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Food SelectionNCT05664256

Evaluation of a Healthy Food Procurement Policy at Municipality-level in Nepal

A study testing Build capacity of canteen, Information, Education and Communication materials and Monitoring visit in people with Food Selection, run by Kathmandu University School of Medical Sciences at 1 site in Nepal.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The rise in chronic diseases is attributed to unhealthy eating high in sugar, salt and saturated fats, which is facilitated by the availability and consumption of these unhealthy foods. Read more about this study

Who is it for?
Ages 15 to 59 yearsHealthy volunteers can take part
Conditions the study is for
Food Selection
What is being tested?
Build capacity of canteen, Information, Education and Communication materials and Monitoring visit
Could I receive a placebo?
No, everyone receives an active treatment
How many people
402 participants
Where
1 siteNepal
Study dates
27 May 2023to 30 Aug 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 15 to 59 years
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult

Who may be able to join

  • Participants inclusion criteria:
  • Canteen managers or staff who are directly involved in food procurement and service (purchasing, preparation, serve or sell) at the canteen and available at the time of interview; - Canteen managers or staff age between 15-59 year; and
  • who can communicate verbally.
  • Facilities inclusion criteria:
  • facilities: government schools, private schools, government worksites, government hospitals, government care homes and government correctional facilities
  • facilities within the surrounding of the selected municipality
  • facilities who have their own canteen facilities

Who cannot join

  • Participants exclusion criteria
  • Voluntarily requesting exclusion from the study

Trial locations and contacts

1 site in 1 country.

Archana Shrestha, PHD contact

+977-9801002245

archana@kusms.edu.np

Namuna Shrestha, MPH contact

+977-9841418681

namuna@kusms.edu.np

Nepal1 site, 1 recruiting
  • Budhanilkantha

    Hattigauda, Province, +977

    Budhanilkantha, 01-4372725, info@budhanilkanthamun.gov.np

    Kumar Dahal, 9841592308, kmr.dahal24@gmail.com

    Recruiting

Other trials in Nepal

About this study

Official title: Develop, Implement and Evaluate a Public Food Procurement Policy in Nepal

The rise in chronic diseases is attributed to unhealthy eating high in sugar, salt and saturated fats, which is facilitated by the availability and consumption of these unhealthy foods. The investigators will conduct the Randomized Controlled Trial to evaluate the effect of food procurement policy on the food environment in the public facilities like schools, worksites, hospitals, correctional facilities and care homes of four municipalities of Bagmati Province, Nepal. The investigators will develop food procurement policy and get endorsed from each municipality through their legislative process. In three months, the change in the food environment after implementing the policy in public facilities of the respective municipalities will be measured.

Read the detailed description

Introduction:

Unhealthy foods that are high in sugar, salt and saturated fats significantly contribute to poor population health such as obesity and chronic diseases; and are widely available in public facilities including schools, workplaces and health care facilities. Unhealthy diets are thus influenced by an unhealthy food environment. Today's food environment is dependent on the consumer's choice and is supposed to be challenging. Consumers are not taking healthy choices on their nutrition and health. Thus, promotion of a healthier food environment in public facilities is recognized as the best measure for addressing the adverse health outcomes. Healthy public food procurement consists of procuring, distributing, selling, and/or serving food to facilitate healthier dietary behaviors. The development, implementation and adoption of healthy food procurement policy is regarded as the promising strategy to address the health consequences associated with unhealthy foods. Nepal still is struggling in meeting high standards of safe, nutritious diets for the entire population. Due to the increased market prices of the foods, the purchasing capacity of the country has been affected. There are issues of nutrition transition which have resulted in a lack of dietary diversity. The sales as well as demand of ultra-processed foods are increasing. The typical dietary pattern of refined grains, meat and alcohol is associated with a higher prevalence of overweight and obesity. Deep-fried foods are associated with hypertension; the cereal and vegetable pattern are inversely associated with diabetes prevalence. The foods such as packed foods, canned juices, cold drinks, restaurant foods and other junk foods are sold everywhere which is due to attractive media advertisements; increase in street food, supermarkets, fast food chain industries; quick availability/preparation/consumption; easy carrying and handling with home packing system.

