Is a voluntary healthy food policy effective? evaluating effects on foods and drinks for sale in hospitals and resulting policy changes

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dc.citation.issue1
dc.citation.volume23
dc.contributor.authorNi Mhurchu C
dc.contributor.authorRosin M
dc.contributor.authorShen S
dc.contributor.authorKidd B
dc.contributor.authorUmali E
dc.contributor.authorJiang Y
dc.contributor.authorGerritsen S
dc.contributor.authorMackay S
dc.contributor.authorTe Morenga L
dc.date.accessioned2025-06-16T03:12:12Z
dc.date.available2025-06-16T03:12:12Z
dc.date.issued2025-12-01
dc.description.abstractBackground: Healthy food and drink guidelines for public sector settings can improve the healthiness of food environments. This study aimed to assess the implementation and impact of the voluntary National Healthy Food and Drink Policy (the Policy) introduced in New Zealand in 2016 to encourage provision of healthier food and drink options for staff and visitors at healthcare facilities. Methods: A customised digital audit tool was used to collate data on foods and drinks available for sale in healthcare organisations and to systematically classify items as green (‘healthy’), amber (‘less healthy’), or red (‘unhealthy’) according to Policy criteria. On-site audits were undertaken between March 2021 and June 2022 at 19 District Health Boards (organisations responsible for providing public health services) and one central government agency. Forty-three sites were audited, encompassing 229 retail settings (serviced food outlets and vending machines). In total, 8485 foods/drinks were classified according to Policy criteria. The primary outcome was alignment with Policy guidance on the availability of green, amber, and red category food/drink items (≥ 55% green and 0% red items). Secondary outcomes were proportions of green, amber, and red category items, promotional practices, and price. Chi-square tests were used to compare results between categorical variables. Results: No organisation met the criteria for alignment with the Policy. Across all sites, 38.9% of food/drink items were rated red (not permitted), 39.0% were amber, and 22.1% were green. Organisations that adopted the voluntary Policy offered more healthy foods/drinks than those with their own organisational policy, but the proportion of red items remained high: 32.3% versus 47.5% (p < 0.0001). About one-fifth (21.3%) of all items were promoted, with red (24.6%) and amber (22.2%) items significantly more likely to be promoted than green items (14.0%) (p < 0.001). Green items were also significantly more costly on average (NZ$6.00) than either red (NZ$4.00) or amber (NZ$4.70) items (p < 0.0001). Conclusions: Comprehensive and systematic evaluation showed that a voluntary Policy was not effective in ensuring provision of healthier food/drink options in New Zealand hospitals. The adoption of a single, mandatory Policy, accompanied by dedicated support and regular evaluations, could better support Policy implementation.
dc.description.confidentialfalse
dc.edition.editionDecember 2025
dc.identifier.citationNi Mhurchu C, Rosin M, Shen S, Kidd B, Umali E, Jiang Y, Gerritsen S, Mackay S, Te Morenga L. (2025). Is a voluntary healthy food policy effective? evaluating effects on foods and drinks for sale in hospitals and resulting policy changes. BMC Medicine. 23. 1.
dc.identifier.doi10.1186/s12916-025-04122-x
dc.identifier.eissn1741-7015
dc.identifier.elements-typejournal-article
dc.identifier.issn1741-7015
dc.identifier.number299
dc.identifier.piis12916-025-04122-x
dc.identifier.urihttps://mro.massey.ac.nz/handle/10179/73062
dc.languageEnglish
dc.publisherBioMed Central Ltd
dc.publisher.urihttps://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-025-04122-x
dc.relation.isPartOfBMC Medicine
dc.rights(c) 2025 The Author/s
dc.rightsCC BY 4.0
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectHealthy food guidelines
dc.subjectNutrition
dc.subjectHospital
dc.subjectAudit
dc.subjectEvaluation
dc.subjectDigital tool
dc.subjectImplementation
dc.titleIs a voluntary healthy food policy effective? evaluating effects on foods and drinks for sale in hospitals and resulting policy changes
dc.typeJournal article
pubs.elements-id501105
pubs.organisational-groupOther
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