A comprehensive, multi-sectoral approach
The health behaviours which contribute to overweight and obesity are underpinned by a complex range of social, economic, educational and environmental factors. Evidence suggests that strategies targeting individual behaviours relating to diet, energy intake and physical activity without changing the many determinants of these behaviours are unlikely to achieve significant or sustained outcomes.
Central to this approach is the need to change a range of environmental elements to support individuals to make healthier choices. This approach requires action from all levels of society, including individuals and families, industry, schools, workplaces, communities, and health and other professionals, with a steering role for governments. A comprehensive, multi-sectoral approach to improving physical activity levels and nutrition aimed at reducing overweight and obesity at the population level in Australia is needed.
In Australia, certain population groups, including Australians in lower socioeconomic groups, people living in rural and remote areas and Indigenous Australians, have higher rates of obesity and overweight, poor nutrition and physical inactivity. Issues such as access to affordable healthy foods and opportunities to engage in physical activity are likely to be major contributing factors. Therefore, an important part of a comprehensive, multi-sectoral approach to obesity prevention in Australia will be the development and implementation of specific, culturally sensitive interventions addressing the needs of these high risk groups.
This chapter focuses on the evidence informing our policy positions, including the evidence for interventions for the prevention of overweight and obesity, improving diet and physical activity.
Environments that support healthy food choices
Front-of-pack labelling has been shown to be effective in assisting consumers to identify healthier food choices at the point of sale. A number of front-of-pack labelling formats are in use globally, with different levels of effectiveness. Systems with an interpretive element to indicate the healthiness of a product generally perform better in assisting consumers to identify healthier foods. The evidence suggests that traffic light systems, that rank a product's total fat, saturated fat, sugar and salt/sodium levels as high (red), medium (amber) or low (green), are most effective for conveying clear health information to consumers and increasing the selection of healthier options.
There is evidence that front-of-pack food labelling provides an incentive for food manufacturers to increase the availability of healthier products through product reformulation. For example, the adoption of the Choices logo in the Netherlands, mandatory trans-fat labelling in South Korea, Canada, and the US , and the Pick the Tick logo in New Zealand, led to reformulations that improved the nutrient profile of products in these markets. Early evidence from Australia suggests that the Health Star Rating interpretive front-of-pack food labelling system that was introduced in 2014, may already be driving product reformulation, with two multinational food manufacturers both recently improving the composition of popular products to improve their rating.
Approximately 115 companies have adopted the Health Star Rating system since its introduction in 2014 with more than 5,500 products displaying the graphic. Recent surveys have evaluated the Health Star Rating system campaign, as well as consumer use and understanding of the system. Results show that consumer awareness of the system has grown, and is now at 59%. In addition, the system is well supported by consumers with 65% of people wanting to see the Health Star Rating on more products, and 33% of those aware of the system purchasing a new product because it had a higher rating than their usual product.
Nutrition content claims on food labels
Food companies use nutrition content claims to highlight only positive aspects of products that have negative attributes, such as marketing a high-sugar product as low-fat. This is a problem, as consumers perceive foods carrying claims as healthier than foods without claims, regardless of their nutrition composition, and claims influence dietary choices. Research in Australia has found that up to 79% of products carrying nutrition content claims in some food categories are not healthy enough to make a health claim.
Food marketing to children
Children in Australia are exposed to a high number of advertisements for unhealthy food on television and through non-broadcast media. Between 54% and 82% of food advertising during television programs popular with children is for unhealthy foods and beverages that are high in fat, salt and sugar. Substantial exposure also occurs through the internet and packaging promotions.
There is strong evidence that restricting unhealthy food marketing to children is an effective obesity prevention initiative and is a key area for action. Restricting marketing has been identified as one of the most cost-effective population-based interventions available to governments. Evidence indicates that food marketing to children generates positive beliefs about the advertised products, and influences food preferences, purchasing requests and consumption, as well as dietary habits and health status.  Further, the high level of unhealthy food advertising may limit the effectiveness of social marketing campaigns for healthy foods and lifestyles.
