Preference for natural: instrumental and ideational/moral motivations, and the contrast between foods and medicines

Understanding the role of scientific evidence in consumer evaluation of natural health products for osteoarthritis an application of the means end chain approach

Background

Over 30% of individuals use natural health products (NHPs) for osteoarthritis-related pain. The Deficit Model for the Public Understanding of Science suggests that if individuals are given more information (especially about scientific evidence) they will make better health-related decisions. In contrast, the Contextual Model argues that scientific evidence is one of many factors that explain how consumers make health-related decisions. The primary objective was to investigate how the level of scientific evidence supporting the efficacy of NHPs impacts consumer decision-making in the self-selection of NHPs by individuals with osteoarthritis.

Methods

The means-end chain approach to product evaluation was used to compare laddering interviews with two groups of community-dwelling Canadian seniors who had used NHPs to treat their osteoarthritis. Group 1 (n=13) had used only NHPs (glucosamine and/or chondroitin) with “high” scientific evidence of efficacy. Group 2 (n=12) had used NHPs (methylsulfonylmethane (MSM) and/or bromelain) with little or no scientific evidence supporting efficacy. Content analysis and generation of hierarchical value maps facilitated the identification of similarities and differences between the two groups.

Results

The dominant decision-making chains for participants in the two scientific evidence categories were similar. Scientific evidence was an important decision-making factor but not as important as the advice from health care providers, friends and family. Most participants learned about scientific evidence via indirect sources from health care providers and the media.

Conclusions

The Contextual Model of the public understanding of science helps to explain why our participants believed scientific evidence is not the most important factor in their decision to use NHPs to help manage their osteoarthritis.

Causal essentialism in kinds

The current study examines causal essentialism, derived from psychological essentialism of concepts. We examine whether people believe that members of a category share some underlying essence that is both necessary and sufficient for category membership and that also causes surface features. The main claim is that causal essentialism is restricted to categories that correspond to our intuitive notions of existing kinds and hence is more attenuated for categories that are based on arbitrary criteria. Experiments 1 and 3 found that people overtly endorse causal essences in nonarbitrary kinds but are less likely to do so for arbitrary categories. Experiments 2 and 4 found that people were more willing to generalize a member's known causal relations (or lack thereof) when dealing with a kind than when dealing with an arbitrary category. These differences between kinds and arbitrary categories were found across various domains-not only for categories of living things, but also for artefacts. These findings have certain real-world implications, including how people make sense of mental disorders that are treated as real kinds.

Ethical Discourse about the Modification of Food for Therapeutic Purposes: How Patients with Gastrointestinal Diseases View the Good, the Bad, and the Healthy

BACKGROUND: Researchers have the potential to utilize genetic modification (GM) technologies to create a hybrid of "food" and "medicine" that may challenge traditional understandings of what is "natural". Moral and ethical concerns are likely to arise in any discussion of these therapeutic foods and will affect the integration of products into clinical care and daily life. This study examined how patients with chronic gastrointestinal (GI) diseases view probiotics as future bioengineered therapeutic foods. METHODS: A multi-site qualitative study consisting of focus groups with chronic GI diseases was conducted at Cleveland Clinic, Mayo Clinic, and Johns Hopkins University RESULTS: We conducted twenty-two focus groups with 136 patients with major GI diseases between March and August 2009. GI patients associated the term "natural" with concepts of diminished risk and morally "good"; conversely, patients associated the term "unnatural" with things that are "risky," "foreign", and morally "bad". Readily available unmodified probiotics were more commonly described as "natural" while genetically modified probiotics were more commonly labeled as "unnatural" and "risky". However, patients acknowledged that not all natural products are safe, nor are unnatural products always harmful. CONCLUSIONS: If GI patient perspectives are indicative of public perceptions of therapeutic foods, our findings suggest that the potential benefits and risks of clinical and public health initiatives employing therapeutic foods will be understood in moralistic terms. Bioethicists and others should be sensitive to the implicit normative appeals that are often embedded in the language of what is "natural" and "unnatural".

