Climate Impact Label Design and Fast-Food Meal Selection

Testing Climate Impact Menu Labels Influence on Nutrition Quality of Fast-Food Selections: A Pilot Study

Status

Completed

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT06678178

Enrollment

6622

Registered

2024-11-07

Start date

2024-12-02

Completion date

2024-12-06

Last updated

2026-01-06

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Food Selection

Keywords

food labeling, climate labeling, choice behavior

Brief summary

The primary objective of this study is to test the relative effects of climate-impact menu label designs on the healthfulness of consumers' fast-food meal choices. Participants will complete a hypothetical online meal ordering task using a survey which emulates the online menu of a burger restaurant chain. Participants will be randomized for exposure to menus featuring one of five labeling conditions. Secondary objectives include examining total greenhouse gas emissions per meal order and, through a post-order survey, perception of labels between the conditions.

Detailed description

This online randomized trial will test the relative effects of climate impact menu label designs on the healthfulness of consumers' fast-food meal choices and perceptions of menu items. The survey research firm CloudResearch will recruit a sample of 6,250 adults aged 18 years and older who speak English and reside in the United States. Participants will complete a between-subjects online experiment in which the participants will be randomized to view a fast-food online ordering menu with one of five labeling schemes applied: (1) a QR code on all items (control); (2) a high climate impact warning label on high impact items; (3) traffic light labels on all items by level of impact; (4) climate grade labels on all items by level of impact; and (5) numeric carbon footprint labels on all items. All fast-food menus will include main items, sides, desserts, and drinks. Labels will only appear alongside main menu items and will be assigned using thresholds for greenhouse gas emissions set a priori in kilograms of carbon dioxide (CO2) equivalent per kilogram of food. Participants will be instructed to select up to 4 menu items for a hypothetical meal order. After completing the meal ordering task, participants will be prompted to answer questions about the perception of the labeling condition which the participants were randomized to view, perception of the relative effectiveness of all labels in this experiment, and personal values, dietary patterns, and other demographic information. The primary outcome will be the healthfulness of meal orders selected from the online menu, indicated by a modified Nutrient Profile Index meal score for all food items ordered. Secondary outcomes will be total greenhouse gas emissions per meal ordered, total calories ordered, whether a sugar-sweetened beverage was ordered, and perceived message effectiveness of the climate-impact labels.

Interventions

BEHAVIORALControl (QR) Labels

Participants will view a fast-food restaurant menu including main, side, dessert, and drink items. Each menu item will be displayed with an image of the item, name, price, and total calories. For main items only, Control (QR) labels will be displayed beneath each item. Participants will be instructed to select up to 4 menu items for a hypothetical meal order.

BEHAVIORALWarning High Climate Impact Labels

Participants will view a fast-food restaurant menu including main, side, dessert, and drink items. Each menu item will be displayed with an image of the item, name, price, and total calories. For main items only, Warning High Climate Impact labels will be displayed beneath select items. Participants will be instructed to select up to 4 menu items for a hypothetical meal order.

BEHAVIORALTraffic Light Labels

Participants will view a fast-food restaurant menu including main, side, dessert, and drink items. Each menu item will be displayed with an image of the item, name, price, and total calories. For main items only, Traffic Light labels will be displayed beneath each item. Participants will be instructed to select up to 4 menu items for a hypothetical meal order.

BEHAVIORALClimate Grade Labels

Participants will view a fast-food restaurant menu including main, side, dessert, and drink items. Each menu item will be displayed with an image of the item, name, price, and total calories. For main items only, Climate Grade labels will be displayed beneath each item. Participants will be instructed to select up to 4 menu items for a hypothetical meal order.

BEHAVIORALNumeric Carbon Footprint Labels

Participants will view a fast-food restaurant menu including main, side, dessert, and drink items. Each menu item will be displayed with an image of the item, name, price, and total calories. For main items only, Numeric Carbon Footprint labels will be displayed beneath each item. Participants will be instructed to select up to 4 menu items for a hypothetical meal order.

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

PREVENTION

Masking

NONE

Intervention model description

Participants will be randomized to view a fast-food menu with one of five labeling schemes applied: (1) a QR code on all items (control); (2) a high climate impact warning label on high impact items; (3) traffic light labeling on all items by level of impact; (4) climate grade labels on all items by level of impact; and (5) numeric labels on all items. All fast-food menus will include main items, sides, desserts, and drinks. Labels will only appear alongside main menu items and will be assigned using thresholds for greenhouse gas emissions set a priori in kilograms of CO2 equivalent per kilogram of food. Participants will be instructed to select a hypothetical lunch meal order. The investigators will record participant meal selections and, using publicly available nutritional information for each item selected, calculate a score of overall meal healthfulness.

