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Limited progress in nutrition policy action is often blamed on the close relationships the food industry has with health policy decision-makers. This analysis sought to examine this belief through the analysis of health ministers' diaries. Entries were downloaded from health ministers' diaries from two states in Australia from January 2013 to June 2018. Entries were coded according to which interest group met with the minister or whether general parliamentary business was undertaken. Coding was also undertaken for any meeting topics related to nutrition policy. Analysis of health ministers' diaries found that the food industry has limited documented interaction with the two state health ministers in Australia. Instead, medical associations, private hospitals and health services, and sporting associations (rugby league associations) had the most interactions with health ministers. Poor representation was seen on nutrition issues, and there was an apparent lack of nutrition advocates interacting with the health ministers. There are opportunities for nutrition advocates to increase their level of interaction with state health ministers. This could include building alliances with medical associations, as they are in a powerful position, to advocate directly to health ministers. Health ministers' diaries can provide valuable insights into who is meeting officially with ministers. However, there are also limitations with the dataset.

Background: Poor diet is the leading preventable risk factor contributing to the burden of disease in Australia. A range of cost-effective, comprehensive population-focussed strategies are available to address these dietary-related diseases. However, despite evidence of their effectiveness, minimal federal resources are directed to this area. To better understand the limited public health nutrition policy action in Australia, we sought to identify the key policy brokers in the Australian nutrition policy network and consider their level of influence over nutrition policymaking., Methods: A social network analysis involving four rounds of data collection was undertaken using a modified reputational snowball method to identify the nutrition policy network of individuals in direct contact with each other. Centrality measures, in particular betweenness centrality, and a visualisation of the network were used to identify key policy brokers., Results: Three hundred and ninety (390) individual actors with 1917 direct ties were identified within the Australian nutrition policy network. The network revealed two key brokers; a Nutrition Academic and a General Health professional from a non-government organisation (NGO), with the latter being in the greatest strategic position for influencing policymakers., Conclusion: The results of this social network analysis illustrate there are two dominant brokers within the nutrition policy network in Australia. However their structural position in the network means their brokerage roles have different purposes and different levels of influence on policymaking. The results suggest that brokerage in isolation may not adequately represent influence in nutrition policy in Australia. Other factors, such as direct access to decision-makers and the saliency of the solution, must also be considered.

Policy PointsOur research reveals the similarities and differences among the lobbying activities of tobacco, alcohol, gambling, and ultraprocessed food industries, which are often a barrier to the implementation of public health policies.Over 23 years, we found that just six organizations dominated lobbying expenses in the tobacco and alcohol sectors, whereas the gambling sector outsourced most of their lobbying to professional firms.Databases like OpenSecrets are a useful resource to monitor the commercial determinants of health. Context: Commercial lobbying is often a barrier to the development and implementation of public health policies. Yet, little is known about the similarities and differences in the lobbying practices of different industry sectors or types of commercial actors. This study compares the lobbying practices of four industry sectors that have been the focus of much public health research and advocacy: tobacco, alcohol, gambling, and ultraprocessed foods. Methods: Data on lobbying expenditures and lobbyist backgrounds were sourced from the OpenSecrets database, which monitors lobbying in the United States. Lobbying expenditure data were analyzed for the 1998–2020 period. We classified commercial actors as companies or trade associations. We used Power BI software to link, analyze, and visualize data sets. Findings: We found that the ultraprocessed food industry spent the most on lobbying ($1.15 billion), followed by gambling ($817 million), tobacco ($755 million), and alcohol ($541 million). Overall, companies were more active than trade associations, with associations being least active in the tobacco industry. Spending was often highly concentrated, with two organizations accounting for almost 60% of tobacco spending and four organizations accounting for more than half of alcohol spending. Lobbyists that had formerly worked in government were mainly employed by third‐party lobby firms. Conclusions: Our study shows how comparing the lobbying practices of different industry sectors offers a deeper appreciation of the diversity and similarities of commercial actors. Understanding these patterns can help public health actors to develop effective counterstrategies. [ABSTRACT FROM AUTHOR]

Sugar-sweetened beverage (SSB) taxes are present in many countries with evidence that they are effective in decreasing purchases of SSBs. However, in Australia where SSB consumption per capita is high, and calls for an SSB tax are frequent, there is no SSB tax and policymakers have stated their lack of support for such a tax. We examined whether political party voting preference and sociodemographic factors affect individuals' support for an SSB tax, and whether message framing affects this support. A nationally representative sample of 1519 Australian adults was recruited for an online experimental survey. Three persuasive frames and one control frame were randomly provided to participants and measures of agreement towards an SSB tax were assessed. Sociodemographic factors and political party preference were also captured. Message framing had minimal effect on the level of support for the tax. However, participants who received the 'supportive of food and drink companies frame' showed the highest positive feelings towards the tax, and participants in rural areas had higher levels of support for an SSB tax when receiving the 'protecting teenagers' frame. Participants who voted for conservative (right-leaning) parties and for Labour (a centre-left party) had similar levels of support towards the tax, which was considerably lower than Greens voters. Undecided voters had the lowest levels of support for the tax, and the frames had limited impact on them. These findings highlight the potential role of message framing in shaping public support for an SSB tax in Australia, particularly in the context of voting preference and sociodemographic factors. [ABSTRACT FROM AUTHOR]

