Foro Global sobre Seguridad Alimentaria y Nutrición (Foro FSN)

Comments by Corrado Finardi PhD- Coldiretti Italian Farmers Union –University of Parma- food Sciences Dept.- Lecturer

I thank FAO to give the opportunity to contribute at an early stage to this purposeful document, which allows a progression of terms, visual and insights onto the current and coming food systems.  While a number of drifts are apparent out there- such as climatic change, nutrition transition – i.e.,  to animal protein and fats in developing countries, to vegetable- based diets in Western ones-,

Transnational institutions experiment a number of challenges due to several factors. In particular, geopolitical instability and turmoil in wide parts of the planet; the uncertain recourse to trade agreements on a bilateral basis as key feature of the new multilateralism; the coming back of some sort of world equilibrium, in amidst cold war scenario and multi-centric power allocation- all of these pose new questions to the prevalent and yet imperfect world food equilibrium and – most of all- framing of the possible solutions and interventions.

We provide hereinafter basically 2 kinds of suggestions, the first one more conceptual and the second one related to mere formal aspects. Eventually, we believe that a better overall glossary could help greatly in a correct framing of the problems at stake ad possible solutions.

Also we believe that the food value chains should be mirrored better in the risks they currently present: with less choice for consumers, more fragile food security and inherent biological hazards (ie, antimicrobial resistance, loss of biodiversity, spread of diseases at a faster pace due to commoditized food chains, etc).

In particular, the merges and acquisitions process by huge transnational structures, which is on-going, pose serious risks in terms of food safety and food security governance- risks for which there is a lack of tools (political, institutional and economical) for proportionate contrast.

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Line 4 p. 9. “malnourished”. As we intend to comment further, this term without introduction or explanation at the very beginning, may create confusion and it seems not able to face different problems with different genesis and solutions. So we suggest a “In brackets” use of this word, if authors intend to continue using it (“malnourished” encompasses very divergent problems such as lack of energy intake and excess of; or the mix between excesses of caloric intake and micronutrients deficiency).

Footnote1 p. 9. And line 2 p. 9. We hence question the usefulness and conceptual validity of the term “malnutrition” which is comprehensive of a wide array of phenomena needing different tools for solution. In fact, equaling overweight and obesity to micronutrient deficiency or lack of enough energy intake is somehow problematic in our perspective and does not help addressing the issues at stake, the way they develop, the reasons-why, and may  offer limited clues in further problem solving.  So we propose to better clarify or reformulate the initial period “Malnutrition in all its forms” in order to reach an overall clarity, better without explanatory footnotes.

Line 10 p. 9 we suggest to refer expressly to “unhealthy food environments”, since it is going to be better explained in the glossary and it Is a key concept in relation to the draft document.

Line 10 p. 9 it may need attention the “poor diets” wording, which suggest exclusively a lack of micro-macro nutrients or energy and not an overall disequilibrium or lack of variety of the diets as such.

“Unpaired” diets may work better (?)

Line 15 p.11.

Definition 1 Food System

We propose the different wording

“A food system consists of all the elements (environment,rural territories and landscape people, inputs, processes, knowledge and technology, infrastructures and environmental facilities institutions, etc) and activities that relate to the production, processing, distribution, preparation and consumption of food, and the outcomes of these activities, namely nutrition and health status, socio-economic growth and equity and environmental sustainability.

Food systems encompass also the cultural framing and promotion (i.e., marketing) of food in order to make it acceptable and perfectly legitimate in any given context.”

Rationale for consideration: under Food System definition, we suggest a different use of “environment”, due to the ambiguity it may bring due to its reference to landscape, territory, and other anthropic factors. Also, it needs proper consideration that under Definition 3- “Food environments” a definition of “environment is provided. To provide clarity we believe that an unambiguous use of wording should be used whenever possible- hence generic terms such as “environmental” should be avoided.

Line 21 p. 11

We propose the different wording

“A sustainable food system (SFS) is a food system that ensures food security and balanced nutrition for all and everywhere in such a way that economic, institutional, social and environmental bases to generate food security and nutrition of future generations are not compromised”.

Rationale for consideration: Institutions and capacity building are key to achieve a correct understanding of how food systems operate, and to ameliorate the overall status of sustainability in all its features.

