Menu Labels for Dietary Behavior

Overseen By Jennifer Falbe

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, Davis

Disqualifiers: Failing attention check, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines how different menu labels influence ordering decisions, with a focus on added sugar. Researchers aim to determine if red or black labels with icons, some including text, affect the amount of added sugar people select. They compare these labeled menus to standard menus without labels. Individuals who dine out and are mindful of sugar intake may be suitable for this study. Participants must be English-speaking U.S. residents who have dined out at least once in the past month. As an unphased study, this trial provides a unique opportunity to contribute to research that could promote healthier dining choices.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that these menu labels are safe for dietary behavior studies?

Research has shown that using labels to indicate added sugar is safe. Studies have found that these labels can help people choose healthier foods without altering their total calorie intake. One study found that the labels reduced the likelihood of ordering high-sugar foods by 2.2%. This suggests that the labels are well-accepted and do not cause negative effects. Since this trial focuses on menu labels rather than medical treatments, safety concerns are minimal. The aim is to help people make better food choices, and current research supports this approach as safe. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores how different types of menu labels might influence people's food choices, specifically regarding added sugar intake. Unlike standard nutritional labels that provide comprehensive information, this trial tests the impact of eye-catching, simplified labels that highlight high added sugar content. By using large, red icons or smaller, black text-plus-icon labels, the study aims to determine which format is most effective at reducing added sugar consumption. This could lead to innovative ways to encourage healthier eating habits and help people make more informed dietary decisions.

What evidence suggests that this trial's menu label treatments could be effective in reducing added sugar consumption?

This trial will compare different types of added-sugar menu labels to assess their influence on dietary choices. Research has shown that labels indicating added sugar can encourage healthier choices. In this trial, some participants will see large, red, icon-only labels indicating either 50% or 100% of the daily value of added sugar, while others will see small, black, icon-plus-text labels for the same values. Studies have found that labels with icons or icons plus text are more effective than having no labels at all. These labels help people identify menu items high in added sugar, potentially leading to reduced sugar consumption. For instance, an online study demonstrated that these warning labels helped people understand the added sugar content in food items. While some studies have mixed results, the overall trend suggests that clear labeling can guide better eating habits. ^{2 3 4 6 7}

Who Is on the Research Team?

Jennifer Falbe, ScD, MPH

Principal Investigator

University of California, Davis

Are You a Good Fit for This Trial?

This trial is for U.S. residents who are at least 18 years old, speak English, and have eaten restaurant food in the past month. Participants will represent a diverse mix based on sex, race/ethnicity, education level, and age to match U.S. Census data.

Inclusion Criteria

I live in the U.S.

I have eaten food from a restaurant in the past month.

I represent the U.S. population in terms of sex, race/ethnicity, education, and age.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Intervention

Participants order food and beverages from menus with different added-sugar labels or no labels to assess the impact on grams of added sugar ordered

1 day

1 visit (in-person)

Follow-up

Participants' noticing and recall of added-sugar nutrient labels and knowledge of menu items high in added sugar are assessed

10 minutes

What Are the Treatments Tested in This Trial?

Interventions

• Added-sugar Menu Labels

Trial Overview

The study is testing two types of added-sugar labels on menus: one with a black icon only and another with red text plus an icon. They're looking at how these labels affect the amount of added sugar ordered using different labeling thresholds.

How Is the Trial Designed?

Group I: Small, black, icon-plus-text label, 50% daily value Experimental Treatment 1 Intervention

Participant will order food and beverages from three menus containing labels next to items that contain equal to or higher than half the daily value of added sugar (greater than or equal to 25 grams). The label will be on the right of the item, colored black, icon plus text design, and height that is 100% of size of the menu text height.

Group II: Small, black, icon-plus-text label, 100% daily value Experimental Treatment 1 Intervention

Participant will order food and beverages from three menus containing labels next to items that contain equal to or higher than the total daily value of added sugar (greater than or equal to 50 grams). The label will be on the right of the item, colored black, icon plus text design, and height that is 100% of size of the menu text height.

Group III: Large, red, icon-only label, 50% daily value Experimental Treatment 1 Intervention

Participant will order food and beverages from three menus containing labels next to items that contain equal to or higher than half the daily value of added sugar (greater than or equal to 25 grams). The label will be on the right of the item, colored red, icon only design, and height that is 150% of size of the menu text height.

