Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.
Biostatistics Unit, Deakin University, Geelong, Victoria, Australia.
PLoS One. 2023 Jul 19;18(7):e0288719. doi: 10.1371/journal.pone.0288719. eCollection 2023.
This observational study assessed the introduction of a comprehensive healthy food and drink policy across 13 community organisation managed aquatic and recreation centres in Victoria, Australia, and the associated changes on business outcomes, and the healthiness of purchases. The policy, based on state government guidelines, mandated that food and drink availability be based on healthiness classification: 'red' (limit) <10%, and 'green' (best choice) >50%, and the remainder 'amber' (choose carefully).
Six years of monthly sales data were split into three periods, prior to (1/01/2013-31/12/2014), during (1/01/2015-31/12/2016) and post (1/1/2017-31/12/2018), policy implementation. Using point-of-sale data, food and drink nutrient content, and state guidelines, items were classified as 'red'/'amber'/'green'. Linear models with Newey West standard errors were fitted to compare the mean value of outcomes between post- to pre-policy implementation periods, for each outcome and centre; and were pooled using random effect meta-analyses.
Comparing post- to pre-policy implementation periods, total food sales did not change (mean percentage difference: -3.2% (95% confidence interval (CI) -21% to 14%), though total drink sales declined -27% (CI -37% to -17%). The mean percentage of 'red' foods sold declined by -15% (CI -22% to -7.7%), 'amber' food sales increased 11% (CI 5.5% to 16%). 'Green' food sales did not change (3.3%, CI -1.4% to 8.0%). The mean percentage of 'red' drinks sold declined -37% (CI -43% to -31%), 'amber' and 'green' drink sales increased by 8.8% (CI 3.6% to 14%) and 28% (CI 23% to 33%), respectively. The energy density and sugar content (percentage of total weight/volume) of both food and drinks decreased.
This study has shown that the implementation of a policy to improve the health of retail food environments can result in a shift towards healthier purchases. Sales revenue from foods did not decline, though revenue from drinks did, indicating future research needs to explore mitigation of this.
本观察性研究评估了在澳大利亚维多利亚州的 13 个社区组织管理的水上和娱乐中心全面实施健康食品和饮料政策的情况，以及该政策对业务成果和购买食品的健康程度的影响。该政策基于州政府的指导方针，规定食品和饮料的供应必须根据健康分类：“红色”（限制）<10%，“绿色”（最佳选择）>50%，其余为“琥珀色”（谨慎选择）。
六年的月度销售数据分为三个时期，分别为：政策实施前（2013 年 1 月 1 日至 2014 年 12 月 31 日）、政策实施期间（2015 年 1 月 1 日至 2016 年 12 月 31 日）和政策实施后（2017 年 1 月 1 日至 2018 年 12 月 31 日）。使用销售点数据、食品和饮料的营养成分以及州指导方针，将商品分为“红色”/“琥珀色”/“绿色”。使用新威标准误差的线性模型来比较每个结果和中心在政策实施前后时期之间的结果平均值；并使用随机效应荟萃分析进行汇总。
与政策实施前相比，总食品销售额没有变化（平均百分比差异：-3.2%（95%置信区间（CI）-21%至 14%），而总饮料销售额下降了-27%（CI -37%至-17%）。销售的“红色”食品比例下降了 15%（CI -22%至-7.7%），“琥珀色”食品销售额增加了 11%（CI 5.5%至 16%）。“绿色”食品销售额没有变化（3.3%，CI -1.4%至 8.0%）。销售的“红色”饮料比例下降了 37%（CI -43%至-31%），“琥珀色”和“绿色”饮料销售额分别增加了 8.8%（CI 3.6%至 14%）和 28%（CI 23%至 33%）。食品和饮料的能量密度和含糖量（占总重量/体积的百分比）均有所下降。
本研究表明，实施改善零售食品环境健康的政策可以促使购买更健康的食品。食品销售的收入没有下降，尽管饮料的销售收入下降了，这表明未来的研究需要探索减轻这种影响的方法。
