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Stewart-Knox BJ, Poínhos R, Fischer AR, Rankin A, Bunting BP, Oliveira BM, Frewer LJ. Association between nutrition self-efficacy, health locus of control and food choice motives in consumers in nine European countries. J Health Psychol 2024:13591053241249863. [PMID: 38742368 DOI: 10.1177/13591053241249863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
We investigated associations between food choice motives and psychological determinants of dietary health behaviour change (nutrition self-efficacy, NS-E, and health locus of control, HLoC) among 9381 participants (18-65 years, 49.4% females) from nine European countries. Price was the highest rated food choice motive. Higher importance of all motives was associated with higher NS-E and with higher Internal HLoC. Relationships between food choice motives and External HLoC were also in the expected direction in showing negative associations with Health, Natural Content, Weight Control, Mood and Sensory Appeal. Higher External HLoC was also associated with perceived greater importance of 'external' motives Ethical Concern, Familiarity and Convenience. Relationships between External HLoC and food choice motives were not all in the expected direction. Price was unrelated to External HLoC. Females rated the importance of all motives higher than males. People with less education ascribed greater importance to Price in motivating food choices. Together, these findings imply that self-efficacy and health locus of control should be considered along with motivations for food choice in dietary health promotion.
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Nkhoma DE, Mumba WK, Banda KJ, Sakala M, Panyani D, Muwalo B, Mbeye NM. Prevalence and determinants of adult consumer use and comprehension of food labels in sub-Saharan Africa: a systematic review and meta-analysis. Nutr Rev 2024; 82:318-331. [PMID: 37330669 DOI: 10.1093/nutrit/nuad064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/19/2023] Open
Abstract
CONTEXT Food labelling is a global strategy recommended to reduce noncommunicable diseases. Few reviews, however, have focused on food label use in sub-Saharan Africa (SSA). OBJECTIVE To determine the prevalence of food label use and describe determinants of food label use and purchasing decisions of adult consumers in SSA. DATA SOURCE PubMed (Medline), Web of Science, Cochrane Central, and Google Scholar databases. DATA EXTRACTION Search criteria included adults (aged ≥18 years), conducted in SSA, focusing on food label use or understanding and their determinants or determinants of food-purchasing decisions, and articles published in English. STUDY QUALITY AND DATA ANALYSIS Risk-of-bias assessment of included studies was done using the Joann Briggs Institute checklist for prevalence studies. Publication bias was assessed using funnel plots and Egger's test. Analysis included narrative synthesis and moderator and meta-analyses of food label use. RESULTS A total of 124 articles were found, of which 21 were included in the review. Of participants in the selected studies, 58% were female. About 80% reported food label use (either used sometimes or always) (70%-88%) (I2 = 97%; n = 6223), and regular use was estimated at 36% (28%-45%) (I2 = 97%; n = 5147). Food label use was influenced by level of income, education, employment status, and household size. Food-purchasing decisions were influenced by attributes such as expiry dates, price, and taste. Major recommendations reported were tailored education campaigns and reducing barriers to food label use. CONCLUSION Most (80%) of adults in SSA reported using food labels; however, only about one-third used them consistently. Demographic and situation factors determined patterns in food label use, whereas product attributes influenced food purchasing decisions. Complexity of these determinants requires adopting tailored, multisectoral, theory-driven programs to improve food label use. SYSTEMATIC REVIEW REGISTRATION Open Science Framework (https://osf.io/kc562).
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Affiliation(s)
- Dumisani E Nkhoma
- Nkhata Bay District Hospital, Nkhata Bay District Health Office, Nkhata Bay, Malawi
| | - Wongani K Mumba
- Nkhata Bay District Hospital, Nkhata Bay District Health Office, Nkhata Bay, Malawi
| | - Kondwani J Banda
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Endoscopy Unit, Surgery Department, Kamuzu Central Hospital, Lilongwe, Malawi
| | - Melody Sakala
- Policy Engagement Unit, Malawi Liverpool Wellcome Clinical Research Programme, Blantyre, Malawi
| | - David Panyani
- Nkhata Bay District Hospital, Nkhata Bay District Health Office, Nkhata Bay, Malawi
| | - Blessings Muwalo
- Department of Nutrition, HIV & AIDS, Ministry of Health, Lilongwe, Malawi
| | - Nyanyiwe Masingi Mbeye
- Evidence Informed Decision Making Centre, Kamuzu University of Health Sciences, Blantyre, Malawi
- Department of Epidemiology and Biostatistics, Kamuzu University of Health Sciences, Blantyre, Malawi
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Pfledderer CD, Ranjit N, Pérez A, Malkani RI, Ferreira De Moraes AC, Hunt ET, Smith CL, Hoelscher DM. Using the Nutrition Facts Label to Make Food Choices Is Associated with Healthier Eating among 8th and 11th-Grade Students: An Analysis of Statewide Representative Data from the 2019-2020 Texas School Physical Activity and Nutrition Survey. Nutrients 2024; 16:311. [PMID: 38276549 PMCID: PMC10819117 DOI: 10.3390/nu16020311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/12/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Nutrition labels are a tool to inform and encourage the public to make healthier food choices, but little information is available about use in multi-ethnic adolescent populations in the U.S. The purpose of this study was to examine associations between the level of nutrition label usage and healthy/unhealthy eating behaviors among a statewide representative sample of 8th and 11th-grade students in Texas. METHODS We analyzed cross-sectional associations between the Nutrition Facts label use and eating behaviors from a statewide sample of 8th and 11th-grade students in Texas, (n = 4730, weighted n = 710,731, mean age = 14.7 ± 1.6 years; 49% female, 51% Hispanic), who completed the 2019-2020 Texas School