Conducting nutrition labeling interventions in applied settings: Challenges and opportunities

In recent years there has been a move to examine the effects of nutrition labeling on consumer food selection. In particular, there is an interest in conducting this research in applied settings, such as restaurants, schools, and worksites. However, the process of carrying out such studies is complex and presents a number of challenges. Purpose: This talk will detail relevant issues and considerations when designing and implementing a worksite cafeteria nutritional labeling intervention. Methods: In a hospital cafeteria and vending machines, color-coded “traffic lights” were posted at the point-of-purchase for every food item, giving each a color rating (i.e., green, yellow, red). Caloric information along with the approximate number of “steps” needed to burn off those calories was also posted. Results: Calculating nutritional data for hundreds of recipes took considerable time and multiple decisions were required regarding how to categorize foods and determine portion/serving size. Methodological challenges included variation in portion size offered to patrons, unforeseen changes to the menu, improvisation by the chefs, and inconsistencies with the posting of labels each day. Outcome assessment is hampered by having a limited number of cash register keys and when groups of foods are sold by weight (e.g., salad bar). Discussion: Time, planning, and resources are necessary for effectively implementing nutrition labeling interventions in applied settings. Understanding the potential pitfalls as well as the strategies to avoid these and capture outcomes will lead to more methodologically sound interventions.