[Management of healthy food environment improvement through restaurants and other settings by prefectures and cities of cabinet order].

Objectives　In Japanese nutrition policy, emphasis is placed on healthy food environment improvement through restaurants and other settings by prefectures and cities of cabinet order (cities). This study aimed to clarify the actual status of management implementation by prefectures and cities.Methods　A mail survey of 47 prefectures and 106 cities throughout Japan was conducted in October 2020. Management implementation, including the existence of a healthy food environment improvement system (system) for restaurants and other settings, was confirmed. Local governments that had implemented the system were asked about the scope, dissemination efforts, process evaluation, and improvement of the system.Results　Of the local governments that responded, 39/42 prefectures (92.9%) and 57/82 cities (69.5%) implementing the system were included in the study. A total of 84.6% of prefectures and 14.0% of cities assessed the nutrient intake of local residents within the past five years. The median number of dietitians in the main office of the department in charge of healthy food environment improvement was two in both prefectures and cities. A target for healthy food environment improvement was set by 69.2% of prefectures and 54.4% of cities. The scope of the system was restaurant meals for 94.9% of prefectures and 100.0% of cities as well as ready-made meals for 87.2% of prefectures and 93.0% of cities. A total of 69.2% of prefectures and 66.7% of cities collaborated internally or with other local governments, while 15.4% of prefectures and 15.8% of cities entrusted system dissemination to external organizations. A total of 87.2% of prefectures and 89.5% of cities assessed the number of registered stores/companies, while 17.6% of prefectures and 21.6% of cities assessed the number of restaurants and other settings in the entire jurisdiction. A total of 33.3% of prefectures and 40.4% of cities established a renewal system, while 71.8% of prefectures and 33.3% of cities improved the system.Conclusion　Although underreporting due to the COVID-19 pandemic is possible, in local governments that had implemented the system, few cities assessed nutrient intake, and approximately 50-70% of prefectures and cities set targets for healthy food environment improvement. While approximately 90% of each local government assessed the number of registered stores/companies, those that assessed the number of stores/companies in the entire jurisdiction as a population size were approximately 20%. Approximately 30-40% of each local government has established a renewal system.