Physical Activity and Nutrition (TX SPAN) survey. Students self-reported their level of nutrition label usage to make food choices (5-point Likert scale from "Never" to "Always") and previous day consumption of 26 food items (13 healthy, 13 unhealthy). The 26 food items were used to calculate a Healthy Eating Index (HEI) score (0-100), a Healthy Foods Index (HFI) score (0-100), and an Unhealthy Foods Index (UFI) score (0-100). Weighted linear regression models were employed to examine the associations between self-reported use of nutrition labels to make food choices and HEI, HFI, and UFI scores. Marginal predicted means of HEI, HFI, and UFI scores were calculated post hoc from linear regression models. The odds of consuming specific individual food items for nutrition label usage were also calculated from weighted logistic regression models. All linear and logistic regression models were adjusted for grade, sex, Body Mass Index (BMI), race/ethnicity, economic disadvantage, and percentage of English language learners by school. RESULTS A total of 11.0% of students reported always/almost always using nutrition labels to make food choices, 27.9% reported sometimes using them, while 61.0% indicated they never/almost never used nutrition labels to make food choices. The average HEI score among students in the sample was 47.7 ± 5.9. Nutrition Facts label usage was significantly and positively associated with HEI (b = 5.79, 95%CI: 4.45, 7.12) and HFI (b = 7.28, 95%CI:4.48, 10.07), and significantly and negatively associated with UFI (b = -4.30, 95%CI: -6.25, -2.34). A dose-response relationship was observed between nutrition label usage and HEI, HFI, and UFI scores, such that the strength of these associations increased with each one-point increase in nutrition label usage. Students who reported using nutrition labels always/almost always to make food choices had significantly higher odds of consuming healthy foods including baked meat, nuts, brown bread, vegetables, whole fruit, and yogurt (ORrange = 1.31-3.07), and significantly lower odds of consuming unhealthy foods including chips, cake, candy, and soda (ORrange = 0.48-0.68) compared to students who reported never/almost never using the Nutrition Facts label. CONCLUSIONS Using the Nutrition Facts labels to make food choices is beneficially associated with healthy and unhealthy eating among 8th and 11th-grade students, although the proportion of students using nutrition labels to make their food choices was low. Public health efforts should be made to improve nutrition literacy and encourage nutrition label use among secondary students in the United States.
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Affiliation(s)
- Christopher D. Pfledderer
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701, USA; (N.R.); (E.T.H.); (D.M.H.)
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701, USA; (A.P.); (R.I.M.); (C.L.S.)
| | - Nalini Ranjit
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701, USA; (N.R.); (E.T.H.); (D.M.H.)
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701, USA; (A.P.); (R.I.M.); (C.L.S.)
| | - Adriana Pérez
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701, USA; (A.P.); (R.I.M.); (C.L.S.)
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701, USA
| | - Raja I. Malkani
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701, USA; (A.P.); (R.I.M.); (C.L.S.)
| | - Augusto César Ferreira De Moraes
- Department of Epidemiology, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701, USA;
| | - Ethan T. Hunt
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701, USA; (N.R.); (E.T.H.); (D.M.H.)
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701, USA; (A.P.); (R.I.M.); (C.L.S.)
| | - Carolyn L. Smith
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701, USA; (A.P.); (R.I.M.); (C.L.S.)
| | - Deanna M. Hoelscher
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701, USA; (N.R.); (E.T.H.); (D.M.H.)
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701, USA; (A.P.); (R.I.M.); (C.L.S.)
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Seyedhamzeh S, Nedjat S, Shakibazadeh E, Doustmohammadian A, Hosseini H, Kazemi A, Azizolahi N, Chamary M, Clark CCT, Motlagh AD. Designing a new physical activity calorie equivalent food label and comparing its effect on caloric choices to that of the traffic light label among mothers: a mixed-method study. Front Public Health 2023; 11:1280532. [PMID: 38035293 PMCID: PMC10683755 DOI: 10.3389/fpubh.2023.1280532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/23/2023] [Indexed: 12/02/2023] Open
Abstract
Objective We designed a new type of 'physical activity calorie equivalent' (PACE) food label in Iran to compare its effect with that of the traffic light food label (TLL) on caloric choices. Design Mixed-method study. Participants Mothers of school children between the ages of 6-12 years. Setting In the qualitative phase, 10 focus group discussions (FGDs) were conducted with various groups of mothers, and two FGDs were conducted with food science and nutrition experts to design a new PACE label. In the quantitative phase, 496 mothers were randomly assigned to five groups: (1) no nutrition label, (2) current TLL, (3) current TLL + educational brochure, (4) PACE label, and (5) PACE label + brochure. Samples of dairy products, beverages, cakes, and biscuits were presented. ANOVA and multiple linear regressions were applied to examine the association between label types and calories of the selected products as our main outcome. Results The mothers' perspectives were classified into two sub-themes, the PACE label's facilitators and barriers. The new PACE label's characteristics were divided into two subcategories: (a) appearance, and (b) nutritional information, including 14 codes. In the quantitative section, mean calories of the selected foods were lowest in the TLL + brochure group (831.77 kcal; 95% CI: 794.23-869.32), and highest in the PACE label group (971.61; 95% CI: 926.37-1016.84). Conclusion The new PACE label was a combination of PACE, TLL, and warning labels. It did not significantly affect lower caloric choice, however, the TLL + brochure option was effective in choosing foods with fewer calories.Clinical trial registration: The study was registered in the Iranian Registry of Clinical Trials 23 (IRCT20181002041201N1).
