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Schruff-Lim EM, Van Loo EJ, van der Lans IA, van Trijp HCM. Impact of food swap recommendations on dietary choices in an online supermarket: A randomized controlled trial. Appetite 2024; 194:107158. [PMID: 38113984 DOI: 10.1016/j.appet.2023.107158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/01/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023]
Abstract
One novel strategy to shift food choices in digital shopping environments is to automatically recommend healthier alternatives when an unhealthy choice is made. However, this raises the question which alternative products to recommend. This study assesses 1) whether healthier food swap recommendations are effective, even though the unhealthy choice was made in the presence of visible FOP nutrition labels, and 2) how the similarity of the alternatives influences the acceptance of food swap recommendations. Based on a pre-test, similarity of the recommendation was operationalized in terms of animal-based versus plant-based options. A randomized controlled trial (healthy food swap recommendation conditions: none, similar animal-based, dissimilar plant-based, or mixed animal- and plant-based) with 428 Dutch participants was conducted in a simulated online supermarket. Additional healthier food swap recommendations improved the nutritional quality of the final basket compared to only providing Nutri-Score nutrition labels (-1.7 mean FSA score, p < .001, medium Cohen's d = -0.48). Compared to the dissimilar condition, acceptance of an alternative was more likely in the mixed (odds-ratio = 2.78, p = .015) and in the similar condition (odds-ratio = 2.24, p = .048), but the nutritional quality of the final basket did not differ between treatment conditions. Individuals in treatment conditions who did not receive any recommendation (i.e. only made healthy choices) had higher Nutri-Score familiarity and general health interest than individuals who received recommendations. This suggests that for individuals with higher knowledge and motivation FOP nutrition labels were sufficient, whereas for individuals with lower knowledge and motivation additional food swap recommendations can improve dietary choices. Food swap recommendations may act as meaningful reminders by disrupting the automatic choice process and triggering individuals to rethink their (unhealthy) choice.
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Affiliation(s)
- Eva-Maria Schruff-Lim
- Marketing and Consumer Behaviour Group, Wageningen University & Research, Hollandseweg 1, 6706, KN, Wageningen, the Netherlands.
| | - Ellen J Van Loo
- Marketing and Consumer Behaviour Group, Wageningen University & Research, Hollandseweg 1, 6706, KN, Wageningen, the Netherlands
| | - Ivo A van der Lans
- Marketing and Consumer Behaviour Group, Wageningen University & Research, Hollandseweg 1, 6706, KN, Wageningen, the Netherlands
| | - Hans C M van Trijp
- Marketing and Consumer Behaviour Group, Wageningen University & Research, Hollandseweg 1, 6706, KN, Wageningen, the Netherlands
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Gao Z, Li Z, Zhuang X, Ma G. Advantages of graphical nutrition facts label: faster attention capture and improved healthiness judgement. Ergonomics 2023; 66:627-643. [PMID: 35894181 DOI: 10.1080/00140139.2022.2107241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
Consumers have to rely on the traditional back-of-package nutrition facts label (NFL) to obtain nutrition information in many countries. However, traditional NFLs have been criticised for their poor visualisation and low efficiency. This study redesigned back-of-package NFLs integrated with bar graphs (black or coloured) to visually indicate nutrient reference values (NRVs). Two eye movement studies were performed to evaluate the ergonomic advantages of the graphical NFLs. Our findings suggested that the newly designed NFLs led to faster and better healthiness evaluation performance. The newly designed graphical labels led to a shorter time to first fixation duration and offered a higher percentage of fixation time in the nutrient reference values region compared with that observed using traditional text labels. Nowadays, many chronic diseases are associated with poor eating habits, therefore, the importance of visualisation design to nudge healthier food choices could be paid more attention to by policymakers and food manufacturers.Practitioner summary: To improve the ergonomic design of traditional nutrition facts panel (NFL), this study assessed a newly designed graphical NFL. The results showed that graphical NFL captured consumers' attention faster and improved their healthiness judgement. Moreover, a brief nutrition education can improve consumers' attention and understanding of nutrition information.
