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.

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.

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.

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

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.

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

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

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.

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.