Does point-of-purchase nutrition labeling influence meal selections? A test in an Army cafeteria

Military Medicine, Jul 2003 by Sproul, Allen D, Canter, Deborah D, Schmidt, Jeffrey B

Objective: This study assessed the effectiveness of nutrition labeling on sales of targeted entrees and measured the perceived influence that factors such as taste, quality, appearance, fat content, calorie content, and price had on meal selection behavior within an Army cafeteria. Methods: A quasi-experimental design was used to compare targeted entree sales between a 1-year baseline period and two 30-day postintervention periods, after the placement of entree nutrition labels. A brief questionnaire, distributed to 149 patrons, measured the perceived influence of the aforementioned factors on selections. Results: Analysis of variance detected no significant differences in sales between baseline and the two intervention periods; the factors of taste and quality were rated most influential to meal selection (p

Introduction

The Department of Defense mandates that its active duty military personnel maintain certain standards for body fat percentage. If an active duty member fails to maintain these standards, a discharge from service may result. The cost of weight-related discharges is significant and far reaching. According to recent data from the Retirements and Separations Division, U.S. Air Force Personnel Center during 1999, the Air Force lost approximately 126 million dollars because of weight-related discharges.1 Considering administrative costs, severance pay, and costs to recruit and train replacements, the total cost (depending on rank) for each member was between $176,000 and $235,000.

To assist active duty members with maintaining acceptable body composition and ultimately to help reduce weight-related discharges, efforts have been made to provide nutrition labeling at the point of purchase within the Department of Defense base dining facilities. The intent is to influence members to choose those foods that provide the highest nutrient density. Such food selections, which typically are of lower caloric content, might then contribute to the optimum health and body composition of military troops.

Base food service operators have complied with senior leadership requests and mandates to incorporate lower fat choices into the facility menu and to increase marketing efforts such that attention would be drawn to these low-fat menu additions. However, with time, it was noted and voiced that sales of the healthy additions, despite marketing efforts, did not support their continued place on the menu.

In the civilian sector, much effort has been directed at determining the most effective method for providing accurate and reliable nutrition information at the point-of-purchase to dining customers. The goal of any nutrition-labeling program should be to provide adequate information so that customers may feel compelled to choose food items that provide optimum health benefit. Many researchers have determined that despite offering healthful food items and providing influential nutrition information, not all customers opt to select the healthy food.2-4 It has been reported that education, age, and gender are most closely associated with food choice behaviors that reflect recommendations to reduce dietary fat and increase fruit and vegetable consumption.5,6

An abundance of research has been conducted to assess the overall effectiveness of point of purchase nutrition labeling protocols in various settings and has produced mixed findings. Several authors reported positive changes in targeted entree selections following implementation of incentive-based nutrition labeling programs.7-9 The incentives included items such as cash rebates, games, and raffles. Other authors produced significant changes in targeted food selections without the use of incentives.10-15 These programs simply emphasized the health attributes of the targeted foods. However, other researchers, using similar nonincentive-based labeling protocols, produced only limited changes in targeted food selections or none at all.16-21

The emphasis of military nutrition intervention campaigns has typically centered on the health attributes of the targeted food items. However, it has been reported that other factors, such as taste, appearance, value, price, and convenience, may be more influential to meal selections than health attributes.5,14,18,19,22-29

Additionally, it has been reported that education, age, and gender are most closely associated with food choice behaviors that reflect recommendations to reduce dietary fat and increase fruit and vegetable consumption.5,28 Specifically, these authors suggested that younger (~24 years) men would tend to be the least concerned about nutrition-related issues. If a particular military population was concentrated with younger men, it would be reasonable to hypothesize that nutrition intervention messages aimed at influencing meal selections might not be particularly effective, especially if the emphasis of the message was health attribute related.

Although substantial research has been conducted in the civilian setting regarding factors influencing meal selections and on the effects of nutrition labeling protocols, no objective data has been gathered pertaining to this topic from among active duty military members frequenting base dining facilities.