Framework

 The INFORMAS framework consists of 10 modules – click on a module below to learn more…

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The INFORMAS Framework

The INFORMAS framework includes two ‘process’ modules, that monitor the policies and actions of the public and private sectors, seven ‘impact’ modules that monitor the key characteristics of food environments and three ‘outcome’ modules that monitor dietary quality, risk factors and NCD morbidity and mortality.

Monitoring frameworks and indicators have been developed for 10 modules to provide consistency, but allowing for stepwise approaches (‘minimal’, ‘expanded’, ‘optimal’) to data collection and analysis. INFORMAS data will enable benchmarking of food environments between countries, and monitoring of progress over time within countries.

Through monitoring and benchmarking, INFORMAS will strengthen the accountability systems needed to help reduce the burden of obesity, NCDs and their related inequalities.

Diagram of the INFORMAS framework

INFORMAS Monitoring Framework

Public Sector Policies and Actions (Food EPI)

Overview: How much progress have governments made towards good practice in improving food environments and implementing obesity/NCDs prevention policies and actions?

Read more about the module here

Government action is essential to increase the healthiness of food environments and reduce obesity, diet-related non-communicable diseases (NCDs), and their related inequalities.

A Government Healthy Food Environment Policy Index (Food-EPI) has been developed for INFORMAS, which comprises a ‘policy’ component with seven domains on specific aspects of food environments, and an ‘infrastructure support’ component with six domains to strengthen systems to prevent obesity and NCDs.

Module leader is Dr Stefanie Vandevijvere

Senior Research Fellow
Department of Epidemiology and Biostatistics, School of Population Health, The University of Auckland

Relevant paper

Monitoring and benchmarking government policies and actions to improve the healthiness of food environments: a proposed Government Healthy Food Environment Policy Index (pages 24–37) B. Swinburn, S. Vandevijvere, V. Kraak, G. Sacks, W. Snowdon, C. Hawkes, S. Barquera, S. Friel, B. Kelly, S. Kumanyika, M. L’Abbé, A. Lee, T. Lobstein, J. Ma, J. Macmullan, S. Mohan, C. Monteiro, B. Neal, M. Rayner, D. Sanders, C. Walker and INFORMAS

Read the INFORMAS paper online here

 

Private Sector Policies and Actions (BIA Obesity)

Overview

How are private sector organisations affecting food environments and influencing obesity/NCDs prevention efforts?

Private-sector organizations play a critical role in shaping the food environments of individuals and populations. Business Impact Assessment for Obesity (BIA Obesity) is a step-wise approach to data collection is recommended for INFORMAS:

  • The first (‘minimal’) step is the collation of publicly available food and nutrition-related policies of selected private-sector organisations.
  • The second (‘expanded’) step assesses the nutritional composition of each organisation’s products, their promotions to children, their labelling practices, and the accessibility, availability and affordability of their products.
  • The third (‘optimal’) step includes data on other commercial activities that may influence food environments, such as political lobbying and corporate philanthropy.

Module leader is Dr Gary Sacks

Picture of Gary Sacks

Senior Research Fellow
Faculty of Health, Deakin Population Health SRC, Melbourne Burwood Campus,
Deakin University
Melbourne, Australia
Email: Dr Gary Sacks

Relevant paper

A proposed approach to monitor private-sector policies and practices related to food environments, obesity and non-communicable disease prevention (pages 38–48) G. Sacks, B. Swinburn, V. Kraak, S. Downs, C. Walker, S. Barquera, S. Friel, C. Hawkes, B. Kelly, S. Kumanyika, M. L’Abbé, A. Lee, T. Lobstein, J. Ma, J. Macmullan, S. Mohan, C. Monteiro, B. Neal, M. Rayner, D. Sanders, W. Snowdon, S. Vandevijvere and INFORMAS

Read the INFORMAS paper online here

Food Composition

Overview

What is the nutrient composition of foods and non-alcoholic beverages?

A food supply that delivers energy-dense products with high levels of salt, saturated fats and trans fats, in large portion sizes, is a major cause of non-communicable diseases (NCDs).

