Intended for healthcare professionals


Changing the assortment of available food and drink for leaner, greener diets

BMJ 2022; 377 doi: (Published 13 April 2022) Cite this as: BMJ 2022;377:e069848
  1. Theresa M Marteau, director of research1,
  2. Gareth J Hollands, principal research fellow12,
  3. Rachel Pechey, Wellcome Trust and Royal Society Sir Henry Dale fellow3,
  4. James P Reynolds, lecturer in psychology4,
  5. Susan A Jebb, professor of diet and population health3
  1. 1University of Cambridge, Department of Public Health and Primary Care, Cambridge CB2 0SR, UK
  2. 2University College London, EPPI-Centre, UCL Social Research Institute, London WC1H 0NR, UK
  3. 3University of Oxford, Nuffield Department of Primary Care Health Sciences, Radcliffe Primary Care Building, Woodstock Road, Oxford OX2 6GG, UK
  4. 4Aston University, School of Psychology, Birmingham B4 7ET, UK
  1. Correspondence to: T M Marteau tm388{at}

Theresa Marteau and colleagues discuss the potential of “availability interventions” to improve diets and reduce inequalities

Diets that are suboptimal—high in saturated fat, free sugar, and salt and low in fibre—are one of the largest contributors to premature death and preventable diseases and to health inequalities.1 Food production, especially livestock, is also a major contributor to environmental harm.2 Reducing the supply and consumption of meat, alcohol, and sugary foods (such as biscuits and confectionary) that contribute to suboptimal diets would improve population health globally, reduce rates of obesity and related diseases such as cardiovascular disease and many cancers,3456789 and could also reduce the health inequalities that stem from their consumption.101112 Limiting these products would also help control the environmental harms associated with their production, processing, transport, and sale.2131415

Reducing consumption enough to improve health equitably and protect the environment will require multiple interventions delivered at scale with the potential to reach everyone. These include price based interventions such as health taxes and carbon pricing1617 and restrictions on price promotions18 and marketing.19 Interventions that change the assortment of products available to consumers (availability interventions) also have the potential to shift consumption at scale, as shown by several recent real world studies (table 1). But this growing evidence has received little systematic analysis by researchers, so remains largely overlooked by policy makers. Defining and characterising effective availability interventions more precisely will provide greater conceptual clarity and strengthen the evidence base. This in turn could increase the use of availability interventions by policy makers and others, to improve population health both equitably and sustainably.

View this table:
Table 1

Availability studies using randomised or quasi-randomised controlled designs in real world (field) settings

What are availability interventions?

Availability interventions change the variety of …

View Full Text

Log in

Log in through your institution


* For online subscription