Current food marketing regulations are limited, and only apply to specific children’s programming on television. The highest numbers of children watch prime time commercial television between 5:30pm and 9:30pm when the regulations do not apply. Self-regulatory codes are in place, but their effectiveness is limited as they are typically voluntary, permissive, and poorly monitored and enforced.
In 2011 the Australian Communications and Media Authority undertook a review of these codes to determine if industry self-regulation adequately addressed community concern regarding food advertising to children. The monitoring report identified ongoing community concerns and concluded that there was insufficient evidence to suggest that the implementation of the self-regulatory codes had any effect on food marketing to children. A recent study has investigated the impact of self-regulatory initiatives in the four years since the monitoring report was published, and found that there has been no change to unhealthy food advertising to children.
Many processed foods are high in salt, sugar, fat and energy making them low in overall nutritional quality. Improving the nutritional quality of the food supply through product reformulation and innovation has enormous potential for improving population nutrition and health. Reducing portion sizes of processed foods, which have increased substantially in recent years, also has the potential to decrease energy intake as evidence indicates that people tend to consume more kilojoules when they are presented with larger portions of food and beverages.
Internationally, there has been some success with food reformulation having a positive health impact such as reducing intake of salt. A recent systematic review has shown that salt could be reduced by 40% in breads and 70% in processed meats, without impacting consumer acceptability, suggesting there are opportunities for food manufacturers to make their products healthier. In the UK, an analysis of salt reduction initiatives has shown that population salt intake has been reduced by 15% over 7 years, potentially avoiding 6,000 cardiovascular disease deaths and saving the economy £1.5 billion each year. 
In Australia, food reformulation has been shown to be a cost-effective preventive health measure. An evaluation of 123 Australian preventive health interventions found that limiting the salt content of three basic foods (bread, cereals and margarine) on a mandatory basis, would have a large impact on population health. This intervention was shown to not only be cost-effective, but cost saving.
The Food and Health Dialogue, replaced by the Healthy Food Partnership, was established in Australia to enable government, industry and public health groups to work collaboratively on the issue of reformulation.A Reformulation Working Party, established as part of the program, focuses on establishing priorities for food reformulation to help consumers achieve dietary patterns that are consistent with the Australian Dietary Guidelines. Evaluations of the program have shown that reformulation targets were partially achieved in some food categories, with significant variation in success between companies. A number of reasons have been identified for the program’s limited progress, including interruptions in government commitment, leadership and funding, weak incentives and accountability structures for participating companies, as well as a lack of transparency and public reporting of performance.
Economic interventions, such as taxation, grants and subsidies can provide incentives and disincentives to help modify health behaviours relating to overweight and obesity, physical activity and nutrition.
There are increasing calls for the Australian Government to follow the lead of other countries, including the UK, Mexico and France, and develop a policy for taxing and subsiding food and drink in order to promote dietary change and reduce the burden of chronic disease.
A systematic review has shown that taxes and subsidies are likely to be effective in improving consumption patterns contributing to obesity. Soft drink taxes and healthy food subsidies have been shown to be effective in promoting changes in dietary habits.
A recent Australian study has examined the cost-effectiveness of combining taxes on unhealthy foods and subsidies on healthy foods. The combination of the taxes and subsidies could avoid as many as 470,000 disability-adjusted life years in the Australian population, at a net cost-saving of AU$3.4 billion to the health sector. The largest gains in health were achieved by a sugar tax. A fruit and vegetable subsidy is cost-effective when added to a package of taxes.
In Australia, there are a lack of financial incentives and disincentives to support increased physical activity. The fringe benefits tax for private motor vehicle use promotes the use of private cars rather than active transport (such as walking, cycling and public transport), encouraging inactivity. The NSW government has recently introduced the Active Kids program that encourages kids to be more active by subsidising participation fees of recreational activities.