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Affiliation(s)
- Shirin Seyedhamzeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saharnaz Nedjat
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Azam Doustmohammadian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hedayat Hosseini
- Department of Food Sciences and Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Asma Kazemi
- Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nafiseh Azizolahi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Chamary
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Cain C. T. Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Ahmadreza Dorosty Motlagh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Osaili TM, Al-Nabulsi AA, Taybeh AO, Cheikh Ismail L, Saleh ST. Healthy food and determinants of food choice on online food delivery applications. PLoS One 2023; 18:e0293004. [PMID: 37856479 PMCID: PMC10586623 DOI: 10.1371/journal.pone.0293004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 09/21/2023] [Indexed: 10/21/2023] Open
Abstract
Online food delivery applications (OFD apps) provide consumers with a wide range of options to choose from. The present study aimed to assess the usage of OFD apps and investigate the factors that affect food choices with a special emphasis on healthy food choices and hygiene. A cross-sectional study among food delivery application users in Jordan was conducted using an online questionnaire between March and May 2022. A total of 675 eligible subjects participated in the study. Consumers' demographic characteristics, data on consumers' use of OFD apps, consumers' perceptions of healthy food availability in OFD apps, and consumers' attitudes toward food safety and delivery hygiene were collected and analyzed. About 64% of the studied sample used OFD apps weekly. Fast food was the most popular option for ordering (87.1%) and lunchtime was the most preferred time to order food (67.3%) for most of the respondents. Respondents' perceptions of a "healthy meal" was associated with the presence of a variety of vegetables in the meal. Food price, food appearance, time of delivery, macronutrient content information, the availability of healthy options, and considering vegetables as part of a healthy meal were determinants of consumer food choice (p<0.05). The findings suggest that the online food environment in Jordan was perceived to be unhealthy. Nevertheless, the convenient nature and the popularity of OFD apps hold great potential to promote healthy eating among consumers.
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Affiliation(s)
- Tareq M. Osaili
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid, Jordan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Anas A. Al-Nabulsi
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid, Jordan
| | - Asma’ O. Taybeh
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid, Jordan
| | - Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Sheima T. Saleh
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Meza-Hernández M, Yabiku-Soto K, Saavedra-Garcia L, Diez-Canseco F. Nutritional information on the labels of processed and ultra-processed foods and beverages marketed in a supermarket chain in Lima in 2022. Rev Peru Med Exp Salud Publica 2023; 40:141-149. [PMID: 38232260 PMCID: PMC10953672 DOI: 10.17843/rpmesp.2023.402.12714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/24/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVES. Motivation for the study. Peruvian Law No. 30021 establishes the use of warning octagons for foods with high content of critical nutrients (sugar, sodium, saturated and trans fats); however, the declaration of nutritional information is not mandatory. Main findings. Of a total of 4404 processed and ultra-processed foods marketed in supermarkets in Lima, only 71.4% declared some type of nutritional information. In addition, only 46.0% declared information on the content of critical nutrients regulated by Law No. 30021. Implications. There is a need for a mandatory and standardized declaration of nutritional information on packaged foods marketed in Peru, in order to allow the population to make healthy decisions when choosing their food and to monitor the correct use of warning octagons. . To estimate the number of processed and ultra-processed beverages and foods that provide nutritional information on their packaging, and to describe the characteristics of this information, as well as to determine the presence of nutritional information on products with octagons. MATERIALS AND METHODS. Photographs were taken of the labels of 4404 processed and ultra-processed beverages and foods marketed in supermarkets in Metropolitan Lima. The information on the label was collected and registered in the mobile and web version of the Food Label Information Program (FLIP). We analyzed variables related to the nutritional information, the way in which such information is declared and the information in beverages and foods with octagons. RESULTS. Only 71.4% of the products had some type of nutritional information. Of these, 13.8% provided the nutritional information as a text and not in a table, and only 56.3% declared it per 100 grams or milliliters. Of the total number of foods with the octagon "Contains trans fats", only 19.2% declared their content. CONCLUSIONS. More than a quarter of the beverages and packaged foods in the Peruvian market did not provide nutritional information of any kind, and of those that did, only one did so in different formats and units. In addition, we found that a proportion of beverages and foods for each type of octagon did not declare information of the nutrient that is mentioned in the octagon.
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Affiliation(s)
- Mayra Meza-Hernández
- CRONICAS Centro de Excelencia en Enfermedades Crónicas, Universidad Peruana Cayetano Heredia, Lima, Peru.Universidad Peruana Cayetano HerediaCRONICAS Centro de Excelencia en Enfermedades CrónicasUniversidad Peruana Cayetano HerediaLimaPeru
| | - Kiomi Yabiku-Soto
- CRONICAS Centro de Excelencia en Enfermedades Crónicas, Universidad Peruana Cayetano Heredia, Lima, Peru.Universidad Peruana Cayetano HerediaCRONICAS Centro de Excelencia en Enfermedades CrónicasUniversidad Peruana Cayetano HerediaLimaPeru
| | - Lorena Saavedra-Garcia
- CRONICAS Centro de Excelencia en Enfermedades Crónicas, Universidad Peruana Cayetano Heredia, Lima, Peru.Universidad Peruana Cayetano HerediaCRONICAS Centro de Excelencia en Enfermedades CrónicasUniversidad Peruana Cayetano HerediaLimaPeru
| | - Francisco Diez-Canseco
- CRONICAS Centro de Excelencia en Enfermedades Crónicas, Universidad Peruana Cayetano Heredia, Lima, Peru.Universidad Peruana Cayetano HerediaCRONICAS Centro de Excelencia en Enfermedades CrónicasUniversidad Peruana Cayetano HerediaLimaPeru
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Liao Y, Yang J. Status of nutrition labeling knowledge, attitude, and practice (KAP) of residents in the community and structural equation modeling analysis. Front Nutr 2023; 10:1097562. [PMID: 37139447 PMCID: PMC10149812 DOI: 10.3389/fnut.2023.1097562] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/20/2023] [Indexed: 05/05/2023] Open
Abstract
Objective Unhealthy foods were a major contributor to the occurrence of chronic non-communicable diseases. The promotion of nutrition labeling in the community can effectively help residents to choose healthy foods, which plays an important role in the prevention of chronic diseases. However, the public awareness of this measure is not clear. Our study used a structural equation model based on the KAP theory to analyze the interaction mechanisms among knowledge, attitude, and practice and aimed to evaluate the relationships among nutrition knowledge, attitude, and practice of residents, which can provide the basis of policy formulation for nutrition education and behavior intervention. Methods We carried out a cross-sectional study from May 2022 to July 2022 in the "Community Health Service Center", and each "Community Service Station" in Yinchuan use a self-designed questionnaire and convenience sampling to evaluate resident nutrition labeling KAP status. This study adopted the structural equation modeling approach to analyze a survey of Chinese individuals through the cognitive processing model, interrelated nutrition knowledge, nutrition label knowledge, attitude, and practice. Results According to the principle of sample size estimation, a total of 636 individuals were investigated, with the ratio of male to female being 1:1.2. The average score of community residents' nutrition knowledge was 7.48 ± 3.24, and the passing rate was 19.4%. Most residents had a positive attitude toward nutrition labeling, but the awareness rate was only 32.7% and the utilization rate was 38.5%. Univariate analysis showed that women had higher knowledge scores than men (p < 0.05), and young people had higher scores than older adults (p < 0.05), and the difference was significant. Based on the KAP structural equation model (SEM), residents' nutrition knowledge will directly affect their attitude toward nutrition labeling. Attitude played a greater role as an indirect effect between knowledge and behavior, while trust limits residents' practice of nutrition labeling and then affects their practice. It could be explained that nutrition knowledge was the prerequisite for label reading behavior, and attitude was the intermediary effect. Conclusion The nutrition knowledge and nutrition labeling knowledge of respondents hardly directly support the practice of nutrition labeling, but it can influence the use behavior by forming a positive attitude. The KAP model is suitable for explaining residents' use of nutrition labeling in the region. Future research should focus on better understanding the motivations of residents to use nutrition labeling and the opportunity to use nutrition labeling in real-life shopping settings.
