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

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  • Ashkan Afshin
  • José L Peñalvo
  • Liana Del Gobbo
  • Jose Silva
  • Melody Michaelson
  • Martin O'Flaherty
  • Simon Capewell
  • Donna Spiegelman
  • Goodarz Danaei
  • Dariush Mozaffarian

Abstract

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/m2 per 10% price decrease, 95%CI = -0.08–0 kg/m2; 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

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  • Ashkan Afshin & José L Peñalvo & Liana Del Gobbo & Jose Silva & Melody Michaelson & Martin O'Flaherty & Simon Capewell & Donna Spiegelman & Goodarz Danaei & Dariush Mozaffarian, 2017. "The prospective impact of food pricing on improving dietary consumption: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-18, March.
    • Handle: RePEc:plo:pone00:0172277
    DOI: 10.1371/journal.pone.0172277
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    References listed on IDEAS

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    1. Paarlberg, Robert & Mozaffarian, Dariush & Micha, Renata, 2017. "Viewpoint: Can U.S. local soda taxes continue to spread?," Food Policy, Elsevier, vol. 71(C), pages 1-7.
    2. Birgit Kopainsky & Anita Frehner & Adrian Müller, 2020. "Sustainable and healthy diets: Synergies and trade‐offs in Switzerland," Systems Research and Behavioral Science, Wiley Blackwell, vol. 37(6), pages 908-927, November.
    3. Beulah Pretorius & Jane Ambuko & Effie Papargyropoulou & Hettie C. Schönfeldt, 2021. "Guiding Nutritious Food Choices and Diets along Food Systems," Sustainability, MDPI, vol. 13(17), pages 1-19, August.
    4. Nguyen, Ly & Wilson, Norbert L.W., 2017. "Healthy Foods: Tax or Voucher?," 2017 Annual Meeting, July 30-August 1, Chicago, Illinois 258491, Agricultural and Applied Economics Association.
    5. Romain Cadario & Pierre Chandon, 2020. "Which Healthy Eating Nudges Work Best? A Meta-Analysis of Field Experiments," Marketing Science, INFORMS, vol. 39(3), pages 465-486, May.
    6. Laura Cornelsen & Matthew Quaife & Mylene Lagarde & Richard D. Smith, 2020. "Framing and signalling effects of taxes on sugary drinks: A discrete choice experiment among households in Great Britain," Health Economics, John Wiley & Sons, Ltd., vol. 29(10), pages 1132-1147, October.
    7. Cornelsen, Laura & Quaife, Matthew & Lagarde, Mylene & Smith, Richard D., 2020. "Framing and signalling effects of taxes on sugary drinks: a discrete choice experiment among households in Great Britain," LSE Research Online Documents on Economics 105777, London School of Economics and Political Science, LSE Library.
    8. Gustafson, Christopher R., 2023. "Comparing the impact of targeted subsidies and health prompts on choice process variables and food choice: The case of dietary fiber," Staff Papers 330132, University of Nebraska-Lincoln, Department of Agricultural Economics.
    9. Boysen, O. & Bradford, H. & Urban, K. & Balie, J., 2018. "Taxing Highly Processed Foods: Impacts on Obesity and Underweight in Sub-Saharan Africa," 2018 Conference, July 28-August 2, 2018, Vancouver, British Columbia 275990, International Association of Agricultural Economists.
    10. Pasquale E. Rummo & Isabella Higgins & Christina Chauvenet & Annamaria Vesely & Lindsay M. Jaacks & Lindsey Taillie, 2021. "A Standardized Guide to Developing an Online Grocery Store for Testing Nutrition-Related Policies and Interventions in an Online Setting," IJERPH, MDPI, vol. 18(9), pages 1-11, April.
    11. Saha, Sanjib & Nordström, Jonas & Scarborough, Peter & Thunström, Linda & Gerdtham, Ulf-G., 2021. "In search of an appropriate mix of taxes and subsidies on nutrients and food: A modelling study of the effectiveness on health-related consumption and mortality," Social Science & Medicine, Elsevier, vol. 287(C).
