Viera Anthony J, Tuttle Laura, Olsson Emily, Gras-Najjar Julie, Gizlice Ziya, Hales Derek, Linnan Laura, Lin Feng-Chang, Noar Seth M, Ammerman Alice
Department of Family Medicine, University of North Carolina, 590 Manning Drive, Chapel Hill, NC, 27599, USA.
Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, USA.
BMC Public Health. 2017 Sep 12;17(1):702. doi: 10.1186/s12889-017-4710-0.
Obesity and physical inactivity are responsible for more than 365,000 deaths per year and contribute substantially to rising healthcare costs in the US, making clear the need for effective public health interventions. Calorie labeling on menus has been implemented to guide consumer ordering behaviors, but effects on calories purchased has been minimal.
In this project, we tested the effect of physical activity calorie expenditure (PACE) food labels on actual point-of-decision food purchasing behavior as well as physical activity. Using a two-group interrupted time series cohort study design in three worksite cafeterias, one cafeteria was assigned to the intervention condition, and the other two served as controls. Calories from food purchased in the cafeteria were assessed by photographs of meals (accompanied by notes made on-site) using a standardized calorie database and portion size-estimation protocol. Primary outcomes will be average calories purchased and minutes of moderate to vigorous physical activity (MVPA) by individuals in the cohorts. We will compare pre-post changes in study outcomes between study groups using piecewise generalized linear mixed model regressions (segmented regressions) with a single change point in our interrupted time-series study. The results of this project will provide evidence of the effectiveness of worksite cafeteria menu labeling, which could potentially inform policy intervention approaches.
Labels that convey information in a more readily understandable manner may be more effective at motivating behavior change. Strengths of this study include its cohort design and its robust data capture methods using food photographs and accelerometry.
肥胖和缺乏身体活动每年导致超过36.5万人死亡，并在美国医疗保健成本上升中占很大比例，这表明需要有效的公共卫生干预措施。菜单上的卡路里标签已被用于指导消费者的点餐行为，但对购买卡路里量的影响微乎其微。
在本项目中，我们测试了身体活动卡路里消耗（PACE）食品标签对实际决策点食品购买行为以及身体活动的影响。在三个工作场所食堂采用两组间断时间序列队列研究设计，一个食堂被分配到干预组，另外两个作为对照组。通过使用标准化卡路里数据库和份量大小估计协议的餐食照片（并附有现场记录）来评估在食堂购买食物的卡路里含量。主要结果将是队列中个体购买的平均卡路里量以及中度至剧烈身体活动（MVPA）的分钟数。在我们的间断时间序列研究中，我们将使用具有单个变化点的分段广义线性混合模型回归（分段回归）比较研究组之间研究结果的前后变化。本项目的结果将为工作场所食堂菜单标签的有效性提供证据，这可能为政策干预方法提供参考。
以更容易理解的方式传达信息的标签可能在促进行为改变方面更有效。本研究的优势包括其队列设计以及使用食物照片和加速度计的强大数据收集方法。
