Objective: Evidence for effective interventions to improve the quality of out-of-home foods is limited. The Healthier Dining Programme (HDP) is a voluntary government programme designed to increase the availability and accessibility of healthier foods and beverages at eateries in Singapore, a multi-ethnic and highly urbanized, developed nation. The objective of our study was to evaluate effects of the HDP on the out-of-home dietary intakes of consumers at an institute of higher learning.
Design/Setting: We used a cluster-randomized trial design. Six food centers (two food courts and four canteens) at a large university campus were randomly assigned to the intervention or control arm. Participants were university students or staff aged ≥18 years (n=408) who frequently dined at these six food centers. Relevant data were gathered by interview and a 7-day food diary before and after 10 weeks of the intervention. Generalized estimating equations for logistic and linear regression were used to assess the difference in intake of out-of-home healthier dishes between the two study arms.
Results: Participants in the intervention arm were more likely to have at least one healthier out-of-home dish per week as compared to those in the control arm (84% vs. 65%, unadjusted OR: 2.79 95% CI: 1.59, 4.88). This was due mainly to the higher consumption of dishes prepared with healthier oil blends (unadjusted OR: 3.24 95% CI: 1.95, 5.38) and lower-sodium salt (unadjusted OR: 4.36 95% CI: 1.64, 11.58) in the intervention arm. Whilst saturated and polyunsaturated fat intake in the two arms were comparable, participants in the intervention arm had lower total fat (-1.27 g/1000 kcal, 95% CI: -2.48, -0.06) and monounsaturated fat intakes (-0.50 g/1000 kcal, 95% CI: -0.94, -0.06), from out-of-home dishes as compared with the control arm.
Conclusions: These findings suggest that environmental interventions at institutes of higher learning to increase healthier food availability and accessibility can improve dietary intake from out-of-home foods.