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University of New South Wales Law Journal Student Series |
EXPLORING THE RELATIONSHIP BETWEEN FOOD, ENVIRONMENTAL IMPACT LABELLING AND SOCIO-ECONOMIC STATUS
EDWARD CONCEPCION
I INTRODUCTION
As the Earth’s climate crisis rapidly increases, so too does the role of the food industry in driving consumers towards sustainable consumption practices. With health labelling proving an effective front-of-pack labelling (‘FOPL’) initiative to encourage consumers to purchase healthier products off supermarket shelves, calls are being made for the introduction of environmental impact labelling (‘EIL’) to respond to the global climate crisis and mirror the success of health labelling. However, research around the relationship between FOPL and consumers neglects the unique and often integral role socio-economic status (‘SES’) plays in shaping a consumer’s ability to understand and access healthy and sustainable foods. This essay argues that while EIL should be introduced and regulated in the food industry, changes from government and industry to encourage consumers to purchase healthy and sustainable foods should account for the unique socioeconomic landscapes of Australia and how food labelling uniquely impacts low socio-economic status consumers in Australia. This essay argues that legislative and policy mechanisms that regulate food labelling should account for issues of access to healthy and sustainable produce, tighter legislative regulations, and consumer knowledge through robust legal and policy mechanisms to protect low-SES consumers’ ability to choose healthy and sustainable foods. Part I of this essay will examine the status of food sustainability globally and in Australia.[1] Part II will evaluate the dual role of the law in Australia in encouraging and discouraging the consumption of healthy, sustainable food in low-SES communities.[2] Part III will evaluate the policy mechanisms that regulate food labelling in Australia and argues Australian policies require further bolstering to encourage healthier diets in low-SES communities where education, consumer awareness and the urbanised food landscape are intimately connected.[3] Overall, two questions should be addressed by policymakers as revealed by the global experience of health labelling. First, how can policymakers ensure that the ‘greenest’ foods are accessible to low-SES communities in Australia? Secondly, how can policymakers ensure that EIL will necessarily lead to systemic change to increase consumer awareness of greener, sustainable diets in low-SES areas with little to no local agriculture?
II FOOD PACKAGING AND SUSTAINABILITY
A Exploring the Global Experience
The agri-food sector accounts for approximately 30% of the world’s total energy consumption.[4] The global food supply chain accounts for the creation of approximately 26% of the Earth’s greenhouse gas emissions, with food production contributing 32% to the Earth’s terrestrial acidification.[5] To meet the UN Sustainable Development Goals, the EAT-Lancet Commission recognised the need to encourage consumers to shift to primarily plant-based diets (as inherently sustainable) by making healthy foods ‘available, accessible and affordable in places of unhealthier alternatives, improving information and food marketing, [and] investing in public health information and sustainability education’.[6] At the consumer level, the EAT-Lancet Commission suggested a ‘substantial’ dietary shift away from unhealthy foods to prevent further damage to the Earth’s system while also recognising that in some poorer countries animal farming and livestock is often essential to the livelihood of farmers and consumers alike.[7]
Thus, because food packaging is a significant determinant of consumer consumption patterns, governments and the food industry have introduced several FOPL initiatives to shift consumers towards healthier diets. [8] Relevantly, FOPL that signal the nutritional value of foods is fundamental in determining consumer purchasing patterns.[9] In the contemporary food market, purchasing habits are often informed by the ingredients, source, and nutritional value of foods.[10] The Codex Alimentarius Commission states that food labelling should be used to ‘[encourage] the use of sound nutrition principles in the formulation of foods which would benefit public health’.[11] Contrastingly, for consumers, back-of-pack labelling (‘BOPL’) that outlines nutritional content is often time-consuming, confusing, and dissuades consumers from purchasing healthier, sustainable foods.[12] For low-SES communities, this is exacerbated: consumer understanding of BOPL from lower income communities is generally lower compared to higher SES communities, which several countries have responded to by simplifying FOPL to encourage consumers of all SES backgrounds to purchase healthier, more sustainable alternatives. [13]
B Exploring the Australian Experience
In Australia, the agri-food sector has significant environmental impacts. In 2016‒17, Australia’s agricultural sector operated on 51% of Australian land.[14] In 2013, Australian agriculture produced 16% of the country’s greenhouse gas emissions, attributed largely to methane emissions from livestock and agricultural soils.[15] And, between 2018‒19, Australian farms used 8 million megalitres of water in agricultural production and 7.2 million megalitres to crops and pastures, which, despite signalling a decrease of water use in the previous financial year, also saw a decrease in water availability for irrigation.[16]
Relevantly, discretionary foods account for approximately 33‒39% of water use, energy use, greenhouse gas emissions and land use in Australia.[17] Despite this, discretionary foods account for a significant percentage of household incomes.[18] For low-SES consumers in Australia, discretionary foods account for an even higher proportion of household income, with approximately 30% of a household’s disposable income attributed to discretionary foods.[19] Consumer attitudes towards sustainable consumption across all SES communities are mixed. While a high number of Australians have shown concern about the effects on the environment on current and future food supplies,[20] many are adamant that adopting a sustainable diet will not do much in the long-term[21] and are generally unaware and do not understand the health and environmental impacts of unsustainable, discretionary foods.[22]
Consequently, FOPL plays a significant role in determining the purchasing patterns of Australian consumers. In response to Australia’s health concerns, the Australasian Health Star Rating system (‘HSR’) and the Dietary Intake Guide are both FOPL responses that display the ‘healthiness’ of foods to encourage healthier dietary choices, both of which have seen moderate success.[23] While there are few FOPL initiatives that target the environmental impact of foods on supermarket shelves in Australia, EIL has been successful in reducing the adverse anthropogenic effects on the environment. For example, the Water Efficiency Labelling and Standards (‘WELS’) scheme is a FOPL government-mandated initiative that aims to reduce water usage in Australia and the adverse environmental impacts associated with excess water usage, which has been successful in reducing greenhouse gas emissions across households and businesses.[24]
1 Challenges to environmental impact labelling for low-SES communities
There are three unique challenges for low-SES consumers and EIL that warrant analysis. Firstly, the consumption of healthy and environmentally friendly foods in low-SES areas is often barred by complex, cryptic and deceptive packaging practices that rely on consumer lack of understanding of the nutritional value of foods found on BOPL.[25] For low-SES communities in Australia, simple FOPL often impacts consumption patterns more than consumers in higher-SES areas, who generally prefer and use more nutritional information.[26] As such, it is critical for FOPL to ensure that food and environmental labelling schemes are easy to use and understand, while providing a transparent means of understanding the entire scope of the health or environmental impact and how scores are awarded.
