Differences in health and taste attitudes and reported behaviour among Finnish, Dutch and British consumers: a cross-national validation of the Health and Taste Attitude Scales (HTAS)

"I find it hard to change poor food habits": Measuring food choice motives in an emerging economy

Food choices are driven by an array of motives that have been approached, determined and quantified in a number of ways, mainly in developed countries. The objective of this study was to better understand the motives behind food choices in an emerging economy by collecting information from urban people in South Africa in a series of four studies. (1) Items generated through focus group discussions with low, middle and high income participants by Magano et al. (2023) were checked for content and face validity and (2) 123 statements derived from them were evaluated by 621 respondents. After exploratory factor analysis (EFA), 46 statements best representing the motivational space were (3) presented to another group of respondents (n = 259). Here, the EFA resulted in a 31-item, 7-factor food choice questionnaire for emerging economies (FCQ-EE) which was (4) confirmed by a nationwide sample (n = 814) and further refined to an alternative 19-item, 7-factor solution. The emerging factors were: Healthy eating constraints (HEC), Frugality (FR), Emotional eating (EE), Meat appeal (MA), Weather (WE), Quality seeking (QS) and Cooking constraints (CC). Whether used in the 31-item or 19-item format, this set of statements highlights factors underlying food choice in an emerging economy and offers a way to study their importance in similar contexts. Further research is needed to show the extent to which these factors can predict actual food choices.

Quantitative Definition of Low-Health-Interest Populations by Using Regression Trees: A Nationwide Internet Survey in Japan

BACKGROUND

Reducing health disparities is a public health issue. Identification of low-health-interest populations is important, but a definition of people with low health interest has not yet been established. We aimed to quantitatively define low-health-interest populations.

METHODS

A nationwide cross-sectional internet survey was conducted in 2022. We compiled regression tree (RT) analyses with/without adjustment for age, sex, and socioeconomic status with the 12-item Interest in Health Scale (IHS, score range 12-48) as an explanatory variable and the 10 composite health behaviors as a dependent variable. We defined the first IHS branching condition from the root node as a lower-health-interest group and the terminal node with the lowest health behaviors as the lowest-health-interest group.

RESULTS

The mean IHS value of 22,263 analyzed participants was 32.1 ± 5.6; it was higher in females and in those who were aged over 45 years, had a high education, a high income, or a spouse. The first branching condition was IHS 31.5, and the terminal node branched at 24.5, before/after adjustment for covariates.

CONCLUSIONS

We determined the cutoff values of the IHS as <32 for a lower-health-interest group and <25 for the lowest-health-interest group. Using these cutoffs might enable us to reveal the characteristics of low-health-interest populations.

Changes in the choice motive and emotional perception of chocolates in response to stress

Although chocolates are often chosen for sensory pleasure, they are also selected to enhance mood and relieve emotional stress, or potentially chosen for its perceived health benefits if stress adversely affects physical well-being. This study aimed to investigate whether emotional stress influenced the motivations behind chocolate selection, subsequent liking, and emotional response. Participants were divided into a control group (n = 76) and a group with induced acute stress (n = 74). Stimuli were presented as dark chocolate packaging, each evoking sensory appeal, health, and emotional stress relief. Participants chose one stimulus from three options that they were most inclined to consume and evaluated the overall liking and emotional attributes of the stimuli. They also rated the overall liking and emotional attributes of three types of chocolates, each identical but paired with distinct stimuli. Their food attitudes were also assessed. Stress did not change the choice of stimuli, indicating that stress did not influence the motivation for chocolate selection. Instead, the choice of stimuli aligned with participants' food attitudes; those favoring sensory appeal and emotional stress relief prioritized pleasure in their usual food choices. Stress tended to increase liking and chocolate-associated positive emotions with sensory appeal, as opposed to others, to immediately alleviate negative emotions. The most robust motivation to consume chocolates was sensory pleasure, irrespective of stress, because of a preestablished association between sensory pleasure and mood enhancement.

Attitudes towards natural wines among Spanish winemakers: Relationship with environmental awareness

There is an important movement in the wine industry towards the production of alternative and more sustainable wines. Natural wine (NW) is a controversial category of alternative wines, which needs to be further explored. Given the role of technical experts as opinion leaders, the present work aims to explore the attitudes of Spanish winemakers towards NW and their relationship with their overall environmental awareness. Therefore, 307 Spanish winemakers completed a questionnaire to evaluate: (1) their attitudes towards NW by scoring their agreement with 31 statements, (2) their ecological awareness by evaluating 11 items, (3) their frequency of consumption and interest towards NW, and (4) their sociodemographic profile and general information about wine production. PCA with varimax rotation calculated on 28 of the 31 statements related to their attitudes showed six independent dimensions. Further hierarchical cluster analysis calculated with the six dimensions showed five clusters of wine experts with different attitudes towards NW. Results show that there is a major negative attitude towards the flavour of NW, their ageing capacity and their quality-price ratio, but a positive one in terms of economic impact for the wine industry. Aspects related to the role of NW in tradition, social identity, ecology, health, artisanal production and economic feasibility mark differential attitudes. Interestingly, the dimension related to winemakerś attitude towards tradition, social identity, and ecology of NW was positively correlated with their overall ecological awareness and thus their life style. This paper sheds light in the understanding of the behaviour of Spanish winemakers regarding ecological transition and provides tools for policymaking regarding NW certification.

Measuring Pleasure from Food-Validation of the Food Pleasure Scale by Multiple Techniques and Mixed Methods

The development of scales and questionnaires to assess pleasure perception has gained prominence, particularly for evaluating anhedonia in mental disorders. The Food Pleasure Scale is a comprehensive tool exclusively dedicated to measuring pleasure perception from food and food-related experiences. This study aimed to evaluate the face validity and consistency reliability of the Food Pleasure Scale using a mixed methods approach. Twenty-two participants completed the Food Pleasure Scale questionnaire and participated in in-depth interviews to understand their interpretation of the scale items. The interview data underwent thematic analysis, and the quantitative survey data was compared to the qualitative interview responses. Results indicated a high level of understanding of all items in the Food Pleasure Scale, confirming its face validity and applicability. The mixed methods approach supported the consistency reliability, showing consistency between quantitative measures and participants' explicit and implicit expressions of food pleasure. Furthermore, the study revealed a novel aspect related to food pleasure: the concept of "making an effort". Overall, this study highlights the comprehensibility, validity, and potential of the Food Pleasure Scale in consumer studies. It effectively captures the subjective experience of pleasure derived from food and food-related encounters, making it a valuable tool for further research in this domain.