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Affiliation(s)
- Zhibing Gao
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Ziang Li
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Xiangling Zhuang
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Guojie Ma
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, School of Psychology, Shaanxi Normal University, Xi'an, China
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Durán R, Asmitia E, Rivera J, Barquera S, Tolentino-Mayo L. Analysis of stakeholders' responses to the food warning labels regulation in Mexico. Health Res Policy Syst 2022; 20:108. [PMID: 36242086 PMCID: PMC9568963 DOI: 10.1186/s12961-022-00922-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 09/22/2022] [Indexed: 11/23/2022] Open
Abstract
Background In Mexico, the inclusion of a front-of-pack label in the Official Mexican Standard 051 (NOM-051 for its Spanish acronym) has been widely discussed for years by different stakeholder groups. In 2019, the NOM-051 modification project was proposed, which included front-of-pack warning labels. To be modified, it underwent a public consultation period where stakeholders sent their comments to be reviewed and considered. The purpose of this study was to analyse the stakeholders’ perspectives during the public consultation of the NOM-051 modification project. Methods To assess perspectives, the 795 comments available on the National Commission for Regulatory Improvement website were analysed. Identity, expectations and demands were identified from each comment using content analysis in NVivo. In addition, frequencies and percentages were obtained. Results Fifty-six percent of the comments were opposed to the NOM-051 modification project. Industry and business interest nongovernmental organizations were against it; they considered that their revenues and profits would be affected. Public interest nongovernmental organizations, academia and health professionals were in favour, stating that the changes proposed are fundamental to informing consumers and improving food choices, and an essential factor in reducing the prevalence of overweight and obesity. Stakeholders in favour expected that eating habits would improve, and demanded that the front-of-pack warning label suggested in the modification proposal be maintained. Conclusions The comments opposed to the NOM-051 modification project were consistent with the literature, indicating that food industry stakeholders use all possible arguments to interfere in public health policies. The main issues used by the food industry to discredit the NOM-051 modification project coincide with those used in other countries to stop public health policies and with those used by the tobacco industry to avoid market regulations. On the other hand, those in favour looked after the interests of the Mexican population.
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Affiliation(s)
- Regina Durán
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Edalith Asmitia
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Juan Rivera
- Population Health Research Center, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Lizbeth Tolentino-Mayo
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico.
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An R, Shi Y, Shen J, Bullard T, Liu G, Yang Q, Chen N, Cao L. Effect of front-of-package nutrition labeling on food purchases: a systematic review. Public Health 2021; 191:59-67. [PMID: 33517247 DOI: 10.1016/j.puhe.2020.06.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This study systematically reviewed evidence from interventions on the effect of front-of-package (FOP) nutrition labeling on food purchases. STUDY DESIGN The study design used in this study is a systematic review. METHODS Keyword search was performed in PubMed, Web of Science, Scopus, and Cochrane Library. RESULTS Fifteen studies (10 randomized controlled trials, four pre-post studies, and one case-control study) met the eligibility criteria and were included in the review. Five studies were conducted in a controlled setting through the establishment of an online virtual supermarket or physical laboratory food store solely for the intervention. In contrast, the remaining ten studies were conducted in a naturalistic setting where people commonly purchase foods (e.g., supermarket, grocery store, school/hospital cafeteria, or vending machine). FOP labels assessed included traffic lights, health star rating, daily intake guides, health warnings, and high sugar symbol labels. Compared with the control, FOP labels were effective for helping participants make healthier food purchase decisions in five of the 12 studies that assessed traffic lights labels, in one of the two studies that assessed health warning labels, and in one study that assessed high sugar symbol labels. Three assessed health star ratings and one assessed daily intake guide labels, but none revealed an effect on food purchases compared with the control. CONCLUSIONS Findings on the effectiveness of FOP nutrition labels in 'nudging' consumers toward healthier food purchases remain mixed and inconclusive. Future studies should examine other types of FOP labels beside the traffic lights labels and explore the different effects by consumer affordability, population subgroup, and shopping environment.