 Line 25 p. 11 Definition 3 Food environments

We propose the different wording

“Food environments refer to the physical, economic, policy, institutional and socio-cultural surroundings, opportunities and conditions that influence food choices and nutritional status (…)…”

Rationale for consideration: here again we feel useful to insert “institutional”, while “policy” as a particular feature under the wider institutional framing.

Line 1 p. 12 Definition 4 Diets

We propose the different formula

“Diets comprise the individual foods that a person consumes on a given day, week or onth, in a habitual way that forms a dietary pattern refer to a habitual way by which the individual foods enter dietary patterns on a continuous temporal basis (day, week, or month). Diets that are considered nutritious and sustainable are those with lower environmental impacts and contribute to food and nutrition security and to healthy life for present and future generations.

Diets depend not only on food (mixes) but also on ways of processing, transforming, cooking, preserving and storing, as well as serving foods, along with the cultural dimension of sharing meals (conviviality)”.

Rationale for consideration: the ancient Grecian word for “diet” (diaita) refers primarily to the habit under which foods are consumed, more than on individual foods in themselves. It implies not only a social dimension but also a prevalent aspect of combining foods.

Line 21-24 p. 12

Under the enumeration of the numerous factors affecting food systems, still lack the “insitutions” which is indeed a different feature from “political” and “economic”. It could be helpful to add it.

Line 14-18 p. 13. The contributions of Francisco Varela, Humberto Maturana, and more on the sociological side, Niklas Luhmann, (Soziale Systeme - 1984) can be added to explain the interaction across systems and mutual perturbation.

p. 14 graph.-FIGURE 1

To our limited understanding a better highlighting of the features of marketing under “food acceptability and preferences” in turn under “Food Environments” is desirable.

Under Food Environments also, under “information and guidelines” it could be nuanced the difference between public and private ones (i.e, public health authorities or instead, voluntary private guidelines or messages even in the shape of “demi-marketing”).

p. 15 ll. 28 and fw. We propose to reformulate as follows “Innovation is generated through research, but also by less visible enginees such as gradual improvement, technological spillover from other domains, rate of adoption of parallel technologies, shaping the anthropic environment. Also the cultural dimension, habits and uses have a role in favoring innovation adoption “

p. 15 ll 40 to 48. We suggest to add the “institutional drivers” in the paragraph title and at ll.40, “Political, economic and more broadly, institutional drivers…”

In fact, “institutions” are a bundle of shared societal expectations driving behaviors and take the form of norms, prescribed courses of action-habits, as well as other consensual procedures to allocate resources, power and goods. Basically (sociological thinking considers) institutions as norms to behave in a predictable manner and geared inside formalized structures

p- 18 ll. 43, “Food Environments”, at ll. 46, we suggest to include also “citizens” as key to define “food environments”. In fact, citizens increasingly may shape food environments, for instance by social media, blogging, on line polls and surveys, (ie, change.org). In fact, since food requires a wider institutional framework inside which is “made available and accessible”, also citizens may have a clear role in shaping food environment, and not only as consumers.

p.19 ll 27 and fw. It seems it lacks a clear explanation of the ultimate goal of the FBDGs. Examples aslo could help. 

Apologies for the late reply. Please find attached my comments on the report. It's a great start and DFID welcomes the effort of the HLPE for tackling such a vast and important topic.

Thanks,

Pete Howson

Livelihoods Advisor, DFID

Please find attached the final version of the CSM Comments on the HLPE Nutrition Zero Draft in both Word and PDF versions.

Marisa, Stefano and Laura

CSM Nutrition WG Coordinator and Facilitators

Dear Mr. Pingault,

I hope this email finds you well. Kindly find attached the World Food Programme’s inputs to the HLPE zero-draft report on Nutrition and Food Systems.

Many thanks and best regards,

Jacopo Valentini

WFP CFS Team

Please find attached the contributions of the WHO Department of Nutrition for Health and Development to the online consultation on the Zero Draft of the HLPE report on Nutrition and Food Systems.  

Thank you for this opportunity to provide comments. We welcome that the Committee on World Food Security (CFS) has decided to play an important role in advancing nutrition within its mandate and added value, in line with the 2030 Agenda for Sustainable Development and the outcomes of the Second International Conference on Nutrition (ICN2). In this context the new HLPE report on Nutrition and Food Systems is timely and highly relevant, and it will be an important basis for future engagements of CFS in advancing nutrition and potentially to its contribution to the UN Decade of Action on Nutrition over the next 10 years 2016-2025.

We hope our comments are helpful and are available for any further clarifications if needed. 

