This study will investigate whether small changes (nudges) made in a cafeteria, where participants eat for 4 weeks, can improve their food behavior and health during the 4 weeks, and 6 weeks and 6 months after their stay. Half the participants will be exposed to one of four types of nudges (focused on reducing salt intake, increasing vegetable intake, reducing portion size, and a combination of these nudges), and half of the participants will eat in the cafeteria as it is currently, without modifications.
A healthy diet is an important pillar for public health and for the prevention of several lifestyle diseases (e.g. obesity, cardiovascular diseases). However, diet choices are often not conscious choices. While it may help to make individuals more aware of healthy options for example through education or nutrition labels, it remains difficult for many to eat healthy. The food environment in which choices are made has an impact on the choice. Smart design of the food environment may help individuals to make a healthier choice, by nudging them towards the healthier alternative, while not limiting the availability of the less healthy choice. This study tests how these 'nudges' can affect food behavior and health of participants in a 4-week rehabilitation course at Feiring Heart clinic. Nudges will be implemented in the cafeteria at the clinic. Three types of nudges will be tested: * Salt nudge: aims to reduce salt (sodium) intake. Salt will be less easily available in the cafeteria, and other spices (without sodium) will be made easily available. Food in the buffet that is either very high or very low in salt will be labeled. * Vegetable nudge: aims to increase vegetable intake. Names of the vegetable dishes in the buffet will be made more attractive, signs will be placed with reminders to eat more vegetables, and with visual indications of the percentage of vegetables that should be part of a meal. * Portion size nudge: aims to decrease portion size. Smaller plates will be provided, and utensils for self-serving calorie-dense foods in the buffet will be smaller than normal. * One period will also combine all the nudges described above. Outcomes include measures of food intake during the 4-week rehabilitation course, and whether food habits 6 weeks and 6 months after the 4-week course have changed, compared to before the course. BMI will be monitored during the 4-week period and self-assessed in the 6 months after. Physical activity habits will be considered during the entire experimental period, and satisfaction with the cafeteria food and service will be monitored throughout to assess whether the nudges impact customer satisfaction. Results are expected to be transferable to other heart clinics, and cafeterias in other institutions.
Study Type
LHL-klinikkene Feiring
Feiring, Norway
Change in BMI from start of intervention to end of intervention
BMI is measured, and change in BMI between day 0 and day 28 is used.
Time frame: Measured at baseline at day 0 of intervention and at completion of intervention at day 28 of intervention)
Change in dietary habits 1
Habits are compared with habits as listed before the start of the 4 week intervention period. Done through an online survey.
Time frame: 6 weeks after the 4 week intervention period
Change in dietary habits 2
Habits are compared with habits as listed before the start of the 4 week intervention period. Done through an online survey.
Time frame: 6 months after the 4 week intervention period
Dietary choices in cafeteria 1.1
Participants make photos of their meal including drinks, and register any condiments or seasoning added
Time frame: Tuesday lunch meal during the first week of the intervention
Dietary choices in cafeteria 1.2
Participants make photos of their meal including drinks, and register any condiments or seasoning added
Time frame: Thursday lunch meal during the first week of the intervention
Dietary choices in cafeteria 2.1
Participants make photos of their meal including drinks, and register any condiments or seasoning added
Time frame: Tuesday lunch meal during the second week of the intervention
Dietary choices in cafeteria 2.2
Participants make photos of their meal including drinks, and register any condiments or seasoning added
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INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
144
Time frame: Thursday lunch meal during the second week of the intervention
Dietary choices in cafeteria 3.1
Participants make photos of their meal including drinks, and register any condiments or seasoning added
Time frame: Tuesday lunch meal during the third week of the intervention
Dietary choices in cafeteria 3.2
Participants make photos of their meal including drinks, and register any condiments or seasoning added
Time frame: Thursday lunch meal during the third week of the intervention
Dietary choices in cafeteria 4.1
Participants make photos of their meal including drinks, and register any condiments or seasoning added
Time frame: Tuesday lunch meal during the fourth week of the intervention
Dietary choices in cafeteria 4.2
Participants make photos of their meal including drinks, and register any condiments or seasoning added
Time frame: Thursday lunch meal during the fourth week of the intervention