# A longitudinal, randomized-controlled experiment of healthy food policies in online retail settings

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2024 · $719,465

## Abstract

PROJECT SUMMARY
Unhealthy diets significantly contribute to major preventable chronic diseases including type 2 diabetes, obesity,
heart disease and stroke, which disproportionally impact racial/ethnic minority groups and those with lower
income.1–3 Key health organizations agree that policies are needed to support healthier diets, including ultra-
processed food and beverage taxes, nutrition warning labels, and marketing of healthier foods.4 Seven U.S.
cities have sugar-sweetened beverage (SSB) taxes, the FDA is currently considering a national front-of-package
food labeling system, and several U.S. cities have implemented or proposed healthy checkout regulations. It is
now well-established that SSB taxes substantially reduce SSB sales and intake5 and research indicates that
SSB nutrition warning labels can significantly reduce SSB purchases, though most of those data are from one-
time online or lab exposures.6–8 Although taxes and warning labels targeting SSBs have been successful at
shifting behavior, there are many other ultra-processed food products that contribute to unhealthy diets.9 What
is less well-known is whether a suite of healthy food policies that are expanded to target a range of ultra-
processed foods can shift dietary choices and intake in meaningful ways. To advance our understanding of
policies needed to support nutrition security and health, our overall objective is to examine the degree to which
a suite of healthy food policies in online food retailers can increase the purchase and intake of healthy foods and
beverages while reducing the purchase and intake of unhealthy ultra-processed foods and beverages. To
accomplish this objective, we propose using innovative online grocery store and restaurant platforms to
randomize participants to either: 1) control (no taxes, warning labels, or healthy checkout regulations on any
products); or 2) a suite of healthy food policies (ultra-processed food and beverage taxes, front-of-pack nutrition
labeling, and healthy check out regulations that restrict the promotion of ultra-processed products on the
checkout page). We will recruit 300 adults with lower income across Houston and San Antonio, TX, and
Philadelphia, PA to shop once per week for eight weeks in both our online grocery store and restaurant. Week
1 will be a baseline (control) week without interventions, followed by five weeks of the interventions. In the last
two study weeks, we will introduce unhealthy food marketing (e.g., banner ads) into the online platforms to mimic
what we expect industry will do to counter public health policy efforts. Participants will be given money to spend
in these online platforms and purchases will be delivered to them via a real food retail store and restaurant.
Participants will complete surveys at baseline, 6-weeks, and 8-weeks and will complete two dietary recall
interviews during the baseline week and during the fifth intervention week (4 recalls total). The specific aims are:
to evaluate t...

## Key facts

- **NIH application ID:** 10881049
- **Project number:** 1R01DK136779-01A1
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Christina Ann Roberto
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $719,465
- **Award type:** 1
- **Project period:** 2024-08-15 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10881049

## Citation

> US National Institutes of Health, RePORTER application 10881049, A longitudinal, randomized-controlled experiment of healthy food policies in online retail settings (1R01DK136779-01A1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10881049. Licensed CC0.

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