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Jostock C, Luick M, Jebb SA, Pechey R. Changing the availability and positioning of more vs. less environmentally sustainable products: A randomised controlled trial in an online experimental supermarket. Appetite 2024; 200:107579. [PMID: 38914261 DOI: 10.1016/j.appet.2024.107579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 06/20/2024] [Accepted: 06/21/2024] [Indexed: 06/26/2024]
Abstract
Food purchasing behaviours are shaped by the choices available to shoppers and the way they are offered for sale. This study tested whether prominent positioning of more sustainable food items online and increasing their relative availability might reduce the environmental impact of foods selected in a 2x2 (availability x position) factorial randomised controlled trial. Participants (n = 1179) selected items in a shopping task in an experimental online supermarket. The availability intervention added lower-impact products to the regular range. The positioning intervention biased product order to give prominence to lower-impact products. The primary outcome was the environmental impact score (ranging from 1 "least impact" to 5 "most impact", of each item in shopping baskets) analysed using Welch's ANOVA. Secondary outcomes included interactions (analysed via linear regression) by gender, age group, education, income and meat consumption and we assessed intervention acceptability (using different frames) in a post-experiment questionnaire. Compared to control (mean = 21.6), mean eco quintile score was significantly reduced when availability & order was altered (-2.30; 95%CI: 3.04; -1.56) and when order only was changed (-1.67; 95%CI: 2.42; -0.92). No significant difference between availability only (-0.02; 95%CI: 0.73; 0.69) and control was found. There were no significant interactions between interventions or by demographic characteristics. Both interventions were acceptable under certain frames (positioning emphasising lower-impact products: 70.3% support; increasing lower-impact items: 74.3% support). Prominent positioning of more sustainable products may be an effective strategy to encourage more sustainable food purchasing. Increasing availability of more sustainable products alone did not significantly alter the environment impact of products selected.
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Affiliation(s)
- Cinja Jostock
- All authors are affiliated with the Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom.
| | - Madison Luick
- All authors are affiliated with the Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
| | - Susan A Jebb
- All authors are affiliated with the Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
| | - Rachel Pechey
- All authors are affiliated with the Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
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2
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Rummo PE, Seet C, Reimold AE, Duffy EW, Prestemon CE, Hall MG, Bragg MA, Taillie LS. Online retail nudges to help parents with lower-income choose healthy beverages for their children: A randomized clinical trial. Pediatr Obes 2024; 19:e13150. [PMID: 38993007 DOI: 10.1111/ijpo.13150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 05/21/2024] [Accepted: 06/10/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Nudges offer a promising tool to reduce sugary drink intake among children who are most at risk for diet-related disease. OBJECTIVE To examine the impact of online store nudges on purchases of sugary drinks for children in lower-income households. METHODS Caregivers with lower-income were recruited to an online shopping experiment and instructed to spend $10-$30 on three beverages for their child aged 1-5 years. Participants were randomized to navigate an online supermarket in its standard version (n = 1106) or a version with nudges (n = 1135), including a product placement nudge (i.e. placing healthy beverages in prominent positions) and a swap nudge (i.e. offering a swap of water, plain milk and/or 100% fruit juice upon selection of sugary drinks). RESULTS On average, participants purchased 1887 (SD = 2113) and 620 (SD = 1528) calories from sugary drinks per basket in the control and experimental conditions, respectively. Model-based results indicate that those in the experimental condition purchased 1267 (95% CI: 1419, 1114) fewer calories from sugary drinks, and fewer grams of total sugar (β = -253.5 g (95% CI: -286.3, -220.6)) and added sugar (β = -287.8 g (95% CI: -323.1, -252.5)) purchased from sugary drinks. CONCLUSION Nudges may be an effective, acceptable, scalable strategy for leading caregivers in lower-income households to purchase fewer sugary drinks for their children.
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Affiliation(s)
- Pasquale E Rummo
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Carla Seet
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Alexandria E Reimold
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Emily W Duffy
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Carmen E Prestemon
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Marie A Bragg
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Lindsey Smith Taillie
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Boxall LR, Arden-Close E, James J, Appleton KM. Protocol: The effects of nutrient- vs food- vs food-substitution-based dietary recommendations for reducing free sugar intakes, on free sugar intakes, dietary profiles and sweet taste outcomes: A randomised controlled trial. Nutr Health 2024; 30:269-278. [PMID: 35818972 PMCID: PMC11141080 DOI: 10.1177/02601060221111234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Dietary guidelines are intended to inform and aid the general public, with the aim of improving healthy diets and reducing health risk. The effectiveness of these guidelines, however, is rarely investigated. AIM This work investigates the effects of three different types of dietary recommendations for reducing free sugars, on free sugar intakes over 12 weeks. Secondary aims will also investigate how these different recommendations affect secondary outcomes, outcomes in subsets of the trial population, and identify barriers and facilitators to dietary change. METHODS Using a randomised controlled parallel-group trial with three intervention and one control arms, 240 individuals consuming >5% total energy intake from free sugars will be randomized to receive: nutrient-based, nutrient- and food-based, nutrient-, food- and food-substitution-based recommendations or no recommendations, with outcomes assessed for the following 12 weeks. Our primary outcomes are free sugar intakes and adherence to the recommendations. Secondary outcomes are daily energy intake, dietary composition, anthropometry, sweet food perceptions and preferences, sweet food choice, attitudes towards sweet foods, eating behaviour and food choice, knowledge and lifestyle variables, quality of life, adverse events, and barriers and facilitators towards intervention adherence. RESULTS Data will contribute to three distinct analyses: 1) Analyses to investigate the effects of the three different dietary recommendations versus control; 2) Analyses of the effects of the dietary recommendations in different population subgroups, and 3) Investigation of the barriers and facilitators to success. CONCLUSION This work offers new perspectives on the effects of different dietary recommendations to enact behaviour change.
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Grummon AH, Zeitlin AB, Lee CJY. Developing messages to encourage healthy, sustainable dietary substitutions: A qualitative study with US emerging adults. Appetite 2024; 195:107223. [PMID: 38246428 PMCID: PMC10923059 DOI: 10.1016/j.appet.2024.107223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 01/23/2024]
Abstract
Prior research shows that adopting simple dietary substitutions (e.g., replacing beef with poultry or plant-based entrees) can improve dietary quality and reduce the negative environmental consequences of food production, but little is known about how to encourage people to adopt these substitutions. This study aimed to examine reactions to messages encouraging healthy, sustainable dietary substitutions among emerging adults ages 18-25. We conducted four online focus groups with a diverse sample of US emerging adults (n = 28; 61% female). Focus groups explored emerging adults' reactions to messages encouraging them to adopt three target dietary substitutions: replacing beef and pork with poultry and plant-based entrees; replacing juice with whole fruit; and replacing dairy milk with non-dairy milk. We transcribed discussions verbatim and adopted a thematic approach to analyzing the transcripts. Results showed that participants perceived messages to be most effective at encouraging the target dietary substitutions when the messages: encouraged specific, achievable dietary changes; linked these dietary changes to clear consequences; included personally relevant content; included statistics; were succinct; and used a positive tone. Across the target dietary substitutions, two message topics (small changes, big benefits, which emphasized how small dietary changes can have large positive health and environmental impacts, and warning, which discussed the negative health and environmental impacts of dietary choices) were generally perceived to be most effective. A few participants expressed doubt that the target dietary substitutions would have meaningful environmental impacts. Results suggest that campaign messages to encourage healthy, sustainable dietary substitutions may be more effective if the messages make the target dietary substitutions seem achievable and use statistics to clearly describe the positive impacts of making these changes.
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Affiliation(s)
- Anna H Grummon
- Department of Pediatrics, Stanford University School of Medicine, 3145 Porter Dr., Palo Alto, CA 94304, United States; Department of Health Policy, Stanford University School of Medicine, 615 Crothers Way, Encina Commons, Stanford, CA 94305, United States.
| | - Amanda B Zeitlin
- Department of Pediatrics, Stanford University School of Medicine, 3145 Porter Dr., Palo Alto, CA 94304, United States; Department of Medicine, Stanford University School of Medicine, 3180 Porter Dr., Palo Alto, CA 94304, United States.
| | - Cristina J Y Lee
- Department of Pediatrics, Stanford University School of Medicine, 3145 Porter Dr., Palo Alto, CA 94304, United States.
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Schruff-Lim EM, Van Loo EJ, van der Lans IA, van Trijp HCM. Impact of food swap recommendations on dietary choices in an online supermarket: A randomized controlled trial. Appetite 2024; 194:107158. [PMID: 38113984 DOI: 10.1016/j.appet.2023.107158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/01/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023]
Abstract
One novel strategy to shift food choices in digital shopping environments is to automatically recommend healthier alternatives when an unhealthy choice is made. However, this raises the question which alternative products to recommend. This study assesses 1) whether healthier food swap recommendations are effective, even though the unhealthy choice was made in the presence of visible FOP nutrition labels, and 2) how the similarity of the alternatives influences the acceptance of food swap recommendations. Based on a pre-test, similarity of the recommendation was operationalized in terms of animal-based versus plant-based options. A randomized controlled trial (healthy food swap recommendation conditions: none, similar animal-based, dissimilar plant-based, or mixed animal- and plant-based) with 428 Dutch participants was conducted in a simulated online supermarket. Additional healthier food swap recommendations improved the nutritional quality of the final basket compared to only providing Nutri-Score nutrition labels (-1.7 mean FSA score, p < .001, medium Cohen's d = -0.48). Compared to the dissimilar condition, acceptance of an alternative was more likely in the mixed (odds-ratio = 2.78, p = .015) and in the similar condition (odds-ratio = 2.24, p = .048), but the nutritional quality of the final basket did not differ between treatment conditions. Individuals in treatment conditions who did not receive any recommendation (i.e. only made healthy choices) had higher Nutri-Score familiarity and general health interest than individuals who received recommendations. This suggests that for individuals with higher knowledge and motivation FOP nutrition labels were sufficient, whereas for individuals with lower knowledge and motivation additional food swap recommendations can improve dietary choices. Food swap recommendations may act as meaningful reminders by disrupting the automatic choice process and triggering individuals to rethink their (unhealthy) choice.
