Good Food for Germany

Good Food for Germany The Federal Government’s Food and Nutrition Strategy Contents Good Food for Germany ............................................................................................................................ 1 The Federal Government’s Food and Nutrition Strategy ................................................................... 1 I. Introduction ........................................................................................................................................ 1 A. The situation today ....................................................................................................................... 1 1. The individual/cultural dimension ........................................................................................ 1 2. The health dimension .............................................................................................................. 2 3. The environmental dimension ............................................................................................... 5 4. The socioeconomic dimension .............................................................................................. 6 B. Ambition and goals ....................................................................................................................... 6 1. Vision ........................................................................................................................................... 8 2. Mission ........................................................................................................................................ 8 3. Strategic goals ........................................................................................................................... 9 a) Balanced diets and sufficient exercise – promoting adequate nutrient and energy intakes and exercise ...................................................................................................................... 9 b) More vegetables, fruit and legumes – promoting plant-based diets ........................ 9 c) Growing up healthy and growing old healthy – ensuring socially equitable access to healthy and sustainable nutrition ......................................................................................... 9 d) Well-balanced diets in daycare, school and canteen meals – improving mass catering ......................................................................................................................................... 10 e) Good food for us and our planet – increasing the supply of sustainably and organically produced food ........................................................................................................ 10 f) Valuing food – reducing food waste ............................................................................. 10 4. Structural approaches pursued by the Federal Government ....................................... 10 a) Healthy and sustainable food environments............................................................... 11 b) Healthy and sustainable eating patterns ...................................................................... 11 c) Efficient structures and processes ................................................................................. 11 d) Ongoing research .............................................................................................................. 11 C. Development process ................................................................................................................ 11 1. Participative development ................................................................................................... 11 2. Multiphase approach ............................................................................................................ 12 3. Multipolar approach .............................................................................................................. 13 4. Reflexive approach ................................................................................................................ 13 II. Strategy ............................................................................................................................................. 13 A. Healthy and sustainable food environments ........................................................................ 14 1. Out-of-home catering, particularly mass/communal catering ................................... 14 a) Why we have to act ........................................................................................................... 14 b) What is our goal ................................................................................................................. 14 c) How can we achieve our goal? ....................................................................................... 16 2. Shaping the consumption landscape ................................................................................. 20 a) Why we have to act ........................................................................................................... 20 b) What is our goal ................................................................................................................. 20 c) How can we achieve our goal? ....................................................................................... 21 3. Social aspects of food and nutrition .................................................................................. 25 a) Why we have to act ........................................................................................................... 25 b) What is our goal ................................................................................................................. 25 c) How can we achieve our goal? ....................................................................................... 26 4. Links to sustainable food production and supply ........................................................... 27 a) Why we have to act ........................................................................................................... 27 b) What is our goal ................................................................................................................. 28 c) How can we achieve our goal? ....................................................................................... 29 B. Healthy and sustainable eating patterns ............................................................................... 33 1. Dietary guidelines .................................................................................................................. 33 a) Why we have to act ........................................................................................................... 33 b) What is our goal ................................................................................................................. 33 c) How can we achieve our goal? ....................................................................................... 34 2. Nutrition communication and information ...................................................................... 37 a) Why we have to act ........................................................................................................... 37 b) What is our goal ................................................................................................................. 38 c) How can we achieve our goal? ....................................................................................... 38 3. Food and nutrition education ............................................................................................. 41 a) Why we have to act ........................................................................................................... 41 b) What is our goal ................................................................................................................. 41 c) How can we achieve our goal? ....................................................................................... 42 4. Prevention ............................................................................................................................... 43 a) Why we have to act ........................................................................................................... 43 b) What is our goal ................................................................................................................. 44 c) How can we achieve our goal? ....................................................................................... 45 5. Addressing diet and exercise together .............................................................................. 51 a) Why we have to act ........................................................................................................... 51 b) What is our goal ................................................................................................................. 52 c) How can we achieve our goal? ....................................................................................... 52 C. Efficient structures and processes .......................................................................................... 54 1. Why we have to act ............................................................................................................... 54 2. What is our goal ..................................................................................................................... 54 3. How can we achieve our goal? ............................................................................................ 55 D. Ongoing research ....................................................................................................................... 57 1. Why we have to act ............................................................................................................... 57 2. What is our goal ..................................................................................................................... 59 3. How can we achieve our goal? ............................................................................................ 59 III. Outlook ............................................................................................................................................. 63 List of abbreviations AWMF Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (Association of Scientific Medical Societies) BfR Bundesinstitut für Risikobewertung (Federal Institute for Risk Assessment) Bio-AHVV Bio-Außer-Haus-Verpflegung-Verordnung (Organic Out-of-home Catering Ordinance) BLS Bundeslebensmittelschlüssel (German Nutrient Database) BMAS Bundesministerium für Arbeit und Soziales (Federal Ministry of Labour and Social Affairs) BMBF Bundesministerium für Bildung und Forschung (Federal Ministry of Education and Research) BMEL Bundesministerium für Ernährung und Landwirtschaft (Federal Ministry of Food and Agriculture) BMG Bundesministerium für Gesundheit (Federal Ministry of Health) BMI Bundesministerium des Innern, für Bau und Heimat (Federal Ministry of the Interior and Community) BMUV Bundesministerium für Umwelt, Naturschutz, nukleare Sicherheit und Verbraucherschutz (Federal Ministry for the Environment, Nature Conservation, Nuclear Safety and Consumer Protection) BÖL Bundesprogramm Ökologischer Landbau (Federal Organic Farming Scheme) BZfE Bundeszentrum für Ernährung (Federal Centre for Food and Nutrition) DGE Deutsche Gesellschaft für Ernährung e. V. (German Nutrition Society) DIfE Deutsches Institut für Ernährungsforschung (German Institute of Human Nutrition) DNS Deutsche Nachhaltigkeitsstrategie (German Sustainable Development Strategy) EPS Eiweißpflanzenstrategie (Protein Crops Strategy) EsKiMo Ernährungsstudie als KiGGS-Modul (nutrition study module of KiGGS) FAO Food and Agriculture Organization of the United Nations IMAG Interministerielle Arbeitsgruppe (interdepartmental working group) JPI HDHL Joint Programming Initiative “A Healthy Diet for a Healthy Life” KiESEL Kinder-Ernährungsstudie zur Erfassung des Lebensmittelverzehrs (Children’s nutrition survey module of KiGGS Wave 2) KiGGS German Health Interview and Examination Survey for Children and Adolescents MRI Max Rubner Institute NPK Nationale Präventionskonferenz (National Prevention Conference) NPP Nationaler Präventionsplan (National Prevention Plan) NQZ Nationales Qualitätszentrum für Ernährung in Kita und Schule (National Quality Centre for Nutrition in Daycare Centres and Schools) NRI Nationale Reduktions- und Innovationsstrategie für Zucker, Fette und Salz in Fertigprodukten (National Reduction and Innovation Strategy for Sugar, Fats and Salt in Processed Foods) NVS Nationale Verzehrsstudie (National Nutrition Survey) ÖGD Öffentlicher Gesundheitsdienst (Public Health Service) OHC Out-of-home catering PKV Verband der privaten Krankenversicherung e. V. (Association of German Private Healthcare Insurers) RIWert Richtlinie zur Förderung von Bio-Wertschöpfungsketten (Organic Value Chains Funding Guideline) RKI Robert Koch Institute TI Thünen Institute UN FSS UN Food Systems Summit WBAE Wissenschaftlicher Beirat für Agrarpolitik, Ernährung und gesundheitlichen Verbraucherschutz (BMEL Scientific Advisory Board on Agricultural Policy, Food and Consumer Health Protection) WHO World Health Organization ZKL Zukunftskommission Landwirtschaft (Commission on the Future of Agriculture) ZöL Zukunftsstrategie ökologischer Landbau (Strategy for the Future of Organic Farming) 1 Good Food for Germany The Federal Government’s Food and Nutrition Strategy I. Introduction A. The situation today Eating and drinking are basic needs – and much more besides. They can go hand in hand with indulgence, belonging, tradition and togetherness. In many cases, our nutrition reflects our culture and attitudes, or constitutes a form of self-fulfilment. How, and what, we eat not only affects our health and wellbeing. It also has an impact on the foundations of life – on the environment and climate, on animals and biodiversity in Germany and worldwide. So good food, meaning a healthy and sustainable diet, is not only good for each and every one of us in that it is beneficial to our health, positively influences our physical and psychological wellbeing and helps prevent illness. It is also good for the planet. People in Germany have a wide choice of diverse, high-quality foods. Any government initiative for healthier nutrition must therefore also help motivate people to question their individual dietary preferences. As the 2023 Nutrition Report shows, 91 percent of people consider the health aspect of nutrition to be important. For 74 percent, it is important for food to be produced in an environment-friendly and resource-saving way. Most people want to eat healthily and sustainably. We want to support consumers in terms of their everyday nutritional choices. It is precisely the everyday nature of nutrition that makes it a key to effecting change. By adopting this Food and Nutrition Strategy, we want to make use of this as an opportunity to improve individual and planetary health. The Strategy is intended as an important contribution to the transformation towards a resource-saving, climate-friendly and sustainable economy. 1. The individual/cultural dimension Our nutrition is an expression of our tastes, our values and our choices. It is influenced by our social, economic and cultural environment. Nutrition is also to a large extent a matter of habit. In many cases, the foods we eat are part and parcel of an established routine. This is shaped by many influences, including our families, our work environments and our daily lives. It is also the result of societal trends that cause our eating habits to change. 2 Although many people would like to eat a healthy and sustainable diet, average eating habits are not in line with current recommendations.1 This shows that heightened awareness of healthy and sustainable nutrition is not usually enough on its own to actually improve dietary choices. Changes in diet have to fit in with people’s everyday lives. And there are many obstacles to this: information overload, the wide variety of choices and products on offer, language barriers or simply lack of knowledge, time or money. A key prerequisite for good nutrition is the improvement of food environments, meaning the situational conditions that make it difficult up to now for people to eat good food. These are often designed in such a way that it makes eating healthily and sustainably difficult. 2. The health dimension To maintain a healthy diet, we need to ensure an adequate energy and nutrient intake. According to data from a 2019/2020 lifestyle survey by the Robert Koch Institute, fewer than half of all women (45 percent) and only around a quarter of all men (24 percent) eat fruit and vegetables every day.2 Figures from 2022 showed only half of all children and adolescents to eat both fruit and vegetables on a daily basis. One in three 12-17-year-olds drank sugary soft drinks at least three to four times a week.3 In large parts of the population, people’s daily intake of sugar, fats (and especially saturated fatty acids) and salt exceed current recommendations. At an average of around one kilogram of meat and sausage products per person per week, meat consumption in Germany is lower than at any time since consumption calculations began in 1989.4 Yet this is still well above the quantity recommended by the German Nutrition Society (DGE). Average fish consumption in Germany currently falls short of the DGE and EAT-Lancet Commission recommendations.5 The DGE recommends a weekly consumption of one to two portions of fish from sustainable fisheries or aquaculture. A poorly balanced diet – especially in combination with a lack of exercise – increases the risk of overweight and obesity6 and can contribute to diet-related diseases such as type 2 1 See the largely similar recommendations of the German Nutrition Society (DGE) or the EAT-Lancet Commission. The EAT-Lancet Commission published the Planetary Health Diet, a global reference diet to feed a world population of 10 billion people in 2050 within planetary boundaries. See Eat-Lancet Commission (2019): Food. Planet. Health: Summary Report of the EAT-Lancet Commission. https://eatforum.org/content/uploads/2019/07/EAT-Lancet Commission Summary Report.pdf. See also DGE (2022): DGE (2022): DGE Stellungnahme zur Planetary Health Diet (2022/12) [press release]. https://www.dge.de/presse/meldungen/2022/dge-stellungnahme-zur planetary-health-diet/. 2 Richter A. et al. (2021): Health-promoting behaviour among adults in Germany – Results from GEDA 2019/2020-EHIS. In Journal of Health Monitoring 2021 6(3). DOI 10.25646/8460.2, p. 50. 3 RKI (2023): 3. Quartalsbericht – Kindergesundheit in Deutschland aktuell (KIDA): Monitoring der Kindergesundheit in (und nach) der COVID-19-Pandemie. Schwerpunkt Ernährungsverhalten. Ergebnisse des KIDA-Erhebungszeitraum 04/2022 – 11/2022. RKI (2023), p. 3. 4 BLE (2023): Meat consumption at a low in 2022, https://www.ble.de/SharedDocs/Pressemitteilungen/EN/2023/230423 meat consumption.html. 5 See Eat-Lancet Commission (2019). 6 Overweight: body mass index ≥ 25 kg/m2, obesity: ≥ 30 kg/m2. 3 diabetes mellitus and cardiovascular disorders. That has a physical and in some cases a psychological impact on the individual and also has knock-on costs for society. Eating large amounts of red and processed meat increases the risk of developing colorectal cancer, breast cancer or type 2 diabetes mellitus.7 Recommended intake and actual median intake of salt, sugar and fats in children and adolescents (ages 3-17), based on Wave 2 of the RKI Health Interview and Examination Survey for Children and Adolescents (KiGGS-W2, 2014-2017), the KiGGS Module II nutrition survey (EsKiMo II, 2015-2017) and the Children’s Nutrition Survey (KiESEL, 2014-2017) by the Federal Institute for Risk Assessment (BfR). DGE recommended intake/reference value for children and adolescents Intake in Germany among children and adolescents Salt < 3-6 g per day 6.5 g per day (KiGGS-W2) Free sugars8 < 10 En%9 16.8-18.8 En%10 (KiESEL, EsKiMo II)11 Fat 30-35 En% (age 4 to < 15) 32.0-33.9 En% (age 3 to < 15; KiESEL, EsKiMo II) Saturated fatty acids < 10 En% 15.3-15.5 En% (age 3 to 5; KiESEL) > 10 En%12 (age 6 to < 17; EsKiMo II) The direct healthcare costs of excessive sugar, salt and saturated fatty acid intake were estimated for Germany at €16.8 billion in 2008. That corresponded to seven percent of total treatment costs in Germany.13 According to a 2015 study, the total societal cost of obesity in Germany amounts to around €63 billion per year.14 Chronic noncommunicable and frequently nutrition-related diseases such as type 2 diabetes mellitus and cardiovascular disorders impose a heavy disease burden. This can severely curtail quality of life and life expectation for those affected. Unhealthy diets are linked to 14 7 DGE (2020): 14. DGE-Ernährungsbericht. Bonn. 8 Free sugars comprise monosaccharides and disaccharides added to food by producers or consumers, plus naturally occurring sugars in honey, syrups, fruit juice concentrates and fruit juices. 9 Percentage of daily energy intake. 10 Depending on age and gender. 11 Based in this case on average intake. 12 Concrete value not published. 13 Meier T. et al. (2015): Healthcare Costs Associated with an Adequate Intake of Sugars, Salt and Saturated Fat in Germany: A Health Econometrical Analysis. PLoS ONE 10(9):e0135990. doi:10.1371/journal.pone.0135990. 14 Effertz T. et al. (2016): The costs and consequences of obesity in Germany: a new approach from a prevalence and life-cycle perspective. Eur J Health Econ. 2016 Dec;17(9):1141-1158. doi: 10.1007/s10198-015-0751-4. Epub 2015 Dec 23. PMID: 26701837. This figure also includes indirect healthcare costs such as absence due to illness, early retirement and surviving dependents’ pensions. 4 percent of deaths in Germany.15 This figure is higher than ever before, with at least 8.5 million people in Germany currently suffering from type 2 diabetes mellitus.16 Among children and adolescents in Germany alone, around 15 percent are currently overweight, including almost six percent with obesity.17 Children and adolescents of low socioeconomic status18 and children and adolescents with a migrant background19 are more frequently affected.20 These differences became even more pronounced during the Covid-19 pandemic.21 Eating habits are largely formed in childhood. This is therefore the key time of life to target with long-lasting measures to prevent overweight and obesity. The human body requires an intake of macro and micronutrients via food.22 Macro and micronutrients play an important role in growth, development and maintaining good health. A significant number of children and adolescents aged six to under 18 are at risk of deficiencies with regard to specific micronutrients.23 In children, micronutrient deficiencies can lead among other things to stunted growth, delayed speech development or cognitive impairment. Macro and micronutrient intake is also inadequate in other population groups. For example, quantitative malnutrition is encountered in the hospital and nursing home context for reasons including chronic illness, pain, loss of appetite, and also qualitative malnutrition.24 A healthy lifestyle with a balanced diet and sufficient exercise can help prevent, delay or positively influence the progression of noncommunicable diseases. In order to create health promoting conditions, nutrition and exercise must be considered in tandem. 15 OECD/European Observatory on Health Systems and Policies (2021): Germany: Country Health Profile 2021, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels. 16 2021 figures, plus at least two million unreported cases; see Tönnies T. and W. Rathmann (2022): Epidemiologie des Diabetes in Deutschland, in Deutsche Diabetes Gesellschaft et al., Deutscher Gesundheitsbericht. Diabetes 2022. Die Bestandsaufnahme, p. 9. 