Impact of circular economy information on sensory acceptability, purchase intention and perceived value of upcycled foods by young consumers

The acceptability of upcycled foods is influenced by individual, context and product-related factors. This study aimed at investigating the impact of circular economy (CE) information on consumers' sensory acceptability, purchase intention and perceived value of upcycled foods, taking into account eating behaviours and personality traits that could be related to the consumers' sustainable consumption habits. To this aim, a group of young subjects (n = 80, 18-35 years old) participated in a two-step study. Firstly, an online questionnaire was administered to participants to gather information about their individual characteristics. Then, participants were divided into two groups, one receiving CE information (CE+) and one not receiving it (CE-), and they were asked to indicate the sensory acceptability, purchase intention and the perceived value of three upcycled foods, such as biscuits with grape pomace flour, beer brewed with leftover bread and a dairy product made from recovered crushed cheese. Questionnaire results showed that high individual responsibility, interest in healthy foods and high awareness of the social impact of their behaviours could be linked to a positive purchase intention for upcycled foods, as opposed to individual disgust sensitivity. No significant effect of CE information (p > 0.05) on sensory acceptability and purchase intention of all three upcycled foods was observed. Moreover, application of Principal Component Analysis (PCA) to the sensory data resulted in satisfactory classification of upcycled foods in terms of perceived values, explaining 86.83 % of data variability: the first principal component discriminated samples according to product category whereas the second principal component was able to clearly separate products according to CE information. Findings from this study provided valuable insights into the key individual characteristics that impact sustainable consumption habits, also highlighting the role of communication strategies in shaping consumer perceptions of upcycled foods so as to encourage a more sustainable consumption behaviour.

Do cooking and food preparation skills affect healthy eating in college students?

The aim of this study is to investigate the relationship between food and cooking skills and healthy eating attitudes in college students. The demographic characteristics, anthropometric measurements, nutritional habits, attitudes toward healthy eating, and cooking and food preparation skills were questioned. 16.2% of the students have moderate, 63.5% high, and 20.3% ideally high attitudes toward healthy eating. While a positive and significant correlation was found between the total score and sub-factor scores of the "Cooking Skills and Food Skills" scale and the total score of the "Attitude Scale for Healthy Nutrition"; a negative statistically significant correlation was found between the total score and sub-factor scores of the "Cooking Skills and Food Skills" scale and the frequency of consumption of fast-food, processed meat products, packaged foods, and bread types (p < .05). Cooking and food preparation skills seem to be positively associated with healthy attitudes and habits. Considering this positive association, interventions to improve food and cooking skills may help promote healthy eating attitudes in college students. Developing these skills can shed light on increasing the frequency of cooking at home, consuming healthier foods, and as a result, providing a healthy eating attitude. Therefore, more comprehensive intervention studies are needed in this area.

Education- and income-related differences in processed meat consumption across Europe: The role of food-related attitudes

PURPOSE

Dietary behaviors differ between socio-economic groups and are one key determinant of health inequalities. Psychological factors such as attitudes are assumed to underlie the relation between inequality and dietary behaviors, but this assumption has rarely been tested empirically. We focus on a specific food group shown as detrimental to health: processed meat.

METHODS

In two representative international surveys (Survey 1: N = 10,226 participants from nine European countries - Austria, France, Germany, Italy, Netherlands, Poland, Russia, Spain, UK; Survey 2: N = 9149 participants from the same countries, except not including Austria and the Netherlands), participants reported inequality indicators (education, income), processed meat consumption as well as their attitudes toward nutrition and food.

PRINCIPAL RESULTS

There were diverging relationships between indicators of inequality and processed meat consumption: the higher the educational attainment, the lower the consumption of processed meat (r_Survey1 = -0.062, p < .001; r_Survey2 = -0.071, p < .001). At the same time, higher income was related to higher processed meat consumption (r_Survey1 = 0.088, p < .001; r_Survey2 = 0.152, p < .001). A path model showed that four of seven attitude factors mediated the relation between education and processed meat consumption (i.e., indifference toward nutrition and food, preference for regional and fresh food, processed food consumption, health efforts); none of the attitude factors mediated the relation between income and overall processed meat consumption.

CONCLUSIONS

Processed meats are consumed very frequently across European countries. The relation between inequality and processed meat consumption is heterogeneous and partially mediated by attitudes. More research is needed to better understand how psychological factors explain social inequality in nutrition behaviors and health in general.

The Mediator Role of Attitudes in Fish Choice Behavior: A Turkish Market Survey

Due to the dynamic nature of demand, it is becoming increasingly important for the fish industry to investigate the changing choice behaviors of consumers in the face of increasing demand. This research investigated the role of attitudes and socio-demographic characteristics, which are the main factors in the fish choice behavior of consumers and in fish consumption behavior. In this context, an ordered probit model was constructed to analyze the effect of attitudes and socio-demographic characteristics as independent variables on fish consumption and purchase intention as the dependent variables. In addition, descriptive statistics were also used to reveal the current preferences related to fish. The data required for the model and descriptive statistics were obtained from 421 participants using a cross-sectional consumer survey covering the main cities of the seven regions of Turkey. The results show that while consumers prefer fish more than red meat and less than poultry, they mostly buy fresh fish from fish markets. Moreover, taste, physical appearance, convenience, wild fish, and seller trust attitudes have a significant and positive relationship with the dependent variable (the frequency of fish purchase and consumption) and price has a negative and significant relationship. Moreover, an increase in education level has a positive and significant relationship with the frequency of fish consumption. The research results provide important suggestions and information for decision-makers in the fish industry to implement effective policies and meet the consumer expectations of producers and distributors in the fish industry. In addition, the current study provides guidance for future research.

