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Abstract

Ireland has one of the highest levels of obesity in Europe. According to the Health 
Service Executive (HSE), 60% of adults are living with overweight or obesity (Health 
Service Executive, 2022). The Childhood Obesity Surveillance Initiative (COSI) 2020 
report also reveals that one in five primary school children in Ireland have overweight 
or obesity, highlighting the urgent need for public health action, focused on prevention 
(Mitchell et al., 2020). Obesity is associated with other chronic diseases such as type 
2 diabetes, cardiovascular disease, respiratory disease, several types of cancer, and 
pain and musculoskeletal disorders. The projected cost of overweight and obesity in 
Ireland will be over €11 billion by 2030 (World Obesity Federation, 2025).  

Robust government policies are critical to shaping healthier food environments and 
mitigating the burden of obesity, non-communicable diseases (NCDs), and associated 
health inequalities (Swinburn et al., 2013). Unhealthy food environments result in 
unhealthy diets, through the widespread availability of cheap, hyper-palatable, heavily 
promoted, energy-dense and nutrient-poor products (Swinburn et al., 2011). 
Accordingly, Governments must implement comprehensive and systemic policies to 
improve food environments and address the urgency of the burden posed by 
unhealthy diets. To achieve this goal, it is important to take stock of government 
policies, including their extent of development and implementation, and compare this 
to international best practice.  

The Healthy Food Environment Policy Index (Food-EPI) is an instrument and process 
designed to evaluate the extent to which governments have implemented policies to 
create healthy food environments, benchmarked against international best practice 
(Swinburn et al., 2013). Developed in 2013 by the International Network for Food and 
Obesity/NCDs Research, Monitoring and Action Support (INFORMAS), it focuses on 
policy actions aimed at preventing obesity, non-communicable diseases (NCDs), and 
related inequalities. The Food-EPI has been implemented in over 40 countries 
worldwide, including Ireland, with adaptations to reflect national contexts.  

The Food-EPI instrument consists of two components, Policy and Infrastructure 
Support. The two components consist of six domains, each comprising a number of 
good practice indicators. The Policy domains address key aspects of food 
environments that can be influenced by governments to create accessible, available, 
and affordable healthy food choices. The Infrastructure Support domains are related 
to aspects which facilitate policy development and implementation to prevent obesity 
and NCDs.