The increasing global burden of poor diet calls for comprehensive government actions to improve the healthiness of food environments, but accountability tools are lacking. The Government Healthy Food Environment Policy Index [Food-EPI] aims to fill this gap and was recently applied in New Zealand as the first systematic study, in the world, on national food policies. An Expert Panel of 52 independent public health experts rated the extent of government implementation of 42 food environment policy and infrastructure support indicators against international best practice. Their ratings were informed by validated evidence and international benchmarks. Based on the ratings, the experts recommended concrete actions and prioritized those according to their importance and achievability. For 74% of the policy and 48% of the infrastructure support indicators the level of implementation was rated as ‘low’ or ‘very little, if any’. ‘High’ implementation was achieved for providing ingredient lists and nutrient declarations and regulating health claims on packaged foods, transparency in policy development processes, and monitoring prevalence of NCDs and their risk factors. For restrictions on unhealthy food marketing to children, fiscal and food retail policies and protections of food environments from trade and investment agreements, the level of implementation was rated as ‘very little, if any’. Inter-rater reliability was 0.78 (95%CI=0.76-0.79). The experts recommended 34 actions, and prioritized seven for immediate implementation.
The Food-EPI provides a useful set of indicators sharply focusing on where government action is needed most. It is anticipated that assessing and benchmarking the extent of government policy implementation will increase accountability of governments for their actions on food environments. Countries of varying size and income are encouraged to apply the Food-EPI to stimulate government action and support civil society advocacy efforts.