Symbols for Change: Does labelling of healthy foods on menus using symbols promote better choices at the point-of-purchase at university food outlets?

Abstract

Background: Nutrition labelling is an environmental level intervention which has been proposed to help improve the food environment. Research shows that consumers want nutrition information at the point-of-purchase (POP), however it is either unavailable, perceived as ineffective, or difficult to use. Objective: To determine whether symbols on food outlet menus identifying healthier options would increase the sales of these items and to also investigate consumer's awareness of the labels, factors influencing their purchases, and barriers to eating healthy. Design: Two university food outlet menus were analysed using The National Healthy Food and Drink Policy to determine the targeted items. The experimental site displayed an information banner that read, "Look for the '[tick]' for your healthy options" and tick symbols were placed next to the targeted items on the menu. No changes were made at the control outlet. Four weeks of food sales data were collected from both outlets at baseline and during the intervention period. Sales data was also collected from the experimental outlet six weeks following the intervention period (post-intervention period). Customer surveys were also collected at the experimental outlet during the intervention period. Results: No differences in sales data were observed between the baseline and the intervention period at the experimental outlet. Significant findings were observed between the baseline and postintervention period (P = 0.0004), and between the intervention and post-intervention period (P = 0.0002). 68% of participants noticed the symbols at the POP, and of those 30% reported being influenced by them. Taste was the most common factor influencing peoples purchases and people who reported using the symbols were less likely to select taste as a factor influencing their purchase (P = 0.04). Price was the most common barrier to purchasing healthy food and 18-24- year-olds were 1.32 times more likely to select price as a barrier in comparison to 25-34-year-olds (P = 0.04). Conclusion: Identifying healthier menu options with a symbol at the POP increased sales of these items over time. The study identified a number of factors (price, taste and the availability of healthy options) which should be addressed in order to improve the food selections of young adults.