Nutrition knowledge, and use and understanding of nutrition information on food labels among consumers in the UK

Development and validation of a photograph-based instrument to assess nutrition literacy: The NUTLY project

Most instruments measuring nutrition literacy evaluate theoretical knowledge, not necessarily reflecting skills relevant to food choices. We aimed to develop and validate a photograph-based instrument to assess nutrition literacy (NUTLY) among adults in Portugal. NUTLY assesses the ability to distinguish foods with different nutritional profiles; from each of several combinations of three photographs (two foods with similar contents and one with higher content) participants are asked to identify the food with the highest energy/sodium content. The NUTLY version with 79 combinations, obtained after experts/lay people evaluations, was applied to a sample representing different age, gender and education groups (n = 329). Dimensionality was evaluated through latent trait models. Combinations with negative or with positive small factor loadings were excluded after critical assessment. Internal consistency was measured using Cronbach's alpha and construct validity by comparing NUTLY scores with those obtained in the Medical Term Recognition Test and the Newest Vital Sign (NVS), and across education and training in nutrition/health groups. The cut-off to distinguish adequate/inadequate nutrition literacy was defined through ROC analysis using the Youden index criterion, after performing a Latent class analysis which identified a two-class model to have the best goodness of fit. Test-retest reliability was assessed after one month (n = 158). The final NUTLY scale was unidimensional and included 48 combinations (energy: 33; sodium: 15; α = 0.74). Mean scores (±standard deviation) were highest among nutritionists (39.9 ± 4.4), followed by health professionals (38.5 ± 4.1) and declined with decreasing education (p < 0.001). Those with adequate nutrition literacy according to NVS showed higher NUTLY scores (37.9 ± 4.3 vs. 33.9 ± 6.9, p < 0.001). Adequate nutrition literacy was defined as a NUTLY score≥35 (sensitivity: 89.3%; specificity: 93.7%). Test-retest reliability was high (ICC = 0.77). NUTLY is a valid and reliable nutrition literacy measurement tool.

Association between nutritional literacy and nutrition label use in Chinese community residents

Introduction

Nutritional literacy (NL) has a critical influence on food choices. The objective of the present study was to examine the association of NL with nutrition label use.

Methods

A cross-sectional study was conducted in Bengbu, China. In total, 955 adults were interviewed using a questionnaire designed for the present study to collect information on demographics, lifestyle, nutrition label use, and NL. Binary logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (CI) for nutrition label use and its predictive variables.

Results

In total, 40.4% of the participants reported looking at nutrition label when purchasing prepackaged foods. NL was significantly positively associated with nutrition label use and specifically with checking nutrition facts table, purported nutrition benefits and purported health benefits. In terms of specific facets of NL, nutrition knowledge, applying skills, and critical skills were associated with nutrition label use. After stratification by monthly income and education, the association between NL and nutrition label use was discovered only in individuals with low monthly income. Additionally, nutrition knowledge was associated with nutrition label use only in adults with high education level, whereas applying skills were associated with nutrition label use only in those with low education level.

Conclusion

The use of nutrition label remains low among Chinese community residents, especially the purported nutritional benefits and purported health benefits. NL is positively associated with nutrition label use, especially with respect to functional and critical NL, with differences based on socioeconomic status. The findings highlight the need for NL interventions targeting individuals with different levels of education and income to encourage use of nutrition label in China.