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Affiliation(s)
- Yinxia Liao
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Jianjun Yang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, Ningxia, China
- *Correspondence: Jianjun Yang
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Jürkenbeck K, Mehlhose C, Zühlsdorf A. The influence of the Nutri-Score on the perceived healthiness of foods labelled with a nutrition claim of sugar. PLoS One 2022; 17:e0272220. [PMID: 35976882 PMCID: PMC9385015 DOI: 10.1371/journal.pone.0272220] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 07/15/2022] [Indexed: 11/19/2022] Open
Abstract
High sugar intake in humans is associated with the development of overweight and other diet-related diseases. The World Health Organization and other health organizations recommend limiting the sugar intake to 10% of the total energy intake. There have been different approaches of front-of-pack labelling to reduce the amount of sugar in food products. Companies use nutrition claims to advertise the sugar content (e.g., without added sugar, 30% less sugar). Such nutrition claims can lead to false assumptions about the healthiness of foods and can lead to health-halo effects. Nutrition claims make products appear healthier than they really are, the aspect advertised in the nutrition claim is transferred to the entire food product. As a result, food products can be perceived as healthy even though they are not. Recently, the Nutri-Score was introduced in an increasing number of countries throughout Europe to provide consumers with an overview of the overall nutritional quality of a product. This study analyzes if the Nutri-Score can help to prevent health-halo effects caused by nutrition claims on sugar. Therefore, an online survey consisting of a split-sample design with more than 1,000 respondents was assessed. The results show that, depending on the initial perceived healthiness of a product, the Nutri-Score is able to prevent health-halo effects caused by claims on sugar. Making the Nutri-Score mandatory when using nutrition claims would be one possible way to reduce misperceptions about unhealthy food and reduce health-halo effects caused by claims on sugar.
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Affiliation(s)
- Kristin Jürkenbeck
- Department of Agricultural Economics and Rural Development, Marketing of Food and Agricultural Products, University of Goettingen, Goettingen, Germany
| | - Clara Mehlhose
- Department of Agricultural Economics and Rural Development, Marketing of Food and Agricultural Products, University of Goettingen, Goettingen, Germany
| | - Anke Zühlsdorf
- Department of Agricultural Economics and Rural Development, Marketing of Food and Agricultural Products, University of Goettingen, Goettingen, Germany
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Liu R, Liang F, Heng Y, Gao Z, Snell HA, Rae A, Ma H. Do Past Experience and Group Heterogeneity Matter to Consumer Preferences? Evidence From a Choice Experiment in Urban China. Front Psychol 2022; 13:843433. [PMID: 35572270 PMCID: PMC9095496 DOI: 10.3389/fpsyg.2022.843433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
This study uses a discrete choice experiment to examine consumers' preferences for Fuji apple product attributes and willingness to pay (WTP) estimates for consumers in six cities in China. We estimated the preference heterogeneity by linking the stated preference choice data with consumers' past experience and socioeconomic characteristics in the latent class model. The empirical results show that, first, the past experience variables are crucial in explaining consumer preferences and WTP. Second, three classes, namely, certification-oriented, price- and origin-oriented, and not interested, are identified. Furthermore, the same type of Fuji apple attribute does not appeal to every respondent. Third, our results indicate the heterogeneity of preferences across different classes of respondents, as well as differences in WTP for Fuji apples.
