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

11275 Participants Needed

Trial Summary

What is the purpose of this trial?

To compare two added-sugar menu label--(1) red, icon-only, 150% of the menu text height and (2) black, icon-plus-text, 100% of the menu text height--to a no-label control on grams of added sugar ordered using two different added-sugar labeling thresholds: (1) ≥50% of Daily Value for added sugar (equivalent to ≥25g) and (2) ≥100% of Daily Value for added sugar (equivalent to ≥50g)

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 data supports the effectiveness of the treatment Added-sugar Menu Labels for dietary behavior?

Research shows that using added-sugar labels on menus can help people understand which foods are high in sugar, potentially leading them to choose these items less often. In a study, labels with icons and text were found to be more effective than no labels in increasing awareness of sugar content, suggesting that such labels could help reduce sugar consumption. ^{1 2 3 4 5}

Is it safe to participate in a study about menu labels for dietary behavior?

The studies on menu labels for dietary behavior, such as added-sugar warning labels, focus on understanding and influencing consumer choices rather than introducing any physical treatment or intervention. Therefore, they do not present any known safety risks to participants. ^{1 3 6 7 8}

How do added-sugar menu labels differ from other treatments for reducing sugar intake?

Added-sugar menu labels are unique because they aim to reduce sugar consumption by providing clear information on restaurant menus, helping people make informed choices about their food. Unlike other treatments that might involve dietary changes or medications, this approach focuses on increasing awareness and knowledge about the sugar content in menu items. ^{3 8 9 10 11}

Research Team

Jennifer Falbe, ScD, MPH

Principal Investigator

University of California, Davis

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

Consumers' Response to Sugar Label Formats in Packaged Foods: A Multi-Methods Study in Brazil. [2022]

2. United States 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. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Perceived effectiveness of added-sugar warning label designs for U.S. restaurant menus: An online randomized controlled trial. [2023]

4. Switzerland pubmed.ncbi.nlm.nih.gov

Evaluation of Food-Intake Behavior in a Healthy Population: Personalized vs. One-Size-Fits-All. [2021]

5. Netherlands pubmed.ncbi.nlm.nih.gov

Frequent Nutritional Feedback, Personalized Advice, and Behavioral Changes: Findings from the European Food4Me Internet-Based RCT. [2021]

6. England pubmed.ncbi.nlm.nih.gov

Do sugar warning labels influence parents' selection of a labeled snack for their children? A randomized trial in a virtual convenience store. [2023]

7. Netherlands pubmed.ncbi.nlm.nih.gov

Effects of Sugary Beverage Text and Pictorial Warnings: A Randomized Trial. [2023]

8. Netherlands pubmed.ncbi.nlm.nih.gov

Online RCT of Icon Added-Sugar Warning Labels for Restaurant Menus. [2023]

9. United States pubmed.ncbi.nlm.nih.gov

Choose beverages and foods to moderate your intake of sugars: the 2000 dietary guidelines for Americans--what's all the fuss about? [2022]

10. Switzerland pubmed.ncbi.nlm.nih.gov

Charting the Chronology of Research on Added Sugars: A Scoping Review and Evidence Map. [2023]

11. Switzerland pubmed.ncbi.nlm.nih.gov

Sources of Added Sugars in Young Children, Adolescents, and Adults with Low and High Intakes of Added Sugars. [2023]