The INFORMAS monitoring approach seeks to systematically collect information on high-level contextual factors influencing food composition and assess the energy density, salt, saturated fat, trans fats and portion sizes of highly processed foods for sale in retail outlets (with a focus on supermarkets and quick-service restaurants).

Regular surveys of food composition are proposed across geographies and over time using a pragmatic, standardised methodology.

Module leader is Professor Bruce Neal

Picture of Bruce Neal

Senior Director, Food Policy Division
Chair of the Australian Division of World Action on Salt and Health
The George Institute for Global Health 
Camperdown, NSW
Australia
Email: Professor Bruce Neal

Relevant paper

Monitoring the levels of important nutrients in the food supply (pages 49–58) B. Neal, G. Sacks, B. Swinburn, S. Vandevijvere, E. Dunford, W. Snowdon, J. Webster, S. Barquera, S. Friel, C. Hawkes, B. Kelly, S. Kumanyika, M. L’Abbé, A. Lee, T. Lobstein, J. Ma, J. Macmullan, S. Mohan, C. Monteiro, M. Rayner, D. Sanders, C. Walker and INFORMAS

Read the INFORMAS paper online here

Food Labelling

Overview

What health-related labelling is present for foods and non-alcoholic beverages?

Food labelling on food packaging has the potential to have both positive and negative effects on diets. Monitoring different aspects of food labelling would help to identify priority policy options to help people make healthier food choices.

A taxonomy of the elements of health-related food labelling has been proposed for INFORMAS. A step-wise approach has been developed for independently assessing the nature and extent of health-related food labelling in different countries and over time.

Module leader is Dr Mike Rayner

Picture of Mike Rayner

Director, British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention
Nuffield Department of Population Health
University of Oxford, UK
Email: Dr Mike Rayner

Relevant paper

Monitoring the health-related labelling of foods and non-alcoholic beverages in retail settings (pages 70–81) M. Rayner, A. Wood, M. Lawrence, C. N. Mhurchu, J. Albert, S. Barquera, S. Friel, C. Hawkes, B. Kelly, S. Kumanyika, M. L’Abbé, A. Lee, T. Lobstein, J. Ma, J. Macmullan, S. Mohan, C. Monteiro, B. Neal, G. Sacks, D. Sanders, W. Snowdon, B. Swinburn, S. Vandevijvere, C. Walker and INFORMAS

Read the INFORMAS paper online here

Food Promotion

Overview: What is the exposure and power of promotion of unhealthy foods and non-alcoholic beverages to different population groups?

Food and non-alcoholic beverage marketing is recognised as an important factor influencing food choices related to non-communicable diseases.

A step-wise approach, comprising ‘minimal’, ‘expanded’ and ‘optimal’ monitoring activities, has been designed for INFORMAS. This approach can be used to assess the frequency and level of exposure of population groups (especially children) to food promotions, the persuasive power of techniques used in promotional communications (power of promotions) and the nutritional composition of promoted food products.

The proposed framework supports the development of a consistent system for monitoring food and non-alcoholic beverage promotions for comparison between countries and over time.

Module leader is Dr Bridget Kelly

Picture of Bridget Kelly

Senior Lecturer in Public Health
University of Wollongong
Wollongong, Australia
Email: Dr Bridget Kelly

Relevant paper

Monitoring food and non-alcoholic beverage promotions to children (pages 59–69) B. Kelly, L. King, L. Baur, M. Rayner, T. Lobstein, C. Monteiro, J. Macmullan, S. Mohan, S. Barquera, S. Friel, C. Hawkes, S. Kumanyika, M. L’Abbé, A. Lee, J. Ma, B. Neal, G. Sacks, D. Sanders, W. Snowdon, B. Swinburn, S. Vandevijvere, C. Walker and INFORMAS

Read the INFORMAS paper online here

Food Provision

Overview: What is the nutritional quality of foods and non-alcoholic beverages provided in different settings (e.g. schools, hospitals, workplaces)?

The focus is on foods in schools, but the framework can also be applied to foods provided or sold in other publicly funded institutions.

