Understanding Food Choices in Saudi Arabia

NCT05007184 | Completed

• 1 other identifier: 7197919
• Study Type: interventional
• Target: 656
• Locations: 1 country
• Sites: 1

Brief Summary

Using a 3-arm randomized controlled trial, the investigators aim to rigorously evaluate the effects of two front-of-pack (FOP) food labels on diet quality. The first food label is a modified version of Chilean warning FOP label and the second food label is a modified version of French FOP label, Nutri-Score. The investigators used an experimental online grocery store, called NUSMart, which is similar in design to commercial web-based grocery stores to test these two FOP labels. Participants were randomly assigned to one of the following arms and asked to complete a one-time hypothetical shop. Arm 1: Participants experienced a default version of NUSMart which replicated the traditional shopping experience of online grocery stores with no FOP labels (Control). Arm 2: Same as Arm 1 NUSMart except that Chilean warning FOP labels were displayed on less healthy food and beverages. Products with specific nutrients (i.e. sugar, sodium, saturated fat, energy) falling outside the bounds of the thresholds defined by the Chilean warning labels were depicted with the warning labels on them. Arm 3: Same as Arm 1 NUSMart except that Nutri-Score FOP labels along with % sugar per serving were displayed on all food and beverages. These labels score products on the basis of 7 nutrients (calories, saturated fats, sugar, salt, fibre, protein and percentage of fruits, vegetables and nuts) from A to E (best to worst). To ensure that participants understood what Nutri-Score labels mean and how they work, an introductory video was shown before shopping. The investigators hypothesize the following: Hypothesis 1: Diet quality, as measured by weighted average Nutri-Score point of shoppers' final baskets, will be greatest in Arm 3, followed by Arm 2, followed by Control. Hypothesis 2: Grams of sugar per serving/ milligrams of sodium per serving/ grams of saturated fat per serving/ calories per serving will be least in Arm 2, followed by Arm 3, followed by Control.

Conditions

Diet Quality

Keywords

front-of-pack labels; online grocery shopping; Kingdom of Saudi Arabia; Chilean warning labels; Nutri-Score labels

Outcome Measures

Primary Outcomes (1)

• Value of Nutri-Score

  Diet quality measured by the weighted average of all purchased products' Nutri-Score for the shopping trip. Nutri-Score is an individual dietary index based on the British Food Standard Agency Nutrient Profiling System.

  After completion of data collection, an average of about 1 month

Secondary Outcomes (1)

• Quantity of other Nutrients

  After completion of data collection, an average of about 1 month

Study Arms (3)

Control Arm (Arm 1)

NO INTERVENTION

Participants will experience an unmodified version of NUSMart, which replicates the traditional shopping experience of online grocery stores.

Warning Label Arm (Arm 2)

EXPERIMENTAL

Similar to Arm 1 except that products are labeled with Chilean warning FOP labels.

Behavioral: Chilean Warning Labels

Nutri-Score Arm (Arm 3)

EXPERIMENTAL

Similar to Arm 1 except that products are labeled with NutriScore FOP labels.

Behavioral: Nutri-Score Labels

Interventions

Chilean Warning Labels BEHAVIORAL

These labels were implemented in Chile in 2016. They are shown on those less-healthy food and beverage products that do not fall within thresholds that are defined for the following nutrients: sugar, sodium, calories and saturated fats. The original labels are in Spanish but the ones that we displayed were in Arabic.

Warning Label Arm (Arm 2)

Nutri-Score Labels BEHAVIORAL

These labels were implemented by the French government in 2017. They are shown on all food and beverage products and range from A to E with the corresponding colours moving from Green to Red (symbolizing best to worst). The scores and grades are calculated based on 7 different nutrients grouped into 2 categories i.e. nutrients to consume (such as fibre) and nutrients to avoid (such as sugar). We modified the labels by adding % sugar per serving on the right side of the labels.

Nutri-Score Arm (Arm 3)

Eligibility Criteria

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

You may qualify if:

• People who are KSA (Kingdom of Saudi Arabia) citizens
• Age of 18 and above,
• Arabic speakers, and
• A weekly primary grocery shopper for their households can participate in this study.

You may not qualify if:

• People who are not KSA citizens,
• Under 18 years of age,
• Cannot speak Arabic, or
• Are not weekly primary grocery shoppers for their households cannot participate in this study.

Sponsors & Collaborators

• Duke-NUS Graduate Medical School: lead
• World Bank: collaborator
• Public Health Authority of Saudi Arabia: collaborator

Study Sites (1)

Duke-NUS Graduate Medical School

Singapore, 169857, Singapore

Location

Study Officials

• Eric A Finkelstein, PhD MHA

  Duke-NUS Graduate Medical School

  PRINCIPAL INVESTIGATOR

Study Design

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

Study Record Dates

• First Submitted: August 3, 2021
• First Posted: August 16, 2021
• Study Start: July 7, 2021
• Primary Completion: July 26, 2021
• Study Completion: July 26, 2021
• Last Updated: August 16, 2021

Record last verified: 2021-08

Data Sharing

• IPD Sharing: Will not share

Locations

SG (1)