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Calabro R, Kemps E, Prichard I, Tiggemann M. Effects of traffic light labelling and increased healthy range on beverage choices from vending machines. Public Health Nutr 2024; 27:e113. [PMID: 38587000 PMCID: PMC11036432 DOI: 10.1017/s1368980024000843] [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: 08/31/2023] [Revised: 01/28/2024] [Accepted: 03/26/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE To test whether traffic light labels and an increased range of healthy beverages, individually and in combination, can increase healthy beverage choices from vending machines. DESIGN Two studies (n 558, 420) tested whether the provision of traffic light labels (green, amber and red) and an increased range of healthy beverages (from 20 % to 50 % green options), individually and in combination, could increase healthy beverage choices from a digital vending machine display. The studies used a between-subjects experimental design, and a hypothetical beverage choice, a limitation when considering real-world applicability. SETTING Both studies utilised an online Qualtrics survey that featured a digital vending machine display. PARTICIPANTS Both studies (n 558, 420) consisted of university students from Flinders University and individuals from a survey recruitment service. RESULTS Featuring traffic lights did not significantly influence beverage choices (P = 0·074), while increasing the healthy range (P = 0·003, OR = 3·27), and the combination of both, did significantly increase healthier beverage choices (P < 0·001, OR = 4·83). CONCLUSIONS The results suggest that the traffic light system and increased healthy range are not maximally effective when used on their own, and benefit greatly when combined, to increase healthy beverage choices. It was suggested that the provision of traffic light labels supplied the necessary nutritional information, and the increased healthy range offered greater opportunity to act in accordance with that information. In so doing, the present findings offer a promising pathway for reducing unhealthy beverage consumption.
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Affiliation(s)
- Ryan Calabro
- Psychology, College of Education, Psychology and Social Work, Flinders University, Adelaide, SA5001, Australia
| | - Eva Kemps
- Psychology, College of Education, Psychology and Social Work, Flinders University, Adelaide, SA5001, Australia
| | - Ivanka Prichard
- Health & Exercise Sciences, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Marika Tiggemann
- Psychology, College of Education, Psychology and Social Work, Flinders University, Adelaide, SA5001, Australia
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Almoraie NM, Alothmani NM, Alomari WD, Al-Amoudi AH. Addressing nutritional issues and eating behaviours among university students: a narrative review. Nutr Res Rev 2024:1-16. [PMID: 38356364 DOI: 10.1017/s0954422424000088] [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: 02/16/2024]
Abstract
University life is a critical period for establishing healthy eating habits and attitudes. However, university students are at risk of developing poor eating habits due to various factors, including economic conditions, academic stress and lack of information about nutritional concepts. Poor diet quality leads to malnutrition or overnutrition, increasing the risk of preventable diseases. Food environments on university campuses also play a significant role in shaping the dietary habits of students, with the availability of and accessibility to healthy food options being important factors influencing food choices and overall diet quality. Disordered eating habits and body dissatisfaction are prevalent among university students and can lead to eating disorders. Income and living arrangements also influence dietary habits, with low household income and living alone being associated with unhealthy eating habits. This study is a narrative review that aimed to address nutritional issues and eating behaviours, specifically among university students. We investigated the eating behaviours of university students, including their dietary patterns, food choices and food environments. The objective of this review was to provide insights into the nutritional issues and eating behaviours of university students, with the aim of identifying target areas for intervention to improve the overall health and wellbeing among college students. University food environments need to be restructured to promote healthy eating, including the availability, accessibility, affordability and labelling of healthy foods, and policies to limit the availability of unhealthy foods and drinks on campus.
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Affiliation(s)
- Noha M Almoraie
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Noor M Alothmani
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Wajd D Alomari
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amal H Al-Amoudi
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
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Wakui N, Matsuoka R, Ichikawa K, Togawa C, Okami A, Kawakubo S, Kagi H, Watanabe M, Tsubota Y, Yamamura M, Machida Y. Investigation of the 1-week effect of traffic light nutrition labeling on diet selection among Japanese university students: a randomized controlled trial. BMC Public Health 2024; 24:381. [PMID: 38317163 PMCID: PMC10840142 DOI: 10.1186/s12889-024-17815-4] [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: 07/31/2023] [Accepted: 01/19/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND The method of displaying nutrition information labels on the front of food packaging (FOP: Front of Pack) has been implemented worldwide to prevent lifestyle-related diseases. This study aimed to investigate whether the use of the UK's Traffic Light Food (TLF) label, known as the FOP label, influences the dietary choices of Japanese youth and promotes healthy dietary choices. METHODS Diet selection was performed for one week each during the baseline and intervention periods. During the intervention period, TLF labels were displayed on meal images of the intervention group. Participants chose what they would like to have for dinner of the day from 15 images. Each meal was scored based on the color of the nutrition label, and a comparison between groups was made to determine whether TLF labeling influenced meal selection for dinner. The psychological stress caused by the presence or absence of nutrition labels and nutritional components when choosing meals was also evaluated. RESULTS A total of 69 participants were randomly assigned to two groups. Dietary choice scores indicated that the TLF-labeled group made significantly healthier dietary choices than the unlabeled group. Additionally, the TLF-labeled group showed a significant increase in the percentage of people conscious of nutritional components when choosing meals. Furthermore, a significant increase in the number of people conscious of protein, a nutritional ingredient not indicated on the TLF label, was observed. During the test period, no difference in psychological stress caused by the presence and absence of the TLF labels was observed. CONCLUSIONS The use of TLF labels also encouraged healthy dietary choices among Japanese university students. The use of FOP nutrition labels should be considered in Japan to prevent lifestyle-related diseases through healthy dietary choices. TRIAL REGISTRATION UMIN Clinical Trials Registry Number: UMIN000047268. Registered March 23, 2022.
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Affiliation(s)
- Nobuyuki Wakui
- Division of Applied Pharmaceutical Education and Research, Faculty of Pharmaceutical Sciences, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, 142-8501, Tokyo, Japan.
| | - Raini Matsuoka
- Division of Applied Pharmaceutical Education and Research, Faculty of Pharmaceutical Sciences, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, 142-8501, Tokyo, Japan
| | - Kotoha Ichikawa
- Division of Applied Pharmaceutical Education and Research, Faculty of Pharmaceutical Sciences, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, 142-8501, Tokyo, Japan
| | - Chikako Togawa
- Division of Applied Pharmaceutical Education and Research, Faculty of Pharmaceutical Sciences, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, 142-8501, Tokyo, Japan
| | - Aika Okami
- Division of Applied Pharmaceutical Education and Research, Faculty of Pharmaceutical Sciences, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, 142-8501, Tokyo, Japan
| | - Shoko Kawakubo
- Division of Applied Pharmaceutical Education and Research, Faculty of Pharmaceutical Sciences, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, 142-8501, Tokyo, Japan
| | - Hinako Kagi
- Division of Applied Pharmaceutical Education and Research, Faculty of Pharmaceutical Sciences, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, 142-8501, Tokyo, Japan
| | - Mai Watanabe
- Division of Applied Pharmaceutical Education and Research, Faculty of Pharmaceutical Sciences, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, 142-8501, Tokyo, Japan
| | - Yuika Tsubota
- Division of Applied Pharmaceutical Education and Research, Faculty of Pharmaceutical Sciences, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, 142-8501, Tokyo, Japan
| | - Miho Yamamura
- Division of Applied Pharmaceutical Education and Research, Faculty of Pharmaceutical Sciences, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, 142-8501, Tokyo, Japan
| | - Yoshiaki Machida
- Division of Applied Pharmaceutical Education and Research, Faculty of Pharmaceutical Sciences, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, 142-8501, Tokyo, Japan
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Evans CEL, Worth S, White R, Strachan EK. Evaluation of an experiment to increase availability of healthier snack foods in vending machines situated within English sports facilities. Public Health Nutr 2023; 26:3088-3099. [PMID: 37727877 PMCID: PMC10755406 DOI: 10.1017/s1368980023002069] [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: 07/02/2022] [Revised: 06/14/2023] [Accepted: 09/13/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVE To evaluate the impact of increased availability of healthier options on purchasing of different types of vending snack products sold in English leisure (sports) centres. DESIGN An evaluation of an intervention using pre-post methods and interrupted time series analysis. Products within the vending machines were altered over three phases to increase the availability of healthier options, using agreed nutrition criteria - Government Buying Standards for Food and Catering Services (GBSF) for England - as a guide, as well as product availability. The primary outcome was the change in mean weekly purchased energy between the first and third phase. Secondary outcomes included changes by phase and by week in weekly number of purchases, fats, sugars and salt for all products combined and by individual product categories. SETTING Fifteen sports centres in the city of Leeds, West Yorkshire, UK. PARTICIPANTS Snack products sold in eighteen vending machines. RESULTS Energy purchased reduced from baseline to phase 2, for all product categories combined, by 47·25 MJ (95 % CI (-61·22, -33·27)) per machine and by 279 kJ, (95 % CI (-325, -266)) per product unit. There were reductions in most nutrients purchased in all individual product categories except chocolate confectionery. Nutrients per product unit decreased for all product categories except saturated fat in chocolate confectionery. Minimal underlying trends in the baseline phase were identified, indicating changes in outcomes were likely to be due to the intervention. CONCLUSIONS Introducing standards to increase availability of healthier snack products in vending machines is feasible without substantially affecting sales.
