The impact of increasing the availability of lower energy foods for home delivery and socio-economic position: a randomised control trial examining effects on meal energy intake and later energy intake

Abstract

Increasing the availability of lower energy food options is a promising public health approach. However, it is unclear the extent to which availability interventions may result in consumers later ‘compensating’ for reductions in energy intake caused by selecting lower energy food options, and to what extent these effects may differ based on socioeconomic position (SEP). Our objective was to examine the impact of increasing availability of lower energy meal options on immediate meal energy intake and subsequent energy intake in participants of higher vs. lower SEP. In a within-subjects design N=77 UK adults ordered meals from a supermarket ready meal menu with standard (30%) and increased (70%) availability of lower energy options. The meals were delivered to be consumed at home, with meal intake measured using the Digital Photography of Foods Method. Post-meal compensation was measured using food diaries to determine self-reported energy intake after the meal and the next day. Participants consumed significantly less energy (196kcal, 95% CI: 138, 252) from the menu with increased availability of lower energy options versus the standard availability menu (p<.001). There was no statistically significant evidence that this reduction in energy intake was substantially compensated for (33% compensated, p=.57). The effects of increasing availability of lower energy food items were similar in participants from lower and higher SEP. Increasing the availability of lower energy food options is likely to be an effective and equitable approach to reducing energy intake which may contribute to improving diet and population health.

Healthier diets for all? A systematic review and meta‐analysis examining socioeconomic equity of the effect of increasing availability of healthier foods on food choice and energy intake

“…There are also several limitations to the evidence. The vast majority of studies included in this review used hypothetical choices or assessment of food choice during one meal (for an exception see 14 ). Individuals may feel licensed to overeat after making healthier food choices, leading some to “compensate” for choices by consuming more energy at later meals.…”

“…When studies reported categorizing participants as “higher” and “lower” in SEP, the categorization used in the paper was retained. For example, lower SEP was most often defined as up to A level (US equivalent: Advanced Placement [AP] examinations) and higher SEP as higher education (US equivalent: above high school) (e.g 11,14,17 …”

“…For example, lower SEP was most often defined as up to A level (US equivalent: Advanced Placement [AP] examinations) and higher SEP as higher education (US equivalent: above high school) (e.g. 11,14,17 ). Other studies categorized lower SEP as GCSE/equivalent or below (US equivalent: US High school diploma or below) (e.g.…”

“…Although a 2019 review on the impact of availability interventions on food and drink selection found that increasing availability of specific food and drinks increased their selection and consumption by 17–35%, 12 the review did not explicitly examine healthier and less healthy products and critically did not examine whether the effect of availability interventions differed depending on participants' SEP. Furthermore, since Hollands and colleagues conducted their review searches (2018), a number of studies have been published that directly compared the effectiveness of availability interventions between participants of higher and lower SEP (e.g 10,11,13,14 …”

“…Furthermore, since Hollands and colleagues conducted their review searches (2018), a number of studies have been published that directly compared the effectiveness of availability interventions between participants of higher and lower SEP (e.g. 10,11,13,14 ).…”