A Brief Personalised Normative Feedback Intervention to Reduce Sugar Consumption: A Randomised Control Trial

Abstract

Background and aims: Sugar overconsumption is a growing problem worldwide linked to various adverse health outcomes, with organisations such as the World Health Organisation and American Heart Association setting daily recommended consumption limits. Despite this, very few published studies to date explore the ability of brief interventions to reduce sugar in adult populations. The current study investigated if a brief intervention delivering personalised normative feedback and self-help resources could reduce sugar consumption in New Zealand adults compared to a screening-only control group. Methods: This two-arm randomised control trial recruited 605 New Zealand adults via online advertising to complete a baseline and one-month follow-up survey to reduce daily sugar consumption, measured using a short semi-quantitative Food Frequency Questionnaire. On completion of the baseline survey, participants were either randomly selected to the intervention group to receive a personalized feedback report with self- help resources, or to a control group that received a basic feedback sheet with screening scores related to their mean daily sugar consumption, mental well-being, self-efficacy, and sugar craving. Results: Most participants (86.3%) were female and had an average age of 46 years (SD 17.02). For participants who completed both surveys, mean daily sugar consumption at baseline for the intervention and control groups was 49.88 grams and 39.81 grams, respectively. At follow-up, mean daily sugar consumption was 40.73 grams for the intervention and 37.24 grams for the control. This was a significant mean difference of 6.58 grams (p = 0.026) with a small effect size (d = 0.17) between the intervention and control groups. There were no statistically significant differences between the intervention and control groups in the secondary outcomes (mental well-being, self-efficacy, and cravings). Conclusion: This randomised controlled trial study indicates a brief intervention using personalised normative feedback and self-help resources can reduce sugar consumption in New Zealand adults and is more effective than screening-only. The findings suggest this type of intervention may be useful in public health settings to reduce sugar across New Zealand.