Implementation Status of a System to Improve Healthy Food Environments in Restaurants and Other Settings in Local Governments: Web Search on Criterion Combination and Quantitative Criteria for Nutrients and Food Groups

of Niigata Prefecture  ABSTRACT Objective: Health Japan 21 (the second term) promotes an " increase in the number of corporations in the food industry that supply food products low in salt and fat. " However, the status of its implementation is not evident as the specific criteria for registration have not been questioned. A survey was conducted by local governments throughout Japan to determine the implementation rate of the system to improve healthy food environments in restaurants and other settings and criteria for registration of stores to understand the criterion combination and quantitative criteria for nutrients and food groups. Methods: The study comprised 154 local governments, including prefectures, cities with public health cen-ters, and special wards throughout Japan. In October 2019, a web search was conducted on local government websites regarding the system to improve a healthy food environment in restaurants, and the registration criteria were dichotomized into access to information and food. Criterion combination patterns of nutrients and food groups for access to food were categorized and the presence of quantitative criteria was identified. Results: Among the surveyed local governments, 80% confirmed to have implemented the system to improve healthy food environments in restaurants. More than 80% of the local governments that implemented these systems included access to information or food as registration criteria. The most commonly registered items under the criteria for access to food were " lots of vegetables " (approximately 90%) and " low salt " (approximately 80%), and a combination of " lots of vegetables " and " low salt " was confirmed in 29 cases. The items which more than half of the local governments required the quantitative criteria were " lots of vegetables, " " lots of calcium, " and " lots of iron. " Conclusions: The most commonly registered items under access to food were " lots of vegetables " and " low salt. " A limited number of local governments set criterion combination, and the quantitative criteria for which " low salt " was essential was also at