A review on effectiveness of health promotion strategies by the American Heart Association

In an American Heart Association scientific statement published in August, a writing group systematically reviewed the scientific evidence for population approaches to improve dietary habits, increase physical activity, and reduce smoking. Their statement was published in the journal Circulation. Strategies were categorized and reviewed in six domains, i.e. media and educational campaigns; labeling and consumer information; taxation, subsidies, and other economic incentives; school and workplace approaches; local environmental changes; and direct restrictions and mandates. Thus, strategies mainly focussing on the individual as well as on the physical, social and economical environments were included in the review. The writing group also reviewed the potential contributions of healthcare systems and surveillance systems to behavior change efforts. The group showed in their review that there is rather convincing evidence for some intervention approaches, such as subsidy programs for healthier foods, school fruit programs, comprehensive, multicomponent healthy diet and physical activity promotion at schools and workplaces, and restrictions on food advertisement. Labelling of foods was also rated as evidence-based, but not so much as a means to induce healthier choices among consumers, but rather as an incentive for the food industry to make healthier products.