# A large-scale, long-term, randomized trial of nutrition labeling interventions

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2020 · $459,556

## Abstract

PROJECT SUMMARY
Poor dietary habits are associated with obesity, type 2 diabetes, cardiovascular disease, and
certain cancers. Government and institutional policy makers worldwide are interested in food
labeling and messaging as a cost-effective strategy to encourage healthier food choices.
Although there is evidence that nutrition labels can influence behavior, it is unclear which label
designs are most effective at altering behavior for people with different levels of education. There
are three common types of nutrition labels: a single logo highlighting healthier choices, traffic light
labels, or physical activity labels that translate calorie information into exercise required to burn off
the calories. Because there have been no large-scale, long-term randomized trials comparing
the effect of these labels on behavior, the relative impact of these labeling schemes is unknown.
Such rigorous evaluations are needed so policy makers do not have to guess. The overall
objective of this application is to compare four theoretically-informed nutrition label designs in
the first long-term, large-scale randomized trial of nutrition messages. The study will be
conducted in partnership with the Philadelphia Department of Public Health which will enable us
to randomize 267 (107 snack and 160 beverage) vending machines to different nutrition label
messages. Beverage machines will be randomized to one of the following four conditions: 1) A
single green traffic light label next to items meeting a “healthy” threshold; 2) a multiple traffic
light label that displays red, yellow, or green labels to indicate options that range from less to
more healthy; 3) a physical activity label that indicates the number of minutes one would have to
walk to burn off the calories in each food or beverage; or 4) tax-related messaging (Philadelphia
implemented a 1.5 cents per ounce beverage tax in January 2017). Snack machines will be
randomized to the same conditions except for the tax messaging, which does not apply to
foods. We will use vending machine transaction data over three years to compare the influence
each label has on average calories and percentage of healthy and less healthy items purchased
as well as impact on sales. We will also conduct interviews with 2,916 vending machine patrons
to evaluate whether education level and other factors moderate message influence. This study
will provide valuable data to fill research gaps and inform policy makers’ efforts to use nutrition
labeling and messaging as a public health approach to encourage healthier choices and
address health disparities.
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## Key facts

- **NIH application ID:** 9980378
- **Project number:** 5R01DK113307-03
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Christina Ann Roberto
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $459,556
- **Award type:** 5
- **Project period:** 2018-09-17 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9980378

## Citation

> US National Institutes of Health, RePORTER application 9980378, A large-scale, long-term, randomized trial of nutrition labeling interventions (5R01DK113307-03). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/9980378. Licensed CC0.

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