Journal
PLOS ONE
Volume 12, Issue 3, Pages -Publisher
PUBLIC LIBRARY SCIENCE
DOI: 10.1371/journal.pone.0172277
Keywords
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Categories
Funding
- National Heart, Lung, and Blood Institute [T32 HL098048]
- National Heart, Lung, and Blood Institute and a Research Award from The New York Academy of Sciences' Sacker Institute for Nutrition Science [R01 HL115189]
- Bunge Fellowship in Global Nutrition
- McKinsey Health Systems Institute
- Foodminds
- Nutrition Impact
- Amarin
- Omthera
- Winston and Strawn LLP
- GlaxoSmithKline
- Sigma Tau
- Pronova
- Gates Foundation
- Sackler Institute of Nutrition
- National Institutes of Health
- MRC [G0900847] Funding Source: UKRI
- Medical Research Council [G0900847] Funding Source: researchfish
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Background While food pricing is a promising strategy to improve diet, the prospective impact of food pricing on diet has not been systematically quantified. Objective To quantify the prospective effect of changes in food prices on dietary consumption. Design We systematically searched online databases for interventional or prospective observational studies of price change and diet; we also searched for studies evaluating adiposity as a secondary outcome. Studies were excluded if price data were collected before 1990. Data were extracted independently and in duplicate. Findings were pooled using DerSimonianLaird's random effects model. Pre-specified sources of heterogeneity were analyzed using meta-regression; and potential for publication bias, by funnel plots, Begg's and Egger's tests. Results From 3,163 identified abstracts, 23 interventional studies and 7 prospective cohorts with 37 intervention arms met inclusion criteria. In pooled analyses, a 10% decrease in price (i.e., subsidy) increased consumption of healthful foods by 12% (95% CI = 10-15%; N = 22 studies/intervention arms) whereas a 10% increase price (i.e. tax) decreased consumption of unhealthful foods by 6% (95% CI = 4-8%; N = 15). By food group, subsidies increased intake of fruits and vegetables by 14% (95% CI = 11-17%; N = 9); and other healthful foods, by 16% (95% CI = 10-23%; N = 10); without significant effects on more healthful beverages (-3%; 95% CI = -16-11%; N = 3). Each 10% price increase reduced sugar-sweetened beverage intake by 7% (95% CI = 3-10%; N = 5); fast foods, by 3% (95% CI = 1-5%; N = 3); and other unhealthful foods, by 9% (95% CI = 6-12%; N = 3). Changes in price of fruits and vegetables reduced body mass index (-0.04 kg/m(2) per 10% price decrease, 95% CI = -0.08-0 kg/m(2); N = 4); price changes for sugar-sweetened beverages or fast foods did not significantly alter body mass index, based on 4 studies. Meta-regression identified direction of price change (tax vs. subsidy), number of intervention components, intervention duration, and study quality score as significant sources of heterogeneity (P-heterogeneity<0.05 each). Evidence for publication bias was not observed. Conclusions These prospective results, largely from interventional studies, support efficacy of subsidies to increase consumption of healthful foods; and taxation to reduce intake of unhealthful beverages and foods. Use of subsidies and combined multicomponent interventions appear most effective.
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