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Affiliation(s)
- Charlotte EL Evans
- School of Food Science and Nutrition, University of Leeds, Leeds, LS2 9JT, UK
| | | | - Rachel White
- Health Improvement and Disparities, Department of Health and Social Care, London, UK
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Barrett EM, Hart AC, Bhat S, Marklund M, Coyle DH, Heenan M, Pettigrew S, Wu JH. The Effect of Retail Food Environment Interventions on Dietary Behavior in Postsecondary Education Settings: A Systematic Review and Meta-analysis. J Nutr 2023; 153:3122-3130. [PMID: 37741633 DOI: 10.1016/j.tjnut.2023.08.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/24/2023] [Accepted: 08/30/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND Postsecondary education institutions, where hundreds of millions of people work and study globally, are a key setting for retail food environment interventions. OBJECTIVE We aimed to synthesize the evidence for the effectiveness of retail food environment interventions in improving the healthiness of dietary behavior of students and staff in postsecondary education settings. METHODS Academic databases were searched for randomized controlled trials (RCTs) and quasi-experimental studies published until August 2023. Studies were eligible if they assessed the impact of a retail food environment intervention on healthiness of dietary behavior (purchases or consumption) in students or staff in postsecondary education settings and targeted one of the following food environment elements: placement, price, product, or promotion. Business-related outcomes (total sales, profit, or revenue) were included as secondary outcomes. Findings were synthesized in narrative form, organized by retail food environment element. Where comparable dietary outcome data were available from ≥10 interventions, findings were pooled using random effects meta-analysis. RESULTS Of 10,126 studies initially identified, 55 (76% quasi-experimental) were included, describing 71 separate interventions (n = 49 single-element and n = 22 multi-element). Two-thirds (n = 47, 66%) of interventions (n = 32 single-element and n = 15 multi-element) demonstrated significant improvements in dietary behavior. Single-element interventions targeting placement (n = 1) and price (n = 3) improved dietary behavior. Most (n = 9/10, 90%) interventions targeting product availability or convenience (product element) improved dietary behavior, while n = 19/35 (54%) targeting promotion did. Pooled findings from 12 interventions reporting changes in energy content demonstrated a significant decrease in purchased or consumed energy (-7.9%; 95% confidence interval: -10.3%, -5.6%). Almost all interventions (n = 11/12, 92%) that evaluated the impact on business-related outcomes found either a significant increase or no change following the intervention. CONCLUSIONS We established encouraging evidence supporting the role of retail food environment interventions in postsecondary education settings to support healthy dietary behaviors of students and staff. REGISTRY PROSPERO (International Prospective Register of Systematic Reviews, URL: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=295836; registration number CRD42022295836).
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Affiliation(s)
- Eden M Barrett
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
| | - Ashleigh C Hart
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Saiuj Bhat
- Royal Perth Hospital, Victoria Square, Perth, Western Australia; School of Medicine, The University of Western Australia, Crawley, Western Australia
| | - Matti Marklund
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; Department of Epidemiology, John Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Daisy H Coyle
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Maddie Heenan
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Simone Pettigrew
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Jason Hy Wu
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
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Egnell M, Boutron I, Péneau S, Ducrot P, Touvier M, Galan P, Fezeu L, Porcher R, Ravaud P, Hercberg S, Kesse-Guyot E, Julia C. Impact of the Nutri-Score front-of-pack nutrition label on purchasing intentions of individuals with chronic diseases: results of a randomised trial. BMJ Open 2022; 12:e058139. [PMID: 36038180 PMCID: PMC9438084 DOI: 10.1136/bmjopen-2021-058139] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To our knowledge, the effect of front-of-pack nutrition labels such as the Nutri-Score on food purchases has never been assessed among individuals suffering from nutrition-related chronic diseases specifically, while dietary modifications are generally part of their care. This study aimed to investigate the effect of the Nutri-Score on the nutritional quality of purchasing intentions among adults suffering from a cardiometabolic disease, compared with no label and the Reference Intakes (RIs), a label already implemented by some food manufacturers in France. SETTING Secondary prevention-mainland France. PARTICIPANTS 2431 eligible participants were randomly assigned and 1180 participants (65.5% women, mean age 65.0±7.1 years) completed the shopping task and were included in the analyses. INTERVENTION A three-arm randomised controlled trial using an experimental online supermarket was conducted in 2017. Participants with cardiometabolic diseases were invited to simulate food purchases with the Nutri-Score, the RIs or no label. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the nutritional quality of the shopping cart, estimated using the French-modified Food Standard Agency Nutrient Profiling System (FSAm-NPS), and secondary outcomes included the nutrient content of purchases. RESULTS The mean (SD) FSAm-NPS score was significantly lower in the Nutri-Score arm (1.29 (3.61) points), reflecting a higher overall nutritional quality of purchasing intentions, compared with the RIs (1.86 (3.23) points) and no label (1.92 (2.90) points) arms (p=0.01). Moreover, the Nutri-Score led to significantly lower content in calories and saturated fatty acids compared with the two other arms. These differences resulted from participants avoiding some packaged products (sweets, dairy and starches) and purchasing larger amounts of fresh fruit and meat. CONCLUSIONS The Nutri-Score exhibited a significant higher nutritional quality of purchasing intentions, encouraging healthier food choices among individuals suffering from cardiometabolic chronic diseases. TRIAL REGISTRATION NUMBER NCT02769455.
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Affiliation(s)
- Manon Egnell
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Isabelle Boutron
- METHODS team, Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Paris, Île-de-France, France
- Centre d'Epidémiologie Clinique, Hôtel Dieu, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Sandrine Péneau
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Pauline Ducrot
- Santé publique France, Saint-Maurice, Île-de-France, France
| | - Mathilde Touvier
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Pilar Galan
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Léopold Fezeu
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Raphaël Porcher
- METHODS team, Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Paris, Île-de-France, France
| | - Philippe Ravaud
- METHODS team, Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Paris, Île-de-France, France
- Centre d'Epidémiologie Clinique, Hôtel Dieu, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Serge Hercberg
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
- Public Health Department, Hôpitaux Paris Seine-Saint-Denis, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Chantal Julia
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
- Public Health Department, Hôpitaux Paris Seine-Saint-Denis, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France
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Mengarelli CA, Kirchoff C, Palacios C. College Students' Perception of Snacks Sold in Vending Machines in the US: A Mixed-Methods Study. Front Nutr 2021; 8:742121. [PMID: 34778337 PMCID: PMC8578334 DOI: 10.3389/fnut.2021.742121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/01/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction: Food in vending machines in US colleges contain limited nutritious foods available for purchase, which could affect the food choices made by students leading to poor diet quality. Interventions to improve college foodscapes usually follow a top-down approach and fail to affect dietary behavioral changes ultimately. This research aims to uncover what students want and ways to achieve change. Methods: The mixed-methods approach included peer-led qualitative focus group discussions and a brief quantitative questionnaire on satisfaction from foods available in vending machines. A convenience sample of 20 students (15 females) was recruited from a Hispanic serving institution for this study. Results: Vending machines were perceived as convenient, plentiful, and unhealthy. Students expressed dissatisfaction with both the variety and nutritional quality of snacks in vending machines. Suggestions for improvement included more fresh items (fruits and vegetables) and refrigerated items with higher protein content (low-fat yogurt, hummus, and peanut butter). To implement these improvements, participants discussed the cost and feasibility of perishable items. Increasing awareness and partnering strategies were proposed to mediate potential cost and buy-in obstacles as was elevating the appeal of healthy vending machines with technological enhancements that draw customers in and educate. Conclusion and Implication for Practice: This group of college students was eager for positive changes in foods sold in vending machines and understand the major difficulties. The suggested changes may help this and other colleges develop policies to regulate the foods in vending machines to promote overall health and help prevent chronic diseases in the future.