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Affiliation(s)
- R An
- Brown School, Washington University, St. Louis, MO, 63130, USA
| | - Y Shi
- School of Medicine, University of California, La Jolla, San Diego, CA, 92093, USA
| | - J Shen
- Department of Physical Education, China University of Geosciences (Beijing), Beijing, 100083, China
| | - T Bullard
- Department of Kinesiology and Community Health, University of Illinois, Champaign, IL, 61801, USA
| | - G Liu
- Beijing Normal University, Beijing, 100875, China
| | - Q Yang
- Shanghai University of Science and Technology, Shanghai, 201400, China
| | - N Chen
- Tsinghua University, Beijing, 100084, China
| | - L Cao
- School of Management and Journalism, Shenyang Sport University, Shenyang, Liaoning, 110102, China.
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Finkelstein EA, Doble B, Ang FJL, Wong WHM, van Dam RM. A randomized controlled trial testing the effects of a positive front-of-pack label with or without a physical activity equivalent label on food purchases. Appetite 2020; 158:104997. [PMID: 33065191 DOI: 10.1016/j.appet.2020.104997] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 07/21/2020] [Accepted: 10/09/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Positive front-of-pack (FOP) labels, including Singapore's Healthier Choice Symbol (HCS), target a subset of healthier products whose consumption is to be encouraged. However, this may inadvertently lead to excess caloric intake, which could be addressed by including an additional label identifying calories per serving. We test this hypothesis by adding a Physical Activity Equivalent (PAE) label, an indicator of calorie content, to all products available in an on-line grocery store. METHODS We conducted a randomized controlled trial using a 3 arm within-subject crossover design in adult Singapore residents recruited online. Participants shopped once in each condition in an experimental online grocery store in random order: 1) no FOP label (Control); 2) Select products displaying HCS labels (HCS-only); 3) Condition 2 with additional information displaying PAEs per serving on every product (HCS+PAE). 117 participants were recruited and data from 317 shops were analyzed. We used first-differenced regressions to assess the impact of the conditions on calories per serving (primary) and on other measures of diet quality. RESULTS The HCS-only condition led to a statistically significant five-percentage point increase in the proportion of HCS products purchased (95% CI, 1%: 9%). However, neither the HCS-only (3.45; 95% CI, -12.52: 19.43) nor HCS + PAE (8.14; 95% CI, -5.25: 21.54) condition led to a change in the number of calories per serving purchased or changes in other measures of diet quality. CONCLUSIONS Positive labels, like the HCS, are likely to increase purchases of labelled products. However, these changes may not lead to improvements in diet quality or calorie intake. Combining positive labels with additional PAE information does not appear to address this concern.
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Affiliation(s)
- Eric A Finkelstein
- Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
| | - Brett Doble
- Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Felicia Jia Ler Ang
- Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Wei Han Melvin Wong
- Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Ma G, Zhuang X. Nutrition label processing in the past 10 years: Contributions from eye tracking approach. Appetite 2020; 156:104859. [PMID: 32916209 DOI: 10.1016/j.appet.2020.104859] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 07/24/2020] [Accepted: 09/03/2020] [Indexed: 10/23/2022]
Abstract
Healthy eating plays a critical role in preventing diet-related chronic diseases. To promote healthy eating, nutrition labels have been mandated to certain foods in many countries. To test how different designs of nutrition labels affect consumer behavior, eye tracking technique has been increasingly used to overcome the limitations of subjective report which are susceptible to different biases and a poor indicator of nutrition label use in reality. In this review, we reviewed 45 eye-tracking studies on nutrition label processing. Besides a summary of eye tracking methodology, we found three emerged topics from these studies: attention capture, nutrition label comprehension and food choice. Overall, updated designs of nutrition labels improve attention capture and nutrition label comprehension, but it does not necessarily lead to healthier food choices. The discrepancy between attention capture and food choice also indicate potential limitation in promoting healthy food choice via the indirect attention route (exposure - attention - nutrition label processing - food choice). Instead, actual food choice may be a consequence of a direct heuristic route and modulated by person-, product- and context-related factors. These findings can not only guide future studies, but also have implications on making nutrition label policy and improving human health in eastern developing countries.
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Affiliation(s)
- Guojie Ma
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, School of Psychology, Shaanxi Normal University, Xi'an, China.
| | - Xiangling Zhuang
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, School of Psychology, Shaanxi Normal University, Xi'an, China.
