Food LabellingNCT07809295
Food Menu Labelling Effects on Individuals With Eating Disorders and Other Mental Health Conditions.
A study testing Calorie labelling and Nutri-Score labelling in people with Food Labelling and Eating Behaviour, run by University of Liverpool at 1 site in United Kingdom.
Trial summary
Calorie labelling in out-of-home (OOH) settings was introduced by the government in England as part of a wider strategy to 'tackle obesity' (DHSC, 2020). The OOH sector encompasses outlets where food and drinks are prepared for immediate consumption, on or off the premises (DHSC, 2021). Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Food Labelling, Eating Behaviour, Mental Health
- What is being tested?
- Calorie labelling and Nutri-Score labelling
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 900 participants
- Where
- 1 siteUnited Kingdom
- Study dates
- Sep 2026to Sep 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Residing in the UK
- Regularly eat food prepared out of the home (from restaurants, cafes, fast food etc., at least once a month)
- Over the age of 18 years
- Fluent English speaker
- Can complete the study on a laptop or desktop computer (not touch screen)
- Current or previous eating disorder diagnosis by a medical practitioner
- Current or previous common mental health condition (i.e. anxiety and/or depression) diagnosis by a medical practitioner but no eating disorder diagnosis
- No diagnosis of eating disorder or mental health condition
Who cannot join
- Pregnant/breastfeeding
- Have taken part in a previous study using the same version of the online food choice task (exclusion list obtained from prolific)
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Amy Finlay, PhD contact
United Kingdom1 site
University of Liverpool
Liverpool, Merseyside, L69 7ZA
Eric Robinson, PhD, +44 151794 ext. 1187, robinsoe@liverpool.ac.uk
About this study
Official title: Exploration of Nutri-Score Labelling Out-of-home on Individuals With Eating Disorders and Other Mental Health Diagnoses.
Calorie labelling in out-of-home (OOH) settings was introduced by the government in England as part of a wider strategy to 'tackle obesity' (DHSC, 2020). The OOH sector encompasses outlets where food and drinks are prepared for immediate consumption, on or off the premises (DHSC, 2021). Increased consumption of OOH food is associated with greater intake of energy and nutrients of concern; therefore, is implicated in poorer dietary quality and ill-health (Gesteiro et al., 2022). The key ambition for the calorie labelling policy was to inform consumers of the calorie content of their food choices, making it easier to select healthier food choices (DHSC, 2020). An additional potential benefit of the policy was to prompt reformulation by the food industry to either reduce the calorie content of foods on offer or provide new lower calorie options (DHSC, 2021).
The calorie labelling policy in England was criticised at the time of implementation in the media for its potential to cause harm in individuals with eating disorders (Polden et al., 2023). However, limited research had explored effects on individuals with eating disorders (Robinson et al., 2023). It is estimated that over a million individuals in the UK are living with an eating disorder (Beat Eating disorders, 2026). Therefore, it is important for research to understand the impact of food labelling interventions on mental health outcomes in individuals with eating disorders and other mental health conditions, and whether alternative nutritional labelling practices that are not focused on calories alone could have positive health impacts without unintended negative consequences.
Read more
One alternative form of nutritional labelling that could be considered in OOH settings is Nutri-score. Nutri-score provides food items with a label from A (dark green, healthiest) to E (Red, least healthy) according to the content of both positive (e.g. fibre, protein) and negative (e.g. saturated fat, salt, sugar) nutrients. Nutri-score has been implemented as a front-of-pack label in several countries across Europe, with positive impacts on the healthiness of food purchasing in supermarkets (Andreani et al., 2025). Two studies have assessed Nutri-score in OOH settings, also finding associations between Nutri-score and healthier food choices (Chandon \& Indaburu, 2026; Julia et al., 2021). However, Nutri-score on food menus has not previously been examined in terms of the potential impact on individuals with eating disorders and other mental health outcomes.
Nutri-score encompasses the nutritional quality of a food product, by accounting for both positive and negative components. This may be less harmful to individuals with eating disorders as it would remove the focus on calorie content. Previous qualitative research has shown that individuals with eating disorders may support labelling strategies that provide more holistic approaches to nutrition (Trompeter et al., 2026). It could also be of benefit to general population health to focus on helping individuals to consume a well-rounded diet higher in positive nutrients (fibre, protein), with high fruit, vegetable and nut content, and lower in negative nutrients that contribute to ill health (salt, sugar, fats). To date, limited research has compared Calorie labelling to Nutri-score in the general population or among those living with mental health conditions, like eating disorders.