Secondly, the proliferation of discretionary foods that dominate the urban food landscape in Australia limits the choices for low-SES consumers in urban areas.[27] The lack of agricultural space in dense, urban metropolitan cities means consumers in lower income areas are likely to consume more accessible, energy-dense discretionary foods that are high in saturated fats, sodium and sugar.[28] Similar to the concerns aforementioned, for consumers in low-SES communities, food literacy and understanding of healthier alternatives is intimately connected with the urbanised landscape of lower income communities where the ease of access to faster, cheaper, and often unsustainably manufactured food, particularly in relation to fast food outlets, restricts and dominates low-SES household diets.[29]
Thirdly, low-SES communities have significantly different health landscapes to higher-SES communities. In communities with high populations of low-income earners, price often becomes a central determinant of diets in low-SES households. Consequently, cheaper, ultra-processed foods in supermarkets and fast-foods are most likely consumed by low-SES households,[30] leading to a disproportionate increase in health risks including obesity and other heart-related diseases.[31] At its extreme, where Australian households lack the energy resources to maintain a healthy and environmentally friendly diet (vis-a-vis the unavailability of energy to cook and prepare healthy foods), FOPL does not impact the consumption patterns of lower income households at all. In Australia, approximately 160,000 household energies were disconnected where the health and environmental impacts of food are generally forgone.[32] A similar issue is prevalent in the U.S., where, in 2015, 17 million households received an energy disconnect or delivery stop notice, with 25 million households forgoing food altogether to pay energy bills.[33]
2 Evaluating environmental impact labelling
Despite the unique challenges for low-SES communities, EIL should be regulated. EIL is a useful tool for promoting sustainable diets that benefit the environment and promoting healthy eating habits in low-SES communities where they are disproportionately affected by health-related diseases. However, while EIL may encourage environmentally sustainable consumption of foods, there are several legal and policy barriers that should be addressed by policymakers that uniquely impact low-SES households. These issues are examined in Part III and Part IV.
Finally, this essay does not argue a direct causal link between EIL and access to environmentally sustainable foods. The availability of evidence which creates a direct link between environmental impact labelling and low-SES is sparse. Rather, this essay seeks to address the perception of consumers from low-SES communities of FOPL, their consumption patterns, and draws analogies with FOPL health labelling to assess the potential impacts EIL has on low-SES households. To ensure the efficacy of EIL, this essay argues that stricter legal regulations and stronger policy mechanisms for consumers are necessary in fostering and maintaining healthy, sustainable diets in low-SES communities.
III LAW AND ENVIRONMENTAL IMPACT LABELLING
For low-SES communities in Australia, the law plays a significant role in both encouraging and undermining healthy, sustainable diets. This part will examine three challenges for EIL that the law should respond to better accommodate for low-SES consumers’ decisions to make healthy, sustainable choices. Firstly, the voluntary nature of food labelling regulations that allow manufacturers to opt-in to food labelling acts as a barrier to low-SES consumers’ understanding of the nutritional value of foods. Secondly, food laws around health claims allow manufacturers to use sweeping language as a marketing tool to draw low-SES consumers to purchase their products, encouraging potentially deceptive marketing practices. Thirdly, the ambit for manufacturers to make broad claims in relation to their product’s environmental impact may justify price mark-ups, acting as a significant barrier to low-SES consumers. This part will suggest three responses to combat these legal challenges.
A Challenges to the existing legal regime
1 Accountability and Enforceability: Front-of-Pack Labelling as Voluntary
Firstly, a significant challenge for regulating EIL is that food labelling regulations in Australia are voluntary. Notably, the HSR system is a voluntary FOPL system that scores the nutritional profile of foods from 0.5 to 5 stars in a ‘quick, easy standard way to compare similar packaged foods’.[34] As a result, HSR helps consumers understand the nutritional value of products in a simplified, easily understood and recognisable format: ‘the more stars, the healthier the choice’.[35]
Despite the effectiveness of FOPL across the 17 countries Codex Committee countries that have implemented voluntary FOPL,[36] the voluntary nature of HSR and other health labelling schemes presents significant issues of accountability and enforceability. In Australia, uptake of HSR ‘remains modest and uneven’.[37] Compared to the UK’s traffic light labelling system which is displayed on over 60% of packaged foods displayed the traffic light front-of-pack nutrition labelling,[38] uptake of the HSR by industry in Australia and New Zealand is approximately 30%.[39]
For low-SES households, this is a significant issue. Low-SES communities rely heavily on FOPL such as HSR to necessarily identify which foods are nutritionally beneficial to maintain a healthy diet.[40] Since a majority of HSR labels are found on foods that score higher than 3.0,[41] without a mandatory labelling scheme, consumers in low-SES communities are left to purchase foods which appear more accessible (through tactics such as price promotions) without understanding its nutritional content.
Furthermore, the lack of transparency in health rating systems that determine the scores of foods is a significant challenge.[42] In 2018, Milo’s 4.5 HSR was based on the claim that a single serving consisted of three teaspoons of Milo with 200mL skim milk, a projection divorced from the reality of the average Australian’s consumption of Milo.[43] Similarly, the Daily Intake Guide, a FOPL regulation based on the recommended daily intake of ‘core nutrients’, contains ‘loopholes’ which manufacturers selectively opt-in to market their foods as healthier than competitor products, such as displaying only the energy content of their product.[44] Between January and March of 2012, 75% of energy-dense snack products that displayed the Dietary Intake Guide did not report the saturated fat and sugar content of their products, despite these products containing more than 10 times the saturated fat and twice the sugar of products that did display the Daily Intake Guide.[45] In the UK, similar issues are present in the traffic light labelling system. Despite its high uptake, the adoption of traffic light labels is largely selective among brand foods and generic supermarket foods: in 2008, the UK supermarket Sainsbury only used traffic light labelling on 3.6% of products that were not targeted by the Food Standard Agency.[46]
Therefore, manufacturers who do not take up voluntary FOPL are left unaccountable to low-SES consumers who are most likely to consume discretionary foods without a framework of enforceability for cheap, unhealthy, and unsustainable foods.[47] For EIL, a similar challenge arises: a self-regulatory system where FOPL is voluntary enables manufacturers who do not opt-into EIL to be left unaccountable for unsustainable manufacturing processes and the environmental impact that manufacturers’ foods contribute negatively to.
2 Transparency: Front-of-Pack labelling as Misleading, Deceptive, or non-representations
Secondly, while FOPL is effective in encouraging growth in consumer awareness, FOPL allows manufacturers to make sweeping claims about the health and environmental benefits of their products. For consumers, these claims can be ‘overstated, confusing, misleading, or outright false’,[48] which has generally led to consumer scepticism about health and environmental FOPL.[49]
Caselaw concerning the adverse effects of food labelling on low-SES consumers is limited. However, a connection is still present between misleading marketing and low-SES consumers. The Australian Consumer Law (‘ACL’)[50] contains provisions protecting consumers against misleading and deceptive conduct for health and environmental claims,[51] but leaves open the potential for ‘non-representations’. ACCC v H.J. Heinz Company Australia (‘Heinz’)[52] revealed similar issues of misleading and deceptive practices by Heinz, who sought to market their products as healthier and more nutritional for children despite its high sugar content. Heinz argued that the nutritional value of its product was never expressly stated and that, because ACL does not capture ‘non-representations’, the representation that the nutritional value of their food was equivalent to the natural fruits and vegetables depicted on the packaging could not have been made as it was never expressly stated, which was accepted by White J.[53]
Similar issues around the broad conceptualisation of a valid ‘health claim’ is also evidenced through regulatory standards such as the Australian New Zealand and Food Code Standards (‘ANZFCS’).[54] Under it, manufacturers are required to meet arguably novel thresholds of nutrients to label their products as ‘healthy’, such as having ‘high fibre’ or ‘supporting gut health’,[55] notwithstanding the remaining nutritional content of the food.
