Consumers' decisions to access or avoid added sugars information on the updated Nutrition Facts label

Potential consumer response to the healthy symbol proposed by the U.S. food and Drug Administration

The U.S. Food and Drug Administration (FDA) has proposed updates to the definition of "healthy," including distinctions between types of sugar and fats and limits on added sugar, saturated fat, and sodium. To communicate the updated standards, the FDA is developing a Healthy symbol to display on food packages, which could reduce knowledge gaps by assisting U.S. consumers in meeting recommended nutritional guidelines. This study aimed to explore the potential for the label to increase consumers' ability to correctly identify a food product that met the FDA's criteria for a healthy symbol. To complete the study objective, 1018 adults were recruited to represent the U.S. population regarding gender, age, income, and geographic region, and a randomized group experiment was used to determine the potential communication value of an FDA Healthy symbol. Respondents were randomized to a group shown either a healthy yogurt with the FDA symbol, a healthy yogurt without the symbol, or an unhealthy yogurt. Respondents were then asked whether they considered the yogurt shown to be healthy, a question examining the desired criteria for the Healthy symbol, willingness to accept various costs to implement the symbol, and questions to measure objective dietary knowledge. Adding the symbol to yogurt that already met the healthy criteria only yielded about a 4 percentage point increase in the proportion of respondents identifying it as healthy. However, 53 % of participants still identified a yogurt too high in added sugars as healthy. For the desired label criteria, 64 % of respondents selected limits on added sugars, 57 % selected limits on sodium, and 54 % selected limits on saturated fats, which all align with the proposed updates to the definition of healthy. Over half of the participants supported the implementation of the label, even at a cost of $40 annually, and 86 % supported implementation at no cost.

Nutrition fact label (NFL) use is related to meeting the requirements for vitamins and minerals not listed on NFLs: Data from the Korea National Health and Nutritional Examination Survey VIII (2019-2021) for the prepandemic and pandemic periods

The credibility and wide usability of nutrition fact labels (NFLs) have increased due to the pandemic, which may lead to healthier nutritional choices. This cross-sectional study aimed to evaluate the association between NFL use and meeting the estimated average requirements (EARs) for vitamins and minerals not listed on NFLs during the prepandemic (2019, n = 6606) and pandemic periods (2020 and 2021, n = 12085) using KNHANES data. Household surveys, health behavior interviews, and health checkup examinations were conducted for all participants. Subjects were included in the unAware+noUse, Aware+noUse, and Aware+Use groups according to NFL usage, and nutritional intake was analyzed by the 24-hour recall method. Complex-sample multiple logistic regression analysis was used to determine the odds ratios (ORs) and 95% confidence intervals (CIs) for meeting the EARs according to NFL usage in the crude and adjusted (including metabolic conditions) models. The primary finding was that awareness and NFL use were associated with adequate intake above the EARs for vitamin A, vitamin B2, niacin, folate, Ca, Fe, and P; this association was more evident during the pandemic. After adjusting for covariates, during the pandemic, the ORs of meeting the EARs in the Aware+noUse group and Aware+Use group were 1.25 (CI 1.06-1.47) and 1.36 (CI 1.05-1.75) for vitamin A, 1.26 (CI 1.06-1.50) and 1.54 (CI 1.19-2.00) for vitamin B2, 1.32 (CI 1.13-1.56) and 1.46 (CI 1.15-1.85) for folate, and 1.46 (CI 1.06-2.00) and 1.73 (1.09-2.75) for P, respectively. Additionally, the ORs for niacin (1.21, 1.02-1.43) and Fe (1.29, 1.08-1.54) were significant in the Aware+noUse group, and that for Ca (1.39, 1.08-1.78) was significant in the Aware+Use group (all p <0.05). In conclusion, NFL awareness and use are associated with meeting the EARs for vitamins and minerals not listed on NFLs. For future recurring health crises, effective NFL use is necessary for healthy dietary practices.

Dietary fibre definition revisited - The case of low molecular weight carbohydrates

Low molecular weight (LMW) non-digestible carbohydrates (namely, oligosaccharides and inulin) are accepted as dietary fibre in many countries worldwide. The inclusion of oligosaccharides as dietary fibre was made optional within the Codex Alimentarius definition in 2009, which has caused great controversy. Inulin is accepted as dietary fibre by default, due to being a non-digestible carbohydrate polymer. Oligosaccharides and inulin occur naturally in numerous foods and are frequently incorporated into commonly consumed food products for a variety of purposes, such as to increase dietary fibre content. LMW non-digestible carbohydrates, due to their rapid fermentation in the proximal colon, may cause deleterious effects in individuals with functional bowel disorders (FBDs) and, as such, are excluded on the low FODMAP (fermentable oligosaccharides, disaccharides, and polyols) diet and similar protocols. Their addition to food products as dietary fibre allows the use of associated nutrition/health claims, causing a paradox for those with FBDs, which is further complicated by lack of clarity on food labelling. Therefore, this review aimed to discuss whether the inclusion of LMW non-digestible carbohydrates within the Codex definition of dietary fibre is warranted. This review provides justification for the exclusion of oligosaccharides and inulin from the Codex definition of dietary fibre. LMW non-digestible carbohydrates could, instead, be placed in their own category as prebiotics, recognised for their specific functional properties, or considered food additives, whereby they are not promoted for being beneficial for health. This would preserve the concept of dietary fibre being a universally beneficial dietary component for all individuals.

The Contribution of Nutrients of Concern to the Diets of 18-to-30-Year-Old Australians from Food Prepared Outside Home Differs by Food Outlet Types: The MYMeals Cross-Sectional Study

Young adults are frequent consumers of food prepared outside the home (FOH). In a cross-sectional survey, the MYMeals study, we showed FOH provided one-third of meals and snacks for young Australian adults, yet it contributed higher proportions of energy and nutrients of concern, such as saturated fat and sodium. This study aimed to determine the detailed proportional contribution of nutrients of concern from the nine food outlet types captured in the MYMeals study. Young adults residing in New South Wales (NSW), Australia, (n = 1001) used a validated smartphone app to report all types and amounts of food and beverages consumed for three consecutive days, as well as their preparation location. The proportions of daily energy, macronutrients, sodium, total sugars, and saturated fat were calculated for each of the nine following outlet types: bakeries or patisseries, coffee chains, cold-drink chains, fast-food chains, ice creamery or frozen yoghurt outlets, independent cafes or restaurants, pubs (hotels) and clubs, service stations or convenience stores, and others not fitting the above categories. Of all FOH outlet types, independent cafes or restaurants contributed the most energy (17.5%), sodium (20.0%) and saturated fat (17.8%) to the total diet, followed by fast-food chains (12.0% energy, 15.8% sodium, and 12.0% saturated fat) and other outlets, with smaller proportions. For males, the proportion of energy and nutrients contributed by fast-food outlets was higher than for females (14.8% versus 9.8% energy). Menu labelling at independent cafes and restaurants is recommended, comprising, in addition to the energy labels already in use in fast-food restaurants, the labelling of nutrients of concern. The feasibility of this recommendation warrants further exploration.