Use of Natural Health Products

Introduction. Little is currently known about how and why consumers choose to use natural health products (NHPs), such as herbs and vitamins. Objective. The objective of this study was to explore how the product attributes of NHPs and conventional pharmaceutical sleep aids are linked to consequences and values in consumers’ decision making. Methods. During the spring and summer of 2007, 60- to 90-minute semistructured, laddering interviews based on the means-ends chain approach were conducted with 25 participants experiencing sleep problems in Toronto, Canada, who were selected to have a range of demographic characteristics. Results. Participants varied considerably in the complexity of their decision processes, as between 3 and 14 attribute-consequence-value associations were elicited per interview. The factors found to be most important in determining the type of sleep aid chosen by consumers were whether the product was natural or chemical, whether it was perceived to work or have side effects, and participants’ perceptions of the impact of product use on their relationships and, subsequently, on their quality of life. Participants described making different tradeoffs between product attributes (e.g., naturalness) and perceived consequences (e.g., efficacy and side effects) depending on the situational context and indicated that these tradeoffs were done in an effort to maximize values such as overall quality of life. Conclusions. The naturalness and associated perceived lack of side effects of a product were more important than perceived efficacy for consumers selecting sleep aids for regular use. Only in special cases where efficacy was deemed essential (e.g., prior to important life or work events) did efficacy become a more important factor in the decision-making process.

Antioxidant activity and protecting health effects of common medicinal plants

Medicinal plants are traditionally used in folk medicine as natural healing remedies with therapeutic effects such as prevention of cardiovascular diseases, inflammation disorders, or reducing the risk of cancer. In addition, pharmacological industry utilizes medicinal plants due to the presence of active chemical substances as agents for drug synthesis. They are valuable also for food and cosmetic industry as additives, due to their preservative effects because of the presence of antioxidants and antimicrobial constituents. To commonly used medicinal plants with antioxidant activity known worldwide belong plants from several families, especially Lamiaceae (rosemary, sage, oregano, marjoram, basil, thyme, mints, balm), Apiaceae (cumin, fennel, caraway), and Zingiberaceae (turmeric, ginger). The antioxidant properties of medicinal plants depend on the plant, its variety, environmental conditions, climatic and seasonal variations, geographical regions of growth, degree of ripeness, growing practices, and many other factors such as postharvest treatment and processing. In addition, composition and concentration of present antioxidants, such as phenolic compounds, are related to antioxidant effect. For appropriate determination of antioxidant capacity, the extraction technique, its conditions, solvent used, and particular assay methodology are important.

Labeling of nanotechnology consumer products can influence risk and benefit perceptions

Currently, there is no mandatory labeling for products containing synthetic nanoparticles. The public as well as other stakeholders have positive views about mandatory labeling. However, little is known how such a label influences the risk and benefit perception of a product. Consumers may infer that a label is a signal that there are risks associated with this technology. Data were collected in a survey experiment (N= 1,382). Participants were randomly assigned to one of six conditions. The control group received a picture of a sunscreen container without a label. One experimental group received a picture of a sunscreen container with a label. The other groups received, in addition to the sunscreen container with a label, some risk or benefit information. Results suggest that labeling of products may reduce consumers' benefit perception and increase risk perception. Labeling nanotechnology consumer products may change the public perception of the products. Respondents may have relied on the affect heuristic for assessing the risks and benefits of the sunscreen.

Would you rather be injured by lightning or a downed power line? Preference for natural hazards

Past research has shown that many people prefer natural foods and medicines over artificial counterparts. The present study focused on examination of aversive events and hazards. Preferences were compared by having subjects consider pairs of scenarios, one natural and one artificial, matched in negative outcome and severity. Pairings were also rated along several dimensions of risk perception such as dangerousness, scariness, likelihood, and fairness. As hypothesized, natural hazards were consistently preferred to functionally identical artificial ones. Additionally, natural hazards tended to be considered less scary and dangerous, but not necessarily more unfair or unlikely than equivalent artificial counterparts. Results are discussed in terms of risk perception, and how that can lead to people diminishing risks associated with natural hazards.

I can't believe this isn't wood! An investigation in the perception of naturalness

For most people "naturalness" is a highly appreciated material characteristic. For instance, a natural wooden floor is seen as more valuable than a fake replica, though they may be comparable in quality and durability. In the present study we investigated how sensory input (vision and touch) contributes to the perception of naturalness in wood. Participants rated samples of wood or imitations thereof, such as vinyl and veneers. We first attempted to provide a validation of the measurement of perceived naturalness by comparing four psychophysical measurement methods (labelled scaling, magnitude estimation, binary decision, and ranked ordering). Second, we investigated the contribution of vision and touch by measuring the perception of naturalness in three exploration modalities (vision only, touch only, and visuo-tactile). The results show a high degree of consistency across measurement methods, suggesting that we measured a common underlying construct that relates to naturalness. It also suggests that this construct is represented on a metathetic (categorical) continuum. Moreover, we found that both vision and touch are highly correlated predictors of visuo-tactile perception of naturalness.