The NCD Alliance and World Cancer Research Fund International congratulate the authors for a comprehensive V0 draft and welcome this opportunity to comment on the report early enough to allow sufficient time to give proper consideration to the feedback received.

Please find attached our feedback.

Bonsoir,

Je vous prie de trouver ci-joint les remarques de la France concernant le projet de Rapport V0 « Nutrition ».

Nous vous remercions de bien vouloir mettre en ligne celles-ci, par ailleurs.

Bien cordialement,

Isabelle Mialet-Serra (PhD)

Conseiller scientifique

Représentante du CIRAD, de l’INRA, de l’IRD et d’IAVFF/AGREENIUM à Rome.

Please find below, consolidated response from Australia concerning the HLPE (Zero draft) Report on Nutrition and Food Systems.

Thank you for the opportunity to review the zero draft of the Nutrition and Food Systems report. It is clear a lot of high quality work has gone into its development. We look forward to assisting as the report develops.

Globally there has been an increasing focus on the malnutrition challenge – both overnutrition and undernutrition. The Indo-Pacific region is grappling with particularly serious and complex nutrition issues. We therefore welcome the HLPE’s focus on this important issue. 

Whilst we recognise the report’s specific focus on food systems, we note that nutrition is a complex issue requiring coordinated action across many sectors including health, social protection, education and WASH (water sanitation and hygiene). 

We are generally supportive of the report’s contents and provide comments on specific sections of the report below.

Future Research Areas and Data Needs

We welcome the recommendation in subsection 4.1.1 Knowledge gaps and areas for future work, to undertake further research and data collection on the impact of food systems on nutrition. Despite the links between agriculture and nutrition, the global donor community is challenged by the paucity of evidence on the nutritional impact of agricultural and food security interventions.

Private Sector

Food production and distribution is largely a private sector endeavour. It involves private sector players in various roles along the value chain including as input providers, food producers, traders, processors, transporters, wholesalers and retailers. We therefore welcome the report’s focus on the role of the private sector in ensuring positive nutrition outcomes. Given the important role played by the sector in this area, we suggest including the private sector as a key area of focus in subsection 4.2.3 Nutrition governance, institutions and partnerships. Beyond public-private partnerships, the private sector contributes to positive nutrition outcomes in various ways including by providing investment for improved postharvest and irrigation practices and improved food distribution facilities.

Overnutrition in the Pacific Region

We welcome the report’s focus on the causes of overnutrition and obesity in the Pacific region in section 2.2 Overweight and obesity and its causes and consequences. Section 3.1 Changing Diets – what do diets look like currently? analyses the differences in diet between key regions globally but does not consider the Pacific region. Given the challenges of obesity and overnutrition in the region, as outlined in section 2.2, we recommend that data for the Pacific region be included in 3.1.

Also of note is the mention of Australia on pages 20 and 87. Page 20 references the Australian Dietary Guidelines and accurately reflects the guidelines at a high level. On page 87, the Australian Health Star Rating (HSR) system is used as a case study.  We are pleased that Australia’s initiatives are being showcased in this publication.

In relation to the HSR reference on page 87, the authors may wish to note that updated figures are now available.  The data referenced is correctly sourced from the 2015 Parker and Frith report, however the 2016 Parker and Frith report is now available on the HSR website: http://www.healthstarrating.gov.au/internet/healthstarrating/publishing.nsf/Content/formative-research

Regards and many thanks

Tony

Tony Prescott

Policy Officer – FAO

Agricultural Cooperation, Capability and Standards

Trade and Market Access Division

Department of Agriculture and Water Resources

Ladies and Gentlemen:  Please find attached comments from the National Fisheries Institute regarding food systems and nutrition, as they apply to seafood.  We look forward to continuing to be part of this dialogue.

John Connelly

President

National Fisheries Institute  (USA)

McLean, Virginia

Swiss Comments to the HLPE Report and answers to the questions

In order to strengthen this draft, the HLPE would welcome submission of material, evidence-based suggestions, references, and examples, in particular addressing the following important questions:

1. The purpose of this report is to analyse the ways in which food systems influence dietary patterns and hence nutritional outcomes. The objective is to focus on consumers and consider sustainability issues. The report aims to be solution oriented and to highlight efficient policies and programs. Are those major objective(s) clearly reflected in the V0 draft?

There are many interesting views and graphics in this report. The reader can understand well the complexity of food systems and especially of how to make them more sustainable and improve nutrition globally.