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Nieto C, Tolentino-Mayo L, Monterrubio-Flores E, Medina C, Patiño SRG, Aguirre-Hernández R, Barquera S. Nutrition Label Use Is Related to Chronic Conditions among Mexicans: Data from the Mexican National Health and Nutrition Survey 2016. J Acad Nutr Diet 2019; 120:804-814. [PMID: 31585829 DOI: 10.1016/j.jand.2019.07.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 07/22/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Non-communicable diseases, such as obesity, diabetes, and hypertension, can be prevented and treated through a balanced nutrient-rich diet. Nutrition labels have been recognized as crucial to preventing obesity and non-communicable diseases through a healthier diet. OBJECTIVE Our aim was to examine the association between nutrition label use and chronic conditions (overweight, obesity, previously diagnosed diabetes, and hypertension) among an adult Mexican population. DESIGN This was a cross-sectional study that used data from the Mexican National Health and Nutrition Survey of 2016 (ENSANUT MC 2016). PARTICIPANTS/SETTING The participants were 5,013 adults aged 20 to 70 years old. Older adults (>70 years), illiterate participants, pregnant women, and participants with implausible blood pressure data were excluded from the sample. The survey was conducted from May to August 2016 in the participants' households. MAIN OUTCOME MEASURES We measured chronic conditions (overweight, obesity, previously diagnosed diabetes, and hypertension). STATISTICAL ANALYSES PERFORMED Pearson χ2 test was used to examine the associations among the use of nutrition labels and sociodemographic characteristics and chronic conditions. Multiple logistic regression was used to determine the association between nutrition label use and chronic conditions adjusting for the effect of confounding variables like sex, age, body mass index, education level, marital status, ethnicity, residence area, region, and socioeconomic status. RESULTS From the total sample, 40.9% (95% CI 38.4% to 43.8%) reported using nutrition labeling. Respondents with overweight or obesity were less likely to use nutrition labels (odds ratio 0.74; P<0.05). Participants who self-reported diabetes had significantly lower odds of nutrition label use than participants who did not report to have diabetes (odds ratio 0.66; P<0.05). Participants having 3 chronic conditions had lower odds of nutrition label use (odds ratio 0.34; P<0.01) relative to having zero chronic conditions. CONCLUSIONS This study suggests an association between nutrition label use and chronic conditions (obesity and diabetes). These findings demonstrate that people with obesity, diabetes, and a combination of chronic conditions were less likely to use nutrition labels than people without these conditions.
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Albuquerque TG, Nunes MA, Oliveira MBPP, Costa HS. Compliance of declared vs. analysed values with EU tolerance limits for mandatory nutrients in prepacked foods. Food Chem 2019; 302:125330. [PMID: 31404872 DOI: 10.1016/j.foodchem.2019.125330] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 08/01/2019] [Accepted: 08/04/2019] [Indexed: 11/30/2022]
Abstract
This study assessed compliance between declared and analysed values on prepacked foods, considering the tolerance limits for salt, fat and saturated fatty acids. Foods were distributed by food categories (e.g. snacks, ready-to-eat meals, potato and potato-products, bakery and pastry products) and a total of 209 products were analysed. Only half of the samples with a declared value ≥1.25 g/100 g were within tolerance limits for salt content. The lowest number of samples outside tolerance limits was observed for fat content; for saturated fatty acids, 27% of the samples were outside of tolerance limits. Only amongst "cereal products" were 100% of products compliant for fat and salt declarations. It is of utmost importance that manufacturers update continuously values declared for prepacked foods, because this information is crucial for consumers and food policy-makers as well as being a legal requirement.
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Affiliation(s)
- Tânia Gonçalves Albuquerque
- Department of Food and Nutrition, National Institute of Health Dr. Ricardo Jorge, I.P., Lisbon, Portugal; REQUIMTE/LAQV, Dept. of Chemical Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - M Antónia Nunes
- REQUIMTE/LAQV, Dept. of Chemical Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - M Beatriz P P Oliveira
- REQUIMTE/LAQV, Dept. of Chemical Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Helena S Costa
- Department of Food and Nutrition, National Institute of Health Dr. Ricardo Jorge, I.P., Lisbon, Portugal; REQUIMTE/LAQV, Dept. of Chemical Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.