Eating Choices—The Roles of Motivation and Health Literacy: A Cross-Sectional Study

Food choices are determined by intrinsic and extrinsic product characteristics, biological and physiological features, psychological factors, and situational and socio-cultural factors. Self-determination theory offers the explanation of health behavior change identifying motivations located along a continuum of autonomy. Another approach to the motivations guiding health behaviors, including food choices, relies on distinguishing thematic categories. Health motivations seem to be an obvious determinant of health behaviors, but final decisions regarding health are also the effect of other types of motivations such as economic, cultural, or emotional. The role of marketing pressure in modern society is perceived to be an important source of motivation for purchasing food and other products. The Motivation–Opportunity–Ability (MOA) framework was initially proposed in order to explain the processing of brand information from advertisements and was later expanded to other areas, including health and nutritional behaviors. The aim of this study was the analysis of determinants of food choices. We have developed a common regression model including six categories of motivations addressed by the Eating Motivations Scale and three health literacy types corresponding with element of ability from the MOA framework, adjusted for socio-demographic factors, health status, and the use of the Internet and TV. The analysis was performed on data from a computer-assisted web-based interviewing (CAWI) survey among 2008 adult Internet users completed in May 2022. The uni- and multivariate linear regression models were developed with the Index of Unhealthy Food Choices (IUFC), calculated based on the responses to items asking about the frequency of the consumption of twelve food categories. Univariate modeling revealed that IUFC is significantly associated with health, food, and e-health literacies and with five out of six eating motivations. However, the multivariate regression model yielded significant associations only for eating motivations but not for the three literacy scores. Health motivation was negatively associated with IUFC (B, standard error (SE): 0.83, 0.07; 95% confidence interval (95% CI): 0.98–0.69), but positively with emotional (B, SE: 0.22, 0.04; 95% CI: 0.14–0.3), economic (B, SE: 0.41, 0.08; 95% CI: 0.25–0.56), and marketing (B, SE: 0.62, 0.08; 95% CI: 0.47–0.78) motivations. Our findings suggest that motivations guiding food choices may prevail over the element of ‘ability’ distinguished in the frameworks and models that explain people’s behaviors, including behaviors relating to health. Thus, it is essential to emphasize development of appropriate motivations and not only to provide knowledge and skills. Furthermore, one should also remember motivations other than health motivations when searching for the determinants of health behaviors.

The Symmetry Effect: Symmetrical Shapes Increase Consumer’s Health Perception of Food

Focusing on the physical appearance of the food itself, and limiting the focus on shape to the concept of symmetry, this research investigated how food shape influences consumer perceptions of healthiness and naturalness and their subsequent food preferences. By conducting three empirical studies involving self-reported preference and trade-off choices, this research verified that it is a two-staged process of naturalness and healthiness that mediates the main effect of symmetry on foods preference. Furthermore, the incremental perceived unhealthiness of food would mitigate the positive effect of food symmetry. These findings are meaningful for food marketing managers and policymakers when making food-related decisions.

Rebalancing meat and legume consumption: change-inducing food choice motives and associated individual characteristics in non-vegetarian adults

BACKGROUND

A shift toward more plant-based foods in diets is required to improve health and to reduce environmental impact. Little is known about food choice motives and associated characteristics of those individuals who have actually reduced their consumption of animal-based foods. The aim of this cross-sectional study was to identify change-inducing motives related to meat and legume consumptions among non-vegetarians. The association between change-inducing motives and individual characteristics was also studied.

METHODS

This study included 25,393 non-vegetarian participants in the French NutriNet-Santé cohort (77.4% women, mean age 55.4 ± 13.9 y.). The motives related to the declared change in meat and legume consumptions (e.g., taste, environment, social pressure) were assessed by an online questionnaire in 2018. For each motive, respondents could be classified into three groups: no motive; motive, not change-inducing; change-inducing motive. Associations between change-inducing motives and individual characteristics were evaluated using multivariable polytomic logistic regressions. Characteristics of participants who rebalanced their meat and legume consumptions were also compared to those who reduced their meat but did not increase their legume consumption.

RESULTS

Motives most strongly declared as having induced a change in meat or legume consumptions were health and nutrition (respectively 90.7 and 81.0% declared these motives as change-inducing for the meat reduction), physical environment (82.0% for meat reduction only) and taste preferences (77.7% for legume increase only). Other motives related to social influences, meat avoidance and meat dislike were reported by fewer individuals, but were declared as having induced changes in food consumption. Most motives that induced a meat reduction and a legume increase were more likely to be associated with specific individual characteristics, for example being a woman or highly educated for health motives.

CONCLUSIONS

Besides the motives reported as important, some motives less frequently felt important were declared as having induced changes in meat or legume consumptions. Change-inducing motives were reported by specific subpopulations. Public campaigns on health and sustainability could usefully develop new tools to reach populations less willing to change.

TRIAL REGISTRATIONS

The study was registered at ClinicalTrials.gov (NCT03335644).

Perception of Gluten-Free Bread as Influenced by Information and Health and Taste Attitudes of Millennials

Information on what drives consumers to like or dislike bread is needed to provide insight on developing gluten-free (GF) bread, using indigenous and sustainable crops in Africa, such as sorghum and millet. Consumer attitudes toward the health and taste aspects of food are major drivers of food choices. The objectives of this work were (1) to determine the health and taste attitudes (HTAs) and general perceptions of a group of millennial consumers in South Africa (n = 354), concerning GF breads; and (2) to determine whether HTAs affect the acceptability of sensory properties of commercial GF breads, as assessed by consumers (n = 173), under informed and uninformed conditions. Mean scores of the taste factors were higher compared to health factors, indicating a greater taste orientation. The sensory properties of standard wheat breads were preferred over two commercial GF breads, irrespective of the health/taste interests of consumers, or if they were informed/uninformed about the nature of the bread (GF or wheat). Knowledge that bread samples were GF reduced only the acceptability of the aroma of GF bread. GF bread was perceived as healthier, but less tasty. For this group of millennials, the sensory properties of bread was the main driver of choice.