EIL faces similar issues. While the Federal Trade Commission Act[56] contains similar provisions that protect consumers from false and misleading claims, US manufacturers have capitalised on ‘green’ marketing tactics to appeal to a growing demographic of environmentally conscious consumers.[57] For example, products labelled ‘biodegradable’ have been criticised for the carbon footprint its manufacturing processes leave,[58] and products that claim they are ‘environmentally safe’ and ‘eco-friendly’ purposefully use general wording to conflate its products with being environmentally safe overall.[59] While the Federal Trade Commission’s Green Guides outline the acceptable means by which companies can claim the environmental benefits of their products, litigation based on the Federal Trade Commission’s Green Guides are limited, often resulting in consent orders or a negotiated agreement compared to a court decision or penal order.[60]
For low-SES consumers, these challenges echo similar concerns explored earlier. Because low-SES consumer choices are often limited to supermarket products, where manufacturers’ products are not captured by the ‘misleading’ or ‘deceptive’ provisions of ACL, low-SES communities are left at a standstill: if they understand the health or environmental impact of the products they purchase, low-SES consumers must navigate a food landscape of potentially deceptive marketing tactics that rely on a lack of understanding of back-of-label nutritional information, how health claims and scores are awarded to these products, and secretive manufacturing processes. For example, Impossible Foods and Beyond Meat were criticised for marketing their products as using less water and land and emitting fewer greenhouse gas emissions than traditional framing. However, both companies rely on claims published in their ‘life cycle assessments’ which fail to account for soil carbon or deforestation, and publish calculations that are largely comparative to beef footprint studies.[61] As explored earlier, given that low-SES consumers generally pay less attention to BOPL, it seems less useful in the context of EIL to expect consumers to make quick environmentally conscious decisions if the true environmental footprint being left by foods are not found on the food label at all and are hidden within ambiguous, inconsistent reports. While White J’s ‘pragmatic’ approach in Heinz focused on how products are conveyed to ‘ordinary and reasonable’ consumers, such an approach may be inappropriate to apply to low-SES demographics where FOPL plays an even larger role in dictating consumer purchasing patterns.[62] As such, given the unique demographic and food landscape of low-SES communities outlined in Part II, deceptive and misleading marketing techniques may disproportionately bear harshly on low-SES consumers.
3 Accessibility: Justifying Price Mark-ups and Price Promotions
Thirdly, flowing on from the issues explored earlier, fresh produce and supermarket foods that are labelled as healthier or ‘organic’ often provide opportunities for sellers to mark-up their prices.[63] Because a large proportion of higher SES consumers are willing to pay more for environmentally friendly, ‘greener’ products,[64] sellers rely on the perception that their products are inherently better for the environment to justify price mark-ups.[65] Therefore, if sellers opt-in to voluntary labelling systems such as HSR and their product sufficiently meets the labelling requirements under ACL and ANZFCS, limited legal regulations prevent sellers from marking up their products based on green marketing tactics. This is often the case for organic certification processes in which manufacturers and retailers incur additional application fees for the certification of domestic operations, soil testing, international operations and industry development licensing fees. Consequently, for low-SES households, the affordability of healthier, sustainable foods is often recognised as a primary barrier to healthier sustainable diets.[66] For example, in lower income rural Australian communities, the price of fresh produce is almost twice as urban supermarkets for significantly worse quality food.[67] Furthermore, under the current tax policy, healthy diets cost over 30% of the disposable income of low-income households.[68] Similar issues of accessibility to fresh produce at higher prices are present in rural low-SES US counties. [69]
Additionally, supermarkets are less likely to place healthier foods on price promotion. Instead, supermarkets generally target communities that cannot afford healthier foods by placing foods that are unhealthy and unsustainable on price promotions[70] in strategically ‘accessible’ areas of supermarkets.[71] For low-SES consumers, the immediate perception of ‘accessible’ foods is conflated with those that are cheap, unhealthy and unsustainable, leading to disproportionately increased health risks in these communities.[72] EIL faces a similar challenge: FOPL intended to persuade consumers to purchase their products based solely on its environmental ‘benefits’ may provide manufacturers a similar justification to mark-up their prices.
B Responding to Australia’s Legal Challenges
1 Improving Accountability: Environmental Impact Labelling as a Mandatory Scheme
As revealed in sub-s A(1), one of the legal challenges for FOPL in Australia is their voluntary nature. As a result of consumer growth in awareness of sustainable diets, Australians are generally very supportive of mandatory labelling.[73]
The HSR system is successful: for consumer health, HSR is reliable in aligning with the Australian Dietary Guidelines which encourages health and wellbeing and reducing the risks of chronic diseases.[74] For industry, approximately one-third of Australian and New Zealand products displayed HSR in 2017‒18,[75] and the food industry is generally receptive to labelling guidelines to ensure that their product’s nutritional content is represented in an accurate, transparent manner.[76] For consumers, 67% of Australians are confident in HSR’s system, with three in five Australians purchasing a product with a HSR on the label in 2017.[77] Relevantly, for low-SES households, the percentage of consumers’ use of HSR increased from 14% in 2015 to 36% in 2018, signalling an increase of low-SES communities awareness of the necessity for healthier consumption.[78]
Despite this, HSR as a voluntary scheme continues to be favoured in Australia on the basis that uptake of HSR continues to grow and that the recommended dietary requirements of Australians are constantly shifting and that a mandated HSR would rest enforcement and monitoring of HSR within several jurisdictions.[79] However, as explored, HSR as a voluntary scheme broadens the ambit of misleading and deceptive conduct explored earlier, with many of its adverse effects bearing harshly on low-SES households. Furthermore, HSR remains an essential tool for low-SES households in understanding the general nutritional value of the food they are purchasing; dismissing HSR and EIL as a mandatory scheme because of high uptake rates should not be a barrier to mandatory regulation, especially if HSR is effective in shifting consumers towards healthier options. Rather, creating a mandatory framework for FOPL would ensure that food manufacturers are held accountable for the nutritional and environmental impact of their products.[80] For low-SES communities and EIL, this is particularly important: because FOPL is a significant determinant of low-SES consumer purchasing patterns and is proven effective, a mandatory EIL scheme would ensure that all food products (1) have undergone vigorous, transparent testing, and (2) are subject to the same set of testing guidelines.