Self -reported knowledge and understanding of added sugars by consumers in Ghana

The consumption of added sugars has been a major concern among consumers and researchers around the world. Some of these added sugars pose health threats such as obesity, and liver diseases to consumers. Therefore, consumers' understanding and knowledge of added sugars is important in regulating the intake of food items that contain different types and levels of added sugar. In this study, the knowledge and understanding of staff (consumers) of the University of Energy and Natural Resources, Ghana, was assessed through survey The results showed that about 38.5 % of consumers always read food labels whereas 3.1 % never read the labels of food they purchased. However, only about 20 % of consumers considered added sugars as most important information on food labels while most (about 38 %) were concerned about the calorie level in food items purchased. Based on the consumer's knowledge of sugars and sweeteners, there was a high level of disparity in classifying sugars in food as sugars and sweeteners. In addition, most consumers reported that they would adversely avoid food items containing lactose, isoglucose, and saccharin. The awareness of the consumers to the WHO recommendation for sugar reduction, the gender (P = 0.278), age (P = 0.959), level of education (P = 0.888), and staff category (P = 0.944) did not influence their decisions on purchasing food items with added sugars Most consumers were interested in issues of food and nutrition. Therefore, it is recommended that staff are taken through aspects of food nutrition as well as the consumption of added sugar towards the recommended levels.

Predicting willingness to consume healthy brand foods using the theory of planned behavior: the role of nutritional literacy

Introduction

The willingness to consume healthy foods has highlighted the growing importance of health, even more so when it comes to food choice, and predicting the willingness to consume foods of a healthy brand represents an action that leads to the practice of conscious eating habits, but what is behind this willingness? To answer this question and based on previous studies such as the theory of planned behavior and nutritional literacy, this study aimed to build a predictive model through an empirical study to examine the influence of nutritional literacy (NL) on attitude (ATT), subjective norm (SN) and perceived behavioral control (PBC), as well as to determine the influence of the three variables of the theory of planned behavior (TPB) on the willingness to consume healthy brand foods (WCHBF) in the Peruvian market.

Methods

The research focused on the population that stated that they were consumers of the Unión brand (a brand whose value proposition is the sale of healthy foods), obtaining 482 consumers. The study was conducted under a quantitative, non-experimental, cross-sectional design approach.

Results

The results support the existence of a positive and significant effect of NL on ATT, SN, and PBC, finding the exact behavior of SN and PBC in WCHBF; however, in the proposed model, it is observed that ATT has no impact on WCHBF.

Conclusion

Applying strategies that lead to a change in consumer behavior towards healthy brands is a matter of time and will. In this context, the findings indicate that nutritional literacy plays an essential role in the willingness to consume healthy foods, which sheds more light on the design of educational interventions and awareness campaigns that independently inform about nutritional benefits and empower consumers, allowing them to make informed and healthy choices.

Incidence of traffic light labelling on noncommunicable diseases: a roadmap for achieving sustainable development

The production and diversity of the supply of food products has grown exponentially in recent decades, along with the increase in cardiovascular diseases associated with poor diet. Among the factors, one of the most important is the lack of information for the consumer when purchasing. The present work evaluates the impact of implementing the traffic light labelling of foods in reducing deaths due to Noncommunicable Diseases (NCD). Econometric techniques of two-way effects panel data from 21 Ecuadorian provinces taken from official sources for the analysis period 2010-2019. For Ecuador, a favourable impact was found in the reduction of the NCD mortality rate, especially in the last three years; in 2017, it was reduced by 0.129%, in 2018 by 0.305%, and in 2019 by 0.289%. An implication of economic policy is the advertising regulation of products that may affect health, strengthening surveillance and sanctioning companies that fail to comply with the regulation.

