1Institute for Physical Activity and Nutrition (IPAN),Deakin University,1 Gheringhap Street,Geelong,VIC3220,Australia.
2School of Public Health,Curtin University,Perth,Western Australia,Australia.
Public Health Nutr. 2019 Apr;22(5):912-926. doi: 10.1017/S1368980018003786. Epub 2019 Feb 28.
To assess current performance and identify opportunities and reforms necessary for positioning a food standards programme to help protect public health against dietary risk factors.
A case study design in which a food standards programme's public health protection performance was analysed against an adapted Donabedian model for assessing health-care quality. The criteria were the food standards programme's structure (governance arrangements and membership of its decision-making committees), process (decision-making tools, public engagement and transparency) and food standards outcomes, which provided the information base on which performance quality was inferred.
The Australia and New Zealand food standards programme.ParticipantsThe structure, process and outcomes of the Programme.
The Programme's structure and processes produce food standards outcomes that perform well in protecting public health from risks associated with nutrient intake excess or inadequacy. The Programme performs less well in protecting public health from the proliferation and marketing of 'discretionary' foods that can exacerbate dietary risks. Opportunities to set food standards to help protect public health against dietary risks are identified.
The structures and decision-making processes used in food standards programmes need to be reformed so they are fit for purpose for helping combat dietary risks caused by dietary excess and imbalances. Priorities include reforming the risk analysis framework, including the nutrient profiling scoring criterion, by extending their nutrition science orientation from a nutrient (reductionist) paradigm to be more inclusive of a food/diet (holistic) paradigm.
评估当前的绩效，并确定必要的机会和改革措施，以定位食品标准计划，帮助保护公众健康免受饮食风险因素的影响。
采用案例研究设计，根据评估医疗保健质量的改编的 Donabedian 模型，分析食品标准计划的公共卫生保护绩效。标准是食品标准计划的结构（治理安排和决策委员会成员）、过程（决策工具、公众参与和透明度）和食品标准结果，为推断绩效质量提供了信息基础。
澳大利亚和新西兰食品标准计划。
计划的结构、过程和结果。
该计划的结构和流程产生的食品标准结果在保护公众健康免受与营养摄入过多或不足相关的风险方面表现良好。该计划在保护公众健康免受“随意”食品的扩散和营销方面的表现较差，这些食品会加剧饮食风险。确定了制定食品标准以帮助保护公众健康免受饮食风险的机会。
需要改革食品标准计划中使用的结构和决策流程，使其适合于帮助应对由饮食过量和失衡引起的饮食风险。优先事项包括改革风险分析框架，包括营养成分分析评分标准，将其营养科学方向从营养素（还原论）范式扩展到更包括食物/饮食（整体）范式。
