新年最常见的决议之一是减肥。尽管如此，尽管我们的意图良好，但年复一年，我们只有很少的人实现了这个崇高的目标。结果，肥胖和超重没有下降。显然，这是一个复杂的主题，许多因素可以归因于为什么减肥不像获得的那样容易。早些时候，它已经强调了肥胖的环境如何与我们的人类/心理缺陷相结合，破坏了我们维持健康体重的计划。在最近的一个systematic reviewpublished inBMC Public Health,we considered one important environmental factor that plays a major role in calories consumed: the food store. We surveyed and then evaluated health interventions aiming to promote healthy food purchase behavior at food stores and among targeted populations. We assessed not only the effectiveness of various strategies, but we also put the methodological quality of the addressed studies to test. Following is a summary of the main findings from our review.
What characterizes effective food store health interventions?
我们评论的总体发现是，尽管有一些方法学质量低，但店内/购买点健康食品干预的功效。此外，食品商店健康干预措施的有效性取决于几个因素，包括干预组件的类型和数量，参与商店所有者的激励结构以及有针对性的消费者，利益相关者的参与和批准，社区/消费者的参与以及干预实施。
与多种策略相互补充的干预措施将是优选的。此外，我们发现价格激励措施在结果方面得到了最强烈的反应。直接价格折扣，健康食品的代金券以及某些营养食品的补贴也是如此。激励措施不仅适用于消费者，而且对参与食品商店也有效。成功激励食品商店的示例包括美国的妇女，婴儿和儿童（WIC）计划，该计划激励符合条件的商店储存某些促进健康食品，以及南非的国家折扣计划（Vitality Healthitalfood Program）他们是一家保险公司的成员，并在全国800多个超市提供了高达25％的健康食品折扣。由于它们的规模很大，这两个计划都为超级市场以及有针对性的消费者群体创造了激励措施，以展示亲保健行为。应当指出的是，商店也可以通过货币以外的其他激励措施来吸引商店。一些商店可能有兴趣建立自己的声誉，因此可以说服他们作为企业社会责任的一部分促进亲保健食品存货策略。
Moreover, engaging consumers and creating an interactive environment for them, in addition to posters and shelf labels, seems to be more helpful than mere labels or nutrition information. Examples of successful consumer engagement include cooking demonstrations/taste tests, and interactive education.
What could be improved in the future?
关于研究质量，我们发现，根据选定的评估工具，论文的方法学质量得分范围从最低分数42.9％到最高分数92.9％，得出所有论文的平均质量得分为65.0。％。这一结果的主要收获是需要更多的高质量研究。与其他环境（例如报告基于学校的干预措施的研究）不同，随机对照试验（RCT）的数量在食品商店环境中受到限制，尽管最近取得了令人鼓舞的进展。因此，需要以RCT形式进行更多的高质量研究。
Although price interventions have the strongest impact on the outcome of healthful food purchase, we note, however, important observations. It is not trivial to implement price incentives on a large scale and for sustained periods. Therefore, it needs more persuasion than other interventions (such as information campaigns) as someone has to bear costs associated with subsidizing healthier foods (or higher prices for less healthier foods). The difficulty is even more pronounced if their implementation is not cost-neutral, as someone has to finance the difference due to changes in the original prices. In certain cases, storeowners may be convinced that, due to economies of scale, they will not incur losses despite price reductions of healthier foods. In most cases sustained price interventions need political solutions, and as such research should be disseminated in a way that motivates political action.
A related observation when conducting this review is the limited number of studies that use the currently influential concept of nudging which is believed to be a low-cost alternative to other intervention approaches. For example, few studies demonstrate the effect of using shelf space management to promote healthy foods in prime in-store locations. It is particularly interesting as some prime locations like the checkout area are currently used for promoting high calorie foods. Therefore, more experiments with nudging and other innovative intervention methods in grocery settings are needed.
此外，应该将更多的重点放在健康和不健康的食物和替代行为上。当前大多数干预措施都集中在F＆V上，作为促进健康食品。尽管这些干预措施是正确的，因为许多国家中的大多数人都不符合F＆V饮食指南，但还需要考虑干预措施以限制较低健康食品的消费，例如高能源物品，例如糖甜饮料（SSB）和咸零食。如果可能的话，应使用食品商店的总销售来判断干预措施的总体影响（包括替代效果）。尽管研究的差异是不可避免的且可以理解的，但是采用一些共同的结果指标将有助于提高研究的可比性。此外，如果可能的话，应补充某些研究中使用的食物频率问卷。
最后,我们的结果也强调了挑战s involved with in-store healthy food interventions. We cannot stress enough the importance of stakeholder management and the use of correct incentives for these agents, particularly the food stores whose support is critical for any effort in this direction. It is important to show store managers how their stores can benefit from the proposed intervention, and not just present them with how the intervention benefits research or even the target group. Show them what is in it for them.
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