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Affiliation(s)
- Eva-Maria Schruff-Lim
- Marketing and Consumer Behaviour Group, Wageningen University & Research, Hollandseweg 1, 6706, KN, Wageningen, the Netherlands.
| | - Ellen J Van Loo
- Marketing and Consumer Behaviour Group, Wageningen University & Research, Hollandseweg 1, 6706, KN, Wageningen, the Netherlands
| | - Ivo A van der Lans
- Marketing and Consumer Behaviour Group, Wageningen University & Research, Hollandseweg 1, 6706, KN, Wageningen, the Netherlands
| | - Hans C M van Trijp
- Marketing and Consumer Behaviour Group, Wageningen University & Research, Hollandseweg 1, 6706, KN, Wageningen, the Netherlands
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Piernas C, Lee C, Hobson A, Harmer G, Payne Riches S, Noreik M, Jebb SA. A Behaviorally Informed Mobile App to Improve the Nutritional Quality of Grocery Shopping (SwapSHOP): Feasibility Randomized Controlled Trial. JMIR Mhealth Uhealth 2024; 12:e45854. [PMID: 38206671 PMCID: PMC10811579 DOI: 10.2196/45854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/29/2023] [Accepted: 11/27/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Interventions targeting the nutritional quality of grocery shopping have the potential to help improve diet and health outcomes. OBJECTIVE This study aims to assess the feasibility and acceptability of receiving advice on healthier food purchases through SwapSHOP, a behaviorally informed smartphone app that allows users to scan barcodes of grocery products from the United Kingdom, providing nutritional information and personalized swap suggestions to encourage healthier purchases. METHODS We randomized adult volunteers in a 6-arm parallel-group controlled feasibility trial. Participants used the SwapSHOP app to record their grocery shopping during a 2-week run-in period and were individually randomized in a 3:1 ratio to either intervention or control arms within 3 strata related to a nutrient of concern of their choice: saturated fat (SFA), sugar, or salt. Participants randomized to the intervention received the SwapSHOP app with a healthier swap function, goal setting, and personalized feedback. Participants in the control group were instructed to use a simpler version of the app to log all their food purchases without receiving any guidance or advice. The primary outcome was the feasibility of progression to a full trial, including app use and follow-up rates at 6 weeks. The secondary outcomes included other feasibility outcomes, process and qualitative measures, and exploratory effectiveness outcomes to assess changes in the nutrient content of the purchased foods. RESULTS A total of 112 participants were randomized into 3 groups: SFA (n=38 intervention and n=13 control), sugar (n=40 intervention and n=15 control), and salt (n=5 intervention and n=1 control, not analyzed). The 2 progression criteria were met for SFA and sugar: 81% (30/37) and 87% (34/39) of intervention participants in the SFA and sugar groups, respectively, used the app to obtain healthier swaps, and 89% (68/76) of intervention participants and 96% (23/24) of control participants completed follow-up by scanning all purchases over the follow-up period. The process and qualitative outcomes suggested that the intervention was acceptable and has the potential to influence shopping behaviors. There were reductions of -0.56 g per 100 g (95% CI -1.02 to -0.19) in SFA and -1 g per 100 g (95% CI -1.97 to -0.03) in total sugars across all food purchases in the intervention groups. CONCLUSIONS People were willing to use the SwapSHOP app to help reduce sugar and SFA (but not salt) in their grocery shopping. Adherence and follow-up rates suggest that a full trial is feasible. Given the suggestive evidence indicating that the intervention resulted in reductions in sugars and SFA, a definitive trial is necessary to target improvements in health outcomes. TRIAL REGISTRATION International Standard Randomised Controlled Trial Number ISRCTN13022312; https://doi.org/10.1186/ISRCTN13022312.
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Affiliation(s)
- Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Department of Biochemistry and Molecular Biology II, Center for Biomedical Research (CIBM), Institute of Nutrition and Food Technology (INYTA), University of Granada, Granada, Spain
| | - Charlotte Lee
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Alice Hobson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Georgina Harmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Sarah Payne Riches
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Michaela Noreik
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Faculty of Food and Nutrition Sciences, Hochschule Niederrhein, Mönchengladbach, Germany
| | - Susan A Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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Valenčič E, Beckett E, Collins CE, Koroušić Seljak B, Bucher T. Changing the default order of food items in an online grocery store may nudge healthier food choices. Appetite 2024; 192:107072. [PMID: 37797817 DOI: 10.1016/j.appet.2023.107072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/22/2023] [Accepted: 10/02/2023] [Indexed: 10/07/2023]
Abstract
Restructuring food environments, such as online grocery stores, has the potential to improve consumer health by encouraging healthier food choices. The aim of this study was to investigate whether repositioning foods within an experimental online grocery store can be used to nudge healthier choices. Specifically, we investigated whether repositioning product categories displayed on the website main page, and repositioning individual products within those categories, will influence selection. Adults residing in Australia (n = 175) were randomised to either intervention (high-fibre foods on top) or comparator condition (high-fibre foods on the bottom). Participants completed a shopping task using the experimental online grocery store, with a budget of up to AU$100 to for one person's weekly groceries. The results of this study show that the total fibre content per 100 kcal per cart (p < .001) and total fibre content per cart (p = .036) was higher in the intervention compared to comparator condition. Moreover, no statistical difference between conditions was found for the total number of fibre-source foods (p = .67), the total energy per cart (p = .17), and the total grocery price per cart (p = .70) indicating no evidence of implications for affordability. Approximately half of the participants (48%) reported that they would like to have the option to sort foods based on a specific nutrient criterion when shopping online. This study specifically showed that presenting higher-fibre products and product categories higher up on the online grocery store can increase the fibre content of customers' purchases. These findings have important implications for consumers, digital platform operators, researchers in health and food domains, and for policy makers.
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Affiliation(s)
- Eva Valenčič
- University of Newcastle, School of Health Sciences, College of Health, Medicine and Wellbeing, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, Food and Nutrition Research Program, NSW, 2305, Australia; Jožef Stefan Institute, Computer Systems Department, Ljubljana, 1000, Slovenia; Jožef Stefan International Postgraduate School, Ljubljana, 1000, Slovenia.
| | - Emma Beckett
- University of Newcastle, School of Environmental and Life Sciences, College of Engineering, Science and Environment, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, Food and Nutrition Research Program, NSW, 2305, Australia; Department of Science, Nutrition Research Australia, Sydney, NSW, 2000, Australia
| | - Clare E Collins
- University of Newcastle, School of Health Sciences, College of Health, Medicine and Wellbeing, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, Food and Nutrition Research Program, NSW, 2305, Australia
| | - Barbara Koroušić Seljak
- Jožef Stefan Institute, Computer Systems Department, Ljubljana, 1000, Slovenia; Jožef Stefan International Postgraduate School, Ljubljana, 1000, Slovenia
| | - Tamara Bucher
- University of Newcastle, School of Environmental and Life Sciences, College of Engineering, Science and Environment, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, Food and Nutrition Research Program, NSW, 2305, Australia
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Yau A, Law C, Cornelsen L, Adams J, Boyland E, Burgoine T, de Vocht F, White M, Cummins S. Association Between Household Online Grocery Delivery Service Use and Food and Drink Purchase Behavior in England: Cross-Sectional Analysis. JMIR Public Health Surveill 2023; 9:e41540. [PMID: 38113090 PMCID: PMC10762614 DOI: 10.2196/41540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 03/14/2023] [Accepted: 08/29/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Online grocery delivery services (OGDSs) are a popular way of acquiring food. However, it is unclear whether OGDS use is associated with the healthiness of purchases and whether there are sociodemographic differences in OGDS use. If so, the increased prevalence of OGDS use may have implications for population diet, and differential OGDS use could contribute to diet inequalities. OBJECTIVE This study aimed to examine whether OGDS use varies by sociodemographic characteristics and is associated with the amount and types of groceries purchased. METHODS Item-level take-home food and drink purchase data (n=3,233,920 items) from households in London and the North of England were available from the 2019 UK Kantar fast-moving consumer goods panel (N=1911). Purchases were categorized as being bought online or in-store. We used logistic regression to estimate the likelihood of an above-median frequency of OGDS use by sociodemographic characteristics. We used Poisson regression to estimate the differences in energy and nutrients purchased by households that had above- and below-median OGDS use and the proportion of energy purchased from products high in fat, salt, and sugar (HFSS) online versus in-store among households that used both shopping methods (n=665). RESULTS In total, 668 (35%) households used OGDSs at least once in 2019. Of the households that used OGDSs, the median use was 5 occasions in 2019. Households were more likely to have above-median use in London versus in the North of England (odds ratio 1.29, 95% CI 1.01-1.65) and if they had a higher annual household income (odds ratio 1.56, 95% CI 1.02-2.38 for ≥£50,000 [US $64,000] vs <£20,000 [$25,600]). Households with above-median OGDS use had a higher weekly mean purchase of energy by 1461 (95% CI 1448-1474) kcal per person compared with households with below-median OGDS use. For households that used a combination of in-store and online shopping, HFSS products made up a lower proportion (-10.1%, 95% CI -12% to -8.1%) of energy purchased online compared to in-store. CONCLUSIONS Differences in grocery purchases between households with above- and below-median OGDS use could have positive or negative consequences. The extra energy purchased among households with above-median OGDS use could lead to overconsumption or food waste, which has negative consequences for population and environmental health. Alternatively, this extra energy may be replacing out-of-home purchasing, which tends to be less healthy, and may be beneficial for the population diet. Households made fewer HFSS purchases when shopping online compared to in-store, which may be due to differences in the shopping environment or experience, such as fewer promotions and advertisements when shopping online or not having to transport and carry purchases home. As higher-income households used OGDS more frequently, the implications of this sociodemographic pattern on dietary inequalities must be explored.
