Evaluating the Effectiveness of Within Versus Across-Category Front-of-Package Lower-Calorie Labelling on Food Demand

NCT04165447 | Completed

• 1 other identifier: AG-2014-001
• Study Type: interventional
• Target: 146
• Locations: 1 country
• Sites: 1

Brief Summary

The important role that diet plays in health and disease is well established, as is its association with rising rates of obesity-a phenomenon of increasing concern in Singapore. Changes in lifestyle patterns, including a movement towards a more western-style diet with an emphasis on pre-packaged and fast food, have contributed to the upward trend in weight. This study aims to test two competing approaches for calorie labelling in efforts to reduce total calories purchased. In Arm 1 (termed across category labelling) a low calorie logo will be displayed on the 20% of products on the web store that are lowest in calories per serving. Arm 2 will display this logo on the 20% of products that are lowest in calories per serving within each product category (termed within category labelling). Arm 3 is the Control condition which will not display any logo on any products. For our primary outcome, the investigators hypothesize that the proportion of labelled products (or those that would have been labelled if not in control arm) purchased in each intervention arm will be greater than in control. For secondary hypotheses the investigators expect the following ordering across the three (Control, Within category, Across category) arms:

1. 1.total calories (adjusted for household size): C \> A \> W
2. 2.calories per serving: C \> A \> W
3. 3.calories per dollar spent: W \> A \> C
4. 4.total dollars spent (adjusted for household size) : W \> A \> C

Conditions

Food Selection

Keywords

nutrition; front-of-pack label; calories; online grocery store; diet; groceries; obesity

Outcome Measures

Primary Outcomes (1)

• Proportion of the basket represented by Lower Calorie products per shopping trip

  Proportion of products that are designated as labelled in the interventions

  Once a week for three weeks

Secondary Outcomes (4)

• Calories purchased per dollar spent per shopping trip

  Once a week for three weeks

• Total spending per shopping trip

  Once a week for three weeks

• Total calories purchased per shopping trip

  Once a week for three weeks

• Calories per serving per shopping trip

  Once a week for three weeks

Study Arms (3)

No labeling Control

NO INTERVENTION

Arm 1 was the Control condition, which did not display the label on any products.

Within-category labeling

EXPERIMENTAL

Arm 2 displayed the label on the 20% of products that were lowest in calories per serving within each product category (termed Within-category Labeling, WC).

Behavioral: Front-of-pack labeling strategy

Across-category labeling

EXPERIMENTAL

Arm 3 displayed the label on the 20% of all products that were lowest in calories per serving (termed Across-category Labeling, AC).

Behavioral: Front-of-pack labeling strategy

Interventions

Front-of-pack labeling strategy BEHAVIORAL

We designed a simple 'Lower Calorie' directive logo. We labeled the 20% of products with the lowest calories per serving within or across categories. All serving sizes used in this study were the average of the serving sizes within each category. Prior to conducting the analysis, we standardized the serving size by using the mean serving size within each subcategory. This standardization ensures that similar products are compared equally as serving sizes can be arbitrarily set by the manufacturers. The labels were displayed below the product images.

Across-category labeling; Within-category labeling

Eligibility Criteria

• Age: 21 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults aged 21 years and above
• Primary grocery shopper for the household
• Registered RedMart (an online grocery store) shoppers

You may not qualify if:

• Under 21 years of age
• Not the primary grocery shopper for the household
• Not a resident in Singapore
• Not a registered online shopper of RedMart

Sponsors & Collaborators

• Duke-NUS Graduate Medical School: lead
• National University of Singapore: collaborator

Study Sites (1)

Duke-NUS Medical School

Singapore, 169857, Singapore

Location

Related Publications (1)

• Finkelstein EA, Ang FJL, Doble B. Randomized trial evaluating the effectiveness of within versus across-category front-of-package lower-calorie labelling on food demand. BMC Public Health. 2020 Mar 12;20(1):312. doi: 10.1186/s12889-020-8434-1.

  PMID: 32164634 DERIVED

MeSH Terms

Conditions

Food Preferences; Obesity

Condition Hierarchy (Ancestors)

Feeding Behavior; Behavior; Overweight; Overnutrition; Nutrition Disorders; Nutritional and Metabolic Diseases; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator, Professor

Study Record Dates

• First Submitted: November 11, 2019
• First Posted: November 18, 2019
• Study Start: October 1, 2017
• Primary Completion: April 30, 2018
• Study Completion: April 30, 2018
• Last Updated: November 18, 2019

Record last verified: 2019-11

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, ICF, CSR, ANALYTIC CODE
• Time Frame: Up to 10 years after study conclusion.
• Access Criteria: Reasonable request.

Locations

SG (1)