17 Schienkiewitz et al. (2018): Übergewicht und Adipositas im Kindes- und Jugendalter in Deutschland – Querschnittergebnisse aus KiGGS Welle 2 und Trends, in Journal of Health Monitoring 3(1), p. 16‒23. DOI 10.17886/RKI-GBE-2018-005.2. 18 Ibid. 19 Definition of migrant background: a person has a migrant background if he or she or at least one parent did not acquire German citizenship by birth. (Federal Statistical Office). 20 According to one study, children and adolescents with a migrant background are even more frequently likely to be overweight; see Kolloschek et al. (2019): The health of children and adolescents with a migration background in Germany, Journal of Health Monitoring, 2019 4(3) DOI 10.25646/6070. 21 https://www.bmfsfj.de/resource/blob/214866/fbb00bcf0395b4450d1037616450cfb5/ima-abschlussbericht-gesundheitliche auswirkungen-auf-kinder-und-jugendliche-durch-corona-data.pdf. 22 Macronutrients comprise the three energy-containing dietary components: carbohydrates, proteins and fats. Micronutrients (vitamins, minerals and trace elements) are needed for almost every process in the body. 23 There is also a need for improvements in dietary fat quality. Vitamin D and E and folate intakes are also probably inadequate, as the estimated intake values for Germany, Austria and Switzerland are not reached in the majority of adolescents. A majority of over 90 percent of adolescents of all age groups do not reach the German, Austrian and Swiss mineral intake reference values for iodine, potassium, calcium and iron. See Lehman F. et al. (2020): Nährstoffversorgung und Rahmenbedingungen des Ernährungsverhaltens bei Kindern und Jugendlichen: Ergebnisse aus der Ernährungsstudie EsKiMo II. 14. DGE-Ernährungsbericht, p. 114 ff. 24 According to the 14th DGE Nutrition Report (2020), almost 30 percent of hospital patients and nursing home residents internationally are malnourished, see DGE (ed.) (2020): 14. DGE-Ernährungsbericht. Bonn. According to the most recent (non-representative) analysis of the 2018 nutritionDay project (a global initiative to combat malnutrition in healthcare institutions), nursing staff reported that 12 percent of hospital patients and 11 percent of nursing home residents in Germany are malnourished. 5 3. The environmental dimension How our foods are produced, processed and consumed has an impact on the environment. According to the Intergovernmental Panel on Climate Change, the global food system accounts for roughly 21-37 percent of global25 – and around a fifth of German26 greenhouse gas emissions. The food system is a driver of species extinction and accounts for 80 percent of land use change worldwide.27 Today’s food system is coming up against planetary limits. Sustainable cultivation systems such as organic farming are under particular pressure to succeed. Animal-based foods have an outsized ecological footprint. Producing them uses large quantities of finite resources such as water, fertile soils, phosphorus and fossil fuels. Around 80 percent of farmland worldwide is used for the production of animal-based foods; 67 percent of that land is grassland and pasture.28 More sustainable, plant-based nutrition is a key element of the transformation to a resource saving, climate-friendly and sustainable economy. It is also important for food waste and losses to be avoided along the entire value chain. A sustainable Food and Nutrition Strategy therefore also has to consider environmental impacts of nutrition along with other factors. According to the Nutrition Report 2023, 46 percent of respondents in Germany are flexitarian and eat meat only occasionally. Eight percent of respondents are vegetarian and two percent are vegan.29 There are now a wide variety of vegetarian and vegan alternatives to animal-based foods,30 in line with the growing level of interest. It is important for mass catering facilities and restaurants to offer more plant-based options to meet the increasing customer demand. The environmental hidden costs of the food system for Germany have been estimated by the Food and Agriculture Organization of the United Nations (FAO) at around US$30 billion per 25 IPCC (2019): Climate Change and Land: an IPCC special report on climate change, desertification, land degradation, sustainable land management, food security, and greenhouse gas fluxes in terrestrial ecosystems [P.R. Shukla, J. Skea, E. Calvo Buendia, V. Masson Delmotte, H.-O. Pörtner, D. C. Roberts, P. Zhai, R. Slade, S. Connors, R. van Diemen, M. Ferrat, E. Haughey, S. Luz, S. Neogi, M. Pathak, J. Petzold, J. Portugal Pereira, P. Vyas, E. Huntley, K. Kissick, M. Belkacemi, J. Malley, (eds.)]. In press. 26 WBAE (2020): Politik für eine nachhaltigere Ernährung – Eine integrierte Ernährungspolitik entwickeln und faire Ernährungsumgebungen gestalten. Berlin. 27 Benton et al. (2021): Food system impacts on biodiversity loss: Three levers for food system transformation in support of nature. https://www.chathamhouse.org/sites/default/files/2021-02/2021-02-03-food-system-biodiversity-loss-benton-et-al 0.pdf. 28 Fesenfeld, L. et al. (2022): Policy Brief, p. 2 and FAO (2023): World Food and Agriculture – Statistical Yearbook 2023. Rome. P. 3. https://doi.org/10.4060/cc8166en. 29 BMEL (2023): Deutschland, wie es isst. Der BMEL-Ernährungsreport 2023. Berlin, p. 10. 30 This also correlates with the survey figures from the 2023 Nutrition Report: 53 percent of respondents have bought vegetarian or vegan alternatives to animal products at least once. This represents a six percentage point increase on the previous year. BMEL (2023): BMEL Ernährungsreport 2023. Berlin, p. 10. 6 year. Together with the health costs, the hidden costs total around US$328 billion per year, corresponding to around 7 percent of Germany’s gross domestic product.31 4. The socioeconomic dimension The goal of easy and equitable access to sufficient and healthy food for all is yet to be achieved. Food poverty is defined as a qualitatively or quantitatively insufficient diet, which can have various causes, such as insufficient access to healthy and sustainable food or a lack of food literacy. This can lead to health and social problems. In Germany, socioeconomic status has a significant influence on diet and hence also on people’s health prospects.32 People of low socioeconomic status are more likely to suffer from obesity and have a shorter life expectancy. Quantitative or qualitative malnutrition can have a negative impact on children’s physical and cognitive development, which in turn restricts their opportunities for the rest of their lives. Furthermore, nutrition is important for social participation, which is again related to psychological and physical health. Crises such as the Covid-19 pandemic and the Russian war of aggression against Ukraine have led to price increases and supply shortages. In the medium to long term, impacts of the climate and biodiversity crisis, too, could result in even more supply shortages, rising production costs and hence higher prices. This particularly affects the financially vulnerable, who already spend a greater proportion of their household income on food and are therefore hit relatively harder by higher food prices. They also have little or no reserves to compensate for higher food prices by making savings in other areas. B. Ambition and goals The Federal Government’s aim is to make it as easy as possible for all consumers to eat good food. There are synergies with environmental protection, climate change mitigation and animal welfare. Access to good food for all is also a question of equity and participation. This aspect has been neglected for too long in Germany33 and is to receive greater attention under the Food and Nutrition Strategy. A particular focus will be placed on children and people with low incomes.34 31 FAO (2023): The State of Food and Agriculture 2023: Revealing the true cost of food to transform agrifood systems. The State of Food and Agriculture (SOFA) 2023. Rome, Italy: Food and Agriculture Organization of the United Nations (FAO). https://doi.org/10.4060/cc7724en. 32 Around two-thirds of food bank users in Germany suffer from one or more chronic or diet-related illnesses, including type 2 diabetes, cardiovascular disease, gastrointestinal disease, liver and kidney disease, gout, rheumatism, cancer and tooth decay; see Depa, J. (2018): Ernährung von sozial benachteiligten Menschen am Beispiel von Tafelkunden. Betrachtung des Ernährungs- und Gesundheitsverhaltens, der Verbreitung von Ernährungsarmut und des Obst- und Gemüsekonsums. People of low socioeconomic status are also twice as likely to suffer a heart attack and three times as likely to suffer a stroke than people of higher socioeconomic status; see also FOES (2021): Ernährungsarmut: In Deutschland (k)ein Thema? Policy Brief. https://foes.de/publikationen/2021/2021 11 FOES Ernaehrungsarmut Teil 1.pdf. 33 WBAE (2023): Ernährungsarmut unter Pandemiebedingungen. Stellungnahme. Berlin, p. 1. 34 This includes people with low income from employment and/or from transfer payments. 7 Nutrition plays a pivotal role both in individual health and wellbeing and in societal goals such as preserving biodiversity and combating the climate crisis. It is a key factor in achieving our national and international climate, biodiversity and sustainability goals. The Federal Government’s Food and Nutrition Strategy aims to contribute to the implementation of the German Sustainable Development Strategy,35 to meeting the commitments under the Paris Climate Agreement, to the European Commission’s Farm to Fork strategy,36 to the national follow-up process of the UN Food Systems Summit (UN FSS),37 to the implementation of the Council Recommendation establishing a European Child Guarantee38 and to the realisation of the human right to adequate food.39 The Food and Nutrition Strategy aims to contribute towards the further integration of agricultural and food policies to achieve a sustainable balance between human, animal and ecosystem health consistent with the collective, unifying principle of the One Health approach.40 In line with national and international climate targets, Germany’s food supplies are to be carbon-neutral by 2045. Several action areas under the Food and Nutrition Strategy overlap with strategic activities undertaken by the Federal Ministry of Food and Agriculture (BMEL) to strengthen the organic farming and food sector. The provision of protein for humans and animals plays a key role in the transformation of the agricultural and food sector for greater sustainability, climate change mitigation and resilience. Through the action area “Links to sustainable food production and supply”, the Food and Nutrition Strategy connects with the BMEL’s Protein Crops Strategy (EPS). By further developing that strategy, a decisive contribution can be made to achieving sustainability goals in the areas of climate change mitigation, the environment and health. The same action area has important links to the National Strategy on Genetic Resources for Food, Agriculture, Forestry and Fisheries, above all in terms of support for the promotion of regional or region-specific products. The natural diversity of genetic resources is the basis for resilient varieties and breeds, whose conservation and cultivation promote diversified agriculture and regional value chains. There are also links to the implementation of the National Bioeconomy Strategy, which among other things addresses the establishment of sustainable food production. 35https://www.bundesregierung.de/resource/blob/974430/1940716/8943e3f421a7a0d8bcd06a1cc66e92d0/2021-07-26-gsds-en data.pdf?download=1. 36 https://food.ec.europa.eu/document/download/472acca8-7f7b-4171-98b0-ed76720d68d3 en?filename=f2f action plan 2020 strategy-info en.pdf 37 https://www.ble.de/SharedDocs/Downloads/DE/BLE/UNFSS/UNFSS Abschlussbericht 230524.pdf;jsessionid=6C87FA27BBB31899784C812F6FE26390.internet992? blob=publicationFile&v=3. 38 https://ec.europa.eu/social/main.jsp?catId=1428&langId=en 39 https://www.fao.org/3/y7937e/y7937e.pdf. 40 https://www.who.int/news/item/01-12-2021-tripartite-and-unep-support-ohhlep-s-definition-of-one-health. 8 The Food and Nutrition Strategy is also coordinated with the National Strategy for the Promotion of Breastfeeding, the National Reduction and Innovation Strategy for Sugar, Fats and Salt in Processed Foods (NRI) and the National Strategy to Reduce Food Waste. In the following, we describe the vision (Where do we want to go?) and mission (What is our ambition?) for the Federal Government’s Food and Nutrition Strategy together with the Federal Government’s strategic goals and structural approaches. 1. Vision By 2050, it will be possible and easy for everyone in Germany to eat good food. Our food system will be changed so that everyone can eat healthily and sustainably, regardless of their background, education or income. We will direct our efforts at prevention rather than aftercare. The focus will be on more plant-based diets with preferably organic, seasonal and regional produce and a minimum of food waste. We also contribute with what we eat to food security in the future. 2. Mission We want to pave the way for our diets to be compatible with planetary boundaries and the science on healthy nutrition and by doing so to make our food system fit for the future. At the same time, we recognise that food choices are diverse and personal. Nutrition is also constantly evolving thanks to creative ideas. We want to harness this creativity to promote green, climate-friendly innovation in the food system. Our motivation is the enjoyment of good food – and making good food accessible to all. We also consider global food issues, because our diets have an impact on other countries. The Federal Government’s policy mandate to compile a food and nutrition strategy comes from the coalition agreement for the 20th electoral term and from society. The Federal Government and the Länder (states) can make a key contribution to creating a health promoting environment that makes good food and exercise easy to achieve. With this strategy, we are establishing the structures for everyone in Germany to be able to eat good food. Our task as the Federal Government is to shape conditions that contribute to improving the health of children and adolescents, people with qualitative or quantitative malnutrition and households at risk of or affected by poverty. We place a focus on people with an immigration history, where children and adolescents are more likely to face social and language barriers when accessing recommendations on healthy and sustainable nutrition. The Federal Government’s Food and Nutrition Strategy covers science and evidence-based measures within the Federal Government remit. They are intended to complement initiatives 9 launched by the Länder and local authorities in a multilevel solution. We closely involve civil society, business, the scientific community, government departments, the Länder and local authorities in the development of the Food and Nutrition Strategy and the implementation of its measures. The Strategy is to be regularly reviewed and revised. 3. Strategic goals On the basis of the above vision and mission, we derive the following strategic goals to achieve what we envisage: a) Balanced diets and sufficient exercise – promoting adequate nutrient and energy intakes and exercise We want to help people in Germany to eat good food and get more exercise. To this end, we want to make it easier for them to consume less sugar, fats and salt and obtain sufficient important nutrients such as iodine, iron, vitamin D and folate. We aim to achieve these goals among other things by revising the National Reduction and Innovation Strategy for Sugar, Fats and Salt in Processed Foods and the IN FORM National Action Plan for Nutrition and Physical Activity, supporting the mandatory introduction of the Nutri-Score across the EU and by restricting the advertising of foods with high sugar, fat or salt content to children. b) More vegetables, fruit and legumes – promoting plant-based diets Our aim is to improve access to plant-based diets with a high proportion of unprocessed seasonal and regional fruit and vegetables, fibre-rich cereals, legumes and nuts. At the same time, we want to help people make their consumption of animal-based foods healthy and sustainable. This is to be achieved among other things by mandatory compliance with German Nutrition Society (DGE) quality standards in mass catering and by promoting attractive plant-based options. c) Growing up healthy and growing old healthy – ensuring socially equitable access to healthy and sustainable nutrition How to enable everyone in Germany to eat healthily and sustainably – regardless of income, education or background – is a question of pressing importance given the problems faced today. Adequate, healthy and sustainable nutrition must be available to all. Ensuring that young people grow up healthy is particularly important. We want to combat food poverty in Germany. The Federal Government is developing a package of measures and gathering meaningful data for this purpose. 10 d) Well-balanced diets in daycare, school and canteen meals – improving mass catering Mass catering should enable access to good food. Healthy and sustainable food with mostly plant-based, seasonal and where possible regional and organic produce should be an easy and affordable choice and be presented in such a way that young people enjoy eating it. The DGE quality standards are to be made mandatory and to be established in mass catering by 2030. We want to help mass caterers improve quality and offer more organic food. The range of support is to be expanded accordingly. e) Good food for us and our planet – increasing the supply of sustainably and organically produced food Supply and demand have to be considered in tandem. Given the growing demand for plant-based foods, we want to create the conditions to ensure that the produce for these foods can be grown and processed sustainably in Germany. We want to make the food system more resilient and strengthen regional value creation. Measures under the Food and Nutrition Strategy have to be compatible with the necessary transformation of agricultural systems towards greater sustainability, climate change mitigation, global social equity and resilience. However, the transformation of agricultural systems – nationally, at EU level in the Common Agricultural Policy (CAP) and internationally – is not itself part of the Federal Government’s Food and Nutrition Strategy. This is addressed among other things in the 2035 Arable Farming Strategy and the CAP Strategy Plan. f) Valuing food – reducing food waste We want to do even more to encourage people to value food, halve food waste by 2030 and further reduce food losses. To achieve this goal, we are continuously developing the National Strategy to Reduce Food Waste together with the relevant federal and Länder ministries and stakeholders. Behavioural change is needed at all stages of the food supply chain. Measures and programmes promoting such change are developed and implemented in the BMEL’s Too Good for the Bin! initiative and the Dialogue Forum Private Households 2.0. It is also important for food waste to be recorded more consistently. The Federal Government is also exploring legislative measures to reduce food waste, such as making it easier to donate food. 4. Structural approaches pursued by the Federal Government To achieve our strategic goals, we need to work on multiple levels while taking account of prevailing circumstances and individual dietary habits together with the interrelationships between them. We aim to promote beneficial food environments and eating patterns that make it easy for people to eat good food. Making optimum use of the Federal Government’s 11 scope for action under the federal division of powers requires efficient structures and processes. A prerequisite for future-ready food policy is ongoing research. This leads to the following structural approaches: a) Healthy and sustainable food environments We often choose what we eat in response to the encountered food environments. The key here is structural prevention: We want to create food environments that make healthy and sustainable eating easy and attractive. In doing so, we look at supply and demand together, including with regard to resource-efficiency, climate change mitigation and environmental protection. b) Healthy and sustainable eating patterns Behaviourally oriented, low-threshold nutrition education and information campaigns address people’s individual ability to make choices and act on them. They are a prerequisite for conscious consumption and help people eat healthily and sustainably. c) Efficient structures and processes The focus is on measures within the remit of the Federal Government. However, it is always necessary to look at how measures at the various federal levels can be usefully coordinated with each other. Established structures need to be made more effective and processes streamlined. d) Ongoing research Ongoing research is a key basis for science-based, future-ready food policy. In addition to providing findings in areas such as nutritional physiology, it serves among other things to ensure the currency of data on the nutritional situation, its health, environmental and climate impacts and its social dimension. C. Development process 1. Participative development The Food and Nutrition Strategy was developed in an open-outcome participative process. This involved representatives from administration, the scientific community, business, consumers, the health sector, environmental protection and civil society. The BMEL was consequently able to gain a comprehensive overview of the various stakeholders’ perspectives, interests, expertise and experience and collected numerous ideas and suggestions. These were then taken into account in the strategy’s development. The BMEL conducted the participation process from June 2022 to February 2023. It included several events and a broad-based online survey:  June 2022: At the kick-off event, 150 participants provided important input for the development of the concept paper and the Food and Nutrition Strategy. 12  October 2022: At an event entitled “The future of food – more plant-based diets” organised by the National Dialogue on the UN FSS, 160 participants discussed the topic of plant-based diets in Germany.  December 2022: In connection with a broad-based stakeholder survey, some 180 participants provided important input on action areas and measures.  January 2023: At a three-day Citizens’ Forum on the Federal Government’s Food and Nutrition Strategy, members of the public discussed all aspects of the concept paper, “Pathway to the Federal Government’s Food and Nutrition Strategy”, and made important suggestions for the further development of the Food and Nutrition Strategy.  January to February 2023: In eleven digital workshops, measures in various thematic areas were developed and further elaborated together with 189 participating organisations. The outcomes of the various stakeholder consultation formats were examined, evaluated and incorporated into the development process. Participants in the Citizen’s Forum, for example, advocated stricter regulation of advertising. The possibility of exploring legislative options for reducing food waste was also discussed in the Citizens’ Forum and included in the measures under the Food and Nutrition Strategy, as was the call for developing and making use of more databases on eating habits. Additionally, the recommendations of the Citizens’ Council on Sustainable Nutrition, which was organised by the Federal Ministry for the Environment, Nature Conservation, Nuclear Safety and Consumer Protection (BMUV) from May 2022 to October 2023 were included. Among other things, participants recommended the application of German Nutrition Society (DGE) quality standards in mass catering, environment-friendly food taxation and subsidies, the introduction of an environmental and health label for food, an information campaign and the promotion of regional cultivation and sourcing of plant-based products. The Food and Nutrition Strategy is based on strategic and scientific work products of various bodies, including the BMEL Scientific Advisory Board on Agricultural Policy, Food and Consumer Health Protection (WBAE), the Federal Environment Agency (UBA) and the Commission on the Future of Agriculture (ZKL). Another focus of attention was on consistency with food and nutrition strategies already developed by a number of the Länder, so that measures at the various different levels could be usefully coordinated. 