Nav: Home

Color-coded labels improve healthy food choices in employees from all backgrounds

August 07, 2012

A program designed to encourage more healthful food choices through simple color-coded labels and the positioning of items in display cases was equally successful across all categories of employees at a large hospital cafeteria. In an article appearing in American Journal of Preventive Medicine, a team of Massachusetts General Hospital (MGH) researchers report that the interventions worked equally well across all racial and ethnic groups and educational levels.

"These findings are important because obesity is much more common among Americans who are black or Latino and among those of low socioeconomic status," says Douglas Levy, PhD, of the Mongan Institute for Health Policy at MGH, lead author of the AJPM report. "Improving food choices in these groups may help reduce their obesity levels and improve population health."

The authors note that current efforts to encourage healthful food choices by labeling or posting the calorie content of foods have had uncertain results. Even individuals with relatively high educational levels may have difficulty reading and understanding nutritional labels, and the problem is probably greater among low-income or minority individuals with limited literacy. As reported earlier this year, the MGH research team - which includes leaders of the MGH Nutrition and Food Service - devised a two-phase plan to encourage more healthful food purchases without the need for complex food labels.

In the first phase, which began in March 2010, color-coded labels were attached to all items in the main hospital cafeteria - green signifying the healthiest items, such as fruits, vegetables and lean meats; yellow indicating less healthy items, and red for those with little or no nutritional value. The second "choice architecture" phase, which began in June 2010, focused on popular items - cold beverages, pre-made sandwiches and chips - likely to be purchased by customers with little time to spend who may be more influenced by location and convenience. Cafeteria beverage refrigerators were arranged to place water, diet beverages and low-fat dairy products at eye level, while beverages with a red or yellow label were placed below eye level. Refrigerators and racks containing sandwiches or chips were similarly arranged, and additional baskets of bottled water were placed near stations where hot food was served.

The study was designed to measure changes in employee purchases of green-, yellow- and red-labeled items by racial/ethnic categories and by job type during both phases of the program. Data reflecting purchases by more than 4,600 employees, each of whom was enrolled in a program allowing them to pay for meals through payroll deduction, was recorded by cafeteria cash registers and matched to human resources information. While it was possible to track how an individual employee's food choices changed during the study period, no information that could identify an employee was available to the research team. Participants were categorized by self-reported race or ethnicity - white, black, Latino or Asian. Educational level was reflected by job type - service workers; administrative/support staff; technicians, including radiology technicians and respiratory therapists; health professionals, such as pharmacists and occupational therapists; or management/clinicians, which included physicians and nurses.

At the outset of the study, black and Latino employees and those in job categories associated with lower education purchased more red items and fewer green items than did white employees or those in higher-education job types. But at the end of both phases of the intervention, employees in all groups purchased fewer red items and more green items. A specific analysis of beverage purchases - chosen because the consumption of sugar-sweetened beverage is highest among black and low-income individuals and strongly linked to obesity, diabetes and heart disease - found that the purchase of healthful beverages increased for all groups. In addition, black and low-education employees, who paid the highest cost per beverage at the study's outset, were paying significantly less per beverage purchased at the end of the study period.

All elements of the overall program remain in place at the MGH, and the color-coded labeling has been extended to all food service sites. "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," says Levy, an assistant professor of Medicine at Harvard Medical School. "But because these measures are both simple and inexpensive to implement, they could easily be tried in a variety of food sales environments - such as cafeterias, convenience stories and even vending machines."
-end-
Additional co-authors of the study - which was supported by the National Center for Research Resources and the National Heart, Lung and Blood Institute - are Lillian Sonnenberg, DSC, RD, LDN, and Susan Barraclough, MS, RD, LDN, MGH Nutrition and Food Services; Anne Thorndike, MD, MPH, MGH division of General Medicine; and Jason Riis, PhD, Harvard Business School.

Massachusetts General Hospital (www.massgeneral.org), founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of more than $750 million and major research centers in AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, human genetics, medical imaging, neurodegenerative disorders, regenerative medicine, reproductive biology, systems biology, transplantation biology and photomedicine. In July 2012, MGH moved into the number one spot on the 2012-13 U.S. News & World Report list of "America's Best Hospitals."

Massachusetts General Hospital

Related Employees Articles:

How employees' rankings disrupt cooperation and how managers can restore it
First prize is a Cadillac Eldorado, second prize a set of steak knives, third prize you're fired».
Employees less upset at being replaced by robots than by other people
Generally speaking, most people find the idea of workers being replaced by robots or software worse than if the jobs are taken over by other workers.
Some LGBT employees feel less supported at federal agencies
Workplace inequality is visible when it involves gender and race, but less so with sexual identity and gender expression.
Workplace interventions may improve sleep habits and duration for employees
Simple workplace interventions, like educating employees about the importance of sleep and providing behavioral sleep strategies, may produce beneficial results, according to a new review.
To keep the creative juices flowing, employees should be receptive to criticism
Though most firms today embrace a culture of criticism, when supervisors and peers dispense negative feedback it can actually stunt the creative process, according to a new study co-authored by Yeun Joon Kim, a Ph.D. student at the University of Toronto's Rotman School of Management.
How a positive work environment leads to feelings of inclusion among employees
Fostering an inclusive work environment can lead to higher satisfaction, innovation, trust and retention among employees, according to new research from Binghamton University, State University of New York.
How susceptible are hospital employees to phishing attacks?
A multicenter study finds high click rate for simulated phishing emails, potential benefit in phishing awareness training.
Good grief: Victimized employees don't get a break
As if being picked on wasn't bad enough, victims of workplace mistreatment may also be seen as bullies themselves, even if they've never engaged in such behavior.
It pays to be nice to your employees, new study shows
New research from Binghamton University, State University at New York finds that showing compassion to subordinates almost always pays off, especially when combined with the enforcement of clear goals and benchmarks.
PTSD rate among prison employees equals that of war veterans
Prison employees experience PTSD on par with Iraq and Afghanistan war veterans, a new study from a Washington State University College of Nursing researcher found.
More Employees News and Employees Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Uncharted
There's so much we've yet to explore–from outer space to the deep ocean to our own brains. This hour, Manoush goes on a journey through those uncharted places, led by TED Science Curator David Biello.
Now Playing: Science for the People

#555 Coronavirus
It's everywhere, and it felt disingenuous for us here at Science for the People to avoid it, so here is our episode on Coronavirus. It's ok to give this one a skip if this isn't what you want to listen to right now. Check out the links below for other great podcasts mentioned in the intro. Host Rachelle Saunders gets us up to date on what the Coronavirus is, how it spreads, and what we know and don't know with Dr Jason Kindrachuk, Assistant Professor in the Department of Medical Microbiology and infectious diseases at the University of Manitoba. And...
Now Playing: Radiolab

Dispatch 1: Numbers
In a recent Radiolab group huddle, with coronavirus unraveling around us, the team found themselves grappling with all the numbers connected to COVID-19. Our new found 6 foot bubbles of personal space. Three percent mortality rate (or 1, or 2, or 4). 7,000 cases (now, much much more). So in the wake of that meeting, we reflect on the onslaught of numbers - what they reveal, and what they hide.  Support Radiolab today at Radiolab.org/donate.