Critical review of economic evaluation studies of interventions promoting low-fat diets

Various national and local policies encouraging healthy eating have recently been proposed. This study aims to summarize and critically assess economic evaluation studies of direct (e.g., diet counseling) and indirect (e.g., food labeling) interventions aimed at improving dietary habits. We performed a systematic literature review by searching three databases (PubMed, Ovid Medline, Embase) using a combination of diet-related (fat, diet, intake, nutrition) and economics-related (cost-effectiveness, cost-benefit, cost-utility, health economics, economic evaluation) keywords. Our search yielded 38 studies. The studies varied in target populations (e.g., healthy or unhealthy subjects), study designs (e.g., modeling, experiments), economic evaluation methods and health/economic outcomes. In general, all provide limited experimental evidence and adopt the framework of economic evaluations in healthcare. Certain important aspects are not well considered: (i) the non-health-related effects of nutrition interventions on well-being; (ii) the private nature of food expenditures ; (iii) the distributional effects on food expenditures across socio-economic groups; and (iv) the general economic implications (e.g., agro-foods, import/export) of such interventions. Overall, the methodology for the economic evaluation of nutrition interventions should be substantially improved.