A Small Nudge for Better Health Through Reduced Salt Intake, Increased Vegetable Intake, and Smaller Portion Size
- Conditions
- Cardiovascular DiseaseObesity
- Interventions
- Behavioral: Nudged to eat smaller portionsBehavioral: Nudged to eat less added salt and more other seasoningsBehavioral: Nudged to avoid foods high in salt content, and to choose foods low in salt contentBehavioral: Nudged to eat more vegetablesBehavioral: Nudged to eat less calorie-dense food
- Registration Number
- NCT02808910
- Lead Sponsor
- LHL Helse
- Brief Summary
This study will investigate whether small changes (nudges) made in a cafeteria, where participants eat for 4 weeks, can improve their food behavior and health during the 4 weeks, and 6 weeks and 6 months after their stay. Half the participants will be exposed to one of four types of nudges (focused on reducing salt intake, increasing vegetable intake, reducing portion size, and a combination of these nudges), and half of the participants will eat in the cafeteria as it is currently, without modifications.
- Detailed Description
A healthy diet is an important pillar for public health and for the prevention of several lifestyle diseases (e.g. obesity, cardiovascular diseases). However, diet choices are often not conscious choices. While it may help to make individuals more aware of healthy options for example through education or nutrition labels, it remains difficult for many to eat healthy. The food environment in which choices are made has an impact on the choice. Smart design of the food environment may help individuals to make a healthier choice, by nudging them towards the healthier alternative, while not limiting the availability of the less healthy choice.
This study tests how these 'nudges' can affect food behavior and health of participants in a 4-week rehabilitation course at Feiring Heart clinic. Nudges will be implemented in the cafeteria at the clinic.
Three types of nudges will be tested:
* Salt nudge: aims to reduce salt (sodium) intake. Salt will be less easily available in the cafeteria, and other spices (without sodium) will be made easily available. Food in the buffet that is either very high or very low in salt will be labeled.
* Vegetable nudge: aims to increase vegetable intake. Names of the vegetable dishes in the buffet will be made more attractive, signs will be placed with reminders to eat more vegetables, and with visual indications of the percentage of vegetables that should be part of a meal.
* Portion size nudge: aims to decrease portion size. Smaller plates will be provided, and utensils for self-serving calorie-dense foods in the buffet will be smaller than normal.
* One period will also combine all the nudges described above.
Outcomes include measures of food intake during the 4-week rehabilitation course, and whether food habits 6 weeks and 6 months after the 4-week course have changed, compared to before the course. BMI will be monitored during the 4-week period and self-assessed in the 6 months after. Physical activity habits will be considered during the entire experimental period, and satisfaction with the cafeteria food and service will be monitored throughout to assess whether the nudges impact customer satisfaction.
Results are expected to be transferable to other heart clinics, and cafeterias in other institutions.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 144
- Participants should be part of the 4 week rehabilitation course at the Feiring heart clinic
- Participants should be willing and able to complete the necessary registration of food choices, and the relevant questionnaires
- None
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Portion size nudge Nudged to eat smaller portions The following changes will be made in the cafeteria: Smaller plates will replace the regular plates. Verbal and visual nudges to reduce portion size will be given. Utensils for self-serving calorie-dense foods in the buffet will be smaller than normal. Combined nudge Nudged to eat more vegetables All three nudges are combined in this intervention. Combined nudge Nudged to eat less calorie-dense food All three nudges are combined in this intervention. Combined nudge Nudged to eat less added salt and more other seasonings All three nudges are combined in this intervention. Combined nudge Nudged to avoid foods high in salt content, and to choose foods low in salt content All three nudges are combined in this intervention. Salt nudge Nudged to eat less added salt and more other seasonings The following changes will be made in the cafeteria: Salt will be placed in a corner of the buffet, rather than on each dining table. Other spices, without sodium, will be provided on the table. A sign will be placed on the table that nudges participants to try the other spices. Food in the buffet that is high in salt will be labeled with a negative-appearing symbol, and food in the buffet that is low in salt will be labeled with a positive symbol. Vegetable nudge Nudged to eat more vegetables The following changes will be made in the cafeteria: Names of the vegetable dishes in the buffet will be made more attractive. Signs will be placed with reminders to eat more vegetables. Signs will be placed with a visual indication of the percentage of a meal that should consist of vegetables. Portion size nudge Nudged to eat less calorie-dense food The following changes will be made in the cafeteria: Smaller plates will replace the regular plates. Verbal and visual nudges to reduce portion size will be given. Utensils for self-serving calorie-dense foods in the buffet will be smaller than normal. Salt nudge Nudged to avoid foods high in salt content, and to choose foods low in salt content The following changes will be made in the cafeteria: Salt will be placed in a corner of the buffet, rather than on each dining table. Other spices, without sodium, will be provided on the table. A sign will be placed on the table that nudges participants to try the other spices. Food in the buffet that is high in salt will be labeled with a negative-appearing symbol, and food in the buffet that is low in salt will be labeled with a positive symbol. Combined nudge Nudged to eat smaller portions All three nudges are combined in this intervention.
- Primary Outcome Measures
Name Time Method Change in BMI from start of intervention to end of intervention Measured at baseline at day 0 of intervention and at completion of intervention at day 28 of intervention) BMI is measured, and change in BMI between day 0 and day 28 is used.
Change in dietary habits 1 6 weeks after the 4 week intervention period Habits are compared with habits as listed before the start of the 4 week intervention period. Done through an online survey.
Change in dietary habits 2 6 months after the 4 week intervention period Habits are compared with habits as listed before the start of the 4 week intervention period. Done through an online survey.
- Secondary Outcome Measures
Name Time Method Dietary choices in cafeteria 1.1 Tuesday lunch meal during the first week of the intervention Participants make photos of their meal including drinks, and register any condiments or seasoning added
Dietary choices in cafeteria 1.2 Thursday lunch meal during the first week of the intervention Participants make photos of their meal including drinks, and register any condiments or seasoning added
Dietary choices in cafeteria 2.1 Tuesday lunch meal during the second week of the intervention Participants make photos of their meal including drinks, and register any condiments or seasoning added
Dietary choices in cafeteria 2.2 Thursday lunch meal during the second week of the intervention Participants make photos of their meal including drinks, and register any condiments or seasoning added
Dietary choices in cafeteria 3.1 Tuesday lunch meal during the third week of the intervention Participants make photos of their meal including drinks, and register any condiments or seasoning added
Dietary choices in cafeteria 4.1 Tuesday lunch meal during the fourth week of the intervention Participants make photos of their meal including drinks, and register any condiments or seasoning added
Dietary choices in cafeteria 3.2 Thursday lunch meal during the third week of the intervention Participants make photos of their meal including drinks, and register any condiments or seasoning added
Dietary choices in cafeteria 4.2 Thursday lunch meal during the fourth week of the intervention Participants make photos of their meal including drinks, and register any condiments or seasoning added
Trial Locations
- Locations (1)
LHL-klinikkene Feiring
🇳🇴Feiring, Norway