Commentaries The Norwegian Food and Nutritional Policy KNUT RINGEN, MHA, MPH Few people concerned with public health can have avoided noticing the importance of nutrition to health. Two major issues are involved: 1) to create in the industrialized countries an environment conducive to the production and consumption of foodstuffs not merely for successful marketing but, more importantly, for the creation of a nutritional basis that will maintain and promote health; and 2) in light of a global perspective to develop national food policies that will allow for the most efficient satisfaction of nutritional needs in countries where food surpluses are created and a redistribution of nutritional surpluses to those countries where domestic production cannot satisfy domestic needs. On the one hand the issues involve improving the malnutrition and overconsumption of food in the industrialized countries, and on the other hand they involve a redistribution of nutrition from the industrialized countries to the developing countries where under-nutrition and the lack of a differentiated diet are the chief nutritional problems. The industrialized countries, with nearly 30 per cent of the world population, produce roughly 60 per cent of the most important foodstuffs in the world. There is nothing new about the need for nutritional and food policies on the national level. In the 1920s the Health Section of the League of Nations recommended that all countries develop national food policies, and this most likely led to the creation in some countries of certain guidelines for the production and consumption of food. The ability of countries to adapt to the extraordinary circumstances created by World War 11 undoubtedly was a result of the initiative taken by the League of Nations some 15 years earlier. At the first United Nations Conference at Hot Springs, Virginia in May 1943, there was a call for the development of not merely national but also international food policies. The result of this conference was the creation of the Food and Agricultural Organization (FAO) of the United Nations, and its chief aim was to encourage the creation of national food policies as well as coordinate the distribution of foodstuffs from the producing nations to the consuming nations. In 1948 a World Food Board was
established under the FAO and later a World Food Council. The Council, however, lacking any jurisdictional mandate, has been and continues to be an advisory body where nations can present their views and where resolutions can be passed, but where no definitive affirmative action can be taken to alleviate the global differential distribution of food and nutritional supplies. Indeed, the development of national policies has also lagged. Mostly in the platforms of political parties or as general but non-comprehensive guidelines limited to the agricultural sector have proposals approaching national food policies been developed. It was thus somewhat of a milestone when the Ministry of Agriculture of Norway presented, in December 1975, a government white paper outlining a proposal for a comprehensive national food and nutritional policy.' It is comprehensive in that it was developed in a cooperative effort between experts in agriculture and public health and it is promising in that it is the culmination of a long development of policy in the health and agricultural sectors. It is important because it is more than a proposal; the continuous policy development has made its overall intent politically acceptable and its implementation is not merely feasible, but likely. The proposal has four major goals: 1. To stimulate the consumption of healthy foodstuffs; 2. To develop guidelines for food production in accordance with the recommendations of the World Food Council; 3. To increase domestic independence from the importation of food supplies by encouraging increases in the production and consumption of domestic foodstuffs that both satisfy health requirements in terms of nutritional value and agricultural requirements in terms of the specific natural conditions delimiting the potential for food production; 4. In response to the general economic aim of strengthening outlying districts, agricultural production is to be promoted in districts and regions with otherwise poor industrial bases. The more specific objectives of the government's policy are:
Address reprint requests to Knut Ringen, Doctoral Candidate, Dept. of Health Care Organization, The Johns Hopkins University School of Hygiene and Public Health, 615 N. Wolfe St., Baltimore, MD 21205. 550
1. To maintain the existing advantageous nutritional aspects of current agricultural production and patterns of consumption. It is recognized that taste cannot be altered significantly through policy, and it is also recognized that variations AJPH June, 1977, Vol. 67, No. 6
COMMENTARIES
in consumption patterns differ both regionally and with regard to different population groups. It is the aim of the policy to work within the limitations imposed by those differences; 2. To improve the nutritional quality of the overall national diet, it is the aim to reduce the overall intake of fats as a source of energy. The reduction in fats should eventually be to about 35 per cent of the total diet; 3. To substitute for the decline in fat consumption, it is the aim to increase the intake of foodstuffs with heavy concentrations of starches, especially grains and potatoes. Sugar as a source of energy ought to be reduced; 4. In terms of total fat consumption it is the aim to increase the proportion of polyunsaturated fats and decrease the proportion of saturated fats. The means for implementation of this policy are: 1. The specific means must be developed on a cooperative basis between: a) local and central governmental administrations; b) the trade and professional organizations; c) the voluntary organizations; and d) groups representing different consumer interests; 2. Policy related to agriculture, fisheries, and prices. Agricultural changes will come through the existing system of price negotiations between farm organizations and the government. The fisheries are much more of a problem since the price of fish is largely determined by the international market, and 85-90 per cent of Norwegian fish production is exported. To encourage the production and consumption of desirable foodstuffs, production subsidies will be used as much as possible to regulate the production of those foods that are supplied mainly through domestic production, and consumer subsidies will be used to make those products that are desirable, but whose price is fixed in the international market, competitively advantageous on the domestic market. Attempts will be made to develop international agreements where the value of foodstuffs is not merely determined by their availability but, more importantly, by their nutritional quality; 3. Means will be promoted to make production and marketing based on nutritional quality. Proposals have been developed that marketing information must emphasize qualita-