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Affiliation(s)
- Cristiana Assumpção Mengarelli
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
| | - Christie Kirchoff
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
| | - Cristina Palacios
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
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Consumption, Attitudes, and Trends of Vending Machine Foods at a University Campus: A Cross-Sectional Study. Foods 2021; 10:foods10092122. [PMID: 34574231 PMCID: PMC8470557 DOI: 10.3390/foods10092122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/01/2021] [Accepted: 09/05/2021] [Indexed: 01/10/2023] Open
Abstract
Vending machines (VMs) have been identified as an obesogenic factor, offering mainly energy-dense and nutrient-poor foods, with limited healthy options available. This cross-sectional study aimed to assess consumption trends and attitude toward vending machine (VM) foods in a university setting. A web-based survey was conducted among 1250 students and staff. Most participants reported weight gain (43.4%) and poorer food choices (53.4%) since joining the university. Participants described VM foods as expensive (53.7%) and lacking variety (34.3%). Over 81% demanded the availability of healthier options. About 75% of participants were VMs users. The most frequently purchased VM items were water, chocolate, and chips. Males reported consuming nuts, soda, iced tea, and energy drinks more frequently than females (p < 0.005). The main reasons for using the VM were hunger and lack of time. Over 40% nominated fresh fruits, baked chips, sandwiches, and dry roasted nuts to be provided in the VMs as healthier food options. Males and those responsible for buying their own food were more likely to select healthier options (p = 0.001). Findings can be used to inform stakeholders of current vending behaviors and to plan tailored interventions to improve the nutritional quality of vended items and promote healthier food choices.
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Availability, Nutritional Profile and Processing Level of Food Products Sold in Vending Machines in a Spanish Public University. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136842. [PMID: 34202231 PMCID: PMC8297357 DOI: 10.3390/ijerph18136842] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/19/2021] [Accepted: 06/20/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Given the lack of data about the nutritional value and other determinants of the consumption of foods and drinks sold in vending machines in European universities and the relevance of this sector in Spain, it is necessary to obtain scientific data on this topic. The present study aimed to assess the availability, nutritional profile and processing level of food products from vending machines at a Spanish public university and to investigate differences in nutritional profile according to the cost and promotion. METHODS Cross-sectional descriptive study. Data from all products available (3894) were collected and analysed using the criteria of the Spanish Agency for Consumption, Food Safety and Nutrition and the United Kingdom nutrient profiling model. The items were also classified according to the degree of industrial processing through the NOVA system. Promotion was assessed, taking into account where products were displayed in vending machines. RESULTS The most common products were sweets (23.4% of the total options), coffee (20.3%) and salty snacks (11.7%). According to the combination of the two criteria used to assess nutritional profile, 48.6% of the products were classified as with low nutritional quality (LNQ). In addition, 73.8% of the items were categorised as "ultra-processed". Foods (β = 0.31, 95% CI 0.24, 0.39, p < 0.001) and hot drinks (β = 0.46, 95% CI 0.39, 0.52, p < 0.001) with high nutritional quality (HNQ) were more likely to have higher prices than alternatives with LNQ. Both foods and cold drinks that support healthy dietary recommendations were promoted to a lesser extent than those with LNQ (p < 0.001). CONCLUSION Almost half of the products were of LNQ and three-quarters had a high level of processing. Moreover, foods and cold drinks with LNQ were less expensive and more often promoted than alternatives with HNQ.
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Favorable Commercial and Health Behavior Impacts of a Healthy Vending Policy at an Australian University. J Acad Nutr Diet 2021; 121:2201-2209.e14. [PMID: 34092531 DOI: 10.1016/j.jand.2021.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 04/01/2021] [Accepted: 04/06/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND The World Health Organization recognizes universities as an important health-promotion setting, including in healthy food provision. Previous research shows that healthy food retail interventions also need to consider commercial sustainability, including financial outcomes, and should take a holistic approach to consumer experience. OBJECTIVE Our aim was to determine the health behavior and commercial outcomes of a multicomponent traffic light-based healthy vending policy implemented as one part of a holistic university food policy. The hypothesis was that purchases of less healthy "red" beverages would decrease compared with predicted sales, that purchases of healthier "green" and "amber" alternatives would increase, and that there would be no change in revenue. DESIGN A quasi-experimental design evaluated a real-world food policy using monthly aggregated sales data to compare pre-intervention (January 2016 to March 2018) and post-intervention period sales (December 2018 to December 2019). PARTICIPANTS/SETTING Electronic sales data were collected from 51 beverage vending machines across 4 university campuses in Victoria, Australia. INTERVENTION A multicomponent policy was implemented between April and November 2018. Beverages were classified using a voluntary state government traffic light framework. Policy included display ≤20% red beverages and ≥50% green beverages; machine traffic light labeling; health-promoting machine branding; review of machine placement; and recycled bottle packaging. MAIN OUTCOME MEASURES Changes in red, amber, and green volume sales, and revenue compared with predicated sales. STATISTICAL ANALYSES PERFORMED Interrupted time series analysis of sales data compared post-policy sales with predicted sales. RESULTS In the 13th month post-policy implementation, there was a 93.2% (95% CI +35.9% to +150.5%) increase in total beverage volume sold and an 88.6% (95% CI +39.2% to +138.1%) increase in revenue. There was no change in red beverage volume sold, but increases in green (+120.8%; 95% CI +59.0% to +182.6%) and amber (+223.2%; 95% CI +122.4% to +323.9%) volume sold. CONCLUSIONS Sustained behavior change and commercial outcomes suggest that holistic vending interventions can effectively promote healthier beverage sales.
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Egnell M, Galan P, Fialon M, Touvier M, Péneau S, Kesse-Guyot E, Hercberg S, Julia C. The impact of the Nutri-Score front-of-pack nutrition label on purchasing intentions of unprocessed and processed foods: post-hoc analyses from three randomized controlled trials. Int J Behav Nutr Phys Act 2021; 18:38. [PMID: 33731145 PMCID: PMC7968175 DOI: 10.1186/s12966-021-01108-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 03/05/2021] [Indexed: 11/21/2022] Open
Abstract
Background The Nutri-Score summary graded front-of-pack nutrition label has been identified as an efficient tool to increase the nutritional quality of pre-packed food purchases. However, no study has been conducted to investigate the effect of the Nutri-Score on the shopping cart composition, considering the type of foods. The present paper aims to investigate the effect of the Nutri-Score on the type of food purchases, in terms of the relative contribution of unpacked and pre-packed foods, or the processing degree of foods. Methods Between September 2016 and April 2017, three consecutive randomized controlled trials were conducted in three specific populations – students (N = 1866), low-income individuals (N = 336) and subjects suffering from cardiometabolic diseases (N = 1180) – to investigate the effect of the Nutri-Score on purchasing intentions compared to the Reference Intakes and no label. Using these combined data, the proportion of unpacked products in the shopping carts, as well as the distribution of products across food categories taking into account the degree of processing (NOVA classification) were assessed by trials arm. Results The shopping carts of participants simulating purchases with the Nutri-Score affixed on pre-packed foods contained higher proportion of unpacked products – especially raw fruits and meats, i.e. with no FoPL –, compared to participants purchasing with no label (difference of 5.93 percentage points [3.88–7.99], p-value< 0.0001) or with the Reference Intakes (difference of 5.27[3.25–7.29], p-value< 0.0001). This higher proportion was partly explained by fewer purchases of pre-packed processed and ultra-processed products overall in the Nutri-Score group. Conclusions These findings provide new insights on the positive effect of the Nutri-Score, which appears to decrease purchases in processed products resulting in higher proportions of unprocessed and unpacked foods, in line with public health recommendations. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01108-9.
