A rapid review of the effectiveness of hospital-based food interventions on healthy weight outcomes for staff

Supporting healthy weight among hospital employees is a workforce priority. This review aimed to assess the effectiveness of hospital-based food environment interventions in supporting healthy weight outcomes among hospital staff.
The review included evidence published between 2010 and 2024. Twenty-nine comparative studies were included in the review, and these were conducted in a range of countries including the USA and UK. Most studies were conducted in hospital cafeterias or canteens and included hospital staff as the primary target group. A subset of studies recruited hospital staff specifically as participants.
The interventions were predominantly multicomponent, targeting the hospital food environment. Interventions fell across three broad categories: 1) Monetary components (e.g. financial incentives such as food vouchers), 2) Information-based components (e.g. nutritional and healthy labelling), 3) Choice architecture components (e.g. changes to the prominence of healthy food items). We mapped the interventions to the COM-B behaviour framework and identified patterns to support interpretation of the results.
Multicomponent hospital-based food environment interventions had little effect on weight, Body Mass Index (BMI) or waist circumference. Most differences between groups were small and uncertain. Only five USA studies that recruited hospital employees, reported on these primary outcomes. The evidence was more consistent for behaviour change outcomes. Across all 29 studies, multicomponent interventions were associated with i) Increased purchases of healthier foods and beverages and/or decreased purchases of less healthy options, ii) Lower energy (calories) purchased from food and beverages, iii) Positive changes in self-reported eating behaviours, and iv) Improvements in purchases across specific food groups. These behaviour change outcomes, particularly shifts in purchasing patterns, are meaningful stepping stones towards healthy weight, even where direct effects on weight were not demonstrated.
While current studies do not demonstrate strong effects on weight, BMI, or waist circumference, workplace food interventions remain a safe and potentially beneficial strategy. The review outlines a range of different interventions which are reasonable to pursue. The most consistently supported interventions are those that modify the physical food environment particularly changes to product placement, availability, and pricing. These represent relatively low-burden, scalable approaches.
Interventions that additionally incorporate social or behavioural regulation showed promise but were underrepresented in the evidence base.
The review identified evidence gaps and a need for further robust research.