Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2020 Jul 20;12(7):2158.
doi: 10.3390/nu12072158.

The Effect of Dynamic Food Labels with Real-Time Feedback on Diet Quality: Results from a Randomized Controlled Trial

Soye Shin  1 , Rob M van Dam  2 , Eric A Finkelstein  1   2
Affiliations
Randomized Controlled Trial

The Effect of Dynamic Food Labels with Real-Time Feedback on Diet Quality: Results from a Randomized Controlled Trial

Soye Shin et al. Nutrients. .

Abstract

The rising prevalence of non-communicable diseases has brought attention to the importance of consuming a healthy diet. One strategy to improve diet quality is through front-of-pack (FOP) nutrition labels. Taking advantage of an online grocery store, we allowed consumers to choose the FOP labels they preferred, and combined this information with real-time feedback on the overall nutritional quality of the shopping basket. We hypothesized that these dynamic food labels with real-time feedback (DFLF) would improve nutritional quality of food purchases. This trial followed a two-arm (no-label control and DFLF) crossover design with 125 participants exposed to each condition once in random order via an online grocery store. A first difference regression model allowed for estimating the unbiased effect of the DFLF on diet quality, measured by the weighted average Nutri-Score (ranging 1 to 5) per serving (primary) and changes in select nutrients and calories. The mean weighted Nutri-Score was 0.4 (12.6%) higher in the DFLF arm (CI: [0.2, 0.6]) relative to the control. The DFLF also decreased the amount of sugar per serving by 0.9 g (CI: [-1.7, -0.0]) and total sugar per shop by 169.5 g (CI: [-284.5, -54.5]). The DFLF features significantly improved nutrition quality relative to no labelling, as measured by average Nutri-Score values. These results shed light on the considerable potential of the online shopping environment to improve diet quality through customization and real time feedback.

Keywords: Nutri-Score; diet quality; dynamic labels; front-of-pack labeling; nutrition labeling; online grocery store; real-time feedback.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
A screenshot of the product-reordering function by food labels. Note: The default food label was Nutri-Score.
Figure A2
Figure A2
Seven icons representing the seven different nutrient labels, respectively. Note: The active icon affecting the DFLF functions is colored in green. The active button in Figure A2 represents the Nutri-Score label.
Figure 1
Figure 1
Screenshots of the two versions of the NUSMart webpage: (A) control arm and (B) dynamic food labels with real-time feedback (DFLF) arm.
Figure 2
Figure 2
A screenshot of a dairy drink product listing with two different types of labels. (Left: Nutri-Score label. Right: saturated fat label).
Figure 3
Figure 3
A screenshot of a shopping basket summary along with MyCart Summary.
Figure 4
Figure 4
CONSORT flow diagram for participation recruitment and randomization.
See this image and copyright information in PMC

References

    1. Hall K.D., Ayuketah A., Brychta R., Cai H., Cassimatis T., Chen K.Y., Chung S.T., Costa E., Courville A., Darcey V., et al. Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metab. 2019;30:226. doi: 10.1016/j.cmet.2019.05.020. - DOI - PMC - PubMed
    1. Mendonça R.D.D., Pimenta A.M., Gea A., De La Fuente-Arrillaga C., Martínez-González M., Lopes A.C.S., Bes-Rastrollo M. Ultra-processed food consumption and risk of overweight and obesity: The University of Navarra Follow-Up (SUN) cohort study. Am. J. Clin. Nutr. 2016;104:1433–1440. doi: 10.3945/ajcn.116.135004. - DOI - PubMed
    1. Malik V.S., Popkin B.M., Bray G.A., Després J.-P., Hu F.B. Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk. Circulation. 2010;121:1356–1364. doi: 10.1161/CIRCULATIONAHA.109.876185. - DOI - PMC - PubMed
    1. Nseir W., Nassar F., Assy N.N. Soft drinks consumption and nonalcoholic fatty liver disease. World J. Gastroenterol. 2010;16:2579–2588. doi: 10.3748/wjg.v16.i21.2579. - DOI - PMC - PubMed
    1. Mozaffarian D., Katan M.B., Ascherio A., Stampfer M.J., Willett W.C. Trans Fatty Acids and Cardiovascular Disease. N. Engl. J. Med. 2006;354:1601–1613. doi: 10.1056/NEJMra054035. - DOI - PubMed

Publication types