2. Multiphase approach Systemic changes take time. Nutritional behaviour is also largely connected to habit. The Federal Government’s Food and Nutrition Strategy takes account of this fact. It sets out short, medium and long-term food policy priorities, action areas and related objectives, and it identifies measures and effective ways to implement them. The Federal Government 13 measures identified or resulting from the Food and Nutrition Strategy are subject to the availability of funding and budget staff positions in the respective departmental budgets. 3. Multipolar approach In many cases, the implementation of food policy measures is outside of the Federal Government remit. The Federal Government and the Länder, the scientific community, business, the health sector and civil society must therefore work together on a decentralised, participatory and connected basis. They must combine their respective areas of responsibility and expertise to achieve the common sustainability policy goals. In order to set local change processes in motion and strengthen local prevention structures, it is essential to involve local authorities – for example through local authority associations – together with other stakeholders at the various levels. 4. Reflexive approach Nutrition is dynamic and is embedded in the sociopolitical environment. Future policy trends, including nutrition policy trends, depend on numerous and in some cases unknown extraneous factors. The Food and Nutrition Strategy cannot therefore present a definitive solution. Instead, the aim of the Food and Nutrition Strategy is to develop solutions that can be flexibly adapted as needed on the basis of current and foreseeable developments. Key tools of a reflexive, adaptive policy are monitoring and evaluation. Through the Food and Nutrition Strategy, we aim to create structures that are able to learn and adapt. This makes it necessary to regularly review the implementation of the Food and Nutrition Strategy, use feedback to identify any need for adjustments and make them as required. Where practicable and possible, subgoals are defined with time horizons. II. Strategy To make it possible for everyone to eat good food, we start with conditions and behaviour. A prerequisite for effective and sustainable change consists of improvements in the food environment and the enabling conditions. This is one focus of the Food and Nutrition Strategy (subsection A). Improved food environments, in combination with the required food literacy, promote healthy and sustainable eating patterns (subsection B). Efficient structures and lean processes, ongoing research and sound, comprehensive data are essential tools for future-oriented food and nutrition policy. We therefore present cross-cutting measures in these areas in subsections C and D. In the action areas and measures set out in the following, a role is also played by the government policy framework, which has an influence on the prices of foods and can therefore indirectly affect food product formulations. People’s income situation has an additional influence on sociocultural access to the food on offer. This primarily applies to people on low incomes and to welfare benefit recipients. Rising food prices are taken into 14 account in the annual revision of the “standard needs” rates that determine benefit amounts. The Federal Government will monitor developments in these areas and decide accordingly as needed. A. Healthy and sustainable food environments 1. Out-of-home catering, particularly mass/communal catering a) Why we have to act Facilities with mass catering, such as daycare centres, schools, workplaces, hospitals and senior living communities can play a key role in providing people in Germany with a healthy and sustainable diet. All too often, however, they provide just the opposite, with daycare and school meals featuring too small a proportion of cooked vegetables, raw vegetables and salad and too much meat. Wholemeal products and fish are likewise underrepresented,41 as are organic products.42 Challenges include limited financial resources and a lack of energy-efficient equipment. Also, (public) procurement processes for food are complex and require in-depth knowledge. This is partly due to the legal framework. In many areas, there is a lack of regional processing and distribution structures for sustainable and organic food. Workplace canteens have to contend with smaller and fluctuating numbers of users due to the spread of remote working. Rising labour and energy costs, inflation and the resulting price increases are a major burden for many caterers. The quality standards for mass catering developed by the German Nutrition Society (DGE) provide support in offering balanced meals. They are a quality assurance tool and aim to ensure health-promoting and sustainable food offers. Compliance with the DGE quality standards is mandatory for Federal Government departmental canteens and in some German states for schools and daycare centres. Mass catering also has considerable potential with regard to the goal of reducing food waste. Out-of-home catering (OHC) as a whole, including mass catering, accounts for 17 percent of all food waste (1.9 million tonnes).43 b) What is our goal Mass catering facilities serve a total of almost 40 million portions of food every day.44 Therefore, they are a powerful lever for implementing healthy and sustainable diets. By 41 WBAE (2020): Politik für eine nachhaltigere Ernährung, Eine integrierte Ernährungspolitik entwickeln und faire Ernährungsumgebungen gestalten. Gutachten. Berlin, p. 441. 42 https://mlr.baden-wuerttemberg.de/fileadmin/redaktion/m-mlr/intern/dateien/PDFs/Landwirtschaft/Oekologischer-Landbau/EVA BIOBW-2030 Endbericht.pdf, p. 62. 43 https://www.bmel.de/DE/themen/ernaehrung/lebensmittelverschwendung/studie-lebensmittelabfaelle-deutschland.html. 44 Wuppertal Institut (2021): Vom Acker bis zum Teller. Gemeinsam die Ernährungswende meistern. https://wupperinst.org/a/wi/a/s/ad/7430. 15 virtue of its formative influence, daycare and school catering can also positively influence the dietary habits of the future. Responsibility for mass catering lies with the authority or organisation in charge of the facility concerned. It is essential for stakeholders to link up and for measures to be coordinated across all levels (Federal Government, the Länder and local authorities) and along the entire value chain. The food on offer in mass catering benefits from the promotion of sustainable, regional production, and sustainable production, in turn, benefits from increased demand from more sustainable mass catering.45 The aim is requirements-driven, balanced and sustainable mass catering on the basis of the DGE quality standards: – with a large proportion where possible of unprocessed, seasonal, regional and ideally organic fruit and vegetables, high-fibre cereal products, legumes and nuts; – with less sugar, saturated fats and salt; – that is available to and affordable for all potential users; – and that contributes to reducing food waste. The DGE quality standards for catering in daycare centres and schools are to be made mandatory by 2030. The Federal Government has also set the goal of expanding agricultural production and organic farming in Germany to 30 percent of farmland by 2030 and of developing a strategy along the value chain to that end. That goal can ultimately only be achieved in step with an expansion of processing, distribution and consumption. The Federal Government also aims to lead by example with the Federal Government’s departmental canteens. Under canteen policies updated in 2023, menus there must comply with the DGE quality standards for workplace canteens. In federal administration canteens, the proportion of organic food is to be increased beyond the target currently agreed under the German Sustainable Development Strategy (at least 20 percent by 2025) to at least 30 percent in the ensuing years. The plan is also wherever possible to offer seasonal fruit and vegetables and use regional produce. Provision of sustainably produced, preferably regional and seasonal food (and particularly fruit, vegetables, legumes and nuts) is to be significantly increased in mass catering by 2030. With regard to beverages, greater emphasis is to be placed on (tap) water and unsweetened drinks.46 Food waste in out-of-home catering (OHC) is to be halved in Germany by 2030, with an interim target of a 30 percent reduction by 2025. 45 In public procurement, quality, innovation, social and environmental aspects should be incorporated as criteria in contracting terms. In calls for tenders, care must be taken to avoid restriction of competition. 46 ZKL (2021): Zukunft Landwirtschaft. Eine gesamtgesellschaftliche Aufgabe. Empfehlungen der Zukunftskommission Landwirtschaft. Berlin, p. 67. 16 c) How can we achieve our goal? (1) DGE quality standards for mass catering (a) Making DGE quality standards mandatory in schools and daycare centres To ensure that the DGE quality standard for mass catering is applied across the board – initially in schools and in the long term also in daycare centres, the Federal Government is supporting the Networking Centres for Daycare and School Catering and the activities of the National Quality Centre for Nutrition in Daycare Centres and Schools (NQZ). The initial focus is on implementing the standard in schools. A digital quality management tool, “Unser Schulessen” (“Our School Meals”), aims to help establish and maintain balanced and sustainable catering options in schools by helping schools apply individual quality assurance in the analysis, evaluation and selection of menu choices. In collaboration with the Länder Networking Centres for School Catering, the Federal Government plans to develop the tool further so that it can be made available in future to as many schools and school authorities as possible throughout the country. (b) Actively offering suitably sized servings Food waste is to be given greater consideration in all areas of mass catering when updating the DGE quality standards. For example, feedback and requests from users about serving sizes should be taken into account when planning the numbers of servings to be sold, and users should be given the option of a second helping or a smaller portion. Adjusting serving sizes can help reduce leftovers and hence food waste. This has not yet been extensively tested in practice and the additional effort and expense for catering providers is yet to be quantified. Innovative approaches are being initiated in both school and workplace catering. The aim is to actively offer suitably sized servings. This means, for example, children being able to choose smaller servings to prevent food waste, but still to have the option of a larger serving if they want. (c) Regular updating of the DGE quality standards The DGE quality standards for all areas of mass catering must be regularly updated in line with scientific advice to ensure their continued acceptance. Publication of updates creates a need for more advocacy and advice to promote their practical implementation. The Federal Government supports the updating of the quality standards, their adaptation to diverse dietary choices and their dissemination. (2) Increasing the proportion of organic food in out-of-home catering (OHC) A major factor in socially equitable access to organic products is a significant increase in the proportion of organic products in OHC. Substantial use of organic foods is a key means of positively influencing the shift towards a healthy and sustainable cuisine with low proportions of processed food and of driving a rise in demand for seasonal organic foods 17 from the local region. A high proportion of organic produce is also an element in the Federal Government’s 2030 Organic Strategy to expand and strengthen the organic farming and food sector. (3) Reducing OHC food waste In 2021, the BMEL and OHC associations signed an agreement setting targets for the reduction of food waste. Among other things, companies undertook to track food waste in their operations and to develop tailored measures to reduce it. The Competence Centre for Out-of-Home Catering (KAHV) organises the implementation of the target-setting agreement, among other things by signing up more companies to the commitment. It also continues the sectoral dialogue and reviews and documents the successes achieved. (4) Expansion of support for procurement in daycare and school catering Food procurement for daycare and school catering is crucial to providing high-quality, healthy and sustainable meals. Procurement is normally the responsibility of the authority or organisation in charge of the school or daycare centre. The NQZ will continue to offer training on procurement for healthy and sustainable school catering on the basis of the DGE quality standards. The legal entitlement to all-day care for primary school children from 2026 and the resulting expected growth in the number of schools offering such supervision will create an increased need for advice. Sustainability aspects such as seasonal and regional produce need to be taken into account.47 The NQZ will extend its training programme in future to include daycare catering. (5) Feasibility study on safeguarding daycare and school catering in times of crisis For children, adolescents or young adults who are entitled under minimum benefits systems and who use an already established lunch programme at their school or daycare centre, the costs of a (shared) lunch are reimbursed through the education and participation benefits. The Scientific Advisory Board on Agricultural Policy, Food and Consumer Health Protection (WBAE) examined the costs and benefits of universal free school meals in its 2020 report.48 As experience from the Covid-19 pandemic has shown, the structures supporting healthy daycare and school catering are not crisis-proof. A feasibility study is to examine the possibilities for a crisis-proof national catering programme (for daycare and school meals) that can be implemented step by step on a modular basis. 47 Quality, innovation, social and environmental aspects should also be included. 48 WBAE (2020): Gutachten. 18 (6) “Ernährungswende in der Region” (“Regional Food Transition”) model regions competition The BMEL model regions competition funds example-setting projects that contribute to healthy nutrition aligned to planetary boundaries. The focus is on healthy and sustainable nutrition, the implementation of DGE quality standards in mass catering, increasing the share of organic food in out-of-home catering to at least 30 percent, establishing and expanding regional value chains, reducing food waste, participative processes and connecting stakeholders. The competition targets stakeholders who contribute to the food transition in all regions of Germany. These include food policy councils, environmental and nature conservation organisations, scientific institutions, canteen operators, restaurants, retailers, regional producers and representatives of “edible city” initiatives. The projects aim among other things to establish and build networking and procurement structures in such a way that they can be extended or transferred beyond their model region in the future. They also need to create the conditions to ensure that they remain in place. (7) Further development of the EU School Scheme The EU School Scheme supports the distribution of fruit, vegetables, milk and dairy products to schools in order to make them appealing to children and adolescents and promote a healthy and sustainable diet. In Germany, the scheme is implemented by the Länder. The Federal Government acts in a coordinating capacity and is not authorised to provide funding. The EU School Scheme is a sales promotion programme that includes food education measures. It is currently being revised at EU level to increase its contribution to the consumption of sustainable food and to education on healthy eating, sustainable food production and the reduction of food waste. Among other things, the Federal Government is proposing to the European Commission that the scheme be extended to plant-based drinks and that EU subsidies for fruit and vegetables be increased. (8) Support for Networking Centres The Länder networking centres for daycare and school catering and for catering in senior living communities support daycare centres, schools and facilities in providing healthy and sustainable meals. To support the networking centres with their growing range of activities, the Federal Government plans to provide them with project-specific funding beyond the current funding period. Future project funding will be aligned with the strategic goals of the Food and Nutrition Strategy. The Federal Government also provides the networking centres with standardised programmes (such as through the NQZ). These include cross-cutting training in the form of web seminar series for the authorities or organisations in charge of schools or daycare centres. Tried and tested event formats such as the NQZ networking meetings on 19 nutrition in daycare centres and schools and IN FORM networking meetings on nutrition for the elderly are to be organised on a regular basis. (9) Survey on awareness and acceptance of plant-based foods The BMEL is supporting a project to improve the acceptance of plant-based nutrition and make it easier for daycare centres, schools and higher education institutions to offer it in catering. An online survey will be used to gather information on the level of knowledge, experience and implementation of plant-based diets among those in charge of daycare centres, schools and student unions, to identify resources and challenges, and to develop recommendations for sustainable implementation of healthier diets in nurseries, schools and higher education institutions. (10) Analysis and evaluation of the food products on offer in the food service industry The food service industry49 accounts for a growing share of OHC, especially among younger consumer groups. However, little research has been done so far into the food on offer and consumer behaviour in this sector. A BMEL-funded project, “Survey, analysis and comparison of a specified meal range in the food service industry”, aims to survey the range of meals offered by selected establishments and to analyse, compare and evaluate them from a nutritional, physiological and environmental sustainability perspective. Consumers’ use patterns are also to be surveyed. The project is intended to aid the BMEL in identifying new approaches and possible policy recommendations for nutritionally beneficial and sustainable menus. (11) Funding programmes for drinking water dispensers in social amenities Tap water is a good and inexpensive thirst quencher. It is also climate-friendly as it entails few carbon emissions, requires no packaging and avoids the transportation of drinks. Since 2020, under a funding programme for climate adaptation in social amenities, the Federal Ministry for the Environment, Nature Conservation, Nuclear Safety and Consumer Protection (BMUV) supports the purchase of drinking water dispensers, connected to the tap water supply, in social amenities such as daycare centres, schools, clubs, hospitals, nursing homes and retirement homes. A total of €150 million has been made available to date. The response to the funding programme so far has been tremendous. There is still a great need for support and the BMUV has successfully pushed for the funding programme to be continued after 2023. 49 The food service industry differs from independent restaurants and other food outlets in that it has standardised menus and standardised organisational structures. 20 (12) Improving the food environment in schools In order to make school food environments healthier and more sustainable, the Federal Government will support the Länder and local authorities – which are responsible for non academic school needs such as setting up and running school kitchens and furnishing and fitting out buildings – in creating healthy and sustainable catering services. A further focus alongside school kitchens will be on school kiosks, vending machines and innovative approaches, such as nudging,50 the supervision of school meals by teaching staff, and break times to ensure that students have enough time to eat. One potentially important factor for young people especially is that healthy food needs to be equally appealing in presentation as less healthy options. The Federal Government is making €3 billion available to the Länder in an investment programme to expand the provision of all-day care in schools (Investitionsprogramm Ganztagsausbau). The funding can be also be used to support food provision and exercise (such as school kitchens, exercise rooms and investment spending on related equipment). Funding can commence as soon as a state has adopted a programme of its own in agreement with the Federal Government. The funding is applied for and managed in each state. 2. Shaping the consumption landscape a) Why we have to act Consumers are exposed to a wide variety of external influencing factors when purchasing food. These include presentation (including the product range, product placement, availability, food composition and labelling) and advertising. As the intermediary between producers and consumers, food retailers have a strong position in the value chain.51 Among other things, the retail sector has a key role to play in reducing food waste in terms of quality requirements, marketing standards, portioning and supply chain organisation.52 For example, the food industry has freedom of scope when it comes to determining food recipes and packaging sizes, and also with regard to voluntary labelling. In this way, and through food advertising, it has a significant influence on purchasing behaviour. b) What is our goal The aim is for the consumer landscape to support healthy and sustainable eating. Government helps to set the framework for this and can regulate to protect public health (in the interests of child welfare, for example) while keeping any restrictions on the freedom of operators to the necessary minimum. The Federal Government plans to restrict advertising 50 Nudging as a means of changing behaviour or habits in a specific direction without specifically banning other options. An example is altering the placement of selected foods. 51 WBAE (2020): Gutachten, p. 196 and Keller, O. et al. (2022): Wie nachhaltig sind die deutschen Supermärkte? Systematische Bewertung der acht umsatzstärksten Unternehmen des Lebensmitteleinzelhandels in Deutschland aus Umweltsicht. Dessau-Roßlau. 52 WBAE (2020): Gutachten, p. 196 and Ebert, V. et al. (2020): Umwelt- und klimarelevante Qualitätsstandards im Lebensmitteleinzelhandel. Dessau-Roßlau. 