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Yes

Inclusion criteria

* 18 years of age or older * Member of the CloudResearch panel * Residing in the United States

Exclusion criteria

* Under 18 years of age * Not residing in the United States * Completed the survey implausibly quick based on the distribution of the time to complete the survey among all participants * Failed the built-in Qualtrics survey fraud detection measures

Design outcomes

Primary

Measure	Time frame	Description
Modified Nutrient Profile Index Score	approximately 1 minute	The primary outcome measure will be the healthfulness of the fast-food meal selections, measured with a modified Nutrient Profile Index (NPI) score. NPI scores are based on the United Kingdom (UK) Ofcom Nutrient Profiling Model, which is used to score individual foods in the UK to determine which ones can be marketed to children. The NPI is a 0 to 100-point score for foods; scores \>=64 are considered healthy. NPI awards points from nutrients to encourage (e.g., fiber, protein) and nutrients of concern (e.g., sodium, sugar) per 100 grams. The investigators will generate a modified NPI score to evaluate the healthfulness of full meals comprised of multiple food items. This measure will be determined by calculating the weighted mean NPI score of all food items selected per meal, with each item's NPI score weighted by its proportionate contribution of mass in grams to the total mass of the meal.

Secondary

Measure	Time frame	Description
Total Greenhouse Gas Emissions as Assessed by Cumulative Total Kilograms of Carbon Equivalent (kgCO2e) Per Kilogram	approximately 1 minute	Cumulative total kilograms of carbon equivalent (kgCO2e) per kilogram of food for all meal items.
Perceived Message Effectiveness (PME) as Assessed by the University of North Carolina (UNC) PME Scale	approximately 1 minute	The 3-item University of North Carolina (UNC)-PME scale measures how much the label placed beneath high climate impact menu items, discouraged consumption or evoked concern or unpleasantness about consumption of high climate impact foods. Responses to all questions will be measured on a 5-point unipolar Likert scale from 1=Not at all to 5= A great deal. Preceding the questions, participants will view the assigned label demonstrating high climate impact and the following prompt: Considering this label, how much do you agree or disagree with the following statements. The exact text for each question is: This label discourages me from wanting to eat foods with a high climate impact. This label makes eating foods with a high climate impact seem unpleasant. This label makes me concerned about eating foods with a high climate impact. The mean likert scale choice is reported. The scale choice range is between 1 and 5, with higher scores interpreted as better.
Total Energy (Calories) Selected	approximately 1 minute	The total number of calories in participants' hypothetical meal orders, calculated as the sum of calories across all menu items selected. Higher values indicate more calories selected.
Number of Participants Who Selected Sugar-sweetened Beverage	approximately 1 minute	Measured as a dichotomous variable (yes/no) indicating whether participants' hypothetical meal orders include a sugar-sweetened beverage.

Countries

United States

Participant flow

Participants by arm

Arm	Count
Control (QR) Labels A black label featuring a QR code and white text that reads SCAN HERE will be placed beneath all main menu items. Explanatory text describing the label's meaning will be displayed at the top of the menu.	1,245
Warning High Climate Impact Labels A red icon-plus-text label that reads WARNING: HIGH CLIMATE IMPACT in white text will be placed beneath main menu items with a high climate impact using a predetermined threshold of estimated greenhouse gas emissions set at \>=9.2 kgCO2e. Labels will include a white globe icon directly preceding the label text. Explanatory text describing the label's meaning will be displayed at the top of the menu.	1,245
Traffic Light Labels Traffic Light labels will be placed beneath all main menu items. Using predetermined estimated greenhouse gas emission thresholds, each item will be assigned one of three icon-plus-text labels within this scheme: low-, medium-, or high-impact label, set in kgCO2e at \<2.6, \>=2.6 & \<9.2, and \>=9.2, respectively. Each will read, HIGH CLIMATE IMPACT within a red label, MED. CLIMATE IMPACT in a yellow label, and LOW CLIMATE IMPACT in a green label. Text for all labels written in white, and a white globe icon will precede the text. Explanatory text describing the meaning of the labels will be displayed at the top of the menu.	1,257
Climate Grade Labels Climate Grade labels will be placed beneath all main menu items, using predetermined estimated greenhouse gas emission thresholds to assign one of five icon-plus-text labels which indicate a specific climate impact grade (A, B, C, D, and F). Thresholds are set in kgCO2e as follows: \[A\] \<1.7, \[B\] \>=1.7 & \<2.6, \[C\] \>=2.6 & \<9.2, \[D\] \>=9.2 & \<28, \[F\] \>=28. All labels are solid black with a white globe icon followed by white text which reads CLIMATE GRADE. On the left side of each label, a grade is displayed, capitalized and in a white font within a solid-colored box. The color of the box corresponds with each letter grade: A = dark green, B = light green, C = yellow, D = orange, F = red. Beneath the letter grade, a gradient of all possible grades is displayed horizontally in smaller font, each grade atop a small solid box in the respective grade color. Explanatory text describing the meaning of the labels will be displayed at the top of the menu.	1,229
Numeric Carbon Footprint Labels Numeric Carbon Footprint labels will be placed beneath all main menu items and display the estimated greenhouse gas emissions in kilograms of carbon dioxide equivalents (kgCO2e) for each item. All labels have a solid black background and an icon-plus-text design. A white globe icon is followed by text stating the value of the items estimated emissions and the unit kgCO2e. Explanatory text describing the meaning of the labels will be displayed at the top of the menu.	1,245
Total	6,221

