Impact of increasing the availability of healthier vs. less-healthy food on food selection: a randomised laboratory experiment

Abstract: Background: Environmental cues shape behaviour, but few studies compare the impact of targeting healthier vs. less-healthy cues. One online study suggested greater impact on selection from increasing the number of less-healthy (vs. healthier) snacks. The current study aimed to: (1) extend the previous study by using physically-present snacks for immediate consumption; (2) explore responsiveness by socio-economic position; (3) investigate possible mediators (response inhibition, food appeal) of any socio-economic differences in selection. Methods: In a between-subjects laboratory experiment UK adults (n = 417) were randomised according to their ID number (without blinding) to one of three ranges of options: Two healthier, two less-healthy [“Equal”] (n = 136); Six healthier, two less-healthy [“Increased Healthier”] (n = 143); Two healthier, six less-healthy [“Increased Less-Healthy”] (n = 138). Participants completed measures of response inhibition and food appeal, and selected a snack for immediate consumption from their allocated range. The primary outcome was selection of a healthier (over less-healthy) snack. Results: The odds of selecting a less-healthy snack were 2.9 times higher (95%CIs:1.7,5.1) in the Increased Less-Healthy condition compared to the Equal condition. The odds of selecting a healthier snack were 2.5 times higher (95%CIs:1.5,4.1) in the Increased Healthier (vs. Equal) condition. There was no significant difference in the size of these effects (− 0.2; 95%CIs:-1.1,0.7). Findings were inconclusive with regard to interactions by education, but the direction of effects was consistent with potentially larger impact of the Increased Healthier condition on selection for higher-educated participants, and potentially larger impact of the Increased Less-Healthy condition for less-educated participants. Conclusions: A greater impact from increasing the number of less-healthy (over healthier) foods was not replicated when selecting snacks for immediate consumption: both increased selections of the targeted foods with no evidence of a difference in effectiveness. The observed pattern of results suggested possible differential impact by education, albeit not statistically significant. If replicated in larger studies, this could suggest that removing less-healthy options has the potential to reduce health inequalities due to unhealthier diets. Conversely, adding healthier options could have the potential to increase these inequalities. Trial registration: ISRCTN: ISRCTN34626166; 11/06/2018; Retrospectively registered

The impact of 'on-pack' pictorial health warning labels and calorie information labels on drink choice: A laboratory experiment.

Sugar-sweetened beverages (SSBs) are one of the largest added sugar sources to diets in the UK and USA. Health warning labels reduce hypothetical selection of SSBs in online studies but uncertainty surrounds their impact on selection of drinks for consumption. Calorie information labels are also promising but their impact on SSB selection is unclear. This laboratory study assessed the impact on SSB selection of 'on-pack' labels placed directly on physical products: i.a pictorial health warning label depicting an adverse health consequence of excess sugar consumption; and ii.calorie information labels. Potential moderation of any effects by socio-economic position (SEP) was also examined. Participants - 401 adults, resident in England, approximately half of whom were of lower SEP and half of higher SEP, were asked to select a drink from a range of two non-SSBs and four SSBs (subsequent to completing a separate study assessing the effects of food availability on snack selection). The drinks included 'on-pack' labels according to randomisation: Group 1: pictorial health warning label on SSBs; Group 2: calorie information label on all drinks; Group 3: no additional label. The primary outcome was the proportion of participants selecting an SSB. Compared to not having additional labels (39%), neither the pictorial health warning label (40%) nor calorie information labels (43%) affected the proportion of participants selecting an SSB. Lower SEP participants (45%) were more likely to select an SSB compared to those of higher SEP (35%), but SEP did not moderate the impact of labels on drink selection. In conclusion, pictorial health warning labels may be less effective in reducing SSB selection in lab-based compared with online settings, or depending on label design and placement. Findings suggest that effects might be absent when choosing from real products with actual 'on-pack' labels, positioned in a 'realistic' manner. Field studies are needed to further assess the impact of 'on-pack' SSB warning labels in real-world settings to rule out the possible contribution of study design factors

What does ALSPAC data tell us about the relationship between physical activity, alcohol consumption and psychosocial health in adolescents?