21 to children for foods high in sugar, fat or salt in broadcasting and other formats aimed at under-14s. It aims to set science-based, target group-specific reduction targets for sugar, fat and salt in processed foods. It will also create more transparency for consumers on product characteristics (such as Nutri-Score and origin labelling). By 2030, food waste is to be halved in every sector of the food supply chain. Plant protein sources will become increasingly important in a plant-based diet. The Federal Government will look at measures to effectively support this development. c) How can we achieve our goal? (1) Reformulation (a) Further development of the National Reduction and Innovation Strategy for Sugar, Fats and Salt in Processed Foods (NRI) The formulation changes made so far under the NRI do not go far enough. Science-based, target group-specific reduction targets are therefore to be set for sugar, fat and salt in processed foods. The methodology for determining reduction targets is to be developed by mid-2024 in a stakeholder consultation process led by the Max Rubner Institute (MRI). A particular focus will be on children and adolescents as a specific target group for the setting of appropriate reduction targets. The BMEL will then commission departmental research for the development of quantified reduction targets for relevant food groups by the end of 2024. These science-based reduction targets will be designed to provide specific guidance for the food industry to reduce the amount of sugar, fat and salt in its products. In its ongoing product monitoring, the MRI tracks how the energy, sugar, fat and salt content of processed foods change over time. This makes it possible to reliably record and check progress. (b) Limits on added vitamins and minerals in fortified foods and food supplements An excessive intake of vitamins and minerals increases the risk of oversupply with adverse effects on human health. The EU Food Supplements Directive53 and Fortified Foods Regulation54 therefore provide for the European Commission to specify maximum amounts for vitamins and minerals when added to food. The European Commission has not yet met this obligation. However, on the initiative of Germany in particular, it has resumed work on setting maximum amounts. The BMEL and the Federal Institute for Risk Assessment (BfR) are working intensively in a special European Commission task force to ensure that the maximum amounts for vitamins and minerals, 53 Directive 2002/46/EC. 54 Regulation (EC) No 1925/2006. 22 which have long been provided for in EU law, are implemented in a timely manner for the protection of consumers. (2) Restrictions on food advertising directed at children The Federal Government has the aim of protecting children, as a particularly vulnerable consumer group, from advertising for foods with high sugar, fat or salt content. It therefore plans to restrict advertising to children for foods high in sugar, fat or salt. (3) Food labelling (a) Further development, communication and monitoring of the Nutri-Score The Federal Government advocates making extended nutrition labelling in the form of the Nutri-Score mandatory across the EU. The European Commission has announced that it will present a proposal for uniform and binding legislation. An independent scientific committee has been reviewing adjustments to the algorithm since 2021. The aim is to reflect the nutritional differences between foods even more accurately and in line with general dietary guidelines. The revised algorithm came into use at the beginning of 2024. The revised Nutri-Score makes it easier to select products that are lower in sugar and salt and to distinguish between high-fibre and low-fibre foods. To prevent food from being wasted, a transitional period applies for foods with an “old” Nutri-Score.55 In addition, the Federal Government plans to work with the countries officially involved in Nutri-Score to develop a framework that would enable the use of Nutri-Score in OHC. This would make it easier to compare the nutritional values of foods in a given product group in everyday situations and would benefit a broad cross-section of the population, covering daycare centres, university and workplace canteens as well as commercial restaurant chains. The BMEL is already in talks with companies and the Nutri-Score brand owner, which is currently examining whether and under what conditions the Nutri-Score also provides accurate results for OHC. The Nutri-Score conditions of use could then be amended and its scope extended to include OHC. The proper registration, calculation and use of the Nutri-Score on the German market is monitored. (b) Extending mandatory origin indications for foods The Federal Government aims to implement comprehensive origin indications for foods. This enables consumers to make transparent purchase decisions. The European Commission’s forthcoming legislative proposal for the extension of mandatory origin indications to certain foods, as announced in the Farm to Fork Strategy, is of particular importance to the Federal Government. A legal framework is needed for this purpose at EU 55 The BMEL provides transparent information about the Nutri-Score activities for all involved at www.nutri-score.de. 23 level in order to ensure uniform information for all consumers in the EU and a free internal market. Separately from this, the BMEL has compiled a proposal for a national statutory instrument to extend the existing origin indications for fresh, refrigerated and frozen pork, lamb/mutton, goat and poultry meat to include produce sold loose. The BMEL will establish further national rules if the relevant EU initiatives fail to materialise. (c) Regional origin indications The labelling of regional products is to be improved and made more transparent to make it easier for consumers to choose regional foods. It is necessary to increase the recognition and market penetration of transparent, credible regional labelling schemes such as the “Regionalfenster” (“Regional Window”) scheme. The BMEL continues to provide the operating organisation Regionalfenster e. V. with non financial support for this purpose. Cooperation is to be stepped up with the Länder with regard to their regional quality labels. The BMEL is also funding a research project on success factors in regional marketing.56 In view of the many different private regional labelling schemes in Germany, the BMEL has started to look into possible approaches to improve transparency on the market for regionally labelled products. (d) Sustainability labelling The presentation of sustainability criteria along the food value chain is complex and depends on the availability of underlying data on a large scale. An EU-wide legal framework for sustainability labelling is needed in order to ensure suitable and comparable sustainability criteria and data. The possibility of such a legal framework is currently being considered by the European Commission. In addition to supporting the ongoing processes at EU level, we will continue to drive the development of appropriate methodologies for environmental criteria along the food value chain. (4) Plant-based alternatives to animal-based foods (a) Protein strategy for Germany Implementing a sustainable approach to the supply of protein for human nutrition is a cross cutting task that involves various areas of responsibility within the BMEL and the Federal Government. It makes sense for the activities of the BMEL here to be actively coordinated with those of other federal government departments under an overarching protein strategy for Germany. The Federal Government will coordinate the various funding programmes for alternative protein sources. The BMEL plans to develop a research focus. 56 See the “Expansion of regional value chains” measure in the “Links to sustainable food production and supply” action area. 24 (b) Supporting innovation for plant-based alternatives Sales of alternatives to animal-based foods have increased in recent years but are still at a relatively low level. An innovation funding programme for producers could lower barriers to entry, boost competition and ultimately reduce consumer prices. Support for direct matching between farmers and processors can also be of major assistance. Both of these aspects are addressed in a BMEL funding announcement on alternative protein sources for human nutrition. (5) Reduction of food waste (a) Measures by primary producers, processors, wholesalers and retailers at points of contact with private households In 2020, private households accounted for 59% of food waste in Germany – 6.5 million out of a total of 11 million tonnes. Changes in the consumption landscape can help consumers waste less food – for example by buying and using food as needed or by making it easier for them to store foods correctly. The BMEL has worked with economic operators to develop measures for this purpose in sector-specific dialogue forums.57 The Federal Government is continuing and refocusing this stakeholder dialogue. A stronger focus will be placed on the food environments at operators’ points of contact with private households in order to identify further approaches that make it easier to reduce food waste in private households. This could include measures relating to serving or package sizes. (b) Legislative measures to reduce food waste Legislative measures to make it easier to donate unsold food that is still fit for consumption are being looked into together with related liability and taxation questions. Donations of food that is no longer marketable or of limited marketability are already subject to reduced rate or zero value added tax. Subject to certain requirements, non-cash donations to tax privileged corporations can be deducted from income taxes on profits. Other matters raised by economic operators are being examined. The BMEL will issue guidance for both donating and receiving organisations in guidance that sets out the legal issues connected with passing on food in a way that is simpler and easier to understand. Further legislative measures to avoid food waste and make it easier to donate food are also being examined. The adoption of mandatory reduction targets at EU level is welcomed in principle. In this connection, the European Commission has presented proposals that, once adopted, will have to be transposed into national law. 57 See, for example, the case studies from the wholesale and retail dialogue forum: https://www.zugutfuerdietonne.de/fileadmin/zgfdt/sektorspezifische Dialogforen/Gross-und Einzelhandel/Dialogforum Fallstudien Sammlung.pdf. 25 3. Social aspects of food and nutrition a) Why we have to act People who cannot afford a healthy and sustainable diet can experience health problems and be restricted in their social participation. Those who do not eat enough or eat an unbalanced diet and therefore do not get enough essential nutrients are less physically fit. In children, malnutrition can slow development and growth. The problems are compounded by structural barriers such as limited mobility (such as lack of access to shops), cramped housing (including lack of storage space for fresh food) and the fact that tight finances are in themselves a major stress factor in people’s lives. Foods high in sugar, saturated fat and salt, which the German Nutrition Society (DGE) recommends reducing, are relatively inexpensive compared with vegetables, fruit and nuts. Particularly for consumers on low incomes, it is cheaper to opt for high energy density, low priced foods at the expense of a balanced diet of vegetables, fruit, whole grains, legumes and nuts.58 Germany has not systematically collected statistics on food poverty to date. Nutritional studies suggest that recipients of basic income support from the state find it difficult to maintain a healthy and sustainable diet. b) What is our goal The Federal Government plans to take effective action to combat food poverty, especially given the sharp rise in food prices. We pay particular attention to the situation of the 2.5 million children and adolescents59 in low-income households across the country. The planned basic income support for children will combine various different financial benefits and reach more eligible children and adolescents. The Federal Government already makes an important contribution by providing “education and participation assistance” for children, adolescents and young adults from low-income families, among other things by enabling them to participate in communal lunchtime meals in schools and daycare centres. The planned basic income support for children is intended to go hand in hand with an increase in the uptake of education and participation assistance. Every child should have access to preschool and school meals irrespective of whether they receive minimum income benefits. For persons with disabilities who receive basic income support under Book XII of the Social Code (SGB XII), an additional amount is recognised for communal lunches in workshops for persons with disabilities and similar establishments. 58 DGE (2014): Biss für Biss das Körpergewicht senken; DGE empfiehlt den Blick auf die Energiedichte von Lebensmitteln (2014/01) [press release]. https://www.dge.de/presse/meldungen/2011-2018/biss-fuer-biss-das-koerpergewicht-senken/ https://www.dge.de/presse/pm/biss-fuer-biss-das-koerpergewicht-senken/ (2014). 59 WBAE (2020): Gutachten, p. 100. 26 As a matter of principle, in the future we want to examine the impact of food policy instruments on low-income households and mitigate any effects with social policy. c) How can we achieve our goal? (1) Improving the knowledge base on food poverty In order to better understand the connection between poverty and nutritional and health status, and to develop appropriate policies, a deeper knowledge of the interrelationships between them is required. We aim to gain a more precise understanding of the links between income, food literacy, eating habits and nutritional status. A research concept is being developed for this purpose in order to derive approaches for monitoring. Initial findings on the topic are being provided by the MEGA kids multidisciplinary survey of the nutritional and health situation of people in poverty-risk households with children. Conducted by the University of Hohenheim and Charité Universitätsmedizin Berlin, MEGA kids is the first large-scale research project in this field. By mid-2024, the project will have gathered evidence on eating habits, attitudes to nutrition, food literacy, health and demographic backgrounds in order to derive approaches for support services and measures to be taken. The Federal Government is examining how socioeconomic factors can be better incorporated into existing studies in the future, or whether it would be useful to introduce independent monitoring. Data is also being collected on people living in institutions (such as persons with disabilities living in special forms of accommodation or in care establishments). The Federal Government will report on the outcomes of the monitoring in the Food Policy Report once the monitoring is established. (2) Transformation-oriented research on combating food poverty Transformation-oriented research works with relevant stakeholders and target groups to develop ways for them to implement solutions on their own. Ideally, the practical implementation of the developed solutions is evaluated in a follow-up study. The Max Rubner Institute (MRI) has initiated transformation-oriented research with the ELSinA project on the nutritional situation and living conditions of senior citizens in poverty. This research approach is to be expanded and intensified. (3) Innovative approaches in socio-diverse nutrition education A current project by Tafelakademie e. V. – the academy run by the Tafel food bank organisation – raises awareness among food bank users and their children regarding healthy and sustainable nutrition. The aim is to provide people with the knowledge and skills they 27 need to ensure the best possible nutrition in spite of difficult circumstances. Special care must be taken to avoid stigmatisation. Further measures are to be established within the relevant settings, including with a focus on population groups affected by poverty. Collaboration with a range of organisations such as food banks and charitable organisations is important here. The Federal Government will also support the acquisition of knowledge and skills on nutrition-related topics in out-of-school settings (such as children’s and family centres) for children and parents from socioeconomically disadvantaged backgrounds. In this way, parents or other carers can also be directly involved. (4) Funding of pilot projects Targeted funding is to be provided for projects to trial approaches and ideas for combating food poverty. Their effectiveness and goal achievement will be evaluated scientifically. The Scientific Advisory Board on Agricultural Policy, Food and Consumer Health Protection (WBAE) has highlighted the importance of food banks in distributing food to people in poverty. In many places, growth in demand is outstripping the amount of food donated to food banks, forcing them to temporarily stop accepting new users. The BMEL has provided project-related support for food banks (including the development of an “Eco Platform” to digitalise and simplify the donation process, and an ongoing nutrition education project) and it will continue this support in the future. 4. Links to sustainable food production and supply a) Why we have to act The Covid-19 pandemic and the Russian war of aggression against Ukraine have severely stretched international supply chains. This has highlighted the complex interdependencies in our food systems today and has accentuated the value of regional production and of diversified and well-connected food systems.60 The demand for fruit and vegetables in Germany is not even close to being met by domestic production, with a self-sufficiency rate of 35 per cent for vegetables and 20 per cent for fruit.61 Economic considerations are at the forefront of farmers’ choices of what crops to grow. Legumes such as peas, beans, lupins and lentils continue to face competitive disadvantages in the marketplace due to their higher cultivation risk compared to other crops, high transaction costs in a small, volatile and non-transparent market, knowledge gaps in cultivation and use, and small-scale producers facing buyers who demand large 60 A particularly important aspect here is close collaboration with and proactive support for local civil society initiatives such as food policy councils and pilot projects such as “Edible Cities” and “Organic Cities” (see the “Networking and knowledge transfer” measure in this action area and the “‘Ernährungswende in der Region’ (‘Regional Food Transition’) model regions competition” in the “Out-of-home catering, including mass catering” action area. 61 https://www.bzfe.de/service/news/aktuelle-meldungen/news-archiv/meldungen-2023/maerz/selbstversorgungsgrad-in-deutschland/. 28 uniform quantities. The Planetary Health Diet recommends a per-capita consumption of 27 kilograms of legumes per year. The Federal Information Centre for Agriculture (BZL) estimates the current figure at around two kilograms. As valuable resources are used to produce food , an important element of sustainable food production and supply alongside responsible and environmentally sustainable farming is the reduction of food waste. Along the food supply chain, 24 percent of food waste62 is generated in primary production (0.2 million tonnes), processing (1.6 million tonnes) and retail (0.8 million tonnes).63 Added to this are food losses.64 b) What is our goal Improvements in food environments and eating patterns also affect demand for specific foods. The structures have to be adapted and strengthened to ensure an appropriate supply. The Federal Government wants to make the agricultural and food sector in Germany fit for the future with a stronger focus on environmental protection and resource conservation. After all, sustainable and efficient use of natural resources and safeguarding supply structures are essential for the protection of our livelihoods. One element of this is organic farming, as it can contribute to the protection of biodiversity and mitigate climate change, particularly by reducing the use of nitrogen, doing without easily soluble mineral nitrogen fertilisers and increasing carbon sequestration in the soil.65 Regulation (EU) 2018/848 defines and legislates on organic production with a particular focus on resource efficiency and environmental compatibility. The Federal Government has also set the goal of expanding agricultural production and organic farming in Germany to 30 percent of farmland by 2030 (see the 2030 Organic Strategy). A further aim is to strengthen regional value chains. With this in mind, the Strategy for the Future of Organic Farming (ZöL) was expanded under the BMEL’s 2030 Organic Strategy to include the entire organic value chain. The Federal Government is also seeking to expand and diversify the cultivation and processing of plant-based foods, particularly plant based protein sources. Alongside the Food and Nutrition Strategy, these goals can also be 62 All food as defined in Article 2 of Regulation (EC) No 178/2002 of the European Parliament and of the Council that has become waste (Article 3(4a) of Directive 2008/98/EC as amended by Directive (EU) 2018/851). 63 Statistisches Bundesamt (2022): Lebensmittelabfälle in Deutschland – Bezugsjahr 2020 (https://www.destatis.de/DE/Themen/Gesellschaft-Umwelt/Umwelt/Abfallwirtschaft/Tabellen/lebensmittelabfaelle.html). For example, surplus and spoiled food that is recycled within an operation is not included in the data collected on the disposal side. 64 Food losses relate to other material flows (other than food waste) that are fit for and could be used for human consumption but are removed from the food chain. 65 Weckenbrock et al., (2019): Klimaschutz. In: Sanders J, Heß J: Leistungen des ökologischen Landbaus für Umwelt und Gesellschaft. Johann Heinrich von Thünen-Institut, Braunschweig, Thünen. Rep 65, 398 p. doi: 10.3220/REP1576488624000; Sanders & Heß, (2019): Leistungen des ökologischen Landbaus für Umwelt und Gesellschaft. Johann Heinrich von Thünen-Institut, Braunschweig, Thünen Report 65, 398 p. doi: 10.3220/REP1576488624000 and Hülsbergen et al. (2022): Steigerung der Ressourceneffizienz durch gesamtbetriebliche Optimierung der Pflanzen- und Milchproduktion unter Einbindung von Tierwohlaspekten. Untersuchungen in einem Netzwerk von Pilotbetrieben. Johann Heinrich von Thünen-Institut, Braunschweig, Thünen Report 92, 540 p. doi: 10.3220/REP1646034190000 and Chiriaco et al., (2022): Determining organic versus conventional food emissions to foster the transition to sustainable food systems and diets: Insights from a systematic review. Journal of Cleaner Production. 380(2): 134937. doi: 10.1016/j.jclepro.2022.134937. 