A Systematic Review of the Effect of Retail Food Environment Interventions on Diet and Health with a Focus on the Enabling Role of Public Policies

Abstract

Purpose of ReviewUpdate the state of evidence on the effectiveness of retail food environment interventions in influencing diet and explore the underlying role of public policy, through a systematic review of population-level interventions to promote health in the retail food environment, including community and consumer environments. Diet-related outcomes included purchasing, dietary intakes, diet quality, and health including weight. We coded studies for enabling public policy levers underpinning the intervention, using two widely used conceptual frameworks.Recent FindingsOf 86 articles (1974–2018), the majority (58 articles, 67%) showed at least one positive effect on diet. Thirteen articles (15%) discussed natural experiments, 27 articles (31%) used a design involving comparison groups including 23 articles (27%) specifically describing randomized controlled trials, and 46 (53%) were quasi-experimental (cross-sectional) evaluations. Across the “4Ps” of marketing (product, promotion, placement, and price), promotion comprised the greatest proportion of intervention strategies, especially in earlier literature (pre-2008). Few studies combined geographic access interventions with 4P strategies, and few used robust dietary intake assessments. Behavior change communication remains an intervention mainstay, but recent work has also incorporated environmental and social planning, and fiscal strategies. More recent interventions were multi-component.SummaryThe retail food environment intervention literature continues to grow and has become more robust overall, with clearer evidence of the effect of interventions on diet-related outcomes, including consumer purchasing, dietary intakes, and health. There is still much scope for development in the field. Attention to enabling public policy could help to strengthen intervention implementation and evaluation in the retail food environment.

Effects of food policy actions on Indigenous Peoples’ nutrition-related outcomes: a systematic review

“…37 Food retail and supply chain interventions to improve local food and beverage environments in rural and remote Indigenous communities were consistently effective across included studies. Consistent with the results of a recent review of retail food environment interventions, 102 all studies targeting local food retail and supply chains within Indigenous communities were able to demonstrate improvements in at least one outcome including dietary quality, healthy food purchasing, food security, nutrition or chronic disease biomarkers, and one reported a downward trend in mean BMI. 67 Furthermore, the use of store sales data to evaluate the impact of remote Indigenous community store interventions in Australia provided objective evidence for multisectoral food system interventions to increase purchasing of fruits and vegetables, and decrease purchasing of confectionary and sugar-sweetened beverages.…”

“…Food retail and supply chain interventions to improve local food and beverage environments in rural and remote Indigenous communities were consistently effective across included studies. Consistent with the results of a recent review of retail food environment interventions, 102 all studies targeting local food retail and supply chains within Indigenous communities were able to demonstrate improvements in at least one outcome including dietary quality, healthy food purchasing, food security, nutrition or chronic disease biomarkers, and one reported a downward trend in mean BMI. 67 …”

Improving Consumption and Purchases of Healthier Foods in Retail Environments: A Systematic Review

“…In-store promotion interventions are increasingly common, often with positive effects, either in combination with other approaches, or used alone. Previous reviews have found that older interventions, specifically those prior to 2008, were more likely to manipulate promotion, most often in single-component interventions [ 9 , 11 ]. In the more recent studies examined in this review, promotional interventions were frequently paired with placement and product strategies in multi-component interventions, for example including the coupling of a shelf labeling intervention with an end of aisle display, yielding positive effects.…”

“…Prior literature has identified multi-component interventions’ added complexities in deciphering effects of its individual components [ 4 , 11 ]. There are two reasons for this complexity.…”

“…Despite growing research, increasing recognition of the importance of marketing in the food retail environment and the popularizing practice of multi-component interventions, which manipulate more than one of the four Ps [ 11 ], there remain many unanswered questions about best practices for implementing effective in-store interventions. Food marketing and consumer behavior research is cross-disciplinary by nature, with outcomes published in outlets unique to industry, business, agriculture as well as public health, creating an aggregation challenge for practitioners.…”