The neural model of front-of-package label processing

Front-of-package (FOP) labels have been adopted in many countries to battle the obesity pandemic and its serious health consequences by providing clearer and easier-to-understand nutrition and health information. The effectiveness of FOP labels has been generally confirmed, with some contextual and individual factors modifying their effectiveness. Existing theories (eg, the dual-process theory) and shifting priorities for self-control, provide some explanations for the FOP label effect. However, the cognitive and neural mechanisms underlying the processing of FOP labels remain unknown. Here, a new model, namely, the neural model of FOP label processing, has been proposed to fill this gap by providing an integrated account of FOP label processing while simultaneously considering multiple important situational and individual factors in the same framework. This neural model is built on the core eating network (ie, the ventral reward pathway and the dorsal control pathway) for food cue processing and actual food consumption. The new model explains how FOP labels may facilitate attention, influence the core eating network, and thus alter food choices. It also demonstrates how motivation may modify FOP label processing in 2 ways: affecting attention (the indirect way) and changing the process of evaluating the food (the direct way). It further explains how some contextual and individual factors (eg, ego depletion, time pressure, and health knowledge) influence the process. Thus, the neural model integrates evidence from behavioral, eye-tracking, and neuroimaging studies into a single, integrated account, deepening understanding of the cognitive and neural mechanisms of FOP label processing. This model might facilitate consensus on the most successful FOP label. Moreover, it could provide insights for consumers, food industries, and policy makers and encourage healthy eating behaviors.

Public awareness, attitude, and practice regarding food labeling, Alexandria, Egypt

BACKGROUND

Food labeling is an important public health tool allowing consumers to make informed and healthy choices. Considering how important it is for consumers to be aware of food labels while choosing healthy foods, this study aims at assessing public awareness, attitude, and practice regarding food labeling in Alexandria Governorate, Egypt.

METHODS

A cross sectional study using a predesigned interview questionnaire to collect data from 719 adult consumers from both sexes (28.2% males: 71.8% females), recruited from different branches of one of the largest supermarkets in Alexandria.

RESULTS

More than half of the participants (55.6%) reported reading food labels. The most frequently read information was production/ expiry date (76.8%), product name (68.3%), and ingredients (38.0%) while the least frequently read was nutritional facts (29.9%). More than half of the study sample (50.9%) had low awareness about the content of food labels, nevertheless, having higher scores on awareness about food labels predicted reading practice. Nearly three-quarters of the respondents had average to good food label reading practice. Most respondents (81.8%) had a favorable attitude about food labeling in its present form, however, higher attitude scores did not seem to influence their use of food labels. Being older (β = 0.045, CI; 0.014-0.076, p = 0.005), being female (β = 1.162, CI; 0.541-1.784, p = 0.000), having secondary education or equivalent (β = 1.042,CI; 0.050-2.034, p = 0.040), having university education or beyond (β = 3.090, CI; 2.132-4.048, p = 0.000), and having higher scores on awareness about food labels (β = 1.407, CI; 1.324-1.490, p = 0.000) were significant predictors of reading food labels.

CONCLUSIONS

Most of the studied consumers had a positive attitude towards food labeling, however, more than half of them had low awareness of food labeling content. Nutritional facts were the least frequently read by consumers. Reading food labels was significantly predicted by having higher education, being older, being a female, and having better awareness.

The combined effect of front-of-package labels and influencer recommendations on food choice decisions

Many governments have adopted front-of-pack nutrition labels (FOP labels) that give advice about how healthy a product is. An increasing number of digital food influencers are also informing consumers about the nutritional quality of products and promoting healthy consumption. In this context, the current study analyzes how both sources of information come together to affect purchase intention. Drawing on congruence theory, we propose that the influencer's recommendation reinforces the effect of the FOP label when there is congruence between the two; however, consumers clearly prefer to follow the recommendation of the influencer over the FOP label when the information sources are non-congruent. We develop a between-subjects experimental design in which the level of congruence between the two information sources is manipulated. The effect of the influencer on purchase intention is mediated by the credibility of the FOP label. A second study confirms the superiority of the influencer effect observed in the first study.