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Affiliation(s)
- Amy Yau
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Cherry Law
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Agri-Food Economics & Marketing, School of Agriculture, Policy and Development, University of Reading, Reading, United Kingdom
| | - Laura Cornelsen
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jean Adams
- Medical Research Council (MRC) Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Emma Boyland
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Thomas Burgoine
- Medical Research Council (MRC) Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), Bristol, United Kingdom
| | - Martin White
- Medical Research Council (MRC) Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Steven Cummins
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Grummon AH, Lee CJY, Robinson TN, Rimm EB, Rose D. Simple dietary substitutions can reduce carbon footprints and improve dietary quality across diverse segments of the US population. NATURE FOOD 2023; 4:966-977. [PMID: 37884673 PMCID: PMC10725296 DOI: 10.1038/s43016-023-00864-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 09/19/2023] [Indexed: 10/28/2023]
Abstract
Changing what foods we eat could reduce environmental harms and improve human health, but sweeping dietary change is challenging. We used dietary intake data from a nationally representative sample of 7,753 US children and adults to identify simple, actionable dietary substitutions from higher- to lower-carbon foods (for example, substituting chicken for beef in mixed dishes such as burritos, but making no other changes to the diet). We simulated the potential impact of these substitutions on dietary carbon emissions and dietary quality. If all consumers who ate the high-carbon foods instead consumed a lower-carbon substitute, the total dietary carbon footprint in the United States would be reduced by more than 35%. Moreover, if adopted, these substitutions would improve consumers' overall dietary quality by 4-10%, with benefits projected for all age, gender, and racial and ethnic groups. These results suggest that a 'small changes' approach could be a valuable starting point for addressing diet's impact on climate and health.
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Affiliation(s)
- Anna H Grummon
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.
- Department of Health Policy, Stanford University School of Medicine, Stanford, CA, USA.
| | - Cristina J Y Lee
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Thomas N Robinson
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
- Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Eric B Rimm
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Donald Rose
- Tulane Nutrition, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
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10
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Jansen LZH, Van Loo EJ, Bennin KE, van Kleef E. Exploring the role of decision support systems in promoting healthier and more sustainable online food shopping: A card sorting study. Appetite 2023; 188:106638. [PMID: 37331520 DOI: 10.1016/j.appet.2023.106638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/12/2023] [Accepted: 06/15/2023] [Indexed: 06/20/2023]
Abstract
This study aims to identify opportunities and barriers in developing and implementing Food Shopping Support Systems (FSSS) for healthier and more sustainable choices, given the growing consumer demand and persistent societal problems related to food. The study examined the social and technical value of FSSS in an early development stage through one-on-one expert interviews (n = 20) and consumer focus groups (4 groups, n = 19). Experts were employed in the fields of behavioral sciences, digital marketing, decision aids, software development, persuasive technologies, and public health and sustainability. Consumer participants were used to shopping online. Through a card sorting task followed by semi-structured interview questions, responses were elicited. Participants were presented with 17 cards in 5 rounds, each addressing a different topic related to decision support. Results show that support is perceived useful, particularly when suggestions are personalized, transparent, and justified (using labelling or informative text). Opportunities for uptake were presenting suggestions early in the shopping trip in a visible but non-disruptive manner, allowing autonomy to choose the type of guidance (e.g., show sustainable but not healthier suggestions) and to (not) provide personal data, and educating consumers. Negative attitudes were associated with support being disruptive or steering, being of low credibility, and unclarity about what is healthy or sustainable. Consumer participants expressed concerns about too generic suggestions in relation to health and lack of knowledge about labelling. They emphasized that excessive support and required effort, such as repeatedly providing data, can be burdensome. Experts also worried about limited consumer interest and not having the required data to provide support. Results from this study reveal the potential for successful digital interventions to encourage healthier and more sustainable choices and what this means for further development.
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Affiliation(s)
- Laura Z H Jansen
- Marketing and Consumer Behavior Group, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, the Netherlands; Information Technology Group, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, the Netherlands.
| | - Ellen J Van Loo
- Marketing and Consumer Behavior Group, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, the Netherlands
| | - Kwabena E Bennin
- Information Technology Group, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, the Netherlands
| | - Ellen van Kleef
- Marketing and Consumer Behavior Group, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, the Netherlands
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11
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Bianchi F, Luick M, Bandy L, Bone J, Kelly S, Farrington J, Leung J, Mottershow A, Murar F, Jebb SA, Harper H, Pechey R. The impact of altering restaurant and menu option position on food selected from an experimental food delivery platform: a randomised controlled trial. Int J Behav Nutr Phys Act 2023; 20:60. [PMID: 37208720 PMCID: PMC10197857 DOI: 10.1186/s12966-023-01456-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 04/24/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Overconsumption is one of the most serious public health challenges in the UK and has been linked to increased consumption of food ordered through delivery platforms. This study tested whether repositioning foods and/or restaurant options in a simulated food delivery platform could help to reduce the energy content of users' shopping basket. METHODS UK adult food delivery platform users (N = 9,003) selected a meal in a simulated platform. Participants were randomly allocated to a control condition (choices listed randomly) or to one of four intervention groups, (1) food options listed in ascending order of energy content, (2) restaurant options listed in ascending order of average energy content per main meal, (3) interventions 1 and 2 combined (4) interventions 1 and 2 combined, but food and restaurant options repositioned based on a kcal/price index to display options lower in energy but higher in price at the top. Gamma regressions assessed the impact of interventions on total energy content of baskets at checkout. RESULTS The energy content of participants' baskets in the control condition was 1382 kcals. All interventions significantly reduced energy content of baskets: Compared to control, repositioning both foods and restaurants purely based on energy content of options resulted in the greatest effect (-209kcal; 95%CIs: -248,-168), followed by repositioning restaurants (-161kcal; 95%CIs: -201,-121), repositioning restaurants and foods based on a kcal/price index (-117kcals; 95%CI: -158,-74) and repositioning foods based on energy content (-88kcals; 95%CI: -130,-45). All interventions reduced the basket price compared to the control, except for the intervention repositioning restaurants and foods based on a kcal/price index, which increased the basket price. CONCLUSIONS This proof-of-concept study suggests repositioning lower-energy options more prominently may encourage lower energy food choices in online delivery platforms and can be implemented in a sustainable business model.
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Affiliation(s)
| | - Madison Luick
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | - Lauren Bandy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Stefan Kelly
- Behavioural Insights Team, London, UK
- Nesta, London, UK
| | | | | | | | | | - Susan A Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Hugo Harper
- Behavioural Insights Team, London, UK
- Nesta, London, UK
| | - Rachel Pechey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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12
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Rummo PE, Roberto CA, Thorpe LE, Troxel AB, Elbel B. Effect of Financial Incentives and Default Options on Food Choices of Adults With Low Income in Online Retail Settings: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e232371. [PMID: 36897592 PMCID: PMC10789116 DOI: 10.1001/jamanetworkopen.2023.2371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
Importance Despite recent growth in online redemption of Supplemental Nutrition Assistance Program (SNAP) benefits, no previous work has tested the impact of economic and behavioral economic strategies on food purchasing behaviors in an online grocery retail setting among adults with low income. Objective To examine the extent to which financial incentives and default shopping cart options influence fruit and vegetable purchases. Design, Setting, and Participants This randomized clinical trial used an experimental online grocery store for adults who currently or have ever received SNAP benefits. From October 7 to December 2, 2021, participants were instructed to shop for a week's worth of groceries for their household, with a budget tailored to household size; no payment was taken. Interventions Random assignment to 1 of 4 conditions: no intervention, 50% discount on eligible fruits and vegetables, prefilled shopping carts with tailored fruit and vegetable items (ie, default options), or a combination of the discount and default options. Main Outcomes and Measures The primary outcome was the percentage of nondiscounted dollars spent on eligible fruit and vegetables per basket. Results Of 2744 participants, mean (SD) age was 46.7 (16.0) years, and 1447 (52.7%) identified as women. A total of 1842 participants (67.1%) reported currently receiving SNAP benefits and 1492 (54.4%) reported shopping online for groceries in the previous 12 months. Participants spent a mean (SD) 20.5% (23.5%) of total dollars on eligible fruits and vegetables. Compared with no intervention, those in the discount condition spent 4.7% (98.3% CI, 1.7%-7.7%) of more total dollars on eligible fruits and vegetables; those in the default condition, 7.8% (98.3% CI, 4.8%-10.7%) more; and those in the combination condition, 13.0% (98.3% CI, 10.0%-16.0%) more (P < .001 for all). There was no difference between the discount and the default conditions (P = .06), but the effect in the combination condition was significantly larger than both discount and default conditions (P < .001). Default shopping cart items were purchased by 679 participants (93.4%) in the default condition and 655 (95.5%) in the combination condition, whereas 297 (45.8%) in the control and 361 (52.9%) in the discount conditions purchased those items (P < .001). No variation was observed by age, sex, or race and ethnicity, and results were similar when those who reported never shopping online for groceries were excluded. Conclusions and Relevance In this randomized clinical trial, financial incentives for fruits and vegetables and default options, especially in combination, led to meaningful increases in online fruit and vegetable purchases among adults with low income. Trial Registration ClinicalTrials.gov Identifier: NCT04766034.