2 Improving Transparency: Restrictive Labelling Guidelines
As revealed in sub-s A(2), the broad legal framework that regulates health claims and environmental claims allows manufacturers to mislead low-SES consumers to purchase their foods with novel health benefits.[81] Therefore, a transparent, standardised regulatory system that clearly sets out how a health rating (and potentially an ‘environmental impact’ score) has been reached is necessary for FOPL. Following a similar path of restructuring developed by Jones et al, to best represent the nutritional or environmental content of foods, health and environmental regulations should reconsider the amount of nutrition present in a food (or the environmental impact of the food via rigorous environmental testing such as carbon emissions reporting) to validly make a health or environmental claim and the types of foods that are subject to health scores.[82]
Similarly, because fast-food outlets dominate low-SES urbanised landscapes, introducing a transparent, restrictive menu labelling scheme can encourage a shift in consumer diet by dissuading consumers from cheap, discretionary foods and providing healthier, sustainable options. For example, in New South Wales, alongside the inclusion of kilojoule labelling, consumers across all income levels respond well to traffic light menu labelling: consumers can interpret and identify healthier food options and generally consume less menu items that are high in kilojoules.[83] For EIL, a similar approach should be applied: since fast food manufacturing processes are estimated to account for a significant amount of the Earth’s maximum allowable greenhouse gases,[84] EIL on menu items through a simple colour-coded system such as traffic light labelling may encourage low-SES consumers to choose more sustainable alternatives.
3 Improving Accessibility: Pricing Caps, Taxes and Subsidies
As revealed in sub-s A(3), a lack of legal regulations monitoring the pricing of healthy and sustainable foods often means price mark-ups act as a significant barrier to accessing healthy, sustainable for low-SES consumers. For several actors at the stages of the food-supply chain, the cost of environmentally sustainable produce is often traded for lower yields in produce and increased land cultivation which adversely impacts biodiversity.[85] Similarly, farmers’ wages often disincentivises the expense of investing in environmentally sound agricultural practices such as minimising the use of fertilisers and pesticides.[86]
Therefore, economic restrictions and standardised pricing mechanisms should be introduced in two ways. First, price caps for healthy and sustainable foods should be introduced to incentivise purchasing healthy foods and dissuade purchasing unhealthy foods which dominate low-SES landscapes that do not align with recommended dietary guidelines (or, in the case of EIL, foods that contribute a certain amount of carbon emissions) such as the Australian Dietary Guidelines.[87] Naturally, because the cost of healthier foods is a barrier to healthy eating, price caps would allow consumers to reliably navigate the food market knowing that healthy and sustainable produce will generally be equally accessible in price to discretionary foods.[88]
Secondly, increased taxes on discretionary foods should be introduced to dissuade customers from purchasing unhealthy foods that contribute negatively to the environment.[89] A sales tax on discretionary foods in Australia would also result in savings to the cost of healthcare, accruing most to low-SES groups.[90] This may be introduced alongside restrictions on the number of discretionary foods which are placed on price promotions: naturally, if low-SES consumers are exposed to less discounted discretionary foods and exposed to more healthy alternatives, consumer perception and association of accessible foods with discretionary foods is likely to shift. For EIL and low-SES consumers, a similar regulation would make the distinction clear: foods that comply with environmental regulations and mandatory front-of-pack EIL would be cheaper and therefore more accessible, while discretionary foods that contribute negatively to consumer health and the environment would be more expensive and less accessible.[91] Indeed, a bigger question concerning the political viability of pricing taxes on Australian imports is difficult to navigate considering approximately $16.8 million is spent on imported processed foods.[92] However, with international calls growing to better meet Australia’s climate commitments, pricing mechanisms would provide the Australian government an opportunity to meet its commitments under the UN Sustainable Development Goals, which could be satisfied by investing in sustainable agriculture and incentivising sustainable consumption and food production.[93]
IV POLICY AND ENVIRONMENTAL IMPACT LABELLING
The legal challenges to EIL demonstrate the viability and importance of EIL through restrictive legislative regulations. However, as aforementioned, the viability of EIL heavily relies on consumer knowledge of FOPL to understand the nutritional content of supermarket foods and menu items. EIL also relies on an availability of local agriculture which encourages healthy and sustainable consumption beyond supermarket shelves. In responding to these considerations, this part suggests three policy developments that should be introduced to better ensure that EIL is effective in low-SES communities. Overall, for low-SES communities, it is necessary that consumers, industry, and government contribute to implement effective EIL regulations alongside top-down changes through planning law to develop better eco-agricultural consumption practices and considers the broader analysis of how these policy suggestions overall should encourage and give effect to local food sovereignty and food security in low-SES communities.
A Responding to Australia’s Policy Challenges
1 Targeted Education
Firstly, for consumers, sustainability is an ‘abstract concept’ which people attach ‘different meanings to’.[94] To eat a sustainable and healthy diet, ‘you’ve got to keep up on the latest scientific research, study ever-longer and more confusing ingredients labels, sift through increasingly dubious health claims, and then attempt to enjoy foods that have been engineered with many other objectives in view than simply tasting good’.[95] For low-SES consumers, education is generally recognised as a central means of providing consumers navigating the dense food landscape of discretionary foods. For example, consumers from low-SES backgrounds in the US, particularly from culturally and linguistically diverse rural households with less educational attainment, are less likely to pay attention to or understand FOPL and the nutritional content of foods than those from higher-SES communities with higher educational attainment.[96] Similar patterns occur in Australia: consumers from low-socio economic areas are less likely to use or understand FOPL,[97] and in some instances, perceive foods that are labelled high in energy as being more nutritionally beneficial.[98]
Despite this, health campaigns that specifically target low-SES remain sparse.[99] Where discretionary foods target communities who do not understand FOPL, there is little evidence to suggest the availability of targeted education programs to help low-SES consumers navigate a vastly unique food landscape that naturally encourages the consumption of unhealthy foods. Therefore, alongside simplifying and restricting FOPL for low-SES consumers to make better informed decisions as explored in Part III, for EIL to be effective, governments and industry should collaborate to implement targeted educational campaigns that educate consumers about the operation of front-of-label health and environmental packaging such as the HSR system and the Dietary Intake Guide. This can come in the form of industry-level responses such as food and alcohol manufacturer campaigns to better encourage healthier diets in a simple-to-understand manner, establishing and bolstering consumer organisations that provide support and advice to help consumers understand the cost and benefits of healthy food diets, encouraging workplaces to deliver equitable, accessible health programs and ensuring that local healthcare services such as Medicare Locals and mental health services provide interpersonal communication training to employees to better understand the health literacy needs of low-SES communities.[100]
2 Early Intervention
Secondly, children in low-SES communities are uniquely exposed to discretionary foods and fast-foods.[101] Consequently, education programs for children at a young age are necessary to engrain and encourage a culture of healthy sustainable eating. Establishing a culture of healthy eating naturally feeds into sustainable and healthy eating practices into adulthood and a thorough understanding of how to identify sustainable and healthy products outside of school.