Public education campaigns utilise commercial marketing principles and mass media to distribute and promote public health messages. Increasingly, social marketing has been used as a public education strategy. The value of social marketing as a public education tool – as seen in tobacco control – is in its role in influencing attitudes and shifting cultural norms with regard to health behaviours.
Evidence increasingly shows that well designed and executed social marketing campaigns on health issues can be effective in changing health knowledge, beliefs, attitudes and behaviours across large populations. While the bulk of current evidence relates to tobacco control, social marketing interventions have also been shown to be effective in increasing physical activity and improving nutrition.
More recently, studies have highlighted the characteristics of effective obesity prevention mass media campaigns, showing that presenting hard-hitting information about the health consequences of overweight and obesity appear most effective. These findings are consistent with the literature on anti-smoking mass media campaigns.
In a public health setting, public education mass media campaigns are often supported by complementary messaging through other channels including healthcare providers and community programs. This allows for integrated universal and targeted approaches, so that social marketing campaigns are supported by local level initiatives tailored to the needs of specific communities. The LiveLighter public education campaign to address overweight and obesity includes mass media, advocacy initiatives and education and support tools. The first campaign phase highlighted that overweight and obesity was a risk factor for chronic disease. Evaluation showed it successfully raised awareness of the issue as well as increasing intention to change behaviour. The second phase of the campaign highlighted the link between sugary drink consumption and weight gain. Evaluation showed that overweight respondents reduced their intake of sugar sweetened beverages. 
The effectiveness of social marketing interventions is improved when they are one component of a comprehensive approach targeting population health behaviours; outcomes of these interventions are generally better when they are supported by complementary policies and programs to support behavioural change, and competing marketing messages are restricted.
The physical environment
The body of evidence suggests that 'walkable' environments are associated with decreased obesity and higher levels of physical activity. Key characteristics of a walkable environment include mixed land use, higher residential density, street connectivity and design, availability of footpaths, attractive surrounds and perceptions that the environment is safe. Positive associations have been shown between walkability, street connectivity and residential density/urbanisation, and total walking for transport in adults aged 65 years and older.
Physical environments designed to facilitate active transport such as cycling, walking and public transport are associated with increased physical activity. Infrastructure enabling active transport between residential, commercial and business areas, and access to recreational facilities and sporting infrastructure are key components of such environments. A review of the literature suggests that active transport interventions that are low cost and targeted to those most amenable are the most likely to be effective and cost-effective.
There is some evidence that the physical environment can influence diet - improved access to healthy foods may increase their consumption. There is evidence from the US to suggest that neighbourhoods with better access to supermarkets and fewer fast food outlets tend to have healthier diets and lower levels of obesity. A Canadian study has shown that having grocery stores within close proximity to place of residence is associated with a lower likelihood of regular sugar-sweetened beverage consumption (a probable risk factor for weight gain and obesity), among pre-school children.
- National Preventative Health Taskforce. Australia: the healthiest country by 2020. National preventative health strategy – the roadmap for action. Canberra: Commonwealth of Australia; 2009 Jun 30 Available from: http://www.preventativehealth.org.au/internet/preventativehealth/publishing.nsf/Content/nphs-roadmap/$File/nphs-roadmap.pdf.
- Butland B, Jebb S, Kopelman P, McPherson K, Thomas S, Mardell J, et al. Foresight. tackling obesities: future choices - project report. Second edition. UK: Government Office for Science; 2007 Available from: http://www.bis.gov.uk/assets/foresight/docs/obesity/17.pdf.
- World Cancer Research Fund, American Institute for Cancer Research. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Washington DC: AICR; 2007.
- World Health Organization. Global strategy on diet, physical activity and health. Geneva: WHO; 2004 Available from: http://www.who.int/nmh/wha/59/dpas/en/.
- Australian Institute of Health and Welfare. Australia’s health 2014. Canberra: AIHW; 2019 Apr 20. Report No.: Australia’s health series no. 14. Cat. no. AUS 178.