Group IV: Large, red, icon-only label, 100% daily value Experimental Treatment 1 Intervention

Participant will order food and beverages from three menus containing labels next to items that contain equal to or higher than the total daily value of added sugar (greater than or equal to 50 grams). The label will be on the right of the item, colored red, icon only design, and height that is 150% of size of the menu text height.

Group V: Control Active Control 1 Intervention

Participant will order food and beverages from three menus. The menus will not contain any added sugar labels.

Who Is Running the Clinical Trial?

University of California, Davis

Lead Sponsor

Trials

958

Recruited

4,816,000+

Published Research Related to This Trial

A study involving 228 pediatric and family medicine clinic staff showed that training improved their knowledge about sugar-sweetened beverages and increased the acceptability of using a screener in electronic health records.

After implementing the screener, 47% of eligible pediatric patients were screened within 6 months, indicating that engaging healthcare staff in screening for sugary beverage consumption is feasible and can help address children's health risks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Staff Knowledge, Attitudes, and Beliefs About Child Sugar-Sweetened Beverage Intake and Acceptability of a Pediatric Clinic-Based Beverage Screener. Howell, BL., Skelton, JA., Jayaprakash, MS., et al.[2023]

In a study involving 155 participants aged 25 to 70, personalized nutrition advice (PNA) led to significant improvements in dietary intake, including increased consumption of fruits, whole grains, and fish, compared to those receiving generic nutrition advice (GNA) or no advice.

Setting personal dietary goals within the PNA group further enhanced positive changes in food choices, demonstrating that tailored advice and goal-setting can effectively promote healthier eating behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of Food-Intake Behavior in a Healthy Population: Personalized vs. One-Size-Fits-All. Hoevenaars, FPM., Berendsen, CMM., Pasman, WJ., et al.[2021]

In a 6-month randomized controlled trial with 1,125 participants, those receiving higher-frequency personalized nutritional feedback showed significantly greater improvements in diet quality and reductions in body weight and waist circumference at 3 months compared to those receiving lower-frequency feedback.

While the benefits in diet quality were not sustained, the reductions in body weight and BMI remained significant at 6 months, indicating that more frequent feedback can lead to meaningful changes in obesity-related traits over time.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Frequent Nutritional Feedback, Personalized Advice, and Behavioral Changes: Findings from the European Food4Me Internet-Based RCT. Celis-Morales, C., Livingstone, KM., Petermann-Rocha, F., et al.[2021]

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC9236625/

Perceived Effectiveness of Added-Sugar Warning Label ...

Icon-only and icon-plus-text added-sugar labels were perceived as more effective than control labels, helping consumers identify high-sugar items.

2.

clinicaltrials.gov

clinicaltrials.gov/study/NCT06666725?term=AREA%5BLocationSearch%5D(%22University%20of%20California,%20Davis%22)&rank=9

NCT06666725 | Effect of Added-sugar Menu Labels

The two primary outcomes are (1) grams of added sugar ordered averaged across a fast-food and full-service restaurant menus and (2) grams of added sugar ordered ...

3.

ajpmonline.org

ajpmonline.org/article/S0749-3797(23)00071-5/fulltext

Online RCT of Icon Added-Sugar Warning Labels for ...

This study examined the impacts of added-sugar warning labels on hypothetical choices, knowledge of items' added-sugar content, and perceptions of high-added- ...

4.

jamanetwork.com

jamanetwork.com/journals/jamanetworkopen/fullarticle/2834247

Traffic Light Labels and Dietary Behavior Change

In this randomized clinical trial, TLLs indicating added sugar, fat, and sodium ratings on menus failed to improve dietary consumption and choices in a company ...

5.

sciencedirect.com

sciencedirect.com/science/article/pii/S0195666325004611

“High-In” front-of-package labeling of foods high in added ...

A “High-In” front-of-package label, with separate labels for each nutrient, was the most efficacious at helping participants identify products ...

6.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC6340779/

A Meta-analysis of Food Labeling Effects on Consumer Diet ...

A pooled analysis of nine trials found that labeling systems increased selection of healthier products, but did not alter energy intake. In a meta-analysis of ...

7.

ucdavis.edu

ucdavis.edu/blog/warning-labels-restaurant-menus-reduced-likelihood-consumers-would-order-high-sugar-foods

Warning Labels on Restaurant Menus Reduced Likelihood ...

In a randomized controlled trial, researchers found that warning labels reduced the probability of ordering a high-added-sugar item by 2.2%.