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Rimpeekool W, Kirk M, Yiengprugsawan V, Banwell C, Seubsman SA, Sleigh A. Nutrition label experience and consumption of transitional foods among a nationwide cohort of 42,750 Thai adults. Br Food J 2017; 119:425-439. [PMID: 28539674 PMCID: PMC5439508 DOI: 10.1108/bfj-07-2016-0327] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE The purpose of this paper is to assess the usefulness of nutrition labels in Thailand during nutrition transition from traditional to modern diets that increase salt, sugar, and calorie intake and to note socio-demographic interactions and associations with consumption of transitional processed foods. DESIGN/METHODOLOGY/APPROACH The authors studied 42,750 distance learning Open University adults aged 23-96 years in 2013 residing nationwide and participating in an ongoing community-based prospective cohort study. The authors used multivariable logistic regression to relate nutrition label experiences ("read", "good understand", "frequent use"), socio-demographic factors, and consumption of four transitional foods. These foods included "unhealthy" instant foods, carbonated soft drinks, and sweet drinks, or "healthy" milk. FINDINGS Overall, two-thirds reported good understanding and frequent use of nutrition labels. Unhealthy transition-indicator processed foods were frequently consumed: instant foods (7 per cent), (carbonated) soft drinks (15 per cent), and sweet drinks (41 per cent). Frequent users of nutrition labels (e.g. females, older persons, professionals) were less likely to consume unhealthy indicator foods. Those with the most positive overall nutrition label experience ("read" + "good understanding" + "frequent use") had the best indicator food profiles: instant foods (odds ratio (OR) 0.63; 95%CI, 0.56-0.70); soft drinks (OR 0.56; 95%CI, 0.52-0.61); sweet drinks (OR 0.79; 95%CI, 0.74-0.85); milk (OR 1.87; 95%CI, 1.74-2.00). ORIGINALITY/VALUE Knowledge protected - those with most nutrition label experience were least likely to consume unhealthy foods. Results support government regulated nutrition labels, expanding to include sweet drinks. The study is remarkable for its large size and nationwide footprint. Study subjects were educated, represent Thais of the future, and show high awareness of transition-indicator foods.
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Affiliation(s)
- Wimalin Rimpeekool
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Martyn Kirk
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Vasoontara Yiengprugsawan
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia
| | - Cathy Banwell
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Sam-Ang Seubsman
- School of Human Ecology, Sukhothai Thammathirat Open University, Nonthaburi, Thailand
| | - Adrian Sleigh
- Research School of Population Health, Australian National University, Canberra, Australia
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Talati Z, Pettigrew S, Kelly B, Ball K, Dixon H, Shilton T. Consumers' responses to front-of-pack labels that vary by interpretive content. Appetite 2016; 101:205-13. [PMID: 26970293 DOI: 10.1016/j.appet.2016.03.009] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 03/04/2016] [Accepted: 03/04/2016] [Indexed: 10/22/2022]
Abstract
Previous research has shown that front-of-pack labels (FoPLs) can assist people to make healthier food choices if they are easy to understand and people are motivated to use them. There is some evidence that FoPLs providing an assessment of a food's health value (evaluative FoPLs) are easier to use than those providing only numerical information on nutrients (reductive FoPLs). Recently, a new evaluative FoPL (the Health Star Rating (HSR)) has been introduced to Australia and New Zealand. The HSR features a summary indicator, differentiating it from many other FoPLs being used around the world. The aim of this study was to understand how consumers of all ages use and make sense of reductive FoPLs and evaluative FoPLs including evaluative FoPLs with and without summary indicators. Ten focus groups were conducted in Perth, Western Australia with adults (n = 50) and children aged 10-17 years (n = 35) to explore reactions to one reductive FoPL (the Daily Intake Guide), an existing evaluative FoPL (multiple traffic lights), and a new evaluative FoPL (the HSR). Participants preferred the evaluative FoPLs over the reductive FoPL, with the strongest preference being for the FoPL with the summary indicator (HSR). Discussions revealed the cognitive strategies used when interpreting each FoPL (e.g., using cut offs, heuristics, and the process of elimination), which differed according to FoPL format. Most participants reported being motivated to use the evaluative FoPLs (particularly the HSR) to make choices about foods consumed as part of regular daily meals, but not for discretionary foods consumed as snacks or deserts. The findings provide further evidence of the potential utility of evaluative FoPLs in supporting healthy food choices and can assist policy makers in selecting between alternative FoPL formats.