Baseline characteristics

Characteristic	Warning High Climate Impact Labels	Control (QR) Labels	Traffic Light Labels	Climate Grade Labels	Numeric Carbon Footprint Labels	Total
Age, Continuous	47 Years STANDARD_DEVIATION 17	48 Years STANDARD_DEVIATION 17	48 Years STANDARD_DEVIATION 17	46 Years STANDARD_DEVIATION 17	47 Years STANDARD_DEVIATION 17	47 Years STANDARD_DEVIATION 17
Climate Concern A great deal	315 Participants	264 Participants	285 Participants	288 Participants	285 Participants	1437 Participants
Climate Concern A little bit	157 Participants	169 Participants	162 Participants	176 Participants	158 Participants	822 Participants
Climate Concern Not at all	127 Participants	184 Participants	156 Participants	133 Participants	160 Participants	760 Participants
Climate Concern Quite a bit	286 Participants	257 Participants	300 Participants	291 Participants	262 Participants	1396 Participants
Climate Concern Somewhat	360 Participants	371 Participants	354 Participants	341 Participants	380 Participants	1806 Participants
Ethnicity (NIH/OMB) Hispanic or Latino	177 Participants	174 Participants	188 Participants	168 Participants	171 Participants	878 Participants
Ethnicity (NIH/OMB) Not Hispanic or Latino	1068 Participants	1071 Participants	1069 Participants	1060 Participants	1074 Participants	5342 Participants
Ethnicity (NIH/OMB) Unknown or Not Reported	0 Participants	0 Participants	0 Participants	1 Participants	0 Participants	1 Participants
Political Affiliation Democrat	443 Participants	424 Participants	453 Participants	424 Participants	425 Participants	2169 Participants
Political Affiliation Independent	365 Participants	399 Participants	372 Participants	371 Participants	373 Participants	1880 Participants
Political Affiliation Republican	437 Participants	422 Participants	432 Participants	434 Participants	447 Participants	2172 Participants
Race (NIH/OMB) American Indian or Alaska Native	18 Participants	19 Participants	26 Participants	19 Participants	23 Participants	105 Participants
Race (NIH/OMB) Asian	57 Participants	56 Participants	46 Participants	56 Participants	55 Participants	270 Participants
Race (NIH/OMB) Black or African American	160 Participants	171 Participants	166 Participants	156 Participants	165 Participants	818 Participants
Race (NIH/OMB) More than one race	0 Participants	0 Participants	0 Participants	0 Participants	0 Participants	0 Participants
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	0 Participants	0 Participants	0 Participants	0 Participants	0 Participants	0 Participants
Race (NIH/OMB) Unknown or Not Reported	30 Participants	43 Participants	38 Participants	33 Participants	36 Participants	180 Participants
Race (NIH/OMB) White	980 Participants	956 Participants	981 Participants	965 Participants	966 Participants	4848 Participants
Sex: Female, Male Female	633 Participants	629 Participants	670 Participants	658 Participants	643 Participants	3233 Participants
Sex: Female, Male Male	612 Participants	616 Participants	587 Participants	571 Participants	602 Participants	2988 Participants
Special Diet Gluten free	55 Participants	49 Participants	45 Participants	33 Participants	47 Participants	229 Participants
Special Diet No special diet	1010 Participants	1031 Participants	1044 Participants	1034 Participants	1022 Participants	5141 Participants
Special Diet Other	107 Participants	97 Participants	91 Participants	101 Participants	108 Participants	504 Participants
Special Diet Pescatarian	38 Participants	30 Participants	36 Participants	24 Participants	30 Participants	158 Participants
Special Diet Vegan	14 Participants	9 Participants	16 Participants	13 Participants	10 Participants	62 Participants
Special Diet Vegetarian	21 Participants	29 Participants	25 Participants	24 Participants	28 Participants	127 Participants

Adverse events

Event type	EG000 affected / at risk	EG001 affected / at risk	EG002 affected / at risk	EG003 affected / at risk	EG004 affected / at risk
deaths Total, all-cause mortality	0 / 1,320	0 / 1,339	0 / 1,332	0 / 1,305	0 / 1,326
other Total, other adverse events	0 / 1,320	0 / 1,339	0 / 1,332	0 / 1,305	0 / 1,326
serious Total, serious adverse events	0 / 1,320	0 / 1,339	0 / 1,332	0 / 1,305	0 / 1,326

Outcome results

Primary

Modified Nutrient Profile Index Score

The primary outcome measure will be the healthfulness of the fast-food meal selections, measured with a modified Nutrient Profile Index (NPI) score. NPI scores are based on the United Kingdom (UK) Ofcom Nutrient Profiling Model, which is used to score individual foods in the UK to determine which ones can be marketed to children. The NPI is a 0 to 100-point score for foods; scores \>=64 are considered healthy. NPI awards points from nutrients to encourage (e.g., fiber, protein) and nutrients of concern (e.g., sodium, sugar) per 100 grams. The investigators will generate a modified NPI score to evaluate the healthfulness of full meals comprised of multiple food items. This measure will be determined by calculating the weighted mean NPI score of all food items selected per meal, with each item's NPI score weighted by its proportionate contribution of mass in grams to the total mass of the meal.