A randomised, controlled, double blind study to assess mechanistic effects of combination therapy of dapagliflozin with exenatide QW versus dapagliflozin alone in obese patients with type 2 diabetes mellitus (RESILIENT): study protocol

INTRODUCTION

The newer glucose-lowering therapies for type 2 diabetes (T2D), the glucagon-like peptide-1 receptor agonists (GLP1-RAs) and the sodium-glucose co-transporter 2 inhibitors (SGLT2i), have additional clinical benefits beyond improving glycaemic control; promoting weight loss, addressing associated cardiovascular risk factors and reducing macrovascular and microvascular complications. Considering their independent mechanisms of actions, there is a potential for significant synergy with combination therapy, yet limited data exist. This 32-week randomised, double-blind, placebo-controlled trial will gain mechanistic insight into the effects of coadministration of exenatide QW, a weekly subcutaneous GLP1-RA, with dapagliflozin, a once daily oral SGLT2i, on the dynamic, adaptive changes in energy balance, total, regional and organ-specific fat mass and multiorgan insulin sensitivity.

METHODS AND ANALYSIS

110 obese patients with diagnosed T2D (glycated haemoglobin, HbA_1c ≥48 mmol/mol) will be treated for 32 weeks with dapagliflozin (10 mg once daily either alone or in combination with exenatide QW (2 mg once weekly); active treatments will be compared with a control group (placebo tablet and sham injection). The primary objective of the study is to compare the adjusted mean reduction in total body fat mass (determined by dual-energy X-ray absorptiometry, DEXA) from baseline following 32 weeks of treatment with exenatide QW and dapagliflozin versus dapagliflozin alone compared with control (placebo). Secondary outcome measures include changes in (1) energy balance (energy intake and energy expenditure measured by indirect calorimetry); (2) appetite (between and within meals) and satiety quotient; (3) body composition including visceral adipose tissue, subcutaneous adipose tissue, liver and pancreatic fat. Exploratory outcome measures include metabolic changes in hepatic and peripheral insulin sensitivity (using a two-stage hyperinsulinaemic, euglycaemic clamp), central nervous system responses to food images using blood oxygen level-dependent (BOLD) functional MRI (fMRI) and changes in cardiovascular function (using transthoracic echocardiography, cardiac MR and duplex ultrasonography).

ETHICS AND DISSEMINATION

This study has been approved by the North West Liverpool Central Research Ethics Committee (14/NW/1147) and is conducted in accordance with the Declaration of Helsinki and the Good Clinical Practice. Results from the study will be published in peer-reviewed scientific and open access journals and/or presented at scientific conferences and summarised for distribution to the participants.

TRIAL SPONSOR

University of Liverpool.

TRIAL REGISTRATION NUMBER

ISRCTN 52028580; EUDRACT number 2015-005242-60.

Measuring and Leveraging Motives and Values in Dietary Interventions

Why measure and leverage food motives and values? Every failure and every success in dietary change can be connected to motivation. Therefore, this research question naturally arises: How can food motives and values be measured and leveraged to improve diet outcomes from the individual to populations? There are four ways that food motives and values (FMVs) can assist researchers and health professionals. First, FMVs can help to create a personalized approach to dietary change. Second, FMVs can inform content for dietary interventions. Third, these FMV measures can be used in data analysis to elucidate differences in adherence and outcomes among participants. Fourth, public health nutrition messages can be tailored using information on FMVs. Each of these uses has the potential to further the literature and inform future efforts to improve diet. A central aim of our study is to provide specific examples and recommendations on how to measure and leverage FMVs. To do so, we reviewed 12 measures included in the literature citing the Food Choice Questionnaire by Steptoe, Pollard, and Wardle, which was identified as the earliest, highly cited article appearing under the search terms “food motives” AND “food values” AND “eating behavior” AND “measure”. Specific details on how articles were selected from the citing literature are described in the Methods section. We also expound on our reasoning for including the Three-Factor Eating Questionnaire, which made for 13 measures in total. Our main finding is that each measure has strengths and shortcomings to consider in using FMVs to inform nutritional recommendations at different levels.

Impact of warning labels on reducing health halo effects of nutrient content claims on breakfast cereal packages: A mixed-measures experiment

Chile recently implemented a food labeling law that requires packaged foods with sugar, saturated fats, sodium, and/or calorie content that exceeds government-defined thresholds to carry a front-of-package warning for each excessive nutrient. This law does not prohibit the use of nutrient content (NC) marketing claims on packages, as long as the claims do not directly contradict the warnings. Yet, having NC claims alongside nutrient warnings might send mixed messages confusing consumers about the overall healthiness of a product. The present study tests the co-occurrence of warning labels and NC claims in breakfast cereal packages on product perceptions and behavioral intentions of Chilean adults in a 3 (warnings: none, high calorie, high calorie/high sugar) × 3 (NC claims: none, fiber/wholegrain, low fat/cholesterol-free) mixed-measures experiment. Fiber-related claims had a main effect leading to more positive ratings of the product, compared to having no NC claims or fat-related claims. These positive ratings extended beyond perceptions of the fiber content to perceptions of overall healthiness, naturalness, quality, vitamin content, and intentions to purchase and recommend the product-a health halo effect. No significant interaction between warnings and NC claims was found. However, warnings had a main effect on perceptions irrespective of the presence of NC claims, with one warning significantly reducing ratings, dampening any halo effects, and two warnings further dampening any effects. These findings indicate that warning labels can mitigate, but not eliminate the influences of NC claims on consumer perceptions of product healthiness.