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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.
| | - Bridget Kelly
- School of Health and Society, University of Wollongong, New South Wales, Australia.
| | - Kylie Ball
- Deakin University Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Victoria, Australia.
| | | | - Trevor Shilton
- National Heart Foundation, Western Australia, Australia.
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12
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Ng SW, Bricker G, Li KP, Yoon EF, Kang J, Westrich B. Estimating added sugars in US consumer packaged goods: An application to beverages in 2007-08. J Food Compost Anal 2015; 43:7-17. [PMID: 26273127 PMCID: PMC4528366 DOI: 10.1016/j.jfca.2015.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This study developed a method to estimate added sugar content in consumer packaged goods (CPG) that can keep pace with the dynamic food system. A team including registered dietitians, a food scientist and programmers developed a batch-mode ingredient matching and linear programming (LP) approach to estimate the amount of each ingredient needed in a given product to produce a nutrient profile similar to that reported on its nutrition facts label (NFL). Added sugar content was estimated for 7021 products available in 2007-08 that contain sugar from ten beverage categories. Of these, flavored waters had the lowest added sugar amounts (4.3g/100g), while sweetened dairy and dairy alternative beverages had the smallest percentage of added sugars (65.6% of Total Sugars; 33.8% of Calories). Estimation validity was determined by comparing LP estimated values to NFL values, as well as in a small validation study. LP estimates appeared reasonable compared to NFL values for calories, carbohydrates and total sugars, and performed well in the validation test; however, further work is needed to obtain more definitive conclusions on the accuracy of added sugar estimates in CPGs. As nutrition labeling regulations evolve, this approach can be adapted to test for potential product-specific, category-level, and population-level implications.
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Affiliation(s)
- Shu Wen Ng
- University of North Carolina at Chapel Hill CB #8120, Chapel Hill, NC
27599
| | - Gregory Bricker
- University of North Carolina at Chapel Hill CB #8120, Chapel Hill, NC
27599
| | - Kuo-ping Li
- University of North Carolina at Chapel Hill CB #8120, Chapel Hill, NC
27599
| | - Emily Ford Yoon
- University of North Carolina at Chapel Hill CB #8120, Chapel Hill, NC
27599
| | - Jiyoung Kang
- University of North Carolina at Chapel Hill CB #8120, Chapel Hill, NC
27599
- JK conducted this work while with UNC-Chapel Hill
| | - Brian Westrich
- McWest Corporation 2321 30th Ave S, Minneapolis, MN 55406
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Rimpeekool W, Seubsman SA, Banwell C, Kirk M, Yiengprugsawan V, Sleigh A. Food and nutrition labelling in Thailand: a long march from subsistence producers to international traders. Food Policy 2015; 56:59-66. [PMID: 26538793 PMCID: PMC4608433 DOI: 10.1016/j.foodpol.2015.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 06/12/2015] [Accepted: 07/30/2015] [Indexed: 06/05/2023]
Abstract
This paper reviews the evolution of Thai food and nutrition label policies and Thailand's international role relating to food product safety and standards. The historical record has been interpreted to identify future trends and challenges related to food labelling. These challenges are arising in Thailand and many similar emerging economies. Thailand has a good reputation in world food markets and is now becoming a global leader in food production and export. It has become deeply involved with regulations and standards applied by World Trade Organization and Codex Alimentarius while serving its own population with a safe and secure food supply. For consumers considering Thai food products, food labels can provide useful nutrition information and help build trust. Thais began a century ago with policies and laws to enhance food safety and to protect Thai consumers. During the lengthy journey from national to global standards Thai food labels have evolved and now contribute to international food labelling policies. This contribution comes from the perspective of a leading middle income south-east Asian food producer now trading with high income countries around the world. The story of that journey - a case study for many other countries in a similar situation - has not previously been told. This article provides information for policy makers dealing with food labelling, embedding trends and tensions for one middle income food exporter in a long history. Information captured here should be helpful for other middle income countries, especially those with limited records. This strategic knowledge will enable better decisions for future policies.