OBJECTIVES This new study will explore the impact of Nutri-score labelling vs Calorie labelling vs no labelling (Control) in a simulated OOH food delivery ordering platform (common setting for food purchasing and calorie labelling is required by law in England) on participants' perceived effectiveness of nutritional labelling, healthiness of food choices, positive and negative affect, and perceived impacts on mental health.
We will examine effects in a general population sample (no eating disorder diagnosis), a sample of participants with a past or current diagnosis of an eating disorder by a medical practitioner and a sample of participants with a common mental health condition diagnosed by a medical practitioner without eating disorder (e.g., anxiety), in order to understand potential effects across groups of participants who may differ in their risk of poorer mental health in response to nutritional labelling.
(references in attached protocol)
Read the detailed description
See attached study protocol for detailed information
- Conditions
- Food Labelling, Eating Behaviour, Mental Health, Eating Disorder
- Being tested
- Control condition, Calorie labelling, Nutri-Score labelling
- Keywords
- Obesity, Food policy, Nutritional labelling, Food choice
- Medical subject headings
- Feeding Behavior, Psychological Well-Being, Feeding and Eating Disorders, Obesity
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Control conditionBehavioural
Participants will be asked to select a meal from a food menu with no nutritional labelling
Calorie labellingBehavioural
Participants will be asked to select a meal from a food menu with calorie labelling
Nutri-Score labellingBehavioural
Participants will be asked to select a meal from a food menu with calorie labelling
| Study group | Role | What they receive |
|---|---|---|
| Control group | Other | Participants with no diagnosis of a mental health or eating disorder Receives: Behavioral: Control condition; Behavioral: Calorie labelling; Behavioral: Nutri-Score labelling |
| Mental health diagnosis group | Experimental | Participants with a diagnosis of a mental health condition but no diagnosis of an eating disorder Receives: Behavioral: Control condition; Behavioral: Calorie labelling; Behavioral: Nutri-Score labelling |
| Eating disorder diagnosis group | Experimental | Participants with a diagnosis of an eating disorder Receives: Behavioral: Control condition; Behavioral: Calorie labelling; Behavioral: Nutri-Score labelling |
What is being measured
The primary outcome is the main question the study is designed to answer.
Perceived Message Effectiveness
An adapted version of the University of North Carolina Perceived Message Effectiveness (PME) scale will be used as a measurement of how effective participants believe nutritional labelling is in promoting behaviour change. The scale measures health concern, product attitude, and discouragement of item consumption in response to public health messaging or in this context, the food menu presented during the study. Participants will be shown a screenshot of the menu they ordered. All participants will answer 3 questions using a Likert scale ranging from 1 - 5 anchored by "Strongly disagree" and "Strongly agree". The mean response to the three items will be calculated. PME is used as an early indicator of a health messages potential to change behaviour (e.g., reduce selection of less healthy items). The scale has been used previously to identify the potential impact of food labels and is predictive of long-term behaviour.
Measured: Day 1 of 1: the PME measure will be completed immediately after participants have made their food selection
Perceived usefulness of menu in identifying healthier/less healthy food choices
Participants will be asked 'To what extent was the menu useful in helping you identify healthy vs. less healthy food choices'. Participants will select their answer on a Likert scale ranging from 1 - 5 anchored by "Strongly disagree" and "Strongly agree".
Measured: Day 1 of 1: Participants will rate the perceived usefulness of the menu immediately after making their food selection.
Nutritional quality of food ordered
An overall measure of nutritional quality of participants food order will be calculated using mean UK NPM scores of individual items, weighted according to the energy content of the item. Nutritional content used to calculate NPM scores for each menu item was obtained from outlet websites and input into the online NPM calculation tool (2004/05). Weighted scores will be calculated using the weighted.mean function in R.
Measured: Day 1 of 1: Food orders (item names, energy content, UK Nutrient Profiling Model scores) will be recorded immediately after the baseline questionnaire. The recorded information will be used to calculate weighted NPM scores.]