Impact of sustainability and nutritional messaging on Italian consumers' purchase intent of cereal bars made with brewery spent grains

This work focuses on the reuse of brewery spent grains (BSGs), the most abundant by-product of the beer industry, today mainly used as animal feed. BSGs are rich in fibers and proteins as well as phenolic compounds, all of which are beneficial for human nutrition. Cereal bars containing 12% BSG were formulated and characterized instrumentally. Moreover, 159 panelists representative of young Italian consumers evaluated the bars in a central location test, along with a commercial cereal bar. Products were first evaluated blind, and then in an informed condition where additional product-specific nutritional and sustainability information was revealed, thus the purchase intent was determined. While the control product outperformed the BSG bar in most of the hedonic and sensory measures, the BSG sample was perceived as "natural/made with natural ingredients" by a significantly higher number of panelists (49%) compared to the control (30%). Additionally, even in the lower performing formulation, a significant positive effect on purchase intent was observed when providing either nutrition (fiber content) or sustainability (use of upcycled ingredients) information. The acceptable price range for the BSG and the commercial bar was very similar, whereas the optimal pricing point for the BSG was lower than the control. For the BSG product, sustainability information had significantly higher impact on purchase intent than nutrition-based information. Results highlight the importance of understanding consumer attitudes toward upcycling and the use of byproducts as ingredients in new food formulations. PRACTICAL APPLICATION: Results show how providing information on product nutrition and sustainability can increase purchase intent in the context of a cereal bar containing upcycled ingredients. The findings of this study can help food and consumer researchers to develop acceptable products that include BSG as an ingredient, potentially replacing other cereals in the recipe. The use of this brewery by-product could add value to the beer supply chain and to the final product as well, being also aligned with the current market trend of sustainability and functional health benefits.

Can eating pleasure be a lever for healthy eating? A systematic scoping review of eating pleasure and its links with dietary behaviors and health

The aims of this review were to map and summarize data currently available about 1) key dimensions of eating pleasure; 2) associations of eating pleasure, and its key dimensions, with dietary and health outcomes and 3) the most promising intervention strategies using eating pleasure to promote healthy eating. Using the scoping review methodology, a comprehensive search of the peer-reviewed literature (Medline, PsycInfo, Embase, ERIC, Web of Science, CINAHL, ABI/Inform global and Sociology Abstract) and of the grey literature (ProQuest Dissertations & Theses and Google) was carried out by two independent reviewers. We included 119 of the 28,908 studies found. In total, 89 sub-dimensions of eating pleasure were grouped into 22 key dimensions. The most frequently found related to sensory experiences (in 50.9% of the documents), social experiences (42.7%), food characteristics besides sensory attributes (27.3%), food preparation process (19.1%), novelty (16.4%), variety (14.5%), mindful eating (13.6%), visceral eating (12.7%), place where food is consumed (11.8%) and memories associated with eating (10.9%). Forty-five studies, mostly cross-sectional (62.2%), have documented links between eating pleasure and dietary and/or health outcomes. Most studies (57.1%) reported favorable associations between eating pleasure and dietary outcomes. For health outcomes, results were less consistent. The links between eating pleasure and both dietary and health outcomes varied according to the dimensions of eating pleasure studied. Finally, results from 11 independent interventions suggested that strategies focusing on sensory experiences, cooking and/or sharing activities, mindful eating, and positive memories related to healthy food may be most promising. Thus, eating pleasure may be an ally in the promotion of healthy eating. However, systematically developed, evidence-based interventions are needed to better understand how eating pleasure may be a lever for healthy eating.

Cook-EdTM: A Model for Planning, Implementing and Evaluating Cooking Programs to Improve Diet and Health

Domestic cooking education programs are typically designed to improve an individual’s food and cooking skills, although not necessarily diet quality. Currently, there are no comprehensive models to guide the planning, implementation and evaluation of domestic cooking education programs that focus on improving diet and health. Our aim was to address this through development of the Cooking Education (“Cook-Ed^TM”) model, using the PRECEDE-PROCEED model as the underlying Cook-Ed^TM framework. A review of the food and cooking skills education literature informed the content of the Cook-Ed^TM model. Cook-Ed^TM was critiqued by experts in consumer behaviour, cooking and nutrition education research and education until consensus on model content and format was reached. Cook-Ed^TM leads cooking program developers through eight distinct stages, engaging key stakeholders in a co-design process from the outset to tailor programs to address the need of individuals and inform the development of program content, program delivery, and evaluation. A Cook-Ed^TM scenario applied in practice is described. The proposed Cook-Ed^TM model has potential to be adapted for use in domestic cooking education programs delivered in clinical, community, school or research settings. Further research will establish Cook-Ed^TM’s utility in enhancing program development and in improving food and cooking skills, dietary patterns and health outcomes.

Gender, Age, Geographical Area, Food Neophobia and Their Relationships with the Adherence to the Mediterranean Diet: New Insights from a Large Population Cross-Sectional Study

The Mediterranean diet (MD) is associated with many health benefits. The association between the MD and food neophobia (FN) is still unexplored in adults. The present cross-sectional study was aimed to explore the relationships between adherence to the MD, FN, and sociodemographic variables in a large Italian cohort. Familiarity and frequency use (FFI) of prototypical and non-prototypical Mediterranean foods were used to calculate a new adherence index: the Italian Taste Mediterranean Index (ITMI). The FFI of all Mediterranean foods increased with age, while butter, soft drinks, red/cured meat, and sweets were more common in younger people. Accordingly, ITMI increased with age (F_2,2384 = 54.11; p < 0.0001). Women recorded a higher ITMI (6.70) than men (6.10). Individuals with high FN showed higher FFI for soft drinks and sweets and lower ones for most typical MD foods, than individuals with low FNs. A decrease of ITMI was recorded with the increase of the FN(F_2,2384 = 22.84; p < 0.0001). With ageing, ITMI increased even in individuals with a high FN. The results suggest that FN may negatively affect adherence to the MD, lowering its potential health benefits, in the adult population. Monitoring of food habits, dietary education, and anxiety management, may be valuable tools to control FN and support the adherence to the MD.

