NCT05018026

Brief Summary

This study aims to systematically evaluate the effect of Singapore's new front-of-pack non-alcoholic beverage labels, called Nutri-Grade, on the consumption of processed beverages. Using a fully functional grocery webstore, the investigators wish to assess the causal effect of the new labels on food and beverage purchase, sugar intake, and overall diet quality and examine how this effect varies by shoppers' income and education level. The investigators' hypotheses about the effects of these new food labels, measured by the grams of sugar per serving (primary) of finalized shopping baskets, are as follows:

  1. 1.Hypotheses 1: The new sugar-sweetened beverage (SSB) labels will shift consumers toward healthier products. Sugar-sweetened beverages are any liquids that have been sweetened with one or more of the different forms of added sugars.
  2. 2.Hypotheses 2: The new SSB labels will reduce overall sugar and calories purchased and increase overall diet quality.
  3. 3.Hypotheses 3: Effects will be greater for those with low income/low education as they are least familiar with the nutrition facts panel and thus most likely to benefit from the new information.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
110

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Sep 2021

Shorter than P25 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

August 13, 2021

Completed
11 days until next milestone

First Posted

Study publicly available on registry

August 24, 2021

Completed
8 days until next milestone

Study Start

First participant enrolled

September 1, 2021

Completed
4 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2021

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

January 31, 2022

Completed
Last Updated

March 23, 2022

Status Verified

March 1, 2022

Enrollment Period

4 months

First QC Date

August 13, 2021

Last Update Submit

March 21, 2022

Conditions

Diet Quality

Keywords

Nutri-Grade labelsDiet qualitySugar-sweetened beveragesOnline grocery shopping

Outcome Measures

Primary Outcomes (1)

  • Sugar Levels

    Grams of sugar per serving

    After completion of data collection, an average of about 5 months

Secondary Outcomes (3)

  • Calorie Intake

    After completion of data collection, an average of about 5 months

  • Purchased Beverage Quality

    After completion of data collection, an average of about 5 months

  • Overall Diet Quality

    After completion of data collection, an average of about 5 months

Study Arms (2)

Arm 1 (Control Arm)

NO INTERVENTION

A default NUSMart that mirrors a conventional web-grocery store in Singapore where some healthier products are displayed with Singapore's Healthier Choice Symbol (HCS) logos (Control).

Arm 2 (Nutri-Grade Arm)

EXPERIMENTAL

Similar to Arm 1 except that beverages will be displayed with a color-coded and graded Nutri-Grade label.

Behavioral: Nutri-Grade labels

Interventions

Nutri-Grade labelsBEHAVIORAL

All beverage products in the arm are displayed with the Nutri-Grade label. This label was proposed by the Ministry of Health in Singapore to be implemented at the end of 2021. It will apply to all pre-packaged non-alcoholic beverages sold in Singapore. It will have four color-coded grades wherein Grade A, corresponding to the lowest sugar and saturated fat thresholds, will be in green and Grade D, corresponding to the highest sugar and saturated fat thresholds, will be in red.

Arm 2 (Nutri-Grade Arm)

Eligibility Criteria

Age21 Years+
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Singapore resident
  • Age 21 and above
  • Must be the primary weekly grocery shopper in their household
  • Must have an account with our appointed online grocery service provider or is willing to create one.

You may not qualify if:

  • Non-Singapore resident
  • Non-primary grocery shopper in their household
  • Less than 21 years old
  • Doesn't have an account with our appointed online grocery service provider and is unwilling to create one.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Duke-NUS Graduate Medical School

Singapore, 169857, Singapore

Location

Related Publications (1)

  • Shin S, Puri J, Finkelstein E. A randomized trial to evaluate the impact of Singapore's forthcoming Nutri-grade front-of-pack beverage label on food and beverage purchases. Int J Behav Nutr Phys Act. 2023 Feb 15;20(1):18. doi: 10.1186/s12966-023-01422-4.

    PMID: 36793058DERIVED

Study Officials

  • Soye Shin, PhD

    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
CROSSOVER
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Research Fellow

Study Record Dates

First Submitted

August 13, 2021

First Posted

August 24, 2021

Study Start

September 1, 2021

Primary Completion

December 31, 2021

Study Completion

January 31, 2022

Last Updated

March 23, 2022

Record last verified: 2022-03

Data Sharing

IPD Sharing
Will not share

Locations

SG(1)