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Objective: To determine key points of intervention in urban food systems to improve the climate resilience, equity and healthfulness of the whole system., Design: The paper brings together evidence from a 3-year, Australia-based mixed-methods research project focused on climate change adaptation, cities, food systems and health. In an integrated analysis of the three research domains - encompassing the production, distribution and consumption sectors of the food chain - the paper examines the efficacy of various food subsystems (industrial, alternative commercial and civic) in achieving climate resilience and good nutrition., Setting: Greater Western Sydney, Australia., Subjects: Primary producers, retailers and consumers in Western Sydney., Results: This overarching analysis of the tripartite study found that: (i) industrial food production systems can be more environmentally sustainable than alternative systems, indicating the importance of multiple food subsystems for food security; (ii) a variety of food distributors stocking healthy and sustainable items is required to ensure that these items are accessible, affordable and available to all; and (iii) it is not enough that healthy and sustainable foods are produced or sold, consumers must also want to consume them. In summary, a resilient urban food system requires that healthy and sustainable food items are produced, that consumers can attain them and that they actually wish to purchase them., Conclusions: This capstone paper found that the interconnected nature of the different sectors in the food system means that to improve environmental sustainability, equity and population health outcomes, action should focus on the system as a whole and not just on any one sector.

Objective: To develop a policy formulation tool for strategically informing food and nutrition policy activities to promote healthy and sustainable diets (HSD)., Design: A policy formulation tool consisting of two complementary components was developed. First, a conceptual framework of the environment-public health nutrition relationship was constructed to characterise and conceptualise the food system problem. Second, an 'Orders of Food Systems Change' schema drawing on systems dynamics thinking was developed to identify, assess and propose policy options to redesign food systems., Setting: Food and nutrition policy activities to promote HSD have been politicised, fragmented and lacking a coherent conceptual and strategic focus to tackle complex food system challenges., Results: The tool's conceptual framework component comprises three integrated dimensions: (i) a structure built around the environment and public health nutrition relationship that is mediated via the food system; (ii) internal mechanisms that operate through system dynamics; and (iii) external interactions that frame its nature and a scope within ecological parameters. The accompanying schema is structured around three orders of change distinguished by contrasting ideological perspectives on the type and extent of change needed to 'solve' the HSD problem., Conclusions: The conceptual framework's systems analysis of the environment-public health nutrition relationship sets out the food system challenges for HSD. The schema helps account for political realities in policy making and is a key link to operationalise the framework's concepts to actions aimed at redesigning food systems. In combination they provide a policy formulation tool to strategically inform policy activities to redesign food systems and promote HSD.

There is increasing attention to the importance of healthy and environmentally sustainable food supply and demand but little empirical research exists on how this might be achieved. This study examines the potential for inter-sectoral policy and action to support consumer adoption of healthy and sustainable food behaviours, focusing on three key themes: (1) sectoral understandings of healthy and sustainable food behaviours; (2) modes of governance for inter-sectoral action on healthy and sustainable behaviours; and (3) barriers and enablers to inter-sectoral action. We undertook 29 semi-structured interviews with representatives of key government, food industry and non-government organisations in food-related health and environment sectors in Australia. We found that while definitions of health and sustainability are still diverse and often siloed, the rationale of a combined concept was generally acknowledged. There was also consensus on the need for any action to be inter-sectoral, but diverse views on what such action should entail. The main barriers to inter-sectoral action identified included relationships between food system actors and a lack of organisational attention to the issue. Enablers included political and institutional leadership to drive action as well as sector-specific enablers such as market incentives. Overall a range of governance modes were identified that would potentially create a suite of actions across sectors, as well as opportunities to facilitate their implementation. Drawn together our findings outline a framework for action to move beyond the prevailing focus on individual-level change and develop inter-sectoral action and collaboration to support adoption of healthy and sustainable food behaviours. [ABSTRACT FROM AUTHOR]