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Affiliation(s)
- Manon Egnell
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), SMBH Paris 13, 74 rue Marcel Cachin, F-93017, Bobigny Cedex, France.
| | - Pilar Galan
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), SMBH Paris 13, 74 rue Marcel Cachin, F-93017, Bobigny Cedex, France
| | - Morgane Fialon
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), SMBH Paris 13, 74 rue Marcel Cachin, F-93017, Bobigny Cedex, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), SMBH Paris 13, 74 rue Marcel Cachin, F-93017, Bobigny Cedex, France
| | - Sandrine Péneau
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), SMBH Paris 13, 74 rue Marcel Cachin, F-93017, Bobigny Cedex, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), SMBH Paris 13, 74 rue Marcel Cachin, F-93017, Bobigny Cedex, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), SMBH Paris 13, 74 rue Marcel Cachin, F-93017, Bobigny Cedex, France.,Public Health department, Avicenne Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Bobigny, France
| | - Chantal Julia
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), SMBH Paris 13, 74 rue Marcel Cachin, F-93017, Bobigny Cedex, France.,Public Health department, Avicenne Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Bobigny, France
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12
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Egnell M, Boutron I, Péneau S, Ducrot P, Touvier M, Galan P, Buscail C, Porcher R, Ravaud P, Hercberg S, Kesse-Guyot E, Julia C. Randomised controlled trial in an experimental online supermarket testing the effects of front-of-pack nutrition labelling on food purchasing intentions in a low-income population. BMJ Open 2021; 11:e041196. [PMID: 33558350 PMCID: PMC7871692 DOI: 10.1136/bmjopen-2020-041196] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The Nutri-Score, a front-of-pack nutrition label, has been adopted in 2017 in France but its impact on low-income populations is unknown, and they are more at risk of having unhealthy diets. The present study assessed the effects of the Nutri-Score on the nutritional quality of purchasing intentions among low-income individuals, compared with the current French labelling situation: references intakes (RIs) and no label, using a three-arm parallel-group randomised controlled trial. METHODS Low-income active adults from the NutriNet-Santé cohort (household income below €1200/month) were asked to perform a shopping task in an experimental online supermarket after being randomised in one of the three conditions (Nutri-Score, RIs or no labelling). The main outcome was the overall nutritional quality of the virtual shopping cart, assessed with the French-modified Food Standards Agency Nutrient Profiling System (FSAm-NPS), and secondary outcomes were the nutrient content of the shopping carts. 524 subjects were randomised, and 336 included in the analyses. RESULTS The Nutri-Score resulted in the highest overall nutritional quality of the shopping cart, as reflected by a FSAm-NPS score (1.86 (SD 3.59) points) significantly lower (reflecting higher nutritional quality) than the RIs (3.21 (SD 4.14) points, p≤0.05) but not significantly lower than no label (2.60 (SD 3.09) points, p=0.3). The Nutri-Score also resulted into significantly lower contents in calories and saturated fatty acids in the shopping cart, compared with the RIs only (p≤0.05). CONCLUSION The implementation of the front of pack nutrition label Nutri-Score, adopted in France and in different European countries, appears to have the potential to encourage purchasing intentions of foods from higher nutritional quality among low-income individuals, compared with the RIs label promoted by food manufacturers.Trial registration number: NCT02769455.
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Affiliation(s)
- Manon Egnell
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, France
| | - Isabelle Boutron
- METHODS team, Epidemiology and Biostatistics Centre, Inserm UMR 1153, Paris, France
| | - Sandrine Péneau
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, France
| | | | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, France
| | - Camille Buscail
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, France
| | - Raphaël Porcher
- METHODS team, Epidemiology and Biostatistics Centre, Inserm UMR 1153, Paris, France
| | - Philippe Ravaud
- METHODS team, Epidemiology and Biostatistics Centre, Inserm UMR 1153, Paris, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, France
- Public Health Department, Avicenne Hospital, Bobigny cedex, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, France
| | - Chantal Julia
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, France
- Public Health Department, Avicenne Hospital, Bobigny cedex, France
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Utter J, McCray S. Vending Machines in Australian Hospitals: Are They Meeting the Needs of the Consumer? JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:183-186. [PMID: 33573768 DOI: 10.1016/j.jneb.2020.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 11/18/2020] [Accepted: 11/22/2020] [Indexed: 06/12/2023]
Abstract
The current report explores how well vending machines are meeting the needs of health care organizations and their staff and visitors in Australia. Hospital vending machines often provide the only source of food through the night to staff and visitors and traditionally offer less-healthy options. Findings presented in this report suggest that vending machines are not meeting current statewide policies and guidelines for healthier food environments in health care. This is despite widespread support for healthier refreshments in hospitals by staff, visitors, and patients. Alternatives to traditional vending and opportunities for nutrition educators and researchers are discussed.
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Affiliation(s)
- Jennifer Utter
- Department of Dietetics and Foodservices, Mater Health, South Brisbane, Queensland, Australia.
| | - Sally McCray
- Department of Dietetics and Foodservices, Mater Health, South Brisbane, Queensland, Australia
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Vehmas K, Calton A, Grenman K, Aisala H, Sozer N, Nordlund E. Development and Consumer Perception of a Snack Machine Producing Customized Spoonable and Drinkable Products Enriched in Dietary Fiber and Protein. Foods 2020; 9:foods9101454. [PMID: 33066150 PMCID: PMC7601953 DOI: 10.3390/foods9101454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/23/2020] [Accepted: 10/12/2020] [Indexed: 12/01/2022] Open
Abstract
The aim of the study was to evaluate consumer perceptions toward customized snacks produced with a Healthy Snack Machine (HSM) prototype, at-site of the purchase and consumption. The present study had a multi-disciplinary approach including both snack product and HSM development (hardware and user interface). Snack development included both instrumental (viscosity, colloidal stability) and sensory characterization (by trained sensory (N = 10) and consumer (N = 55) panels) of spoonable and drinkable, oat- and dairy-based snack products, fortified with protein and/or dietary fiber. The protein and fiber addition reduced viscosity in spoonable products but did not affect the consistency of drinkable samples. Oat-based samples differed from dairy-based in multiple attributes in sensory profiling. In consumer sample testing, sample odor and taste were the most and least preferred aspects, respectively. In the snack machine testing, a qualitative consumer study (N = 33) showed that the HSM was easy to use, the user interface was clear, the ordering process was quick, and the participants were interested in using the HSM in the future. The snack choices (spoonable/drinkable and dairy/oat base) made by the consumers were distributed equally, but the berry-flavor was preferred over cocoa and vanilla. The most common HSM usage scenarios were “between work/school and hobbies” and “in transit from one place to another”.
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15
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The efficacy of 'high in' warning labels, health star and traffic light front-of-package labelling: an online randomised control trial. Public Health Nutr 2020; 24:62-74. [PMID: 33019950 DOI: 10.1017/s1368980020003213] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To examine the impact of front-of-package (FOP) labels on perceived healthfulness, purchasing intentions and understanding of common FOP systems. DESIGN A parallel, open-label design randomised participants to different FOP labelling conditions: 'high in' warning labels (WL), multiple traffic light labelling (TLL), health star ratings (HSR) (all displayed per serving) or control with no interpretive FOP labelling. Participants completed a brief educational session via a smartphone application and two experimental tasks. In Task 1, participants viewed healthy or unhealthy versions of four products and rated healthiness and purchasing intention on a seven-point Likert-type scale. In Task 2, participants ranked three sets of five products from healthiest to least healthy. SETTING Online commercial panel. PARTICIPANTS Canadian residents ≥ 18 years who were involved in household grocery shopping, owned a smartphone and met minimum screen requirements. RESULTS Data from 1997 participants (n 500/condition) were analysed. Task 1: across most product categories, the TLL and HSR increased perceived healthiness of healthier products. All FOP systems decreased perceived healthiness of less healthy products. Similar, albeit dampened, effects were seen regarding purchasing intentions. Task 2: participants performed best in the HSR, followed by the TLL, WL and control conditions. Lower health literacy was associated with higher perceived healthiness and purchasing intentions and poorer ranking task performance across all conditions. CONCLUSIONS All FOP labelling systems, after a brief educational session, improved task performance across a wide spectrum of foods. This effect differed depending on the nutritional quality of the products and the information communicated on labels.Trial Registration: NCT03290118.