Dietary Attitude of Adults with Type 2 Diabetes Mellitus in the Kingdom of Saudi Arabia:A Cross-sectional study

Background and Objectives: There is a paucity of literature on the dietary attitude (DA) of patients with type 2 diabetes in the Kingdom of Saudi Arabia (KSA). Although the prevalence of diabetes mellitus (DM) is high in Gulf countries, there remains a lack of understanding of the importance of dietary behavior in diabetes management among patients. Understanding the behavior of patients with diabetes towards the disease requires knowledge of their DA. Therefore, this study aimed to assess and evaluate the DA of type 2 diabetes patients, and it is the first of its kind in the KSA. Material and Methods: An analytical cross-sectional study was conducted among 350 patients with type 2 diabetes. A self-administered DA questionnaire was used to collect the data. Psychometric properties of the questionnaire were assessed by face validity, content validity, exploratory factor analysis, and internal consistency reliability. The data were collected using a systematic random sampling technique. Results: The overall DA of the patients was inappropriate (p = 0.014). Patients had an inappropriate DA towards food selection (p = 0.003), healthy choices(p = 0.005), food restraint (p < 0.001), health impact (p < 0.001), and food categorization (p = 0.033). A poor DA was also observed in relation to the consumption of red meat(p < 0.001), rice (p < 0.001), soup and sauces (p = 0.040), dairy products (p = 0.015), and junk food(p < 0.001). Conclusions: It is highly recommended that patients with diabetes receive counseling with an empowerment approach, as this can bring about changes in their dietary behavior, which is deeply rooted in their daily routine. Healthcare providers should also be well-informed about patients' attitudes and beliefs towards diabetes to design tailored educational and salutary programs for this specific community. Diabetes self-management educational programs should also be provided on a regular basis with a special emphasis on diet and its related components.

Individual Differences in Sweetness Ratings and Cross-Modal Aroma-Taste Interactions

Aroma-taste interactions, which are believed to occur due to previous coexposure (concurrent presence of aroma and taste), have been suggested as a strategy to aid sugar reduction in food and beverages. However, coexposures might be influenced by individual differences. We therefore hypothesized that aroma-taste interactions vary across individuals. The present study investigated how individual differences (gender, age, and sweet liker status) influenced the effect of aroma on sweetness intensity among young adults. An initial screening of five aromas, all congruent with sweet taste, for their sweetness enhancing effect was carried out using descriptive analysis. Among the aromas tested, vanilla was found most promising for its sweet enhancing effects and was therefore tested across three sucrose concentrations by 129 young adults. Among the subjects tested, females were found to be more susceptible to the sweetness enhancing effect of vanilla aroma than males. For males, the addition of vanilla aroma increased the sweet taste ratings significantly for the 22–25-year-olds, but not the 19–21-year-olds. Consumers were clustered according to their sweet liker status based on their liking for the samples. Although sweet taste ratings were found to vary with the sweet liker status, aroma enhanced the sweetness ratings similarly across clusters. These results call for more targeted product development in order to aid sugar reduction.

Organic Consumer Choices for Nutrient Labels on Dried Strawberries among Different Health Attitude Segments in Norway, Romania, and Turkey

Consumer interest towards healthy food is driving the growth of the organic food market because consumers perceive organic food products to improve their personal health. Berries have well-known health benefits and show increasing market shares in European markets. This manuscript investigates for the first time how health attitudes relate to organic consumers’ choices for nutrient labels of organic dried strawberry products. We conducted an online survey with 614 consumers from Norway, Romania, and Turkey. All participants consumed and liked strawberries and purchased organic food at least once a month. Participants filled out attitudinal questionnaires and conducted an experimental choice task featuring paired images of packaged organic dried strawberries varying in nutrients content label and other factors. The pooled sample was split into three groups of varying health attitudes for profiling and choice analysis. The results show that broad variations exist in health attitudes among Norwegian, Romanian, and Turkish organic consumers. A non-linear effect of health attitude is revealed, where a moderate health attitude is more strongly associated with the selection of products with increased nutrients content than either a low or a high health attitude. The results highlight the complexity in targeting nutrition labels to organic consumers. Finally, implications and suggestions for organic food operators are discussed along with future research avenues.

Colouring perception: Package colour cues affect neural responses to sweet dairy drinks in reward and inhibition related regions

Extrinsic product cues such as package colour may change product perception and perceived reward value during product evaluation. Healthier foods (i.e., 'light', sugar- or fat-reduced) often have different packages than regular products, e.g., they may be less vibrantly coloured. People vary in their degree of health-interest and self-control ability and may be affected differently by package colour. This study assesses the extent to which package colour and participant characteristics interact and influence product perception and brain responses. Thirty-four healthy females performed a functional MRI task in which they viewed four differently coloured packages (regular vs. healthier; differing in brightness and saturation levels) with or without simultaneously tasting a either a regular or a healthier calorie-reduced drink. Results indicate main effects of package and taste and a package*taste interaction effect. Compared to healthier packages viewing regular packages enhanced activation in region implicated in inhibitory control (inferior frontal gyrus) and a reward-related region (striatum), the latter even more so as participants' health interest increased (r = 0.43, p = 0.01). Incongruent package-taste combinations decreased activation in the orbitofrontal cortex (OFC, a region implicated in reward representation) compared to congruent combinations. Tasting the healthier compared to regular product enhanced activation in the middle and superior frontal gyrus, which are implicated in inhibitory control, as well as the striatum and OFC, suggesting a cognitively driven preference for the healthier product. In conclusion, this paper provides evidence for the conditions under which package colour and taste properties modulate neural correlates related to reward and inhibition. Individual differences in health-interest and impulsivity influence package- and taste-related neural correlates and thus underscore the importance of taking participant characteristics into account in food research.

Mobile Phone App for Self-Monitoring of Eating Rhythm: Field Experiment

Background

Temporal aspects of eating are an integral part of healthy eating, and regular eating has been associated with good diet quality and more successful weight control. Unfortunately, irregular eating is becoming more common. Self-monitoring of behavior has been found to be an efficient behavioral change technique, but the solution should be simple enough to ensure long-lasting adherence.

Objective

This study aimed to explore the influence of self-monitoring of daily eating pattern with mobile phone app on eating rhythm, eating behavior tendencies, and the underlying motives and attitudes related to eating.

Methods

A mobile phone app, Button, was developed for effortless self-monitoring of eating rhythm. The feasibility of the app was tested in a 30-day intervention. The participants (N=74) recorded their eating occasions during the intervention by pressing a button in the app widget.

Results

The average interval between meals increased (96 [SD 24] min during the first 10 days vs 109.1[SD 36.4] during the last 10 days) and the number of daily eating occasions decreased (4.9 [SD 0.9] during the first 10 days vs 4.4 [SD 0.9] during the last 10 days). The tendencies for cognitive restraint, emotional eating, and uncontrolled eating increased. Eating-related attitudes and motives remained largely unchanged.