    12. Celia Burgaz & Vanessa Gorasso & Wouter M. J. Achten & Carolina Batis & Luciana Castronuovo & Adama Diouf & Gershim Asiki & Boyd A. Swinburn & Mishel Unar-Munguía & Brecht Devleesschauwer & Gary Sacks, 2023. "The effectiveness of food system policies to improve nutrition, nutrition-related inequalities and environmental sustainability: a scoping review," Food Security: The Science, Sociology and Economics of Food Production and Access to Food, Springer;The International Society for Plant Pathology, vol. 15(5), pages 1313-1344, October.
    13. Selena Ahmed & Carmen Byker Shanks & Teresa Smith & Justin Shanks, 2018. "Fruit and vegetable desirability is lower in more rural built food environments of Montana, USA using the Produce Desirability (ProDes) Tool," Food Security: The Science, Sociology and Economics of Food Production and Access to Food, Springer;The International Society for Plant Pathology, vol. 10(1), pages 169-182, February.
    14. Sarah Gerritsen & Sophia Harré & Boyd Swinburn & David Rees & Ana Renker-Darby & Ann E. Bartos & Wilma E. Waterlander, 2019. "Systemic Barriers and Equitable Interventions to Improve Vegetable and Fruit Intake in Children: Interviews with National Food System Actors," IJERPH, MDPI, vol. 16(8), pages 1-19, April.
    15. Rosario Pastor & Noemi Pinilla & Josep A. Tur, 2021. "The Economic Cost of Diet and Its Association with Adherence to the Mediterranean Diet in a Cohort of Spanish Primary Schoolchildren," IJERPH, MDPI, vol. 18(3), pages 1-10, January.
    16. Jacobi Liana & Kwok Chun Fung & Ramírez-Hassan Andrés & Nghiem Nhung, 2024. "Posterior Manifolds over Prior Parameter Regions: Beyond Pointwise Sensitivity Assessments for Posterior Statistics from MCMC Inference," Studies in Nonlinear Dynamics & Econometrics, De Gruyter, vol. 28(2), pages 403-434, April.
    17. Liana Jacobi & Nhung Nghiem & Andrés Ramírez‐Hassan & Tony Blakely, 2021. "Food Price Elasticities for Policy Interventions: Estimates from a Virtual Supermarket Experiment in a Multistage Demand Analysis with (Expert) Prior Information," The Economic Record, The Economic Society of Australia, vol. 97(319), pages 457-490, December.
    18. Purushotham, Anjali & Aiyar, Anaka & von Cramon-Taubadel, Stephan, 2023. "Processed foods, socio-economic status, and peri-urban obesity in India," Food Policy, Elsevier, vol. 117(C).
    19. repec:ags:aaea22:335637 is not listed on IDEAS
    20. Thiboonboon, Kittiphong & Lourenco, Richard De Abreu & Cronin, Paula & Khoo, Terence & Goodall, Stephen, 2024. "Economic Evaluations of Obesity-Targeted Sugar-Sweetened Beverage (SSB) Taxes–A Review to Identify Methodological Issues," Health Policy, Elsevier, vol. 144(C).
    21. Chiara Milani & Chiara Lorini & Alberto Baldasseroni & Claudia Dellisanti & Guglielmo Bonaccorsi, 2019. "An Umbrella Review and Narrative Synthesis of the Effectiveness of Interventions Aimed at Decreasing Food Prices to Increase Food Quality," IJERPH, MDPI, vol. 16(13), pages 1-15, July.
    22. Bernardo García Bulle Bueno & Abigail L. Horn & Brooke M. Bell & Mohsen Bahrami & Burçin Bozkaya & Alex Pentland & Kayla Haye & Esteban Moro, 2024. "Effect of mobile food environments on fast food visits," Nature Communications, Nature, vol. 15(1), pages 1-11, December.
    23. Gustafson, Christopher R., 2023. "Comparing the impact of subsidies and health prompts on choice process variables and food choice: The case of dietary fiber," OSF Preprints u4v5c, Center for Open Science.

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