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Affiliation(s)
- Ruifeng Liu
- College of Economics and Management, Henan Agricultural University, Zhengzhou, China
| | - Fei Liang
- College of Economics and Management, Henan Agricultural University, Zhengzhou, China
| | - Yan Heng
- Department of Food and Resource Economics, University of Florida, Gainesville, FL, United States
| | - Zhifeng Gao
- Department of Food and Resource Economics, University of Florida, Gainesville, FL, United States
| | - Heather Arielle Snell
- Department of Agricultural Economics and Agribusiness, University of Arkansas, Fayetteville, AR, United States
| | - Allan Rae
- School of Economics and Finance, Massey University, Palmerston North, New Zealand
| | - Hengyun Ma
- School of Economics and Finance, Massey University, Palmerston North, New Zealand
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Hall MG, Lazard AJ, Higgins ICA, Blitstein JL, Duffy EW, Greenthal E, Sorscher S, Taillie LS. Nutrition-related claims lead parents to choose less healthy drinks for young children: a randomized trial in a virtual convenience store. Am J Clin Nutr 2022; 115:1144-1154. [PMID: 35040866 PMCID: PMC8971006 DOI: 10.1093/ajcn/nqac008] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/13/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Consumption of sugar-sweetened beverages, including fruit drinks (i.e., fruit-flavored drinks containing added sugar), contributes to childhood obesity. OBJECTIVES We aimed to examine whether nutrition-related claims on fruit drinks influence purchasing among parents and lead to misperceptions of healthfulness. METHODS We conducted an experiment in a virtual convenience store with 2219 parents of children ages 1-5 y. Parents were randomly assigned to view fruit drinks displaying 1 of 3 claims ("No artificial sweeteners," "100% Vitamin C," and "100% All Natural") or no claim (i.e., control group). Parents selected among each of 2 drinks for their young child: 1) a fruit drink or 100% juice (primary outcome), and 2) a fruit drink or water. RESULTS When choosing between a fruit drink and 100% juice, 45% of parents who viewed the fruit drink with the "No artificial sweeteners" claim, 51% who viewed the "100% Vitamin C" claim, and 54% who viewed the "100% All Natural" claim selected the fruit drink, compared with 32% in the no-claim control group (all P < 0.001). "No artificial sweeteners" (Cohen's d = 0.13, P < 0.05) and "100% All Natural" (d = 0.15, P < 0.05) claims increased the likelihood of parents choosing the fruit drink instead of water but "100% Vitamin C" did not (P = 0.06). All claims made parents more likely to incorrectly believe that the fruit drinks contained no added sugar and were 100% juice than the control (d ranged from 0.26 to 0.84, all P < 0.001), as assessed in a posttest survey. The impact of claims on selection of the fruit drink (compared with 100% juice) did not vary by any of the moderators examined (e.g., race/ethnicity, income; all moderation P > 0.05). CONCLUSIONS Nutrition-related claims led parents to choose less healthy beverages for their children and misled them about the healthfulness of fruit drinks. Labeling regulations could mitigate misleading marketing of fruit drinks.This trial was registered at clinicaltrials.gov as NCT04381481.
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Affiliation(s)
- Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
| | - Allison J Lazard
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, USA
| | - Isabella C A Higgins
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
| | | | - Emily W Duffy
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Eva Greenthal
- Center for Science in the Public Interest, Washington, DC, USA
| | - Sarah Sorscher
- Center for Science in the Public Interest, Washington, DC, USA
| | - Lindsey Smith Taillie
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
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Determinants of Nutrition Facts Table Use by Chinese Consumers for Nutritional Value Comparisons. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020673. [PMID: 35055492 PMCID: PMC8775507 DOI: 10.3390/ijerph19020673] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 12/10/2022]
Abstract
The nutrition facts table is a nutrition labeling tool designed to inform consumers of food nutritional contents and enable them to make healthier choices by comparing the nutritional values of similar foods. However, its adoption level is considerably low in China. This study employed the Chi-squared Automatic Interaction Detection (CHAID) algorithm to explore the factors associated with respondents’ adoption of nutrition facts table to compare the nutritional values of similar foods. Data were gathered through a nationally representative online survey of 1500 samples. Results suggested that consumers’ comprehension of the nutrition facts table was a direct explanatory factor for its use. The usage was also indirectly explained by people’s nutrition knowledge, the usage of nutrition facts table by their relatives and friends, and their focus on a healthy diet. Therefore, to increase the use of nutrition facts table by Chinese consumers, the first consideration should be given to enhancing consumers’ comprehension of the labeling
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Clerkin KD, Pohl CJ, Shupe ER, Kim MJ. Influencing nutritional habits of college students using a food pantry. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:937-941. [PMID: 32045338 DOI: 10.1080/07448481.2020.1721506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 11/17/2019] [Accepted: 12/19/2019] [Indexed: 06/10/2023]
Abstract
Objective: Food insecurity in college students is associated with poor eating habits. The purpose of this project was to increase consumption of fruits and vegetables in college students using a campus food pantry. Participants: Twenty-nine college students completed the study. Methods: Participants viewed weekly food preparation videos demonstrating cost-effective recipes containing fruits and vegetables and a key take-away message. Participants were provided a recipe and food to cook at home based on the Cooking Matters Food Pantry Toolkit. A 24-h dietary recall was collected pre- and postintervention using the Automated Self-Administered 24-H Dietary Assessment. This descriptive comparative study used repeated measure ANOVA. Results: Females (n = 19) increased their fruit and vegetable consumption by 1.3 cups daily (p < .05) while males (n = 10) decreased fruit and vegetable consumption at the postintervention measurement. Conclusion: Increased consumption of fruits and vegetables in female college students using the food pantry was a modifiable behavior in this study.
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Affiliation(s)
- Kirsten D Clerkin
- Mennonite College of Nursing, Illinois State University, Normal, Illinois, USA
| | - Carla J Pohl
- Mennonite College of Nursing, Illinois State University, Normal, Illinois, USA
| | - Emily R Shupe
- Department of Kinesiology, Western Illinois University, Macomb, Illinois, USA
| | - Myoung Jin Kim
- Mennonite College of Nursing, Illinois State University, Normal, Illinois, USA
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Ashoori M, Omidvar N, Eini-Zinab H, Shakibazadeh E, Doustmohamadian A, Abdar-Esfahani B, Mazandaranian M. Food and nutrition literacy status and its correlates in Iranian senior high-school students. BMC Nutr 2021; 7:19. [PMID: 34082827 PMCID: PMC8176697 DOI: 10.1186/s40795-021-00426-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/30/2021] [Indexed: 12/01/2022] Open
Abstract
Background Planning interventions to promote food and nutrition literacy (FNL) require a better understanding of the FNL status of the target group and its correlates. Aims This study aimed to examine the FNL status and its determinants in Iranian senior high-school students. Methods In this cross-sectional study, FNL and its components (food and nutrition knowledge, functional skills, interactive skills, advocacy, critical analysis of information, and food label reading skill) were evaluated by a locally designed and validated, self-administered questionnaire. Besides, socioeconomic, demographic, anthropometric measures, as well as academic performance of 626 senior high-school students were assessed. Results The mean ± SD of the total FNL score (within potential range of 0 to 100) was 52.1 ± 10.96, which is below the minimum adequate level of 60. The probability of high FNL knowledge score was significantly higher among students who majored in Natural Sciences (OR = 1.73, CI = 1.09–2.75), had better school performance (OR = 1.13, CI = 1.06–1.20) and higher SES score (OR = 1.20, CI = 1.01–1.44). The score for food label reading was significantly lower in girls (OR = 0.45, CI = 0.31–0.67), while those who had a family member with the nutrition-related disease were more likely to have a higher score of food label reading skill (OR = 1.48, CI = 1.01–1.64). Conclusion The level of FNL in senior high-school students in Tehran was relatively low. These findings have key messages for the education system and curriculum designers to have more consideration for food and nutrition-related knowledge and skills in schools. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-021-00426-2.
