The document, which evaluated the performance of public policies related to healthy eating, also recommends expanding the plan to reformulate food products, involving catering.

According to the report, released by the Directorate-General for Health (DGS), to ensure the application of existing guidelines for food supply in schools, a model should be defined that includes more supervision.

The authors of the document also recommend the definition of a nutritional profile model that serves as a basis for implementing measures to promote healthy food environments and propose an amendment to the Value Added Tax (VAT) code.

The intention is “to include other criteria(s) for the attribution of VAT rates, in addition to the criterion of essentiality, which consider the nutritional profile of foods and/or their framework within the scope of a healthy diet”.

The inclusion of the program to promote healthy eating in the basic portfolio of Primary Health Care services and the definition of indicators to regularly monitor food consumption, nutritional status and health outcomes related to food and nutrition.

Specialists also suggest an improvement in the workforce in the area of ​​nutrition and public health, adjusting the ratio of nutritionists in Primary Health Care and integrating at least one of these professionals in each Public Health Unit at the level of Primary Health Care.

Including in national programs in the area of ​​nutrition and healthy eating the most vulnerable population groups, namely the elderly, pregnant women, children, adolescents and immigrants, as priority action groups is another recommendation.

The document recalls that inadequate nutrition is one of the main preventable causes of chronic non-communicable diseases, namely obesity, oncological diseases, cerebrovascular diseases and type 2 diabetes mellitus, and underlines that the most recent data from the Global Burden Disease, 2019 , show that “in Portugal, inadequate eating habits are among the five risk factors that most determine the loss of years of healthy life and mortality”.

“Given the weight that dietary risk factors have on the burden of disease in Portugal, similarly to what has been seen in other European countries, the implementation of measures that promote healthy eating is required, namely measures aimed at creating healthy food environments,” the experts write.

They emphasize that Portugal has sought to respond and has followed international recommendations, applying “a wide range of measures aimed at creating healthy food environments”, and they give as an example the excise tax on sugary drinks, legislation that introduces restrictions food advertising aimed at children and the regulation of food supply in different public spaces (eg educational institutions and the National Health Service).

More than half of the Portuguese population (56%) does not comply with the World Health Organization (WHO) recommendation to consume more than 400g/day of fruit and vegetables, according to data from the latest National Food and Physical Activity Survey (2015- 2016).

Data from the last National Health Survey (2019), released by the National Statistics Institute (INE), reveal that 53.6% of the Portuguese adult population is overweight (pre-obesity or obesity), with obesity affecting 1 .5 million people (16.9%).