Data collection and evaluation within this INFORMAS monitoring framework will consist of two components:

  • In component I, information on existing food or nutrition policies and/or programmes within settings would be compiled.
  • In component II, the quality of foods provided or sold in public sector settings is evaluated relative to existing national or sub-national nutrition standards or voluntary guidelines.

Module leader is Professor Mary L’Abbe

Picture of Mary L'Abbe

Earle W. McHenry Professor, and Chair, Department of Nutritional Sciences
Faculty of Medicine, University of Toronto
Toronto, Canada
Email: Professor Mary L’Abbe

Relevant paper

Monitoring foods and beverages provided and sold in public sector settings (pages 96–107) M. L’Abbé, A. Schermel, L. Minaker, B. Kelly, A. Lee, S. Vandevijvere, P. Twohig, S. Barquera, S. Friel, C. Hawkes, S. Kumanyika, T. Lobstein, J. Ma, J. Macmullan, S. Mohan, C. Monteiro, B. Neal, M. Rayner, G. Sacks, D. Sanders, W. Snowdon, B. Swinburn, C. Walker and INFORMAS

Read the INFORMAS paper online here

Food Retail

Overview: What is the availability of healthy and unhealthy foods and non-alcoholic beverages in communities and within retail outlets?

Retail food environments are increasingly considered influential in determining dietary behaviours and health outcomes.

INFORMAS propose a step-wise framework to monitor and benchmark community and consumer retail food environments that can be used to assess:

  • Density of healthy and unhealthy food outlets
  • Measure proximity of healthy and unhealthy food outlets to homes/schools
  • Evaluate availability of healthy and unhealthy foods in-store
  • Compare food environments over time and between regions and countries
  • Evaluate compliance with local policies, guidelines or voluntary codes of practice
  • And determine the impact of changes to retail food environments on health outcomes, such as obesity.

Module leader is Professor Cliona Ni Mhurchu

Picture of Cliona Ni Mhurchu

Programme Leader
Nutrition Research at the National Institute for Health Innovation
The University of Auckland
Email: Professor Cliona Ni Mhurchu

Relevant paper

Monitoring the availability of healthy and unhealthy foods and non-alcoholic beverages in community and consumer retail food environments globally (pages 108–119) C. Ni Mhurchu, S. Vandevijvere, W. Waterlander, L. E. Thornton, B. Kelly, A. J. Cameron, W. Snowdon, B. Swinburn and INFORMAS

Read the INFORMAS paper online here

Food Prices

Overview: What is the relative price and affordability of ‘less healthy’ vs ‘healthy’ foods, meals and diets?

Food prices and food affordability are important determinants of food choices, obesity and non-communicable diseases. The monitoring of the price and affordability of ‘healthy’ and ‘less healthy’ foods and diets globally will provide robust data and benchmarks to inform economic and fiscal policy responses.

A step-wise monitoring framework, including measurement indicators, has been proposed for INFORMAS:

  • ‘Minimal’ data collection will assess the differential price of ‘healthy’ and ‘less healthy’ foods
  • ‘Expanded’ monitoring will assess the differential price of ‘healthy’ and ‘less healthy’ diets
  • And the ‘optimal’ approach will also monitor food affordability, by taking into account household income

Module leader is Professor Amanda Lee

Picture of Amanda Lee

School of Public Health and Social Work and School of Exercise and Nutrition Sciences
Faculty of Health, Queensland University of Technology
Queensland, Australia
Email: Professor Amanda Lee

Relevant paper

Monitoring the price and affordability of foods and diets globally (pages 82–95) A. Lee, C. N. Mhurchu, G. Sacks, B. Swinburn, W. Snowdon, S. Vandevijvere, C. Hawkes, M. L’Abbé, M. Rayner, D. Sanders, S. Barquera, S. Friel, B. Kelly, S. Kumanyika, T. Lobstein, J. Ma, J. Macmullan, S. Mohan, C. Monteiro, B. Neal, C. Walker and INFORMAS

Read the INFORMAS paper online here

Food Trade and Investment

Overview

What are the impacts of trade and investment agreements on the healthiness of food environments?