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Affiliation(s)
- Marziyeh Ashoori
- Student Research Committee, Department of Community Nutrition, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI) and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan St. Farahzadi Blvd., Sharake Qods, Tehran, Iran.
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI) and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan St. Farahzadi Blvd., Sharake Qods, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Azam Doustmohamadian
- Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Behnaz Abdar-Esfahani
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI) and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan St. Farahzadi Blvd., Sharake Qods, Tehran, Iran
| | - Mohammad Mazandaranian
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI) and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan St. Farahzadi Blvd., Sharake Qods, Tehran, Iran
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Silva ARCS, Braga LVM, Anastácio LR. A comparison of four different Nutritional Profile models in their scoring of critical nutrient levels in food products targeted at Brazilian children. NUTR BULL 2021. [DOI: 10.1111/nbu.12490] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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15
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The Influence of Health Messages in Nudging Consumption of Whole Grain Pasta. Nutrients 2019; 11:nu11122993. [PMID: 31817749 PMCID: PMC6950528 DOI: 10.3390/nu11122993] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 12/03/2019] [Accepted: 12/03/2019] [Indexed: 12/27/2022] Open
Abstract
Health messages may be an important predictor in the selection of healthier food choices among young adults. The primary objective of our study is to test the impact of labeling whole grain pasta with a health message descriptor displayed at the point-of-purchase (POP) on consumer choice in a campus dining setting. The study was conducted in a large US college dining venue during lunch service; data were collected during a nine-week period, for a total of 18 days of observation. Each day, an information treatment (i.e., no-message condition; vitamin message; fiber message) was alternated assigned to whole grain penne. Over the study period, the selection of four pasta options (white penne, whole grain penne, spinach fettuccine, and tortellini) were recorded and compiled for analysis. Logistic regression and pairwise comparison analyses were performed to estimate the impact of health messages on diners’ decisions to choose whole grain penne among the four pasta types. Our results indicate that only the message about vitamin benefits had a significant effect on this choice, with a 7.4% higher probability of selecting this pasta than the no-message condition and 6.0% higher than the fiber message condition. These findings suggest that psychological health claims (e.g., reduction of fatigue) of whole grains seem more attractive than physiological health claims (e.g., maintaining a healthy weight) for university students. In line with the 2015–2020 Dietary Guidelines for Americans, our results suggest that small changes made at the POP have the potential to contribute to significant improvements in diet (e.g., achieving recommended levels of dietary fiber). These findings have important implications for food service practitioners in delivering information with the greatest impact on healthy food choices.
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Christoph MJ, Larson N, Laska MN, Neumark-Sztainer D. Nutrition Facts Panels: Who Uses Them, What Do They Use, and How Does Use Relate to Dietary Intake? J Acad Nutr Diet 2019; 118:217-228. [PMID: 29389508 DOI: 10.1016/j.jand.2017.10.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 10/16/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND Nutrition labels are a low-cost tool with the potential to encourage healthy eating habits. OBJECTIVE To investigate correlates of frequent Nutrition Facts label use, describe the types of label information most often used, and measure how label use relates to dietary intake in young adults. DESIGN Cross-sectional population-based study of young adults participating in Project Eating and Activity in Teens and Young Adults-IV. PARTICIPANTS/SETTING Surveys and food frequency questionnaires were completed during 2015-2016 by young adults (N=1,817; weighted sample=49% women) aged 25 to 36 years. MAIN OUTCOME MEASURES Nutrition Facts label use, frequency of using specific information on labels, and dietary intake. STATISTICAL ANALYSES PERFORMED Relative risks and adjusted means were used to examine how demographic, behavior, and weight-related factors were associated with Nutrition Facts panel use, and how label use related to dietary outcomes. Associations with P values <0.05 were considered statistically significant. RESULTS Approximately one-third (31.4%) of participants used Nutrition Facts labels "frequently." Use was significantly higher for women; for participants with high education and income; among those who prepared food regularly; among those who were physically active; among those with a weight status classified as overweight; and among those who were trying to lose, gain, or maintain weight. Label components used most often included sugars (74.1%), total calories (72.9%), serving size (67.9%), and the ingredient list (65.8%). Nutrition Facts label users consumed significantly more fruits, vegetables, and whole grains and fewer sugar-sweetened beverages, compared with nonusers. Nutrition Facts label users ate significantly more frequently at sit-down restaurants but less frequently at fast-food restaurants compared with nonusers. CONCLUSIONS Although Nutrition Facts label use was associated with markers of better dietary quality in a population-based sample of young adults, only one-third of participants used labels frequently. Methods to improve label use should be studied, particularly through leveraging weight- or health-related goals (eg, interest in making healthier food choices), and meeting consumer preferences concerning label content.