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Affiliation(s)
- Wimalin Rimpeekool
- National Centre of Epidemiology and Population Health, Research School of Population Health, Australian National University, 62 Mills Road, Canberra, ACT 2601, Australia
| | - Sam-ang Seubsman
- National Centre of Epidemiology and Population Health, Research School of Population Health, Australian National University, 62 Mills Road, Canberra, ACT 2601, Australia
- School of Human Ecology, Sukhothai Thammathirat Open University, Chaengwattana Rd, Muang Thong Thani, Bangpood, Nonthaburi 11120, Thailand
| | - Cathy Banwell
- National Centre of Epidemiology and Population Health, Research School of Population Health, Australian National University, 62 Mills Road, Canberra, ACT 2601, Australia
| | - Martyn Kirk
- National Centre of Epidemiology and Population Health, Research School of Population Health, Australian National University, 62 Mills Road, Canberra, ACT 2601, Australia
| | - Vasoontara Yiengprugsawan
- National Centre of Epidemiology and Population Health, Research School of Population Health, Australian National University, 62 Mills Road, Canberra, ACT 2601, Australia
| | - Adrian Sleigh
- National Centre of Epidemiology and Population Health, Research School of Population Health, Australian National University, 62 Mills Road, Canberra, ACT 2601, Australia
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Lim HJ, Kim MJ, Kim KW. Factors associated with nutrition label use among female college students applying the theory of planned behavior. Nutr Res Pract 2015; 9:63-70. [PMID: 25671070 PMCID: PMC4317482 DOI: 10.4162/nrp.2015.9.1.63] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 11/03/2014] [Accepted: 11/03/2014] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND/OBJECTIVES Use of nutrition labels in food selection is recommended for consumers. The aim of this study is to examine factors, mainly beliefs explaining nutrition label use in female college students based on the Theory of Planned Behavior (TPB). SUBJECTS/METHODS The subjects were female college students from a university in Seoul, Korea. The survey questionnaire was composed of items examining general characteristics, nutrition label use, behavioral beliefs, normative beliefs, corresponding motivation to comply, and control beliefs. The subjects (n = 300) responded to the questionnaire by self-report, and data from 275 students were analyzed using t-test or χ2-test. RESULTS The results showed that 37.8% of subjects were nutrition label users. Three out of 15 behavioral beliefs differed significantly by nutrition label use. Nutrition label users agreed more strongly on the benefits of using nutrition labels including 'comparing and selecting better foods' (P < 0.001), 'selecting healthy foods' (P < 0.05). The negative belief of 'annoying' was stronger in non-users than in users (P < 0.001). Three out of 7 sources (parents, siblings, best friend) were important in nutrition label use. Twelve out of 15 control beliefs differed significantly by nutrition label use. These included beliefs regarding constraints of using nutrition labels (e.g., time, spending money for healthy foods) and lack of nutrition knowledge (P < 0.001). Perceived confidence in understanding and applying the specifics of nutrition labels in food selection was also significantly related to nutrition label use (P < 0.001). CONCLUSIONS This study found that the beliefs, especially control beliefs, suggested in the TPB were important in explaining nutrition label use. To promote nutrition label use, nutrition education might focus on increasing perceived control over constraints of using nutrition labels, acquiring skills for checking nutrition labels, as well as the benefits of using nutrition labels and receiving support from significant others for nutrition label use.
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Affiliation(s)
- Hyun Jeong Lim
- Department of Food and Nutrition, Seoul Women's University, 621 Hwarangro, Nowon-gu, Seoul, 139-774, Korea
| | - Min Ju Kim
- Department of Food and Nutrition, Seoul Women's University, 621 Hwarangro, Nowon-gu, Seoul, 139-774, Korea
| | - Kyung Won Kim
- Department of Food and Nutrition, Seoul Women's University, 621 Hwarangro, Nowon-gu, Seoul, 139-774, Korea
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