A study carried out in a hospital cafeteria in the USA shows that color-coding food labels to indicate whether the foods are healthy or unhealthy can significantly improve the dietary choices made by employees.
Notably, the scheme, which labeled healthy food types with green labels, neither healthy nor unhealthy types with yellow, and unhealthy ones with red labels, demonstrated improvements in food choice across all ethnicities and job types.
"These findings are important because obesity is much more common among Americans who are Black or Latino and among those of low socioeconomic status," said lead author Douglas Levy (Harvard Medical School, Boston, Massachusetts, USA) in a press statement.
"Improving food choices in these groups may help reduce their obesity levels and improve population health," he said.
The study, which was published in the American Journal of Preventive Medicine, was carried out in the cafeteria of Massachusetts General Hospital between December 2009 when the new labeling system was introduced and August 2010.
Each food type was given a positive point if they contained fruits/vegetables, whole grains, or lean protein/low-fat dairy, and a negative point if they contained saturated fat or had a high caloric content. Items were then classified as green if they had more positive points, yellow if they had equal positive and negative points, and red if they had more negative points.
In total, 4642 employees of the hospital who were regular cafeteria users were enrolled in the study, of whom 73% were of White, 10% of Black, 7% of Latino, and 10% of Asian ethnicity. Regarding employment types, 53% were clinicians or in management, 20% were other health professionals, 9% were technicians, 12% were administrative or support personnel, and 7% were service workers.
When compared with White employees, Black and Latino employees purchased more red items at baseline, at 18% versus 33% and 28%, respectively, and fewer green items, at 48% versus a respective 33% and 38%.
However, the new labeling system improved the dietary choices of all employees by a comparable amount regardless of their ethnicity or job type. For all study participants, the number of red products bought decreased by 11.2% on average and the number of green products bought increased by 6.6% on average over the study period.
Additional improvements were seen after a "choice architecture" intervention was put in place in the cafeteria 3 months into the study. This involved making selected green label products more visible and red label products less visible.
"Further study is needed to determine the long-term effect of these interventions and whether additional steps could improve their effectiveness in particularly vulnerable populations," commented Levy.
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