Local urban government policies to facilitate healthy and environmentally sustainable diet-related practices: A scoping review

Objective: This scoping review sought to describe the policy actions that urban local governments globally have implemented to facilitate healthy and environmentally sustainable diet-related practices. Design: Five databases were searched to identify publications which cited policies being implemented by local governments within the 199 signatory cities of the Milan Urban Food Policy Pact (MUFPP) that targeted at least one healthy and sustainable diet-related practice. Grey literature was then searched to retrieve associated policy documentation. Data from both sources were charted against the MUFPP's monitoring framework to analyse the policy actions included in each overarching policy. Results: From 2624 screened peer-reviewed studies, 27 met inclusion criteria and cited 36 relevant policies amongst signatory cities to the Milan Urban Food Policy Pact. Most were from high income countries (n=29; 81%), considered health (n=31; 86%), equity (n=29; 81%) and the broader food system beyond dietary consumption (n=34; 94%). Of the 66 policy actions described, the most common involved food procurement within public facilities (n=16; 44%) and establishing guidelines for school feeding programs (n=12; 33%). Conclusions: This review has demonstrated that urban local government authorities are implementing policies that consider multiple phases of the food supply chain to facilitate population-wide uptake of healthy and sustainable diet-related practices. Opportunities exist for local governments to leverage the dual benefits to human and planetary health of policy actions, such as those which discourage the overconsumption of food including less meat consumption and the regulation of ultra-processed foods.