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European Journal of Clinical Nutrition (2021)
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Unhealthy population diets contribute to the burden of non-communicable diseases. Policies targeting food environments (FE policies) may improve population diets. This review of systematic reviews aims to summarise recent evidence of the effectiveness of FE policies in improving diets. We searched PubMed for systematic reviews published from January 2010 onwards. Eligible FE policies included: nutrition and food labelling, provision of foods in public institutions or specific settings, price, marketing, nutrition quality and portion size, and availability of foods in retail and food service establishments. A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR 2) instrument was used to assess review quality. Reviews of critically low quality were excluded. Results were narratively reported in text and tables. The search identified 1102 records after removing duplicates. Following screening and quality assessment we included 12 systematic reviews. Two reviews focused on nutrition and food labelling, two on provision of foods in school settings, four on price, none on marketing policies, three on nutrition quality and portion size and one on the availability of foods in retail and food service establishments. Pricing policies (tax/subsidy) appear effective in altering intake and purchase of targeted foods and beverages. FE policies targeting the availability of foods in retail and food establishments, food provision in school settings, product reformulation and the size of portions/packages or items of tableware also appear effective. Overall, policies targeting food environments appear effective in improving population diets. However, there is a need for further high-quality evidence.
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The authors would like to thank Nanna Louise Riis, Kirsten Bjørnsbo, Kamille Almer Bernsdorf Torp, Signe Damsbo Birch and Tine Buch-Andersen for providing helpful comments on a previous version of this paper.
Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
Katrine Lindberg Hansen, Sanja Golubovic, Christian Ulrich Eriksen, Torben Jørgensen & Ulla Toft
Department of Public Health, Faculty of Medicine and Health Sciences, University of Copenhagen, Copenhagen, Denmark
Torben Jørgensen & Ulla Toft
The Faculty of Medicine, Aalborg University, Aalborg, Denmark
Torben Jørgensen
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KLH was responsible for designing the review, writing the review article, conducting the search, pre-liminary and full-text screening, quality assessment, data extraction and narrative synthesis, interpretation of results, creating tables and figures, and updating references list. SG was responsible for writing the review article, for full-text screening, quality assessment, data extraction and narrative synthesis, and interpretation of results. CUE was responsible for designing the review, conducting the search, full-text screening, quality assessment, data extraction and provided feedback on the paper. UT and TJ were responsible for designing the review and provided feedback on the paper. All authors read and approved the final paper.
Correspondence to Ulla Toft.
The authors declare no competing interests.
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Hansen, K.L., Golubovic, S., Eriksen, C.U. et al. Effectiveness of food environment policies in improving population diets: a review of systematic reviews. Eur J Clin Nutr (2021). https://doi.org/10.1038/s41430-021-01008-y
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Received: 23 April 2021
Revised: 11 August 2021
Accepted: 03 September 2021
Published: 20 September 2021
DOI: https://doi.org/10.1038/s41430-021-01008-y
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