Food Swaps for Healthy Eating

Overseen By Amanda B. Zeitlin, MPH

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Stanford University

Disqualifiers: Under 18, Reside outside US, others

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

Compensation: Varies

Number of Visits: 3

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how health and climate labels in an online grocery store can influence food choices. Participants will encounter various labels or swap suggestions to guide them toward healthier or more climate-friendly foods. The goal is to determine if these suggestions, including combined health and environment swaps, lead to better health and a smaller carbon footprint compared to shopping without guidance. Individuals living in the U.S., with internet access, and the ability to complete an English survey may be suitable candidates. As an unphased trial, this study provides a unique opportunity to contribute to research that could enhance both personal health and environmental sustainability.

Do I need to stop taking my current medications for this trial?

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

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research shows that simple changes in food choices benefit both health and the environment. Studies have found that suggesting healthier food options, or "health swaps," helps people make better eating decisions. This approach is safe because it involves choosing different foods rather than introducing new substances or medications.

Similarly, "climate swaps" encourage selecting products that are better for the environment. Although less research exists on the safety of climate swaps, they focus on promoting eco-friendly choices without health risks.

When health and climate swaps are combined, research suggests they improve both personal health and environmental impact. These swaps are safe because they involve choosing different foods, not adding new ones.

Overall, participating in a study involving these swaps is considered safe. The goal is to educate and guide choices positively. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it's exploring how simple food swaps can promote healthier eating, considering both health and environmental impacts. Unlike traditional dietary guidance that may focus solely on nutrition, this approach introduces "nutrition grades" and "climate grades" to food products. This dual perspective allows individuals to make informed choices that are better for their health and the planet. By suggesting alternatives that are superior in at least one grading aspect and not worse in the other, the trial aims to find out how these swaps can help people adopt more sustainable and nutritious diets.

What evidence suggests that this trial's treatments could be effective?

Research has shown that health swaps, like Nutri-Score labels, help people make healthier online shopping choices. For example, one study found that these swaps make healthier options more visible, leading to better nutrition choices. In this trial, participants may receive health swaps, climate swaps, or combined health and climate swaps. Climate swaps—such as choosing chicken instead of beef—can lower carbon footprints by up to 35% and also improve diets. Studies indicate that even simple swaps can have a significant environmental impact. Combining health and climate swaps enhances both nutrition and sustainability, allowing people to make choices that benefit their health and the planet. Specifically, these combined swaps have reduced carbon footprints and improved dietary health. ^{6 7 8 9 10}

Who Is on the Research Team?

Anna H. Grummon, PhD

Principal Investigator

Stanford School of Medicine

Are You a Good Fit for This Trial?

This trial is for individuals interested in making healthier and more environmentally sustainable food choices. Participants should be regular online grocery shoppers willing to receive recommendations for alternative products. Specific eligibility criteria are not provided, so generally healthy adults who shop online may apply.

Inclusion Criteria

Have internet access to complete the 3 online study visits

Reside in the United States

Exclusion Criteria

Reside outside of the United States

I do not have internet access for online study visits.

I am under 18 years old.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 week

Baseline Shopping Task

Participants complete an online grocery shopping task without intervention and complete a survey

1 week

1 online visit

Intervention

Participants are randomized to one of four conditions and complete a shopping task with or without labels and swap recommendations

1 week

1 online visit

Follow-up

Participants repeat the shopping task and survey in their assigned group

1 week

1 online visit

What Are the Treatments Tested in This Trial?

Interventions

• Combined health and environment swaps
• Control
• Environment swaps
• Health swaps

Trial Overview The study tests if suggesting healthier or eco-friendlier food swaps—or a combination of both—can improve the nutritional quality and sustainability of online grocery purchases compared to usual shopping without suggestions.

How Is the Trial Designed?

Group I: Health swaps Experimental Treatment 1 Intervention

Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.

Group II: Combined health and climate swaps Experimental Treatment 1 Intervention

Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.

Group III: Climate swaps Experimental Treatment 1 Intervention

Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.

Group IV: Control Active Control 1 Intervention

No labels or swaps.

Who Is Running the Clinical Trial?

Stanford University

Lead Sponsor

Trials

2,527

Recruited

17,430,000+

National Heart, Lung, and Blood Institute (NHLBI)

Collaborator

Trials

3,987

Recruited

47,860,000+

Citations

1. med.stanford.edu med.stanford.edu/news/all-news/2023/10/diet-carbon-health.html

Easy diet changes can lower carbon footprint, according to ... Researchers led by the Stanford School of Medicine have identified a set of simple food swaps that can make a big difference in an individual's carbon ...

2. sph.tulane.edu sph.tulane.edu/study-shows-simple-diet-swaps-can-cut-carbon-emissions-and-improve-your-health

Study shows simple diet swaps can cut carbon emissions and ... Simple swaps like switching from beef to chicken or plant-based milk can reduce carbon footprint by 35% and improve diet quality by 4-10%. One swap can be a ...

3. nature.com nature.com/articles/s43016-025-01218-8

Dish swap across a weekly menu can deliver health and ... Without students noticing, mathematically optimized menus achieved 30.7% and 6.3% reductions in carbon footprint and saturated fatty acid intake ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9388151/

Estimating the environmental impacts of 57000 food products Our analysis on similar foods shows that reducing food-related environmental impacts may be possible by food swaps between similar products (e. ...

5. abcnews.go.com abcnews.go.com/Health/small-swaps-climate-friendly-diet-significantly-reduce-carbon/story?id=104360020

'Small swaps' to climate-friendly diet can significantly reduce ... The study found that food swaps toward diets high in fruits, vegetables, and legumes and lower in red and processed meats can reduce a person's carbon ...

6. imf.org imf.org/-/media/Files/Publications/WP/2022/English/wpiea2022162-print-pdf.ashx

Debt-for-Climate Swaps: Analysis, Design, and ... Debt-for-climate swaps are partial debt relief conditional on debtor commitments to undertake climate-related investments.

7. climatepolicyinitiative.org climatepolicyinitiative.org/publication/debt-for-climate-swaps/debt-for-climate-swaps-blueprint-may-2021/

Debt for Climate Swaps A financial and skills package for labor and communities to just transition from coal to clean energy, or provision of an appropriate safety net for displaced ...

8. sciencedirect.com sciencedirect.com/science/article/pii/S2214845023001084

Does climate change affect sovereign credit risk ... The findings indicate that nations more susceptible to climate change experience higher sovereign credit risk, as evidenced by higher SCDS spreads.

9. igsd.org igsd.org/wp-content/uploads/2024/01/Background-Note-Debt-Swaps.pdf

Debt-for-Climate Swaps Debt-for-climate swaps involve debtor countries using local currency to fund climate projects instead of external payments, to address debt and climate issues.

10. home.treasury.gov home.treasury.gov/system/files/261/FSOC-Climate-Report.pdf

FSOC Report on Climate-Related Financial Risk The adverse effects of climate change disproportionately impact financially vulnerable populations, potentially including lower-income ...