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Front-of-Pack Labeling and the Nutritional Quality of Students' Food Purchases: A 3-Arm Randomized Controlled Trial
Manon Egnell1, Isabelle Boutron1, Sandrine Péneau1
1Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France.
Abstract:
Objectives. To assess the effects of the Nutri-Score label (relative to the Reference Intakes label or no label) on the nutritional quality of students' food purchases. Methods. A 3-arm randomized controlled trial was conducted in France in 2017; 2907 participants were randomized into 1 of the 3 study arms (Nutri-Score, Reference Intakes, no label) and invited to purchase groceries from an experimental Web-based supermarket. The main outcome was the overall nutritional quality of purchases, measured according to a modified version of the Food Standards Agency Nutrient Profiling System (FSAm-NPS/HCSP) score. Results. The mean (±SD) FSAm-NPS/HCSP score was lower in the Nutri-Score group (2.02 ±3.56) than in the Reference Intakes group (2.69 ±3.44), reflecting higher nutritional quality; however, there was no significant difference between the Nutri-Score and no-label (2.45 ±3.28) groups or between the Reference Intakes and no-label groups. Shopping cart content was lower in calories and saturated fatty acids and higher in fruits and vegetables in the Nutri-Score arm than in the other arms. Conclusions. The Nutri-Score label appeared to improve the nutritional composition of students' food purchases relative to the Reference Intakes label or no label.