29 advanced by strategic activities undertaken by the BMEL to strengthen the organic farming and food sector and to further develop the BMEL’s Protein Crops Strategy (EPS). By 2030, in a joint effort with all stakeholders, food waste in Germany is to be halved in all sectors and food losses reduced. c) How can we achieve our goal? (1) Promotion of sustainable value chains (a) Expansion of regional value chains Since summer 2023, the federal programme for rural development and regional value creation (BULEplus) has made an initial funding announcement for start-up phase management in regional value creation projects. The aim is to stimulate the processing and marketing of regional foods by supporting local stakeholders in preparing and implementing project ideas. In addition, in collaboration with the Länder, the BMEL is revising the funding opportunities for the processing and marketing of agricultural projects provided under the Joint Task for the Improvement of Agricultural Structures and Coastal Protection (GAK). The aim here is to improve investment grant funding for regional value chains. A research project is also being developed for the identification of success factors in regional food processing and marketing. (b) Development of organic value chains, including for OHC Under the RIWERT organic value chains funding guideline, which implements measures under the Strategy for the Future of Organic Farming (ZÖL), the BMEL supports the development of new and the further development of existing organic value chains. Funding is available for the appointment of regional managers, professional training, consulting, and events for the establishment of organic value chains. To ensure that organic value chains are fit for the future and that new distribution channels and partnerships can be developed, the BMEL is funding research and development projects on organic value chains via the Federal Organic Farming Scheme (BÖL). As out-of-home catering is a significant factor for the regional organic sector, the focus here is on developing and optimising organic value chains geared to OHC. (c) Networking and knowledge transfer Networking and knowledge transfer are the basis for successful collaboration and for transitioning operations towards organic produce. With regard to OHC, workshops on organic catering in schools and daycare centres are offered in a BÖL-funded initiative called “Bio kann jeder” (“Anyone can do organic”). At local level, event formats under another BÖL initiative, “BioBitte” (“Organic please”) bring local authority decision makers together with local stakeholders who want to increase the proportion of organic food in OHC. 30 In more than 90 organic cities and organic regions, value chains are supported by value chain managers and coordination centres. “Bio Verbindet” (“Organic Connects”), a BÖL dialogue format, links up these coordinators at Länder level, including local authorities and caterers, facilitating continuous knowledge transfer through dialogue. In its strategic activities to strengthen the organic farming and food sector, the BMEL also addresses additional measures for the further evolution of suitable networking and education formats. (d) Communication on regional value chains Activities to promote regional value chains also include public relations work and a professional dialogue on labelling matters. The BMEL provides additional factual information for the public and organises events for the general and professional public. The BMEL provides funding for public knowledge dissemination projects under the RIGE programme for the funding of consumer information projects on regional value chains for the production of organic products and for the implementation of accompanying educational campaigns. Regional and local authorities can inform consumers about regional organic value chains and develop and implement educational campaigns. Additional communication measures are covered in the BMEL’s strategic activities to strengthen the organic farming and food sector. (e) Enhancing the attractiveness of the food trades, organic processing and retail Sustainable food ends up on peoples’ plates at home and on the menus of mass catering when the corresponding structures are in place and focused on sustainability. This requires key players to be suitably qualified and access to organic processing practices to be facilitated for interested enterprises. Chefs, bakers, confectioners, butchers, dairies, cheesemakers and the food industry therefore need to be provided with a range of practical information and advice on trends, opportunities and challenges in the processing of organic raw materials and the production of tasty, sustainable products and dishes. This approach is closely tied into the BMEL’s strategic activities to strengthen the organic farming and food sector. The Federal Government is supporting the food trade, organic processors and retailers by providing information and advice, by removing potential barriers for businesses interested in transitioning to organic and by engaging with trainees. (f) Funding of environmental protection and climate change mitigation projects in production and processing For food producers and the food industry to effectively reduce their impact on biodiversity, water and land use, and also to lower their energy and resource use and hence their greenhouse gas emissions, they need to identify and assess their main environmental impacts and develop action plans accordingly. This requires, among other things, more advice on effective climate and environmentally relevant measures and on comparable 31 climate and environmental impact assessments. For this purpose, companies need standardised methods and data from sources such as primary databases. Key elements in the development of a sustainability label incorporating environmental criteria and climate impacts include regional conditions, transportation routes, the various production methods and emission reductions. As part of an ongoing project under the German Adaptation and Resilience Plan, a data based transparency system is being developed and prototyped to clearly identify sustainability characteristics in the food value chain. (2) Promoting cultivation (a) Promoting the cultivation, processing and use of plant-based foods The specific support needed to increase cultivation and to promote regional and supraregional market structures for the marketing and processing of legumes will be addressed in the further development of the Protein Crops Strategy (EPS). The cultivation and use of non-leguminous plant-based protein sources such as nuts and mushrooms is also to be promoted. Information management, networking and knowledge transfer measures supplement these efforts. On behalf of the BMEL, the Thünen Institute (TI) has identified challenges and options for supporting the fruit and vegetable sector. Climate change requires renewable propulsion and heating technologies, a demand-driven and economical water supply system and further technological and economic adjustments. Extending indications of origin to include the raw materials of processed products will make it easier for consumers to see the country of origin and make informed purchase decisions. Regional origin labelling is also important.66 To increase self-sufficiency in vegetables, fruit, nuts and legumes,67 research projects are needed to enhance the competitiveness of domestic plant-based products throughout the value chain. (b) Further development of the Protein Crops Strategy (EPS) The BMEL’s Protein Crops Strategy can make a decisive contribution to achieving sustainability goals in the areas of climate change mitigation, the environment and health. It must take into account the growing demand for sustainable protein sources in human and animal nutrition and enable the positive environmental benefits of domestic protein crop cultivation to be realised on a large scale. Establishing and strengthening regional value chains, using legumes in OHC and increasing market supply can also be important factors in supporting the expansion of the area under cultivation with legumes and other protein crops. 66 See the “Regional origin indications” measure in the “Shaping the consumption landscape” action area. 67 The self-sufficiency rate for legumes in Germany is approximately 62 percent. 32 These measures are to be supplemented by information management, networking and knowledge transfer. The BMEL’s Protein Crops Strategy is being further developed and elaborated in a process involving the BMEL, the Federal Office for Agriculture and Food (BLE) and stakeholders, and is being extended to include non-legume plant protein sources such as mushrooms and nuts. (3) Reduction of food waste (a) Supporting legally binding reduction targets for food waste In its Farm to Fork Strategy, the European Commission has presented a legislative proposal for the introduction of binding EU-level reduction targets for food waste in the Waste Framework Directive. The Federal Government supports the introduction of binding reduction targets for food waste for all sectors of the food supply chain at an ambition level consistent with international sustainability goals. In this context, the Federal Government believes that due consideration must be given to the major importance of reducing food waste in terms of climate change mitigation and environmental protection. (b) Measurement of food waste and losses The Federal Government will continue to measure and report on the volume of food waste as required by the European Commission, as it did for the first time in June 2022 for the 2020 reporting year. We aim to continuously improve data quality and to present the trend consistently from 2015 onwards. Furthermore, the BMEL urges the European Commission to provide that in future, food losses that do not come under the definition of food waste but are not used for human consumption – for example because they are used as animal feed or in the chemical industry – are additionally recorded as a separate category. In line with this, mandatory data collection is included in the commitments that companies make when signing up to the target-setting agreement on OHC and in the Pact Against Food Waste signed with wholesalers and retailers.68 (c) Reducing food waste in transfers between economic operators The sector-specific dialogue forums funded by the Federal Government under the National Strategy to Reduce Food Waste identified the points at which products are transferred between sectors as an important target for action. Related measures include optimising process and supply chains, collaboration between supplying and purchasing operators, and private quality standards. These measures need to be further elaborated and widely adopted. An aim for the future is to improve existing approaches and collaboration between players. 68 See the “Reducing food waste” measure in the “Out-of-home catering, including mass catering” action area. 33 Innovative approaches, for example from start-ups and regional or local initiatives, should be followed-up. The Federal Government is continuing the cross-stakeholder dialogue and refocusing it in line with impact potential. B. Healthy and sustainable eating patterns 1. Dietary guidelines a) Why we have to act The Federal Government bases its nutrition policy strategies and measures on scientific evidence. For example, the DGE publishes nutrient intake reference values for many population groups and food-based dietary guidelines69 for healthy adults. The latter also apply to pregnant and breastfeeding women. The food-based dietary guidelines are the scientific basis for the DGE’s quality standards for mass catering. The DGE has so far mainly based food-based dietary guidelines on health aspects such as the reference values for nutrient intake and evidence on the prevention of nutrition-related diseases. Minimising harmful environmental and climate impacts and the consideration of social aspects, animal welfare and special diets70 have so far played a secondary role: waters and soils are already negatively affected in many places by pesticides and nutrients, rising temperatures and declining water availability. We will continue to drive the development of methodologies for data on a range of environmental indicators and climate impacts related to foods or food groups. The current dietary guidelines for children and adolescents also need to be updated to reflect new scientific evidence and changing eating habits. b) What is our goal Revised food-based dietary guidelines for healthy adults will be available by 2024, and guidelines for children and adolescents as soon as possible. Both sets of guidelines are to be updated at regular intervals. In the future, they are additionally to take into account different cultural backgrounds, special diets and also climate and environmental aspects. In the development of dietary guidelines, consideration should be given from an early stage to their implementation and also to communication in the various settings. Guidelines must be written so that they are easy to understand and remember. In order to assess the implementation of dietary guidelines, the food consumption of the population is to be regularly surveyed and analysed on the basis of representative samples.71 69 Food-based dietary guidelines (FBDGs) aim to summarise the extensive current scientific evidence on the relationship between foods, eating habits and human and environmental health in recommendations for food choices. 70 The term “special diets” refers, for example, to vegan/vegetarian, cultural and lifestyle diets. 71 See the “National nutrition monitoring” measure in the “Ongoing research” action area. 34 Continuously updated nutrient databases – and in particular the German Nutrient Database (BLS)72 – and total diet studies such as the MEAL study by the Federal Institute for Risk Assessment (BfR) are an important source for estimating nutrient intakes and assessing health risks, for example from residues and contaminants. Mass catering provides opportunities to implement dietary guidelines in day-to-day life. The DGE quality standard for catering in schools and daycare centres is therefore to be made mandatory and established by 2030.73 c) How can we achieve our goal? (1) Development of dietary guidelines (a) Current food-based dietary guidelines for adults The DGE plans to publish fully revised food-based dietary guidelines for healthy adults in 2024. A new mathematical optimisation model developed in a participatory process combines various target dimensions. Specific guidelines on areas such as fortified foods, vegetarian/vegan diets and for special target groups are to be derived from the basic model for the average healthy adult population. Support will be provided for the regular updating of the guidelines. This requires the ongoing collection of health, consumption and environmental data in order to keep them up to date and on-target.74 The acceptance, understandability and implementation of the guidelines will also be evaluated. (b) Development of evidence-based food-based dietary guidelines for infants, children and adolescents The BMEL supports the development of evidence-based food-based dietary guidelines for infants (of complementary food age and older), children and adolescents. These must take account of children’s changing needs in different development phases and also of diversity sensitive implementation choices. Relevant professions are to be involved in developing the guidelines in a transparent, consensus-based participative process. 72 See the “Establishing a modern, permanent food monitoring system” measure in the “Ongoing research” action area. 73 See the “DGE quality standards for mass catering” cluster in the “Out-of-home catering, including mass catering” action area. 74 See the “National nutrition monitoring” measure in the “Ongoing research” action area. 35 (2) Implementation in medical guidelines and recommendations (a) Development of evidence-based medical guidelines for medical and nursing professionals Medical and nursing professionals are frequently a first point of contact for dietary questions. Medical guidelines on the health effects of dietary patterns – at the highest quality level (S3) – are to be used to promote the implementation of food-based dietary guidelines in healthcare. Responsibility for compiling medical guidelines lies with the Association of Scientific Medical Societies (AWMF). Medical and nursing professionals follow such medical guidelines in prevention and therapy. They are familiar with the methodology of medical guidelines, which ensure a science-based approach and thus provide quality assurance On the publication of new food-based dietary guidelines, the Federal Government examines any related policy action and research needs in departmental research activities. The resulting new findings can then be used to develop new evidence-based AWMF medical guidelines as needed. An S3 medical guideline on breastfeeding duration and interventions to promote breastfeeding is currently under development as an important element of the National Strategy for the Promotion of Breastfeeding.75 All relevant professions and scientific societies are involved in its development. As well as the health effects for mother and child, they also cover the effectiveness of interventions to promote breastfeeding and include public health recommendations.76 The recommendations are to be widely disseminated to establish them across all professions. A laypeople’s version is being developed for distribution to families. (b) Evidence-based medical guideline on breastfeeding All professions that come into contact with pregnant and breastfeeding women are called upon to issue standardised, science-based recommendations. These are to be based on an AWMF S3 medical guideline representing the highest scientific standards. The development of a medical guideline on breastfeeding duration and interventions to promote breastfeeding is an important element of the National Strategy for the Promotion of Breastfeeding. The MRI Department of Child Nutrition is coordinating its development with the involvement of all relevant professions and medical societies. As well as the health effects for mother and child, they also cover the effectiveness of interventions to promote breastfeeding and include public health recommendations.77 The recommendations are to be 75 S3 medical guideline on breastfeeding duration and interventions to promote breastfeeding, https://register.awmf.org/de/leitlinien/detail/027-072. 76 Medical guideline on breastfeeding duration and interventions to promote breastfeeding. 77 Medical guideline on breastfeeding duration and interventions to promote breastfeeding. 36 widely disseminated to establish them across all professions. A laypeople’s version is being developed for distribution to families. (c) Regular updating and supplementing of the recommendations on nutrition and physical activity in the first 1,000 days The recommendations of the “Gesund ins Leben” (“Healthy Start”) network on nutrition and physical activity before and during pregnancy, during breastfeeding and in infancy and early childhood combine all the main health-promoting lifestyle recommendations for mother and child in the first 1,000 days. They comprise widely accepted and recognised consulting standards. Their use is promoted by various implementation measures for professionals and young families. The recommendations are to be updated on a regular basis and supplemented as needed. They are based on existing food-based dietary guidelines (such as the DGE guidelines, the Optimised Mixed Diet approach and the Dietary Scheme for the First Year of Life) for the relevant development stages. The recommendations need to be updated in particular when there is an update to the food-based dietary guidelines for infants, children and adolescents. (3) Improving iodine intake Data from the Robert Koch Institute shows a downward trend in iodine intake and a mild iodine deficiency in children and adolescents in Germany. In KiGGS Wave 2, almost 44 percent of children and adolescents showed a risk of iodine deficiency. Iodine deficiency can lead to goitre, thyroid nodules, hypothyroidism and developmental disorders in children.78 Furthermore, a representative market survey by the University of Giessen shows fewer than a third of industrially produced salted meat products, bakery products and dairy products to contain iodised salt.79 To counter this, the BMEL launched a long-term information campaign in 2023.80 The BMEL is also working to raise awareness in the food industry of the use of iodised salt in food processing in view of the declining trend in iodine intakes in Germany. The campaign slogan is “Wenn Salz, dann Jodsalz” (literally, “If salt, then iodised salt”). In parallel, the BMEL is establishing a monitoring system as the basis for further possible measures81 to improve iodine intake. 78 Gärtner, R. et al. (2021): Jod. Ein essenzielles Spurenelement in der Dauerkritik. Ernährungs Umschau; 68(12): M702–11. DOI: 10.4455/eu.2021.047. 79 Bissinger, K. et al. (2018): Repräsentative Markterhebung zur Verwendung von Jodsalz in handwerklich und industriell gefertigten Lebensmitteln. http://dx.doi.org/10.22029/jlupub-9874. 80 See the “Iodised salt information campaign” measure in the “Nutrition communication and information” action area 81 This could involve revision of the legal basis for the voluntary addition of iodised salt to table salt or increasing the iodisation level in iodised table salt. The changes to the legal requirements would also apply to iodised table salt used in food production and mass catering as well as to table salt for household use. 37 (4) Communication and implementation in practice Disseminating the food-based dietary guidelines to all relevant target groups requires communication to be broken down into stages:  Communication to professionals: People in key communicating positions such as health professionals, nutritionists, childcare professionals, preschool staff and teachers play a major role in disseminating the food-based dietary guidelines. Training and professional development programmes, whether they have a subject matter or methodological focus – such as courses leading to a certified nutritionist qualification or educating professionals on food and nutrition-related topics – need to be supported with a variety of different media. Materials for use in consulting and visualisation models need to be provided.  Communication to mass caterers: The revised food-based dietary guidelines are to be incorporated into the DGE quality standards for mass catering, where they are to be communicated and explained.  Communication to consumers: It is essential for communication campaigns to be tailored to the target audience. The established visualisation models for the new food-based dietary guidelines are to be science-based, accessible, easily understood and visually appealing.82 Additional communication campaigns are being planned. The focus of communication is to be on easy implementation of the food-based dietary guidelines with practical tips and recommendations. 2. Nutrition communication and information a) Why we have to act In many cases, conventional measures to improve food literacy only have limited impact. Professionalised nutrition communication does not reach all target groups equally, with the approach taken and the choice of communication tools frequently failing to match target groups’ real needs and interests. Personal factors such as language barriers or poverty can also prevent nutrition communication from achieving its aims. People obtain information about food and nutrition issues from a wide variety of media. Social media play an increasingly important role. According to the Federal Statistical Office, 48 percent of the German population actively used social media in 2022, with the main users groups among 16 to 24-year-olds at 77 percent and 25 to 44-year-olds at 64 percent.83 At 44 percent, diet and cooking are the highest-interest topics for social media users in Germany.84 82 See the measure “Studies on the effectiveness of nutrition communication using the example of food-based dietary guidelines” in the “Ongoing research” action area. 83 https://www.destatis.de/DE/Themen/Gesellschaft-Umwelt/Einkommen-Konsum-Lebensbedingungen/IT-Nutzung/Tabellen/nutzung internet-privatezwecke-alter-mz-ikt.html 84 Godemann J. und T. Barthelmeß (2021): Ernährungskommunikation, Interdisziplinäre Perspektiven – Theorien – Methoden. Heidelberg. 