- Australian Bureau of Statistics. National Health Survey: First Results - Australia, 2014-15. Canberra, Australia: Australian Bureau of Statistics; 2015 Dec Available from: http://www.ausstats.abs.gov.au/ausstats/subscriber.nsf/0/CDA852A349B4CEE6CA257F150009FC53/$File/national%20health%20survey%20first%20results,%202014-15.pdf.
- Parker G, Frith R.. Health Star Rating System: Campaign Evaluation Report. Sydney; 2016 Jun Available from: http://healthstarrating.gov.au/internet/healthstarrating/publishing.nsf/Content/8240FC006B958E48CA257FB000190995/$File/Health%20Star%20Rating%20System%20-%20Campaign%20Evaluation%20Report%20-%202016.pdf.
- Cowburn G, Stockley L. Consumer understanding and use of nutrition labelling: a systematic review. Public Health Nutr 2005 Feb;8(1):21-8 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/15705241.
- Cecchini M, Warin L. Impact of food labelling systems on food choices and eating behaviours: a systematic review and meta-analysis of randomized studies. Obes Rev 2016 Mar;17(3):201-10 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/26693944.
- Gorton D, Ni Mhurchu C, Chen MH, Dixon R. Nutrition labels: a survey of use, understanding and preferences among ethnically diverse shoppers in New Zealand. Public Health Nutr 2009 Sep;12(9):1359-65 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/19087382.
- Kelly B, Hughes C, Chapman K, Louie JC, Dixon H, Crawford J, et al. Consumer testing of the acceptability and effectiveness of front-of-pack food labelling systems for the Australian grocery market. Health Promot Int 2009 Jun;24(2):120-9 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/19336501.
- Maubach N, Hoek J. The effect of alternative nutrition information formats on consumers’ evaluations of a children’s breakfast cereal. In: University of Wollongong. Partnerships, proof and practice - International Nonprofit and Social Marketing Conference 2008 Jul 15-16 Wollongong: University of Wollongong; 2008 Available from: http://ro.uow.edu.au/cgi/viewcontent.cgi?article=1000&context=insm08.
- US Food and Drug Administration. Calories count: report of the working group on obesity. [homepage on the internet] USA: US FDA; 2004 Mar 12 [cited 2013 Sep 30; updated 2013 Feb 6]. Available from: http://www.fda.gov/Food/FoodScienceResearch/ConsumerBehaviorResearch/ucm081696.htm.
- Conquest Research. Food labelling study prepared for Which? United Kingdom: Conquest Research; 2006 Jun.
- Malam S, Clegg S, Kirwan S, McGinigal S. Comprehension and use of UK nutrition signpost labelling schemes. UK: Food Standards Agency; 2009 May Available from: http://www.food.gov.uk/multimedia/pdfs/pmpreport.pdf.
- Vyth EL, Steenhuis IH, Roodenburg AJ, Brug J, Seidell JC. Front-of-pack nutrition label stimulates healthier product development: a quantitative analysis. Int J Behav Nutr Phys Act 2010 Sep 8;7:65 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/20825645.
- Lee JH, Adhikari P, Kim SA, Yoon T, Kim IH, Lee KT. Trans fatty acids content and fatty acid profiles in the selected food products from Korea between 2005 and 2008. J Food Sci 2010 Sep;75(7):C647-52 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/21535532.
- Unnevehr LJ, Jagmanaite E.. Getting rid of trans fats in the US diet: policies, incentives and progress. Food Policy 2008;33: 497–503.
- Canadian Food Inspection Agency. Labelling of Trans Fatty Acids. [homepage on the internet] Government of Canada; 2019 Apr 20 Available from: http://www.inspection.gc.ca/food/labelling/food-labelling-for-industry/nutrition-labelling/additional-information/labelling-of-trans-fatty-acids/eng/1415805355559/1415805356965.
- Young L, Swinburn B. Impact of the Pick the Tick food information programme on the salt content of food in New Zealand. Health Promot Int 2002 Mar;17(1):13-9 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/11847134.
