The effect of Position and Availability interventions on adolescents' food choice: An online experimental study

Interventions that alter characteristics of the food environment have been found to reduce energy intake in adults. However, few studies have examined the effect of Availability (reducing the number of higher energy options) and Position (altering the order of options) interventions on food choices by younger populations. Hence, this study examined the individual and combined effects of Availability and Position interventions on adolescents' energy selection from restaurant menus. In this online experiment, adolescents (13-17 years; N = 434) were randomly assigned to one of four groups: (1) Availability and Position absent (control group) = 60% higher energy options, ordered randomly by energy content; (2) Availability present, Position absent = 40% higher energy options, ordered randomly by energy content; (3) Position present, Availability absent = 60% higher energy options, menu options were ordered from lower to higher energy; (4) Availability present, Position present = 40% higher energy options, menu options were ordered from lower to higher energy. The primary outcome was average energy selected per meal (starter, main, and dessert). Findings showed that both the Availability and Position interventions reduced adolescents' meal energy selection, whether presented as individual interventions or combined. Thus, reducing the availability of higher energy menu options, and ordering menu options from low to high energy, appear to be effective strategies for reducing adolescents' energy selection from overall meals. Further research is needed to determine whether these findings translate to real-life food choices.