38 b) What is our goal Nutrition communication can complement measures in the other action areas. It can help people to acquire food literacy and apply it in their everyday lives. Modern institutional nutrition communication seeks dialogue and is understandable and accessible. It provides specific and practical recommendations. To this end, information and communication channels must be tailored to the needs of the target audience, be easy to find and take into account current developments in the provision of information and nutrition education.85 In order to increase the acceptance and effectiveness of nutrition education and communication measures, young people in particular need to be involved in their development to a greater extent than in the past. Nutrition communication targets the entire population and all age groups. Particular attention needs to be paid to groups who have not been well reached by existing communication channels. When implementing communication measures, therefore, it is important to take a socio diverse and inclusive approach and employ motivational language. Information must be provided in different languages and be user-friendly and accessible. This includes visualisations and imagery. Nutrition communication needs to become more digital, especially to reach the under-49s. Target group-specific outreach, including through professionals who can serve as disseminators, is particularly effective and should be included in funding projects. Professionalising “ambassadors” from among the public is a proven approach from the IN FORM-funded KINDERLEICHT Regions project to combat overweight and obesity in children and adolescents. The communication formats must also incorporate environmental as well as nutritional physiology aspects. The various information campaigns should be coordinated and communication concentrated on clearly specified communication goals. c) How can we achieve our goal? (1) Digital nutrition communication To appeal to younger people in particular, a focus should be placed on digital nutrition communication. A social media strategy is being developed and implemented for a range of different target groups. Working with ambassadors for specific target groups can help gain access. The possibility of making greater use of digital, application-oriented communication is also being 85 See also the measure “Studies on the effectiveness of nutrition communication using the example of food-based dietary guidelines” in the “Ongoing research” action area. 39 looked at for existing and planned information activities86 and for action plans and national strategies such as IN FORM. (2) Information campaigns on selected aspects of good nutrition Information campaigns are being developed and implemented to promote healthy and sustainable diets and to improve food literacy. They are directed at the general public, divided into various target audiences. A special focus is placed on the priority target groups under the Food and Nutrition Strategy. For quality assurance, pre-tests are conducted to check the campaigns in advance for criteria such as understandability and target group reach. In addition to consumers, the information campaigns also target food environments (such as daycare centres, schools, facilities for disabled persons, senior citizen’s facilities, public catering facilities and retailers). The information campaigns within BMEL’s remit are accompanied by scientific follow-up studies and impact studies for evaluation. (3) Future development of nutrition communication under IN FORM In the onward development of IN FORM, its nutrition activities will take greater account of consumers’ shifting communication and lifestyle habits. Outreach programmes will play a special role with regard to the priority target groups under the Food and Nutrition Strategy. Particular importance is attached to involving and networking with relevant stakeholders in order to support and facilitate access to specific target groups. Key criteria include the visualisation of information and socio-diverse, inclusive communication. As a tool for knowledge transfer and for networking and the design of projects and structures, digitalisation plays a very important role in project funding. It is particularly effective when it comes to reaching younger age groups. (4) Strengthening civil society organisations and initiatives for food literacy in specific consumer groups As part of project funding through IN FORM, the BMEL supports institutions such as the German National Association of Senior Citizens’ Organisations (BAGSO), Tafelakademie e. V. (the academy run by the Tafel food bank organisation) and consumer advice centres. The focus is on lonely elderly people, elderly people on low incomes or with an immigration history, and population groups affected by poverty. Collaboration with various other organisations such as food banks, migrant associations and charitable organisations and alignment with strategic goals and priority groups is important for the development of food literacy. 86 With regard to iodised salt, for example, see the “Iodised salt information campaign” measure in this action area and the “Further development, communication and monitoring of the Nutri-Score” measure in the “Shaping the consumption landscape” action area. 40 Other important collaboration partners include local interest groups, civil society actors, representatives of migrant organisations and integration agencies, and food policy councils. (5) Communication campaigns on breastfeeding The Federal Government has brought together and is stepping up communication on breastfeeding through the implementation of the National Strategy for the Promotion of Breastfeeding. Families are provided with target group-specific information and support from pregnancy to birth and during breastfeeding. The “Gesund ins Leben” (“Healthy Start”) network established by the Federal Centre for Food and Nutrition (BZfE) carries out ongoing communication activities to promote breastfeeding, with a particular focus on women who have previously breastfed less frequently or for a shorter duration than comparison groups.87 The network also links up relevant stakeholders. In two leaflets, “Stillfreundlichkeit im Betrieb” (“Breastfeeding Friendly Workplace”) and “Stillfreundliche Kommune” (“Breastfeeding-Friendly Local Authorities”), the Federal Government provides employers and local authorities with guidance on how to create living and working environments that make it easier to breastfeed.88 (6) Information campaign on iodised salt To counteract the declining trend in iodine intakes and at the same time reduce salt intakes under the National Reduction and Innovation Strategy for Sugar, Fats and Salt in Processed Foods (NRI), the BMEL launched a long-term information campaign in 2023 to raise awareness among consumers and the food industry about the health benefits of iodine and the use of iodised salt. As well as the food industry, the campaign primarily targets women of childbearing age, pregnant and breastfeeding women, families with underage children and people who maintain special diets (primarily vegetarians and vegans). The information campaign is mainly in digital form and is carried out in cooperation with agencies within the remit of the BMEL and the Federal Ministry of Health (BMG) and with the Working Group on Iodine Deficiency (Arbeitskreis Jodmangel e. V.). (7) Further development of Too good for the bin! Germany aims to halve household food waste by 2030. To this end, the Too good for the bin! initiative is to be developed further based on the outcomes of the private households dialogue forum, Dialogforum private Haushalte. The aim is to make it easier and more second-nature for consumers to reduce food waste in everyday life, notably by planning ahead, storing food properly and creatively reusing leftover food. Too good for the bin! also 87 See the measure “Establishing easy-access breastfeeding promotion programmes and strengthening food literacy in early childhood intervention” in the “Prevention” action area. 88 See the measure „Unterstützung der kommunalen Stillförderung“ in the “Prevention” action area. 41 communicates, with a practical focus, successes and activities surrounding the reduction of food waste along the entire food supply chain. 3. Food and nutrition education a) Why we have to act The foundations of adequate food literacy are laid in early childhood and adolescence. Nutrition education in daycare centres, preschools and schools is the responsibility of the Länder, as are the design of nutrition education curricula and the initial, further and continuing training of daycare and teaching staff, including subject teachers. The education plans of the various Länder differ greatly in their coverage of food and nutrition. Nutrition related subjects in secondary school are frequently offered solely as electives, and not in all types of school. Relevant teacher training courses do not always include nutrition-related content. In many cases, it features only as a marginal topic in teacher training. 89 b) What is our goal The aim is to provide nutrition education that meets future needs and takes greater account of health, environmental, climate and social aspects. Due to the federal structure of the education sector, the activities at Länder and federal level need to be well-coordinated in order to achieve improvements. Networking activities between the Federal Government and the Länder will be gradually expanded in consultation with the Länder and a coordinated approach established by 2027. By 2030, within the framework of the federal system, target group-specific, attractive and permanent education programmes are to be established everywhere in order to improve food literacy and help translate theoretical knowledge and practical skills into suitable choices in everyday nutrition. Knowledge about reducing food waste imparted from an early age also helps children learn to appreciate the value of food. In daycare centres and schools, nutrition education has been shown to be particularly successful when accompanied by high-quality meals that are easily available to all. Formal nutrition education in the classroom should therefore be consistent with the food provided in school meals.90 Daycare and school canteens are included as places of learning and experience. Nutrition education should cover all bases, going beyond the nutritional physiology foundations to cover the production of foods and their environmental impacts – by visiting farms, for example – together with the preparation of food and the avoidance of food waste. Food and nutrition education should also be more closely integrated into 89 Heseker, H., Dankers, R. und Hirsch, H. (2018): Ernährungsbezogene Bildungsarbeit in Kitas und Schulen (ErnBildung). Schlussbericht für das Bundeministerium für Ernährung und Landwirtschaft (BMEL) (Förderkennzeichen 2816HS006). 90 See the measures “Expansion of support for procurement in daycare and school catering”, “Further development of the EU School Scheme” and “Improving the food environment in schools” in the “Out-of-home catering, including mass catering” action area. 42 curricula and education plans. In addition, more should be done to promote food literacy among teaching staff. c) How can we achieve our goal? (1) Interagency networking between the Federal Government and the Länder The Federal Government is working to strengthen nutrition education in cooperation with the Standing Conference of the Ministers of Education and Cultural Affairs of the Länder (KMK), the Standing Conference of the Ministers of Youth and Family Affairs of the Länder (JFMK) and nutrition policy officers in the Länder. It also works to enable dialogue in order to reach agreement on shared goals. Disciplines such as environmental and health education and education for sustainable development are included in the networking activities. Additional policy instruments include the intensive use of existing networking formats and the establishment of an interdepartmental working group.91 Interchange with Länder agencies is maintained on an ongoing basis and collaborations initiated through federal government agencies, dialogue formats and a variety of communication channels. (2) Quality-tested information and materials for nutrition education A wide range of nutrition education materials are available that vary widely in quality. Much of these come on the market without prior professional scrutiny. The Federal Government is committed to ensuring that quality-assured, accessible information and materials are clearly recognisable and that school and nursery teachers, daycare staff and those involved in child and youth welfare have easy, transparent access to quality-assured content. One selection aid is already available in the form of a material compass on consumer education published by the Federation of German Consumer Organisations (vzbv) and funded by the Federal Ministry for the Environment, Nature Conservation, Nuclear Safety and Consumer Protection (BMUV). All nutrition education materials should meet the same standard of quality. (3) Widespread distribution of nutrition education media The Federal Government provides accessible information materials that can also be used for education purposes, together with science-based information for education, primarily in digital form and free of charge, and publicises them among the target group. It aims for teaching approaches to be widely disseminated, preferably using quality-tested digital platforms. In addition to lists of nutrition education materials, it is useful to provide ways to connect with other learners, plus e-learning modules for self-study independent of time and place. The offerings should be user-friendly and accessible and be available nationwide to everyone involved in nutrition education. A priority is placed on collaboration with existing 91 See the measures “Enhancing interagency networking between the Federal Government, the Länder and local authorities” and “Enhancing interdepartmental networking” in the “Efficient structures and processes” action area. 43 digital platforms. Quality assurance standards are to be developed in consultation with the Länder. (4) Promoting food literacy among teaching staff In Germany, nutrition-related content is taught in general education schools, in some cases without the teachers and educational assistants having any special training on the subject. Nutritional topics currently play only a minor role in the training of nursery teachers and daycare staff. The Federal Government provides teachers and educational assistants with information that can be used for further training in the field of nutrition and that supports the acquisition of the basic nutritional, didactic and methodological skills. This material needs to be developed in close consultation with the Länder, which are responsible for education matters, and is to be considered as complementary to initial and further teacher training in the Länder. (5) Funding for the “Lernort Bauernhof” farm-based learning initiative In order to promote farms as places of learning for children and adolescents, the BMEL funded the implementation of a model project, “Bundesinitiative – Lernen auf dem Bauernhof” (“Federal Initiative for Farm-based Learning”, December 2001 to November 2003). This resulted in the establishment of BAG LoB, the federal working group on farms as places of learning. BAG LoB is a grouping of education projects and institutions that provides networking and represents the interests of all interested participating farms. The BMEL supports BAG LoB with federal funding for holding federal-level information events on the subject of farm-based learning. 4. Prevention a) Why we have to act A wide range of diseases can be prevented by a healthy diet and other preventive measures. Within the Federal Government, responsibility for preventive healthcare primarily lies with the Federal Ministry of Health (BMG). Specific nutrient requirements arise during pregnancy, breastfeeding and infancy. Studies show that in the first 1,000 days – from the time of conception to age two – parents’ lifestyles influence their child’s own health later in life.92 An unfavourable diet during pregnancy and in the first two years of a child’s life can increase the longer-term risk of overweight, obesity and type 2 diabetes mellitus. This means that the diet and health of pregnant mothers, younger families and small children play a special role in prevention. 92 WBAE (2020): Gutachten. p. 87 et seq.: The first 1,000 days are crucial with regard to the intake of micronutrients like iron, zinc, calcium, iodine, folate and vitamins A, D, B6 and B12. This is also where the foundation is laid for later dietary habits (such as preferences for certain foods/meals) along with key factors that shape healthy growth and development (for example, breastfeeding reduces the risk of overweight and type 2 diabetes). 44 Elderly people can also develop special nutrient requirements. For this group of individuals, an inadequate intake of specific nutrients – often identified as a secondary diagnosis in hospital patients and nursing home residents – can be a particular problem that affects their health. Various measures implemented by the Federal Government already address the preventive potential of a healthy diet. For example, the IN FORM National Action Plan relies on behavioural and situational prevention in real-life settings. The National Strategy for the Promotion of Breastfeeding focuses on the health benefits of breastfeeding for mother and child. The Prevention Act adopted in 2015 strengthened health promotion and preventive healthcare, primarily via the statutory social insurance funds. Health targets directly relating to diet93 are addressed by health promotion activities of the statutory health insurance funds. A focus is on benefits and assistance for groups in specific situations. The Coalition Agreement provides for further development of the Prevention Act. b) What is our goal A balanced and healthy diet needs to be given more attention and consideration in the medical context. This calls for initial, further and continuing training in medical professions, including in nursing care, to be evaluated in relation to nutrition-related topics and supplemented with effective measures to take greater account of nutritional subject matter. Quality-focused mass catering plays an important role in prevention. When people fall ill and need hospital treatment or medical rehabilitation, the meals they are provided with should better aid their recovery. Especially in the case of illnesses partly caused by unfavourable diets and lifestyles, patients should be given advice on ways to maintain a healthy, sustainable diet at home. Hospital catering must not be inconsistent with any education programmes provided there. Initial approaches as to how the DGE Quality Standards for Meals in Clinics (meaning hospitals and rehabilitation clinics) are to be further developed and expanded. Catering in occupational rehabilitation establishments must also be healthy and sustainable in line with the prevailing DGE quality standards; this includes workshops for persons with disabilities, vocational training centres and occupational rehabilitation centres, daycare centres for disabled adults and special (including non-residential) forms of assisted living for persons with disabilities. The coalition agreement for the 20th electoral term provides for an action plan to implement the National Health Target on Maternal and Child Health with a focus among other things on preventive healthcare and health promotion from pregnancy through to infancy. The Federal Government will emphasise the importance of a balanced diet in developing a 93 “Type 2 diabetes mellitus: Reducing the risk of disease, recognising and treating patients early” and “Growing up healthy: Life skills, exercise, nutrition.” See section 20 (3) of Book V of the German Social Code (SGB V). 45 National Prevention Plan and the Action Plan for the Promotion of the National Health Target on Maternal and Child Health. And in implementing the National Strategy for the Promotion of Breastfeeding, the Federal Government is helping to exploit the potential of healthy nutrition from the time of birth onwards. The existing healthcare and prevention policy instruments (such as Federal and Länder recommendations, prevention guidelines and strategies) will continue to be used, reviewed and further developed as needed. c) How can we achieve our goal? (1) Strengthening local health promotion and further developing the legal framework and a joint prevention strategy Local authorities are the central level for health promotion and preventive healthcare in various settings: at home, school, higher education, medical and nursing care, and recreation, including sport. The programmes on offer vary significantly, however. In order to strengthen health promotion in the long term, some structural improvements are proposed at local authority level. For example, in its second report on prevention in the Länder, the National Prevention Conference (NPK) concluded that health promotion and preventive healthcare must be firmly established as statutory responsibilities in local authorities and the Public Health Service (ÖGD). The Federal Government can support the different stakeholders through its own agencies – notably the Robert Koch Institute, the Federal Centre for Health Education and, in the future, the planned Federal Institute for Prevention and Education in Medicine (Bundesinstitut für Prävention und Aufklärung in der Medizin – BIPAM). The National Prevention Strategy developed by the National Prevention Conference of the umbrella associations of social insurance providers and the Association of German Private Healthcare Insurers (PKV Verband) pursues the goal of enabling all people in Germany to grow up healthy, live and work healthily, and be healthy in old age. Local authorities, daycare centres, schools, employers and nursing homes should provide conditions that promote health, safety and participation. Experience with the National Prevention Strategy shows this joint strategy agreed by social insurance providers and private health insurers to have reached its limits, since most health problems are strongly influenced by factors that lie outside the scope of their statutory remit. The Federal Government’s Framework Recommendations and the goals they contain – healthy growing up, healthy life and work and healthy old age – show that prevention in the area of food and nutrition is a cross-cutting responsibility that has to be embraced by various players and established in all settings of everyday life. A crucial role is played here by the National Prevention Conference and by all entities responsible for promoting prevention, health, safety and participation, including the Länder and local authorities. To improve the overall quality and efficiency of programmes and services to promote health and prevention, the National Prevention Plan (NPP), too, should therefore foster better 46 networking between the various players to coordinate their activities in all areas of prevention and health promotion. The NPP, which is currently being developed, is seen among other things as a major contribution towards cross-cutting health-promoting umbrella policy in line with the health in all policies approach. By following a non-disease specific approach, it also aims to strengthen health resources and reduce health risks. (2) Embedding nutrition and prevention of nutrition-related disease in initial, further and continuing training in the healthcare sector Besides qualified nutritionists such as dieticians, medical staff, including doctors, practice teams, nursing staff and midwives, also need to have the subject-matter expertise required to provide competent advice on preventing overweight, malnutrition and nutrition-related diseases. It is therefore necessary to systematically improve training on the prevention and treatment of nutrition-related disease. On behalf of the Federal Government, an analysis is to be conducted on the status quo, for example by evaluating the relevant curricula or surveying the current state of knowledge in the field. The findings can be used to derive measures for use in improving initial, further and continuing training, such as the funding of professional development programmes for doctors in cooperation with the German Medical Association (Bundesärztekammer). In this way the Federal Government supports those responsible for deciding curriculum content and for further and continuing training, including the Länder, faculties, schools and professional governing bodies. (3) Support for local-level breastfeeding promotion programmes Local authorities are especially important in the promotion of breastfeeding because young families can best be reached at the local level. Coordinating bodies and professionals operating at local level such as early childhood healthcare workers play an important educational role in breastfeeding support programmes. Breastfeeding-friendly locations and self-help programmes make it easier for families to breastfeed their babies. To promote breastfeeding at local level, it must be made an integral component of health promotion and preventive healthcare surrounding childbirth and interlinked with other prevention measures. This requires permanent structures at all levels along with coordination and networking of breastfeeding promotion activities at federal, state and local level. To support breastfeeding promotion at local authority level, the Federal Government is developing guidance for breastfeeding-friendly local authorities.94 It also provides quality tested information and materials to promote breastfeeding. 