Feasibility of a Community Healthy Eating and Cooking Intervention Featuring Traditional African Caribbean Foods from Participant and Staff Perspectives

Culturally appropriate healthy eating resources are intended to help people from different ethnic backgrounds consume diets reflecting government dietary recommendations, yet evidence on use in the target groups is lacking. This study evaluated the feasibility of a new brief culturally appropriate community intervention that aimed to introduce food-based healthy eating and recipe resources featuring African Caribbean foods, which were recently co-developed with people from these ethnic backgrounds. Working with a community organization in the UK, a single-arm study was used to collect verbal data from participants and staff on the acceptability of intervention whilst knowledge, skills and behaviours related to healthy eating were evaluated using pre-, post- and follow-up questionnaires. A total of 30 participants were recruited, and 22 completed all three questionnaires; who were mostly female aged 55 years+ (n = 17) and of African Caribbean ethnicity (45%, n = 10), with 32% (n = 7) reporting no educational attainment. At post-intervention and follow-up, most participants reported high satisfaction (n = 21, 95%) with the intervention sessions and high levels of confidence in using the resources at home within budget. The number of participants who were familiar with the healthy eating guidance featuring Caribbean foods increased from pre- (36%, n = 8) to post-intervention/follow-up (n = 22, 100%) (p < 0.05). Findings suggest the intervention is feasible in a community setting and could help increase awareness and use of culturally appropriate healthy eating guidance amongst a diverse group.

South African Consumers' Knowledge, Opinions and Awareness of Whole Grains and Their Health Benefits: A Cross-Sectional Online Survey

Evidence indicates that whole-grain food consumption reduces the risk of cardiovascular disease, type-2 diabetes, and some cancers. Increasing whole-grain consumption in developing countries is likely to significantly benefit the health of the population. However, there is very limited information on consumer whole-grain knowledge, attitudes, and behaviors in developing countries. An online cross-sectional survey was conducted among 1000 South African consumers with sufficient income to make food purchase choices and who were generally representative in terms of gender, age, and ethnicity. Most respondents (64%) were confident of their whole-grain knowledge. However, 60% of all participants selected incorrect definitions of whole grains. Whilst most correctly identified common cereals as whole grains, at most 50% of participants correctly identified common whole-grain foods. Also, whilst most (67%) thought that they were consuming enough whole grains, the majority (62%) underestimated the recommended level of consumption. Furthermore, respondent knowledge regarding whole-grain food attributes and the health benefits of whole-grain consumption was generally poor. Clearly, consumer-focused strategies are needed in developing countries to increase whole-grain food consumption to help the broader population achieve a healthy and sustainable diet. Actions proposed include: simple-to-understand information on whole-grain content relative to recommendations on food product labels, the provision of whole-grain foods in school nutrition schemes, and coordinated social and behavior change communication initiatives.

Efficacy of front-of-pack warning label system versus guideline for daily amount on healthfulness perception, purchase intention and objective understanding of nutrient content of food products in Guatemala: a cross-over cluster randomized controlled experiment

BACKGROUND

Front-of-package warning labels (FOPWL) have been adopted in many countries aiming at reducing the consumption of unhealthy food and drink products and have also been considered in Guatemala. The aim of the study is to evaluate the efficacy of FOPWL versus Guidelines for Daily Amount (GDA) on products' healthfulness perception (HP), purchase intention (PI) and the objective understanding of the nutrient content (UNC) in Guatemala.

METHODS

Participants (children and adults) (n = 356) were randomly assigned to evaluate either FOPWL or GDA during a crossover cluster randomized experiment in rural and urban areas across 3 phases of exposure. During phase 1, participants evaluated mock-up images of single products (single task) and compared pairs of products within the same food category (comparison task) without any label. In phase 2, participants evaluated labels only (without any product), and during phase 3, they evaluated the same products and questions from phase 1, now depicting the assigned front-of-package label. We generated indicators for single-task questions and scores for comparison tasks, one for each HP, PI and UNC questions. We used intention-to-treat, difference-in-difference regression analysis to test whether exposure to FOPWL was associated with HP, PI and UNC, compared to GDA. We also tested models for children and adults and by area (rural/urban) separately adjusting for sociodemographic variables.

