Abstract
Reducing the energy density (ED) of product selections made during online supermarket food shopping has potential to decrease energy intake. Yet it is unclear which types of intervention are likely to be most effective and equitable. We recruited 899 UK adults of lower and higher socioeconomic position (SEP) who completed a shopping task in an online experimental supermarket. Participants were randomised in a 2 × 2 between-subjects design to test the effects of two interventions on the ED of shopping basket selections: labelling lower-ED products as healthier choices and increasing the relative availability of lower-ED products within a range (referred to as proportion). Labelling of lower-ED products resulted in a small but significant decrease (−4.2 kcal/100 g, 95% CIs −7.8 to −0.6) in the ED of the shopping basket. Increasing the proportion of lower-ED products significantly decreased the ED of the shopping basket (−17 kcal/100 g, 95% CIs −21 to −14). There was no evidence that the effect of either intervention was moderated by SEP. Thus, both types of intervention decreased the ED of foods selected in an online experimental supermarket. There was no evidence that the effectiveness of either intervention differed in people of lower vs. higher SEP.
Highlights
Lower dietary energy density (ED) is associated with lower bodyweight [1,2] and weight loss in people with obesity [3]
A small number of studies testing interventions in online supermarkets have shown that offering shoppers healthier product “swaps” and positioning healthier food products more prominently can improve the nutritional quality of food purchases [8,9,10]
It has been proposed that because information provision approaches rely on conscious effort and motivation, they may be less equitable than structural-based interventions and may widen socioeconomic position (SEP) inequalities in health [13,14,15]
Summary
Lower dietary energy density (ED) is associated with lower bodyweight [1,2] and weight loss in people with obesity [3]. Reducing the ED of food products has been shown to decrease daily energy intake in experimental studies [4,5], suggesting that scalable interventions to reduce dietary ED could benefit population health. A small number of studies testing interventions in online supermarkets have shown that offering shoppers healthier product “swaps” and positioning healthier food products more prominently can improve the nutritional quality of food purchases [8,9,10]. A common type of nutrition-based intervention is the use of information provision (e.g., labelling of lower-energy products) to alter choice behaviour [11]. It has been proposed that because information provision approaches rely on conscious effort and motivation, they may be less equitable than structural-based interventions and may widen socioeconomic position (SEP) inequalities in health [13,14,15]
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