An evaluation of the healthier dining programme effects on university student and staff choices in Singapore: A cluster-randomized trial

Abstract

The Healthier Dining Programme (HDP) was launched to increase the availability and accessibility of healthier foods and beverages at food centers in Singapore. Our study's objective was to evaluate effects of the HDP on out-of-home dietary intakes of consumers at an institute of higher learning using a cluster-randomized trial. Six food centers at a large university campus were randomly assigned to the intervention or control arm. Participants were university students or staff aged ≥ 18 years (n = 247) who frequently dined at these centers. Out-of-home food consumption was assessed using a 7-day food diary before and after 10 weeks of intervention. Modified Poisson regression was used to assess differences in healthier dish intakes between the two study arms. Participants in the intervention arm were found to be more likely to have at least one healthier out-of-home dish per week than those in the control arm (84% vs. 65%, relative risk: 1.29; 95% confidence interval: 1.08, 1.54). This difference was due mainly to higher consumption of dishes prepared with healthier oil blends (1.47; 1.19, 1.82) and lower-sodium salt (3.25; 1.56, 6.78) in the intervention arm. While saturated and polyunsaturated fat intakes in the two arms were comparable, participants in the intervention arm had lower total fat (−1.27 g/1000 kcal, −2.48, −0.06) and monounsaturated fat (−0.50 g/1000 kcal, −0.94, −0.06) intakes, from out-of-home dishes as compared with the control arm. These findings suggest that environmental interventions at institutes of higher education to increase healthier food availability can improve dietary intake from out-of-home foods.