Positive/negative affect
Participants will complete an adapted version of PANAS after completing the food selection task. This is a 20-item measure, whereby participants will be asked to 'indicate the extent you feel this way right now' on a scale of 1 to 5 from 'very slightly or not at all' to 'extremely'. Participants receive a positive affect score and a negative affect score.
Measured: Day 1 of 1: Participants will complete the PANAS measure immediately after making their food selection
Perceived impact of labelling on mental health
Questions were developed based on self-reported mental health-related outcomes in previous research. Participants will be asked to respond to each of the following points on a scale of 1 to 5 from 'very slightly or not at all' to 'extremely'.
The information on the menus made me feel...
- Anxious about my food choice
- Guilty about my food choice
- Reassured about my food choice
- Ashamed about my food choice
- Fixated on the nutritional content of my food choice
Measured: Day 1 of 1: Participants will complete these measures immediately after making their food choices.
Perceived impact of labelling on mental health
Two additional questions relating to compensation were adapted from an existing scale related to compensatory eating behaviour and alcohol (CEBRACS). Participants will be asked to respond to each of the following points on a scale of 1 to 5 from 'very slightly or not at all' to 'extremely'.
- Like I should eat less than usual during one or more meals to make up for the amount of food I have selected
- Like I should skip one or more meals to make up for the amount of food I have selected
Measured: Day 1 of 1: Participants will complete this measure immediately after making their food choices
Secondary outcomes (2)
Nutri-Score labels of selected food items
We will record the Nutri-Score values (A-E) of all items selected by participants in the food choice task. Participants will be coded as having ordered any of the healthiest menu items labelled A or B (Y/N) and/or the least healthy menu items labelled D or E (Y/N).
Measured: Day 1 of 1: UK Nutrient Profiling Model scores of food orders will be recorded immediately after the baseline questionnaire.
Energy content of meals
We will record the energy and nutrient content of all items selected by participants in the food choice task. The total energy content of the ordered meal will be calculated.
Measured: Day 1 of 1: energy content of food orders will be recorded immediately after the baseline questionnaire.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Sep 2026
- Study startSep 2026 (estimated)
- Primary completionSep 2026 (estimated)
- Study completionSep 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Food LabellingStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 900 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Liverpool
- Sponsor type
- University, hospital or other
- Collaborators
- King's College London, University of Oxford, Liverpool John Moores University
- Responsible party
- Sponsor
- Investigators
- Eric Robinson, PhD, Principal investigator, University of Liverpool
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07809295
- Sponsor's protocol ID
- Nutri-Score and mental health
- Other IDs
- NIHR203316
- Status last verified
- Aug 2026
- First submitted
- 26 Aug 2026
- Last updated
- 9 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Anonymised participant data will be placed in an online data repository for other researchers to use in the future.
Study at a glance
From the registry record, last updated by the sponsor on 9 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Exploration of Nutri-Score Labelling Out-of-home on Individuals With Eating Disorders and Other Mental Health Diagnoses.
- ClinicalTrials.gov ID
- NCT07809295
- Acronym / sponsor ID
- Nutri-Score and mental health
- Conditions
- Food Labelling, Eating Behaviour, Mental Health, Eating Disorder
- Keywords
- Obesity, Food policy, Nutritional labelling, Food choice
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 900 participants (estimated)
- Lead sponsor
- University of LiverpoolUniversity, hospital or other
- Collaborators
- King's College London, University of Oxford, Liverpool John Moores University
- Study start
- Sep 2026 (estimated)
- Primary completion
- Sep 2026 (estimated)
- Study completion
- Sep 2026 (estimated)
- First posted
- 9 Sep 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Calorie labelling in out-of-home (OOH) settings was introduced by the government in England as part of a wider strategy to 'tackle obesity' (DHSC, 2020). The OOH sector encompasses outlets where food and drinks are prepared for immediate consumption, on or off the premises (DHSC, 2021). Increased consumption of OOH food is associated with greater intake of energy and nutrients of concern; therefore, is implicated in poorer dietary quality and ill-health (Gesteiro et al., 2022). The key ambition for the calorie labelling policy was to inform consumers of the calorie content of their food choices, making it easier to select healthier food choices (DHSC, 2020). An additional potential benefit of the policy was to prompt reformulation by the food industry to either reduce the calorie content of foods on offer or provide new lower calorie options (DHSC, 2021).
