Healthy Food Environment Features Widely on Dutch Political Agenda

In the past few weeks, the importance of a healthy food environment has been widely discussed in Dutch parliamentary circles. On 21 March there was a roundtable discussion on lifestyle prevention. Sanne Djojosoeparto, PhD-researcher at Utrecht University (Department of Human Geography and Spatial Planning) was one of the co-authors of a position paper that was presented by the lead author Maartje Poelman (Wageningen University & Research). On 24 March in turn, there was a committee debate on lifestyle prevention, which amongst others addressed government policies to create healthy food environments. Which policies should the national government implement to improve food environments in the Netherlands and with that prevent overweight, obesity and diet-related chronic diseases? Future Food asked Sanne Djojosoeparto to share her thoughts on recent developments.

A system-based approach with multiple structural, preventive measures targeted at the entire population, is needed to stimulate healthy food choices.

Sanne, you conducted an extensive study (Food-EPI on behalf of the Policy Evaluation Network) on EU and national level policies that may have a positive influence on healthy food environments. Are the policies discussed in the Netherlands at the moment similar to the ones that you proposed in your final report?

Yes, many of the debates now evolve around measures that we also recommended to the Dutch national government based on our Food-EPI research . In our study, we presented 18 policy actions and 11 infrastructure support actions. Policy actions included for example: increasing the prices of unhealthy foods, reducing the prices of healthy foods (e.g. by reducing the VAT on fruits and vegetables to 0%), banning unhealthy food marketing targeting children, making binding agreements with the food industry about food composition targets and implementing regulations so that local governments can improve the food availability in cities (e.g. by banning fast food restaurants). Infrastructure support actions that were recommended were for example: developing a government-wide national prevention policy and increasing the budget for prevention. These measures were also included in the position paper that was written for the roundtable discussion on 21 March.

How do you see your recommendations being used to further the policy making process? Do you feel that your research has an impact on this process?

As appears from the recommended and prioritized actions in our study, there is a need for less self-regulation and more ambitious, structural, universal interventions by the Dutch government. This need has also been recognized by the former State Secretary for Health in a reaction to our Food-EPI report. In the recently published coalition agreement 2021–2025, the new Dutch government announces a few structural and strict measures towards healthier food environments. Actions included in this agreement are making binding agreements with the food industry about healthier foods, increasing taxes on sugar-sweetened beverages and investigating how to introduce a sugar tax and lower the current VAT tariff of 9% on vegetables and fruit to 0%. Furthermore, the government promises to protect children against inappropriate online promotion and marketing. However, it is not specified if this will also include protection against food marketing, which is currently regulated via the Advertising Code for Food products (2019) initiated by the Dutch Food Industry Federation. The current State Secretary announced that he will explore the legal possibilities that enable local governments to ban fast food restaurants in cities, especially around schools .

Critics have stated that increasing the prices of unhealthy foods may create problems for certain income groups, making it more difficult for them to make ends meet?

Although increasing the prices of unhealthy foods can have a larger impact on the budgets of certain income groups, these kind of policies could also have greater health benefits among these groups. Furthermore, it is recommended to combine these kind of policies with additional actions such as the decreasing  prices of healthy foods to make it easier for people to lower the consumption of unhealthy foods and make the healthy choice the easy choice or investing the revenues of a food-related tax in favor of certain income groups. Using the revenue for health initiatives can also increase the public acceptability of a tax. A system-based approach with multiple structural, preventive measures targeted at the entire population, is needed to stimulate healthy food choices. These kind of interventions are more effective than interventions which address individual behavior, such health mass media campaigns.

How do you see the future of these debates in the Netherlands? Introducing all these different policies may be very complicated?

There is large potential for the Dutch national government to strengthen its policies in order to improve the healthiness of food environments in the Netherlands. This is very much needed, to reverse the obesogenic nature of our food environment in which unhealthy food choices are easier made than healthy food choices. I therefore look forward to the implementation of the intentions agreed on in the coalition agreement and hope that these are first steps towards a food environment that makes the healthy choice the easy choice and with that contribute to a healthier future for the Dutch population.

Some European countries have already implemented more extensive measures. For example, regarding restricting unhealthy food marketing to children, the UK is considering a total ban on online advertising of foods high in fat, sugar, or salt to children and Spain plans a ban on unhealthy food advertising aimed at children and adolescents via TV, radio, social media, websites, applications, cinemas and newspapers. In Portugal, Law 30/2019 restricts unhealthy food advertising directed to children via broad-cast media and digital marketing. Related to price measures, various other European countries have already implemented food-related health taxes, such as the sugar-sweetened beverages taxes in the UK, Ireland, France, Spain, Portugal and the public health product tax in Hungary.  

We also have to consider that the Dutch national government is dependent on EU regulations. A Food-EPI study at EU-level was conducted to gain insight into the policies that need to be improved to create healthy food environments in EU Member States . Thus, in addition to the actions that the Dutch national government can implement immediately, some actions (e.g., allowing a VAT of 0% on fruits and vegetables which was recently agreed on by the EU finance ministers) cannot be implemented without policy changes at EU-level. It is therefore essential that national governments stimulate the EU to remove bottlenecks for creating healthy food environments at national level.

Read more about the EPI study in the Netherlands on the website of Future Food Utrecht

Academic papers

• Djojosoeparto et al (2020). Stakeholder views on the potential impact of a sugar-sweetened beverages tax on the budgets, dietary intake, and health of lower and higher socioeconomic groups in the Netherlands. In: Archives of Public Health.
• Djojosoeparto et al (2022). Strength of EU-level food environment policies and priority recommendations to create healthy food environments. In: European Journal of Public Health.
• Djojosoeparto et at (2022). How can National Government Policies Improve Food Environments in the Netherlands? In: International Journal of Public Health