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The European Policy Evaluation Network (PEN), initiated in autumn 2018, aimed at advancing the evidence base for public policies impacting dietary behaviour, physical activity and sedentary behaviours in Europe. This is needed because non-communicable diseases—the leading cause of global mortality—are substantially caused by physical inactivity and unhealthy dietary behaviours, which in turn are driven by upstream factors that have not yet been addressed effectively by prevention approaches. Thus, successful policy interventions are required that target entire populations and tackle the ‘causes of the causes’. To advance our knowledge on the effective implementation of policies and their impact in terms of improving health behaviours, PEN focused on five research tasks: (i) Adaptation and implementation of a Food Environment Policy Index (Food-EPI) and development of a Physical Activity Environment Policy Index (PA-EPI); (ii) Mapping of health-related indicators needed for policy evaluation and facilitating a harmonized pan-European approach for surveillance to assess the impact of policy interventions; (iii) Refining quantitative methods to evaluate the impact of public policies; (iv) Identifying key barriers and facilitators of implementation of policies; and (v) Advance understanding the equity impact of the development, implementation and evaluation of policies aimed at promoting physical activity and a healthy diet. Finally, and in order to provide concrete evidence for policymaking, existing exemplary policies, namely sugar-sweetened beverages taxation, active transport policies and school policies on nutrition and physical activity were assessed in consideration of these five tasks. At the end of the PEN project’s formal runtime, considerable advancements have been made. Here, we present an overview of the most important learnings and outputs.

Additional file 3. Full text screening guide. Detailed guidance with exclusion and inclusion criteria used in the full text screening stage.

Additional file 6. AMSTAR 2 assessment. Table showing the quality assessment per AMSTAR item.

Additional file 2. Medline search strategy. Search string as performed in Medline.

Additional file 4. Example data extraction form. Table showing the different items that were extracted for the umbrella review.

Additional file 9. List of primary studies reported in reviews. A list showing all primary studies that form the evidence base of the included systematic reviews included in the umbrella review, also showing what primary studies have been reported in more than one review.

Additional file 1. PRISMA Checklist. Table explaining where PRISMA items are reported in the manuscript, if applicable.

Additional file 5. Revised AMSTAR 2. Table showing all AMSTAR items and how certain items were revised before quality appraisal.

Additional file 7. List of excluded articles. A list of the articles that were excluded at full text screening, with five different exclusion reasons.

The perspective of sustainable healthy diet that guides this paper builds on the holistic view of diet, health and wellbeing and involves “dietary patterns that have low environmental pressure and impact; are accessible, affordable, safe and equitable; and are culturally acceptable (FAO-WHO, 2019)”. Sustainable consumption, which is also a concept opening towards a wider dialogue, combines social, cultural, environmental and economic aspects.In this paper we propose a closer look at “all dimensions” of individuals' health and wellbeing and sustainable consumption, including GIs, through the prism of everyday eating. Based on results from a qualitative consumer study done in the Strength2Food project (EU project from the H2020 program aiming at Strengthening European Food Chain Sustainability by Quality and Procurement Policy), we will present thoughts around GIs, health and sustainability. We and our colleagues* from seven countries did fieldwork among 40 families across these countries to get a better understanding of GIs as part of everyday food practices. In contrast to consumer research on attitudes and perceptions the main material in this paper comes from ethnographic fieldwork and thus focuses on food practices and words in the context of everyday consumption – focusing on at least four complementary phases : planning, purchasing, using (including cooking, eating as well as cleaning) and at last disposal. One of the main findings of this study was that consumers knew very little about GIs and they seldom associated them to sustainability and health.The lack of knowledge and interest for GIs linked to health among the consumers inspired us to take a here closer look at GIs and traditional food in everyday food practices through a theoretical approach called “a cultural adaptation work” (Hegnes 2013).Eventually we will consider how to promote GIs and health and reflect upon possible contribution of GI products (traditional products in general) to healthy diets.

Additional file 8. Study characteristics. Table describing study characteristics and key findings of included systematic reviews.

