Milio N
School of Public Health, University of North Carolina, Chapel Hill, USA.
WHO Reg Publ Eur Ser. 1998;73:63-75.
Some progress has clearly been made in several aspects of Finland's food and nutrition policy: access to nutrition information and education, improvements in mass catering, increased availability of healthier food products, and pricing and quality requirements favourable to a healthy diet. Finnish eating patterns have improved in relation to some recommended foods and macronutrients. The structural changes in farm and food production are largely the result of new political and economic realities both in Finland and internationally, resulting in the Government focusing on fiscal efficiency, decentralization and a more competitive, consumer-oriented market. This new environment is creating pressures to reduce surplus animal fat production and to expand markets in new foods for Finns and other Europeans who, for reasons of demography, health or working or living arrangements, demand new and sometimes healthier foods. Within this context, some health leaders have been able to make and work for proposals that are consistent both with political and economic imperatives and with health needs. Although the populations health status is improving and in some respects is exemplary, diet-related death and illness rates and risk factors (such as serum cholesterol and obesity) are high and their decline, along with some healthy changes in eating patterns, has slowed since the mid-1980s (ironically, since the adoption of the nutrition policy). The more slowly improvements occur, the higher will be the social and economic costs. Major problems in policy implementation exist. Although much has been done in research and demonstration and in the development of national guidelines (in public catering and labeling, for example) there is an apparent lag in translating such soft technology into action and monitoring its implementation in order to develop corrective measures at the operational level. This problem may increase with decentralized budget control and a less regulated market, where listening to the consumer (whether an individual, retailer or caterer) may not necessarily result in healthier products are more accurate consumer information, especially as foreign products and media continue to attract Finnish young people. The lack of a leading strategic body that can authoritatively assess and anticipate problems in implementation, deal with them and coordinate and monitor the necessary action in fundamental to these issues. Rapid progress in economic and farm policy development and food enterprises can provide conditions supportive of health and nutrition goals if such interests are systematically taken into account and allowed to moderate potential negative changes. If it is to be effective, such accounting will require initiative, clarity of strategic purpose and organization by health and nutrition leaders.
获取营养信息和教育的机会、大规模餐饮的改善、更健康食品的供应增加，以及有利于健康饮食的定价和质量要求。芬兰人的饮食模式在一些推荐食品和常量营养素方面已有改善。农场和食品生产的结构变化在很大程度上是芬兰国内外新的政治和经济现实的结果，这导致政府注重财政效率、权力下放以及建立一个更具竞争力、以消费者为导向的市场。这种新环境正在形成压力，促使减少过剩动物脂肪的生产，并为芬兰人和其他欧洲人开拓新食品市场，这些人由于人口统计学、健康状况或工作或生活安排等原因，需要新的、有时更健康的食品。在这种背景下，一些卫生领域的领导者能够提出并致力于那些既符合政治和经济要求又符合健康需求的提议。尽管民众的健康状况正在改善，在某些方面堪称典范，但与饮食相关的死亡率和发病率以及风险因素（如血清胆固醇和肥胖）仍然很高，自20世纪80年代中期以来（具有讽刺意味的是，自营养政策实施以来），这些指标的下降以及饮食模式的一些健康变化已经放缓。改善进展越缓慢，社会和经济成本就越高。政策实施存在重大问题。尽管在研究、示范以及国家指导方针的制定（例如在公共餐饮和标签方面）已经做了很多工作，但在将这种软技术转化为行动并监测其实施情况以便在操作层面制定纠正措施方面，显然存在滞后。随着预算控制的分散和市场监管的减少，这个问题可能会加剧，在这种情况下，倾听消费者（无论是个人、零售商还是餐饮服务商）的意见不一定会带来更健康的产品或更准确的消费者信息，尤其是当外国产品和媒体继续吸引芬兰年轻人的时候。缺乏一个能够权威性地评估和预测实施问题、处理这些问题并协调和监测必要行动的牵头战略机构，是这些问题的根本所在。如果系统地考虑经济和农业政策发展以及食品企业的利益，并使其缓和潜在的负面变化，那么它们的快速发展可以为支持健康和营养目标提供条件。要使其有效，这种考量将需要卫生和营养领域的领导者具备主动性并明确战略目标和组织架构。
