Voluntary cooperation between the food industry and government for a healthier diet in the population-the case of Norway

Background and objectives: In Norway, there has been an initiative since 2017 to make the population's diet healthier through a voluntary agreement between the food industry and health authorities. The letter of intent has been signed by around 100 actors including the Ministry of Health and Care, and all the major actors in the food industry-food and trade organizations, food and beverage manufacturers, food retailers and food service industry. The overall aims of the initiative are to reduce the intake of salt, added sugar and saturated fat in the population, and to increase the consumption of vegetables, fruits and berries, whole grain products and seafood. Methods: The initiative has been followed by a formative evaluation, including annual surveys to agreement partners from 2017 to 2021 and qualitative interviews with stakeholders from industry, organisations, and government in 2018, 2020 and 2022. Results: The different measures utilised by the actors varied as expected, according to the aims. For the reduction of salt, sugar and fat, gradual changes over time and development of new products were the most dominant measures used by the actors. While for the increased consumption of vegetables, fruits and berries, whole grain products and seafood, marketing initiatives and changed product placement has been important. A few similar initiatives have been initiated earlier in other countries, however most of them has failed when government has changed. The Norwegian initiative is unique in the sense that it has survived changes of government. It is based on trust between the industrial partners and the health authorities. Both sides highlighted the value of a common meeting place. Conclusion: The cooperation among partners becomes easier when they can settle upon meetings and discussions regularly. In addition, a strong motivation for the actors is to address public health as part of their corporate social responsibility. The contract thus contributed to an already shared objective between the partners and the authorities. Even though there have been challenges during the agreement period, the parties find the voluntary cooperation a useful way to work and have signed a new agreement for the period 2022-2025.