The “organic” path to obesity? Organic claims influence calorie judgments and exercise recommendations

Labeling a food as “organic” entails a claim about its production but is silent on its calorie content. Nevertheless, people infer that organic cookies are lower in calories and can be eaten more often than conventional cookies (Study 1). These inferences are observed even when the nutrition label conveys identical calorie content and are more pronounced among perceivers high on pro-environmentalism. Moreover, when evaluating a person with a weight-loss goal, forgoing exercise is deemed more acceptable when the person has just chosen organic rather than conventional dessert (Study 2). These results reflect an “organic/natural”-“healthy” association that is capable of biasing everyday judgments about diet and exercise.

Barriers and paths to market for genetically engineered crops

Each year, billions of dollars are invested in efforts to improve crops through genetic engineering (GE). These activities have resulted in a surge of publications and patents on technologies and genes: a momentum in basic research that, unfortunately, is not sustained throughout the subsequent phases of product development. After more than two decades of intensive research, the market for transgenic crops is still dominated by applications of just a handful of methods and genes. This discrepancy between research and development reflects difficulties in understanding and overcoming seven main barriers-to-entry: (1) trait efficacy in the field, (2) critical product concepts, (3) freedom-to-operate, (4) industry support, (5) identity preservation and stewardship, (6) regulatory approval and (7) retail and consumer acceptance. In this review, I describe the various roadblocks to market for transgenic crops and also discuss methods and approaches on how to overcome these, especially in the United States.

Consumers' willingness to buy functional foods. The influence of carrier, benefit and trust

The goal of the present study was to examine factors that influence willingness to buy functional foods. Data were collected from a representative mail survey in Switzerland (n=249). Results suggest that consumers are more inclined to buy functional foods with physiological health claims compared with psychological health claims. Health claims were most positively evaluated when attached to a product with a positive health image. Results further show that participants who have trust in the food industry are more likely to buy functional foods compared with participants who do not have trust in the food industry. Older consumers were more interested in functional foods than younger consumers.

"I always thought they were all pure tobacco": American smokers' perceptions of "natural" cigarettes and tobacco industry advertising strategies

OBJECTIVE

To examine how the US tobacco industry markets cigarettes as "natural" and American smokers' views of the "naturalness" (or unnaturalness) of cigarettes.

METHODS

Internal tobacco industry documents, the Pollay 20th Century Tobacco Ad Collection, and newspaper sources were reviewed, themes and strategies were categorised, and the findings were summarised.

RESULTS

Cigarette advertisements have used the term "natural" since at least 1910, but it was not until the 1950s that "natural" referred to a core element of brand identity, used to describe specific product attributes (filter, menthol, tobacco leaf). The term "additive-free", introduced in the 1980s, is now commonly used to define natural cigarettes. Tobacco company market research, available from 1970 to 1998, consistently revealed that within focus group sessions, smokers initially had difficulty interpreting the term "natural" in relation to cigarettes; however, after discussion of cigarette ingredients, smokers viewed "natural" cigarettes as healthier. Tobacco companies regarded the implied health benefits of natural cigarettes as their key selling point, but hesitated to market them because doing so might raise doubts about the composition of their highly profitable "regular" brands.

CONCLUSION

Although our findings support the idea advanced by some tobacco control advocates that informing smokers of conventional cigarettes' chemical ingredients could promote cessation, they also suggest that such a measure could increase the ubiquity and popularity of "natural" cigarettes. A more effective approach may be to "denaturalise" smoking.

Perceived risks and perceived benefits of different nanotechnology foods and nanotechnology food packaging

Nanotechnology has the potential to generate new food products and new food packaging. In a mail survey in the German speaking part of Switzerland, lay people's (N=337) perceptions of 19 nanotechnology applications were examined. The goal was to identify food applications that are more likely and food applications that are less likely to be accepted by the public. The psychometric paradigm was employed, and applications were described in short scenarios. Results suggest that affect and perceived control are important factors influencing risk and benefit perception. Nanotechnology food packaging was assessed as less problematic than nanotechnology foods. Analyses of individual data showed that the importance of naturalness in food products and trust were significant factors influencing the perceived risk and the perceived benefit of nanotechnology foods and nanotechnology food packaging.