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16
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Cranney L, Drayton B, Thomas M, Tang B, O'Connell T, Crino M, Cobcroft M, Chau J, Bauman A, Phongsavan P. Impact and acceptance of a state-wide policy to remove sugar-sweetened beverages in hospitals in New South Wales, Australia. Health Promot J Austr 2020; 32:444-450. [PMID: 32713051 DOI: 10.1002/hpja.390] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 07/15/2020] [Indexed: 01/17/2023] Open
Abstract
ISSUE ADDRESSED Policy and environmental approaches can reduce the accessibility and purchasing of sugar-sweetened beverages (SSBs), potentially reducing overweight and obesity. This study examined the impact of a state-wide policy on removal of SSBs from sale in NSW public hospitals (launched July 2017), and explored consumer awareness and support. METHODS A convenience sample of 81 food outlets in 26 hospitals were audited for SSB availability before and after the target date for SSB removal (31 December 2017). An interviewer-administered intercept survey in 10 randomly selected hospitals (March-May 2018), assessed staff and visitors' awareness of and support for SSB removal. Descriptive and χ2 analyses assessed differences in: SSB availability; staff and visitor awareness and support. Open-ended survey responses were thematically analysed. RESULTS The proportion of outlets that removed SSBs increased from 58.0% to 96.3% (P < .001). The majority (79.5%) of the 2394 surveyed supported SSB removal, with nearly half (48.4%) reporting it would improve people's health. A minority (13.4%) did not support SSB removal, more than half (61.4%) of those said individuals should have free choice. More staff than visitors were aware of the change (61.9% vs 31.2%; P < .0001). CONCLUSIONS Availability of SSBs in NSW hospitals was significantly reduced after implementation of a policy to remove them from sale. There was strong staff and visitor support for the initiative. SO WHAT?: This study provides clear evidence that a policy designed to provide a healthy hospital retail drink environment can be successfully implemented at scale with high levels of support from staff and visitors. SUMMARY A state-wide policy initiative to remove SSBs from sale in NSW hospital food outlets in 2017 was successfully implemented, with a sample of outlets having nearly 100% compliance. The majority of staff and visitors (80%) supported the removal of SSBs, mostly because they believed it would improve individual and population health.
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Affiliation(s)
- Leonie Cranney
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Bradley Drayton
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Margaret Thomas
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Beatrice Tang
- Centre for Population Health, NSW Ministry of Health, North Sydney, Australia
| | - Tarli O'Connell
- Centre for Population Health, NSW Ministry of Health, North Sydney, Australia
| | - Michelle Crino
- Centre for Population Health, NSW Ministry of Health, North Sydney, Australia
| | - Megan Cobcroft
- Centre for Population Health, NSW Ministry of Health, North Sydney, Australia
| | - Josephine Chau
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Department of Health Systems and Populations, Macquarie University, Sydney, Australia
| | - Adrian Bauman
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Philayrath Phongsavan
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
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17
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Fialon M, Egnell M, Talati Z, Galan P, Dréano-Trécant L, Touvier M, Pettigrew S, Hercberg S, Julia C. Effectiveness of Different Front-of-Pack Nutrition Labels among Italian Consumers: Results from an Online Randomized Controlled Trial. Nutrients 2020; 12:nu12082307. [PMID: 32752021 PMCID: PMC7468990 DOI: 10.3390/nu12082307] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/21/2020] [Accepted: 07/29/2020] [Indexed: 11/16/2022] Open
Abstract
In Italy, discussions are currently ongoing to implement a front-of-pack nutrition label (FoPL) while a growing number of European countries are adopting the Nutri-Score. The effectiveness of the Nutri-Score among Italian consumers requires further investigation. This study compared five FoPLs among Italian participants (Health Star Rating system, multiple traffic lights, Nutri-Score, reference intakes, warning symbol) in terms of food choices and understanding of the labels by consumers. In 2019, 1032 Italian consumers completed an online survey in which they were asked to select one product they would likely purchase from a set of three foods with different nutrient profiles and then classify the products within the set according to their nutritional quality, first with no label and then with one of the five FoPLs on the pack. While no significant difference across labels was observed for food choices, the Nutri-Score demonstrated the highest overall performance in helping consumers to correctly rank the products according to their nutritional quality compared to the reference intakes (OR = 2.18 (1.50–3.17), p-value < 0.0001). Our results provide new insights on the effectiveness of the Nutri-Score, which would be a relevant tool to inform Italian consumers on the nutritional quality of food products.
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Affiliation(s)
- Morgane Fialon
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), 93000 Bobigny, France; (M.E.); (P.G.); (L.D.-T.); (M.T.); (S.H.); (C.J.)
- Correspondence: ; Tel.: +33-1483-876-38
| | - Manon Egnell
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), 93000 Bobigny, France; (M.E.); (P.G.); (L.D.-T.); (M.T.); (S.H.); (C.J.)
| | - Zenobia Talati
- School of Psychology, Curtin University, Kent St, Bentley, WA 6102, Australia;
| | - Pilar Galan
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), 93000 Bobigny, France; (M.E.); (P.G.); (L.D.-T.); (M.T.); (S.H.); (C.J.)
| | - Louise Dréano-Trécant
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), 93000 Bobigny, France; (M.E.); (P.G.); (L.D.-T.); (M.T.); (S.H.); (C.J.)
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), 93000 Bobigny, France; (M.E.); (P.G.); (L.D.-T.); (M.T.); (S.H.); (C.J.)
| | - Simone Pettigrew
- The George Institute for Global Health, Newtown, Sydney 2042, Australia;
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), 93000 Bobigny, France; (M.E.); (P.G.); (L.D.-T.); (M.T.); (S.H.); (C.J.)
- Public Health department, Avicenne Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), 93000 Bobigny, France
| | - Chantal Julia
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), 93000 Bobigny, France; (M.E.); (P.G.); (L.D.-T.); (M.T.); (S.H.); (C.J.)
- Public Health department, Avicenne Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), 93000 Bobigny, France
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18
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Egnell M, Galan P, Farpour-Lambert NJ, Talati Z, Pettigrew S, Hercberg S, Julia C. Compared to other front-of-pack nutrition labels, the Nutri-Score emerged as the most efficient to inform Swiss consumers on the nutritional quality of food products. PLoS One 2020; 15:e0228179. [PMID: 32107489 PMCID: PMC7046267 DOI: 10.1371/journal.pone.0228179] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 01/08/2020] [Indexed: 12/12/2022] Open
Abstract
Background Switzerland, like other high-income countries, is facing a major public health challenge with the increasing burden of non-communicable diseases. Discussions are currently on-going in Switzerland regarding the implementation of a Front-of-Pack nutrition label (FoPL) as a public health measure to guide consumers towards healthier food choices, and the Nutri-Score represents an alternative supported by multiple actors. To date, no studies have investigated the performance of the Nutri-Score among Swiss consumers. This study aimed to compare the response of Swiss consumers to five FoPLs (Health Star Rating system, Multiple Traffic Lights, Nutri-Score, Reference Intakes and Warning symbol) in terms of perception and understanding of these labels and effects on food choices. Methods In 2019, 1,088 Swiss consumers were recruited and asked to select one product from among a set of three foods with different nutritional profiles and then classify the products within the sets according to their nutritional quality. Tasks were performed in situations without a label and then with one of the five FoPLs–depending on the group in which they were randomized–on the pack. Finally, participants were questioned on their perceptions regarding the label to which they were exposed. Results All FoPLs were favorably perceived, with marginal differences between FoPLs. The Nutri-Score demonstrated the highest percentage of improvement in food choices and the highest overall performance in helping consumers rank the products according to their nutritional quality. Conclusion Overall, the Nutri-Score was the most efficient FoPL in informing Swiss consumers of the nutritional quality of food products, and as such could be a useful tool to improve food choices and reduce the burden of chronic diseases in Switzerland.