tive considerations; 4. Legislation should be improved and simplified to prevent the production and distribution of foods and drinks that are detrimental to health, to prevent unsanitary means of production and refinement of foods and drinks, to promote the labeling of foods and drinks according to how they have been produced and what they contain, and to prevent erroneous information and beliefs about the origin and value of foods and drinks; 5. Research and education should be better coordinated and directed at the economic and nutritional value of foodstuffs. Nutritional education should be promoted at all levels of public education, and especially medical personnel should
AJPH June, 1977, Vol. 67, No. 6
be more familiar with, and promote the dissemination of, the value of nutrition on health; 6. Public information will be used to motivate people towards an improved diet, to disseminate a broad understanding of the major components in such a diet, and develop the basis for people to acquire the needed skills and knowledge so that they can become self-sufficient in questions of diet relative to the available information and supply of foods and drinks; 7., Establish the needed administrative facilities and procedures to ensure that the goals and objectives of this policy are implemented and that its intent is maintained into the future. This white paper should be of interest to many people involved in public health. lt gives a good historical perspective, and couples the question of health to its widest social, economic, and political circumscription. While it may be faulted for emphasizing individual behavior as a major determinant of a less than optimal diet, it also stresses the role of the producers and distributors in this capacity. And although it is limited to cooperation between the agricultural and health sectors, it does demonstrate that policy need not be sectoral. It thus presents a basis on which more comprehensive health policies can be developed. More than anything, perhaps, it should demonstrate that it is possible to develop comprehensive national policies in the area of health and agriculture. Such national policies are sorely needed if we are ever to achieve a global coordination for the exploitation, refinement, and distribution of resources in a time that international dependencies of all kinds are obviously increasing. No nation can afford taact solely upon its limited self-interest. Hopefully, this document can provide the impetus for policy researchers and policy makers to acknowledge that it is not sufficient to think mainly along sectoral lines or solely on the basis of national needs. Health status cannot be maintained without considering health as being intricately interwoven into the entire social fabric, nor can domestic needs and aspirations be satisfied without realizing the international interdependencies of the current world. The time for broadening our view on public health matters is long overdue-and this white paper has demonstrated that this is possible providing that we are willing to give up some preeminence in our fields of expertise. Once this hurdle is overcome it should also be possible to expand this view in terms of the global nature of current needs and resources to satisfy those needs. REFERENCE
1. Ministry of Agriculture, Government of Norway, Norwegian Food and Nutritional Policy, White Paper no. 32 (1975-76), Ministry of Agriculture, Government of Norway, Oslo-Dep., Oslo 1, Norway, 184 pp., 1975 (English edition available free of charge from the Ministry of Agriculture, Government of Norway, OsloDep., Oslo 1, Norway)
551
established under the FAO and later a World Food Council. The Council, however, lacking any jurisdictional mandate, has been and continues to be an advisory body where nations can present their views and where resolutions can be passed, but where no definitive affirmative action can be taken to alleviate the global differential distribution of food and nutritional supplies. Indeed, the development of national policies has also lagged. Mostly in the platforms of political parties or as general but non-comprehensive guidelines limited to the agricultural sector have proposals approaching national food policies been developed. It was thus somewhat of a milestone when the Ministry of Agriculture of Norway presented, in December 1975, a government white paper outlining a proposal for a comprehensive national food and nutritional policy.' It is comprehensive in that it was developed in a cooperative effort between experts in agriculture and public health and it is promising in that it is the culmination of a long development of policy in the health and agricultural sectors. It is important because it is more than a proposal; the continuous policy development has made its overall intent politically acceptable and its implementation is not merely feasible, but likely. The proposal has four major goals: 1. To stimulate the consumption of healthy foodstuffs; 2. To develop guidelines for food production in accordance with the recommendations of the World Food Council; 3. To increase domestic independence from the importation of food supplies by encouraging increases in the production and consumption of domestic foodstuffs that both satisfy health requirements in terms of nutritional value and agricultural requirements in terms of the specific natural conditions delimiting the potential for food production; 4. In response to the general economic aim of strengthening outlying districts, agricultural production is to be promoted in districts and regions with otherwise poor industrial bases. The more specific objectives of the government's policy are:
