Table 2 PEN Key diet behaviour indicators with highest priority, ordered by rating score, per domain

 Prices

Taxes or levies on healthy foods are minimised to encourage healthy food and beverage choices (e.g. low or no sales tax, excise, value-added or import duties on fruit and vegetables, subsidies).

 Composition

Food composition targets/standards/restrictions/mandatory limits have been established and a monitoring system is in place by the government for the content of the nutrients of concern (trans fats, free sugars, salt, saturated fat, fibre) in industrially processed foods, in particular for those food groups that are major contributors to population intakes of those nutrients of concern.

 Labelling

The government endorses one evidence informed front-of-pack labelling system containing nutritional information and interpretational aides (e.g. Nutriscore, traffic light system, keyhole) that readily allow consumers to assess a product’s unhealthiness/healthiness, and policy provisions are in place to encourage widespread uptake of endorsed system.

 Prices

Taxes or levies on unhealthy foods and beverages (e.g. sugar-sweetened beverages, foods high in nutrients of concern) are in place and increase the retail prices of these foods to discourage unhealthy food choices where possible.

 Provision

The government ensures that there are clear, consistent policies (including nutrition standards) which can be feasibly implemented in schools and early childhood education services for food service activities (canteens, food at events, fundraising, promotions, vending machines etc.) to provide and promote healthy food choices.

 Monitoring and evaluation

There is regular monitoring of adult and childhood nutrition status, weight status, Body Mass Index and risk of NCDs.

 Education

Pre-registration education curricula for all Health Care Professionals include a minimum of one nutrition module of five European Credit Transfer System or equivalent.

 Promotion

Governmental policies are implemented to restrict commercial marketing (including sponsorship, promotion and advertisement) of unhealthy foods and beverages to children, including adolescents, in settings where children gather (e.g. preschools, schools, sports clubs and facilities and cultural events).

 Promotion

Effective policies are implemented by the government to restrict exposure and power of promotion of unhealthy foods to children including adolescents through all media and marketing channels.

 Education

School curricula must include knowledge and skills targets for the development of nutrition education for primary and secondary school pupils.

 Extrinsic product attributes

Relative and absolute price of healthy and unhealthy food

 Exposure to food promotion

Exposure to food adverts for unhealthy food and beverages through all media and marketing channels.

 Portion size

Portion size from manufacturers and food outlets in settings

 Environmental food availability and accessibility

School food environment

 Food outlet density

Fast food outlet density

 Household literacy level

Food literacy on the household level (composite score)

 Household socio-economic status

Relative household income (household income / household size)

 Household socio-economic status

Financial strain

 Anthropometrics

Body Mass Index

 Personal socio-economic status

Level of education

 Personal socio-economic status

Food and nutrition insecurity

 Food beliefs

General and relative enjoyment of healthy and unhealthy food

 Health

Psychological/mental well-being

 Energy, protein and fibre intake and macronutrient distribution

Number of portions per day of pulses

 Energy, protein and fibre intake and macronutrient distribution

Number of portions per /day of wholegrains

 Foods and beverages, groups

Fruit intake, number of portions per day

 Foods and beverages, groups

Vegetable intake, number of portions per day

 Foods and beverages, groups

Sugar-sweetened beverages, glasses per day