Children are uniquely affected by advertisements of discretionary foods. In 2016, Chile established the Law of Food Labelling and Advertising, a national regulation that aimed to restrict advertisements and the sale of foods to children that exceeded high levels of ‘unhealthy’ nutrients such as sugar and sodium. The regulation was successful: early adolescent consumer patterns shifted to healthier options, consumption of foods that were high in sugar and sodium decreased significantly[102] and industry was receptive to calls for restricting the use of cartoon characters on cereal boxes marketed specifically towards children.[103] However, SES played a unique role in its effectiveness: SES households with higher educational attainment had a bigger reduction in discretionary foods than households with lower educational attainment.[104]
Similarly, Australia has attempted to restrict children’s exposure to unhealthy food advertisements through self-regulatory means. The Australian Association of National Advertisers has developed a series of codes that applies a broad range of restrictions of marketing of unhealthy foods to children. However, because of its weak restrictions on children’s marketing, the codes have generally failed to reduce children’s exposure to discretionary foods.[105] Similarly, the Quick Service Restaurant Initiative for Responsible Advertising and Marketing to Children is a voluntary initiative taken up by seven fast-food restaurant chains with obligations to ensure that only healthier choices are promoted toward children.[106] However, the initiative has been criticised for several ‘loopholes’ found within its terms, namely that the initiative lacks a strict definition of what constitutes a ‘healthier choice’ and that obligations primarily apply to fast-food meals and not to individual items.[107] Consequently, this has resulted in increased rates of childhood obesity within low-SES communities and a lack of understanding of identifying healthier food options.[108]
Therefore, the role of government is crucial to responding to the challenges faced by children from low-SES areas and EIL. For children in low-SES areas, education about food labelling at an early age is essential in providing the necessary means of making informed choices about the foods that are available to them in communities where the availability of fresh agriculture is limited compared to other SES areas. For example, in Australian school canteens, there are limited initiatives dedicated to increasing the availability of healthy foods and restricting discretionary foods to children.[109] School canteens should not only seek to increase the number of healthy foods available to children, but also employ a similar FOPL traffic light labelling system or a ‘score’ system similar to HSR (which children generally receptive to)[110] for children to easily identify discretionary foods that have significant health and environmental risks.[111]
To respond to the abundance of advertisements that are directed toward children in low-SES areas, policymakers should take an approach similar to Chile in children’s marketing by restricting the visibility of unhealthy and unsustainable foods nearby schools and on supermarket shelves (such as regulating advertisements on public transport, schools and billboards on government-controlled land). Specifically, policymakers should consider a cap on the number of advertisements on free-to-air television that are directed toward children during peak hours of children’s viewing and ensure that similar restrictions apply to all forms of digital media (such as streaming services).[112]
3 Developing a culture of sustainable eating beyond supermarket shelves
Thirdly, while EIL is a useful short-term solution to providing consumers with the knowledge required to make healthy and sustainable food choices, FOPL is not the only modifier in consumer diets.[113] Therefore, for EIL to effect systemic change, Australian policymakers should consider whether low-SES communities can maintain a culture of sustainable eating beyond supermarket shelves using a top-down approach in collaboration with planning law initiatives.
For local governments, it is necessary that they implement the tools of planning law to respond to the low-SES ‘food deserts’ of Australia.[114] In the US, rural cities face a similar challenge in accessing equitable means of healthy foods: in 2014, rural counties reported low healthy food availability in local supermarkets, thereby having to rely on non-traditional food sources such as discount stores.[115] Therefore, alongside EIL, planning law plays an important role in developing a culture of sustainable eating beyond manufacturers’ foods on supermarket shelves because local urban agriculture contributes significantly to issues of food security and access to healthy, sustainable produce.
Furthermore, it is necessary that a culture of sustainable eating is bolstered in low-SES communities through community engagement and education about the potential for urban agriculture (through initiatives like developing community gardens, grants for local food production and local markets that sell fresh healthy food).[116] For local governments, community strategic plans and policies that are directly related to improving nutrition in low-SES communities is necessary in ensuring that EIL is effective in not only drawing attention to the adverse effects of unsustainable foods on supermarket shelves, but also providing practical means for low-SES communities to access sustainable foods beyond supermarket shelves.[117] Similarly, because fast-food chains have capitalised on the density of low-SES communities, restrictions on the number of fast-food outlets in close proximity may provide for lucrative local agriculture opportunities, combat disproportionate obesity rates in low-SES communities and encourage alternative diets beyond fast-food chains.[118]
Overall, the experience of health FOPL and the analysis of EIL speaks to the importance of giving effect to local food sovereignty and warrants analysis in the context of these broader structural questions. The experience of FOPL stresses the importance of investing in low-SES areas where local agriculture is lacking. Where the local food chain is out of reach for low-SES communities, investing in urban gardens, local farms and agricultural space is imperative to providing low-SES communities an avenue for gaining an insight into how agriculture in urban spaces can be made accessible without the complexity and the expense of accessing healthy, environmentally conscious foods through retailers and corporate farms, which, as is often the case with global supply chains, places great pressure on ecosystems and natural resources.[119] Planning law initiatives and investment in agriculture in low-SES areas is also important for rural and remote parts of Australia. In rural areas, the importance of community collaboration with culturally diverse people, vulnerable groups in society and Indigenous communities is imperative to giving effect to local food sovereignty and food security: where retailers lack culturally appropriate foods, community collaboration would be key in developing local food systems that can accommodate for the unique food landscapes of low-SES communities.[120]
V CONCLUSION
In conclusion, policymakers should regulate EIL on Australian food products. For consumers, EIL promotes healthier and sustainable consumer diets and combats obesity. For government, mandatory regulation of EIL provides an opportunity for policymakers to reassess the legal and policy mechanisms which provide equitable access to both healthy and environmentally sustainable foods. For industry, EIL provides an opportunity for corporations to capitalise on the success and profitability of FOPL regulations that persuade consumers to purchase environmentally sustainable products. However, policymakers should be aware of the unique food landscapes of low-SES households and the role that EIL plays. From a legal perspective, Australia’s food laws require a rethinking of the potentially harsh consequences that food law has on low-SES consumer choices in three areas. Firstly, mandatory FOPL should be introduced to hold manufacturers with unhealthy and unsustainable manufacturing processes accountable for the health and environmental risks of their products. Secondly, stricter regulations governing health and environmental claims should be introduced to prevent purposefully misleading and confusing consumers. Thirdly, price caps on healthy foods and restrictions on price promotions on discretionary foods should be introduced to prevent manufacturers from justifying price mark-ups on healthy foods. From a policy perspective, Australia’s food policies require a rethinking of how low-SES consumers can switch to healthy and sustainable diets in three ways. Firstly, providing consumers in low-SES communities the necessary education resources to make informed decisions about dietary choices. Secondly, educating children in low-SES communities about the benefits of healthy and sustainable eating and methods of navigating the unique food landscapes in low-SES areas. Thirdly, developing a culture of sustainable eating through EIL alongside planning law to develop urban local agricultures and combat the proliferation of fast-food chains, thereby giving effect to local food systems that account for the unique and diverse needs of low-SES communities.
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B Cases
Australian Competition and Consumer Commission v Heinz [2018] FCA 360
C Other
Australian Food and Grocery Council, Quick Service Restaurant Initiative for Responsible Advertising and Marketing to Children (2018)
Australian and New Zealand Food Standards Code 2015 (Cth)
Codex Alimentarius Commission Guidelines on Nutritional Labelling 1985
Competition and Consumer Act 2010 (Cth)
Federal Trade Commission Act of 1914 15 USC
[1] See Part II below.
