies

Only later, in the 1960s and 70s, as a result of the increased prevalence of chronic diseases and research in the field of nutritional sciences, which began to prioritize a possible association between inadequate food consumption and the risk of developing these diseases, did the concept of "nutritional policies" or "qualitative nutritional policies ," as named by Elizabeth Helsing, emerge. But it was above all at the World Food Conference in 1974 that nutritional policies, with specific health objectives, gained expression, through the proposals presented by the Nordic conference participants.

During this period (the 1960s and until the mid-1970s), there seemed to be a marked differentiation between "quantitative nutritional policies" or "food policies" and "qualitative nutritional policies" or "nutritional policies," with noticeable divergences between the objectives of agricultural policies and the nutritional recommendations that were taking shape. While "quantitative nutritional policies" aimed to meet the needs of poorer and developing countries in an attempt to guarantee sufficient food availability, "qualitative nutritional policies" began to be discussed within more developed countries with the goal of improving the nutritional and health status of populations, attempting to moderate or even reduce the intake of certain nutrients.

Beyond this ongoing debate, in 1997, in Portugal and at what was then ISCNAUP, we began teaching what we still call "Nutrition Policy" as an autonomous subject. That is, a distinct curricular area that has since grown and later expanded to all higher education institutions teaching Nutrition Sciences in Portugal, distinguishing us from other European countries. As a result of this discussion, in 2013, we developed a consensus document on pedagogical and ethical aspects of training in the area of "nutrition policy ." In this way, we integrated the nutritionist's perspective and their knowledge of the relationship between nutrients and human health into the discussion of public health policies.

2012 – A historic milestone for food and nutrition policies in Portugal

However, in Portugal, after Gonçalves Ferreira's initial proposals in the 1970s, it was only in 2012, in an article entitled " Evolution of food and nutrition policy in Portugal and its relations with the international context ," that we returned to discussing this issue in depth as a central theme of public policy. In this article, we use the term "food and nutrition policy," which we define as "a concerted and transversal set of actions aimed at guaranteeing and encouraging the availability of and access to certain types of food, with the objective of improving the nutritional status and promoting the health of the population." The combination of the terms "food" and "nutrition" in the definition of a policy, as presented here, relates to the result that intervention on the food component (based on nutritional knowledge) can have on shaping the intake and nutritional profile of the people it targets. In this way, the agri-food sector is also integrated, which should align itself with nutrition and health issues in the search for more sustainable and healthy food solutions.

Internationally, the terminology used in various strategic documents also follows this model, particularly in countries with a long tradition of intervention in this area. Norway uses the term " Norwegian Nutrition and Food Policy ," highlighting the importance of an integrated approach to a public health problem. Brazil also follows this model with its " National Food and Nutrition Policy (PNAN) ." Finally, the combination of the terms "food" and "nutrition" is also found in WHO strategic documents, with the most recent WHO European Region plan being designated as the " European Food and Nutrition Action Plan 2015-2020 ."

Also in 2012, during the development of the National Program for the Promotion of Healthy Eating (PNPAS) and its programmatic definition as the first national strategy in the area of food and nutrition policy, we went a little further by identifying that "a food and nutrition policy with the consequent improvement in the nutritional status of citizens has a direct impact on the prevention and control of the most prevalent diseases (cardiovascular, oncological, diabetes, obesity, etc.) but should also simultaneously allow for sustainable growth and economic competitiveness of the country in other sectors such as those related to agriculture, environment, tourism, employment or professional qualification". In other words, the vision of nutrition in the formulation of a strategy to shape the food consumption of a population requires strong nutritional knowledge, which is clearly fundamental, and the integration of various areas of knowledge from agricultural production to the environment and economy.

In summary, we can say that the concepts of "nutritional policy" and "food policy" are not interchangeable, as they represent distinct and, in a way, ideologically differentiated fields. These fields can and should be integrated when defining political strategies in this area, representing more tangible (food-related) and less tangible (nutritional) end goals, and aiming for an integrated intervention approach to solve a complex problem.

On the other hand, the concept of "Nutrition Policy" as a curricular training area for Nutritionists should continue to allow these professionals to understand and technically support political decision-making and public intervention measures at the population level in the area of nutrition, based on the best scientific evidence.

Conflict of interest

Pedro Graça coordinated the Platform Against Obesity from 2009 to 2011 and created the National Program for the Promotion of Healthy Eating at the DGS (Directorate-General of Health), which he directed from 2012 to 2018.

Maria João Gregório is the Director of the National Program for the Promotion of Healthy Eating (2019 to the present).

Both authors teach Nutrition Policy at FCNAUP .

PS – This text is also in memory of Elisabet Helsing , who passed away this year and who was one of the people at the European level, practically since the Rome Conference in 1974, who advocated for the need for European policies in the area of food and nutrition.

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