The article discusses the lack of political transparency in Australia and the potential influence of commercial actors on public health policy decisions. Lobbying is identified as an important strategy used by both health advocates and business sector actors to influence policy making. However, the extent of public health lobbying is overshadowed by the business sector, leading to stalled or weakened public health policies. The article highlights the need for improved transparency in lobbying and other political practices to hold governments accountable and ensure that public health voices are not drowned out. The limitations of current data sources on commercial political activities in Australia are also discussed. The article concludes by emphasizing the importance of making information about commercial political activities more accessible and transparent to challenge undue influence and promote government accountability. [Extracted from the article]

Marketing responses to sugar-sweetened beverage (SSB) taxes are understudied in the literature. Previous research has been limited to examining price and advertising, in particular promotions responses. Forde et al advocate for a focus on exploring a range of marketing responses to a SSB tax, with an emphasis on the marketing mix (price, promotion, product, and place). Their qualitative findings from the United Kingdom focus mostly on possible product and price decisions, with limited discussion of place and promotions decisions. We argue that the proposed marketing mix decisions may be used to avoid or side-step a SSB tax and that their likelihood of adoption may be dependent upon additional factors besides brand strength, reputation, and portfolio size highlighted by Forde and colleagues, such as organizational capabilities, industry competition, and brand positioning. We recommend future research examine the importance of consumer behaviour in developing marketing programs and in response to the marketing mix levers pulled by industry. [ABSTRACT FROM AUTHOR]

Background: Enacting evidence-based public health policy can be challenging. One factor contributing to this challenge is a lack of public support for specific policies, which may stem from limited interest or conviction by policy arguments. This can happen when messaging strategies regarding policy do not resonate with the target group and/or policy narratives compete in public discourse. To understand how policy messaging can better resonate with a target audience, we examined the frames and narratives used by the Australian public when discussing nutrition policies.Methods: We conducted 76 street intercept interviews in urban and regional settings in Queensland, Australia. Quantitative data were analysed using mean agreement scores and t-tests, and the qualitative data were analysed using an adapted qualitative narrative policy framework (QNPF). The QNPF is used to illustrate how competing narratives vary in the way they define different elements. These elements often include setting, characters, plot, policy solution and belief systems.Results: Level of support for all nutrition policies was generally moderate to high, although nutrition policies perceived to be most intrusive to personal freedoms were the least popular among the public. The value of fairness was consistently invoked when participants discussed their support for or opposition to policy. Using the QNPF, two distinct settings were evident in the narratives: concern for the community or concern for self. Villains were identified as either "other individuals, in particular parents" or "Big Food". Victims were identified as "children" or "the food industry, in particular farmers". Frequently used plots focused on individuals making poor choices because they were uneducated, versus Big Food being powerful and controlling people and the government.Conclusions: The study examined the frames and narratives used by the Australian public when discussing nutrition policies. By examining these frames and narratives, we gained insight into multiple strategies which may increase public support for certain nutrition policies in Australia. [ABSTRACT FROM AUTHOR]

The issue of public health and policy communities engaging with food sector companies has long caused tension and debate. Ralston and colleagues' article 'Towards Preventing and Managing Conflict of Interest in Nutrition Policy? An Analysis of Submissions to a Consultation on a Draft WHO Tool' further examines this issue. They found widespread food industry opposition, not just to the details of the World Health Organization (WHO) tool, but to the very idea of it. In this commentary we reflect on this finding and the arguments for and against interacting with the food industry during different stages of the policy process. While involving the food industry in certain aspects of the policy process without favouring their business goals may seem like an intractable problem, we believe there are opportunities for progress that do not compromise our values as public health professionals. We suggest three key steps to making progress. [ABSTRACT FROM AUTHOR]

Summary: Effective government policies are crucial to creating healthy food environments. However, changing public policy is a slow and challenging process involving many competing factors. One cited factor is public opinion towards a proposed policy. This study aimed to systematically explore public opinion on regulatory nutrition policy issues in Australia from 2009 to 2019, to determine whether low levels of public opinion corresponded with the low levels of regulatory policy action in this country. We found that there was varying levels of public support in Australia for public health nutrition action. Regulatory‐ and legislative‐based policies generally had moderate to high levels of support except for food and drink taxes, which had low to moderate support. Despite high levels of public support for certain policy initiatives, national public health nutrition policy in Australia has not evolved consistently with the level of public support nor the evidence base over the past decade indicating other more important factors at play in policymaking. [ABSTRACT FROM AUTHOR]

Objective: Junk-food marketing contributes significantly to childhood obesity, which in turn imposes major health and economic burdens. Despite this, political priority for addressing junk-food marketing has been weak in many countries. Competing interests, worldviews and beliefs of stakeholders involved with the issue contribute to this political inertia. An integral group of actors for driving policy change are parliamentarians, who champion policy and enact legislation. However, how parliamentarians interpret and portray (i.e. frame) the causes and solutions of public health nutrition problems is poorly understood. The present study aimed to understand how Australian parliamentarians from different political parties frame the problem of junk-food marketing.Design: Framing analysis of transcripts from the Australian Government's Parliamentary Hansard, involving development of a theoretical framework, data collection, coding transcripts and thematic synthesis of results.Settings: Australia.Participants: None.Results: Parliamentarian framing generally reflected political party ideology. Liberal parliamentarians called for minimal government regulation and greater personal responsibility, reflecting the party's core values of liberalism and neoliberalism. Greens parliamentarians framed the issue as systemic, highlighting the need for government intervention and reflecting the core party value of social justice. Labor parliamentarians used both frames at varying times.Conclusions: Parliamentarians' framing was generally consistent with their party ideology, though subject to changes over time. This project provides insights into the role of framing and ideology in shaping public health policy responses and may inform communication strategies for nutrition advocates. Advocates might consider using frames that resonate with the ideologies of different political parties and adapting these over time. [ABSTRACT FROM AUTHOR]