- Han E. Uncle Tobys cuts fat, salt and sugar from muesli bars to boost health star rating. [homepage on the internet] Sydney: Sydney Morning Herald; 2015 Oct Available from: https://www.smh.com.au/business/companies/uncle-tobys-cuts-fat-salt-and-sugar-from-museli-bars-to-boost-health-star-rating-20151013-gk7n4j.html.
- Harris JL, Thompson JM, Schwartz MB, Brownell KD. Nutrition-related claims on children's cereals: what do they mean to parents and do they influence willingness to buy? Public Health Nutr 2011 Dec;14(12):2207-12 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/21806872.
- Kozup JC, Creyer EH, Burton S.. Making Healthful Food Choices: The Influence of Health Claims and Nutrition Information on Consumers’ Evaluations of Packaged Food Products and Restaurant Menu Items. Journal of Marketing 2003 Apr Abstract available at https://archive.ama.org/archive/ResourceLibrary/JournalofMarketing/documents/9431547.pdf.
- Chan C, Patch C, Williams P. Australian consumers are sceptical about but influenced by claims about fat on food labels. Eur J Clin Nutr 2005 Jan;59(1):148-51 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/15305180.
- Kaur A, Scarborough P, Rayner M. A systematic review, and meta-analyses, of the impact of health-related claims on dietary choices. Int J Behav Nutr Phys Act 2017 Jul 11;14(1):93 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/28697787.
- Hughes C, Wellard L, Lin J, Suen KL, Chapman K. Regulating health claims on food labels using nutrient profiling: what will the proposed standard mean in the Australian supermarket? Public Health Nutr 2013 Dec;16(12):2154-61 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/23308399.
- Kelly B, Chapman K, King L, Hebden L. Trends in food advertising to children on free-to-air television in Australia. Aust N Z J Public Health 2011 Apr;35(2):131-4 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/21463408.
- Hebden L, King L, Chau J, Kelly B. Food advertising on children's popular subscription television channels in Australia. Aust N Z J Public Health 2011 Apr;35(2):127-30 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/21463407.
- Watson WL, Lau V, Wellard L, Hughes C, Chapman K. Advertising to children initiatives have not reduced unhealthy food advertising on Australian television. J Public Health (Oxf) 2017 Dec 1;39(4):787-792 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/28158840.
- Kervin L, Jones S, Mantei J.. Online advertising: examining the content and messages within websites targeted at children. E-Learning and Digital Media 2012;9(1):69-82.
- Freeman B, Kelly B, Baur L, Chapman K, Chapman S, Gill T, et al. Digital junk: food and beverage marketing on Facebook. Am J Public Health 2014 Dec;104(12):e56-64 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/25322294.
- CHOICE. Food marketing: child's play? [homepage on the internet] Australian Consumers Association; 2006 [cited 2006 Sep 18; updated 2006 Sep 18]. Available from: http://www.choice.com.au/viewArticle.aspx?id=105275&catId.
- Chapman K, Nicholas P, Banovic D, Supramaniam R. The extent and nature of food promotion directed to children in Australian supermarkets. Health Promot Int 2006 Dec;21(4):331-9 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/16885173.
- Hebden L, King L, Kelly B, Chapman K, Innes-Hughes C. A menagerie of promotional characters: promoting food to children through food packaging. J Nutr Educ Behav 2011 Sep;43(5):349-55 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/21906547.
- Bauman A, Bellew B, Boylan S, Crane M, Foley B, Gill T, King L, Kite J, Mihrshahi S.. Obesity Prevention in Children and Young People aged 0-18 Years: a Rapid Evidence Review. Sydney: The Sax Institute; 2016 Available from: http://sydney.edu.au/medicine/public-health/prevention-research/policy-advice/OBESITY%20PREVENTION%20IN%20CHILDREN%20AND%20YOUNG%20PEOPLE_Full%20Technical%20Report%20_Final.pdf.
- World Health Organization, Food and Agriculture Organization. Diet, nutrition and the prevention of chronic diseases. Geneva, Switzerland: WHO; 2003. Report No.: WHO technical report series 916. Available from: http://apps.who.int/iris/bitstream/10665/42665/1/WHO_TRS_916.pdf.