Conclusions

These results indicate that a simple self-monitoring tool is able to draw a user’s attention to eating and is a potential tool to aid people to change their eating rhythm.

Understanding How Consumers Categorise Health Related Claims on Foods: A Consumer-Derived Typology of Health-Related Claims

The Nutrition and Health Claims Regulation (NHCR) EC No 1924/2006 aims to provide an appropriate level of consumer protection whilst supporting future innovation and fair competition within the EU food industry. However, consumers’ interpretation of health claims is less well understood. There is a lack of evidence on the extent to which consumers are able to understand claims defined by this regulatory framework. Utilising the Multiple Sort Procedure (MSP), a study was performed (N = 100 participants across five countries: Germany, the Netherlands, Slovenia, Spain and the United Kingdom) to facilitate development of a framework of health-related claims encompassing dimensions derived from consumers. Our results provide useful insight into how consumers make sense of these claims and how claims may be optimised to enhance appropriate consumer understanding. They suggest consumers may not consciously differentiate between a nutrition claim and a health claim in the way that regulatory experts do and provide insight into where this might occur. A consumer-derived typology of health-related claims based on three key dimensions is proposed: (1) Familiarity with the nutrient, substance or food stated in the claim; (2) statement type in terms of simplicity/complexity; (3) relevance of the claim, either personally or for a stated population group.

The influence of front-of-pack nutrition information on consumers' portion size perceptions

Issue addressed Portion size guidance strategies have been suggested as an important component of weight management; therefore, the Health Star Rating (HSR) front-of-pack labels could influence consumers' portion-size decisions. However, this has not been investigated to date. This study aims to evaluate whether presenting energy content information and HSRs influences portion size self-selection of specific foods and meals. Methods Adults were randomly assigned to one of three experimental groups in this randomised controlled experiment. Each participant was given either a kJ/100g food label or a HSR label, or was given no information on nutrient composition. They were then asked to serve themselves an adequate portion of breakfast cereal (Kellogg's Nutri-Grain), fruit salad and chocolate, plus a three-component meal (chicken, fries and mixed vegetables). Portion serves and meal weights were compared between each experimental group using ANOVA and the discretionary foods were also compared with the Australian Guide to Healthy Eating (AGHE). Results Neither the kilojoule nor HSR information influenced the self-served portion size of foods or meal components. Mean self-served portion size of the discretionary foods were significantly greater than the standard serving sizes as specified in the AGHE. Conclusion Although food labels have the potential to assist consumers in making product choices, this study indicates that presenting nutrition information does not affect portion size decisions in young adults. So what? Strategies that assist consumers to choose appropriate portion sizes should be developed as a weight management tool.

People Believe and Behave as if Consumers of Natural Foods Are Especially Virtuous

We examined here whether people believe consumers of natural foods are more virtuous than consumers of unnatural foods. In Study 1, we asked student participants (n = 84; 77 female, M age = 19.5) to form an impression of another person based solely upon whether they ate natural or unnatural foods, these being determined in a pilot survey. On an open-response format, participants reported more positive moral and health traits in consumers of natural foods. These findings were further confirmed using rating-based evaluations. In Study 2, we determined if this belief in the virtuousness of natural food consumers translated into behavior. Student participants (n = 40; 25 female, M age = 20.2) played a trust game, exchanging tokens with a fictitious player. Incidental diet information about the fictitious player was provided, with participants in one group playing against a natural food consumer and those in another against an unnatural food consumer. Participants who played against a natural food consumer behaved as if they trusted this person more, and their performance on the game was predicted by how moral they felt the fictitious player was, but not by other attributes such as health. These findings suggest that people believe consumers of natural food are more virtuous, and we suggest this is driven by the altruistic attitudes that people believe to be associated with natural food consumption.

The Impact of Nutrition and Health Claims on Consumer Perceptions and Portion Size Selection: Results from a Nationally Representative Survey

Nutrition and health claims on foods can help consumers make healthier food choices. However, claims may have a ‘halo’ effect, influencing consumer perceptions of foods and increasing consumption. Evidence for these effects are typically demonstrated in experiments with small samples, limiting generalisability. The current study aimed to overcome this limitation through the use of a nationally representative survey. In a cross-sectional survey of 1039 adults across the island of Ireland, respondents were presented with three different claims (nutrition claim = “Low in fat”; health claim = “With plant sterols. Proven to lower cholesterol”; satiety claim = “Fuller for longer”) on four different foods (cereal, soup, lasagne, and yoghurt). Participants answered questions on perceived healthiness, tastiness, and fillingness of the products with different claims and also selected a portion size they would consume. Claims influenced fillingness perceptions of some of the foods. However, there was little influence of claims on tastiness or healthiness perceptions or the portion size selected. Psychological factors such as consumers’ familiarity with foods carrying claims and belief in the claims were the most consistent predictors of perceptions and portion size selection. Future research should identify additional consumer factors that may moderate the relationships between claims, perceptions, and consumption.

Consumers' willingness to buy innovative traditional food products: The case of extra-virgin olive oil extracted by ultrasound

Innovation is fundamental for all agri-food companies to increase competitiveness, however the industrial process of extra virgin olive oil (EVOO) has changed very little over the last few decades. As it is a traditional food product (TFP), the main obstacle to innovation is precisely its traditional nature. According to the literature, any innovation regarding TFPs should be considered in terms of the specific product, and market success mainly depends upon the perceptions and traits of consumers. The present study evaluated the willingness of consumers to buy an innovative EVOO obtained by ultrasound extraction (ultrasonic EVOO) through an ordered logit model. The sample was composed by 961 EVOO consumers. The average age of respondents was 39 and the majority were female (55.4%). At first, the respondents reacted almost equally to the idea of buying ultrasonic EVOO, with 49% of the sample stating they were not willing to buy the product and 51% stating that they were willing to. The major insight from our study is that consumers who are the most willing to buy the product are those who formed a positive quality perception after being introduced to the key characteristics of the new product. In addition, the willingness to buy seems to be higher for consumers who prefer EVOO with a fruity flavour and without a sweet taste, for consumers who attach great importance to the taste of food and with a higher than average educational level. This predominant role of consumers' perception in the case of innovative TFPs should, thus, be researched further.

