Abstract
Poor diet is the leading cause of cardiovascular disease in the USA and globally. Evidence-based policies are crucial to improve diet and population health. We reviewed the effectiveness for a range of policy levers to alter diet and diet-related risk factors. We identified evidence to support benefits of focused mass media campaigns (especially for fruits, vegetables, salt), food pricing strategies (both subsidies and taxation, with stronger effects at lower income levels), school procurement policies (for increasing healthful or reducing unhealthful choices), and worksite wellness programs (especially when comprehensive and multicomponent). Evidence was inconclusive for food and menu labeling (for consumer or industry behavior) and changes in local built environment (e.g., availability or accessibility of supermarkets, fast food outlets). We found little empiric evidence evaluating marketing restrictions, although broad principles and large resources spent on marketing suggest utility. Widespread implementation and evaluation of evidence-based policy strategies, with further research on other strategies with mixed/limited evidence, are essential “population medicine” to reduce health and economic burdens and inequities of diet-related illness worldwide.
Highlights
Poor diet is the leading cause of cardiovascular disease (CVD), total mortality, and morbidity in the USA and globallyThis article is part of the Topical Collection on Public Health Policy 98 Page 2 of 12Curr Cardiol Rep (2015) 17: 98[1, 2]
To better understand the current evidence for different policy levers, we systematically reviewed the evidence for effectiveness of specific policies to improve dietary habits and reduce cardiovascular and metabolic risk factors
We focused on policies in several domains with prior evidence for effectiveness [9], including mass media campaigns, food and menu labeling, taxation and subsidies, local built environment, school procurement policies, worksite wellness programs, and marketing standards
Summary
Poor diet is the leading cause of cardiovascular disease (CVD), total mortality, and morbidity in the USA and globallyThis article is part of the Topical Collection on Public Health Policy 98 Page 2 of 12Curr Cardiol Rep (2015) 17: 98[1, 2]. Current intakes of major dietary risk factors are suboptimal across the world [3,4,5,6]. While individual-level and health care system-based behavioral change efforts can be partly effective [7, 8], policy changes at organizational, community, and government levels can have broader, more equitable, and more sustainable impact [9]. Because dietary choices are influenced by a range of determinants at individual, sociocultural, community, national, and global levels, potential policy strategies can be applied across a range of different domains (Fig. 1) [10]. To better understand the current evidence for different policy levers, we systematically reviewed the evidence for effectiveness of specific policies to improve dietary habits and reduce cardiovascular and metabolic risk factors
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