The calorie labelling policy in England was criticised at the time of implementation in the media for its potential to cause harm in individuals with eating disorders (Polden et al., 2023). However, limited research had explored effects on individuals with eating disorders (Robinson et al., 2023). It is estimated that over a million individuals in the UK are living with an eating disorder (Beat Eating disorders, 2026). Therefore, it is important for research to understand the impact of food labelling interventions on mental health outcomes in individuals with eating disorders and other mental health conditions, and whether alternative nutritional labelling practices that are not focused on calories alone could have positive health impacts without unintended negative consequences.
One alternative form of nutritional labelling that could be considered in OOH settings is Nutri-score. Nutri-score provides food items with a label from A (dark green, healthiest) to E (Red, least healthy) according to the content of both positive (e.g. fibre, protein) and negative (e.g. saturated fat, salt, sugar) nutrients. Nutri-score has been implemented as a front-of-pack label in several countries across Europe, with positive impacts on the healthiness of food purchasing in supermarkets (Andreani et al., 2025). Two studies have assessed Nutri-score in OOH settings, also finding associations between Nutri-score and healthier food choices (Chandon \& Indaburu, 2026; Julia et al., 2021). However, Nutri-score on food menus has not previously been examined in terms of the potential impact on individuals with eating disorders and other mental health outcomes.
Nutri-score encompasses the nutritional quality of a food product, by accounting for both positive and negative components. This may be less harmful to individuals with eating disorders as it would remove the focus on calorie content. Previous qualitative research has shown that individuals with eating disorders may support labelling strategies that provide more holistic approaches to nutrition (Trompeter et al., 2026). It could also be of benefit to general population health to focus on helping individuals to consume a well-rounded diet higher in positive nutrients (fibre, protein), with high fruit, vegetable and nut content, and lower in negative nutrients that contribute to ill health (salt, sugar, fats). To date, limited research has compared Calorie labelling to Nutri-score in the general population or among those living with mental health conditions, like eating disorders.
OBJECTIVES This new study will explore the impact of Nutri-score labelling vs Calorie labelling vs no labelling (Control) in a simulated OOH food delivery ordering platform (common setting for food purchasing and calorie labelling is required by law in England) on participants' perceived effectiveness of nutritional labelling, healthiness of food choices, positive and negative affect, and perceived impacts on mental health.
We will examine effects in a general population sample (no eating disorder diagnosis), a sample of participants with a past or current diagnosis of an eating disorder by a medical practitioner and a sample of participants with a common mental health condition diagnosed by a medical practitioner without eating disorder (e.g., anxiety), in order to understand potential effects across groups of participants who may differ in their risk of poorer mental health in response to nutritional labelling.
(references in attached protocol)
Detailed description
See attached study protocol for detailed information
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Control group | Other | Behavioral: Control condition, Behavioral: Calorie labelling, Behavioral: Nutri-Score labellingParticipants with no diagnosis of a mental health or eating disorder |
| Mental health diagnosis group | Experimental | Behavioral: Control condition, Behavioral: Calorie labelling, Behavioral: Nutri-Score labellingParticipants with a diagnosis of a mental health condition but no diagnosis of an eating disorder |
| Eating disorder diagnosis group | Experimental | Behavioral: Control condition, Behavioral: Calorie labelling, Behavioral: Nutri-Score labellingParticipants with a diagnosis of an eating disorder |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- Residing in the UK
- Regularly eat food prepared out of the home (from restaurants, cafes, fast food etc., at least once a month)
- Over the age of 18 years
- Fluent English speaker
- Can complete the study on a laptop or desktop computer (not touch screen)
Key exclusion criteria (2 listed)
- Pregnant/breastfeeding
- Have taken part in a previous study using the same version of the online food choice task (exclusion list obtained from prolific)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Control conditionParticipants will be asked to select a meal from a food menu with no nutritional labelling | Behavioural | Control group, Eating disorder diagnosis group, Mental health diagnosis group |
| Calorie labellingParticipants will be asked to select a meal from a food menu with calorie labelling | Behavioural | Control group, Eating disorder diagnosis group, Mental health diagnosis group |
| Nutri-Score labellingParticipants will be asked to select a meal from a food menu with calorie labelling | Behavioural | Control group, Eating disorder diagnosis group, Mental health diagnosis group |
Primary outcome
Perceived Message Effectiveness
Time frame: Day 1 of 1: the PME measure will be completed immediately after participants have made their food selection
An adapted version of the University of North Carolina Perceived Message Effectiveness (PME) scale will be used as a measurement of how effective participants believe nutritional labelling is in promoting behaviour change. The scale measures health concern, product attitude, and discouragement of item consumption in response to public health messaging or in this context, the food menu presented during the study. Participants will be shown a screenshot of the menu they ordered. All participants will answer 3 questions using a Likert scale ranging from 1 - 5 anchored by "Strongly disagree" and "Strongly agree". The mean response to the three items will be calculated. PME is used as an early indicator of a health messages potential to change behaviour (e.g., reduce selection of less healthy items). The scale has been used previously to identify the potential impact of food labels and is predictive of long-term behaviour.