94 See the “Communication campaigns on breastfeeding” measure in the “Nutrition communication and information” action area. 47 (4) Establishing easy-access breastfeeding promotion programmes and strengthening food literacy in early childhood intervention The Federal Government is committed to ensuring lasting improvement of the individual, social and structural conditions for breastfeeding and involves all relevant stakeholders in the process. The core objectives of the National Strategy for the Promotion of Breastfeeding include promoting breastfeeding-friendly settings and needs-focused, interconnected, easy access programmes as part of prevention and healthcare structures and local preventive healthcare. Families in difficult circumstances benefit most from this approach. This is also the case for outreach family support, health promotion and early childhood intervention. An important role is also played by early intervention networks in which child and youth welfare, healthcare, pregnancy counselling and early intervention professionals all work together. Early childhood intervention professionals reach out to affected families with children aged three and younger and help them to organise their daily lives around adopting healthy lifestyles. This work needs to be backed up with quality-assured, target group specific education and information programmes. The Federal Centre for Food and Nutrition (BZfE) and the National Centre for Early Childhood Intervention (NZFH) are developing e learning modules that can be integrated into existing early childhood intervention learning platforms. (5) Review of breastfeeding counselling in medical care structures To ensure that the preventive potential of breastfeeding can be exploited to the full, it is necessary to provide support in order to prevent difficulties surrounding breastfeeding and to detect and deal with them at an early stage. This means providing pregnant mothers and mothers of newborn babies with easily accessible breastfeeding counselling and advice. An assessment is to be made as to whether the need for counselling can be adequately covered by the existing healthcare structures and by the provision funded by health insurance funds and local authorities. If deficits are identified, the causes must be analysed and solutions developed to eliminate them. Potential approaches include covering breastfeeding in the maternal healthcare directive (Mutterschaftsrichtlinie) issued by the Federal Joint Committee (G-BA) or into prenatal advice provided with the maternity record issued to mothers (Mutterpass). The promotion of breastfeeding is to be incorporated as part of examinations for the detection of early childhood diseases by amending the Federal Joint Committee’s paediatrics directive (Kinder-Richtlinie). Any amendments are decided by the Federal Joint Committee (the joint self-administration body of the healthcare sector). The Federal Government supports initiatives towards structural improvement in breastfeeding promotion. Through research and development of suitable measures and model projects, it will work to ensure that all women in Germany have access to adequate breastfeeding programmes and support. This goal is also being pursued as part of the Action Plan on Maternal and Child Health. 48 (6) Increasing the availability of personal nutritional counselling Prevention programmes usually provide for the provision of behaviour-oriented information in group settings as part of nutrition counselling and advice. In many cases, health insurance funds only pay for personal nutrition counselling if certain pre-existing conditions are present. This can mean that insufficient focus is placed on preventive nutritional counselling which, among other things, takes account of individual nutritional needs in various life phases (such as special nutrient requirement during pregnancy, when breastfeeding and in old age). One approach to make preventive nutritional counselling available to all persons with special nutritional needs is to incorporate personal nutritional counselling into the provisions on preventive care in Book V of the German Social Code (SGB V). Nutritional counselling is to be incorporated as part of examinations for the detection of early childhood diseases by amending the Federal Joint Committee’s paediatrics directive (Kinder-Richtlinie). Such amendments are decided by the Federal Joint Committee (the joint self-administration body of the healthcare sector). The Federal Government supports initiatives towards personalised, health insurance-funded nutritional counselling before a disease is diagnosed and will examine available options. (7) Preventive nutritional counselling for families with small children Measures targeting young families to improve food literacy with the aims of ensuring adequate nutrient intake and preventing childhood obesity can help ensure that children grow up healthy. The Federal Joint Committee’s maternal health directive (Mutterschaftsrichtlinie) and paediatrics directive (Kinder-Richtlinie) do not yet contain provision for strengthening food literacy.95 In the long term, measures to improve food literacy among young families must become a matter of healthcare routine (in preventive healthcare checks, for example) and be incorporated into the prevention programmes of the statutory health insurance funds. Easily accessible programmes, including outreach work, are to be developed whose use do not require any medical indication. Paediatricians can arrange access. The programmes should build on existing structures (such as birth preparation courses and postnatal midwifery care). In addition, target group-specific assessments are to be made to identify other channels through which young families can also be reached (such as medical staff, daycare centres, the Public Health Service, networks, clubs and associations). Account must be taken of the differing dietary preferences of persons with migration backgrounds and any potential language barriers. The decision regarding the forms of provision paid for by statutory health insurance funds lies with the joint self-administration body of the healthcare sector (the Federal Joint 95 Currently, only midwives can charge for counselling on infant nutrition if certain conditions are met. 49 Committee). The Federal Government can contribute to the debate and to research on the effectiveness of differing forms of intervention. The Federal Government should provide means of funding food literacy measures, such as tax deductibility or partial payment by health insurance funds. As with the payment of costs in the care of pregnant women and new mothers, this provision could be extended until the child reaches the age of three. (8) Funding digital model projects Digitalisation takes on an important role in the prevention of disease, including in relation to nutrition and food. For example, apps and web-based solutions can be used as new resources in prevention – both to disseminate knowledge and to enable users to learn health-promoting behaviours. In supporting and funding digital applications, particular focus is to be placed on innovative digital approaches for preventive healthcare in the areas of nutrition and physical activity. The SMARTACT research project funded by the Federal Ministry of Education and Research (BMBF) from 2015 to 2023 has provided important groundwork for the use of digital applications with regard to matters such as technical requirements and reaching target groups. (9) Strengthening healthy catering programmes in healthcare facilities The DGE quality standards for hospitals and residential care facilities provide detailed, target group-appropriate recommendations for good catering. The Federal Government will work to ensure their widespread application. Reasonable catering charges for care services provided in approved care facilities play an important role in implementing these standards. They should be agreed upon by the contracting parties in such a way that healthy and sustainable catering for those in need of inpatient or residential care can be financed according to the prevailing DGE quality standards. Discussions should also be held with the main stakeholders in the hospital sector on whether quality indicators, such as the results of external quality audits, could be taken into account in the financing of catering services. It is important to have staff trained in nutrition on hand to prevent the risk of malnutrition and ensure that any malnutrition is recognised in good time. This includes care in long-term care facilities. (10) Mandatory screening for malnutrition in hospitals; greater transparency on malnutrition in care facilities Detection of malnutrition and routine screening of vulnerable groups are important steps in recognising patients’ needs. Under Section 11 of Book XI of the German Social Code (SGB XI), care facilities are required to care for patients in accordance with the generally accepted standards of medical and nursing care. These standards are laid down in the Expert Standards of the German Network for Quality Development in Nursing (DNQP). The Expert Standard on Nutrition Management for Ensuring and Promoting Oral Nutrition in Care 50 stipulates that all residents must be screened for signs of actual or impending malnutrition at the beginning of their stay, whenever acute changes occur and at specific intervals. Compliance with the expert standards is monitored in the course of regular quality audits under Section 114 SGB XI by the statutory health insurance medical review board and the private health insurance audit service. In addition, since 1 January 2022, inpatient and residential care facilities have been required by law to collect indicator-based qualitative data for all residents every six months and to transmit it to the independent data analysis centre in accordance with Section 113 (1b) SGB XI. The qualitative data to be collected also includes data on the nutritional situation. To improve transparency on the prevalence of malnutrition in care facilities, the Federal Ministry of Health (BMG) will request the Statutory Health Insurance Federal Medical Review Board (Medizinischer Dienst Bund) to focus specifically on the nutritional situation of those in need of care as part of its regular quality reporting in accordance with Section 114a (6) SGB XI. Where responsibility for structuring and stipulating on quality assurance in hospitals is assigned to it under Sections 136 onwards of Book V of the German Social Code (SGB V), the Federal Joint Committee (B-GA) is authorised to specify requirements for the improvement of nutrition in hospitals as part of its quality management directive. The Federal Joint Committee has not made use of this authorisation so far. It should be noted here that the Federal Joint Committee may only decide quality assurance measures when, specifically on the basis of scientific evidence, it is sufficiently probable that the measures assure or promote the quality of service provided. Ascertaining this is to be the subject of a scientific review to be conducted by the Federal Joint Committee. Additional measures used for quality assurance in hospitals take the form of so called quality contracts. These are fixed-term agreements between health insurance funds and hospital operators in compliance with special quality requirements. By law, the Federal Joint Committee is responsible for defining the standards to be applied in selecting the respective services or service areas. This serves as a basis for an increase in commitment and resources in these service areas, thus improving the quality of care for the patients concerned. On 11 August 2022, a Federal Joint Committee resolution entered into force, enabling quality contracts to be signed between health insurance funds and hospitals on malnutrition diagnostics, malnutrition treatment and malnutrition prevention. Key objectives include restoring a good nutritional status with the associated beneficial effects on patients’ state of health. Oncology and geriatric patients and those in intensive/critical care and abdominal surgery units would especially benefit from the associated measures. Validated screening instruments can be useful in identifying patients in need of treatment. A possible prerequisite for entering into such quality contracts could be the requirements of the OPS Code “8-98j – complex nutritional medical treatment” which, among other things, provide for standardised screening of nutritional status. This places a greater focus on malnutrition, 51 while compliance with related quality requirements can be made part of dedicated incentive systems. (11) Analysis and evaluation of the nutritional situation and the quality of nutritional care in hospitals and facilities providing residential long-term care To raise awareness of malnutrition among patients and people in need of long-term care, an annual nutritionDay is marked worldwide. This takes the form of a survey of the nutritional situation in hospitals and residential care institutions using questionnaires completed on a voluntary basis by staff and patients/residents. The aim is to collect data on the prevalence of malnutrition and identify the nutrition-relevant structures in medical and nursing care. The BMEL is funding a research project to evaluate the data collected in the nutritionDay 2022 survey. In a second step, the quality of nutritional care in German hospitals and residential care institutions will be evaluated on the basis of additional surveys. The findings will then be used to derive recommendations for action to improve nutritional care. There are also plans for an analysis of the cost-effectiveness of measures involving nutritional care along with model calculations for the German healthcare system. These can provide valuable insights for use in deriving and evaluating targeted measures.96 5. Addressing diet and exercise together a) Why we have to act Lifestyles that include an adequate amount of physical activity and a balanced diet can go a long way in ensuring that people remain healthy. In contrast, a lack of exercise and an unbalanced diet that does not meet nutritional needs can play a major role in the development of overweight and nutrition-related diseases such as type 2 diabetes mellitus, cardiovascular disorders and cancer. Malnutrition and lack of exercise are widespread among people in Germany. Current statistics show that only a quarter of the adult population meet both of the WHO recommendations for physical activity97 and that during the COVID-19 pandemic, 42 percent of adults engaged in less physical activity than before or stopped exercising altogether.98 According to data published by the Robert Koch Institute (RKI), 57 percent of children and adolescents in Germany average at least one hour of vigorous physical activity per day, thus meeting the WHO’s minimum recommendation. Older children and adolescents tend to be less and less physically active. 96 The project is being carried out by the University of Erlangen-Nuremberg in cooperation with the nutritionDay Office and the German Society for Nutritional Medicine (DGEM). 97 European Commission & WHO/Europe (2021): 2021 Physical Activity Factsheets for the European Union Member States in the WHO European Region. The combined recommendation for adults comprises at least 150 minutes of physical activity and twice-weekly muscle strengthening activities. https://www.who.int/europe/publications/i/item/WHO-EURO-2021-3409-43168-60449. 98 European Commission (2022): Special Eurobarometer 525: Sport and Physical Activity. https://europa.eu/eurobarometer/surveys/detail/2668. 52 b) What is our goal Shaping health-promoting conditions in which diet and exercise are considered together in respect of differing phases of life and settings harbours vast potential for reducing the risk of disease. This is especially the case for childhood and adolescence: A balanced diet and an adequate amount of physical activity are the basis for healthy growth and development, foster healthy lifestyles and are key elements in childhood wellbeing. For this reason, a systematic approach comprising behavioural and situational prevention is needed that combines the thematic areas of diet and exercise and also considers environmental and climate impacts. A range of measures implemented by the Federal Government already address the health promoting and preventive potential of a healthy lifestyle with a healthy diet and sufficient exercise. The Federal Government’s National Action Plan “IN FORM – German national initiative to promote healthy diets and physical activity” combines federal, Länder, local authority and civil society strategies, programmes and measures aimed at promoting healthy lifestyles with balanced diets and more exercise. It is designed to effect lasting improvements in dietary and exercise habits in Germany in order to reduce overweight and lifestyle-related disease. Diet and exercise are seen as equally important, decisive elements of a healthy way of life. IN FORM intensifies cooperation, disseminates practical approaches and information, and supports related networks. As part of an ongoing process, IN FORM is being continuously developed and adapted to social needs. Since 2010, the BMBF and the BMEL have been part of the European Joint Programming Initiative “A Healthy Diet for a Healthy Life” (HDHL), which also funds transnational research projects to promote healthy lifestyles. c) How can we achieve our goal? (1) Onward development of IN FORM IN FORM places particular focus on creating health-promoting and sustainable eating and exercise environments. In the future, as part of the IN FORM action plan, along with the various measures focused separately on exercise and on diet, greater attention is to be given to approaches that address diet and exercise together, combining them to support healthy, sustainable lifestyles in differing settings. Project funding in the area of food and nutrition will prioritise measures addressing children and adolescents, households at risk of or affected by poverty, and people with immigrant backgrounds. Looking to improve equal opportunities with regard to health, IN FORM will increasingly address additional population groups with a particular need for support. Funding will thus be provided to projects conducted by civil society organisations and 53 initiatives with the aim of improving food literacy among specific consumer groups.99 A quality framework will be developed to ensure long-term improvements in the quality of the nutrition-related projects conducted under IN FORM. A quality monitoring programme will also be established to provide information on the targets addressed and the status of implementation. The approaches successfully developed in IN FORM are to be established as permanent programmes, transferred to lasting structures and better communicated and promoted. Measures to promote physical activity as part of IN FORM will be led and conducted by the Federal Ministry of Health (BMG). The outcomes of the Round Table on Physical Activity and Health are to be taken into account when planning additional measures in this area. (2) Round Table on Physical Activity and Health The BMG-initiated Round Table on Physical Activity and Health serves as a platform for sharing experience gained along with tried and tested practices and for future activities with regard to physical activity and its promotion. Relevant stakeholders from the Federal Government, the Länder, local authorities, clubs, associations and other interest groups were brought to the table to discuss how physical activity and active lifestyles can be promoted among all people in Germany. The Round Table discussions also covered aspects of addressing diet and exercise together. The outcomes and recommendations from the Round Table are intended to help drive policy decisions and activities to promote physical activity and health. The Round Table discussions placed particular focus on various life phases. For example, they looked at families and small children, pre-school and school-age children and adolescents, adults of working age and elderly people. A planned outcome of the Round Table is a consensus paper with recommendations and measures. The consensus paper is expected to be presented in early 2024. (3) ReStart programme promoting sports clubs Up to the end of 2023, the “ReStart – Sport bewegt Deutschland” (“Sport Gets Germany Moving”) programme was funded by the Federal Ministry of the Interior and Community (BMI) in an amount of €25 million. The programme comprises various pillars and modules targeting sports associations, sports clubs, volunteers, club members, local authorities and the general public. One of its main aims is to get people in Germany interested in exercising again after the COVID-19 pandemic, encourage them to join a sports club, deal with the backlog in training certified sports instructors, trainers and referees, and support the development of sports clubs. 99 See the measure “Innovative approaches in socio-diverse nutrition education” in the “Social aspects” action area and the measure “Strengthening civil society organisations and initiatives for food literacy in specific consumer groups” in the “Nutrition communication and information” action area. 54 (4) The Sport Development Plan The Sport Development Plan (“Entwicklungsplan Sport”) builds on the Federal Government’s Physical Activity Summit held in December 2022 and addresses sport as a common agenda. After stocktaking and analysis, concrete proposals are to be developed ready for implementation in 2023. The most innovative, sustainable and promising proposals in terms of the goals of the Sport Development Plan are to be implemented on a large scale in 2024. The key action areas will be upgrading sports facilities, sustainability, integration and inclusion, sport in daycare centres and schools, and promoting the role of volunteers and unpaid office holders. C. Efficient structures and processes 1. Why we have to act Food and nutrition is a cross-cutting topic with numerous different public and civil society stakeholders. The various institutional, federal and regional structures involved make for a highly complex hierarchy of responsibilities. To ensure that the measures developed for the various action areas of the Food and Nutrition Strategy can be implemented and linked in a meaningful way, there is a need for even closer networking and further improvement of both interdisciplinary and transdisciplinary collaboration between the different stakeholders across all levels and all areas of responsibility. 2. What is our goal The structures needed for collaboration between the Federal Government, the Länder, public institutions and all relevant civil society stakeholders are to be efficiently utilised and enhanced in the interests of future-ready food and nutrition policy. The aim is to pool expertise, exploit synergies and generally develop intelligent structures to enable food and nutrition policy that focuses on people and the environment in the decades to come. The Federal Government continues to rely on dialogue with the relevant civil society stakeholders and groups, and with experts in the field, taking account of their expertise and recommendations. Interdepartmental collaboration is to be intensified, interdisciplinary interchange promoted across federal levels and civil society initiatives better connected at various local levels. The implementation and further development of the Food and Nutrition Strategy is to be institutionalised. 