Health Criteria One

Food labeling is a critical component to freedom of information, and should be promoted robustly in Australia. The currently existing Percentage Daily Intake food labeling system is part of the Australian Health Department's overall strategy towards increasing consumer awareness about nutrition. Of course, not all of our foods are labeled. Food made and packaged on premises such as what is available at a local bakery, need not be labeled according to law. Similarly, deli products, fruits, vegetables, unpackaged foods, and foods sold for delivery are not required to carry labels ("Food Labeling" n.d.). In the case of products that are not labeled, consumers are strongly encouraged to use common sense and rely on a prior understanding of nutritional values, health, and food safety. For example, one of the functions of labeling is to alert the customer to use-by dates. When a customer purchases a loaf of bread from a bakery, there is no use-by date because the consumer is generally aware of when the bread is no longer fit for consumption.

The current food-labeling program of the Australian Health Department represents a top-down approach. This approach works best in the area of food labeling for several reasons. First, it would be unfeasible to consult with nutritionists every time a new food product hits store shelves. Second, the top-down approach ensures consistency of health-related messages. If too many individuals have a say in food labeling standards, the result would be chaos and confusion, which harms the consumer. Third, a top-down approach ensures that public safety is the number one concern. Consumers need to know that the source of nutritional and health-related data comes not from profit motive but from objective third party interests. Fourth, food labeling must be consistent nationwide. A top-down approach ensures that products purchased in Sydney share common information with those sold in Darwin.

Of course, there are some limitations with the top-down approach. One of the most glaring problems is that the top-down approach precludes any individualized information that may be helpful to specific population groups. For example, individuals with diabetes and other medical conditions requiring a radical change in dietary habits need to be aware of more than just ingredient lists. Another problem with the top-down approach is that health information is not the same as health education. A consumer can read a food ingredient label, but might not understand what that label means in terms of health, nutrition, and safety. For instance, partially hydrogenated oil and other trans-fats are in a wide range of processed foods available at grocery stores nationwide. Many of those products also happen to be marketed as low-sodium, low-fat, or dietary products. Yet trans-fats are not recommended as part of a healthy diet. The city of New York went so far as to ban trans-fats completely (Okie, 2007). Consumers unaware of the issues related to trans-fats would need education and awareness in addition to robust food labeling.

It is possible that Australia also needs to be more aggressive in its nutritional awareness campaigns. Rather than rely solely on food labeling as a means of increasing public health, the country should promote nutrition more comprehensively. The media is one of the keys to increasing public awareness of health and nutrition. Therefore, the government and the Australian Health Department need to collaborate with public and private media enterprises in the interests of health promotion. When the media offers regular segments on nutrition, the public has greater access to information related to understanding the food labels they read. Countries like Brazil have reported tremendous success with media collaboration programs designed to promote public health (Coitinho, Montiero & Popkin, 2002). Armed with knowledge, the consumer is more likely to make healthy choices. Even without a top-down intervention on food manufacturers, the consumer-driven market might help phase out unhealthy products in favor of healthier choices.

Another important drawback with a top-down approach is that it does not necessarily account for differences in demographic responses to food knowledge campaigns, food labeling programs, or nutritional promotion. Poverty, for example, is strongly correlated with a number of preventable health problems that are related to poor nutrition and diet (Haddad, 2002). A bottom-up approach may be more appropriate when targeting specific populations or health issues. The British government is well aware of the domestic public health issues related to poverty and has implemented community action programs specifically targeted at low-income neighborhoods (Kennedy, 2001). A combination of neighborhood action, local health promotion programs, and targeted promotional campaigns may be the best multifaceted approach toward improving public health. Therefore, a top-down approach used nationwide should be combined with a bottom-up approach...

Moreover, the Australian government's percentage daily intake labeling system does not necessarily improve nutrition knowledge; it is simply an adjunct to more global knowledge related to health and nutrition. The percentage daily intake labeling system requires some prior knowledge of the terms and issues related to nutrition and food safety. This prior knowledge must be established firmly in social norms and educational programs as well as the media in order to invoke widespread changes in consumer behavior.
Positive changes in food behavior will require a lot more than the current food labeling system. Models and theories of nutrition provide some guidance as to how to effectively tailor a food and nutrition awareness program that creates change. A results-based approach is one that is multifaceted. Behavioral change also requires awareness of the diversity of Australian society; it is impossible to generalize about what factors induce behavioral change. Gender, race, social class, and extraneous lifestyle factors will impact food and nutrition choices. Research by Booth & Shepherd (1988) revealed the importance of sensory input too, in the making of consumer food choices. In fact, sensory input was shown to be linked more closely to actual changes in behavior than intellectual knowledge alone (Booth & Shepherd, 1988).

While direct data is sparse regarding the relationship between nutritional knowledge and behavioral change in Australia, the United States and Great Britain both offer some parameters that can be applied down under. The diversity of Great Britain and the United States at least highlights some of the ways that heterogeneous societies can promote change in a results-oriented nutritional awareness campaign. American researchers have been distinguishing "between dietary guidance and nutrition promotion," (Sutton, S.M., Layden, W. & Haven, J., 1996). Ultimately the goal is to present hard science in a consumer friendly manner in ways that create measureable results: to "translate the science-based dietary guidance into consumer-oriented messages that facilitate behavior change," (Sutton et al., 1996). It is also crucial to create measures of behavior change such as the Healthy Eating Index (Kennedy, Ohls, Carlson & Fleming, 1995).

One model of creating behavioral change with regards to nutrition is rooted in the work of Michel Foucault, who framed health promotion as an ethical duty (Coveney, 1997). Yet it is not the imposition of external belief systems that induces change. Rather, health promotion is effective when it is "producing the means by which subjects assess their own desires, attitudes and conducts in relation to those set out by health promotion expertise," (Coveney, 1997). There are a number of widely accepted models and theories used in nutrition promotion that are relevant to the Australian experience. Adult learning theory, the Bright Ideas approach, Child Feeding Principles, Dale's Cone of Learning, Multiple Intelligence Theory, Health Belief model, Social Marketing Process, the Spectrum of Prevention, and the Theory of Reasoned Action and Theory of Planned Behavior are some of the most effective ways of approaching nutrition education. What many of these theories share in common is a multifaceted, heterogeneous approach that works especially well in Australia.

Oenema, Brug & Lechner (2001) found that Web-based education interventions had a direct impact on behavioral change. Likewise, Brug, Campbell & van Assema (1999) found that computer-tailored nutritional education helped create behavioral change because it was personalized. Environmental factors, such as exposure to healthy foods and access to produce, have a strong bearing on consumer choices. Social factors such as norms of behavior and stigmas against eating unhealthy food are also critical components of behavioral change. The social marketing process combines environmental with social and psychological factors, using commercial marketing techniques in ways that create measurable behavioral change ("Key Theories, Models, and Processes Relevant to Nutrition Education," n.d.). Evidence that social marketing is already working may not be available in Australia, but it is in Europe. For instance, "societal pressure" has led to significant reduction of trans-fat content of fast foods (Katan, 2006). Katan (2006) notes that as a result, "McDonald's French fries in The Netherlands now have less than 4% trans and 24% saturates, as opposed to 21% trans and 21% saturates in the U.S.A."

References

Booth, D.A. & Shepherd, R. (2007). Sensory influences on food acceptance: -- the neglected approach to nutrition promotion. Nutrition Bulletin 13(1):39-54.

Brug, J., Campbell, M. & van Assema, P. (1999). The application and impact of computer-generated personalized nutrition education: A review of the…