We particularly appreciate that a focus is given to the links between nutrition and trade policy instruments, bearing in mind their significance in shaping food systems, and yet often not being articulated enough. We are of the view, that all instruments having a particularly negative impact on food systems of net food-importing developing countries should be addressed.

The consideration of nutrition and diets through the report lack the sustainability criteria, in its economic, environmental and social dimension. Yet these criteria are essential elements to apprehend the interconnections and linkages between humans, their health and environment. In order to make food systems more sustainable by policies and programs, it is crucial to include the social and economic dimension of sustainability, and consider the whole food chain, including the production level. Food production - and thus food security - relies on a natural resource bases that is becoming increasingly more fragile and scarce, and that is extremely vulnerable to climate change as well as biodiversity loss.

2. Do you think that the overall structure of the draft is comprehensive enough, and adequately considered and articulated? Does the draft strike the right balance of coverage across the various chapters? Are there important aspects that are missing? Does the report correctly focus on the links between nutrition and food systems without straying beyond that?

The following aspects are not stressed enough from our perspective:

• Education and Knowledge: Education and knowledge creation of the different actors along the whole value chain is not given appropriate attention, despite its importance to improve nutrition. Enhancing knowledge must encompass diverse aspects such as human rights, safety of workers, food safety, or retail to the final consumers as well as food literacy, cooking skills and the understanding of nutritive value throughout the food chain.
• Gender: The section on gender in the report is entirely about women. We consider it important to also reflect about the role of men for improving nutrition. This includes their role for women empowerment but also beyond.
• Humanitarian Aid/ Protracted crisis: An important dimension not yet covered by the report is challenges and opportunities for Nutrition and Food Systems in protracted crisis and in humanitarian food aid programs in general.
• Farmers and Food producers: Even though the focus can be on consumers, producers are key to any solutions leading to any sustainable and healthy nutrition and food systems.
• Investment: the effects of investments into agricultural production, infrastructure and trade on nutrition outcomes should be mentioned and developed further as they form an important part of a favorable or unfavorable food environment.
• Collaboration approach:  Multistakeholder initiatives are not yet mentioned, as well as the Sustainable Food Systems Programme of the 10YFP as one key Multistakeholder Programme for Food Security, Nutrition and sustainable food production and consumption.

3. Does the conceptual framework need to be edited? Simplified? Should “the food environment” as defined in the draft be central to the framework?

The causal links within the framework are not very clear (p. 14). It seems diets are only influenced by consumer behaviors which again are influenced by food environment. However, if someone has not access to nutritious food and therefore changes his/her diet this cannot be considered results of consumer behavior only, but the dietary choice is influenced by the food environment on his diet.

We think the conceptual framework could gain significantly in clarity if the “Food Environment” is central to the framework. This may help to show interdependencies and feedback loops in given food system more clearly, cross-sectoral, integrated and therefore comprehensively. And at the same time keep the framework clear and simple not to hamper understanding.  

4. Are production systems and their role in shaping diets and nutritional outcomes adequately addressed?

We appreciate the link made between agricultural production subsidies, divers primary production and nutrition (p.56) and would suggest to replace the term “agricultural production subsidies” with policy instruments to cover the full range of influencing measures.

However, we think that actors in the production system still don’t get enough focus, such as producers (in particular farmers), investors, and commodity traders. Farmers are at the heart of any sustainable and healthy diets and should be included in this report as producers but also as consumers. 

5. Does this draft cover adequately the main controversies in the field of Nutrition and food systems? Are there any remaining gaps?

A reflection on marketing/ advertisement of unhealthy food and beverages and the role of media should figure in the section of “economic drivers”, given the importance of these factors in influencing changing diets (p.50).

In the area of sustainable consumption, the importance of label and non label approaches should be explored. For example Multi-stakeholder sector initiatives like the Round Table on Responsible Soy, the Better Cotton Initiative or the Sustainable Trade Initiative can contribute to market transformation by setting new standards for entire sectors. However, other and non-label based approaches to enhance shared/equitable valorization and sustainability should be explored.

6. The project team is working on a categorization of food systems. Are you aware of specific approaches of use in that perspective, and particularly of quantitative indicators that could be used?

Typologies of Food Systems (p. 21 ff)

Appreciating the attempt to categorize Food Systems into typologies, the list of elements relevant to a food system as well as the list of indicators proposed seems not yet comprehensive or representative.