The study aim was to investigate the connection between early to mid-adolescent alcohol consumption and physical activity. Two models of association were identified, from a critical review of 30 studies on European adolescents aged between 11-17 years. However, inferences were restricted by study heterogeneity and widespread use of measures of short duration. The model developed for cross-sectional analyses, using data from a cohort of 10,380 adolescents aged 13-14, 15-16, and 17 years, suggested that engaging in structured physical activity on a regular basis, or meeting physical activity guideline levels i.e., an average of 60 minutes per day of moderate-to-vigorous physical activity, were negatively associated with ever-intoxication, higher frequency of intoxication, or consuming alcohol prior to age 14. Using k-Means clustering analysis, three psychosocial profiles were generated for each age-group and entered into the regression models as a factor, with PA added as a covariate. Compared to those undertaking an average of 60 minutes of moderate-to-vigorous physical activity - undertaking an average of 30-59 minutes of MVPA per day, and having higher-risk psychosocial profiles, were significantly associated with being at risk of alcohol-related harm (RARH) at age 13-14 and age 15-16. Club membership-type and frequency of attending club were not statistically significant. However, while those with sports club-membership only had a higher risk of alcohol-related harm, attending club > once a week was negatively associated with risk of alcohol-related harm. Further adolescent longitudinal studies using repeated measures, and more extensive PA measures, are needed to test the robustness of this association. This study has found a potential explanation for why physical activity can lead to higher RARH. Additionally, it suggests that a PA intervention, with an emphasis on psychosocial support and health education, has the potential to support adolescents to engage in more physical activity, reduce or abstain from alcohol; and ultimately improve sense of wellbeing

Impact of increasing the availability of healthier vs. less-healthy food on food selection: a randomised laboratory experiment

Abstract Background Environmental cues shape behaviour, but few studies compare the impact of targeting healthier vs. less-healthy cues. One online study suggested greater impact on selection from increasing the number of less-healthy (vs. healthier) snacks. The current study aimed to: (1) extend the previous study by using physically-present snacks for immediate consumption; (2) explore responsiveness by socio-economic position; (3) investigate possible mediators (response inhibition, food appeal) of any socio-economic differences in selection. Methods In a between-subjects laboratory experiment UK adults (n = 417) were randomised according to their ID number (without blinding) to one of three ranges of options: Two healthier, two less-healthy [“Equal”] (n = 136); Six healthier, two less-healthy [“Increased Healthier”] (n = 143); Two healthier, six less-healthy [“Increased Less-Healthy”] (n = 138). Participants completed measures of response inhibition and food appeal, and selected a snack for immediate consumption from their allocated range. The primary outcome was selection of a healthier (over less-healthy) snack. Results The odds of selecting a less-healthy snack were 2.9 times higher (95%CIs:1.7,5.1) in the Increased Less-Healthy condition compared to the Equal condition. The odds of selecting a healthier snack were 2.5 times higher (95%CIs:1.5,4.1) in the Increased Healthier (vs. Equal) condition. There was no significant difference in the size of these effects (− 0.2; 95%CIs:-1.1,0.7). Findings were inconclusive with regard to interactions by education, but the direction of effects was consistent with potentially larger impact of the Increased Healthier condition on selection for higher-educated participants, and potentially larger impact of the Increased Less-Healthy condition for less-educated participants. Conclusions A greater impact from increasing the number of less-healthy (over healthier) foods was not replicated when selecting snacks for immediate consumption: both increased selections of the targeted foods with no evidence of a difference in effectiveness. The observed pattern of results suggested possible differential impact by education, albeit not statistically significant. If replicated in larger studies, this could suggest that removing less-healthy options has the potential to reduce health inequalities due to unhealthier diets. Conversely, adding healthier options could have the potential to increase these inequalities. Trial registration ISRCTN: ISRCTN34626166; 11/06/2018; Retrospectively registered. </jats:sec

Impact of increasing the availability of healthier vs. less-healthy food on food selection: A randomised laboratory experiment