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Affiliation(s)
- Manon Egnell
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125, Inra, Cnam, Paris 13 University, Bobigny, France
- * E-mail:
| | - Pilar Galan
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125, Inra, Cnam, Paris 13 University, Bobigny, France
| | | | - Zenobia Talati
- School of Psychology, Curtin University, Bentley, WA, Australia
| | | | - Serge Hercberg
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125, Inra, Cnam, Paris 13 University, Bobigny, France
- Public health department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Chantal Julia
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125, Inra, Cnam, Paris 13 University, Bobigny, France
- Public health department, Avicenne Hospital, AP-HP, Bobigny, France
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19
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Carrillo-Álvarez E, Caro-García E, Cayssials V, Jakszyn P. Application of nutrient profile models to compare products offered in 'healthy' vs 'conventional' vending machines in a Spanish hospital environment. Public Health 2019; 179:135-146. [PMID: 31812091 DOI: 10.1016/j.puhe.2019.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 10/02/2019] [Accepted: 10/10/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Vending machines promote easy access to food with low nutritional value. 'Healthy' vending machines (HVM) have been introduced as a means to improve the availability and accessibility of healthy food options, and the healthiness of the foods, however, has not been evaluated. OBJECTIVE Our aim was to assess the healthiness of the products offered in HVM and 'conventional' vending machines (CVM), located in the Catalan Institute of Oncology. STUDY DESIGN AND METHODS All products available in vending machines (HVM (n = 33) and CVM (n = 62) were evaluate during three nutrient profile models (NPMs): the World Health Organization's European Regional Office model (WHO), Nutrient Profile Model UK (NPM-UK), and Australian Health Star Rating system (HSR). RESULTS Regardless of the NPM used, significant differences found in the proportion of healthy products among HVM and CVM (WHO: P-value = 0.005, NPM-UK: P value < 0.001, HSR: P-value < 0.001). The healthy products offered in HVM accounted for 30%, 73%, and 52% of the total content, while CVM offered 6%, 32%, and 15% of the content, as assessed by WHO, NPM-UK, and HSR, respectively. The WHO model was the most restrictive model, and the NPM-UK was the most permissible one. CONCLUSIONS Although not all products in HVM are rated as healthy by the different NPMs, the percentage of healthy products was significantly higher than those in CVM.
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Affiliation(s)
- E Carrillo-Álvarez
- Blanquerna School of Health Sciences, Ramon Llull University, C. Padilla, 326-332, 08025 Barcelona, Spain; Global Research on Wellbeing (GRoW) Research Group, Blanquerna School of Health Sciences, Ramon Llull University, C. Padilla, 326-332, 08025 Barcelona, Spain.
| | - E Caro-García
- Unit of Nutrition and Cancer, Catalan Institute of Oncology - ICO, Nutrition and Cancer Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona 08908, Spain; Blanquerna School of Health Sciences, Ramon Llull University, C. Padilla, 326-332, 08025 Barcelona, Spain.
| | - V Cayssials
- Unit of Nutrition and Cancer, Catalan Institute of Oncology - ICO, Nutrition and Cancer Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona 08908, Spain.
| | - P Jakszyn
- Unit of Nutrition and Cancer, Catalan Institute of Oncology - ICO, Nutrition and Cancer Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona 08908, Spain; Blanquerna School of Health Sciences, Ramon Llull University, C. Padilla, 326-332, 08025 Barcelona, Spain.
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Calton A, Ma H, Nordlund E, Poutanen K, Sozer N. Instant properties of ingredients used for point of consumption production of high-moisture food structures selectively fortified with protein and dietary fibre. J FOOD ENG 2019. [DOI: 10.1016/j.jfoodeng.2019.06.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Egnell M, Talati Z, Gombaud M, Galan P, Hercberg S, Pettigrew S, Julia C. Consumers' Responses to Front-of-Pack Nutrition Labelling: Results from a Sample from The Netherlands. Nutrients 2019; 11:nu11081817. [PMID: 31390835 PMCID: PMC6723811 DOI: 10.3390/nu11081817] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 07/31/2019] [Accepted: 08/02/2019] [Indexed: 11/17/2022] Open
Abstract
Front-of-pack labels (FoPLs) are efficient tools for helping consumers identify healthier food products. Although discussions on nutritional labelling are currently ongoing in Europe, few studies have compared the effectiveness of FoPLs in European countries, including the Netherlands. This study aimed to compare five FoPLs among Dutch participants (the Health Star Rating (HSR) system, Multiple Traffic Lights (MTL), Nutri-Score, Reference Intakes (RIs), and Warning symbols) in terms of perception and understanding of the labels and food choices. In 2019, 1032 Dutch consumers were recruited and asked to select one product from among a set of three foods with different nutritional profiles, and then rank the products within the sets according to their nutritional quality. These tasks were performed with no label and then with one of the five FoPLs on the package, depending on the randomization arm. Finally, participants were questioned on their perceptions regarding the label to which they were exposed. Regarding perceptions, all FoPLs were favorably perceived but with only marginal differences between FoPLs. While no significant difference across labels was observed for food choices, the Nutri-Score demonstrated the highest overall performance in helping consumers rank the products according to their nutritional quality.
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Affiliation(s)
- Manon Egnell
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125 Inra, Cnam, Paris 13 University, 93000 Bobigny, France.
| | - Zenobia Talati
- School of Psychology, Curtin University, Kent St, Bentley, WA 6102, Australia
| | - Marion Gombaud
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125 Inra, Cnam, Paris 13 University, 93000 Bobigny, France
| | - Pilar Galan
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125 Inra, Cnam, Paris 13 University, 93000 Bobigny, France
| | - Serge Hercberg
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125 Inra, Cnam, Paris 13 University, 93000 Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, 93000 Bobigny, France
| | - Simone Pettigrew
- The George Institute for Global Health, Sydney, NSW 2042, Australia
| | - Chantal Julia
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125 Inra, Cnam, Paris 13 University, 93000 Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, 93000 Bobigny, France
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22
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Egnell M, Boutron I, Péneau S, Ducrot P, Touvier M, Galan P, Buscail C, Porcher R, Ravaud P, Hercberg S, Kesse-Guyot E, Julia C. Front-of-Pack Labeling and the Nutritional Quality of Students' Food Purchases: A 3-Arm Randomized Controlled Trial. Am J Public Health 2019; 109:1122-1129. [PMID: 31219721 DOI: 10.2105/ajph.2019.305115] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To assess the effects of the Nutri-Score label (relative to the Reference Intakes label or no label) on the nutritional quality of students' food purchases. Methods. A 3-arm randomized controlled trial was conducted in France in 2017; 2907 participants were randomized into 1 of the 3 study arms (Nutri-Score, Reference Intakes, no label) and invited to purchase groceries from an experimental Web-based supermarket. The main outcome was the overall nutritional quality of purchases, measured according to a modified version of the Food Standards Agency Nutrient Profiling System (FSAm-NPS/HCSP) score. Results. The mean (±SD) FSAm-NPS/HCSP score was lower in the Nutri-Score group (2.02 ±3.56) than in the Reference Intakes group (2.69 ±3.44), reflecting higher nutritional quality; however, there was no significant difference between the Nutri-Score and no-label (2.45 ±3.28) groups or between the Reference Intakes and no-label groups. Shopping cart content was lower in calories and saturated fatty acids and higher in fruits and vegetables in the Nutri-Score arm than in the other arms. Conclusions. The Nutri-Score label appeared to improve the nutritional composition of students' food purchases relative to the Reference Intakes label or no label.
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Affiliation(s)
- Manon Egnell
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Isabelle Boutron
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Sandrine Péneau
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Pauline Ducrot
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Mathilde Touvier
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Pilar Galan
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Camille Buscail
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Raphaël Porcher
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Philippe Ravaud
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Serge Hercberg
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Emmanuelle Kesse-Guyot
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Chantal Julia
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
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Prowse RJL, Tomlin DL, Naylor PJ, Raine KD. Exploring Nutrition Labelling of Food and Beverages in Vending Machines in Canadian Recreational Sport Settings. CAN J DIET PRACT RES 2019; 80:55-62. [PMID: 30430860 DOI: 10.3148/cjdpr-2018-039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: To evaluate whether interpretive "health" labels placed in vending machines in recreation centres represented products' nutrient content when compared with provincial nutrition guidelines. Methods: A cross-sectional audit (November 2015 - April 2016) of 139 vending machines in recreation facilities found 525 foods and beverages in 17 machines labelled by vendors according to healthfulness. Product nutrient content was compared with provincial nutrition guideline criteria. Cross-tabulation and weighted Cohen's kappa evaluated agreement between vendor interpretive labels and guideline ranks. Descriptive statistics evaluated how mislabelled products deviated from recommended nutrient content. Mann-Whitney tests compared nutrient content of "healthy" and "unhealthy" labelled products. Results: Almost one-third of all products were mislabelled by vendors with 72% of those labelled healthier than their actual guideline rank. Energy, total fat, sugar, and sodium contents exceeded recommended levels in one-third to one-half of mislabelled products. Overall, products labelled healthy by vendors were significantly lower in energy, sodium, and fat compared with those labelled unhealthy; however, not for all food types (e.g., bars, fruit snacks, nuts). Conclusions: For certain product categories, vendor interpretive nutrition labels poorly represented products' nutrient content according to provincial nutrition guidelines. Dietitians may be a valuable resource to help implement nutrition guidelines to create credible interpretive product labelling systems.