The table on p.22 may have to better reflect the aspects of a food system influencing consumer behavior and final diet composition, beyond what is currently described as food environment. The policies, programs and institutional actions influencing food environments and thus consumer behavior and diets are not satisfyingly incorporated in the current proposal of elements to be assessed. As this classification will serve to observe trends and changes, it seems crucial to capture this dimension well.  

A few concrete proposals on expanding the indicators are mentioned below:

• Element Production: As policy instruments are actively shaping agricultural production priorities, volumes as well as production methods, it is crucial to include an indicator assessing the public investment for making primary production more divers and nutritious. We therefore suggest developing an indicator which assesses which policy instruments are existing and putting them into relation to each other regarding financial volume (and possibly also their contribution to world trade): One could imagine the following categories of subsidy schemes relevant for nutrition
  • Policy instruments promoting the (over-) use of agricultural inputs (seeds, fertilizers)
  • Policy instruments dedicated to support beans, fruit and vegetables production
  • Policy instruments dedicated to promote staple crops (maize, rice, wheat)

• Element Processing/ Packaging: Fortification may be one cost effective approach to some nutrient deficiencies, keeping fully in mind that malnutrition cannot be mainly approached by filling single nutrient gaps. Furthermore, legislations aiming to avoid the production and presence of unhealthy food items on the market are equally crucial and information on it needs to be gathered.
  • Make the “Fortification legislation” Indicator more comprehensive and include salt iodination (besides wheat fortification)
  • Assess the existence of legislations which define the maximum content of ingredients classified as unhealthy when consumed in high quantities, such as trans-fat, sugar, sodium, etc.

Element Food access: Besides FIES, there may be an additional indicator which reflects more directly on the accessibility of healthy nutritious food items, like fruit and vegetables.  Include the following information in form of indicators:

• Number of servings of fruit and vegetables consumed per day
• Share of Fruit and Vegetable sales on food sales in general (in volume and financial)

• Element Information and guidelines: Food Based Dietary Guidelines (FBDG) are vital not only to shape consumer knowledge, awareness and habits, but also to inform policy measures.
  • Include an indicator on the existence/absence of nationally/regionally adapted FBDG (WHO)

• Element composition, quality and safety: The two proposals on assessing percent of calories coming from food groups (1. Fruit and vegetables, 2. Animal protein) are both addressing nutrient adequacy issues, but neglect the dimension of challenges leading towards overweight/obesity. We therefore advocate for identifying an additional suitable indicator which captures the unhealthy share of calories consumed.
  • Percent of calories coming from ultra-processed food, Food related to NCD’s (for definitions, see publications of Carlos Monteiro and/or Dario Mozzafarino)

7. Does this draft adequately show the multiplicity and complexity of diets and nutrition issues across different food systems and specific contexts with a good regional balance?

8. What areas of the document are in need of strengthening or shortening

As seen in the section on Typologies of Food Systems, having adequate indicators and data to measure changes in Food systems is vital and yet a big challenge. This report may stress further the need of better and more globally available data on indicator relevant to observe the sustainability of food Systems.

Develop further on the solution of strengthen direct food sales and marketing from producer to consumer to increase food security, nutrition, fair price and sustainability. The impact of well-designed nutritious school feeding programs may also be further elaborated in this view, highlighting on the impact as well as policies required and the potential on supply chains with smallholder farmers in the center.

The importance of responsible investment (in agriculture and food chains) should be strengthened in the report.

A lot of emphasize is placed on various definitions, which is important to understand the background but which leads to some redundancies that should be prevented.

9. Chapter 4, Section 4.1 contains case studies/examples of effective policies and actions in different contexts/countries across the food system for diets and nutrition. Could you offer other practical, well-documented and significant examples to enrich the report and provide better balance to the variety of cases and the lessons learned, including the trade-offs or win-win outcomes in terms of addressing the different dimensions of diets for FSN?

10. Section 4.2.2 on “Institutional Changes and Governance Across the Food System Movements for Nutrition” requires more work, and more inclusion of evidence and of the various players. Any inputs on this section are most welcome.

If this report really would like to be solution oriented and highlight efficient policies and programs it has then to include a specific chapter on Collaboration issues and Partnerships, and in particular multi-stakeholder initiatives, as these are essential to address the multiple challenges of food systems and Nutrition. Food systems are simply too big and complex to be tackled by any single stakeholder group in isolation. Moreover, SDG 17 specifically underlines their importance.