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Affiliation(s)
- Pasquale E. Rummo
- Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | | | - Lorna E. Thorpe
- Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | - Andrea B. Troxel
- Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | - Brian Elbel
- Department of Population Health, New York University Grossman School of Medicine, New York, NY
- Wagner Graduate School of Public Service, New York University, New York, NY
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13
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Zhuo S, Ratajczak M, Thornton K, Jones P, Jarchlo AI, Gold N. Testing the impact of overt and covert ordering interventions on sustainable consumption choices: A randomised controlled trial. Appetite 2023; 181:106368. [PMID: 36356913 DOI: 10.1016/j.appet.2022.106368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/21/2022] [Accepted: 11/05/2022] [Indexed: 11/09/2022]
Abstract
Food products have significant impacts on the environment over their life cycle. We investigated whether displaying products in ascending order of carbon footprint in an online supermarket environment can shift consumer choices towards more sustainable options. We examined whether the effect of the ordering intervention differs when the ordering is overt (information about the ordering is explicit), compared to when it is covert (participants not told about the ordering). We conducted a three-arm parallel-group randomised trial using 1842 online participants from England, Wales, and Northern Ireland. Participants shopped for a meal, choosing one product from each of six product categories in a simulated online supermarket. Six products were listed vertically on each product-category page. Products were randomly ordered for the control arm but ordered by carbon footprint in the covert and overt ordering arms. In the overt ordering arm, a statement was displayed at the top of each product page about the ordering of products. The primary outcome was whether one of the three most sustainable products was chosen in each product category. There was no effect of the covert ordering on the probability of choosing more sustainable products compared with the control arm (OR = 0.97, 95% CI 0.88-1.07, p = 0.533). Furthermore, we did not find evidence that the effects of the covert ordering and overt ordering differed (p = 0.594). Within the control condition, products in different positions were chosen with similar frequencies, suggesting that product positioning does not have an impact on choices. This may explain why re-ordering products had no effect. In the overt condition, only 19.5% of people correctly answered that the products were ordered according to sustainability in a follow-up question, suggesting that they didn't notice the statement. Results suggest that choices for grocery products might be too ingrained to be changed by subtle rearrangements of choice architecture like the ordering interventions, and highlight the difficulty of conveying information effectively to consumers in the online grocery shopping environment.
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Affiliation(s)
- Shi Zhuo
- Behavioural Practice, Kantar Public UK: 4 Millbank, London, SW1P 3JA, United Kingdom.
| | - Michael Ratajczak
- Behavioural Practice, Kantar Public UK: 4 Millbank, London, SW1P 3JA, United Kingdom; Department of Linguistics and English Language, Lancaster University, LA1 4YL, United Kingdom
| | - Katie Thornton
- Behavioural Practice, Kantar Public UK: 4 Millbank, London, SW1P 3JA, United Kingdom
| | - Phil Jones
- Social Science Team, Food Standards Agency: Clive House, 70 Petty France, London, SW1H 9EX, United Kingdom
| | - Ayla Ibrahimi Jarchlo
- Social Science Team, Food Standards Agency: Clive House, 70 Petty France, London, SW1H 9EX, United Kingdom
| | - Natalie Gold
- Behavioural Practice, Kantar Public UK: 4 Millbank, London, SW1P 3JA, United Kingdom; Centre for Philosophy of Natural and Social Science (CPNSS), London School of Economics, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, United Kingdom
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14
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Liang D, Wu F, Zhou D, Tan B, Chen T. Commercial probiotic products in public health: current status and potential limitations. Crit Rev Food Sci Nutr 2023; 64:6455-6476. [PMID: 36688290 DOI: 10.1080/10408398.2023.2169858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Consumption of commercial probiotics for health improvement and disease treatment has increased in popularity among the public in recent years. The local shops and pharmacies are brimming with various probiotic products such as probiotic food, dietary supplement and pharmaceuticals that herald a range of health benefits, from nutraceutical benefits to pharmaceutical effects. However, although the probiotic market is expanding rapidly, there is increasing evidence challenging it. Emerging insights from microbiome research and public health demonstrate several potential limitations of the natural properties, regulatory frameworks, and market consequences of commercial probiotics. In this review, we highlight the potential safety and performance issues of the natural properties of commercial probiotics, from the genetic level to trait characteristics and probiotic properties and further to the probiotic-host interaction. Besides, the diverse regulatory frameworks and confusing probiotic guidelines worldwide have led to product consequences such as pathogenic contamination, overstated claims, inaccurate labeling and counterfeit trademarks for probiotic products. Here, we propose a plethora of available methods and strategies related to strain selection and modification, safety and efficacy assessment, and some recommendations for regulatory agencies to address these limitations to guarantee sustainability and progress in the probiotic industry and improve long-term public health and development.
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Affiliation(s)
- Dingfa Liang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, PR China
- Queen Mary School, Nanchang University, Nanchang, China
| | - Fei Wu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, PR China
| | - Dexi Zhou
- National Engineering Research Centre for Bioengineering Drugs and Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, China
| | - Buzhen Tan
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, PR China
| | - Tingtao Chen
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, PR China
- National Engineering Research Centre for Bioengineering Drugs and Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, China
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15
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Potter C, Pechey R, Clark M, Frie K, Bateman PA, Cook B, Stewart C, Piernas C, Lynch J, Rayner M, Poore J, Jebb SA. Effects of environmental impact labels on the sustainability of food purchases: Two randomised controlled trials in an experimental online supermarket. PLoS One 2022; 17:e0272800. [PMID: 36327277 PMCID: PMC9632881 DOI: 10.1371/journal.pone.0272800] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 07/26/2022] [Indexed: 11/06/2022] Open
Abstract
Providing consumers with product-specific environmental impact information for food products (ecolabels) may promote more sustainable purchasing, needed to meet global environmental targets. Two UK studies investigated the effectiveness of different ecolabels using an experimental online supermarket platform. Study 1 (N = 1051 participants) compared three labels against control (no label), while Study 2 (N = 4979) tested four designs against control. Study 1 found significant reductions in the environmental impact score (EIS) for all labels compared to control (labels presented: values for four environmental indicators [-3.9 percentiles, 95%CIs: -5.2,-2.6]; a composite score [taking values from A to E; -3.9, 95%CIs: -5.2,-2.5]; or both together [-3.2, 95%CIs: -4.5,-1.9]). Study 2 showed significant reductions in EIS compared to control for A-E labels [-2.3, 95%CIs: -3.0,-1.5], coloured globes with A-E scores [-3.2, 95%CIs:-3.9,-2.4], and red globes highlighting 'worse' products [-3.2, 95%CIs:-3.9,-2.5]. There was no evidence that green globes highlighting 'better' products were effective [-0.5, 95%CIs:-1.3,0.2]. Providing ecolabels is a promising intervention to promote the selection of more sustainable products.
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Affiliation(s)
- Christina Potter
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Oxford, United Kingdom
| | - Rachel Pechey
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Oxford, United Kingdom
| | - Michael Clark
- Oxford Martin Programme on the Future of Food and Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Department of Zoology, University of Oxford, Oxford, United Kingdom
- School of Geography & Environment, University of Oxford, Oxford, United Kingdom
- Smith School of Enterprise and Environment, University of Oxford, Oxford, United Kingdom
| | - Kerstin Frie
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Oxford, United Kingdom
| | - Paul A. Bateman
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Oxford, United Kingdom
| | - Brian Cook
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Oxford, United Kingdom
| | - Cristina Stewart
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Oxford, United Kingdom
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Oxford, United Kingdom
| | - John Lynch
- Department of Physics, University of Oxford, Clarendon Laboratory, Oxford, United Kingdom
| | - Mike Rayner
- Oxford Martin Programme on the Future of Food and Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Joseph Poore
- Department of Zoology, University of Oxford, Oxford, United Kingdom
- School of Geography & Environment, University of Oxford, Oxford, United Kingdom
| | - Susan A. Jebb
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Oxford, United Kingdom
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16
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Çoker EN, Jebb SA, Stewart C, Clark M, Pechey R. Perceptions of social norms around healthy and environmentally-friendly food choices: Linking the role of referent groups to behavior. Front Psychol 2022; 13:974830. [PMID: 36312106 PMCID: PMC9611198 DOI: 10.3389/fpsyg.2022.974830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
Referent groups can moderate the perception of social norms and individuals' likelihood to model these norms in food choice contexts, including vegetable intake and reduced meat consumption. The present study investigated whether having a close vs. a distant social group as the referent changed perceptions of social norms around making healthy and eco-friendly food choices. It also assessed whether these changes were associated with a difference in the health and environmental impacts of food choice in a virtual grocery shopping task. A nationally representative sample of UK adults (N = 2,488) reported their perceptions of making healthy and eco-friendly food choices being the norm among people they share meals with (close referent group) and most people in the UK (distant referent group). The former was more commonly perceived to be making both healthy (Z = -12.0, p < 0.001) and eco-friendly (Z = -13.27, p < 0.001) food choices than the latter. Perceptions of norms referring to the close group were significantly associated with the environmental (β = -0.90, 95% CIs: -1.49, -0.28) and health (β = -0.38 p < 0.05, 95% CIs: -0.68, -0.08) impacts of participants' food choices in a virtual shopping task. No such relationship was found for norms referring to the distant group for both environmental (β =0.43, p > 0.05, 95% CIs: -1.12, 0.25) and health (β = -0.06, p > 0.05, 95% CIs: -0.37, 0.25) impacts. Framing social norms around making healthy and eco-friendly food choices to refer to a close referent group may change their perceptions and ability to encourage sustainable and healthy food purchasing.