[2] See Part III below.
[3] See Part IV below.
[4] Food and Agriculture Organization of the United Nations, Energy-Smart Food for People and Climate (Issue Paper, 2011) 2.
[5] Joseph Poore and Thomas Nemecek, ‘Reducing food’s environmental impacts through producers and consumers’ (2019) 360(6392) Science 987, 987.
[6] Eat Forum, EAT-Lancet Commission: Healthy Diets From Sustainable Food Systems (Executive Summary) 21.
[7] Ibid 12.
[8] See, eg, Yohan Bernard, Laurent Bertranadias and Leila Elgaaied-Gambier, ‘Shoppers’ grocery choices in the presence of generalized eco-labelling’ (2015) 43(4/5) International Journal of Retail and Distribution Management 448; Peter Helfer and Thomas R. Shultz, ‘The effects of nutrition labeling on consumer food choice: a psychological experiment and computational model’ (2014) 1331(1) Annals of the New York Academy of Sciences’ 174.
[9] Bernard et al (n 8); Helfer and Shultz (n 8).
[10] Robert Hamlin and Lisa McNeill, ‘Does the Australasian “Health Star Rating” Front of Pack Nutritional Label System Work?’ (2016) 8(1) Nutrients 327.
[11] Codex Alimentarius Commission Guidelines on Nutritional Labelling (1985).
[12] Robert Shewfeld, In Defense of Processed Food: It’s Not Nearly As Bad As You Think (Springer International Publishing, 2016) 91.
[13] See, eg, Jorge Vargas-Meza et al, ‘Front-of-pack nutritional labels: Understanding by low- and middle-income Mexican consumers’ (2019) 14(11) PLOS One 1; Sarah Sinclair, David Hammond and Samantha Goodman, ‘Sociodemographic differences in the comprehension of nutritional labels on food products’ 45(6) Journal of Nutrition Education and Behaviour 767, 770‒1.
[14] Australian Bureau of Statistics, Land Management and Farming in Australia, 2016‒17 (Catalogue No 4627.0, 6 June 2020).
[15] ‘How Australia accounts for agricultural greenhouse gas emissions’, Western Australia Department of Primary Industries and Regional Development (Web Page, 27 January 2021) < https://www.agric.wa.gov.au/climate-change/how-australia-accounts-agricultural-greenhouse-gas-emissions>.
[16] Australian Bureau of Statistics, Water Use on Australian Farms, 2018‒19 (Catalogue No 4618.0, 28 May 2020).
[17] Michalis Hadjikakou, ‘Trimming the excess: environmental impacts of discretionary food consumption in Australia’ (2017) 131(1) Ecological Economics 119.
[18] Ibid.
[19] Ibid.
[20] Amelia Harray et al, ‘Healthy and sustainable diets: Community concern about the effect of the future food environments and support for governing regulating sustainable food supplies in Western Australia’ (2018) 125(1) Appetite 225, 227‒31; Annet Hoek et al, ‘Shrinking the food-print: A qualitative study into consumer perceptions, experiences and attitudes towards healthy and environmentally friendly food behaviours’ (2017) 108(1) Appetite 117, 126‒7.
[21] Davina Mann et al, ‘Australian consumers’ views towards an environmentally sustainable eating pattern’ (2018) 21(14) Public Health Nutrition 2714, 2718‒21.
[22] Hoek et al (n 20) 126.
[23] Michael Moore et al, ‘Development of Australia’s front-of-pack interpretive nutrition labelling Health Star Rating system: lessons for public health advocates’ (2019) 43(4) Australian and New Zealand Journal of Public Health 352, 353‒4; Hamlin and McNeill (n 10) 337; Alexandra Jones et al, ‘The performance and potential of the Australasian Health Star Rating system: a four-year review using the RE-AIM framework’ (2019) 43(4) Australian and New Zealand Journal of Public Health 355.
[24] Institute for Sustainable Futures, submission to Department of Agriculture and Water Resources, Evaluation of the environmental and economic impacts of the WELS scheme (February, 2019) 54‒55.
[25] Hamlin and McNeill (n 10).
[26] Liyuwork Dana et al, ‘Consumers’ views on the importance of specific front-of-pack nutrition information: A latent profile analysis’ (2019) 11(5) Nutrients 1158, 1166‒7.
[27] See especially Hadjikakou (n 17) 121; Claire Elizabeth Pulker, Jane Anne Scott and Christina Mary Pollard, ‘Ultra-processed family foods in Australia: nutrition claims, health claims and marketing techniques’ (2017) 21(1) Public Health Nutrition 38, 43‒5.
[28] Adrian Cameron et al, ‘Variation in supermarket exposure to energy-dense snack foods by socio-economic position’ (2012) 16(7) Public Health Nutrition 1178, 1182‒4.
[29] Hadjikakou (n 17).
[30] Ibid 121.
[31] Cameron et al (n 28) 1178.
[32] See, eg, Alison Rowe and Rachel Maddocks, ‘Why energy poverty is something we have to urgently end’, The Fifth State (online, 11 September 2018) <https://www.thefifthestate.com.au/columns/spinifex/energy-poverty-urgently-end-2/>.
[33] Dominic Bednar and Tony Reames, ‘Recognition of and response to energy poverty in the United States’ (2020) 5(1) Nature Energy 432.
[34] ‘About Health Star Ratings’, Health Star Rating (Web Page, 13 November 2020) <http://www.healthstarrating.gov.au/internet/healthstarrating/publishing.nsf/Content/About-health-stars> .
[35] Ibid.
[36] Ibid.
[37] Alexandra Jones, Maria Shahid and Bruce Neal, ‘Uptake of Australia’s Health Star Rating System’ (2018) 10(1) Nutrients 997, 1002.
[38] Ibid.
[39] Ibid.
[40] See, eg, Rachel Crockett, ‘The impact of nutritional labels and socioeconomic status on energy intake. An experimental field study’ (2014) 81(1) Appetite 12, 17‒9.
[41] Jones et al (n 23).
[42] Fiona Pelly et al, ‘Consumers’ Perceptions of the Australian Health Star Rating Labelling Scheme’ (2020) 12(3) Nutrients 704.
[43] See, eg, ‘Milo comes clean on health stars’, Choice (Web Page, 1 March 2018) <https://www.choice.com.au/about-us/media-releases/2018/february/milo-rating>; Lexi Metherell, ‘Nestle removes Milo’s 4.5 Health Star Rating in response to criticism from public health groups’, ABC News (online, 1 March 2018) <https://www.abc.net.au/news/2018-03-01/milos-4.5-health-star-rating-stripped-away-by-nestle/9496890>.
[44] Owen Carter et al, ‘An independent audit of the Australian food industry’s voluntary front-of-pack nutrition labelling scheme for energy-dense nutrition-poor foods’ (2013) 67(1) European Journal of Clinical Nutrition 31, 33‒4.
[45] Ibid 33‒4.
[46] DJ Van Camp, NH Hooker and DM Souza-Monteiro, ‘Adoption of voluntary front of package nutrition schemes in UK food innovations’ (2010) 112(6) British Food Journal 580, 584.
