Is a Front-of-package Label Contaning Information on Both Nutrient Profile and Ultra-processing Well Understood?

NCT05610930 | Completed

• 1 other identifier: UParis13-BS
• Study Type: interventional
• Target: 21,159
• Locations: 1 country
• Sites: 1

Brief Summary

A modified version of the Nutri-Score (Nutri-Score 2.0), containing an additional graphic mention when the product is ultra-processed, has been proposed. The investigators aim to study, in a randomised controlled trial design nested in the NutriNet-Santé cohort, the impact of this modified version on the objective understanding of foods' nutritional quality, and on the identification of UPFs as primary outcomes. They also aim to study as secondary outcomes the impact of this label on purchasing intentions and the product perceived as the healthiest.

Conditions

Objective Understanding of Nutritional Label

Outcome Measures

Primary Outcomes (2)

• Objective understanding the nutritional quality.

  The answers of the participants on the corresponding questionnaire (via the NutriNet-Santé website) were expected to match the order according to which Nutri-Score ranks the 3 products (highest nutritional quality, second highest, third highest). In case of ex-æquos (i.e., two products having the same Nutri-Score), both were considered correct. Therefore, the number of correct answers for the nutritional dimension could range between 0 (no correct answers) to 9 (3 best products\*3 food categories, all correct answers).

  Between 30 minutes and 1 hour (the time needed to fill the questionnaire)

• Objective understanding the ultra-processing dimension.

  Participants were expected to identify all UPFs on the corresponding questionnaire (via the NutriNet-Santé website). For each product, the answer was considered correct if an UPF was identified as such by the participant (the gold standard being the presence of the black banner of the Nutri-Score 2.0, corresponding to the NOVA 4 "ultra-processed" definition), and a non-UPF was identified as such. Therefore, the number of correct answers for the food processing dimension could range between 0 (no correct answers) and 22 (correct answer for all 22 products).

  Between 30 minutes and 1 hour (the time needed to fill the questionnaire)

Secondary Outcomes (2)

• Purchasing intentions

  Between 30 minutes and 1 hour (the time needed to fill the questionnaire)

• Product perceived as the healthiest

  Between 30 minutes and 1 hour (the time needed to fill the questionnaire)

Study Arms (2)

Control arm

NO INTERVENTION

Participants received a questionnaire including 3 sets of images of food packaging, (brand blinded), categorized by food groups: 8 cookies, 7 breakfast cereals, and 7 ready-to-eat meals, but without front-of-pack nutritional label (in case the original Nutri-Score was displayed on the product, it was hidden by the investigators). They had the possibility to check the back-of-pack nutrition facts and ingredient information. First, they were asked which product they would intend to purchase in each category, and which product they thought to be the "healthiest". Then, participants were asked 1) to rank them according to their nutritional quality by identifying the first, the second and the third products with the best nutritional quality (in this order) and 2) to identify those that were ultra-processed.

Experimental arm

EXPERIMENTAL

Participants received a questionnaire including 3 sets of images of real food product packaging (brand blinded), categorized by food groups: 8 cookies, 7 breakfast cereals, and 7 ready-to-eat meals, with the Nutri-Score 2.0 displayed on the front-of-pack of each product. First, they were asked which product they would intend to purchase in each category, and which product they thought to be the "healthiest". Then, participants were asked 1) to rank them according to their nutritional quality by identifying the first, the second and the third products with the best nutritional quality (in this order) and 2) to identify those that were ultra-processed. Last, a series of questions evaluated how participants of this arm perceived the Nutri-Score 2.0 and whether they found it helpful.

Other: Front-of-pack label NutriScore 2.0

Interventions

Front-of-pack label NutriScore 2.0 OTHER

Participants in the experimental arm can see, in case the product is ultra-processed, a black banner surrounding the Nutri-Score, with the word "ultra-transformé", meaning ultra-processed, and no black banner otherwise. Participants in the control arm had no label at all. The intervention (the Nutri-Score 2.0) was added on the packaging on the products included in the 3 sets of images that participants recieved via the questionnaire.

Experimental arm

Eligibility Criteria

• Age: 18 Years - 99 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Enrolled in the NutriNet-Santé cohort

You may not qualify if:

• None

Sponsors & Collaborators

• University of Paris 13: lead

Study Sites (1)

Equipe de recherche en Epidémiologie nutritionnelle

Bobigny, 93017, France

Location

Related Publications (1)

• Srour B, Hercberg S, Galan P, Monteiro CA, Szabo de Edelenyi F, Bourhis L, Fialon M, Sarda B, Druesne-Pecollo N, Esseddik Y, Deschasaux-Tanguy M, Julia C, Touvier M. Effect of a new graphically modified Nutri-Score on the objective understanding of foods' nutrient profile and ultraprocessing: a randomised controlled trial. BMJ Nutr Prev Health. 2023 Jun;6(1):108-118. doi: 10.1136/bmjnph-2022-000599. Epub 2023 Jun 8.

  PMID: 37484539 DERIVED

Study Officials

• Bernard Srour, PhD, PharmD

  Institut National de la Santé Et de la Recherche Médicale, France

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Epidemiologist

Study Record Dates

• First Submitted: October 28, 2022
• First Posted: November 9, 2022
• Study Start: May 1, 2022
• Primary Completion: July 7, 2022
• Study Completion: July 7, 2022
• Last Updated: May 12, 2023

Record last verified: 2023-05

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)