There is sufficient evidence that public food procurement policy with randomized controlled trials (RCTs) shows increasing the consumption and availability of healthy food in public facilities such as school, hospital, correctional facilities and care homes; there is no such study in Nepal. In this study, the investigators will take reference from the World Health Organization Action framework for developing and implementing public food procurement and service policies for a healthy diet. The healthy food procurement and service policy can be a "double duty action" for improving health and reducing all forms of malnutrition in the population. Making public food procurement and service policies healthier is a low-cost strategy that can improve the health and nutritional status, including weight-related outcomes, of the population by increasing the availability and consumption of healthier food in public settings, while simultaneously decreasing availability and consumption of unhealthy food. Different countries have committed to taking action to promote healthy diets and eliminate malnutrition in all its forms, including ensuring healthy food in public facilities.

Rationale:

Unhealthy foods that are high in sugar, salt and saturated fats significantly contribute to poor population health such as obesity and chronic diseases; and are widely available in public facilities including schools, workplaces and health care facilities. People tend to be unaware or ignore the health effects of these unhealthy foods. Improving knowledge on unhealthy eating is necessary but not sufficient to change dietary behaviors at the population level. Therefore, population-level policies and programs are necessary to address unhealthy eating at societal level. Nepal Government recognizes nutrition and food security as a top priority. However, no specific food procurement policy to regulate purchase and availability of healthy foods is in place. Development and implementation of a sustainable public food procurement and service policy will lead to availability of a wider variety of healthier products for the public.

Objectives:

Assess the effectiveness of public food procurement policy implementation.

Conditions
Food Selection
Being tested
Build capacity of canteen, Information, Education and Communication materials, Monitoring visit
Keywords
Food availability, Healthy Food, Food Procurement Policy
Medical subject headings
Food Preferences

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Build capacity of canteenOther

    The investigators will conduct 1 day orientation training to the school nurse, principal and canteen managers of the facilities.

    Different sessions on basic nutrition concept, healthy eating, healthy cooking practices including purchasing and serving will be conducted.

    The investigators will develop training manuals: training curriculum, facilitators guide, and participants guide, aligning with policy contents.

  • Information, Education and Communication materialsOther

    Posters showing healthy plate model will be displayed on the canteen walls. The fact sheet on healthy eating will be distributed to all the public facilities and make it available at the entrance/ gate of the canteen.

  • Monitoring visitOther

    A monitoring team from each municipality will be formed. The monitoring plan will be prepared with the team. At least one monitoring visit from the municipality government with onsite feedback will be done.

Study groups in NCT05664256
Study groupRoleWhat they receive
policy intervention groupExperimentalThe group will receive the policy intervention package.
Receives: Other: Build capacity of canteen; Other: Information, Education and Communication materials; Other: Monitoring visit
policy control groupNo interventionThe group will follow the usual guidelines for food procurement policy at the canteen. After three months, the group will receive the policy intervention package.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in availability of healthy and unhealthy food options

    We will calculate the percentage change in both the availability and sales of the foods such as fruits, vegetables, whole grains, trans fats, high sodium and sugar containing foods.

    Measured: 3 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Dec 2022
  2. Study start27 May 2023
  3. Primary completion30 Dec 2023
  4. Study completion30 Aug 2024 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
402 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05664256
Sponsor's protocol ID
628b9a3dcaeacc9d7bbc90f7
Status last verified
Mar 2024
First submitted
1 Nov 2022
Last updated
4 Mar 2024
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Vandevijvere S, Chow CC, Hall KD, Umali E, Swinburn BA. Increased food energy supply as a major driver of the obesity epidemic: a global analysis. Bull World Health Organ. 2015 Jul 1;93(7):446-56. doi: 10.2471/BLT.14.150565.