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Affiliation(s)
- Elif Naz Çoker
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Susan A. Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Cristina Stewart
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Michael Clark
- Oxford Martin School, University of Oxford, Oxford, United Kingdom
| | - Rachel Pechey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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17
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Valenčič E, Beckett E, Collins CE, Seljak BK, Bucher T. Digital nudging in online grocery stores: A scoping review on current p ractices and gaps. Trends Food Sci Technol 2022. [DOI: 10.1016/j.tifs.2022.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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18
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Breathnach S, Lally P, Llewellyn CH, Sutherland A, Koutoukidis DA. Strategies to reduce the energy content of foods pre-ordered for lunch in the workplace: a randomised controlled trial in an experimental online canteen. Int J Behav Nutr Phys Act 2022; 19:54. [PMID: 35550584 PMCID: PMC9096740 DOI: 10.1186/s12966-022-01257-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 02/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prompting employees to swap their usual lunches for lower-energy alternatives may help align energy intake with public health recommendations. We tested the effect of offering lower-energy swaps with and without physical activity calorie equivalent (PACE) information on the energy of lunches pre-ordered in an online hypothetical workplace canteen. METHODS UK employed adults (n = 2,150) were invited to hypothetically pre-order their lunch from the canteen through a custom-made online platform. They were randomised 1:1:1 to: (i) control: no swaps offered; (ii) lower-energy swaps offered; or (iii) lower-energy swaps offered with PACE information. The primary outcome was the total energy ordered using analysis of covariance and controlling for the energy content of the initial items ordered. Secondary outcomes were swap acceptance rate and intervention acceptability. RESULTS Participants were 54% female, had a mean age of 36.8 (SD = 11.6) and a BMI of 26.3 (SD = 5.6). Compared with an average 819 kcal energy ordered in the control, both the swaps and swaps + PACE interventions significantly reduced average energy ordered by 47 kcal (95% CI: -82 to -13, p = 0.003) and 66 kcal (95% CI: -100 to -31, p < 0.001), respectively. Compared with offering swaps only, the swaps + PACE intervention led to significantly higher swap acceptance (OR: 1.63, 95% CI: 1.27 to 2.09, p < 0.001) but did not significantly reduce energy ordered (-19 kcal, 95% CI: -53 to 16, p = 0.591). About 65% and 16% of intervention participants found the swap interventions acceptable and unacceptable, respectively, with the swaps + PACE intervention being considered more acceptable than swaps only (OR: 1.32, 95%CI: 1.09 to 1.60, p < 0.004). CONCLUSION Offering lower-energy swaps with or without PACE information reduced the energy of pre-ordered lunches experimentally. Both interventions hold promise for reducing the energy of purchased foods and drinks. Trial Registration As Predicted reference number: 56358, 22/01/21, https://aspredicted.org/pw2qr.pdf.
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Affiliation(s)
- Sarah Breathnach
- Research Department of Behavioural Science and Health, Faculty of Epidemiology & Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - Phillippa Lally
- Research Department of Behavioural Science and Health, Faculty of Epidemiology & Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Clare H Llewellyn
- Research Department of Behavioural Science and Health, Faculty of Epidemiology & Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Alex Sutherland
- Behavioural Insights Team, 4 Matthew Parker Street, SW1H 9NP, London, UK
| | - Dimitrios A Koutoukidis
- Nuffield Department of Primary Care Health Sciences, University of Oxford NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation, Oxford, Trust, UK
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Bunten A, Shute B, Golding SE, Charlton C, Porter L, Willis Z, Gold N, Saei A, Tempest B, Sritharan N, Arambepola R, Yau A, Chadborn T. Encouraging healthier grocery purchases online: A randomised controlled trial and lessons learned. NUTR BULL 2022; 47:217-229. [DOI: 10.1111/nbu.12552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 03/28/2022] [Accepted: 04/06/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Amanda Bunten
- Public Health England Behavioural Insights Public Health England London UK
- GSK London UK
| | | | - Sarah E. Golding
- Public Health England Behavioural Insights Public Health England London UK
- School of Hospitality & Tourism Management University of Surrey Guildford UK
| | - Caroline Charlton
- Public Health England Behavioural Insights Public Health England London UK
| | - Lucy Porter
- Public Health England Behavioural Insights Public Health England London UK
| | | | - Natalie Gold
- Public Health England Behavioural Insights Public Health England London UK
- Behavioural Practice Kantar Public London UK
- Centre for Philosophy of Natural and Social Science London School of Economics London UK
| | - Ayoub Saei
- Public Health England Behavioural Insights Public Health England London UK
| | | | | | - Rohan Arambepola
- Public Health England Behavioural Insights Public Health England London UK
- Big Data Institute Li Ka Shing Centre for Health Information and Discovery University of Oxford Oxford UK
| | - Amy Yau
- Public Health England Behavioural Insights Public Health England London UK
- Department of Public Health, Environments & Society London School of Hygiene & Tropical Medicine London UK
| | - Tim Chadborn
- Public Health England Behavioural Insights Public Health England London UK
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20
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Moran AJ, Headrick G, Perez C, Greatsinger A, Taillie LS, Zatz L, Bleich SN, Rimm EB, Khandpur N. Food marketing practices of major online grocery retailers in the United States, 2019-2020. J Acad Nutr Diet 2022; 122:2295-2310.e2. [DOI: 10.1016/j.jand.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 03/02/2022] [Accepted: 04/07/2022] [Indexed: 11/30/2022]
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21
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Chia M, Naim AN, Tay AS, Lim K, Lee CK, Yow SJ, Chen J, Common JE, Nagarajan N, Tham EH. Shared signatures and divergence in skin microbiomes of children with atopic dermatitis and their caregivers. J Allergy Clin Immunol 2022; 150:894-908. [DOI: 10.1016/j.jaci.2022.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 01/17/2022] [Accepted: 01/25/2022] [Indexed: 10/18/2022]
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22
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Headrick G, Khandpur N, Perez C, Taillie LS, Bleich SN, Rimm EB, Moran A. Content Analysis of Online Grocery Retail Policies and Practices Affecting Healthy Food Access. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:219-229. [PMID: 34920967 DOI: 10.1016/j.jneb.2021.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/14/2021] [Accepted: 09/16/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To describe policies and practices of online grocery retailers that may affect healthy food access, including retailers participating in the US Department of Agriculture's Supplemental Nutrition Assistance Program Online Purchasing Pilot. DESIGN Cross-sectional, quantitative content analysis of 21 online grocery retail websites from November 2019 to January 2020. MAIN OUTCOME MEASURES Data collected using a coding instrument capturing the presence of policies and practices related to (1) online purchasing and delivery access; (2) availability of features that allow price comparisons and provide nutrition information; and (3) data privacy. ANALYSIS Descriptive statistics for features, practices, and policies across online grocery retail websites. RESULTS Most retailers (95%) added fees to online orders. Among pilot retailers, 38% added ≥ 3 fees, and 50% required a minimum order > $15. Few retailers (29%) displayed Nutrition Facts Labels on all products, including 50% of pilot retailers. All retailers collected personal information from shoppers and automatically shared data with affiliated companies. CONCLUSIONS AND IMPLICATIONS High fees, limited access to nutrition information on retailer sites, and lack of data privacy are prevalent in online grocery retail settings, including among Online Purchasing Pilot retailers. Online retail practices may perpetuate disparities in healthy food access by discouraging use through fees and making nutritious food choices difficult.
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Affiliation(s)
- Gabby Headrick
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
| | - Neha Khandpur
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
| | - Crystal Perez
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Lindsey Smith Taillie
- Department of Nutrition, UNC Gillings School of Global Public Health, Caroline Population Center, University of North Carolina, Chapel Hill, NC
| | - Sara N Bleich
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Eric B Rimm
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Alyssa Moran
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Stuber JM, Lakerveld J, Kievitsbosch LW, Mackenbach JD, Beulens JWJ. Nudging customers towards healthier food and beverage purchases in a real-life online supermarket: a multi-arm randomized controlled trial. BMC Med 2022; 20:10. [PMID: 35034635 PMCID: PMC8762859 DOI: 10.1186/s12916-021-02205-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/03/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Nudging is increasingly used to promote healthy food choices in supermarkets. Ordering groceries online is gaining in popularity and nudging seems efficacious there as well, but is never comprehensively tested in real-life. We evaluated the real-life effectiveness of nudging in an online supermarket on healthy food purchases. METHODS We conducted a multi-arm, parallel-group, individually randomized controlled trial in an online supermarket. During 1 month, all customers were randomized to (1) control condition, (2) information nudges, (3) position nudges, and (4) information and position nudges combined. Allocation was concealed and customers were not blinded, but unaware of the intervention. Mean differences between the control condition and the intervention arms in the total percentage of healthy purchases were assessed with a linear mixed model. We tested for effect modification by area-level deprivation. RESULTS Based on sales data from 11,775 shoppers, no overall significant effects were detected. Yet, effects were modified by area-level deprivation (pArm 2 < 0.001). Among shoppers from deprived areas, those allocated to information nudges purchased a 2.4% (95%CI 0.8, 4.0) higher percentage of healthy products compared to controls. No significant differences were observed for position (- 1.3%; 95%CI - 2.8, 0.3) and combined nudges (- 0.1%; 95%CI - 1.7, 1.5). Shoppers from non-deprived areas exposed to information nudges (- 1.6%; 95%CI - 3.2, - 0.1) and the combined nudges (- 2.1%; 95%CI - 3.6, - 0.6), but not position nudges (- 0.9%; 95%CI - 2.4, 0.7), purchased a lower percentage of healthy products. CONCLUSION Information nudges in an online supermarket can increase healthy product purchases, but only for those living in deprived areas. The adverse effects found on purchasing behaviors for those from non-deprived areas call for further research. Further research should also focus on real-life effects of online healthy food nudging as part of a broader nutrition intervention strategy, and on the equitability of the online nudging intervention within populations. TRIAL REGISTRATION Retrospectively registered in the ISRCTN registry at May 21, 2021 ( ISRCTN10491616 ).