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Affiliation(s)
| | - Dona L Tomlin
- b School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC
| | - Patti-Jean Naylor
- b School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC
| | - Kim D Raine
- a School of Public Health, University of Alberta, Edmonton, AB
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Sowers MF, Colby S, Kavanagh K, Zhou W. Testing product, pricing, and promotional strategies for vending machine interventions with a college population. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/15378020.2019.1592653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Morgan F. Sowers
- Department of Nutrition, University of Tennessee, Knoxville, TN, USA
| | - Sarah Colby
- Department of Nutrition, University of Tennessee, Knoxville, TN, USA
| | - Katie Kavanagh
- Department of Nutrition, University of Tennessee, Knoxville, TN, USA
| | - Wenjun Zhou
- Department of Business Analytics and Statistics, University of Tennessee, Knoxville, TN, USA
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Shi Y, Grech AL, Allman-Farinelli M. Changes in the nutritional quality of products sold in university vending machines since implementation of the health star rating in 2014; an environmental audit. BMC Public Health 2018; 18:1255. [PMID: 30428873 PMCID: PMC6234540 DOI: 10.1186/s12889-018-6177-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 11/01/2018] [Indexed: 01/01/2023] Open
Abstract
Background Snacking is a prevalent dietary behaviour among young adults, which could independently contribute to weight gain. Vending machines provide easy access to unhealthy snacks and beverages for young adults in universities. A voluntary front-of-pack labelling, named the Health Star Rating (HSR) system, has been implemented nationally by the Australian government as one strategy to address obesity since 2014. The primary aim of this study was to detect changes in the availability, pricing and advertising of healthy and unhealthy snacks and beverages in university vending machines after introduction of the HSR. Methods The study design was two cross-sectional audits of university vending machines one before (in 2014) and another after (in 2017) the implementation of the HSR. Data collections were conducted in a large urban university (> 60,000 students). Every machine was assessed; the product’s name, price, portion sizes and advertisements were recorded. Products were assigned an HSR to classify as healthy (≥3.5 stars) or unhealthy (< 3.5 stars). To compare the differences of product availability between 2014 and 2017, the Chi-square test was used. Results A total of 1836 and 2458 slots were audited in 2014 and 2017, respectively. The proportion of healthy snacks and beverages increased from 7 to 14% (p < 0.001) and 38 to 44% (p < 0.05) since 2014, respectively. The mean costs of unhealthy snacks and healthy beverages increased after three years. Healthy food and drink options were more expensive than unhealthy choices in 2017. Advertisements on vending machines for unhealthy foods and drinks remained prevalent. Conclusion Only small changes have been observed in the availability of healthy snacks and beverages in vending machines since implementation of the HSR system. Policy directives are indicated to encourage further improvements.
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Affiliation(s)
- Yumeng Shi
- Nutrition and Dietetics Group, School of Life and Environmental Sciences, the Charles Perkins Centre, The University of Sydney, Level 4 East, Building D17, John Hopkins Drive, Camperdown, NSW, 2006, Australia.
| | - Amanda Lee Grech
- Nutrition and Dietetics Group, School of Life and Environmental Sciences, the Charles Perkins Centre, The University of Sydney, Level 4 East, Building D17, John Hopkins Drive, Camperdown, NSW, 2006, Australia
| | - Margaret Allman-Farinelli
- Nutrition and Dietetics Group, School of Life and Environmental Sciences, the Charles Perkins Centre, The University of Sydney, Level 4 East, Building D17, John Hopkins Drive, Camperdown, NSW, 2006, Australia
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Ng KW, Sangster J, Priestly J. Assessing the availability, price, nutritional value and consumer views about foods and beverages from vending machines across university campuses in regional New South Wales, Australia. Health Promot J Austr 2018; 30:76-82. [PMID: 30648333 DOI: 10.1002/hpja.34] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 12/13/2017] [Indexed: 01/01/2023] Open
Abstract
ISSUE ADDRESSED Vending machines are ubiquitous. However, there is limited evidence on the nutritional value of food and beverages vended on university campuses and on the views of potential users. This study identified the availability, price and nutritional value of food and beverages vended on regional university campuses and investigated the views of university staff and students. METHODS The availability and price of food and beverages vended on five regional university campuses were assessed by direct observation. Volunteers (n = 222) completed an anonymous, online or paper survey to assess their perspectives on products available in campus vending machines. RESULTS Sixty per cent of 1259 slots identified in 49 vending machines were for foods and 40% were for beverages. Almost all foods (93%) and the majority of beverages (53%) vended were categorised as "less healthy." The mean difference between the prices of healthier and less healthy foods and beverages was $0.72 and $0.16, respectively, but these differences were not statistically significant. Nearly 40% of participants were unsatisfied with the products available. CONCLUSION Vending machines on regional university campuses contained a high proportion of energy-dense nutrient-poor foods which contribute to an obesogenic environment. Regional university staff and students desire healthier vending options. SO WHAT?: Findings can be used to inform stakeholders of the need to improve the nutritional quality of food and beverages vended on regional university campuses. Development of food policy for university settings and adoption of strategies to improve the availability and price of healthy foods would promote healthier food choices.
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Affiliation(s)
- Ker Wei Ng
- Charles Sturt University, Wagga Wagga, NSW, Australia
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27
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Tsai C, Svensen E, Flood VM, Probst Y, Reilly K, Corbett S, Wu JHY. Healthiness of Food and Beverages for Sale at Two Public Hospitals in New South Wales, Australia. Nutrients 2018; 10:nu10020216. [PMID: 29462881 PMCID: PMC5852792 DOI: 10.3390/nu10020216] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 02/12/2018] [Accepted: 02/13/2018] [Indexed: 01/23/2023] Open
Abstract
(1) Background: Our aim was to conduct objective, baseline food environment audits of two major western Sydney public hospitals and compare them to recently revised state nutritional guidelines. (2) Methods: A cross-sectional assessment was conducted (June-July2017) across 14 fixed food outlets and 70 vending machines in two hospitals using an audit tool designed to assess the guideline's key food environment parameters of availability, placement, and promotion of 'Everyday' (healthy) and 'Occasional' (less healthy) products. (3) Results: Availability: Overall, Everyday products made up 51% and 44% of all products available at the two hospitals. Only 1/14(7%) fixed outlets and 16/70(23%) vending machines met the guideline's availability benchmarks of ≥75% Everyday food and beverages. Proportion of Everyday products differed among different types of food outlets (café, cafeteria, convenience stores). Placement: On average, food outlets did not meet recommendations of limiting Occasional products in prominent positions, with checkout areas and countertops displaying over 60% Occasional items. Promotion: Over two-thirds of meal deals at both hospitals included Occasional products. (4) Conclusion: Baseline audit results show that substantial improvements in availability, placement, and promotion can be made at these public hospitals to meet the nutrition guidelines. Audits of other NSW hospitals using the developed tool are needed to investigate similarities and differences in food environment between sites. These findings highlight the need for ongoing tracking to inform whether the revised guidelines are leading to improved food environments in health facilities.
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Affiliation(s)
- Carrie Tsai
- Faculty of Dentistry, University of Sydney, Westmead, NSW 2145, Australia.
| | - Erika Svensen
- Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW 2522, Australia.
| | - Victoria M Flood
- Western Sydney Local Health District, Westmead, NSW 2145, Australia.
- Faculty of Health Sciences, University of Sydney, Lidcombe, NSW 2141, Australia.
| | - Yasmine Probst
- Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW 2522, Australia.
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia.
| | - Kathryn Reilly
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia.
