Document Detail

Traffic-light labels and choice architecture: promoting healthy food choices.
MedLine Citation:
PMID:  24439347     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Preventing obesity requires maintenance of healthy eating behaviors over time. Food labels and strategies that increase visibility and convenience of healthy foods (choice architecture) promote healthier choices, but long-term effectiveness is unknown.
PURPOSE: Assess effectiveness of traffic-light labeling and choice architecture cafeteria intervention over 24 months.
DESIGN: Longitudinal pre-post cohort follow-up study between December 2009 and February 2012. Data were analyzed in 2012.
SETTING/PARTICIPANTS: Large hospital cafeteria with a mean of 6511 transactions daily. Cafeteria sales were analyzed for (1) all cafeteria customers and (2) a longitudinal cohort of 2285 hospital employees who used the cafeteria regularly.
INTERVENTION: After a 3-month baseline period, cafeteria items were labeled green (healthy); yellow (less healthy); or red (unhealthy) and rearranged to make healthy items more accessible.
MAIN OUTCOME MEASURES: Proportion of cafeteria sales that were green or red during each 3-month period from baseline to 24 months. Changes in 12- and 24-month sales were compared to baseline for all transactions and transactions by the employee cohort.
RESULTS: The proportion of sales of red items decreased from 24% at baseline to 20% at 24 months (p<0.001), and green sales increased from 41% to 46% (p<0.001). Red beverages decreased from 26% of beverage sales at baseline to 17% at 24 months (p<0.001); green beverages increased from 52% to 60% (p<0.001). Similar patterns were observed for the cohort of employees, with the largest change for red beverages (23%-14%, p<0.001).
CONCLUSIONS: A traffic-light and choice architecture cafeteria intervention resulted in sustained healthier choices over 2 years, suggesting that food environment interventions can promote long-term changes in population eating behaviors.
Anne N Thorndike; Jason Riis; Lillian M Sonnenberg; Douglas E Levy
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of preventive medicine     Volume:  46     ISSN:  1873-2607     ISO Abbreviation:  Am J Prev Med     Publication Date:  2014 Feb 
Date Detail:
Created Date:  2014-01-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8704773     Medline TA:  Am J Prev Med     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  143-9     Citation Subset:  IM    
Copyright Information:
© 2013 American Journal of Preventive Medicine Published by American Journal of Preventive Medicine All rights reserved.
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