Effects of a grocery shopping intervention designed to improve diet adherence in diabetes: a randomized trial

Abstract

Objective The goal of this study was to examine the potential of an optimal‐defaults intervention to promote grocery purchases corresponding to a diet for diabetes. Methods In total, 65 adults diagnosed with or at increased risk for type 2 diabetes who grocery shopped at one of two study stores were randomized to one of three groups: Defaults, Online, or Control. All groups received diabetes‐friendly recipes. In addition, the Online group was asked to grocery shop online during a 3‐week intervention, and the Defaults group was asked to shop online, with their online grocery carts prefilled with food items needed to prepare provided recipes. Participants provided weekly grocery receipt data at baseline, at each week of the 3‐week intervention, and at post‐intervention. Results Overall, the Defaults group had grocery purchases of a significantly greater nutritional quality versus other groups (F = 16.3, p < 0.001). Between‐group comparisons of least‐squares means showed consistent effects of the Defaults intervention while intervention components were in place, with a similar pattern for energy and carbohydrate content of grocery purchases. Conclusions These results build upon emerging evidence that optimal defaults can promote healthier grocery purchases. Continued examination of this approach could promote healthy food acquisition in accordance with individual dietary preferences and needs.

Feasibility and implementation of a grocery shopping intervention for adults diagnosed with or at-risk for type 2 diabetes

“…In the primary outcomes paper for the overarching study, the research team reported that average dollars spent at study grocery stores did not differ between group ( 21 ) . However, multiple participants perceived online shopping to be more expensive than shopping in-person ( n 10 out of the 43 that responded to the open-ended question about online grocery shopping), and a few indicated the inability to use coupons as a barrier ( n 7).…”

“…Findings from this study suggest that it was feasible to implement an optimal defaults intervention to improve the nutritional quality of grocery purchases for people with or at-risk for diabetes ( 21 ) and collect all study data remotely. Most participants found the methods, data collection and prefilled default grocery carts to be acceptable and useful.…”

“…However, another limitation of this study is that food purchases were the only outcome measured over time. In the overarching study, researchers calculated nutritional quality scores to confirm whether participants’ grocery purchases were aligned with recommendations for people with or at-risk for diabetes, and results suggested the Defaults intervention improved the nutritional quality scores based on the receipt data submitted ( 21 ) . However, receipts were not collected for all food purchases (e.g.…”

“…All participants received recipes tailored to a diet for people with or at-risk for type 2 diabetes, and the Defaults group had their online grocery carts prefilled with recipe ingredients during each week of the 3-week intervention period. Overall, participants in the Defaults group had improvements in the nutritional quality of grocery purchases compared to participants in the Control and Online groups ( 21 ) .…”

A Proof-of-Concept Pilot Test of a Behavioral Intervention to Improve Adherence to Dietary Recommendations for Cancer Prevention

“…Previous interventions designed to change grocery shopping habits have primarily focused on providing education and produced only modest changes in food purchasing, with minimal evidence of long-term maintenance of change in dietary quality. [17][18][19] These suboptimal results are unsurprising given the difficulty of selfregulation in the modern food environment. 17,20,21 There are several tools for behavior change that can enhance selfregulation and motivation, that, when added to a foundation of nutrition education, might improve grocery shopping purchases, and ultimately, short and long-term adherence to dietary guidelines.…”