Public acceptance of nanotechnology foods and food packaging: The influence of affect and trust

Nanotechnology is increasingly being employed in the areas of food production and packaging. Public perception will be crucial to the realization of these technological advances. We examined how lay people (N=153) perceive nanotechnology foods and nanotechnology food packaging, and we examined the factors that influence willingness to buy these products. Participants received some general information about nanotechnology, and specific information about four nanotechnology applications. Overall, participants were hesitant to buy nanotechnology foods or food with nanotechnology packaging. Results suggest, however, that nanotechnology packaging is perceived as being more beneficial than nanotechnology foods. Results further suggest that social trust in the food industry is an important factor directly influencing the affect evoked by these new products. As suggested by the affect heuristic, affect had an impact on perceived benefits and perceived risks. Perceived benefit seems to be the most important predictor for willingness to buy.

Predictors of Australian consumers' intentions to consume conventional and novel sources of long-chain omega-3 fatty acids

OBJECTIVES

To elicit predictors of variation in likelihood to purchase foods rich in long-chain omega-3 fatty acids.

DESIGN, SETTING AND SUBJECTS

Responses from a community sample (n = 220) were elicited using a computer-administered questionnaire based on an adaptation of Protection Motivation Theory including measures of perceived risk and vulnerability to coronary heart disease (CHD). Other measures included health status, body mass index (BMI), perceived risk/benefits of novel technologies and sociodemographics. Descriptions of model products were presented, including farmed fish fed fishmeal (FFFF); farmed fish fed genetically modified (GM) oilseed (FFFGM); bread, milk and supplements containing fish oil (SFO) or GM oilseed. It was hypothesised that perceived vulnerability to CHD would enhance acceptance of GM products (H1). Furthermore, information describing the benefits of LCO3FA, limitations to fish supply and potential alternatives was given to a treatment group (50%) and hypothesised to have a positive effect on the acceptance of GM products (H2).

RESULTS

No evidence was found to support H1 or H2. FFFF was most likely to be purchased (P < 0.01), followed by SFO and FFFGM. Multivariate regression analysis identified significant (P < 0.05) predictors (standardised beta) for likelihood to purchase FFFF: self-efficacy 0.56; behaviour (product) efficacy 0.19; belief that fishmeal is unnatural -0.14 (R2 = 0.44) and for FFFGM: self-efficacy 0.65; perceived severity of CHD 0.15; BMI -0.13; significant other has/had arthritis 0.11; belief that GM oilseed is unnatural 0.11 (R2 = 0.49).

CONCLUSIONS

Self-efficacy (confidence to consume) was the most important predictor of likelihood to purchase all products.

Attitudes towards genetically modified and organic foods

Finnish students (N=3261) filled out a questionnaire on attitudes towards genetically modified and organic food, plus the rational-experiential inventory, the magical thinking about food and health scale, Schwartz's value survey and the behavioural inhibition scale. In addition, they reported their eating of meat. Structural equation modelling of these measures had greater explanatory power for attitudes towards genetically modified (GM) foods than for attitudes towards organic foods (OF). GM attitudes were best predicted by natural science education and magical food and health beliefs, which mediated the influence of thinking styles. Positive attitudes towards organic food, on the other hand, were more directly related to such individual differences as thinking styles and set of values. The results of the study indicate that OF attitudes are rooted in more fundamental personal attributes than GM attitudes, which are embedded in a more complex but also in a more modifiable network of characteristics.

The meaning of "natural": process more important than content

The meaning of the desirable attribute "natural" was explored in two samples, American college students and adults in the Philadelphia jury pool. Participants rated the naturalness of a variety of "natural" entities, before and after they were transformed by operations such as freezing, adding or removing components, mixing with other natural or unnatural entities, domestication, and genetic engineering. Results support four hypotheses. First, the principle of contagion accounts for many aspects of the reduction of naturalness by contact with unnatural entities. Second, chemical transformations reduce naturalness much more than physical transformations do. Third, the history of an entity's processing is more important in determining its naturalness than is the nature of the entity's contents. Fourth, mixing like natural entities (e.g., water from different sources) does not markedly reduce naturalness. The insertion of a gene from another species, the process used in producing genetically modified organisms, produces the biggest drop in naturalness; domestication, a human-accomplished activity that changes genotype and phenotype in major ways, is considered much less damaging to naturalness.

Perceived naturalness and acceptance of genetically modified food

This study examines people's acceptance of genetically modified (GM) food. Results suggest that GM acceptance depends most on how natural the genetically modified product is perceived and not directly on how natural the non-GM product is seen. A GM product that is perceived as more natural is more likely to be accepted than a GM product that is perceived as less natural. The extent to which GM affects the perceived naturalness of a product partly depends on the kind of product.