- Magnus A, Haby MM, Carter R, Swinburn B. The cost-effectiveness of removing television advertising of high-fat and/or high-sugar food and beverages to Australian children. Int J Obes (Lond) 2009 Oct;33(10):1094-102 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/19652656.
- Cobiac LJ, Tam K, Veerman L, Blakely T. Taxes and Subsidies for Improving Diet and Population Health in Australia: A Cost-Effectiveness Modelling Study. PLoS Med 2017 Feb;14(2):e1002232 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/28196089.
- McGinnis JM, Gootman JA, Kraak VI. Food marketing to children and youth: threat or opportunity? Washington, DC: The National Academies Press; 2005 Available from: http://www.nap.edu/openbook.php?record_id=11514&page=R1.
- Dalmeny K, Hanna E, Lobstein T. Broadcasting bad health: why food marketing to children needs to be controlled. International Association of Consumer Food Organizations; 2003 Jul Available from: http://cspinet.org/reports/codex/foodmarketingreport.pdf.
- Cairns G, Angus K, Hastings G, Caraher M. Systematic reviews of the evidence on the nature, extent and effects of food marketing to children. A retrospective summary. Appetite 2013 Mar;62:209-15 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/22561190.
- Boyland EJ, Nolan S, Kelly B, Tudur-Smith C, Jones A, Halford JC, et al. Advertising as a cue to consume: a systematic review and meta-analysis of the effects of acute exposure to unhealthy food and nonalcoholic beverage advertising on intake in children and adults. Am J Clin Nutr 2016 Feb;103(2):519-33 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/26791177.
- Kelly B, King MPsy L, Chapman Mnd K, Boyland E, Bauman AE, Baur LA. A hierarchy of unhealthy food promotion effects: identifying methodological approaches and knowledge gaps. Am J Public Health 2015 Apr;105(4):e86-95 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/25713968.
- Wakefield MA, Loken B, Hornik RC. Use of mass media campaigns to change health behaviour. Lancet 2010 Oct 9;376(9748):1261-71 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/20933263.
- Commonwealth of Australia, Attorney General's Department. Children's television standards 2009. Canberra: Office of Legislative Drafting and Publishing; 2012 Available from: http://www.acma.gov.au/webwr/aba/contentreg/codes/television/documents/childrens_tv_standards_2009.pdf.
- Australian Communications and Media Authority. Children's television standards review. Issues paper. ACMA; 2007 Available from: http://www.acma.gov.au/~/media/Content%20Monitoring%20and%20Review/Report/pdf/cts_review_issues_paper%20pdf.pdf.
- Hebden L, King L, Kelly B, Chapman K, Innes-Hughes C. Industry self-regulation of food marketing to children: reading the fine print. Health Promot J Austr 2010 Dec;21(3):229-35 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/21118071.
- Hebden LA, King L, Grunseit A, Kelly B, Chapman K. Advertising of fast food to children on Australian television: the impact of industry self-regulation. Med J Aust 2011 Jul 4;195(1):20-4 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/21728936.
- King L, Hebden L, Grunseit A, Kelly B, Chapman K, Venugopal K. Industry self regulation of television food advertising: responsible or responsive? Int J Pediatr Obes 2011 Jun;6(2-2):e390-8 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/20858046.
- Ronit K, Jensen JD. Obesity and industry self-regulation of food and beverage marketing: a literature review. Eur J Clin Nutr 2014 Jul;68(7):753-9 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/24713622.
- Australian Communications and Media Authority. Industry self-regulation of food and beverage advertising to children. ACMA monitoring report. Commonwealth of Australia; 2011 Dec Available from: http://www.acma.gov.au/webwr/_assets/main/lib310132/industry_self-regulation-advertising_to_children_monitoring_report-dec2011.pdf.
