Randomized trial evaluating the effectiveness of within versus across-category front-of-package lower-calorie labelling on food demand
Abstract Background Several front-of-pack (FOP) labels identify healthier options by comparing foods within product categories. Alternative approaches label healthier options by comparing across categories. Which approach is superior remains unknown. The objective of this study was to test the effec...
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| Format: | Article |
| Language: | English |
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BMC
2020-03-01
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| Series: | BMC Public Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12889-020-8434-1 |
| _version_ | 1828347477388951552 |
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| author | Eric Andrew Finkelstein Felicia Jia Ler Ang Brett Doble |
| author_facet | Eric Andrew Finkelstein Felicia Jia Ler Ang Brett Doble |
| author_sort | Eric Andrew Finkelstein |
| collection | DOAJ |
| description | Abstract Background Several front-of-pack (FOP) labels identify healthier options by comparing foods within product categories. Alternative approaches label healthier options by comparing across categories. Which approach is superior remains unknown. The objective of this study was to test the effect of a within-category versus across-category FOP lower calorie label on 1) the percentage of labeled products purchased, 2) several measures of calories purchased (total, per dollar and per serving), and 3) total spending. We also tested the moderating effects of hunger and mood on purchasing patterns. Methods Using an online grocery store, we conducted a 3 × 3 crossover trial involving actual purchases with 146 participants randomly exposed to: 1) no labeling control; 2) within-category lower calorie labels, and; 3) across-category lower calorie labels. We labeled the 20% of products with the lowest calories per serving within or across categories. Purchases were compared using a fixed effects regression on first-differenced outcomes. Results Relative to the control condition, there was a 3 percentage point increase (p = 0.01) in labelled products purchased in the within-category arm and a non-significant decrease of 1 percentage point (p = 0.711) in the across-category arm. There was no significant difference in the proportion of labeled products purchased between the two labelling conditions. Neither strategy resulted in reductions in any measure of calories purchased or in total spending. When limited to beverages, there was a 398 cal reduction (p = 0.01) in the within-category arm and a 438 cal reduction (p < 0.01) in the across-category arm versus the control. Mood and hunger did not modify the effects for either strategy. Conclusions Results provide evidence that both labelling strategies have the potential to influence food purchasing patterns. However, we cannot definitely state that one labelling approach is superior or even that an increase in the proportion of labelled products purchased will lead to a reduction in calories purchased. Trial registration The American Economic Association’s registry for randomized controlled trials, RCT ID: AEARCTR-0002325; Prospectively Registered October 06, 2017. In compliance with ICMJE policy, the trial was also registered on Clinicaltrials.gov, RCT ID: [ NCT04165447 ]. Retrospectively Registered 11 November 2019. |
| first_indexed | 2024-04-14T00:40:17Z |
| format | Article |
| id | doaj.art-28098eaff61c42bcac383302185fa605 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-04-14T00:40:17Z |
| publishDate | 2020-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-28098eaff61c42bcac383302185fa6052022-12-22T02:22:12ZengBMCBMC Public Health1471-24582020-03-0120111010.1186/s12889-020-8434-1Randomized trial evaluating the effectiveness of within versus across-category front-of-package lower-calorie labelling on food demandEric Andrew Finkelstein0Felicia Jia Ler Ang1Brett Doble2Programme in Health Services & Systems Research, Duke-NUS Medical SchoolProgramme in Health Services & Systems Research, Duke-NUS Medical SchoolProgramme in Health Services & Systems Research, Duke-NUS Medical SchoolAbstract Background Several front-of-pack (FOP) labels identify healthier options by comparing foods within product categories. Alternative approaches label healthier options by comparing across categories. Which approach is superior remains unknown. The objective of this study was to test the effect of a within-category versus across-category FOP lower calorie label on 1) the percentage of labeled products purchased, 2) several measures of calories purchased (total, per dollar and per serving), and 3) total spending. We also tested the moderating effects of hunger and mood on purchasing patterns. Methods Using an online grocery store, we conducted a 3 × 3 crossover trial involving actual purchases with 146 participants randomly exposed to: 1) no labeling control; 2) within-category lower calorie labels, and; 3) across-category lower calorie labels. We labeled the 20% of products with the lowest calories per serving within or across categories. Purchases were compared using a fixed effects regression on first-differenced outcomes. Results Relative to the control condition, there was a 3 percentage point increase (p = 0.01) in labelled products purchased in the within-category arm and a non-significant decrease of 1 percentage point (p = 0.711) in the across-category arm. There was no significant difference in the proportion of labeled products purchased between the two labelling conditions. Neither strategy resulted in reductions in any measure of calories purchased or in total spending. When limited to beverages, there was a 398 cal reduction (p = 0.01) in the within-category arm and a 438 cal reduction (p < 0.01) in the across-category arm versus the control. Mood and hunger did not modify the effects for either strategy. Conclusions Results provide evidence that both labelling strategies have the potential to influence food purchasing patterns. However, we cannot definitely state that one labelling approach is superior or even that an increase in the proportion of labelled products purchased will lead to a reduction in calories purchased. Trial registration The American Economic Association’s registry for randomized controlled trials, RCT ID: AEARCTR-0002325; Prospectively Registered October 06, 2017. In compliance with ICMJE policy, the trial was also registered on Clinicaltrials.gov, RCT ID: [ NCT04165447 ]. Retrospectively Registered 11 November 2019.http://link.springer.com/article/10.1186/s12889-020-8434-1Front-of-pack labelingNutrition labelingFood intakeCaloriesOnline grocery store |
| spellingShingle | Eric Andrew Finkelstein Felicia Jia Ler Ang Brett Doble Randomized trial evaluating the effectiveness of within versus across-category front-of-package lower-calorie labelling on food demand BMC Public Health Front-of-pack labeling Nutrition labeling Food intake Calories Online grocery store |
| title | Randomized trial evaluating the effectiveness of within versus across-category front-of-package lower-calorie labelling on food demand |
| title_full | Randomized trial evaluating the effectiveness of within versus across-category front-of-package lower-calorie labelling on food demand |
| title_fullStr | Randomized trial evaluating the effectiveness of within versus across-category front-of-package lower-calorie labelling on food demand |
| title_full_unstemmed | Randomized trial evaluating the effectiveness of within versus across-category front-of-package lower-calorie labelling on food demand |
| title_short | Randomized trial evaluating the effectiveness of within versus across-category front-of-package lower-calorie labelling on food demand |
| title_sort | randomized trial evaluating the effectiveness of within versus across category front of package lower calorie labelling on food demand |
| topic | Front-of-pack labeling Nutrition labeling Food intake Calories Online grocery store |
| url | http://link.springer.com/article/10.1186/s12889-020-8434-1 |
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