The effects of acceptance and commitment therapy on eating behavior and diet delivered through face-to-face contact and a mobile app: a randomized controlled trial

Background

Internal motivation and good psychological capabilities are important factors in successful eating-related behavior change. Thus, we investigated whether general acceptance and commitment therapy (ACT) affects reported eating behavior and diet quality and whether baseline perceived stress moderates the intervention effects.

Methods

Secondary analysis of unblinded randomized controlled trial in three Finnish cities. Working-aged adults with psychological distress and overweight or obesity in three parallel groups: (1) ACT-based Face-to-face (n = 70; six group sessions led by a psychologist), (2) ACT-based Mobile (n = 78; one group session and mobile app), and (3) Control (n = 71; only the measurements). At baseline, the participants’ (n = 219, 85% females) mean body mass index was 31.3 kg/m² (SD = 2.9), and mean age was 49.5 years (SD = 7.4). The measurements conducted before the 8-week intervention period (baseline), 10 weeks after the baseline (post-intervention), and 36 weeks after the baseline (follow-up) included clinical measurements, questionnaires of eating behavior (IES-1, TFEQ-R18, HTAS, ecSI 2.0, REBS), diet quality (IDQ), alcohol consumption (AUDIT-C), perceived stress (PSS), and 48-h dietary recall. Hierarchical linear modeling (Wald test) was used to analyze the differences in changes between groups.

Results

Group x time interactions showed that the subcomponent of intuitive eating (IES-1), i.e., Eating for physical rather than emotional reasons, increased in both ACT-based groups (p = .019); the subcomponent of TFEQ-R18, i.e., Uncontrolled eating, decreased in the Face-to-face group (p = .020); the subcomponent of health and taste attitudes (HTAS), i.e., Using food as a reward, decreased in the Mobile group (p = .048); and both subcomponent of eating competence (ecSI 2.0), i.e., Food acceptance (p = .048), and two subcomponents of regulation of eating behavior (REBS), i.e., Integrated and Identified regulation (p = .003, p = .023, respectively), increased in the Face-to-face group. Baseline perceived stress did not moderate effects on these particular features of eating behavior from baseline to follow-up. No statistically significant effects were found for dietary measures.

Conclusions

ACT-based interventions, delivered in group sessions or by mobile app, showed beneficial effects on reported eating behavior. Beneficial effects on eating behavior were, however, not accompanied by parallel changes in diet, which suggests that ACT-based interventions should include nutritional counseling if changes in diet are targeted.

Trial registration

ClinicalTrials.gov (NCT01738256), registered 17 August, 2012.

Electronic supplementary material

The online version of this article (10.1186/s12966-018-0654-8) contains supplementary material, which is available to authorized users.

Health- and Taste-Related Attitudes Associated with Dietary Patterns in a Representative Sample of Polish Girls and Young Women: A Cross-Sectional Study (GEBaHealth Project)

Attitudes can be predictors of certain health-related behaviours. The attitudes of young females towards health and taste have not been yet fully examined and their associations with dietary behaviours remain unclear. The aim of the study was to investigate if attitudes are associated with dietary patterns in a representative sample of Polish girls. The study population consisted of 1107 girls, aged 13-21 and living in Poland. Attitudes were assessed using the Health and Taste Attitudes Scale (HTAS) and categorised as negative, neutral or positive. Dietary data was obtained using a Food Frequency Questionnaire. Dietary patterns (DPs), derived previously with a Principal Component Analysis (PCA), were 'Traditional Polish', 'Fruit and vegetables', 'Fast food and sweets' and 'Dairy and fats'. The associations between attitudes and DPs were assessed using Spearman's correlation coefficients and logistic regression. The reference group were girls with neutral attitudes. Odds ratios (ORs) were adjusted for age, socioeconomic status (SES), and body mass index (BMI). The correlations between attitudes and DPs ranged from -0.28 for attitudes towards health and 'Fast food and sweets' and 'Traditional Polish' DPs to 0.33 for attitudes towards health and the 'Fruit and vegetables' DP (p < 0.05). In the logistic regression analysis, the strongest associations within health-related HTAS subscales were observed between negative attitudes towards natural products and the 'Fast food and sweets' DP (OR: 10.93; 95% CI: 3.32-36.01) and between positive attitudes towards health and the 'Fruit and vegetables' DP (OR: 5.10; 3.11-8.37). The strongest associations within taste-related HTAS subscales were observed between positive attitudes towards craving for sweet foods and the 'Traditional Polish' DP (OR: 1.93; 1.43-2.61) and between positive attitudes towards using food as a reward and the 'Dairy and fats' DP (OR: 2.08; 1.22-3.55) as well as the 'Fast food and sweets' DP (OR: 2.07; 1.14-3.74). Positive attitudes towards health were associated with a pro-healthy dietary pattern characterised by the consumption of fruit and vegetables, while negative attitudes towards natural products as well as a strong craving for sweets and using food as a reward were associated with less healthy dietary patterns. To improve the dietary habits of girls and young women, positive attitudes towards health should be strengthened and supported by emphasizing the sensory values of pro-healthy foods.

Food Integrity and Food Technology Concerns in Canada: Evidence from Two Public Surveys

Food integrity and food technologies both generate public concerns. There is little research to show the interactions between those concerns in particular samples, especially in Canada. In this paper, data from two national online samples are used to examine an aggregate of food integrity concerns, genetic modification in food, and food nanotechnology concerns in the Canadian public. A variety of trust, health, environmental, and science attitude variables are used to help explain the concerns that vary across the population. In addition, the food integrity concerns are tested as explanatory variables in the technology concern models to establish whether there is a strong or weak link between the two. Tobit and ordered probit regressions are used to model the variables for each of the survey samples. Results are examined to see if they are consistent across surveys and also consistent with an earlier study that was done in Australia. The results suggest that trust in people and trust in a variety of agents within the food system are beliefs that ameliorate concerns about food integrity and the two technologies. However, trust in advocacy organizations appears to be related to higher concerns in each case. Fundamentally and similar to the earlier Australian study, positive scientific attitudes are a major determinant of reduced concerns about food integrity and the two technologies.