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Affiliation(s)
- Josine M Stuber
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands.
- Upstream Team, www.upstreamteam.nl, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands.
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
- Upstream Team, www.upstreamteam.nl, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
| | - Loes W Kievitsbosch
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
| | - Joreintje D Mackenbach
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
- Upstream Team, www.upstreamteam.nl, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
| | - Joline W J Beulens
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
- Upstream Team, www.upstreamteam.nl, Amsterdam UMC, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, Netherlands
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Gustafson A, Gillespie R, DeWitt E, Cox B, Dunaway B, Haynes-Maslow L, Steeves EA, Trude ACB. Online Pilot Grocery Intervention among Rural and Urban Residents Aimed to Improve Purchasing Habits. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:871. [PMID: 35055688 PMCID: PMC8775883 DOI: 10.3390/ijerph19020871] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 02/05/2023]
Abstract
Online grocery shopping has the potential to improve access to food, particularly among low-income households located in urban food deserts and rural communities. The primary aim of this pilot intervention was to test whether a three-armed online grocery trial improved fruit and vegetable (F&V) purchases. Rural and urban adults across seven counties in Kentucky, Maryland, and North Carolina were recruited to participate in an 8-week intervention in fall 2021. A total of 184 adults were enrolled into the following groups: (1) brick-and-mortar "BM" (control participants only received reminders to submit weekly grocery shopping receipts); (2) online-only with no support "O" (participants received weekly reminders to grocery shop online and to submit itemized receipts); and (3) online shopping with intervention nudges "O+I" (participants received nudges three times per week to grocery shop online, meal ideas, recipes, Facebook group support, and weekly reminders to shop online and to submit itemized receipts). On average, reported food spending on F/V by the O+I participants was USD 6.84 more compared to the BM arm. Online shopping with behavioral nudges and nutrition information shows great promise for helping customers in diverse locations to navigate the increasing presence of online grocery shopping platforms and to improve F&V purchases.
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Affiliation(s)
- Alison Gustafson
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, KY 40506, USA; (B.C.); (B.D.)
| | - Rachel Gillespie
- Department of Family and Consumer Sciences Extension, University of Kentucky, Lexington, KY 40506, USA; (R.G.); (E.D.)
| | - Emily DeWitt
- Department of Family and Consumer Sciences Extension, University of Kentucky, Lexington, KY 40506, USA; (R.G.); (E.D.)
| | - Brittany Cox
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, KY 40506, USA; (B.C.); (B.D.)
| | - Brynnan Dunaway
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, KY 40506, USA; (B.C.); (B.D.)
| | - Lindsey Haynes-Maslow
- Agricultural & Human Sciences, North Carolina State University, Raleigh, NC 27695, USA;
| | | | - Angela C. B. Trude
- Department of Nutrition and Dietetics, Steinhardt School of Culture, Education, and Human Development, New York University, New York City, NY 10003, USA;
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Jansen L, van Kleef E, Van Loo EJ. The use of food swaps to encourage healthier online food choices: a randomized controlled trial. Int J Behav Nutr Phys Act 2021; 18:156. [PMID: 34863208 PMCID: PMC8642761 DOI: 10.1186/s12966-021-01222-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 10/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Online grocery stores offer opportunities to encourage healthier food choices at the moment that consumers place a product of their choice in their basket. This study assessed the effect of a swap offer, Nutri-Score labeling, and a descriptive norm message on the nutrient profiling (NP) score of food choices in an online food basket. Additionally explored was whether these interventions made it more motivating and easier for consumers to select healthier foods and whether potential effects were moderated by consumer health interest. METHODS Hypotheses were tested with a randomized controlled trial (RCT) in a simulated online supermarket. Dutch participants (n = 550) chose their preferred product out of six product options for four different categories (breakfast cereals, crackers, pizza, and muesli bars). Participants were randomly allocated to one of eight groups based on the interventions in a 2 (Nutri-Score: present, not present) X 2 (swap offer: present, not present) X 2 (norm message: present, not present) between subject design. The primary outcome was the difference in combined NP score of product choices, for which a lower score represented a healthier product. RESULTS Swap offer (B = - 9.58, 95% CI: [- 12.026; - 7.132], Ƞ2 = 0.098) and Nutri-Score labeling (B = - 3.28, 95% CI: [- 5.724; -.829], Ƞ2 = 0.013) significantly improved the combined NP score compared to the control condition (NP score M = 18.03, SD = 14.02), whereas a norm message did not have a significant effect (B = - 1.378, 95% CI [- 3.825; 1.070], Ƞ2 = 0.002). No evidence was found that interventions made it more motivating or easier for consumers to select healthier food, but situational motivation significantly influenced the healthiness score of food choices for both swap offer (b = - 3.40, p < .001) and Nutri-Score (b = - 3.25, p < .001). Consumer health interest only significantly moderated the influence of Nutri-Score on ease of identifying the healthy food option (b = .23, p = .04). CONCLUSIONS Swap offer and Nutri-Score labeling were effective in enhancing healthy purchase behavior in the online store environment. TRIAL REGISTRATION This study was retrospectively registered in the ISRCTN database on 02-09-2021 ( ISRCTN80519674 ).
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Affiliation(s)
- Laura Jansen
- Marketing and Consumer Behaviour Group, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, the Netherlands
| | - Ellen van Kleef
- Marketing and Consumer Behaviour Group, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, the Netherlands
| | - Ellen J Van Loo
- Marketing and Consumer Behaviour Group, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, the Netherlands.
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A Standardized Guide to Developing an Online Grocery Store for Testing Nutrition-Related Policies and Interventions in an Online Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094527. [PMID: 33923246 PMCID: PMC8123213 DOI: 10.3390/ijerph18094527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/19/2021] [Accepted: 04/22/2021] [Indexed: 01/30/2023]
Abstract
Simulated online grocery store platforms are innovative tools for studying nutrition-related policies and point-of-selection/point-of-purchase interventions in online retail settings, yet there is no clear guidance on how to develop these platforms for experimental research. Thus, we created a standardized guide for the development of an online grocery store, including a detailed description of (1) methods for acquiring and cleaning online grocery store data, and (2) how to design a two-dimensional online grocery store experimental platform. We provide guidance on how to address product categorization, product order/sorting and product details, including how to identify outliers and conflicting nutritional information and methods for standardizing prices. We also provide details regarding our process of “tagging” food items that can be leveraged by future studies examining policies and point-of-selection/point-of-purchase interventions targeting red and processed meat and fruits and vegetables. We experienced several challenges, including obtaining accurate and up-to-date product information and images, and accounting for the presence of store-brand products. Regardless, the methodology described herein will enable researchers to examine the effects of a wide array of nutrition-related policies and interventions on food purchasing behaviors in online retail settings, and can be used as a template for reporting procedures in future research.
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Lee CL, Aveyard PN, Jebb SA, Piernas C. Using Supermarket Loyalty Card Data to Provide Personalised Advice to Help Reduce Saturated Fat Intake among Patients with Hypercholesterolemia: A Qualitative Study of Participants' Experiences. Nutrients 2021; 13:nu13041146. [PMID: 33807150 PMCID: PMC8066863 DOI: 10.3390/nu13041146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/25/2021] [Accepted: 03/25/2021] [Indexed: 11/18/2022] Open
Abstract
Background: The ‘Primary Care SHOPping Intervention for Cardiovascular Disease Prevention’ (PCSHOP) trial tested the effectiveness and feasibility of a behavioural intervention to reduce saturated fat in food purchases. The intervention offered feedback from data collected through a supermarket loyalty card to supplement brief advice from a nurse. This qualitative study aimed to describe participants’ experiences of receiving this intervention. Methods: We conducted semi-structured, one-to-one, telephone interviews with participants from the PCSHOP trial. Interviews were audio-recorded and transcribed verbatim. We employed the one sheet of paper technique and a thematic analysis to develop high-level themes in NVivo software. Results: Twenty-four participants were interviewed (mean age: 63 years (SD 12)). They reported that the brief advice did not provide any new information but they welcomed the sense of accountability the nurse provided. The personalised shopping feedback and healthier swap suggestions provided novel information that challenged previously held beliefs about the saturated fat content of food purchases and encouraged some positive dietary changes. However, the taste preferences of the participant or other household members were a barrier to changing food shopping behaviours. Conclusion: Harnessing loyalty card data is a novel and acceptable method to offering personalised dietary feedback. Yet, issues on the suitability of the healthier swap suggestions limited the extent of dietary change. Trial registration: ISRCTN14279335. Registered 1 September 2017.
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Affiliation(s)
- Charlotte L. Lee
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK; (C.L.L.); (P.N.A.); (S.A.J.)
- Oxford Biomedical Research Centre, National Institute for Health Research, Oxford OX2 6GG, UK
| | - Paul N. Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK; (C.L.L.); (P.N.A.); (S.A.J.)
