What is the effectiveness of obesity related interventions at retail grocery stores and supermarkets? —a systematic review

Abstract

BackgroundThe Prevalence of obesity and overweight has been increasing in many countries. Many factors have been identified as contributing to obesity including the food environment, especially the access, availability and affordability of healthy foods in grocery stores and supermarkets. Several interventions have been carried out in retail grocery/supermarket settings as part of an effort to understand and influence consumption of healthful foods. The review’s key outcome variable is sale/purchase of healthy foods as a result of the interventions. This systematic review sheds light on the effectiveness of food store interventions intended to promote the consumption of healthy foods and the methodological quality of studies reporting them.MethodsSystematic literature search spanning from 2003 to 2015 (inclusive both years), and confined to papers in the English language was conducted. Studies fulfilling search criteria were identified and critically appraised. Studies included in this review report health interventions at physical food stores including supermarkets and corner stores, and with outcome variable of adopting healthier food purchasing/consumption behavior. The methodological quality of all included articles has been determined using a validated 16-item quality assessment tool (QATSDD).ResultsThe literature search identified 1580 publications, of which 42 met the inclusion criteria. Most interventions used a combination of information (e.g. awareness raising through food labeling, promotions, campaigns, etc.) and increasing availability of healthy foods such as fruits and vegetables. Few used price interventions. The average quality score for all papers is 65.0%, or an overall medium methodological quality. Apart from few studies, most studies reported that store interventions were effective in promoting purchase of healthy foods.ConclusionGiven the diverse study settings and despite the challenges of methodological quality for some papers, we find efficacy of in-store healthy food interventions in terms of increased purchase of healthy foods. Researchers need to take risk of bias and methodological quality into account when designing future studies that should guide policy makers. Interventions which combine price, information and easy access to and availability of healthy foods with interactive and engaging nutrition information, if carefully designed can help customers of food stores to buy and consume more healthy foods.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3985-x) contains supplementary material, which is available to authorized users.

Efficacy of population‐wide diabetes and obesity prevention programs: An overview of systematic reviews on proximal, intermediate, and distal outcomes and a meta‐analysis of impact on BMI

“…Seven reviews reported effects of food store interventions, with three assessed as good‐quality. Two of these good‐quality reviews found food store interventions increased purchase of healthy food but that a range of intervention components was required, with economic incentives associated with the greatest effect and information‐only campaigns rarely influencing behaviors . And the third good‐quality review found mixed results but included only two papers on this topic .…”

“…And the third good‐quality review found mixed results but included only two papers on this topic . Three of four other included reviews reported increased purchasing of healthy food in the majority of included studies and one found mixed results (one of these included papers up to 2003 . Reviews included 67 studies: 19 RCTs or cluster RCTS, 30 pre‐post design (15 with control), and the remainder employed a wide variety of study designs.…”

Evaluation of Store Environment Changes of an In-Store Intervention to Promote Fruits and Vegetables in Latino/Hispanic-Focused Food Stores

“…Longitudinal studies are needed to further examine the direct influence of the marketing mix elements, such as promotions, on the purchasing of healthy and unhealthy foods. The type of food store in which such studies are conducted need to be considered as the ability to implement marketing mix strategies may differ in small stores versus supermarkets [8,10]. Supermarkets may not have the flexibility to change marketing mix elements due to their organizational policies.…”

“…For example, shelf space [1][2][3], number of store displays [2,4,5], and promotions [6,7] influence customers' purchasing of foods and beverages. Previous interventions that used information-only strategies via print promotions (e.g., shelf labels) observed an increase in sales of targeted foods, including fruits and vegetables (FVs); however, one promotion-related study found no intervention effects on sales of FVs [8]. Furthermore, interventions that increased the availability of FVs did not always find increased purchases of these foods [9].…”

“…Previous studies and systematic reviews on in-store interventions provide evidence for the feasibility of implementation and potential to improve the food store environment [8][9][10]12,18,19]. In studies that aimed to increase the availability of healthier foods such as FVs, low-fat milk, and low-fat baked goods in food stores, they were able to successfully increase the overall number of these products within targeted stores based on observed data [20][21][22][23].…”