Avila-Montiel Diana, Vilchis-Gil Jenny, Miranda-Lora América Liliana, Velázquez-López Lubia, Klünder-Klünder Miguel
Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, CDMX, Mexico.
Clinical Epidemiology Research Unit Dr. Carlos Mac Gregor Sánchez Navarro, Mexican Social Security Institute, CDMX, Mexico.
JMIR Res Protoc. 2024 Apr 1;13:e54783. doi: 10.2196/54783.
Overweight and obesity pose a global public health challenge and have a multifactorial origin. One of these factors includes obesogenic environments, which promote ultraprocessed foods characterized by being high in calories, saturated fats, added sugars, and sodium. In Mexico, it has been estimated that 30% of the total energy consumed comes from processed foods. The Modification to the Official Mexican Standards introduces nutritional information through black octagonal seals that alert consumers about products with excessive amounts of some components for a better food selection in the population. However, the effects of warning labels on processed food selection and purchases among children remain unknown.
We aimed to evaluate the impact of a digital educational intervention focusing on front-of-package warning labels on the food selection and purchasing behavior of elementary schoolchildren and their caregivers.
Children from 4 elementary schools in Mexico City, 2 public and 2 private schools, will participate in a randomized controlled trial. The schools will be chosen by simple random sampling. Schools will be randomized into 2 groups: intervention and control. In the control group, the dyads (caregiver-schoolchildren) will receive general nutritional education, and in the intervention group, they will receive guidance on reading labels and raising awareness about the impact of consuming ultraprocessed products on health. The educational intervention will be conducted via a website. Baseline measurements will be taken for both groups at 3 and 6 months. All participants will have access to an online store through the website, allowing them to engage in exercises for selecting and purchasing food and beverages. In addition, other measures will include a brief 5-question exam to evaluate theoretical understanding, a 24-hour reminder, a survey on food habits and consumption, application of a food preference scale, anthropometric measurements, and recording of school lunch choices.
Registration and funding were authorized in 2022, and we will begin data collection in September 2024. Recruitment has not yet taken place, but the status of data analysis and expected results will be published in April 2025.
The study is expected to contribute to evaluating whether reinforcing front-of-package warning labels with education enhances its effects and makes them more sustainable. Conducting this study will allow us to propose whether or not it is necessary to develop new intervention strategies related to front-of-package labeling for a better understanding of the population, improved food choices, and better health outcomes.
ClinicalTrials.gov NCT06102473; https://clinicaltrials.gov/study/NCT06102473.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/54783.
超重和肥胖构成了全球公共卫生挑战，其成因是多方面的。其中一个因素包括致胖环境，这种环境促使了以高热量、饱和脂肪、添加糖和钠含量高为特征的超加工食品的出现。在墨西哥，据估计，总能量消耗的30%来自加工食品。墨西哥官方标准的修订通过黑色八角形标签引入了营养信息，以此提醒消费者注意某些成分含量过高的产品，以便民众做出更好的食物选择。然而，警告标签对儿童加工食品选择和购买行为的影响尚不清楚。
我们旨在评估一项以包装正面警告标签为重点的数字教育干预措施对小学生及其照顾者的食物选择和购买行为的影响。
来自墨西哥城4所小学（2所公立和2所私立）的儿童将参与一项随机对照试验。学校将通过简单随机抽样选取。学校将被随机分为两组：干预组和对照组。在对照组中，二元组（照顾者-小学生）将接受一般营养教育，而在干预组中，他们将接受阅读标签的指导，并提高对食用超加工产品对健康影响的认识。教育干预将通过网站进行。两组将在3个月和6个月时进行基线测量。所有参与者都可以通过该网站访问一个在线商店，从而能够进行选择和购买食品及饮料的练习。此外，其他措施将包括一个简短的5道题考试以评估理论理解、24小时提醒、饮食习惯和消费调查、食物偏好量表的应用、人体测量以及学校午餐选择记录。
注册和资金在2022年获得批准，我们将于2024年9月开始数据收集。招募工作尚未开展，但数据分析状况和预期结果将于2025年4月公布。
该研究有望有助于评估通过教育强化包装正面警告标签是否能增强其效果并使其更具可持续性。开展这项研究将使我们能够提出是否有必要制定与包装正面标签相关的新干预策略，以便更好地了解民众、改善食物选择并获得更好的健康结果。
ClinicalTrials.gov NCT06102473；https://clinicaltrials.gov/study/NCT06102473。
国际注册报告标识符（IRRID）：PRR1-10.2196/54783。
