Arnold-Wheeler Methods

Presentation
By: Amy Martin
Mentor: Dr. Vollmer
Introduction: Nutrition labelling in college dining halls

● Childhood → adulthood
○ Increase in diet quality (Thiele, Mensink, Beitz, 2004)

● Exception: Adolescence → adulthood

○ Decrease in diet quality (Forshee & Storey, 2006)
○ No parental guidance (Nelson, Story, Larson, Neumark-Sztainer, Lytle, 2008)

● Dining halls
○ Overeating, large serving sizes (Rolls, 1986; Rolls et al, 2002)
○ Difficult to make healthy choices (Peterson et al, 2010)
Introduction: Nutrition labelling in college dining halls

● Use of nutrition labels (Campos et al, 2011; Graham & Laska, 2012)
○ Promotes healthy diet choices
○ Frequent users: more likely to have healthy dietary behaviors

● Study: 1,201 college students (Graham & Laska, 2012)

○ 35% frequently use labels before purchasing

● May struggle to understand nutrition information

○ (Baltas, 2001; Cowburn & Stockley, 2005; Drichoutis, 2006; Mhurchu & Gorton, 2007)

● Label alterations should be explored

○ (Ollenberg & Wolf, 2010)
Introduction: Nutrition labelling in college dining halls

● Food Standards Agency (Food Standards Agency, 2007)

○ Sets standards for this system

● Why was this system developed?

○ Low use of back-of-package label
■ Difficult to understand
■ (Cowburn & Stockley 2005; Grunert & Wills 2007; Graham et al,
2012; Sharf et al, 2012)
○ Grab attention of consumers
■ Easier to understand
■ (Grunert et al, 2010)
Research Question

Does a traffic light system impact the amount of food served among
college students in a dining hall compared to the amount of food
served when nutrition facts panels are present?
Design
● Measurements taken during 3 periods: control, intervention, follow-up
● Lunch & dinner in Geisert dining hall- Daily Feature line only
○ 28-day menu cycle

● Each item assigned to a color depending on nutritional value

○ Using positive & negative criteria
○ Net positive = green
○ Net neutral (0) = yellow
○ Net negative = red
○ (Seward, et al, 2016)
Design- Table 1. Traffic Light Label Nutritional Criteria
Positive Criteria Negative Criteria

Source of fruit or fruit juice (greater than 80% Saturated fat content greater than 5g
juice)

Source of vegetables Added sugar: has a total sugar content of

more than 8g, contains added sugar

Source of whole grains with a carbohydrate- High sugar: has a sugar content greater than
fiber ratio less than 10 20g

Lean protein source: must have less than 5g High sodium: has a sodium content greater
saturated fat and 12g or more of protein than 600mg

Low-fat dairy source: at least 200mg calcium Source of red meat

and less than 2g saturated fat

Source of refined starch with a carbohydrate-

fiber ratio greater than 10

Adapted from: Seward, Michael, et al. (2016). A Traffic-Light Label Intervention and Dietary Choices in College Cafeterias. American Journal of Public
Health, 106(10), 1808-1814.
Color Assignment Example: Black Bean Penne
Fruit Vegetable Whole Lean Low Fat Saturated Added High High Red Refined Traffic
Source Source Grain Protein Dairy Fat Sugar Sugar Sodium Meat Starch Light
Color