Address reprint requests to Knut Ringen, Doctoral Candidate, Dept. of Health Care Organization, The Johns Hopkins University School of Hygiene and Public Health, 615 N. Wolfe St., Baltimore, MD 21205. 550
1. To maintain the existing advantageous nutritional aspects of current agricultural production and patterns of consumption. It is recognized that taste cannot be altered significantly through policy, and it is also recognized that variations AJPH June, 1977, Vol. 67, No. 6
COMMENTARIES
in consumption patterns differ both regionally and with regard to different population groups. It is the aim of the policy to work within the limitations imposed by those differences; 2. To improve the nutritional quality of the overall national diet, it is the aim to reduce the overall intake of fats as a source of energy. The reduction in fats should eventually be to about 35 per cent of the total diet; 3. To substitute for the decline in fat consumption, it is the aim to increase the intake of foodstuffs with heavy concentrations of starches, especially grains and potatoes. Sugar as a source of energy ought to be reduced; 4. In terms of total fat consumption it is the aim to increase the proportion of polyunsaturated fats and decrease the proportion of saturated fats. The means for implementation of this policy are: 1. The specific means must be developed on a cooperative basis between: a) local and central governmental administrations; b) the trade and professional organizations; c) the voluntary organizations; and d) groups representing different consumer interests; 2. Policy related to agriculture, fisheries, and prices. Agricultural changes will come through the existing system of price negotiations between farm organizations and the government. The fisheries are much more of a problem since the price of fish is largely determined by the international market, and 85-90 per cent of Norwegian fish production is exported. To encourage the production and consumption of desirable foodstuffs, production subsidies will be used as much as possible to regulate the production of those foods that are supplied mainly through domestic production, and consumer subsidies will be used to make those products that are desirable, but whose price is fixed in the international market, competitively advantageous on the domestic market. Attempts will be made to develop international agreements where the value of foodstuffs is not merely determined by their availability but, more importantly, by their nutritional quality; 3. Means will be promoted to make production and marketing based on nutritional quality. Proposals have been developed that marketing information must emphasize qualita-
tive considerations; 4. Legislation should be improved and simplified to prevent the production and distribution of foods and drinks that are detrimental to health, to prevent unsanitary means of production and refinement of foods and drinks, to promote the labeling of foods and drinks according to how they have been produced and what they contain, and to prevent erroneous information and beliefs about the origin and value of foods and drinks; 5. Research and education should be better coordinated and directed at the economic and nutritional value of foodstuffs. Nutritional education should be promoted at all levels of public education, and especially medical personnel should
AJPH June, 1977, Vol. 67, No. 6
be more familiar with, and promote the dissemination of, the value of nutrition on health; 6. Public information will be used to motivate people towards an improved diet, to disseminate a broad understanding of the major components in such a diet, and develop the basis for people to acquire the needed skills and knowledge so that they can become self-sufficient in questions of diet relative to the available information and supply of foods and drinks; 7., Establish the needed administrative facilities and procedures to ensure that the goals and objectives of this policy are implemented and that its intent is maintained into the future. This white paper should be of interest to many people involved in public health. lt gives a good historical perspective, and couples the question of health to its widest social, economic, and political circumscription. While it may be faulted for emphasizing individual behavior as a major determinant of a less than optimal diet, it also stresses the role of the producers and distributors in this capacity. And although it is limited to cooperation between the agricultural and health sectors, it does demonstrate that policy need not be sectoral. It thus presents a basis on which more comprehensive health policies can be developed. More than anything, perhaps, it should demonstrate that it is possible to develop comprehensive national policies in the area of health and agriculture. Such national policies are sorely needed if we are ever to achieve a global coordination for the exploitation, refinement, and distribution of resources in a time that international dependencies of all kinds are obviously increasing. No nation can afford taact solely upon its limited self-interest. Hopefully, this document can provide the impetus for policy researchers and policy makers to acknowledge that it is not sufficient to think mainly along sectoral lines or solely on the basis of national needs. Health status cannot be maintained without considering health as being intricately interwoven into the entire social fabric, nor can domestic needs and aspirations be satisfied without realizing the international interdependencies of the current world. The time for broadening our view on public health matters is long overdue-and this white paper has demonstrated that this is possible providing that we are willing to give up some preeminence in our fields of expertise. Once this hurdle is overcome it should also be possible to expand this view in terms of the global nature of current needs and resources to satisfy those needs. REFERENCE
1. Ministry of Agriculture, Government of Norway, Norwegian Food and Nutritional Policy, White Paper no. 32 (1975-76), Ministry of Agriculture, Government of Norway, Oslo-Dep., Oslo 1, Norway, 184 pp., 1975 (English edition available free of charge from the Ministry of Agriculture, Government of Norway, OsloDep., Oslo 1, Norway)
551