- Jaenke R, Barzi F, McMahon E, Webster J, Brimblecombe J. Consumer acceptance of reformulated food products: A systematic review and meta-analysis of salt-reduced foods. Crit Rev Food Sci Nutr 2017 Nov 2;57(16):3357-3372 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/26745848.
- He FJ, Brinsden HC, MacGregor GA. Salt reduction in the United Kingdom: a successful experiment in public health. J Hum Hypertens 2014 Jun;28(6):345-52 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/24172290.
- Vos T, Carter R, Barendregt J, Mihalopoulos C, Veerman JL, Magnus A, et al. ACE–Prevention Team (2010). Assessing cost-effectiveness in prevention (ACE–Prevention): Final report. Brisbane, Melbourne: University of Queensland, Deakin University; 2010 Sep Available from: http://www.deakin.edu.au/strategic-research/population-health/assets/resources/ace-prevention-report.pdf.
- Australian Government Department of Health. Food and Health Dialogue. [homepage on the internet] Canberra, Australia: Australian Government Department of Health; 2009 [updated 2016]. Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/fhd.
- Trevena H, Neal B, Dunford E, Wu JH. An evaluation of the effects of the Australian Food and Health Dialogue targets on the sodium content of bread, breakfast cereals and processed meats. Nutrients 2014 Sep 19;6(9):3802-17 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/25244369.
- Trevena H, Dunford E, Neal B, Webster J. The Australian Food and Health Dialogue - the implications of the sodium recommendation for pasta sauces. Public Health Nutr 2014 Jul;17(7):1647-53 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/23830096.
- Jones A, Magnusson R, Swinburn B, Webster J, Wood A, Sacks G, et al. Designing a Healthy Food Partnership: lessons from the Australian Food and Health Dialogue. BMC Public Health 2016 Jul 27;16:651 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/27465746.
- Thow AM, Downs S, Jan S. A systematic review of the effectiveness of food taxes and subsidies to improve diets: understanding the recent evidence. Nutr Rev 2014 Sep;72(9):551-65 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/25091552.
- Lal A, Mantilla-Herrera AM, Veerman L, Backholer K, Sacks G, Moodie M, et al. Modelled health benefits of a sugar-sweetened beverage tax across different socioeconomic groups in Australia: A cost-effectiveness and equity analysis. PLoS Med 2017 Jun;14(6):e1002326 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/28654688.
- NSW Government Office of Sport. Active Kids. [homepage on the internet] Sydney, Australia: NSW Government; 2018 [updated 2018 Feb]. Available from: https://sport.nsw.gov.au/sectordevelopment/activekids.
- Abroms LC, Maibach EW. The effectiveness of mass communication to change public behavior. Annu Rev Public Health 2008;29:219-34 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/18173391.
- Noar SM. A 10-year retrospective of research in health mass media campaigns: where do we go from here? J Health Commun 2006;11(1):21-42 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/16546917.
- Gordon R, McDermott L, Stead M, Angus K. The effectiveness of social marketing interventions for health improvement: what's the evidence? Public Health 2006 Dec;120(12):1133-9 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/17095026.
- Huhman ME, Potter LD, Duke JC, Judkins DR, Heitzler CD, Wong FL. Evaluation of a national physical activity intervention for children: VERB campaign, 2002-2004. Am J Prev Med 2007 Jan;32(1):38-43 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/17218189.
- Pomerleau J, Lock K, Knai C, McKee M. Interventions designed to increase adult fruit and vegetable intake can be effective: a systematic review of the literature. J Nutr 2005 Oct;135(10):2486-95 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/16177217.
- Xia Y, Deshpande S, Bonates T. Effectiveness of Social Marketing Interventions to Promote Physical Activity Among Adults: A Systematic Review. J Phys Act Health 2016 Nov;13(11):1263-1274 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/27633626.
- Dixon H, Scully M, Durkin S, Brennan E, Cotter T, Maloney S, et al. Finding the keys to successful adult-targeted advertisements on obesity prevention: an experimental audience testing study. BMC Public Health 2015 Aug 20;15:804 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/26290169.
