The Reduced Calorie Food and Mood Study
Condition: Markedly Reduced Food Intake; Satiety and Food Intake
Study type: Interventional

Summary: 
      Health- and nutrient-related labelling is often used to draw consumer's attention to the
      potential benefits of consuming one product over another. However, research suggests that
      products believed to be 'healthier' and/or lower calorie are often experienced as less
      satiating, and may actually prompt people to consume more or these foods, or others.

      The current research aimed to whether consuming a reduced-calorie product labelled "Healthier
      Choice" affects compensatory eating behaviour (relative to an unlabelled product), and the
      extent to which this depends on the product's sensory characteristics.

      A two-session randomised study was used to test the satiety value of a reduced-calorie
      beverage - characterised as changes in rated appetite and later food intake (kcal) relative
      to an original-calorie version - consumed in one of four contexts varying in label and
      sensory cues. The beverage-contexts were assessed in a non-crossover manner.
    

Detailed description: 
      Reformulation strategies to reduce the energy density of commonly consumed food and beverage
      products are needed to support weight management, but one concern is that awareness of
      consuming 'healthier' foods can promote compensatory eating behaviours. An alternative
      solution is not to label calorie-reductions so consumers are unaware that they are consuming
      fewer calories in reformulated products, which has been described as a 'stealth health'
      approach.

      This study investigated whether consuming a reduced-calorie product labelled with Singapore's
      'Healthier Choice Symbol' impacts its satiating power relative to an unlabelled control, and
      the extent to which this can be further modified by changes to the product's sensory
      characteristics.

      Participants were randomised to consume an original (211 kcal per portion; kcal/g) and
      reduced calorie (98 kcal per portion; kcal/g) versions of a soymilk, with the reduced calorie
      version presented in one of four beverage context conditions:

        -  Context 1 - Sensory-matched, unlabelled calorie reduction (control) - Sensory matched to
           taste like the original (equally sweet, thick and creamy), without a label identifier
           (covert energy reduction).

        -  Context 2 - Sensory-matched, labelled calorie reduction - The same sensory matched
           beverage as above, but with the HCS attached (explicit energy reduction).

        -  Context 3 - Sensory-reduced, labelled calorie reduction - Designed to taste less thick,
           sweet and creamy than the original, with the HCS attached (explicit energy reduction).

        -  Context 4 - Sensory-enhanced, labelled calorie reduction - Designed to taste thicker,
           creamier and sweeter than the original, with the HCS attached (explicit energy
           reduction).

      Participants consumed the two beverages (original vs. reduced energy) in one of the four
      beverage contexts on two non-consecutive test sessions at the Clinical Nutrition Research
      Centre, with at least three days washout between each session. The calorie reduction was
      conducted as full-crossover while the beverage context groups were assigned non-crossover, to
      reduce demand awareness.

      The primary objective was to assess changes in lunch energy intake (kcal) after consuming the
      original and reduced-calorie beverages, depending on the beverage context the reduced calorie
      version was presented in.

      The secondary objectives were to assess the sensory evaluations of the beverages (liking and
      perceived thickness, sweetness and expected fullness etc.), changes in rated appetite up to
      180 minutes post-consumption and energy intake (kcal) for the rest of the test day (recorded
      in a food diary), as a function of the beverages energy density and context.
    

Intervention name(s): Product Labelling and Sensory modifications
Intervention type(s): Behavioral
Intervention description(s): the beverages varied in the label that was attached (no label or a 'Healthier Choice' label) and the sensory matching of the calorie reduction (sensory matched, reduced or enhanced).
Allocation: Randomized
Intervention model: Factorial Assignment
Intervention model description: Mixed Design:
4 x Beverage Contexts (assessed in parallel to reduce demand awareness) 2 x Energy Density (assessed as full crossover)
Masking: Single (Participant)
Primary purpose: Basic Science