[47] Alexandra Jones et al, ‘Front-of-pack nutrition labelling to promote healthier diets: current practice and opportunities to strengthen regulation worldwide’ (2019) 4(6) BMJ Global Health 1, 5.
[48] James Nehf, ‘Regulating Green Marketing Claims in the United States’ in Alberto do Amaral Junior, Lucila de Almeida and Luciane Klein Vieira (eds) Sustainable Consumption: The Right to a Healthy Environment (Springer Publishing, 2020) 189.
[49] Suku Bhaskaran et al, ‘Environmentally sustainable food production and marketing: Opportunity or hype?’ (2006) 108(8) British Food Journal 677, 687.
[50] Competition and Consumer Act 2010 (Cth) sch 2 (‘ACL’).
[52] [2018] FCA 360 (‘Heinz’).
[53] Ibid [65]‒[67].
[54] Australian and New Zealand Food Standards Code 2015 (Cth) (‘ANZFSC’).
[55] Ibid standard 1.2.7.
[56] Federal Trade Commission Act of 1914 15 USC § 45(a)(1)
[57] Nehf (n 48) 190; Hoang Viet Nguyen et al, ‘Organic Food Purchases in an Emerging Market: The Influence of Consumers’ Personal Factors and Green Marketing Practices of Food Stores’ (2019) 16(1) International Journal of Environmental Research and Public Health 1, 4‒5.
[58] Nehf (n 48) 190‒1.
[59] Ibid.
[60] Ibid 196.
[61] Maartje Sevenster and Brad Ridoutt, ‘Vegan food’s sustainability claims need to give the full picture’, The Conversation (online, 9 August 2019) <https://theconversation.com/vegan-foods-sustainability-claims-need-to-give-the-full-picture-121051>.
[62] Henry Materne-Smith, ‘Food for Thought: Australian Competition and Consumer Commission v HJ Heinz Company Australia Limited’ [2019] AdelLawRw 67; (2019) 40(3) Adelaide Law Review 891, 899.
[63] See, eg, Sophie Elsworth and John Rolfe, ‘Organic food costs up to three times more’, news.com.au (online, 15 February 2013) <https://www.news.com.au/finance/money/we-plough-millions-into-expensive-organic-food/news-story/acf80568f997899822c39d60fa6f300b>. Cf Joanna Prendergast, ‘Organic fruit and vegetables in demand as supermarkets move to reduce prices’, ABC News (online, 19 February 2020) <https://www.abc.net.au/news/rural/2020-02-19/organic-fruit-and-vegetables-in-demand-push-for-lower-prices/11977032>.
[64] See, eg, Louise Grimmer and Gary Mortimer, ‘Green is the new black why retails want you to know about their green credentials’ The Conversation (online, 29 June 2018) <https://theconversation.com/green-is-the-new-black-why-retailers-want-you-to-know-about-their-green-credentials-99073>.
[65] Nehf (n 48) 190.
[66] Cf M de Abreu et al, ‘Nutrient profiling and food prices: what is the cost of choosing healthier products’ (2019) 32(4) Journal of Human Nutrition and Dietetics 432, 439‒40.
[67] Erin Parke and Ben Collins, ‘Calls for price caps and shopping subsidies to bring grocery pricing equality to remote Australia’, ABC News (online, 11 July 2020) <https://www.abc.net.au/news/2020-07-11/remote-community-food-price-inquiry-details-rotten-meat/12441976>.
[68] Amanda Lee et al, ‘A tale of two cities: the cost, price differential and affordability of current and healthy diets in Sydney and Canberra, Australia’ (2020) 17(80) International Journal of Behaviour Nutrition and Physical Activity 1, 9.
[69] See especially, Mayuree Rao et al, ‘Do healthier foods and diet patterns cost more than less healthy options? A systematic review and meta analysis’ (2013) 3(12) British Medical Journal 1, 10‒2; Ala’a Alkerwi et al, ‘Demographic and socioeconomic disparity in nutrition: application of a novel Correlated Component Regression approach’ (2015) 5(5) British Medical Journal 1.
[70] Belinda Crawford et al, ‘Socioeconomic differences in the cost, availability and quality of healthy food in Sydney’ (2017) 41(6) Australian and New Zealand Journal of Public Health 567.
[71] See, eg, Shewfeld (n 12) 91; Christina Zorbas et al, ‘The frequency and magnitude of price-promoted beverages available for sale in Australian supermarkets’ (2019) 43(4) Australian and New Zealand Journal of Public Health 346, 349‒50.
[72] Devorah Risenberg et al, ‘Price Promotions by Food Category and Product Healthiness in an Australian Supermarket Chain, 2017‒2018’ (2019) 109(10) American Journal of Public Health 1434, 1437‒38; Devorah Risenberg et al, ‘Frequency of price promotions on food in a major Australian supermarket chain: analysis by food category and relative product healthiness’ (2019) 13(3) Obesity Research and Clinical Practice 246. Cf Ryota Nakamura et al, ‘Price promotions on healthier compared with less healthy foods: a hierarchical regression analysis of the impact on sales and social patterning of responses to promotions in Great Britain’ (2015) 101(1) American Journal of Clinical Nutrition 808, 813‒5.
[73] Bridget Kelly et al, ‘Consumer testing of the acceptability and effectiveness of front-of-pack food labelling systems for the Australian grocery market’ (2009) 24(2) Health Promotion International 120, 127‒9.
[74] Alexandra Jones, Karin Radholm and Bruce Neal, ‘Defining ‘Unhealthy’: A Systematic Analysis of Alignment between the Australian Dietary Guidelines and the Health Star Rating System’ 10(1) Nutrients 501, 511‒2; MP Consulting, ‘Health Star Rating System Five Year Review’ (Final Report, May 2019) 21.
[75] Ibid 21.
[76] Ibid.
[77] MP Consulting (n 74) 22.
[78] Ibid.
[79] Ibid 82.
[80] Cf Blanca Salas and Bruno Simoes, ‘The European Commission Initiates Infringement Proceedings against the UK over its ‘Traffic Light’ Nutrition Labelling Scheme’ (2014) 5(4) European Journal of Risk Regulation 531, 532‒3.
[81] Materne-Smith (n 62).
[82] Jones et al (n 23) 9‒14.
[83] Belinda Morley et al, ‘What types of nutrition menu labelling lead consumers to select less energy-dense fast food? An experimental study (2013) 67(1) Appetite 8, 13‒4. See also, Lyndal Wellard-Cole et al, ‘Monitoring the changes to the nutrient composition of fast foods following the introduction of menu labelling in New South Wales, Australia: an observational study’ (2017) 21(6) Public Health Nutrition 1194.
[84] Matt McGrath, ‘Fast food giants under fire on climate and water usage’, BBC News (online, 29 January 2019) <https://www.bbc.com/news/science-environment-47029485>.
[85] Torsten Kurth et al, ‘The True Cost of Food’, BCG (Weg Page, 28 October 2020) <https://www.bcg.com/en-au/publications/2020/evaluating-agricultures-environmental-costs>.
