Assessing and benchmarking voluntary food industry commitments and practices for addressing the double burden of malnutrition in South Africa
1
Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry and Epidemiology, Faculty of Medicine, LMU Munich, Munich, Germany
2
Pettenkofer School of Public Health, Munich, Germany
3
School of Public Health, University of the Western Cape, Bellville, Cape Town, South Africa
4
Non-Communicable Disease Research Unit, South African Medical Research Council, Tygerberg, Cape Town, South Africa
5
Health Economics Unit, School of Public Health, University of Cape Town, Cape Town, South Africa
6
Health through Physical Activity, Lifestyle, and Sport (HPALS) Research Centre, University of Cape Town, Cape Town, South Africa
7
Global Centre for Preventive Health and Nutrition, Deakin University, Geelong, Australia
8
École de Nutrition, Centre NUTRISS, Université Laval, Québec, Canada
9
Chair of Public Health Nutrition, Faculty of Life Sciences, University of Bayreuth, Kulmbach, Germany
10
Chronic Disease Initiative for Africa, University of Cape Town, Cape Town, South Africa
11
Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
Popul. Med. 2026;8(Supplement Supplement 1):A3003
ABSTRACT
INTRODUCTION:
South Africa experiences a double burden of malnutrition (DBM), comprising a high prevalence of both under- and overnutrition, which is partly driven by unhealthy food environments. The food industry plays a central role in shaping food environments and dietary patterns through its commercial practices. This study aimed to identify areas in which large food companies operating in South Africa report taking action in promoting healthier food environments and to highlight opportunities for improvement in addressing the DBM.
METHODS:
We applied the Business Impact Assessment on Obesity and Population-level Nutrition (BIA-Obesity) tool (1), developed by a global network of public-interest organisations and researchers (INFORMAS). The tool was adapted to the South African context by removing non-applicable indicators and adding a seventh domain specifically on the DBM (2). Publicly available company commitments and reporting practices were collected between February 2024 and June 2025 and verified and/or supplemented by company representatives. Company commitments and practices were then assessed against industry and public health benchmarks, and evaluated according to their comprehensiveness, specificity, and transparency. Weighted scores were calculated to generate an overall score out of 100, and tailored company-specific priority recommendations were developed.
RESULTS:
Twenty-nine companies were included based on market share, comprising 15 food and non-alcoholic beverage manufacturers, four supermarket chains, and 10 quick-service restaurant chains. Companies reported action in the domains of corporate strategy, nutrition labelling, and disclosure of external relationships and lobbying. However, substantial room for improvement was identified with regard to product accessibility, promotion practices, product formulation and addressing the DBM. Quick-service restaurants had notably lower scores than the other two sectors.
CONCLUSIONS:
Given insufficient voluntary industry action in key nutrition policy areas, addressing the DBM in South Africa will likely require strengthened governmental approaches to create healthier food environments, alongside substantial improvements in food industry commitments and practices.
South Africa experiences a double burden of malnutrition (DBM), comprising a high prevalence of both under- and overnutrition, which is partly driven by unhealthy food environments. The food industry plays a central role in shaping food environments and dietary patterns through its commercial practices. This study aimed to identify areas in which large food companies operating in South Africa report taking action in promoting healthier food environments and to highlight opportunities for improvement in addressing the DBM.
METHODS:
We applied the Business Impact Assessment on Obesity and Population-level Nutrition (BIA-Obesity) tool (1), developed by a global network of public-interest organisations and researchers (INFORMAS). The tool was adapted to the South African context by removing non-applicable indicators and adding a seventh domain specifically on the DBM (2). Publicly available company commitments and reporting practices were collected between February 2024 and June 2025 and verified and/or supplemented by company representatives. Company commitments and practices were then assessed against industry and public health benchmarks, and evaluated according to their comprehensiveness, specificity, and transparency. Weighted scores were calculated to generate an overall score out of 100, and tailored company-specific priority recommendations were developed.
RESULTS:
Twenty-nine companies were included based on market share, comprising 15 food and non-alcoholic beverage manufacturers, four supermarket chains, and 10 quick-service restaurant chains. Companies reported action in the domains of corporate strategy, nutrition labelling, and disclosure of external relationships and lobbying. However, substantial room for improvement was identified with regard to product accessibility, promotion practices, product formulation and addressing the DBM. Quick-service restaurants had notably lower scores than the other two sectors.
CONCLUSIONS:
Given insufficient voluntary industry action in key nutrition policy areas, addressing the DBM in South Africa will likely require strengthened governmental approaches to create healthier food environments, alongside substantial improvements in food industry commitments and practices.
| eISSN: | 2654-1459 |
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