The liberalisation of international trade and foreign direct investment through multilateral, regional and bilateral agreements has had profound implications for the structure and nature of food systems, and therefore, for the availability, nutritional quality, accessibility, price and promotion of foods in different locations.

The proposed INFORMAS monitoring approach encompasses a set of guiding principles, recommended procedures for data collection and analysis, and quantifiable ‘minimal’, ‘expanded’ and ‘optimal’ measurement indicators to be tailored to national priorities, capacity and resources.

Module leader is Professor Sharon Friel

Picture of Sharon Friel

Professor of Health Equity & ARC Future Fellow, ANU College of Medicine, Biology and Environment|
The Australian National University
Canberra, Australia
Email: Professor Sharon Friel

Relevant paper

Monitoring the impacts of trade agreements on food environments (pages 120–134) S. Friel, L. Hattersley, W. Snowdon, A.-M. Thow, T. Lobstein, D. Sanders, S. Barquera, S. Mohan, C. Hawkes, B. Kelly, S. Kumanyika, M. L’Abbe, A. Lee, J. Ma, J. Macmullan, C. Monteiro, B. Neal, M. Rayner, G. Sacks, B. Swinburn, S. Vandevijvere, C. Walker and INFORMAS

Read the INFORMAS paper online here

Population Diet

Overview: What is the quality of the diet of different populations?

In order to assess the impact of food environments on population diets, it is necessary to monitor population diet quality between countries and over time.

A step-wise INFORMAS framework is proposed for monitoring population diet quality:

  • In the proposed ‘minimal’ approach, national trends of food and energy availability can be explored using FBaS.
  • In the ‘expanded’ and ‘optimal’ approaches, the dietary share of ultra-processed products is measured as an indicator of energy-dense, nutrient-poor diets using HBES and food intake surveys, respectively.

Module leader is Professor Carlos A. Monteiro

Picture of Carlos Monteiro

Department of Nutrition, School of Public Health
University of Sao Paulo
Sao Paulo, Brazil
Email: carlosam@usp.br

Relevant paper

Monitoring and benchmarking population diet quality globally: a step-wise approach (pages 135–149) S. Vandevijvere, C. Monteiro, S. M. Krebs-Smith, A. Lee, B. Swinburn, B. Kelly, B. Neal, W. Snowdon, G. Sacks and INFORMAS

The INFORMAS paper is available online at: http://onlinelibrary.wiley.com/doi/10.1111/obr.12082/abstract

Communication

The communication element of the INFORMAS project sets out to bring the results to the attention of the relevant stakeholders concerned with the quality of food environments, including governments and their agencies, intergovernmental bodies, commercial and trade organisations, health professionals and public health and consumer advocacy organisations.

It is intended that all the base results will be reported and made freely available, subject to confidentiality, copyright and data protection constraints. In this way, it is hoped that INFORMAS outputs can be made an open resource for broad dissemination and widespread use.

Module leader

Dr Tim Lobstein

Dr Tim Lobstein

Director of Policy
World Obesity Federation, formerly,
IASO – The International Association for the Study of Obesity
IOTF – The International Obesity TaskForce
Web: www.worldobesity.org
Email: tlobstein@worldobesity.org

Relevant papers

1. INFORMAS and advocacy for public health nutrition and obesity prevention (pages 150–156) T. Lobstein, H. Brinsden, J. Landon, V. Kraak, A. Musicus and J. Macmullan – available online

2. Monitoring policy and actions on food environments: rationale and outline of the INFORMAS policy engagement and communication strategies (pages 13–23) H. Brinsden, T. Lobstein, J. Landon, V. Kraak, G. Sacks, S. Kumanyika, B. Swinburn, S. Barquera, S. Friel, C. Hawkes, B. Kelly, M. L’Abbé, A. Lee, J. Ma, J. Macmullen, S. Mohan, C. Monteiro, B. Neal, M. Rayner, D. Sanders, W. Snowdon, S. Vandevijvere, C. Walker and INFORMAS – available online

Module Leaders

A list of INFORMAS module leaders can be viewed here.

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