NA (+) (+) (+) NA NA NA NA (-) NA NA

Whole grain pasta blended with black beans, corn and salsa, cheddar cheese and
sliced jalapenos. Serving size 1 cup.
Positive Criteria
Calories: 270 Vegetable Source + 1
Calories from Fat: 80 Whole Grain +1
Total Fat: 8g Lean Protein +1
Saturated Fat: 3.5g
Trans Fat: 0g Negative Criteria
Cholesterol: 15mg High Sodium -1
Sodium: 790 mg
Total Carbohydrate: 39g 1 + 1 + 1 - 1 = 2 → Net positive → Green label
Dietary Fiber: 8g
Sugars: 4g
Protein: 12g
Design
Design- Traffic Light Label
Design- Explanatory Signage
Data Collection
● Main variable of interest -servings taken
○ Observational
○ Data already collected by Bradley University Dining Services
○ Servings taken will be collected
■ For every green, yellow & red item
■ For all 3 time periods
■ At both lunch & dinner
■ Daily Feature line in Geisert only
Survey
● Those who are eligible…
○ Patrons who take food from the Daily Feature line
○ 18 years or older
● Recruitment at lunch & dinner on random days during each cycle (the 3rd & 17th
days)
○ Stand at the end of Daily Feature line
○ Read script
● Following informed consent
○ Fill out survey
○ Control & Intervention: demographics, nutrition course, basic dining hall habits
○ Follow-Up: added questions about traffic-light labels
● Sample Size
○ Usually around 460 patrons at lunch and 439 at dinner
○ Goal: 100 patrons fill out survey at 12 time points
● Survey Draft
Statistical Analysis
● Dependent variables
○ Amount of red, yellow, and green food served
● Independent variables
○ Different labelling conditions present in each phase of the intervention
● One-way repeated measures multivariate analysis of variance (MANOVA analysis)
○ Assess the difference in the amount of food served under three different conditions across time
References
Campos, Sarah, et al. (2011). Nutrition labels on pre-packaged foods: A systematic review. Public Health Nutrition. 14(8), 1496-1506.
Cowburn Gill & Stockley Lynn. (2005). Consumer understanding and use of nutrition labelling: a systematic review. Public Health Nutrition, 8(1), 21–28.
Drichoutis, Andreas C., et al. (2006). Consumers’ use of nutritional labels: a review of research studies and issues. Academy of Marketing Science Review, 9, 93–118.
Food Standards Agency. (2007). Front-of-pack traffic light signpost labelling, Technical guidance. Retrieved from
https://nutritionprogram.files.wordpress.com/2009/11/frontofpackguidance21.pdf.
Forshee Richard A., & Storey, Maureen L. (2006) Demographics, not beverage consumption, is associated with diet quality. International Journal of Food Sciences and Nutrition 57(7-8), 494–
511.
Graham, Dan J., & Laska, Melissa N. (2012). Nutrition Label Use Partially Mediates the Relationship between Attitude toward Healthy Eating and Overall Dietary Quality among College
Students. Journal of The Academy of Nutrition and Dietetics. 112(3), 414-418.
Grunert, Klaus G., Wills, Josephine M., Fernández-Celemín, Laura. (2010). Nutrition knowledge, and use and understanding of nutrition information on food labels among consumers in the UK.
Appetite, 55, 177–189.
Grunert, Klaus G., Laura Fernández-Celemín, Josephine M. Wills, Stefan Storcksdieck genannt Bonsmann, and Liliya Nureeva (2010), “Use and Understanding of Nutrition Information on Food
Labels in Six European Countries,” Journal of Public Health, 18 (3), 261–77.
Mhurchu, Cliona Ni & Gorton, Delvina (2007). Nutrition labels and claims in New Zealand and Australia: a review of use and understanding. Australian and New Zealand Journal of Public
Health, 31(2), 105–112.
Nelson, Melissa C., Story, Mary, Larson, Nicole I., Neumark-Sztainer, Dianne, Lytle, Leslie A. (2008). Emerging adulthood and college-aged youth: An overlooked age for weight related
behavior change. Obesity, 16(10), 2205-2211.
Ollenberg, Nicholas Jay & Wolf, Randi L. (2010). Food Label Use and Its Relation to Dietary Intake among US Adults. Journal of the American Dietetic Association, 110(8), 1233-1237.
Peterson, Sharon, et al. (2010). Positive Changes in Perceptions and Selections of Healthful Foods by College Students After a Short-Term Point-of-Selection Intervention at a Dining Hall.
Journal of American College Health, 58(5), 425-431.
Rolls, Barbara J., Morris, Erin L., Roe, Liane S. (2002). Portion size of food affects energy intake in normal-weight and overweight men and women. The American Journal of Clinical Nutrition,
76(6), 1207–13.
Rolls, Barbara J, et al. (1986). Sensory-specific satiety. Nutrition Reviews, 44(3), 93–101.
Seward, Michael, et al. (2016). A Traffic-Light Label Intervention and Dietary Choices in College Cafeterias. American Journal of Public Health, 106(10), 1808-1814.
Sharf M, Sela R, Zentner G, Shoob H, Shai I, Stein-Zamir C. 2012. Figuring out food labels. Young adults’ understanding of nutritional information presented on food labels is inadequate.
Appetite 58:531–534.
Thiele, Silke, Mensink, Gert BM, Beitz, Roma. (2004). Determinants of diet quality. Public Health Nutrition 7(1), 29–37.