- Oxford Biomedical Research Centre, National Institute for Health Research, Oxford OX2 6GG, UK
| | - Susan A. Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK; (C.L.L.); (P.N.A.); (S.A.J.)
- Oxford Biomedical Research Centre, National Institute for Health Research, Oxford OX2 6GG, UK
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK; (C.L.L.); (P.N.A.); (S.A.J.)
- Correspondence: ; Tel.: +44-18-6528-9284
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Harnack L, Redden J, French S, Sherwood NE, Rivera G, Valluri S, Tahir M. Designing online grocery stores to support healthy eating for weight loss. Public Health Nutr 2021; 25:1-11. [PMID: 33634775 PMCID: PMC8387504 DOI: 10.1017/s1368980021000896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/01/2021] [Accepted: 02/23/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The current study aimed to identify features to include in online grocery stores to support healthful food purchasing by those striving to lose weight. DESIGN A Value Proposition Design approach was used to gain shopper insights, devise potential online grocery store features and obtain feedback on these features. SETTING Telephone interviews were conducted to gain insight into shoppers' needs and perceptions. Results were used by the research team to identify potential online grocery shopping features that may support healthful purchase decisions, and interviews were conducted with a different sample of shoppers to gather feedback on features. PARTICIPANTS Insight (n 25) and feedback (n 25) interviews were conducted with convenience samples of adults trying to lose weight. RESULTS Participants were primarily female, white, college educated and with obesity or overweight. Online grocery features devised by the research team based on findings from the insight interviews included (1) shopping cart nutrition rating tool; (2) healthy meal planning tool; (3) interactive healthy eating inspiration aisle and (4) healthy shopping preference settings option. Findings from the feedback interviews indicated that the healthy meal planning tool, healthy shopping preference settings option and shopping cart nutrition rating tool features were positively rated by most participants. CONCLUSIONS There are multiple features grocers should consider including in their online stores to attract and support customers striving to eat healthy for weight loss.
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Affiliation(s)
- Lisa Harnack
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St., Suite 300, Minneapolis, MN 55454, USA
| | - Joseph Redden
- Carlson School of Management, University of Minnesota, Minneapolis, MN, USA
| | - Simone French
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St., Suite 300, Minneapolis, MN 55454, USA
| | - Nancy E Sherwood
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St., Suite 300, Minneapolis, MN 55454, USA
| | - Gabrielle Rivera
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St., Suite 300, Minneapolis, MN 55454, USA
| | - Sruthi Valluri
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St., Suite 300, Minneapolis, MN 55454, USA
| | - Muna Tahir
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd St., Suite 300, Minneapolis, MN 55454, USA
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A randomised experiment of health, cost and social norm message frames to encourage acceptance of swaps in a simulation online supermarket. PLoS One 2021; 16:e0246455. [PMID: 33596251 PMCID: PMC7888673 DOI: 10.1371/journal.pone.0246455] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 01/19/2021] [Indexed: 12/11/2022] Open
Abstract
Offering lower-energy food swaps to customers of online supermarkets could help to decrease energy (kcal) purchased and consumed. However, acceptance rates of such food swaps tend to be low. This study aimed to see whether framing lower-energy food swaps in terms of cost savings or social norms could improve likelihood of acceptance relative to framing swaps in terms of health benefits. Participants (n = 900) were asked to shop from a 12-item shopping list in a simulation online supermarket. When a target high-energy food was identified in the shopping basket at check-out, one or two lower-energy foods would be suggested as an alternative (a “swap”). Participants were randomised to only see messages emphasising health benefits (fewer calories), cost benefits (lower price) or social norms (others preferred this product). Data were analysed for 713 participants after exclusions. Participants were offered a mean of 3.17 swaps (SD = 1.50), and 12.91% of swaps were accepted (health = 14.31%, cost = 11.49%, social norms = 13.18%). Swap acceptance was not influenced by the specific swap frame used (all p > .170). Age was significantly and positively associated with swap acceptance (b = 0.02, SE = 0.00, p < .001), but was also associated with smaller decreases in energy change (b = 0.46, SE = .19, p = .014). Overall, offering swaps reduced both energy (kcal) per product (b = -9.69, SE = 4.07, p = .017) and energy (kcal) per shopping basket (t712 = 11.09, p < .001) from pre- to post-intervention. Offering lower-energy food swaps could be a successful strategy for reducing energy purchased by customers of online supermarkets. Future research should explore alternative solutions for increasing acceptance rates of such swaps.
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Breathnach S, Llewellyn CH, Koutoukidis DA, van Rugge CR, Sutherland A, Lally P. Experience of Using an Online Pre-Ordering System for A Workplace Canteen That Offers Lower-Energy Swaps: A Think-Aloud Study. Nutrients 2020; 12:nu12123878. [PMID: 33353077 PMCID: PMC7767311 DOI: 10.3390/nu12123878] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/10/2020] [Accepted: 12/15/2020] [Indexed: 11/16/2022] Open
Abstract
Online systems that allow employees to pre-order their lunch may help reduce energy intake. We investigated the acceptability of a pre-ordering website for a workplace canteen that prompts customers to swap to lower-energy swaps and the factors influencing swap acceptance. Employees (n = 30) placed a hypothetical lunch order through a pre-ordering website designed for their canteen while thinking aloud. Semi-structured interview questions supported data collection. Data were analysed using thematic analysis. Acceptability was generally high, but potentially context dependent. Practical considerations, such as reminders to pre-order, user-friendliness, provision of images of menu items and energy information while browsing, an ability to reserve pre-ordered meals, and a swift collection service facilitated acceptability. The restrictive timeframe within which orders could be placed, a lack of opportunity to see foods before ordering, and prompts to swap being perceived as threatening autonomy were barriers to acceptability. Swap acceptance was facilitated by the provision of physical activity calorie equivalents (PACE) information, and swap similarity in terms of taste, texture, and expected satiety as well as the perception that alternatives provided meaningful energy savings. Online canteen pre-ordering systems that prompt lower-energy swaps may be an acceptable approach to help reduce energy intake in the workplace.
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Affiliation(s)
- Sarah Breathnach
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Public Health, 1-19 Torrington Pl, Fitzrovia, University College London, London WC1E 7HB, UK; (S.B.); (C.H.L.)
- Behavioural Insights Team, 4 Matthew Parker Street, London SW1H 9NP, UK;
| | - Clare H. Llewellyn
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Public Health, 1-19 Torrington Pl, Fitzrovia, University College London, London WC1E 7HB, UK; (S.B.); (C.H.L.)
| | - Dimitrios A. Koutoukidis
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK;
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
| | - Christopher R. van Rugge
- Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands;
| | - Alex Sutherland
- Behavioural Insights Team, 4 Matthew Parker Street, London SW1H 9NP, UK;
| | - Phillippa Lally
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Public Health, 1-19 Torrington Pl, Fitzrovia, University College London, London WC1E 7HB, UK; (S.B.); (C.H.L.)
- Correspondence: ; Tel.: +44(0)20-7679-1691
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Marty L, Cook B, Piernas C, Jebb SA, Robinson E. Effects of Labelling and Increasing the Proportion of Lower-Energy Density Products on Online Food Shopping: A Randomised Control Trial in High- and Low-Socioeconomic Position Participants. Nutrients 2020; 12:nu12123618. [PMID: 33255579 PMCID: PMC7760499 DOI: 10.3390/nu12123618] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/12/2020] [Accepted: 11/17/2020] [Indexed: 01/22/2023] Open
Abstract
Reducing the energy density (ED) of product selections made during online supermarket food shopping has potential to decrease energy intake. Yet it is unclear which types of intervention are likely to be most effective and equitable. We recruited 899 UK adults of lower and higher socioeconomic position (SEP) who completed a shopping task in an online experimental supermarket. Participants were randomised in a 2 × 2 between-subjects design to test the effects of two interventions on the ED of shopping basket selections: labelling lower-ED products as healthier choices and increasing the relative availability of lower-ED products within a range (referred to as proportion). Labelling of lower-ED products resulted in a small but significant decrease (−4.2 kcal/100 g, 95% CIs −7.8 to −0.6) in the ED of the shopping basket. Increasing the proportion of lower-ED products significantly decreased the ED of the shopping basket (−17 kcal/100 g, 95% CIs −21 to −14). There was no evidence that the effect of either intervention was moderated by SEP. Thus, both types of intervention decreased the ED of foods selected in an online experimental supermarket. There was no evidence that the effectiveness of either intervention differed in people of lower vs. higher SEP.
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Affiliation(s)
- Lucile Marty
- Department of Psychological Sciences, University of Liverpool, Liverpool L69 7ZA, UK
- Correspondence: (L.M.); (E.R.)
| | - Brian Cook
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK; (B.C.); (C.P.); (S.A.J.)
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK; (B.C.); (C.P.); (S.A.J.)
| | - Susan A. Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK; (B.C.); (C.P.); (S.A.J.)
| | - Eric Robinson
- Department of Psychological Sciences, University of Liverpool, Liverpool L69 7ZA, UK
- Correspondence: (L.M.); (E.R.)
