Effectiveness of strategies to decrease animal sourced protein and/or increase plant sourced protein in foodservice settings: a systematic literature review.
J Acad Nutr Diet 2021;
122:1013-1048. [PMID:
34954384 DOI:
10.1016/j.jand.2021.12.010]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 12/10/2021] [Accepted: 12/20/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND
Effective population-based strategies are required to move towards healthy sustainable diets which replace a proportion of animal- with plant-based protein. Foodservice can support this using a variety of strategies across the food supply chain.
OBJECTIVE
This systematic review aimed to evaluate the effectiveness of strategies to decrease animal protein and/or increase plant protein in foodservice settings on uptake, satisfaction, financial, environmental, and dietary intake outcomes.
METHODS
Seven databases were searched in November 2020 with no restriction on study dates to identify peer-reviewed study designs conducted in commercial and institutional foodservices using any strategy to decrease beef, lamb, pork, poultry, eggs, fish or seafood and/or increase legumes/pulses, legume/pulse-based meat substitutes or nuts and reported this review's primary outcome, uptake by consumers either quantitatively or qualitatively. Secondary outcomes were satisfaction and financial, environmental, and dietary intake outcomes. Titles/abstracts then full texts were screened independently by two authors. The Mixed Methods Appraisal Tool was used for quality appraisal. Results were described using a narrative synthesis by strategy type. The protocol is registered with PROSPERO (CRD42021235015).
RESULTS
From 20,002 records identified, 38 studies met eligibility criteria, of which 16% were high quality. Strategies included forced restriction (n=4), menu re-design (n=6), recipe re-design (n=6), service re-design (n=4), menu labelling (n=7), prompt at point of sale (n=7) and multi-pronged strategies (n=4). Menu labelling, prompting at the point of sale and re-designing menus, recipes, and service increased uptake of target foods in most studies with the largest consistent changes in menu re-design. Few studies explored secondary outcomes. Recipe re-design, prompt at the point of sale and menu labelling strategies that measured satisfaction found a positive or neutral effect.
CONCLUSIONS
The most promising strategies are likely in menu re-design, followed by menu labelling and service re-design. Satisfaction appears to not be negatively impacted by recipe re-design, prompting at the point of sale and menu labelling. More studies are needed to evaluate financial, environmental, and dietary outcomes.
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