Healthier choices in an Australian health service: a pre-post audit of an intervention to improve the nutritional value of foods and drinks in vending machines and food outlets

Abstract

BackgroundVending machines and shops located within health care facilities are a source of food and drinks for staff, visitors and outpatients and they have the potential to promote healthy food and drink choices. This paper describes perceptions of parents and managers of health-service located food outlets towards the availability and labelling of healthier food options and the food and drinks offered for sale in health care facilities in Australia. It also describes the impact of an intervention to improve availability and labelling of healthier foods and drinks for sale.MethodsParents (n = 168) and food outlet managers (n = 17) were surveyed. Food and drinks for sale in health-service operated food outlets (n = 5) and vending machines (n = 90) in health care facilities in the Hunter New England region of NSW were audited pre (2007) and post (2010/11) the introduction of policy and associated support to increase the availability of healthier choices. A traffic light system was used to classify foods from least (red) to most healthy choices (green).ResultsAlmost all (95%) parents and most (65%) food outlet managers thought food outlets on health service sites should have signs clearly showing healthy choices. Parents (90%) also thought all food outlets on health service sites should provide mostly healthy items compared to 47% of managers. The proportion of healthier beverage slots in vending machines increased from 29% to 51% at follow-up and the proportion of machines that labelled healthier drinks increased from 0 to 26%. No outlets labelled healthier items at baseline compared to 4 out of 5 after the intervention. No changes were observed in the availability or labelling of healthier food in vending machines or the availability of healthier food or drinks in food outlets.ConclusionsBaseline availability and labelling of healthier food and beverage choices for sale in health care facilities was poor in spite of the support of parents and outlet managers for such initiatives. The intervention encouraged improvements in the availability and labelling of healthier drinks but not foods in vending machines.

Are products sold in university vending machines nutritionally poor? A food environment audit

“…This research is consistent with international audits that have found that vending machines contribute to unhealthy food environments . Research spanning the past three decades has shown that vending machines on campuses have been a source of unhealthy options, and offerings have been found to be high in fat, sugar and energy and low in fibre .…”

“…Furthermore, our results are likely to be generalisable to other tertiary institutions given that these institutions use the same large vending companies and procurement systems as in the audited university. The product range described in the current study reflects vending machines’ stocks across the country . The audit for some vending machines was conducted over two time periods; however, our test–retest data of the majority of machines (80%) demonstrated that vending machine contents remained static, and seasonal variation did not influence the results of machines compared between the two time points.…”

“…This research is consistent with international audits that have found that vending machines contribute to unhealthy food environments. [13][14][15]23 Research spanning the past three decades has shown that vending machines on campuses have been a source of unhealthy options, 14,24 and offerings have been found to be high in fat, sugar and energy and low in fibre. 14 There have been recent efforts to alter this, and a nutrition policy implemented in the United States by a university specified ratios of healthy and less-healthy snacks and found that the less-healthy items only comprised 33% of machine contents but 58% of sales.…”

Assessing the availability, price, nutritional value and consumer views about foods and beverages from vending machines across university campuses in regional New South Wales, Australia

“…Vending machines are widely distributed and can be found in workplaces, schools, universities and hospitals . A recent Australian study reported that the foods and beverages sold in vending machines at train stations are predominantly of minimal nutritional value .…”

“…7,8 Vending machines are widely distributed and can be found in workplaces, schools, universities and hospitals. 9,10 A recent Australian study reported that the foods and beverages sold in vending machines at train stations are predominantly of minimal nutritional value. 9 Several studies at schools, hospitals and train stations showed that products vended were mainly chips, chocolate, confectionary, soft drinks, sport drinks and energy drinks, 11,12 which were generally high in energy, sugar and salt.…”