- Hunter New England Population Health, Wallsend, NSW 2287, Australia.
| | - Stephen Corbett
- Western Sydney Local Health District, Westmead, NSW 2145, Australia.
| | - Jason H Y Wu
- The George Institute for Global Health, University of New South Wales, Newtown, NSW 2042, Australia.
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Grivois-Shah R, Gonzalez JR, Khandekar SP, Howerter AL, O'Connor PA, Edwards BA. Impact of Healthy Vending Machine Options in a Large Community Health Organization. Am J Health Promot 2017; 32:1425-1430. [PMID: 29129109 DOI: 10.1177/0890117117734989] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE To determine whether increasing the proportion of healthier options in vending machines decreases the amount of calories, fat, sugar, and sodium vended, while maintaining total sales revenue. DESIGN This study evaluated the impact of altering nutritious options to vending machines throughout the Banner Health organization by comparing vended items' sales and nutrition information over 6 months compared to the same 6 months of the previous year. SETTING Twenty-three locations including corporate and patient-care centers. INTERVENTION Changing vending machine composition toward more nutritious options. MEASURES Comparisons of monthly aggregates of sales, units vended, calories, fat, sodium, and sugar vended by site. ANALYSIS A pre-post analysis using paired t tests comparing 6 months before implementation to the equivalent 6 months postimplementation. RESULTS Significant average monthly decreases were seen for calories (16.7%, P = .002), fat (27.4%, P ≤ .0001), sodium (25.9%, P ≤ .0001), and sugar (11.8%, P = .045) vended from 2014 to 2015. Changes in revenue and units vended did not change from 2014 to 2015 ( P = .58 and P = .45, respectively). CONCLUSION Increasing the proportion of healthier options in vending machines from 20% to 80% significantly lowered the amount of calories, sodium, fat, and sugar vended, while not reducing units vended or having a negative financial impact.
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Affiliation(s)
- Ravi Grivois-Shah
- 1 Family and Community Medicine, Banner University Medical Group, University of Arizona College of Medicine, Tucson, AZ, USA
| | | | | | | | - Patrick A O'Connor
- 4 University of Arizona College of Public Health, Family and Community Medicine, Tucson, AZ, USA
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Boelsen-Robinson T, Backholer K, Corben K, Blake MR, Palermo C, Peeters A. The effect of a change to healthy vending in a major Australian health service on sales of healthy and unhealthy food and beverages. Appetite 2017; 114:73-81. [PMID: 28336468 DOI: 10.1016/j.appet.2017.03.026] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 03/01/2017] [Accepted: 03/13/2017] [Indexed: 01/09/2023]
Affiliation(s)
- Tara Boelsen-Robinson
- School of Public Health and Preventive Medicine, Monash University, Australia; School of Health and Social Development, Deakin University, Geelong, Australia.
| | - Kathryn Backholer
- School of Public Health and Preventive Medicine, Monash University, Australia; School of Health and Social Development, Deakin University, Geelong, Australia
| | - Kirstan Corben
- Population Health and Health Promotion, The Alfred, Australia
| | - Miranda R Blake
- School of Public Health and Preventive Medicine, Monash University, Australia; School of Health and Social Development, Deakin University, Geelong, Australia
| | - Claire Palermo
- Department of Nutrition and Dietetics, School of Clinical Science, Monash University, Australia
| | - Anna Peeters
- School of Public Health and Preventive Medicine, Monash University, Australia; School of Health and Social Development, Deakin University, Geelong, Australia
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Talati Z, Pettigrew S, Dixon H, Neal B, Ball K, Hughes C. Do Health Claims and Front-of-Pack Labels Lead to a Positivity Bias in Unhealthy Foods? Nutrients 2016; 8:nu8120787. [PMID: 27918426 PMCID: PMC5188442 DOI: 10.3390/nu8120787] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 11/15/2016] [Accepted: 11/28/2016] [Indexed: 12/04/2022] Open
Abstract
Health claims and front-of-pack labels (FoPLs) may lead consumers to hold more positive attitudes and show a greater willingness to buy food products, regardless of their actual healthiness. A potential negative consequence of this positivity bias is the increased consumption of unhealthy foods. This study investigated whether a positivity bias would occur in unhealthy variations of four products (cookies, corn flakes, pizzas and yoghurts) that featured different health claim conditions (no claim, nutrient claim, general level health claim, and higher level health claim) and FoPL conditions (no FoPL, the Daily Intake Guide (DIG), Multiple Traffic Lights (MTL), and the Health Star Rating (HSR)). Positivity bias was assessed via measures of perceived healthiness, global evaluations (incorporating taste, quality, convenience, etc.) and willingness to buy. On the whole, health claims did not produce a positivity bias, while FoPLs did, with the DIG being the most likely to elicit this bias. The HSR most frequently led to lower ratings of unhealthy foods than the DIG and MTL, suggesting that this FoPL has the lowest risk of creating an inaccurate positivity bias in unhealthy foods.
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Affiliation(s)
- Zenobia Talati
- School of Psychology and Speech Pathology, Curtin University, Kent St, Bentley, WA 6102, Australia.
| | - Simone Pettigrew
- School of Psychology and Speech Pathology, Curtin University, Kent St, Bentley, WA 6102, Australia.
| | - Helen Dixon
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, VIC 3004, Australia.
| | - Bruce Neal
- The George Institute for Global Health, University of Sydney, Sydney, NSW 2000, Australia.
| | - Kylie Ball
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia.
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Grech A, Hebden L, Roy R, Allman-Farinelli M. Are products sold in university vending machines nutritionally poor? A food environment audit. Nutr Diet 2016; 74:185-190. [PMID: 28731640 DOI: 10.1111/1747-0080.12332] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 08/25/2016] [Accepted: 09/19/2016] [Indexed: 11/29/2022]
Abstract
AIM (i) To audit the nutritional composition, promotion and cost of products available from vending machines available to young adults; and (ii) to examine the relationship between product availability and sales. METHODS A cross-sectional analysis of snacks and beverages available and purchased at a large urban university was conducted between March and September 2014. Sales were electronically tracked for nine months. RESULTS A total of 61 vending machines were identified; 95% (n = 864) of the available snacks and 49% of beverages (n = 455) were less-healthy items. The mean (SD) nutrient value of snacks sold was: energy 1173 kJ (437.5), saturated fat 5.36 g (3.6), sodium 251 mg (219), fibre 1.56 g (1.29) and energy density 20.16 kJ/g (2.34) per portion vended. There was a strong correlation between the availability of food and beverages and purchases (R2 = 0.98, P < 0.001). CONCLUSIONS Vending machines market and sell less-healthy food and beverages to university students. Efforts to improve the nutritional quality are indicated and afford an opportunity to improve the diet quality of young adults, a group at risk of obesity.
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Affiliation(s)
- Amanda Grech
- School of Life and Environmental Sciences, The Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Lana Hebden
- School of Life and Environmental Sciences, The Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Rajshri Roy
- School of Life and Environmental Sciences, The Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Margaret Allman-Farinelli
- School of Life and Environmental Sciences, The Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
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Cuschieri S, Mamo J. Getting to grips with the obesity epidemic in Europe. SAGE Open Med 2016; 4:2050312116670406. [PMID: 27708778 PMCID: PMC5034461 DOI: 10.1177/2050312116670406] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 08/22/2016] [Indexed: 11/17/2022] Open
Abstract
Obesity is a global epidemic. It is responsible for increased patient morbidity and mortality. Significant related pathologies including diabetes mellitus compound the overall risks. Obesity is a significant financial burden. This includes direct and indirect medical costs, amounting to millions of euros each year. Multiple European studies have outlined a steady incline in obesity prevalence rates. Tackling obesity is no easy task. Policy makers aiming to reduce obesity rates should adopt an evidence-based approach. This entails adopting both micro- and macro-interventions tweaked to each country’s individual requirements. The ideal way forward would be to tackle obesity from the individual, population-wide and food industry angles. The key towards a successful intervention is for each country to carry out well-planned health examination studies, in an attempt to pin point local risk factors. Having a correct individualized picture, each country can move forward and draw policies and interventional procedures. The aim should be to primarily improve the quality of life. Second, the country’s capital expenditure is also reduced.
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Affiliation(s)
- Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine & Surgery, University of Malta, Msida, Malta
| | - Julian Mamo
- Department of Public Health, Faculty of Medicine & Surgery, University of Malta, Msida, Malta
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