This report is part of the HERANET funded project FOOD2GATHER. The project aims at understanding the question of integration/exclusion of migrants through foodscapes. An important step in this direction is to analyse the contextual framework within which food-related practices, norms and values are embedded in European societies. Food controversies that have raised and have been reported in the media since the “2015 migrants’ crisis” across Europe can reveal important aspects related to such norms and values and indicate possible tensions and compromises. This report presents and discusses relevant food controversies that occurred in the six countries participating in the study (Belgium, France, Germany, Italy, Norway, and the Netherlands). This will generate a contextual overview of the integration/exclusion of migrants through foodscapes. Controversy has been used as a tool and a scanner. Each of the six FOOD2GATHER teams provided two relevant controversies that have reached media attention in the last ten years. One of the two had to be related to halal food. The analysis of the controversies has been conducted by identifying issues they tackled, agents they involved, (public) spaces and situations in which controversies took place and what they produced. A comparative analysis of relevant variables related to migrations, such as the geopolitical position of the countries, organization of reception and food provision, has been conducted as well. The six countries included in the study have different traditions related to migration and have been exposed to the “migrants’ crisis” in different ways. These differences are reflected in the proposed controversies. However, some common traits tend to emerge and reveal power relationships within societies that are different or shared by the countries involved in the project. We show that these power relationships particularly deal with the right to food, citizens’ commitment, identity, the place of religion, animal welfare and political issues. Our study indicates that analysing controversies adds an important dimension to the study of foodscapes. Food controversies that reach the media attention are seldom something migrants have brought up themselves. The migrants’ representation in the media based on food controversies indicated that migrants are given little opportunity to negotiating values and practices, as norms about “the right” quantity and quality of food tend to reproduce the food model of the country they migrate to, also when there is a “positive” focus on ethnic business. To better understand these dynamics, we propose the concept of “food encounters” and illustrate how the type of food encounters can play a role in how foodscapes could evolve or even emerge.

Additional file 1.

Denne rapporten, som i hovedsak er basert på en spørreundersøkelse om barn, klær, mat og kropp blant foreldre med barn i alderen 1-16 år, beskriver barn og unges forbruk av klær og mat og hvordan de forholder seg til kropp, helse og miljø. Undersøkelsen viser at mange foreldre gir klær til gjenbruk, men en mindre andel sier at deres barn bruker brukte klær. Spesielt klær blant de yngste barna går i arv. Det er vanlig å reparere barneklær selv, men uvanlig å betale andre for det. De færreste foreldre svarer at barna går med halvskitne klær, men helse og miljø fremstår ikke som spesielt viktige for foreldre når det gjelder klesvask. Det er delte meninger om og erfaringer omkring spørsmål om klær, klesnormer, kjønn, kjøpepress og religion. Hovedansvar for barns klær har mødrene eller ansvaret deles likt mellom foreldrene. Barn og unges meninger om klærs betydning for inkludering og erting er delte, det samme gjelder skoleuniform som mulig løsning. De er mer positive til dette tiltaket enn foreldrene. Resultatene viser at det mangler kunnskap om hvordan vi kan kle barn slik at de får en sunn, trygg og god barndom og hvem som har ansvar for at det skjer. De fleste barn og unge rapporterer et mat- og spisemønster som er i tråd med ernæringspolitiske målsettinger. Tilgjengeligheten hjemme av sunne matvarer er høy i barnefamilier og tilgjengeligheten av usunne matvarer er lavere, men en av ti sier at de alltid har usunne matvare hjemme. Tre av fire foreldre sier at deres yngste barn spiser matpakke hver dag på skolen, og mange er enige i at matpakka bør erstattes med et skolemåltid. Behovet for å erstatte matpakka med et skolemåltid er størst blant forelde i de laveste inntekts- og utdannelsesgruppene, og for forelder som oppgir at barna deres ikke spiser matpakke daglig på skolen. Foreldre synes at det i stor grad er den enkeltes ansvar å spise sunt, men at også myndighetene har ansvar. Mange foreldre er enige i at myndigheter bør benytte seg av prisvirkemidler og at markedsføring og reklame av usunn mat til barn bør forbys. Barn og unge uttrykker både tilfredshet og misnøye med egen kropp og utseende. Ungdommer, jenter oftere enn gutter, gjennomfører en rekke skjønnhets- og kroppspraksiser regelmessig. Det er vanlig blant unge å unngå mat som allment anses som usunn.

