The impact of educational and environmental interventions in Dutch worksite cafeterias

Environmental interventions such as labeling and an increased availability of healthy foods may help consumers to meet guidelines for a healthy diet. This article describes a study into the effectiveness of two environmental programs to be used in worksite cafeterias along with an educational program. The aim of the interventions was to reduce fat intake, and to increase fruit and vegetable intake. In the labeling program, low-fat products were labeled. The food supply program comprised an increased availability of low-fat products and fruits and vegetables in worksite cafeterias. The educational program consisted of information about healthy nutrition through brochures, table tents, a self-help manual and posters. The design consisted of a pre-test-post-test experimental control group design, with four conditions: the educational program; the food supply program plus educational program; the labeling program plus educational program; and a control group. Seventeen worksites were randomly assigned to one of the four research conditions. Total fat, fruit and vegetable intake was measured with a quantitative, self-administered food frequency questionnaire (35 questions). Intake during lunch was measured by asking respondents to write down which food items they had purchased during their last lunch in the cafeteria. Furthermore, sales data for some targeted product categories were collected (milk, butter, cheese, meat products, desserts). For the whole study population, no significant effects on consumption data were found for any of the programs. The data showed a beneficial and significant treatment effect of the labeling program on total fat intake for respondents who believed they ate a high-fat diet. Sales data revealed a significant effect of the labeling program on desserts, but not for the other products.