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Miller LMS, Sutter C, Wilson MD, Bergman JJ, Beckett LA, Gibson TN. Assessment of an e-training tool for college students to improve accuracy and reduce effort associated with reading nutrition labels. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2019; 67:441-448. [PMID: 29979929 PMCID: PMC6320722 DOI: 10.1080/07448481.2018.1484369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 05/29/2018] [Indexed: 06/08/2023]
Abstract
Objective: Nutrition labels are often underutilized due to the time and effort required to read them. We investigated the impact of label-reading training on effort, as well as accuracy and motivation. Participants: Eighty college students (21 men and 59 women). Methods: The training consisted of a background tutorial on nutrition followed by three blocks of practice reading labels to decide which of two foods was the relatively better choice. Label-reading effort was assessed using an eye tracker and motivation was assessed using a 6-item scale of healthy food-choice empowerment. Results: Students showed increases in label-reading accuracy, decreases in label-reading effort, and increases in empowerment. Conclusions: The nutrition label e-training tool presented here, whether used alone or as part of other wellness and health programs, may be an effective way to boost students' label-reading skills and healthy food choices, before they settle into grocery shopping habits.
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Affiliation(s)
- Lisa M. Soederberg Miller
- Department of Human Ecology, University of California, Davis, One Shields Avenue, Davis, CA 95616; USA; Tel 530-752-3955; Fax 530-752-5660; ;
| | - Carolyn Sutter
- Family Resiliency Center, University of Illinois, Urbana-Champaign, 904 W. Nevada Street, Urbana, IL 61801; USA;
| | - Machelle D. Wilson
- Department of Public Health Sciences, University of California, Davis, One Shields Avenue Davis, CA 95616; USA; ;
| | - Jacqueline J. Bergman
- Nutrition Department, University of California, Davis, One Shields Avenue, Davis, CA 95616; USA;
| | - Laurel A. Beckett
- Department of Public Health Sciences, University of California, Davis, One Shields Avenue Davis, CA 95616; USA; ;
| | - Tanja N. Gibson
- Department of Human Ecology, University of California, Davis, One Shields Avenue, Davis, CA 95616; USA; Tel 530-752-3955; Fax 530-752-5660; ;
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Muth ND, Dietz WH, Magge SN, Johnson RK, Bolling CF, Armstrong SC, Haemer MA, Rausch JC, Rogers VW, Abrams SA, Kim JH, Schwarzenberg SJ, Fuchs GJ, Lindsey CW, Rome ES. Public Policies to Reduce Sugary Drink Consumption in Children and Adolescents. Pediatrics 2019; 143:peds.2019-0282. [PMID: 30910915 DOI: 10.1542/peds.2019-0282] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Excess consumption of added sugars, especially from sugary drinks, poses a grave health threat to children and adolescents, disproportionately affecting children of minority and low-income communities. Public policies, such as those detailed in this statement, are needed to decrease child and adolescent consumption of added sugars and improve health.
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Affiliation(s)
- Natalie D. Muth
- Children’s Primary Care Medical Group, Carlsbad, California
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| | - William H. Dietz
- Sumner M. Redstone Global Center for Prevention and Wellness, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia
| | - Sheela N. Magge
- Division of Pediatric Endocrinology and Diabetes, School of Medicine, Johns Hopkins University, Baltimore, Maryland; and
| | - Rachel K. Johnson
- Department of Nutrition and Food Sciences, University of Vermont, Burlington, Vermont
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Carter P, Bignardi G, Hollands GJ, Marteau TM. Information-based cues at point of choice to change selection and consumption of food, alcohol and tobacco products: a systematic review. BMC Public Health 2018; 18:418. [PMID: 29587686 PMCID: PMC5872569 DOI: 10.1186/s12889-018-5280-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 03/08/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Reducing harmful consumption of food, alcohol, and tobacco products would prevent many cancers, diabetes and cardiovascular disease. Placing information-based cues in the environments in which we select and consume these products has the potential to contribute to changing these behaviours. METHODS In this review, information-based cues are defined as those which comprise any combination of words, symbols, numbers or pictures that convey information about a product or its use. We specifically exclude cues which are located on the products themselves. We conducted a systematic review of randomised, cluster- randomised, and non-randomised controlled trials to assess the impact of such cues on selection and consumption. Thirteen studies met the inclusion criteria, of which 12 targeted food (most commonly fruit and vegetables), one targeted alcohol sales, and none targeted tobacco products. RESULTS Ten studies reported statistically significant effects on some or all of the targeted products, although studies were insufficiently homogenous to justify meta-analysis. Existing evidence suggests information-based cues can influence selection and consumption of food and alcohol products, although significant uncertainty remains. CONCLUSIONS The current evidence base is limited both in quality and quantity, with relatively few, heterogeneous studies at unclear or high risk of bias. Additional, more rigorously conducted studies are warranted to better estimate the potential for these interventions to change selection and consumption of food, alcohol and tobacco products. TRIAL REGISTRATION PROSPERO. 2016; CRD42016051884 .
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Affiliation(s)
- Patrice Carter
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Giacomo Bignardi
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | | | - Theresa M. Marteau
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
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Christoph MJ, Loth KA, Eisenberg ME, Haynos AF, Larson N, Neumark-Sztainer D. Nutrition Facts Use in Relation to Eating Behaviors and Healthy and Unhealthy Weight Control Behaviors. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:267-274.e1. [PMID: 29276019 PMCID: PMC5845784 DOI: 10.1016/j.jneb.2017.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 11/06/2017] [Accepted: 11/09/2017] [Indexed: 05/09/2023]
Abstract
OBJECTIVE Investigate the relationship between use of Nutrition Facts labels on packaged foods and weight-related behaviors. DESIGN Cross-sectional survey in 2015-2016. PARTICIPANTS Young adult respondents (n = 1,817; 57% women; average age 31.0 ± 1.6 years) to the Project Eating and Activity in Teens and Young Adults-IV survey, the fourth wave of a longitudinal cohort study. VARIABLES MEASURED Use of Nutrition Facts labels on packaged foods; healthy, unhealthy, and extreme weight control behaviors; intuitive eating; binge eating. ANALYSIS Linear and logistic regression models were adjusted for age, ethnicity/race, education, income, and weight status. RESULTS In women, greater Nutrition Facts use was associated with a 23% and 10% greater likelihood of engaging in healthy and unhealthy weight control behaviors, respectively, and a 17% greater chance of engaging in binge eating. In men, greater label use was associated with a 27% and 17% greater likelihood of engaging in healthy and unhealthy weight control behaviors, respectively, and a lower level of intuitive eating. CONCLUSIONS AND IMPLICATIONS Professionals advising patients and clients on weight management may consider possible gender differences in response to weight loss and management guidance. Since label use was related to engagement in some unhealthy behaviors in addition to healthy behaviors, it is important to consider how individuals may use labels, particularly those at risk for, or engaging in, disordered eating behaviors. Future research investigating potential relationships between Nutrition Facts use, intuitive eating, and binge eating is needed.
