Portugal's voluntary food reformulation agreement and the WHO reformulation targets

Despite such evidence, after one year of negotiations, the Food Industry representatives have been able to persuade the MoH not only to delay the agreement targets deadline from 2021 to 2022, but also to lower the initial reformulation targets (Table 1). Since the final agreement targets are actually much less ambitious than the preliminary ones, the health impact of the agreement will be considerably smaller. [...]the literature strongly suggests that mandatory approaches generate larger health gains than voluntary agreements [12,13]. Given that the evidence suggests that even the stronger originally proposed voluntary targets would only prevent a small minority of diet-related deaths, we feel that the Government should immediately consider complimentary mandatory policies, including those that cover food served in cafeterias, canteens, restaurants and hotels as one of the leading sources of sugar, salt and trans fats in Portugal. 1 Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London, United Kingdom 2 Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal 3 Center for Innovation, Technology and Policy Research, IN+, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal 4 Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom 5 Centre for Public Administration and Public Policies, Institute of Social and Political Sciences, University of Lisbon, Lisbon, Portugal 6 Nutrition and Metabolism, NOVA Medical School, Faculty of Medical Sciences, NOVA University of Lisbon, Lisbon, Portugal 7 Center for Health Technology Services Research (CINTESIS), Porto, Portugal 8 INSA, National Institute of Health, Lisbon, Portugal 9 Portuguese Order of Nutritionists, Porto, Portugal 10 Department of Management & Centre for Health Economics & Policy Innovation (CHEPI), Imperial College Business School, London, United Kingdom 11 Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom