Cardiovascular Disease, Obesity
Conditions
Keywords
behavior, food intake, salt, vegetables, portion size, weight loss, habits
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.
Interventions
BEHAVIORALNudged to eat less added salt and more other seasonings
BEHAVIORALNudged to avoid foods high in salt content, and to choose foods low in salt content
BEHAVIORALNudged to eat more vegetables
BEHAVIORALNudged to eat smaller portions
BEHAVIORALNudged to eat less calorie-dense food
Sponsors
NIBIO - Norwegian Institute of Bioeconomy Research
Norwegian University of Life Sciences
Animalia
LHL Helse
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 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
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 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. |
| 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. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 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 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 4.1 | 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 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 |
| 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 |
Other
| Measure | Time frame | Description |
|---|---|---|
| Customer satisfaction of the cafeteria through a survey | Once per week during the intervention, on day 3, 11, 18 and 25 of the intervention | A short questionnaire is answered by those eating in the cafeteria, regarding their satisfaction with the food and the cafeteria, to check that the nudges do not impact customer satisfaction negatively. Focus is on quality of the food, the available choices, and satisfaction with the cafeteria layout/atmosphere and staff. The survey is completed once per week. |
Countries
Norway
Outcome results
None listed