Abstract
Supermarkets are natural and important settings for implementing environmental interventions to improve healthy eating, and governmental policies could help improve the nutritional quality of purchases in this setting. This review aimed to: (1) identify governmental policies in the United States (U.S.), including regulatory and legislative actions of federal, tribal, state, and local governments, designed to promote healthy choices in supermarkets; and (2) synthesize evidence of these policies’ effects on retailers, consumers, and community health. We searched five policy databases and developed a list of seven policy actions that meet our inclusion criteria: calorie labeling of prepared foods in supermarkets; increasing U.S. Department of Agriculture (USDA) Supplemental Nutrition Assistance Program (SNAP) benefits; financial incentives for the purchase of fruit and vegetables; sweetened beverage taxes; revisions to the USDA Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package; financial assistance for supermarkets to open in underserved areas; and allowing online purchases with SNAP. We searched PubMed, Econlit, PsycINFO, Web of Science, and Business Source Ultimate to identify peer-reviewed, academic, English-language literature published at any time until January 2020; 147 studies were included in the review. Sweetened beverage taxes, revisions to the WIC food package, and financial incentives for fruits and vegetables were associated with improvements in dietary behaviors (food purchases and/or consumption). Providing financial incentives to supermarkets to open in underserved areas and increases in SNAP benefits were not associated with changes in food purchasing or diet quality but may improve food security. More research is needed to understand the effects of calorie labeling in supermarkets and online SNAP purchasing.
Highlights
Poor diet is widely considered a public health crisis, contributing to many of the leading causes of morbidity and mortality in the United States (U.S.) and globally [1,2]
Compared to nutrition interventions aimed at individuals or groups, upstream interventions designed to alter the environments in which people make food and beverage choices may be more effective for improving health, and are less costly to implement in the long-term [4,5]
According to data from the U.S Department of Agriculture (USDA) Food Acquisition and Purchase Survey, in 2012–2013, 89% of households did their primary shopping at supermarkets or other large grocers, with only 5% doing their primary shopping at other stores [7]
Summary
Poor diet is widely considered a public health crisis, contributing to many of the leading causes of morbidity and mortality in the United States (U.S.) and globally [1,2]. There is growing recognition that dietary behaviors are shaped by the environments in which people live, learn, work, and play, and public health interventions increasingly target these settings [3]. Compared to nutrition interventions aimed at individuals or groups, upstream interventions designed to alter the environments in which people make food and beverage choices may be more effective for improving health, and are less costly to implement in the long-term [4,5]. In the U.S, supermarkets are natural and important settings for implementing environmental interventions to improve healthy eating. These stores, which generate more than $2 million annually in sales volume, are the primary retail store choice for the vast majority of U.S households [6].
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