A study of the importance of education and cost incentives on individual food choices at the Harvard School of Public Health cafeteria

Objectives: To investigate the importance of cost and awareness of health- or disease-promoting properties of foods and meals for choices by customers of a cafeteria. Design: A non-randomized intervention study. Setting: A medium size cafeteria in the Harvard School of Public Health. Participants: Customers of the cafeteria mainly consisting of public health students, faculty, and school staff and workers from the medical campus. Intervention: The purchase of healthy foods and dishes was subsidized and their prices reduced by 20%. This promotion was accompanied by the distribution of educational material. Main Outcome Measures: Change in consumption of healthy and less healthy foods. Analysis: The geometric mean was used to calculate the change in consumption. Results: During the intervention, we observed a 6% increase in the consumption of healthy foods (95% confidence interval [CI]; 5% to 8%), and a 2% decline in the consumption of less-healthy foods (95% CI; -1% to -4%). After the prices returned to their original levels, the consumption of healthy foods increased further to 17% (95% CI; 13% to 20%) and a 2% decline in the consumption of less-healthy foods (95% CI; % 1 to -5%) persisted. Conclusions: Subsidizing healthful meals and educating consumers about the importance of a healthy diet can result in a modest increase in the selection of healthy foods and meals that can be maintained beyond the periods of subsidy and promotion.