The effect of nudges on healthy food choices of individuals with a low socio-economic position: A systematic literature review

Background: Individuals with low socioeconomic position (SEP) often make poor food choices, preferring high-density fast foods that provide sufficient energy at a minimal cost over healthy foods, as fruits and vegetables. Increasing evidence reveals that the traditional view of food choice as a perfectly rational and deliberate process does not reflect reality, in which habits and heuristics strongly impact decisions. Scope and approach: Applying PRISMA guidelines, the current systematic review provides an updated evaluation of the effectiveness of nudges (changes in the choice architecture) in promoting healthy/decrease unhealthy food purchases, choices, and intake among socioeconomically disadvantaged individuals. Key findings and conclusion: Forty-one articles, including forty-three empirical studies (as two articles included two empirical studies each) were analyzed. Extending previous results based on studies performed only in real-life food purchasing scenarios this review reveals high effectiveness of nudges among low SEP individuals. Indeed, only 12% of hypothetical and 28% of real-setting studies showed no efficacy. Nevertheless, due to the extreme variability in measurements, these outcomes urge scholars to establish specific and consistent outcome criteria to robustly determine the effectiveness of nudge interventions.