In the area of sustainable food systems, the Sustainable Food Systems Programme (SFSP) of the UN 10-Year Framework of Programmes on Sustainable Consumption and Production (10YFP) represent one of the main comprehensive Programme worldwide and should therefore be mentioned in the document. This Programme is a multi-stakeholder initiative to accelerate the shift towards more sustainable food systems, aiming to promote sustainability all along the entire food value chain, from farm to fork. The Sustainable Food Systems Programme has a network of already more than 100 members around the globe. They work together to develop and implement concrete projects on the ground in the areas of awareness raising, capacity development, facilitating access to knowledge and information, and strengthening partnerships. The Programme will for example disseminate knowledge on sustainable diets, and it will promote information for consumers enabling them to adopt more sustainable dietary habits promote information for consumers enabling them to adopt more sustainable dietary habits. A strength of the Programme is that it brings together existing initiatives and partnerships working in related areas, highlighting success stories and building synergies among stakeholders to leverage resources towards mutual objectives. For further information on the SFSP of the 10YFP: Website: http://www.scpclearinghouse.org/sustainable-food-system; Email : [email protected]

11. Is the report too technical or too simplistic? Are all the concepts clearly defined?

The report is definitely not too simplistic, rather too technical, if it aims at addressing new audiences not yet well familiar with the issues.

From a communication perspective, the report is way too long and therefore risks not to be read by the audience aspired. Attention shall be given to make it easy readable and avoid redundancies. An excellent summary will be vital to reach the urgently needed new public outside the nutrition community.

12. Are there any major omissions or gaps in the report? Are topics under-or over-represented in relation to their importance?

The report and its content shall be well linked into the Agenda 2030 and the agreed SDG’s.

The research chapter 4.2.4, shall stress more on the importance of Systems Level research, like studying the management of food systems, nutrition sensitive value chain approaches, impacts on nutrition outcome of more diverse production systems, impacts of public regulations, potential and impact of private initiatives to improve sustainable food systems and to secure adequate producer and consumer prices for fresh, healthy and nutritious food; produced, processed and consumed in a sustainable way.

Chapter 4.2.1 instead of focusing on technology, could broaden it perspective on a mere innovation perspective, which would include other kind of promising approaches accessible to smallholders too, such as improved varieties of local crops. In or after the chapter “movements for nutrition” there shall be a paragraph expressing the views and possible contributions of farmers and their organizations.

References are partially not very recent, especially taking into account that the report will only be launched in 2017. This can make the report already out of date when it is issued, what is not wanted.

One aspect that should be mentioned and developed is the importance of informal economy and market, including informal production and accessibility of food (outside the usual market) such as self-production and informal access to food, for example through exchanges of goods. The question of local self-produced nutritious food (food production for self-consumption) is not mentioned, while it represents a substantial part of agricultural production in Southern or Eastern countries, especially in cities, but also – increasingly –Northern countries, especially those in crisis. This kind of production is also increasingly linked to urbanization as it can now be found on roofs, along roads, in community garden, in parks and vacant land; directly in the land or in various containers. Such production is mainly composed of vegetables but can also include eggs, milk and meat.[1]

Further comments to the draft:

p. 18, line 23: there is a new publication by WHO EURO on this topic: WHO (2016). Tackling food marketing to children in a digital world: trans-disciplinary perspectives.

p. 30, line 19 and page 31, line 5: the numbers on obesity and overweight are not coherent with the introduction chapter (page 9, line 8) or within the chapter due to numbers from different sources. Please make sure that numbers are consistent.

p. 44, line 1-13: For readers not familiar with the concept of planetary boundaries it would be helpful to have a box, illustrating the nine planetary boundaries and the consequences of crossing these boundaries.

p. 46, line 11-19: This is a repetition to page 45, lines 28-34

p. 48, line 10-29: repetitions in line 12f and line 28f

p. 49, chapter 3.2.2: There is not much on research here.

p.50, line 7: In the context of what has been said before, the last sentence of this paragraph is biased, as built environments can also be developed in a way that can favor healthy dietary patterns.

p. 50, section on social networks and movements: this section deals with international policy and collaboration at international level. As it is rather related to politics, one could consider putting it under chapter 3.2.3. Political and economic drivers

p. 66, Figure 26: The graphic is very complex and not easily understandable. The numbers need further explanation for “non-statisticians”.