Abstract
BACKGROUND: The eating behaviour of individuals and the influences exerted from the food environment is a key element to promote and facilitate access to healthy foods. However, knowledge about the implementation of policies on healthy food environments in Spain is scarce. The aim of this paper was to identify and assess the level of implementation of environmental food policies and determine and prioritize actions necessary to create healthy food environments in Spain, helped by a panel of experts. METHODS: A panel of experts from the University and the government administration specialized in public health, nutrition, food, or health policies was created and invited to participate, asking them to evaluate the level of implementation of food policies in Spain during 2018-2020, holding workshops to identify and prioritize concrete actions, using the Healthy Food Environmental Policy Index (Food-EPI). Six key policy domains of food environments, and 6 domains of food infrastructure were considered. Interrater reliability was measured using AgreeStat 2015.6.2 through Gwet AC2. The mean rating of the indicators was used. Data analysis was a three-step process by application of the Delphi method. RESULTS: The necessary political actions in healthy eating in Spain were considered low (58%) in food composition, labelling, promotion, and prices, and very low (25%) in food retail trade. The priority actions needed to support healthy food infrastructures were considered of medium importance (52%) for leadership and monitoring, and of low importance (48%) in governance, financing, and platforms. CONCLUSIONS: Spain shows great potential to create healthy food environments, with a low or very low need for policies to implement healthy food environments, and medium or low support for healthy food infrastructures.