    PubMed 26170502
  • Influencing food environments for healthy diets. [cited 11 Oct 2022]. Available: https://www.fao.org/policy-support/tools-and-publications/resources-details/en/c/459821/

  • Towards Zero Hunger in Nepal - A Strategic Review of Food Security and Nutrition 2018. In: ReliefWeb [Internet]. [cited 11 Oct 2022]. Available: https://reliefweb.int/report/nepal/towards-zero-hunger-nepal-strategic-review-food-security-and-nutrition-2018

  • Tamrakar D, Shrestha A, Rai A, Karmacharya BM, Malik V, Mattei J, Spiegelman D. Drivers of healthy eating in a workplace in Nepal: a qualitative study. BMJ Open. 2020 Feb 25;10(2):e031404. doi: 10.1136/bmjopen-2019-031404.

    PubMed 32102804
  • Transforming our world: the 2030 Agenda for Sustainable Development. In: UNDP [Internet]. [cited 11 Oct 2022]. Available: https://www.undp.org/ukraine/publications/transforming-our-world-2030-agenda-sustainable-development

  • Amoroso L. The Second International Conference on Nutrition: Implications for Hidden Hunger. World Rev Nutr Diet. 2016;115:142-52. doi: 10.1159/000442100. Epub 2016 May 19.

    PubMed 27197665
  • Diseases N. Global Action Plan for the Prevention and Control of NCDs 2013-2020. World Health Organization; 14 Nov 2013 [cited 11 Oct 2022]. Available: https://www.who.int/publications/i/item/9789241506236

  • Winson A. School Food Environments and the Obesity Issue: Content, Structural Determinants, and Agency in Canadian High Schools. 2008 [cited 11 Oct 2022].

  • Gardner CD, Whitsel LP, Thorndike AN, Marrow MW, Otten JJ, Foster GD, Carson JA, Johnson RK. Food-and-beverage environment and procurement policies for healthier work environments. Nutr Rev. 2014 Jun;72(6):390-410. doi: 10.1111/nure.12116. Epub 2014 May 6.

    PubMed 24801009
  • Dhungana RR, Thapa P, Devkota S, Banik PC, Gurung Y, Mumu SJ, Shayami A, Ali L. Prevalence of cardiovascular disease risk factors: A community-based cross-sectional study in a peri-urban community of Kathmandu, Nepal. Indian Heart J. 2018 Dec;70 Suppl 3(Suppl 3):S20-S27. doi: 10.1016/j.ihj.2018.03.003. Epub 2018 Mar 10.

    PubMed 30595258
  • Healthy Food Systems - Access to Healthy Food and Water. [cited 11 Oct 2022]. Available: https://phasocal.org/alliance-legislative-platform/healthy-food-systems-access-to-healthy-food-and-water/

  • Raine KD, Atkey K, Olstad DL, Ferdinands AR, Beaulieu D, Buhler S, Campbell N, Cook B, L'Abbe M, Lederer A, Mowat D, Maharaj J, Nykiforuk C, Shelley J, Street J. Healthy food procurement and nutrition standards in public facilities: evidence synthesis and consensus policy recommendations. Health Promot Chronic Dis Prev Can. 2018 Jan;38(1):6-17. doi: 10.24095/hpcdp.38.1.03.

    PubMed 29323862
  • Slater J, Green CG, Sevenhuysen G, Edginton B, O'Neil J, Heasman M. The growing Canadian energy gap: more the can than the couch? Public Health Nutr. 2009 Nov;12(11):2216-24. doi: 10.1017/S1368980009990309. Epub 2009 Jun 17.

    PubMed 19531279

Questions about this trial

What is this clinical trial studying?

A study testing Build capacity of canteen, Information, Education and Communication materials and Monitoring visit in people with Food Selection, run by Kathmandu University School of Medical Sciences at 1 site in Nepal.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 4 Mar 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Nepal. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Archana Shrestha, PHD (+977-9801002245, archana@kusms.edu.np), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in availability of healthy and unhealthy food options (time frame: 3 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05664256, which also lists 13 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Mar 2024.

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