Impact of a Front-of-pack Nutrition Labelling on Food Purchases in Contract Catering

Study Overview
=================
Brief Summary
-----------------
This controlled trial investigates the impact of the implementation of a front-of-pack nutrition label, namely Nutri-Score, on foods and beverages sold in a contract catering in France on the nutritional quality of purchases.

Detailed Description
-----------------
The introduction of front-of-pack nutrition labelling is thought to help consumers making healthier food choices at the point-of-purchase. In 2017, the French government has selected the Nutri-Score as single front-of-pack nutrition label to be applied on food products sold in French supermarkets, on a voluntary basis. Some studies have found that the Nutri-Score would help consumers making healthier choices. Nevertheless, its impact has been demonstrated in experimental supermarkets and its implementation only concerns products sold in groceries and supermarkets, as it is stated in the official decree. The potential impact of the Nutri-Score in contract catering remains unknown, while this sector represents a growing share of out-of-home catering and that the promotion of the Nutri-Score in this sector is now part of the National Public Health Plan. Thus, the objective of the present study is to investigate the impact of the implementation of the Nutri-Score in contract catering restaurants on the nutritional quality of food purchases. The trial will be conducted using a quasi experimental before/after design with a comparison group. Data on purchases will be collected regularly through receipts, and the nutritional quality of purchases will be evaluated over time on two pairs of sites. In each pair of sites, one site will receive an intervention (Nutri-Score) and one site will be a control site. Within each pair, the sites will be comparable in terms of food offer and consumers profile.

Official Title
-----------------
Impact of a Front-of-pack Nutrition Labelling on the Nutritional Quality of Purchases of Customers in Contract Catering - a Controlled Trial

Conditions
-----------------
Food Labeling

Intervention / Treatment
-----------------
* Behavioral: Front-of-pack nutrition label Nutri-Score


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: all individuals purchasing in the contract catering restaurants will be included. Exclusion Criteria: No

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Other
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The trial will include four sites (two pairs, with an intervention site and a control site) and two phases. For each pair of sites: site n°1: one control phase with no intervention followed by an interventional phase with the Nutri-Score applied on products site n°2: control phases only, without the Nutri-Score applied during any of the two phases
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention arm<br>In this arm (site n°1), participants will purchase their products in the restaurant first in a control phase and then in an interventional phase with the Nutri-Score affixed on food products. | Behavioral: Front-of-pack nutrition label Nutri-Score<br>* The intervention consists of displaying the Nutri-Score on dishes and pre-packed foods.<br>|
| No Intervention: Control arm<br>In this arm (site n°2), participants will purchase their products in the restaurant during the whole study without any label affixed on food products. | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in the overall nutritional quality of purchases over time | Score using the Food Standards Agency nutrient profiling system modified by the HCSP, allocating points depending on the amounts in unfavourable elements (energy, saturates, sugars, sodium) and favorable elements (fibres, proteins and fruits, vegetables, nuts and oils (olive, colza, nuts)) | Through study completion, an average of 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in energy content of purchases | Energy content of the purchases in kcal / 100g | Through study completion, an average of 6 months | 
| Change in Saturated fat content of purchases | Saturated fat content of the purchases in g / 100g | Through study completion, an average of 6 months | 
| Change in Sugar content of purchases | Sugar content of the purchases in g / 100g | Through study completion, an average of 6 months | 
| Change in Sodium content of purchases | Sodium content of the purchases in mg / 100g | Through study completion, an average of 6 months | 
| Change in Protein content of purchases | Protein content of the purchases in g / 100g | Through study completion, an average of 6 months | 
| Change in Fibre content of purchases | Fibre content of the purchases in g / 100g | Through study completion, an average of 6 months | 
| Change in Fruit, vegetable and nut content of purchases | Fruit, vegetable and nut content of the purchases in % / 100g | Through study completion, an average of 6 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Food labeling, nutritional quality, food purchases