Background Some ethnic minority populations have a higher risk of non-communicable diseases than the majority European population. Diet and physical activity behaviours contribute to this risk, shaped by a system of inter-related factors. This study mapped a systems-based framework of the factors influencing dietary and physical activity behaviours in ethnic minority populations living in Europe, to inform research prioritisation and intervention development. Methods A concept mapping approach guided by systems thinking was used: i. Preparation (protocol and terminology); ii. Generating a list of factors influencing dietary and physical activity behaviours in ethnic minority populations living in Europe from evidence (systematic mapping reviews) and ‘eminence’ (89 participants from 24 academic disciplines via brainstorming, an international symposium and expert review) and; iii. Seeking consensus on structuring, rating and clustering factors, based on how they relate to each other; and iv. Interpreting/utilising the framework for research and interventions. Similar steps were undertaken for frameworks developed for the majority European population. Results Seven distinct clusters emerged for dietary behaviour (containing 85 factors) and 8 for physical activity behaviours (containing 183 factors). Four clusters were similar across behaviours: Social and cultural environment; Social and material resources; Psychosocial; and Migration context. Similar clusters of factors emerged in the frameworks for diet and physical activity behaviours of the majority European population, except for ‘migration context’. The importance of factors across all clusters was acknowledged, but their relative importance differed for ethnic minority populations compared with the majority population. Conclusions This systems-based framework integrates evidence from both expert opinion and published literature, to map the factors influencing dietary and physical activity behaviours in ethnic minority groups. Our findings illustrate that innovative research and complex interventions need to be developed that are sensitive to the needs of ethnic minority populations. A systems approach that encompasses the complexity of the inter-related factors that drive behaviours may inform a more holistic public health paradigm to more effectively reach ethnic minorities living in Europe, as well as the majority host population.

Vanhempien käsityksiä siitä, mitkä asiat vaikuttavat päiväkoti-ikäisten lasten kasvisten, hedelmien ja sokeripitoisten elintarvikkeiden syömiseen, ei ole juuri tutkittu. Vanhempien merkitys on kuitenkin keskeinen lasten ravitsemuksessa. Tässä tutkimuksessa selvitetään vanhempien käsityksiä lasten hedelmien, kasvisten ja sokeripitoisten elintarvikkeiden syöntiin vaikuttavista tekijöistä. Kuusi fokusryhmähaastattelua toteutettiin 3–5-vuotiaiden lasten vanhemmille (N=17) syksyllä 2014. Kaksi tutkijaa analysoi haastatteluaineiston itsenäisesti. Tutkimuksen tulokset luokiteltiin neljälle vuorovaikutuksen tasolle: a) lapsi ja vanhemmat (lapsen persoonallisuuden piirteet, vanhempien roolimalli), b) kodin fyysinen ja sosiaalinen ympäristö (vanhempien viitseliäisyys, vanhemmuuskäytännöt säätelevät esille laittoa), c) koti ja päiväkoti (päiväkodista uusia makuja perheen arkeen, ateriarytmi) ja d) kotiympäristö ja yhteiskunta (kasvisten ja hedelmien kalleus, julkinen keskustelu). Johtopäätöksenä voidaan todeta, että vanhemmat käsittivät olevansa vuorovaikutuksessa lasten, kodin ympäristön, päiväkodin ja yhteiskunnan kanssa koskien lasten kasvisten, hedelmien ja sokeripitoisten elintarvikkeiden syöntiä. Vanhempien tietoisuuden lisääminen rajoituksista ja selkeistä säännöistä voi olla hyödyllistä. Lisätutkimuksia tarvitaan päiväkodin ja kodin välisestä vuorovaikutuksesta sekä sosioekonomisen aseman merkityksestä., Parents’ perceptions about factors related to their children’s fruit- and vegetable (FV) and sugar-enriched food intake is a less studied subject, even if it is well-known that parents have an important role for their children’s food intake. This study aims to bring up parents’ perceptions of factors influencing children’s intake of FV and sugar-enriched foods. Focus groups (n=6) were conducted among parents (n=17) of 3 to 5–year old children during autumn 2014. Two researchers independently analysed the data. The data was classified into four groups based on the interactions between factors influencing children’s food intake: a) the interaction between child and parents (factors such as the personality of the child, parents as role models), b) the physical and social environment of the home (such as the efforts parents put on feeding, practices related to availability), c) home and preschool (such as new foods tasted at preschool and then tastes are tasted at home, the meal pattern) d) home and the society (the price of FV, the public discussion about food and health). In conclusion, parents’ perceived that they interact with their children, with the home environment, the preschool, and the society when influencing their children’s FV and sugar-enriched food intake. Increasing parents’ awareness and knowledge about food parenting practices and clearly outspoken rules could be beneficial for children’s food intake. More research is needed about the interaction between preschool and home, and about the role of socioeconomic status for children’s food intake.