[86] Ibid. See also, Jacqueline Williams, ‘Australia urgently needs real sustainable agriculture policy’, The Conversation (online, 12 August 2019) <https://theconversation.com/australia-urgently-needs-real-sustainable-agriculture-policy-120597>.
[87] See especially, Amanda Lee et al, ‘Healthy diets ASAP – Australian Standardised Affordability and Pricing methods protocol’ (2018) 17(1) Nutrition Journal 88. See also Amanda Lee and Meron Lewis, ‘Testing the Price of Healthy and Current Diets in Remote Aboriginal Communities to Improve Food Security: Development of the Aboriginal and Torres Strait Islander Healthy Diets ASAP (Australian Standardised Affordability and Pricing) Methods (2018) 15(12) International Journal of Environmental Research and Public Health 2912; Amanda Lee, Sarah Kane and Meron Lewis, ‘Healthy diets ASAP (Australian Standardized Affordability and Pricing) methods and results: Are healthy diets really more expensive and how would price be affected by changes to the GST?’ (2019) 13(1) Obesity Research and Clinical Practice 38.
[88] See especially, Anita Lal et al, ‘Modelled health benefits of a sugar-sweetened beverage tax across different socioeconomic groups in Australia: A cost-effectiveness and equity analysis’ (2017)14(6) PLOS Medicine 1, 12‒3. See also, Hannah Carter et al, ‘The productivity gains associated with a junk food tax and their impact on cost-effectiveness’ (2019) 14(7) PLOS 1, 7‒8.
[89] See, eg, Lee and Lewis (n 87).
[90] Anita Lal et al (n 78) 12.
[91] See, eg, Lee and Lewis (n 87); Lee, Kane and Lewis (n 87).
[92] Bill Bellotti, ‘How many people can Australia feed?’ The Conversation (online, 13 July 2017) <https://theconversation.com/how-many-people-can-australia-feed-76460>.
[93] Williams (n 86).
[94] Klaus Grunert, Sophie Hieke and Josephine Wills, ‘Sustainability labels on food products: Consumer motivation, understanding and use’ (2014) 44(1) Food Policy 177, 183.
[95] Shewfield (n 12) 89.
[96] Xiaoli Chen et al, ‘Who is missing the message? Targeting strategies to increase food label use among US adults’ (2012) 15(5) Public Health Nutrition 760, 770‒2; Alexander Persoskie, Erin Hennessy and Wendy Nelson, ‘US Consumers’ Understanding of Nutrition Labels in 2013: The Importance of Health Literacy’ (2017) 14(1) Preventing Chronic Disease 86; Sinclair et al (n 13) 770.
[97] Kim Anastasiou, Michelle Miller and Kacie Dickinson, ‘The relationship between food label use and dietary intake in adults: A systematic review’ (2019) 138(1) Appetite 280, 289‒90.
[98] Wendy Watson et al, ‘How well do Australian shoppers understand energy terms on food labels?’ (2012) 16(3) Public Health Nutrition 409, 415‒6.
[99] See especially, Australian Commission on Safety and Quality in Health Care, Health Literacy: Taking action to improve safety and quality (Final Report, August 2014).
[100] Ibid 62‒73.
[101] Lukar Thornton, Karen Lamb and Kylie Ball, ‘Fast food restaurant locations according to socioeconomic disadvantage, urban-regional locality, and schools within Victoria, Australia’ (2016) 2(1) Population Health 1, 7.
[102] Lindsey Smith Taillie et al, ‘An evaluation of Chile’s Law of Food Labelling and Advertising on sugar-sweetened beverage purchases from 2015 to 2017: A before-and-after study’ (2020) 17(2) PLOS Medicine 1, 14.
[103] Fernanda Mediano Stolze, ‘Prevalence of Child-Directed Marketing on Breakfast Cereal Packages before and after Chile’s Food Marketing Law; A Pre- and Post-Quantitative Content Analysis’ (2019) 16(22) International Journal of Environmental Research and Public Health 4501.
[104] Taillie et al (n 102).
[105] Rhonda Jolly, ‘Marketing obesity? Junk food, advertising and kids’ (Research Paper No 9/2011, Parliament of Australia, 12 January 2011).
[106] Australian Food and Grocery Council, Quick Service Restaurant Initiative for Responsible Advertising and Marketing to Children (2018) s 1.6.
[107] Jolly (n 105) [7.18].
[108] Simone Pettigrew and Melanie Pescud, ‘The salience of food labeling among low-income families with overweight children’ (2013) 45(4) Journal of Nutrition Education and Behaviour 332, 337‒9.
[109] See, eg, Tara Clinton-McHarg et al, ‘Availability of food and beverage items on school canteen menus and association with items purchased by children of primary-school age’ (2018) 21(15) Public Health Nutrition 2907, 2911‒2.
[110] Simone Pettigrew et al, ‘The types and aspects of front-of-pack food labelling schemes preferred by adults and children’ (2017) 109(1) Appetite 115, 120‒3.
[111] See also, Clinton-McHarg et al (n 109) 2911‒2.
[112] See especially, ‘Policies to reduce children’s exposure to unhealthy food marketing’, Obesity Evidence Hub (Web Page, 17 September 2020) <https://www.obesityevidencehub.org.au/collections/prevention/the-way-forward-policies-to-reduce-childrens-exposure-to-junk-food-advertising>.
[113] Pawel Bryla, ‘Who Reads Food Labels? Selected Predictors of Consumer Interest in Front-of-Package and Back-of-Package Labels during and after the Purchase’ (2020) 12(9) Nutrients 2605, 2618.
[114] See, eg, Mark Colvin and Angela Lavoipierre, ‘’Food deserts’: Grocery dead zones have serious health impacts for residents, experts say’, ABC News (online, 8 July 2015) <https://www.abc.net.au/news/2015-07-08/food-deserts-have-serious-consequences-for-residents-experts/>.
[115] See, eg, Elizabeth Campbell et al, ‘Healthy Food Availability Among Food Sources in Rural Maryland Counties (2018) 12(3) Journal of Hunger and Environmental Nutrition 328; Jennifer Creel et al, ‘Availability of healthier options in traditional and nontraditional rural fast-food outlets’ (2008) 8(1) BMC Public Health 395.
[116] Belinda Reeve et al, ‘The role of Australian local governments in creating a healthy food environment: an analysis of policy documents from six Sydney local governments’ (2020) 44(2) Australian and New Zealand Journal of Public Health 137, 142.
[117] Ibid 142.
[118] See, eg, Candace Nykiforuk et al, ‘Adoption and diffusion of zoning bylaws banning fast food drive-through services across Canadian municipalities’ (2018) 18(1) BMC Public Health 137. Cf Karen Lamb et al, ‘Associations between major chain fast-food outlet and change in body mass index: a longitudinal observational study of women from Victoria, Australia’ (2017) 7(10) British Medical Journal 1.
[119] Karen E Charlton, ‘Food security, food systems and food sovereignty in the 21st century: a new paradigm require to meet Sustainable Development Goals’ (2016) 73(1) Nutrition and Dietetics 3, 12.
[120] Ibid 10.
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