Centre for Public Health, Queen's University, Belfast, United Kingdom.
Brooks School of Public Policy, Cornell University, Ithaca, New York, USA.
Nutr Rev. 2023 Sep 11;81(10):1351-1372. doi: 10.1093/nutrit/nuad011.
Poor diet has been implicated in a range of noncommunicable diseases. Fiscal and pricing policies (FPs) may offer a means by which consumption of food and non-alcoholic beverages with links to such diseases can be influenced to improve public health.
To examine the acceptability of FPs to reduce diet-related noncommunicable disease, based on systematic review evidence.
MEDLINE, EMBASE, PsychInfo, SCI, SSCI, Web of Science, Scopus, EconLit, the Cochrane Library, Epistemonikos, and the Campbell Collaboration Library were searched for relevant studies published between January 1, 1990 and June 2021.
The studies included systematic reviews of diet-related FPs and: used real-world evidence; examined real or perceived barriers/facilitators; targeted the price of food or non-alcoholic beverages; and applied to entire populations within a jurisdiction. A total of 9996 unique relevant records were identified, which were augmented by a search of bibliographies and recommendations from an external expert advisory panel. Following screening, 4 systematic reviews remained.
Quality appraisal was conducted using the AMSTAR 2 tool. A narrative synthesis was undertaken, with outcomes grouped according to the WHO-INTEGRATE criteria. The findings indicated a paucity of high-quality systematic review evidence and limited public support for the use of FPs to change dietary habits. This lack of support was related to a number of factors that included: their perceived potential to be regressive; a lack of transparency, ie, there was mistrust around the use of revenues raised; a paucity of evidence around health benefits; the deliberate choice of rates that were lower than those considered necessary to affect diet; and concerns about the potential of such FPs to harm economic outcomes such as employment.
The findings underscore the need for high-quality systematic review evidence on this topic, and the importance of responding to public concerns and putting in place mechanisms to address these when implementing FPs. This study was funded by Safefood [02A-2020].
PROSPERO registration no. CRD42021274454.
不良饮食与一系列非传染性疾病有关。财政和定价政策（FPs）可能是一种手段，可以通过影响与这些疾病相关的食物和非酒精饮料的消费来改善公共健康。
根据系统评价证据，考察 FP 降低与饮食相关的非传染性疾病的可接受性。
MEDLINE、EMBASE、PsychInfo、SCI、SSCI、Web of Science、Scopus、EconLit、Cochrane 图书馆、Epistemonikos 和 Campbell 合作图书馆自 1990 年 1 月 1 日至 2021 年 6 月期间检索了相关研究。
这些研究包括对与饮食相关的 FP 的系统评价，并且：使用真实世界的证据；检查真实或感知到的障碍/促进因素；针对食品或非酒精饮料的价格；并在司法管辖区内适用于整个人群。共确定了 9996 个独特的相关记录，并通过对外部专家咨询小组的参考文献和建议进行搜索进行了补充。经过筛选，仍有 4 项系统评价。
使用 AMSTAR 2 工具进行质量评估。进行了叙述性综合分析，根据世界卫生组织整合标准对结果进行分组。研究结果表明，缺乏高质量的系统评价证据，公众对 FP 改变饮食习惯的支持有限。这种缺乏支持与一些因素有关，包括：它们被认为可能具有倒退性；缺乏透明度，即对使用收入的使用存在不信任；缺乏有关健康益处的证据；故意选择低于认为必要影响饮食的费率；以及担心此类 FP 会对就业等经济结果造成伤害。
研究结果强调了在这一主题上需要高质量的系统评价证据，以及在实施 FP 时应对公众关注并建立解决这些问题的机制的重要性。本研究由 Safefood [02A-2020] 资助。
PROSPERO 注册号 CRD42021274454。
