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Impact of decreasing the proportion of higher energy foods and reducing portion sizes on food purchased in worksite cafeterias: A stepped-wedge randomised controlled trial

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Listed:
  • James P Reynolds
  • Minna Ventsel
  • Daina Kosīte
  • Brier Rigby Dames
  • Laura Brocklebank
  • Sarah Masterton
  • Emily Pechey
  • Mark Pilling
  • Rachel Pechey
  • Gareth J Hollands
  • Theresa M Marteau

Abstract

Background: Overconsumption of energy from food is a major contributor to the high rates of overweight and obesity in many populations. There is growing evidence that interventions that target the food environment may be effective at reducing energy intake. The current study aimed to estimate the effect of decreasing the proportion of higher energy (kcal) foods, with and without reducing portion size, on energy purchased in worksite cafeterias. Methods and findings: This stepped-wedge randomised controlled trial (RCT) evaluated 2 interventions: (i) availability: replacing higher energy products with lower energy products; and (ii) size: reducing the portion size of higher energy products. A total of 19 cafeterias were randomised to the order in which they introduced the 2 interventions. Availability was implemented first and maintained. Size was added to the availability intervention. Intervention categories included main meals, sides, cold drinks, snacks, and desserts. The study setting was worksite cafeterias located in distribution centres for a major United Kingdom supermarket and lasted for 25 weeks (May to November 2019). These cafeterias were used by 20,327 employees, mainly (96%) in manual occupations. The primary outcome was total energy (kcal) purchased from intervention categories per day. The secondary outcomes were energy (kcal) purchased from nonintervention categories per day, total energy purchased per day, and revenue. Regression models showed an overall reduction in energy purchased from intervention categories of −4.8% (95% CI −7.0% to −2.7%), p

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  • James P Reynolds & Minna Ventsel & Daina Kosīte & Brier Rigby Dames & Laura Brocklebank & Sarah Masterton & Emily Pechey & Mark Pilling & Rachel Pechey & Gareth J Hollands & Theresa M Marteau, 2021. "Impact of decreasing the proportion of higher energy foods and reducing portion sizes on food purchased in worksite cafeterias: A stepped-wedge randomised controlled trial," PLOS Medicine, Public Library of Science, vol. 18(9), pages 1-18, September.
    • Handle: RePEc:plo:pmed00:1003743
    DOI: 10.1371/journal.pmed.1003743
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    References listed on IDEAS

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    1. Sanne Raghoebar & Ellen Van Kleef & Emely De Vet, 2020. "Increasing the Proportion of Plant-Based Foods Available to Shift Social Consumption Norms and Food Choice among Non-Vegetarians," Sustainability, MDPI, vol. 12(13), pages 1-23, July.
    2. Gareth J. Hollands & Giacomo Bignardi & Marie Johnston & Michael P. Kelly & David Ogilvie & Mark Petticrew & Andrew Prestwich & Ian Shemilt & Stephen Sutton & Theresa M. Marteau, 2017. "The TIPPME intervention typology for changing environments to change behaviour," Nature Human Behaviour, Nature, vol. 1(8), pages 1-9, August.
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