An environmental intervention to increase fruit and salad purchases in a cafeteria.

BACKGROUND: This study explored the hypothesis that consumption of fruit and salad in a cafeteria setting would increase if the variety of offerings was increased and their price reduced. METHOD: Food purchases in a cafeteria setting were observed during 3 weeks of baseline observation, 3 weeks of intervention, and 3 weeks of return to baseline conditions. Intervention consisted of doubling the number of fruit choices, increasing salad ingredient selections by three, and reducing the price of both fruit and salad by 50%. The primary outcome measures in the study were daily sales of fruit and salad as assessed by cash register receipts. RESULTS: Fruit and salad purchases increased threefold in the intervention period compared to those in the nonintervention periods. Women and those trying to control their weight were most likely to make these nutritious food choices. CONCLUSION: Results of this study support the argument that increasing the number of nutritious food choices and making them more attractive economically may be important to changing food choice behavior. Further exploration of the practical application of the concept is recommended.

Strengthening behavioral interventions for weight loss: a randomized trial of food provision and monetary incentives.

Behavioral treatments for obesity seek to modify eating and exercise behaviors by a change in their antecedents and consequences. More direct modification of antecedents and consequences by (a) the provision of food to patients and (b) the provision of financial rewards for weight loss was hypothesized to improve treatment outcomes. Two hundred two men and women were randomly assigned to no treatment, standard behavioral treatment (SBT), SBT plus food provision, SBT plus incentives, or SBT plus food provision and incentives. The major finding was that food provision significantly enhanced weight loss. Weight losses with SBT averaged 7.7, 4.5, and 4.1 kg at 6, 12, and 18 months, respectively, compared with 10.1, 9.1, and 6.4 kg, respectively, at the same intervals with the addition of food. Food provision also enhanced attendance, completion of food records, quality of diet, and nutrition knowledge. We conclude that the provision of food to weight-loss patients is a promising methodology that deserves further exploration.