Promoting healthy and sustainable diets through food service interventions in university settings: a scoping review

BackgroundFood service operations in universities and colleges, such as cafeterias and canteens, may support healthy and sustainable diets among students and staff and contribute to a transformation of the wider food system. Multiple studies on interventions to promote health and sustainability in this setting have been conducted, but no up-to-date, comprehensive review exists. This study aims to fill this gap. MethodsWe used state-of-the-art scoping review methodology. We included any study examining interventions in university or college food service settings aimed at, or potentially suitable for: 1), supporting healthy and/or sustainable diets, 2) reducing food waste, or 3) otherwise increasing the sustainability of the food service operation (e.g. by improving energy efficiency). We considered studies using any study design published in any language without publication date restrictions. We comprehensively searched six academic databases and conducted forward and backward citation searches. We extracted and charted data on key study characteristics, including the reported direction of effects/associations. ResultsWe identified 206 studies reporting on 273 interventions. Most studies (71%) used quasi- experimental study designs, were conducted in North America (53%) or Europe (34%), and were implemented in cafeterias or canteens (76%). The most common intervention types were labelling interventions (26%), improved or increased offerings of healthy and/or sustainable food and beverage options (24%), and information and awareness-raising interventions (18%). The most commonly assessed outcomes were implementation-related (e.g. costs, feasibility, acceptability), diet-related (e.g. sales or consumption of specific foods), and sustainability-related (e.g. carbon footprint). Most, but not all, studies reported mostly effects in the desired direction (e.g. increased vegetable consumption, or decreased food waste). DiscussionMultiple approaches for promoting health and sustainability in university and college food service settings exist. The findings of this review suggest that such interventions can be effective, feasible, cost-effective, and aligned with customer and stakeholder expectations. We therefore suggest that they are considered for implementation more widely. Implementation should be accompanied by monitoring and methodologically robust evaluations to allow for evidence-informed tailoring and adjustments and to improve the existing evidence base.