Environmental interventions to promote healthy eating: a review of models, programs, and evidence

Environmental interventions are an important part of efforts to improve health in populations. With respect to strategies to encourage positive nutrition behavior, environmental approaches help create opportunities for action by removing barriers to following a healthy diet. This article reviews the rationale, conceptual models, program examples, and recent empirical evidence regarding the extent and effects of environmental interventions to promote healthy eating. The state of the art is described for five types of interventions: (1) changes in the food supply; (2) point of choice nutrition information; (3) collaboration with private sector food vendors; (4) worksite nutrition policies and incentives; and (5) changes in the structure of health and medical care related to nutrition. Environmental approaches to dietary behavior change can reach large segments of the population through increased availability of nutritious foods, provision of quality nutrition services in workplace and health care settings, and accessible information about healthful food choices. Nutrition intervention can also serve as a model for other types of health promotion initiatives using multidimensional environmental and educational technologies.