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Yoder AD, Proaño GV, Handu D. Retail Nutrition Programs and Outcomes: An Evidence Analysis Center Scoping Review. J Acad Nutr Diet 2020; 121:1866-1880.e4. [PMID: 33229206 DOI: 10.1016/j.jand.2020.08.080] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/05/2020] [Accepted: 08/18/2020] [Indexed: 02/06/2023]
Abstract
As nutrition-related diseases contribute to rising health care costs, food retail settings are providing a unique opportunity for registered dietitian nutritionists (RDNs) to address the nutritional needs of consumers. Food as Medicine interventions play a role in preventing and/or managing many chronic conditions that drive health care costs. The objective of this scoping review was to identify and characterize literature examining Food as Medicine interventions within food retail settings and across consumer demographics. An electronic literature search of 8 databases identified 11,404 relevant articles. Results from the searches were screened against inclusion criteria, and intervention effectiveness was assessed for the following outcomes: improvement in health outcomes and cost-effectiveness. One-hundred and eighty-six papers and 25 systematic reviews met inclusion criteria. Five categories surfaced as single interventions: prescription programs, incentive programs, medically tailored nutrition, path-to-purchase marketing, and personalized nutrition education. Multiple combinations of intervention categories, reporting of health outcomes (nutritional quality of shopping purchases, eating habits, biometric measures), and cost-effectiveness (store sales, health care dollar savings) also emerged. The intervention categories that produced both improved health outcomes and cost-effectiveness included a combination of incentive programs, personalized nutrition education, and path-to-purchase marketing. Food as Medicine interventions in the food retail setting can aid consumers in navigating health through diet and nutrition by encompassing the following strategic focus areas: promotion of health and well-being, managing chronic disease, and improving food security. Food retailers should consider the target population and desired focus areas and should engage registered dietitian nutritionists when developing Food as Medicine interventions.
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Pulker CE, Trapp GSA, Fallows M, Hooper P, McKee H, Pollard CM. Food Outlets Dietary Risk (FODR) assessment tool: study protocol for assessing the public health nutrition risks of community food environments. Nutr J 2020; 19:122. [PMID: 33183279 PMCID: PMC7663896 DOI: 10.1186/s12937-020-00641-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 11/02/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Availability and accessibility of nutritious foods can vary according to the food outlets present within a neighbourhood or community. There is increasing evidence that community food environments influence food choice, diet and the risk of diet-related chronic disease, however contemporary community food environments assessments (e.g. unhealthy fast food outlets versus healthy supermarkets or fruit and vegetable shops) may be too simplistic to accurately summarise the complexities of their impacts on food choice. This study protocol describes the development of the Food Outlets Dietary Risk (FODR) assessment tool for use by local government in Perth, Western Australia. METHODS Similar to food safety risk assessment, the FODR assessment tool rates the potential harmful public health nutrition impact of food outlets by identifying and characterising the issues, and assessing the risk of exposure. Scores are attributed to six public health nutrition attributes: 1) availability of nutrient-poor foods; 2) availability of nutritious foods; 3) acceptability and appeal; 4) accessibility; 5) type of business operation; and 6) complex food outlet considerations. Food retail outlets are then classified as having a low, medium, high or very high dietary risk based on their total score. DISCUSSION A local government administered tool to rate the public health nutrition risk of food outlets requires data which can be collected during routine assessments or sourced from the internet. The ongoing categorical classification of foods available within food outlets as either unhealthy or nutritious will require nutrition scientists' input. An objective risk assessment of the dietary impact of food retail outlets can guide local government planning, policies and interventions to create supportive community food environments. It is intended that locally relevant data can be sourced throughout Australia and in other countries to apply the local context to the FODR assessment tool. Utility and acceptability of the tool will be tested, and consultation with environmental health officers and public health practitioners will inform future iterations.
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Affiliation(s)
- Claire Elizabeth Pulker
- School of Public Health, Curtin University, Kent Street, GPO Box U1987, Perth, Western Australia 6845 Australia
- East Metropolitan Health Service, Kirkman House, 20 Murray Street, East Perth, Perth, Western Australia 6004 Australia
| | - Georgina S. A. Trapp
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia 6872 Australia
- School of Population and Global Health, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009 Australia
| | - Mark Fallows
- Department of Health of Western Australia, Perth, Western Australia 6004 Australia
| | - Paula Hooper
- School of Population and Global Health, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009 Australia
| | - Heather McKee
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia 6872 Australia
| | - Christina Mary Pollard
- School of Public Health, Curtin University, Kent Street, GPO Box U1987, Perth, Western Australia 6845 Australia
- East Metropolitan Health Service, Kirkman House, 20 Murray Street, East Perth, Perth, Western Australia 6004 Australia
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Piernas C, Aveyard P, Lee C, Tsiountsioura M, Noreik M, Astbury NM, Oke J, Madigan C, Jebb SA. Evaluation of an intervention to provide brief support and personalized feedback on food shopping to reduce saturated fat intake (PC-SHOP): A randomized controlled trial. PLoS Med 2020; 17:e1003385. [PMID: 33151934 PMCID: PMC7643942 DOI: 10.1371/journal.pmed.1003385] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 09/18/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Guidelines recommend reducing saturated fat (SFA) intake to decrease cardiovascular disease (CVD) risk, but there is limited evidence on scalable and effective approaches to change dietary intake, given the large proportion of the population exceeding SFA recommendations. We aimed to develop a system to provide monthly personalized feedback and healthier swaps based on nutritional analysis of loyalty card data from the largest United Kingdom grocery store together with brief advice and support from a healthcare professional (HCP) in the primary care practice. Following a hybrid effectiveness-feasibility design, we tested the effects of the intervention on SFA intake and low-density lipoprotein (LDL) cholesterol as well as the feasibility and acceptability of providing nutritional advice using loyalty card data. METHODS AND FINDINGS The Primary Care Shopping Intervention for Cardiovascular Disease Prevention (PC-SHOP) study is a parallel randomized controlled trial with a 3 month follow-up conducted between 21 March 2018 to 16 January2019. Adults ≥18 years with LDL cholesterol >3 mmol/L (n = 113) were recruited from general practitioner (GP) practices in Oxfordshire and randomly allocated to "Brief Support" (BS, n = 48), "Brief Support + Shopping Feedback" (SF, n = 48) or "Control" (n = 17). BS consisted of a 10-minute consultation with an HCP to motivate participants to reduce their SFA intake. Shopping feedback comprised a personalized report on the SFA content of grocery purchases and suggestions for lower SFA swaps. The primary outcome was the between-group difference in change in SFA intake (% total energy intake) at 3 months adjusted for baseline SFA and GP practice using intention-to-treat analysis. Secondary outcomes included %SFA in purchases, LDL cholesterol, and feasibility outcomes. The trial was powered to detect an absolute reduction in SFA of 3% (SD3). Neither participants nor the study team were blinded to group allocation. A total of 106 (94%) participants completed the study: 68% women, 95% white ethnicity, average age 62.4 years (SD 10.8), body mass index (BMI) 27.1 kg/m2 (SD 4.7). There were small decreases in SFA intake at 3 months: control = -0.1% (95% CI -1.8 to 1.7), BS = -0.7% (95% CI -1.8 to 0.3), SF = -0.9% (95% CI -2.0 to 0.2); but no evidence of a significant effect of either intervention compared with control (difference adjusted for GP practice and baseline: BS versus control = -0.33% [95% CI -2.11 to 1.44], p = 0.709; SF versus control = -0.11% [95% CI -1.92 to 1.69], p = 0.901). There were similar trends in %SFA based on supermarket purchases: control = -0.5% (95% CI -2.3 to 1.2), BS = -1.3% (95% CI -2.3 to -0.3), SF = -1.5% (95% CI -2.5 to -0.5) from baseline to follow-up, but these were not significantly different: BS versus control p = 0.379; SF versus control p = 0.411. There were small reductions in LDL from baseline to follow-up (control = -0.14 mmol/L [95% CI -0.48, 0.19), BS: -0.39 mmol/L [95% CI -0.59, -0.19], SF: -0.14 mmol/L [95% CI -0.34, 0.07]), but these were not significantly different: BS versus control p = 0.338; SF versus control p = 0.790. Limitations of this study include the small sample of participants recruited, which limits the power to detect smaller differences, and the low response rate (3%), which may limit the generalisability of these findings. CONCLUSIONS In this study, we have shown it is feasible to deliver brief advice in primary care to encourage reductions in SFA intake and to provide personalized advice to encourage healthier choices using supermarket loyalty card data. There was no evidence of large reductions in SFA, but we are unable to exclude more modest benefits. The feasibility, acceptability, and scalability of these interventions suggest they have potential to encourage small changes in diet, which could be beneficial at the population level. TRIAL REGISTRATION ISRCTN14279335.
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Affiliation(s)
- Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- * E-mail:
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Charlotte Lee
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Melina Tsiountsioura
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Michaela Noreik
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Nerys M. Astbury
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Jason Oke
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Claire Madigan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Susan A. Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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Olzenak K, French S, Sherwood N, Redden JP, Harnack L. How Online Grocery Stores Support Consumer Nutrition Information Needs. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:952-957. [PMID: 33039023 PMCID: PMC7538868 DOI: 10.1016/j.jneb.2020.07.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 07/14/2020] [Accepted: 07/18/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To evaluate the availability of nutrition-related information and features on leading online grocery store Web sites. METHODS Twelve US grocery Web sites were assessed to determine (1) if Nutrition Facts panel or ingredient statements were available for 26 food items; and (2) if options to filter or sort search results by nutrition-related food attributes were available. RESULTS Nutrition Facts panel and ingredient statement information were available for most foods for which this information is required on product packaging (85% of foods). Most stores offered the ability to filter food search results by a nutrition-related food attribute. The ability to sort search results by a nutrition attribute was not an option at any of the stores. CONCLUSIONS AND IMPLICATIONS Online grocery stores include a variety of nutrition-related features. However, the Nutrition Facts panel and ingredient statement information are not universally available for foods for which this information is required on product packaging.
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Affiliation(s)
- Kelly Olzenak
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.
| | - Simone French
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Nancy Sherwood
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Joseph P Redden
- Carlson School of Management, University of Minnesota, Minneapolis, MN
| | - Lisa Harnack
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
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