Assessment of the Commitments and Performance of the European Food Industry to Improve Population Nutrition.

Food companies could play an important role in improving population diets, but often escape accountability through unspecific commitments. This study evaluated nutrition-related commitments and estimated performance of the largest packaged food and non-alcoholic beverage manufacturers, supermarkets and quick-service restaurants (QSR) in Europe. To quantitatively assess companies' publicly available commitments in 2020, the "Business Impact Assessment on Obesity and Population Nutrition" was applied. The proportion of sales from ultra-processed and "unhealthy" food categories (product categories not-permitted to be marketed to children) and over time changes in the number of QSR transactions and QSR and supermarket outlets were calculated. Company commitments fell short of best practice recommendations (median overall score of 21%, range: 1%-62%). Food and beverage companies generated 82% (15%-100%) and 58% (1%-100%) sales from ultra-processed and "unhealthy" products, respectively. The number of QSR outlets and transactions substantially increased in Europe since 2011, while QSR commitments to improve population nutrition remained limited. Whilst most companies made some nutrition-related commitments, they did not comply with best practice recommendations. A large proportion of sales was generated from ultra-processed/unhealthy products and QSR outlets increased. Government regulations are urgently needed.