Creating healthy food environments in recreation and sport settings using choice architecture: a scoping review

Abstract

Recreation and sport settings (RSS) are ideal for health promotion, however, they often promote unhealthy eating. Choice architecture, a strategy to nudge consumers towards healthier options, has not been comprehensively reviewed in RSS and indicators for setting-based multi-level, multi-component healthy eating interventions in RSS are lacking. This scoping review aimed to generate healthy food environment indicators for RSS by reviewing peer-reviewed and grey literature evidence mapped onto an adapted choice architecture framework. One hundred thirty-two documents were included in a systematic search after screening. Data were extracted and coded, first, according to Canada’s dietary guideline key messages, and were, second, mapped onto a choice architecture framework with eight nudging strategies (profile, portion, pricing, promotion, picks, priming, place and proximity) plus two multi-level factors (policy and people). We collated data to identify overarching guiding principles. We identified numerous indicators related to foods, water, sugary beverages, food marketing and sponsorship. There were four cross-cutting guiding principles: (i) healthy food and beverages are available, (ii) the pricing and placement of food and beverages favours healthy options, (iii) promotional messages related to food and beverages supports healthy eating and (iv) RSS are committed to supporting healthy eating and healthy food environments. The findings can be used to design nested, multipronged healthy food environment interventions. Future research is needed to test and systematically review the effectiveness of healthy eating interventions to identify the most promising indicators for setting-based health promotion in RSS.

Evaluation of an Environmental Nutrition Intervention at the 2018 Commonwealth Games

“…Four guiding principles (availability, pricing and placement, promotion, and provider commitment) have been recommended for successful implementation of healthy food environments in recreation and sports settings [12]. As demonstrated through the results of this study, these can be adapted and applied in the context of major competitions.…”

“…The more commonly implemented strategies that promote behaviour change, such as nutrition labelling of menu items, educational information, and changes to serving plates and cutlery, have inconclusive outcomes [10]. Research in recreation and sports settings has suggested that multi-level setting-based approaches may be more impactful than a singular intervention [12]. Menu labelling alone has been shown to have a moderate impact on altering the intake of specific nutrients and dietary components of consumers [13], yet the impact on athletes' diets is unknown.…”