FoodFLIP: Testing the Effectiveness of a Food Information App to Promote the Selection of Healthier Foods

University of Toronto

Status: Completed

Conditions: Diet, Food, and Nutrition; Consumer Behavior

Treatments: Other: Nutrition Rating Systems

Study type: Interventional

Funder types: Other

Identifiers

NCT02814604

499174

Details and patient eligibility

About

There is a lot of confusion when it comes to understanding nutrition information on food packages, thus making it difficult for consumers to choose healthy products. In today's busy and fast-paced shopping environment, mobile digital technology (for example, Smartphone applications) can help consumers make 'healthier' food choices when they are shopping. This study aims to test the effectiveness of a traffic light front-of-pack system, the Health Star Rating System (HSR or Star System), and the proposed sodium, saturated fat and sugar warning labels proposed by Health Canada. The study will also experimentally test the use of a Smartphone application (app), FoodFlip, to help educate consumers on these systems on food packages to explore the impact of a learning effect on the efficacy of the labelling systems.

Full description

The rising rate of obesity and diet-related chronic diseases illustrate that Canadians' eating habits need to change. Equipping Canadians with information and tools to enable healthy food choices that decrease risk for disease is imperative. While the Nutrition Facts table (NFt) is the most standardized and complete form of nutrition labelling, studies have shown that consumers are confused about serving size, nutrient quantities, and the interpretation of the % Daily Value. Thus, expert groups have proposed the introduction of interpretive front-of-pack (FOP) nutrition rating systems (e.g. traffic light labelling or star ratings) that also help consumers understand the significance of the levels of nutrients in relation to the "healthiness" of a food. One of the main barriers to the introduction of such a system is the absence of high quality studies that objectively measure the impact of nutrition information on actual food purchases. This is a consequence of both the practical challenges associated with designing and conducting such studies in 'real-world' settings, and the lack of food industry support to quantitatively examine or publish the potential for enhanced nutrition labels to modify consumer food choices. With the growing burden of diet-related disease, there is an urgent need for robust evidence to evaluate the potential for additional interpretive nutrition labelling systems to modify and improve food purchasing patterns. Given the relative ubiquity of mobile digital technologies, our Canadian Smartphone application (FoodFLIP) provides us with an unprecedented opportunity to examine and improve consumers' diets.

This study will investigate whether a traffic light, a health star rating or a high-in warning label FOP system can help consumers identify and purchase healthier foods.

Objective 1: To evaluate the effects of three FOP systems in helping consumers characterize healthfulness and nutritional content of food items.

Objective 2: To determine which of the three FOP systems support healthier food choices and are preferred by Canadian consumers.

Enrollment: 2,008 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

• Shop at a supermarket owned by one of the largest four national retailers at least twice a month. This includes Loblaws, Sobeys, Metro or Safeway
• Own a smartphone (iPhone version 3 or later or android)
• Are 18 years or over and provide informed consent to participate
• Reside in Canada, excluding Northern Territories

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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2,008 participants in 4 patient groups

Traffic Light

Experimental group

Description:

Participants in this group will download an app which features the nutrition information of the selected product in a multiple coloured traffic light format (i.e. the traffic light system shows a coloured round indicator for each of saturated fat, sugar, and sodium; shaded red (high), amber (medium) or green (low), according to thresholds set for each nutrient). In addition, a list of healthier similar products will appear on screen to facilitate comparisons. Intervention: Device:Smartphone, Behavioural: Nutrition Rating Systems

Treatment:

Other: Nutrition Rating Systems

Health Star Rating System

Experimental group

Description:

Participants in this group will download an app which features the nutrition information of the selected product in a form of 0-5 stars to provide an overall "healthy" rating. The Health Star Rating provides a rating for all products and products not meeting the criteria still carry the symbol (with no colored stars). In addition, a list of healthier similar products will appear on screen to facilitate comparisons. Intervention: Device:Smartphone, Behavioural: Nutrition Rating Systems

Treatment:

Other: Nutrition Rating Systems

Control

No Intervention group

Description:

Participants in this group will only see the Nutrition Facts Table (as it appears on the product's package) when the product is scanned in the app.

High-in Warning Label

Experimental group

Description:

Participants in this group will download an app which features the nutrition information of the selected product in a 'high-in' warning label format (i.e. stop signs for each of saturated fat, sugar, and sodium; according to thresholds set for each nutrient). In addition, a list of healthier similar products will appear on screen to facilitate comparisons. Intervention: Device:Smartphone, Behavioural: Nutrition Rating Systems

Treatment:

Other: Nutrition Rating Systems