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Affiliation(s)
- Mary J Christoph
- Department of Pediatrics, School of Medicine, University of Minnesota, Minneapolis, MN.
| | - Katie A Loth
- Department of Family Medicine and Community Health, School of Medicine, University of Minnesota, Minneapolis, MN
| | - Marla E Eisenberg
- Department of Pediatrics, School of Medicine, University of Minnesota, Minneapolis, MN
| | - Ann F Haynos
- Department of Psychiatry, School of Medicine, University of Minnesota, Minneapolis, MN
| | - Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
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Christoph MJ, An R. Effect of nutrition labels on dietary quality among college students: a systematic review and meta-analysis. Nutr Rev 2018; 76:187-203. [DOI: 10.1093/nutrit/nux069] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Miller LMS, Sutter CA, Wilson MD, Bergman JJ, Beckett LA, Gibson TN. An Evaluation of an eHealth Tool Designed to Improve College Students' Label-Reading Skills and Feelings of Empowerment to Choose Healthful Foods. Front Public Health 2018; 5:359. [PMID: 29376048 PMCID: PMC5768899 DOI: 10.3389/fpubh.2017.00359] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 12/18/2017] [Indexed: 01/06/2023] Open
Abstract
Objective College students are at risk for poor dietary choices. New skills can empower individuals to adopt healthful behaviors, yet eHealth tools designed to develop food-choice skills, such as label-reading skills, are uncommon. We investigated the effects of web-based label-reading training on college students’ perceptions of healthful food-choice empowerment. Methods Students completed label-reading training in which they practiced selecting the more healthful food using nutrition labels. We examined improvements in label-reading accuracy (correct healthfulness decisions) and perceptions of empowerment, using a 6-item scale. Repeated measures ANOVAs and paired-samples t-tests were used to examine changes in accuracy and empowerment across the training session. Results In addition to increases in label-reading accuracy with training, we found increases in healthful food-choice empowerment scores. Specifically, the proportion of correct (i.e., more healthful) food choices increased across the three blocks of practice (p = 0.04) and food-choice empowerment scores were about 7.5% higher on average after training (p < 0.001). Conclusion and implications Label-reading training was associated with increased feelings of empowerment associated with making healthful food choices. Skill focused eHealth tools may offer an important avenue for motivating behavior change through skill development.
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Affiliation(s)
| | - Carolyn A Sutter
- Family Resiliency Center, University of Illinois, Urbana-Champaign, Urbana, IL, United States
| | - Machelle D Wilson
- Department of Public Health Sciences, University of California Davis, Davis, CA, United States
| | | | - Laurel A Beckett
- Department of Public Health Sciences, University of California Davis, Davis, CA, United States
| | - Tanja N Gibson
- Department of Human Ecology, University of California Davis, Davis, CA, United States
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Tallant A. First-Year College Students Increase Food Label–Reading Behaviors and Improve Food Choices in a Personal Nutrition Seminar Course. AMERICAN JOURNAL OF HEALTH EDUCATION 2017. [DOI: 10.1080/19325037.2017.1343160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Christoph MJ, Ellison B. A Cross-Sectional Study of the Relationship between Nutrition Label Use and Food Selection, Servings, and Consumption in a University Dining Setting. J Acad Nutr Diet 2017; 117:1528-1537. [PMID: 28330728 DOI: 10.1016/j.jand.2017.01.027] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 01/24/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Nutrition labels at the point of purchase are recommended to improve food choice, yet food choice does not always translate into food consumption. It is important to understand the relationship between label use, food selection, servings, and consumption. Previous research, which has relied on self-reported intake or inferred label use or intake based on sales data, has not adequately answered this question. OBJECTIVE To combine survey and meal photographic data to compare food selection, servings, and consumption between label users and nonusers. DESIGN Diners were surveyed in two cross-sectional waves during the fall 2014 semester. Food selections were recorded, and pre- and postmeal photographs were taken of diners' plate. Photographs were coded to identify the selection, servings, and consumption of MyPlate food categories. PARTICIPANTS/SETTING Convenience sample of 1,069 diners (39% women, 53% freshman) in two university dining halls. Students had to be older than age 18 years and just beginning their meal to participate. MAIN OUTCOME MEASURES Selection, servings, and consumption of MyPlate food categories for label users and nonusers. STATISTICAL ANALYSES PERFORMED Differences in food selection were tested via χ2 tests, and differences in adjusted least squares means for servings and consumption were tested via t tests. RESULTS A greater proportion of nutrition label users selected fruits, vegetables, and beans and fewer selected potatoes compared with nonusers. In addition, fewer label users selected fried foods and foods with added sugars (all P values <0.05). Label users served themselves and consumed more vegetables and fewer potatoes and refined grains compared with nonusers (all P values <0.05). CONCLUSIONS Our results suggest label users behave differently compared with nonusers. Based on the meals observed, these differences appear more qualitative in nature (selecting different foods) than quantitative (selecting more or less food).
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