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

Catherine L Mah; Gabriella Luongo; Rebecca Hasdell; Nathan G A Taylor; Brian K Lo

doi:10.1007/s13668-019-00295-z

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

Curr Nutr Rep. 2019 Dec;8(4):411-428. doi: 10.1007/s13668-019-00295-z.

Authors

Catherine L Mah^{1

2}, Gabriella Luongo³, Rebecca Hasdell⁴, Nathan G A Taylor⁴, Brian K Lo⁵

Affiliations

¹ School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd Floor, PO Box 15000, Halifax, NS, B3H 4R2, Canada. catherine.mah@dal.ca.
² Dalla Lana School of Public Health, University of Toronto, 155 College Street, 5th Floor, Toronto, ON, M5T 3M7, Canada. catherine.mah@dal.ca.
³ Dalla Lana School of Public Health, University of Toronto, 155 College Street, 5th Floor, Toronto, ON, M5T 3M7, Canada.
⁴ School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd Floor, PO Box 15000, Halifax, NS, B3H 4R2, Canada.
⁵ Division of Nutritional Sciences, Cornell University, 417 Savage Hall, Ithaca, NY, 14850, USA.

Abstract

Purpose of review: Update 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 findings: Of 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. The 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.

Keywords: Community food environment; Consumer food environment; Consumer purchasing; Diet; Health behavior; Intervention; Noncommunicable diseases; Policy context; Public policy; Retail food environment; Review.

Publication types

Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Body Weight
Commerce
Consumer Behavior
Databases, Factual
Diet*
Environment*
Feeding Behavior
Food*
Health Promotion*
Humans
Marketing*
Public Health
Public Policy*

Grants and funding

KAL 139697/CIHR/Canada