Perceived usefulness of menu in identifying healthier/less healthy food choices
Time frame: Day 1 of 1: Participants will rate the perceived usefulness of the menu immediately after making their food selection.
Participants will be asked 'To what extent was the menu useful in helping you identify healthy vs. less healthy food choices'. Participants will select their answer on a Likert scale ranging from 1 - 5 anchored by "Strongly disagree" and "Strongly agree".
Nutritional quality of food ordered
Time frame: Day 1 of 1: Food orders (item names, energy content, UK Nutrient Profiling Model scores) will be recorded immediately after the baseline questionnaire. The recorded information will be used to calculate weighted NPM scores.]
An overall measure of nutritional quality of participants food order will be calculated using mean UK NPM scores of individual items, weighted according to the energy content of the item. Nutritional content used to calculate NPM scores for each menu item was obtained from outlet websites and input into the online NPM calculation tool (2004/05). Weighted scores will be calculated using the weighted.mean function in R.
Positive/negative affect
Time frame: Day 1 of 1: Participants will complete the PANAS measure immediately after making their food selection
Participants will complete an adapted version of PANAS after completing the food selection task. This is a 20-item measure, whereby participants will be asked to 'indicate the extent you feel this way right now' on a scale of 1 to 5 from 'very slightly or not at all' to 'extremely'. Participants receive a positive affect score and a negative affect score.
Perceived impact of labelling on mental health
Time frame: Day 1 of 1: Participants will complete these measures immediately after making their food choices.
Questions were developed based on self-reported mental health-related outcomes in previous research. Participants will be asked to respond to each of the following points on a scale of 1 to 5 from 'very slightly or not at all' to 'extremely'. The information on the menus made me feel... * Anxious about my food choice * Guilty about my food choice * Reassured about my food choice * Ashamed about my food choice * Fixated on the nutritional content of my food choice
Perceived impact of labelling on mental health
Time frame: Day 1 of 1: Participants will complete this measure immediately after making their food choices
Two additional questions relating to compensation were adapted from an existing scale related to compensatory eating behaviour and alcohol (CEBRACS). Participants will be asked to respond to each of the following points on a scale of 1 to 5 from 'very slightly or not at all' to 'extremely'. * Like I should eat less than usual during one or more meals to make up for the amount of food I have selected * Like I should skip one or more meals to make up for the amount of food I have selected
2 secondary outcomes
Nutri-Score labels of selected food items
Time frame: Day 1 of 1: UK Nutrient Profiling Model scores of food orders will be recorded immediately after the baseline questionnaire.
Energy content of meals
Time frame: Day 1 of 1: energy content of food orders will be recorded immediately after the baseline questionnaire.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 Sep 2026.
- Individual participant dataSharing planned: Yes. Anonymised participant data will be placed in an online data repository for other researchers to use in the future.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Amy Finlay, PhD contact
Eric Robinson, PhD principal investigator
University of Liverpool
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Calorie labelling and Nutri-Score labelling in people with Food Labelling and Eating Behaviour, run by University of Liverpool at 1 site in United Kingdom.
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 8 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: opening soon, as of the sponsor's last update on 9 Sep 2026. 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 United Kingdom. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Eric Robinson, PhD (+44 151794 ext. 1187, robinsoe@liverpool.ac.uk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Perceived Message Effectiveness (time frame: Day 1 of 1: the PME measure will be completed immediately after participants have made their food selection). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 9 Sep 2026.