Background. Environmental cues shape behaviour, but few studies compare the impact of targeting healthier vs. less-healthy cues. One online study suggested greater impact on selection from increasing the number of less-healthy (vs. healthier) snacks. The current study aimed to: (1) extend the previous study by using physically-present snacks for immediate consumption; (2) explore responsiveness by socio-economic position; (3) investigate possible mediators (response inhibition, food appeal) of any socio-economic differences in selection. Methods. In a between-subjects laboratory experiment UK adults (n=417) were randomised according to their ID number (without blinding) to one of three ranges of options: Two healthier, two less-healthy [“Equal”] (n=136); Six healthier, two less-healthy [“Increased Healthier”] (n=143); Two healthier, six less-healthy [“Increased Less-Healthy”] (n=138). Participants completed measures of response inhibition and food appeal, and selected a snack for immediate consumption from their allocated range. The primary outcome was selection of a healthier (over less-healthy) snack. Results. The odds of selecting a less-healthy snack were 2.9 times higher (95%CIs:1.7,5.1) in the Increased Less-Healthy condition compared to the Equal condition. The odds of selecting a healthier snack were 2.5 times higher (95%CIs:1.5,4.1) in the Increased Healthier (vs. Equal) condition. There was no significant difference in the size of these effects (-0.2; 95%CIs:-1.1,0.7). Findings were inconclusive with regard to interactions by education, but the direction of effects was consistent with potentially larger impact of the Increased Healthier condition on selection for less-educated participants, and potentially larger impact of the Increased Less-Healthy condition for higher-educated participants. Conclusions. A greater impact from increasing the number of less-healthy (over healthier) foods was not replicated when selecting snacks for immediate consumption: both increased selections of the targeted foods with no evidence of a difference in effectiveness. The observed pattern of results suggested possible differential impact by education, albeit not statistically significant. If replicated in larger studies, this could suggest that removing less-healthy options has the potential to reduce health inequalities due to unhealthier diets. Conversely, adding healthier options could have the potential to increase these inequalities. Trial registration: Retrospectively registered on ISRCTN 11/06/2018 (https://doi.org/10.1186/ISRCTN34626166)

Impact of increasing the availability of healthier vs. less-healthy food on food selection: A randomised laboratory experiment

Background. Environmental cues shape behaviour, but few studies compare the impact of targeting healthier vs. less-healthy cues. One online study suggested greater impact on selection from increasing the number of less-healthy (vs. healthier) snacks. The current study aimed to: (1) extend the previous study by using physically-present snacks for immediate consumption; (2) explore responsiveness by socio-economic position; (3) investigate possible mediators (response inhibition, food appeal) of any socio-economic differences in selection. Methods. In a between-subjects laboratory experiment UK adults (n=417) were randomised according to their ID number (without blinding) to one of three ranges of options: Two healthier, two less-healthy [“Equal”] (n=136); Six healthier, two less-healthy [“Increased Healthier”] (n=143); Two healthier, six less-healthy [“Increased Less-Healthy”] (n=138). Participants completed measures of response inhibition and food appeal, and selected a snack for immediate consumption from their allocated range. The primary outcome was selection of a healthier (over less-healthy) snack.Results. The odds of selecting a less-healthy snack were 2.9 times higher (95%CIs:1.7,5.1) in the Increased Less-Healthy condition compared to the Equal condition. The odds of selecting a healthier snack were 2.5 times higher (95%CIs:1.5,4.1) in the Increased Healthier (vs. Equal) condition. There was no significant difference in the size of these effects (-0.2; 95%CIs:-1.1,0.7). Findings were inconclusive with regard to interactions by education, but the direction of effects was consistent with potentially larger impact of the Increased Healthier condition on selection for less-educated participants, and potentially larger impact of the Increased Less-Healthy condition for higher-educated participants. Conclusions. A greater impact from increasing the number of less-healthy (over healthier) foods was not replicated when selecting snacks for immediate consumption: both increased selections of the targeted foods with no evidence of a difference in effectiveness. The observed pattern of results suggested possible differential impact by education, albeit not statistically significant. If replicated in larger studies, this could suggest that removing less-healthy options has the potential to reduce health inequalities due to unhealthier diets. Conversely, adding healthier options could have the potential to increase these inequalities. Trial registration: Retrospectively registered on ISRCTN 11/06/2018 (https://doi.org/10.1186/ISRCTN34626166).</p