Effects of an Educational Planetary Plate Graphic on Meat Consumption

Effects of an Educational Planetary Plate Graphic on Meat Consumption in Stanford University Dining Hall: a Randomized Controlled Trial

The objective of this research was to determine if adding a plate graphic depicting the components of the Eat Lancet Planetary Health diet (Figure 1) to food labels in Stanford University dining halls would lead to dining hall patrons making dietary decisions that better resemble the Planetary Health diet in comparison to a no signage control group. The study hypothesis was that presenting students with a plate graphic featuring the healthy reference diet would decrease objective measures of the amount of meat taken and therefore the environmental impact of student meals.

Study Overview

• Status: Completed
• Conditions: Diet, Food and Nutrition
• Intervention / Treatment: Behavioral: Planetary Health Plate signage

Detailed Description

Research was conducted into the everyday experience of dining hall patrons. All participants were patrons of Florence Moore Dining Hall on the Stanford University campus where all data was collected. Patrons were largely undergraduate students.This investigation was designed as a crossover randomized control trial with two phases: (1) a Planetary Health Plate (PHP) intervention phase where signage promoting the planetary health diet was posted and (2) a control phase with signage as usual. Stanford Dining serves food on a four-week menu cycle; this pattern results in several academic weeks that are intended to be identical in food served. To standardize the conditions and limit potential confounding, the experimental and control phases were each randomized to one of the weeks throughout the quarter when the same, "week two" menu was to be served. Data was collected for the control phase during week two of the academic winter quarter and data with the PHP posted was collected during week six of the academic winter quarter.

On each data collection day, two different types of meat dishes were provided by the Dining Hall and there were two stations with each type. Research assistants weighed each serving tray of meat as it came from the kitchen and again before returning the used serving tray to the kitchen, to determine the total amount of meat taken from the tray. Tally counters were used to count the number of patrons who took meat from the tray. Qualitative notes about patron behavior and possible deviations from data collection protocol were recorded on data collection sheets. After each dinner collection period, Stanford Dining provided the total number of people who entered the dining hall during the designated dinner periods on each of the data collection days. This was based on the number of unique identification card swipes into the dining hall during dinner times.

Comparison was made between 1) dietary behavior without signage, and 2) behavior while exposed to PHP during four equivalent dinner meals.

• Study Type: Interventional
• Enrollment (Actual): 957
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • California
    • Stanford, California, United States, 94305
      • Florence Moore Dining Hall, Stanford University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion criteria:

• Patrons of Florence Moore Dining Hall at Stanford.

Exclusion criteria:

• None

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Planetary Health Plate Signage; A Planetary Health Plate intervention phase where signage was posted in the dining hall promoting the planetary health diet	Behavioral: Planetary Health Plate signage; A Planetary Health Plate graphic was developed based on the healthy reference diet proposed by the Eat Lancet Commission. The graphic was designed to capture the food groups and proportions of food groups promoted by the Planetary Health diet.
No Intervention: Control; Control phase with dining hall signage as usual.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Meat-dish weight	Meat-dish weight adjusted for the number of people entering the dining hall.	Control: 4 days (during dinner meals Mon -Thurs) during week 2 of the academic quarter. Intervention: 4 days (during dinner meals Mon -Thurs) during week 6.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Meat-dish servings	Number of meat-dish servings	Control: 4 days (during dinner meals Mon -Thurs) during week 2 of the academic quarter. Intervention: 4 days (during dinner meals Mon -Thurs) during week 6.
Meat-dish serving weight	Average meat-dish serving weight	Control: 4 days (during dinner meals Mon -Thurs) during week 2 of the academic quarter. Intervention: 4 days (during dinner meals Mon -Thurs) during week 6.

Collaborators and Investigators

• Sponsor: Stanford University
• Investigators: Principal Investigator: Christopher D Gardner, MD, Stanford University

Publications and helpful links

General Publications

• Willett W, Rockstrom J, Loken B, Springmann M, Lang T, Vermeulen S, Garnett T, Tilman D, DeClerck F, Wood A, Jonell M, Clark M, Gordon LJ, Fanzo J, Hawkes C, Zurayk R, Rivera JA, De Vries W, Majele Sibanda L, Afshin A, Chaudhary A, Herrero M, Agustina R, Branca F, Lartey A, Fan S, Crona B, Fox E, Bignet V, Troell M, Lindahl T, Singh S, Cornell SE, Srinath Reddy K, Narain S, Nishtar S, Murray CJL. Food in the Anthropocene: the EAT-Lancet Commission on healthy diets from sustainable food systems. Lancet. 2019 Feb 2;393(10170):447-492. doi: 10.1016/S0140-6736(18)31788-4. Epub 2019 Jan 16. No abstract available. Erratum In: Lancet. 2019 Feb 9;393(10171):530. Lancet. 2019 Jun 29;393(10191):2590. Lancet. 2020 Feb 1;395(10221):338. Lancet. 2020 Oct 3;396(10256):e56.

Study record dates

Study Major Dates

• Study Start (Actual): January 2, 2020
• Primary Completion (Actual): June 1, 2020
• Study Completion (Actual): March 9, 2022

Study Registration Dates

• First Submitted: July 21, 2022
• First Submitted That Met QC Criteria: September 29, 2022
• First Posted (Actual): October 4, 2022

Study Record Updates

• Last Update Posted (Actual): October 4, 2022
• Last Update Submitted That Met QC Criteria: September 29, 2022
• Last Verified: September 1, 2022

More Information

Terms related to this study

• Keywords: Environment; Food insecurity; Behavior change; Sustainability; Food choices; Planetary health; Educational signage; Dietary behavior
• Other Study ID Numbers: 52769

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No