- Morley B, Niven P, Dixon H, Swanson M, Szybiak M, Shilton T, et al. Population-based evaluation of the 'LiveLighter' healthy weight and lifestyle mass media campaign. Health Educ Res 2016 Apr;31(2):121-35 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/26956039.
- Evans WD. How social marketing works in health care. BMJ 2006 May 20;332(7551):1207-10 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/16710002.
- Morley B, Niven P, Dixon H, Wakefield M, Swanson M, Szybiak M, Shilton T, Pratt S and Slevin T. Evaluation of the LiveLighter "Sugary Drinks" mass media campaign. Obesity Research and Clinical Practice 2014;8, suppl 1, p70 Abstract available at http://www.obesityresearchclinicalpractice.com/article/S1871-403X(14)00674-7/fulltext.
- Morley B, Niven P, Dixon H, Wakefield M, Swanson M, Szybiak M, Shilton T, Pratt S and Slevin T. Social marketing in obesity prevention: The example of 'livelighter'. 2017 Abstract available at http://anzos-aoco-ossanz-2017.p.asnevents.com.au/days/2017-10-05/abstract/46326.
- Kelly B, Bochynska K, Kornman K, Chapman K. Internet food marketing on popular children's websites and food product websites in Australia. Public Health Nutr 2008 Nov;11(11):1180-7 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/18298882.
- Raine K, Spence JC, Church J, Boule N, Slater L, Marko J, Gibbons K and Hemphill E. State of the Evidence Review on Urban Health and Healthy Weights. Ottawa, Canada: Canadian Institute for Health Information; 2008 Available from: https://secure.cihi.ca/free_products/Urban%20Health%20and%20Healthy%20Weights.pdf.
- Frank LD, Andresen MA, Schmid TL. Obesity relationships with community design, physical activity, and time spent in cars. Am J Prev Med 2004 Aug;27(2):87-96 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/15261894.
- Giles-Corti B, Macintyre S, Clarkson JP, Pikora T, Donovan RJ. Environmental and lifestyle factors associated with overweight and obesity in Perth, Australia. Am J Health Promot 2003 Sep;18(1):93-102 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/13677967.
- Schoeppe S and Braubach M. Tackling Obesity by Creating Healthy Residential Environments. Copenhagen, Denmark: World Health Organization Regional Office for Europe; 2007 Available from: http://www.euro.who.int/__data/assets/pdf_file/0012/98697/E90593.pdf.
- Australian Institute of Health and Welfare. Health and the environment: a compilation of evidence. Canberra: AIHW; 2011 Mar. Report No.: PHE 136. Available from: https://www.aihw.gov.au/getmedia/0567e647-f152-4aa9-9e4f-f0404b139574/11937.pdf.aspx?inline=true.
- Gebel K, King L, Bauman A, Vita P, Gill T, Rigby A and Capon A. Creating healthy environments: A review of links between the physical environment, physical activity and obesity. Sydney, Australia: NSW Health Department and NSW Centre for Overweight and Obesity; 2005 Available from: https://ses.library.usyd.edu.au/bitstream/2123/16805/1/2005_creating_healthy_environments.pdf.
- Brown V, Moodie M, Mantilla Herrera AM, Veerman JL, Carter R. Active transport and obesity prevention - A transportation sector obesity impact scoping review and assessment for Melbourne, Australia. Prev Med 2017 Mar;96:49-66 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/28011134.
- Larson NI, Story MT, Nelson MC. Neighborhood environments: disparities in access to healthy foods in the U.S. Am J Prev Med 2009 Jan;36(1):74-81 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/18977112.
- Morland K, Diez Roux AV, Wing S. Supermarkets, other food stores, and obesity: the atherosclerosis risk in communities study. Am J Prev Med 2006 Apr;30(4):333-9 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/16530621.
- Pabayo R, Spence JC, Cutumisu N, Casey L, Storey K. Sociodemographic, behavioural and environmental correlates of sweetened beverage consumption among pre-school children. Public Health Nutr 2012 Aug;15(8):1338-46 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/22269184.