55 3. How can we achieve our goal? (1) Enhancing interministerial networking Interdepartmental networking is to be enhanced by establishing an interministerial working group (IWG) on sustainable and healthy food and nutrition led by the BMEL. The working group is to establish agile dialogue formats between the departments100 involved. Where appropriate, formats should be thematic and involve the Länder and local authorities. The idea is to foster constructive collaboration at points of intersection between departments. The working group may decide to establish subgroups that focus on implementing measures surrounding the strategic goals of the Food and Nutrition Strategy. At the time of writing, subgroups are planned on improving mass catering and on food poverty. Subgroups may also be established for specific target groups or settings. The interdepartmental working group also examines the scope for cross-departmental funding of measures. (2) Enhancing interagency networking between the Federal Government, the Länder and local authorities In the area of food and nutrition, collaboration between the Federal Government and the Länder rests on established bodies and coordination procedures that ensure structured, regular and interaction on a sound legal basis.101 The Länder Working Group for Consumer Health Protection (Länderarbeitsgemeinschaft Verbraucherschutz – LAV) is a coordinating body of the Länder that works with and on behalf of the Conference of Ministers for Consumer Protection (VSMK) and the Conference of Ministers for Agriculture (AMK). The BMEL, among others, is a permanent guest of the LAV. The LAV Working Group on Healthy Nutrition and Nutritional Information (LAV-Arbeitsgruppe Gesunde Ernährung und Ernährungsinformation, LAV AG GEE) supports the LAV in matters concerning food and nutrition. The BMEL convenes a meeting of food and nutrition experts from the Federal Government and the Länder twice a year, where, among other things, it regularly reports on the progress made in implementing the Food and Nutrition Strategy and consults with the Länder. Existing and future funding opportunities and project financing are also addressed in these meetings. 100 Federal Ministry of Food and Agriculture (BMEL), Federal Ministry for the Environment, Nature Conservation, Nuclear Safety and Consumer Protection (BMUV), Federal Ministry of Health (BMG), Federal Ministry of Education and Research (BMBF), Federal Ministry for Economic Affairs and Climate Action (BMWK), Federal Ministry for Family Affairs, Senior Citizens, Women and Youth (BMFSFJ), Federal Ministry of Labour and Social Affairs (BMAS) and Federal Ministry of Finance (BMF). 101 See also the “Interagency networking between the Federal Government and the Länder” measure in the “Nutrition education” action area. 56 Local authorities are key stakeholders when it comes to implementing the measures surrounding healthy, sustainable food and nutrition. An assessment will be made to see how local structures can be given effective support.102 (3) Networking between stakeholders and establishing a German Food and Nutrition Day To further improve networking between all involved, a German Food and Nutrition Day will be introduced and held once a year. The rotating areas of focus will address the various strategic goals of the Food and Nutrition Strategy with the involvement of the main thematically relevant stakeholders and priority target groups. The Federal Centre for Food and Nutrition (BZfE) continues to provide organisational support in connection with further networking programmes (such as roundtables). (4) Regular public involvement in implementing the Food and Nutrition Strategy To obtain knowledge of the level of awareness and the effectiveness of the measures among the German population, surveys will be used to integrate the public into the implementation and onward development of the Food and Nutrition Strategy. The different target groups set out in the Strategy will be taken into account. The Federal Government attaches particular importance to the involvement of young people. The aim is to repeat the surveys at intervals in order to identify changes and lasting effects. Additional focus topics can be added as needed. Detailed feedback on specific issues can also be obtained in connection with information campaigns. The recommendations of the German Bundestag Citizens’ Assembly on “Nutrition in Transition: Between a private matter and governmental responsibilities”, which is to present its report in February 2024, are to be taken into account in further development of the Food and Nutrition Strategy. (5) Management of the further development of the Food and Nutrition Strategy The implementation and further development of the Food and Nutrition Strategy will be managed and supervised under a new governance structure. A dedicated office will be established at the BMEL. The BZfE will assume a supporting role, taking on organisational tasks. An accompanying forum comprising representatives from policymaking, the scientific community, administration and interest groups will serve to foster dialogue and interchange. 102 See also the measure “Strengthening local health promotion and further developing the legal framework and a joint prevention strategy” in the “Prevention” action area. 57 Management of the implementation and further development of the Food and Nutrition Strategy (a) Establishment of a Food and Nutrition Strategy Office A dedicated office will be established at the BMEL. Its core responsibilities will be centralised management, regular monitoring of progress and documenting the implementation of measures. The Office will support the Interdepartmental Working Group (IWG). It will initiate evaluations and work on the further development of the Food and Nutrition Strategy. (b) Accompanying forum on implementation and further development of the Food and Nutrition Strategy To foster interchange and feedback on the implementation and further development of the Food and Nutrition Strategy, an accompanying forum will be established starting in 2025. Comprising representatives from policymaking, the scientific community, administration and interest groups, the forum will convene on an annual basis. D. Ongoing research 1. Why we have to act When designing policy, the Federal Government is constantly reliant on access to current scientific evidence and findings. The Future Research and Innovation Strategy thus serves as the Federal Government’s umbrella strategy for the further evolution of research and innovation policy. One of its main areas of focus is the transfer of knowledge from research findings to practical application in business and society. Mission 2 of the Future Research and Head Office BMEL Management  Coordination, implementation Monitoring Accompanying Forum Policymakers Science Administration Interest groups  Interchange and feedback BMEL Divisions  Implementation of measures BZfE  Project management, implementation of measures  Organisational tasks  Organisation of networking (e.g. roundtables) 58 Innovation Strategy focuses in particular on the targeted promotion of research and innovation to achieve long-term food security. The BMEL also relies on departmental research, scientific advisory councils and expert commissions, scientific societies and Leibniz Association institutes (WGL). With their research spectra, the BMEL’s six departmental research institutions cover the entire value chain in food and feed production. The Max Rubner Institute (MRI) places its main focus on food and nutrition research. The Federal Research Institute for Rural Areas, Forestry and Fisheries (TI) enriches nutrition research through its work in the areas of sustainable nutrition and reducing food waste. The work performed by the German Environment Agency (UBA) also contributes to sustainable food and nutrition. The German Institute of Human Nutrition (DifE) – a Leibniz Association institute – conducts research on the influence of nutrition on human health, particularly as regards prevention and treatment of diet-related illness. The BMEL-funded German Nutrition Society (DGE) developed and published perspectives for nutrition research in 2022.103 The Scientific Advisory Board on Agricultural Policy, Food and Consumer Health Protection (WBAE) and the German Science and Humanities Council (WR) have also identified thematic and also structural changes needed in nutrition research.104 The data currently used on nutritional behaviour and the nutritional status of the German population is largely taken from the MRI’s National Nutrition Study II (NVS II, 2005-2007, adults), the RKI nutrition study module of KiGGS Wave 2 (EsKiMo II, 2015-2017, children and adolescents aged 6 to 17) and the children’s nutrition survey module of KiGGS Wave 2 (the “KiESEL” study) conducted by the German Federal Institute for Risk Assessment (BfR) (KiESEL, 2014-2017, infants, toddlers and children from the age of six months up to and including five years). The data taken from the NVS II study is, however, outdated and does not provide a reliable picture of the current eating habits of Germany’s adult population. Current data is also needed in relation to people’s health. For this reason, the RKI’s health monitoring programme is being redesigned. In addition, the German National Cohort (NAKO) health study will deliver findings on the development of common illnesses and their influencing factors. NAKO is Germany’s largest health study. Funded by the Federal Ministry of Education and Research (BMBF), the Länder and the Helmholz Association, it provides insights into the relationships between common illnesses, eating habits and other health related factors. 103 Ernährungs Umschau (2022): 69(12): 184–9. https://www.ernaehrungs-umschau.de/fileadmin/Ernaehrungs Umschau/pdfs/pdf 2022/12 22/EU12 2022 M662 M667.pdf. 104 See WBAE (2020): Gutachten and Wissenschaftsrat (2023): Perspektiven der Agrar- und Ernährungswissenschaften | Positionspapier; Köln. https://doi.org/10.57674/vzz6-sw54. 59 2. What is our goal In addition to findings from nutritional physiology research, improving the data available on the nutritional situation (including the environmental and climate impacts of food and nutrition) is essential for designing knowledge-based, future-proof food and nutrition policies. This calls for the promotion of nutrition research in Germany along with intensive interdepartmental collaboration that is open to thematic reorientation and structural change. It must also take an interdisciplinary and transdisciplinary approach. With the funding and promotion of four competence clusters in nutrition research by the Federal Ministry of Education and Research (BMBF), an important step has already been taken to strengthen nutrition research in Germany. This has enhanced the interdisciplinary orientation of German nutrition research, boosted capacity building (especially as regards early career researchers) and strengthened its international competitiveness. The aim is to show how data on the food and nutrition situation and on the research priorities set out in the Federal Government's Food and Nutrition Strategy can be collected, evaluated, analysed and interpreted on an ongoing basis. To assess the effectiveness of the Strategy, a set of indicators will be developed by 2027, initially drawing on existing data. The structures of the research landscape within the BMEL’s remit are to be reviewed and areas identified where there is a specific need for change. Departmental research will play a major role as it can assume ongoing tasks such as coordinating the National Nutrition Monitoring programme and further developing the German Nutrient Database (BLS). Lasting prevention of nutrition-related diseases is also to be achieved through successful collaborations between nutrition scientists and related scientific disciplines (including medicine, public health, the social sciences and communication sciences). Freely available data is an essential resource for a wide range of research activities and for consumer information. With open data gaining in importance on a global scale, ways to improve the availability of data are to be identified in conjunction with the stakeholders concerned. 3. How can we achieve our goal? (1) Optimising research structures and impact monitoring The BMEL has commissioned the development of policy recommendations for innovative departmental nutrition research that is geared in subject matter and structure to meet the challenges that lie ahead. Federal research establishments (such as the RKI, the MRI and the UBA) are to engage in more networking and collaboration in order to obtain synergies. It is necessary to identify and increase collaboration on thematically related funding programmes – such as the Federal Organic Farming Scheme (BÖL), the funding programme for International Research Cooperation on Global Food Security and the Protein Crop Strategy 60 (EPS). The same goes for overlaps with related work areas in health research, food research, agricultural research and social research. Funding is to be made available and suitable methodologies developed in the medium term to enable independent and science-based evaluation of research activities. Implementation research is to be expanded with regard to intervention measures concerning sustainability and health promotion. Pilot projects are to be accompanied by scientific follow-up for evidence-based success monitoring of piloted interventions. This should preferably be based on indicators that allow comparisons with other EU member states. (2) Establishing a national data infrastructure for nutrition research With regard to impact and effectiveness indicators for the Food and Nutrition Strategy, the available datasets are to be reviewed and output, outcome and impact indicators identified and agreed for each action area. National databases, such as the German Nutrient Database (BLS), already play an important role in the evaluation of energy and nutrient intake as part of nutritional epidemiology studies and consumption surveys. Systematic expansion and interconnection of existing databases is key in enabling new research approaches, minimising redundant research activity and simplifying monitoring tasks. The data already available in existing databases and datasets related to nutrition research is to be made easy to find, interconnected using smart technologies and made available free of charge. Over time, a data infrastructure containing a large proportion of open data is to be established that all relevant and participating institutions can access and contribute to. Voluntary data donations are to be enabled where useful. The databases and datasets are to be constantly updated and maintained. In the future, data collection will be extended beyond nutritional physiology data and findings on eating habits to additionally include data on food environments. Other aspects, such as sustainability effects, environmental aspects and data on food ingredients are to be integrated and evaluated in collaboration with the Thünen Institute (TI). The data infrastructure should ideally be designed to be interoperable with the National Research Data Infrastructure (NFDI) in order to aid cross-referencing with databases in thematically related NFDI consortiums. (a) National nutrition monitoring Improved, continuous, science-based monitoring of nutritional behaviour and the nutritional status is to be established for all population groups in Germany. The aim is to conduct regular, comprehensive and nationally representative surveys on dietary habits and the nutritional status. Nutrition monitoring generally covers the entire German population. In future, it will place greater focus on the target groups set out in the Food and Nutrition Strategy. The National 61 Nutritional Monitoring programme is managed and coordinated by the Max Rubner Institute (MRI). (b) Establishing a systematic breastfeeding monitoring programme Developing a systematic, standardised breastfeeding monitoring programme is a key component of Germany’s National Strategy for the Promotion of Breastfeeding. This makes it possible to derive, plan, implement and evaluate targeted measures to promote breastfeeding. To enable comparisons to be drawn and to identify trends, regular data collection is necessary using standardised definitions and uniform indicators. The MRI Department of Child Nutrition is establishing a systematic breastfeeding monitoring programme. Data is taken from the mandatory quality assurance processes in perinatal medicine, which cover all births in hospitals and the breastfeeding status at the time mother and child are discharged. Regular examinations for the detection of early childhood diseases will also be used to aid continuous data collection. In the medium term, data collected in the course of breastfeeding monitoring will be published at regular intervals. (c) Establishing a modern, permanent food monitoring system The composition of food in Germany should be systematically tracked and changes in significant nutrient content monitored on an ongoing basis. It is therefore planned to further develop the MRI’s German Nutrient Database (BLS) and to continuously update it, including with the nutritional composition of new and novel foods. In addition, publicly funded food composition databases in Germany are to be better interconnected. Ingredients and nutrient content of packaged foods should be tracked on an ongoing basis. This should increasingly be done online and using artificial intelligence. The collection of data on food composition is to be extended to cover the environmental aspects of production. In the future, databases for use in life cycle assessments and providing environmental criteria for the main environmental impacts of food production will be created, kept current and made publicly available, building on the groundwork done by the Federal Environment Agency (UBA) in this area along with an existing life cycle assessment database (ProBas). Initial approaches towards making the dietary shift to more plant-based foods measurable have been developed in departmental research activities, such as the STErn project on the socio-ecological transformation of the food system105, and will be discussed in the context of the National Programme for Sustainable Consumption (NPNK) and in projects on 105 https://stern-projekt.org/en/results, FKZ 3720 31 102 0. 62 biodiversity impacts. The approaches are to be continued in interdepartmental working groups. (3) Studies on the effectiveness of nutrition communication using the example of food-based dietary guidelines In order to strengthen research in nutrition communication, the BMEL is funding a research programme on the development and evaluation of visualisation in food-based dietary guidelines.106 This provides an evidence-based foundation for visualisation models and communication campaigns that follow this approach. Studies are to be interdisciplinary with links to communication sciences, psychology, medicine, public health and social sciences. Digital communication channels are to be evaluated and their content screened. The commercial communications environment should also be considered in this process. (4) Further flagship initiatives The research topics cited below are to be embedded in the research strategies of the departmental research institutions and given priority consideration in future research funding programmes. (a) Funding research projects for the development and evaluation of effective measures in mass catering To be able to develop effective catering quality measures for daycare centres and schools, valid data must be regularly collected and evaluated, for example to assess the quality of the food provided in daycare centres and schools, and also regarding sustainability and socioeconomic aspects. The data in this area is largely not comparable due to differences in survey methods among the Länder. Nudging and other innovative measures are to be examined for effectiveness. (b) Research on vulnerable target groups and plant-based diets More research is needed on food and nutrition among vulnerable groups such as children and adolescents, persons with disabilities and senior citizens. Longitudinal observational studies are to be conducted to determine, among other things, how dietary preferences and the nutritional status of women during pregnancy influences the diets and health of their children (the PEACHES study). Research is to be conducted to identify measures suitable for improving nutrition in mass catering establishments, and in particular at daycare centres and schools. One option comprises changes to menu lines (menu categories such as organic, vegetarian, etc.). To close the data gaps in relation to vegetarian and vegan diets, the health-related, environmental, social and economic advantages and disadvantages of plant-based diets are to 106 See the “Communication and implementation in practice” cluster in the “Dietary guidelines” action area. 63 be investigated as part of the COPLANT (Cohort on Plant-based Diets) study, the biggest cohort study on plant-based food and nutrition planned in German-speaking countries to date. (c) Research priority: Food poverty The knowledge base is to be improved.107 Food poverty will also be made a focus area under the National Nutrition Monitoring programme. (5) Reducing food waste Continuous follow-up of the measures taken to reduce food waste in the sectors is planned in the form of transdisciplinary research along with research at national, EU and international level. The research findings and outcomes can be taken into account in the further development of Germany’s National Strategy to Reduce Food Waste. (6) Research priority: Protein strategy Innovative and in particular plant-based protein sources and alternative products can make it easier for people to adopt healthy, sustainable, plant-based diets. A research priority on alternative sources of protein is planned as part of the protein strategy for Germany. III. Outlook Good food is essential to everyone’s health. It is a fundamental human right and also a key factor in ensuring planetary health. Given the multiple crises faced by society, it is increasingly important for us to take a new approach to food and nutrition. Nutrition should be healthy, sustainable, socially equitable and (economically) resilient. We, the Federal Government, have set out the framework for this in the Food and Nutrition Strategy. In it, we set short, medium and long-term food and nutrition policy priorities, define relevant action areas and describe measures to be taken. We see the Food and Nutrition Strategy as a dynamic, learning process – one which we will continuously develop and align to changing needs. The measures it contains are not exhaustive because we will continuously devise and test new measures and adapt the existing measures as needed on the basis of scientific findings and developments. We will also subject the Strategy to regular review, update it when needed, report on the progress made and document the measures taken. Making it easier for everyone in Germany to eat good – healthy and sustainable – food is a common agenda that must be addressed interdepartmentally and at all levels. Everyone 107 See the “Improving the knowledge base on food poverty” measure in the “Social aspects” action area. 64 must be involved: policymakers, administration, the scientific community, business, the healthcare sector, civil society and consumers. The Federal Government’s Food and Nutrition Strategy paves the way. Let us now work together on its implementation.