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The prospective impact of food pricing on improving dietary consumption: A systematic review and meta-analysis

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 dat...

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Autores principales: Afshin, Ashkan, Peñalvo, José L., Del Gobbo, Liana, Silva, Jose, Michaelson, Melody, O'Flaherty, Martin, Capewell, Simon, Spiegelman, Donna, Danaei, Goodarz, Mozaffarian, Dariush
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5332034/
https://www.ncbi.nlm.nih.gov/pubmed/28249003
http://dx.doi.org/10.1371/journal.pone.0172277
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author Afshin, Ashkan
Peñalvo, José L.
Del Gobbo, Liana
Silva, Jose
Michaelson, Melody
O'Flaherty, Martin
Capewell, Simon
Spiegelman, Donna
Danaei, Goodarz
Mozaffarian, Dariush
author_facet Afshin, Ashkan
Peñalvo, José L.
Del Gobbo, Liana
Silva, Jose
Michaelson, Melody
O'Flaherty, Martin
Capewell, Simon
Spiegelman, Donna
Danaei, Goodarz
Mozaffarian, Dariush
author_sort Afshin, Ashkan
collection PubMed
description 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 DerSimonian-Laird'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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spelling pubmed-53320342017-03-10 The prospective impact of food pricing on improving dietary consumption: A systematic review and meta-analysis Afshin, Ashkan Peñalvo, José L. Del Gobbo, Liana Silva, Jose Michaelson, Melody O'Flaherty, Martin Capewell, Simon Spiegelman, Donna Danaei, Goodarz Mozaffarian, Dariush PLoS One Research Article 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 DerSimonian-Laird'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. Public Library of Science 2017-03-01 /pmc/articles/PMC5332034/ /pubmed/28249003 http://dx.doi.org/10.1371/journal.pone.0172277 Text en © 2017 Afshin et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Afshin, Ashkan
Peñalvo, José L.
Del Gobbo, Liana
Silva, Jose
Michaelson, Melody
O'Flaherty, Martin
Capewell, Simon
Spiegelman, Donna
Danaei, Goodarz
Mozaffarian, Dariush
The prospective impact of food pricing on improving dietary consumption: A systematic review and meta-analysis
title The prospective impact of food pricing on improving dietary consumption: A systematic review and meta-analysis
title_full The prospective impact of food pricing on improving dietary consumption: A systematic review and meta-analysis
title_fullStr The prospective impact of food pricing on improving dietary consumption: A systematic review and meta-analysis
title_full_unstemmed The prospective impact of food pricing on improving dietary consumption: A systematic review and meta-analysis
title_short The prospective impact of food pricing on improving dietary consumption: A systematic review and meta-analysis
title_sort prospective impact of food pricing on improving dietary consumption: a systematic review and meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5332034/
https://www.ncbi.nlm.nih.gov/pubmed/28249003
http://dx.doi.org/10.1371/journal.pone.0172277
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