title: The efficacy of nudge theory strategies in influencing adult dietary behaviour: a systematic review and meta-analysis.
abstract: Obesity has become a world-wide epidemic and is spreading to countries with emerging economies. Previously tested interventions are often too costly to maintain in the long term. This leaves a need for improved strategies for management of the epidemic. Nudge Theory presents a new collection of methods, deemed "nudges", which have the potential for low-cost and broad application to guide healthier lifestyle choices without the need for restrictive regulation. There has not yet been a large-scale examination of the effectiveness of nudges, despite several policy making bodies now considering their use.
  
  
  
  To address this gap in knowledge, an adapted systematic review methodology was used to collect and consolidate results from current Nudge papers and to determine whether Nudge strategies are successful in changing adults' dietary choices for healthier ones.
  
  
  
  It was found that nudges resulted in an average 15.3 % increase in healthier dietary or nutritional choices, as measured by a change in frequency of healthy choices or a change in overall caloric consumption. All of the included studies were from wealthy nations, with a particular emphasis on the United States with 31 of 42 included experiments.
  
  
  
  This analysis demonstrates Nudge holds promise as a public health strategy to combat obesity. More research is needed in varied settings, however, and future studies should aim to replicate previous results in more geographically and socioeconomically diverse countries.
authors.affiliation: Centre for Global Health, 7-9 Leinster Street South, Dublin 2, Ireland. arnoa@tcd.ie.
authors.forename: Anneliese
authors.initials: A
authors.lastname: Arno
authors.affiliation: Centre for Global Health, 7-9 Leinster Street South, Dublin 2, Ireland.
authors.forename: Steve
authors.initials: S
authors.lastname: Thomas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001521:Behavior Therapy; D002755:Choice Behavior; D004038:Diet, Reducing; D006801:Humans; D008875:Middle Aged; D009042:Motivation; D009765:Obesity / Q000178:diet therapy*; D011634:Public Health; D016896:Treatment Outcome; D055815:Young Adult
keywords: Choice architecture; Cost-effective; Diet; Nudge; Nutrition; Obesity