RESULTS

In single tasks, FOPWL significantly decreased the PI (β -18.1, 95%CI -23.3, -12.8; p < 0.001) and the HP (β -13.2, 95%CI -18.4, -7.9; p < 0.001) of unhealthy food products compared to GDA. In the comparison task, FOPWL significantly increased the UNC (β 20.4, 95%CI 17.0, 23.9; p < 0.001), improved PI towards healthier choices (OR 4.5, 95%CI 2.9, 7.0 p < 0.001) and HP (OR 5.6, 95%CI 2.8, 11.1; p < 0.001) compared to GDA. Similar results were found in children and adults and in urban and rural settings.

CONCLUSIONS

FOPWL reduces products' healthfulness perception and purchase intention, and increases understanding of products' nutrient content compared to GDA.

Kilocalorie labelling in the out-of-home sector: an observational study of business practices and consumer behaviour prior to implementation of the mandatory calorie labelling policy in England, 2022

BACKGROUND

Regulations mandating kilocalorie (kcal) labelling for large businesses in the out-of-home food sector (OHFS) came into force on 6th April 2022 as a policy to reduce obesity in England. To provide indicators of potential reach and impact, kcal labelling practices were studied in the OHFS, and customer purchasing and consumption behaviours prior to implementation of the mandatory kcal labelling policy in England.

METHODS

From August-December 2021, large OHFS businesses subject to the kcal labelling regulations were visited prior to regulations coming into force on 6th April 2022. 3308 customers were recruited from 330 outlets and collected survey information on the number of kcal purchased and consumed by customers, customers' knowledge of the kcal content of their purchases, and customers noticing and use of kcal labelling. In a subset of 117 outlets, data was collected on nine recommended kcal labelling practices.

RESULTS

The average number of kcals purchased (1013 kcal, SD = 632 kcal) was high with 69% of purchases exceeding the recommendation of a maximum of 600 kcal per meal. Participants underestimated the energy content of their purchased meals by on average 253 kcal (SD = 644 kcals). In outlets providing kcal labelling in which customer survey data was collected, a minority of customers reported noticing (21%) or using (20%) kcal labelling. Out of the 117 outlets assessed for kcal labelling practices, 24 (21%) provided any in-store kcal labelling. None of the outlets met all nine aspects of recommended labelling practices.

CONCLUSIONS

Prior to implementation of 2022 kcal labelling policy, the majority of sampled OHFS large business outlets in England did not provide kcal labelling. Few customers noticed or used the labels and on average customers purchased and consumed substantially more energy than recommended in public health guidelines. The findings suggest that reliance on voluntary action for kcal labelling implementation failed to produce widespread, consistent, and adequate kcal labelling practices.

Nutrition Literacy Level in Bank Employees: The Case of a Large Brazilian Company

Nutrition Literacy (NL) positively impacts diet quality and has the potential to promote health and prevent nutrition-related chronic diseases. Brazil is one of the countries with the highest rates of nutrition-related chronic diseases. Nevertheless, in Brazil, few studies have explored the NL levels of its population. To provide remote access to the Nutrition Literacy Assessment Instrument for Brazilians (NLit-Br) and assess Brazilian bank employees, we conducted a study to estimate the validity of the NLit-Br online and to investigate whether bank employees have an adequate NL level. In the first step, we randomly assigned 21 employees from three financial institution branches to two groups to complete NLit-Br paper and online versions. After an interval period, both groups completed the NLit-Br with an opposite delivery method (paper vs. online). We compared the validity of the digital and paper versions of the NLit-Br by the Intraclass Correlation Coefficient (ICC), and the reliability by Kuder-Richardson formula 20. Second, we evaluated 1174 bank employees using the NLit-Br online version. We found an excellent absolute agreement (ICC ≥ 0.75) between the paper and online versions. The questionnaire had good internal consistency (KR-20 = 0.64). The sample was characterized as mostly male (61.0%), married/cohabitant (73.8%), and white (69.8%), with high household income (85.2%), and graduated or postgraduate (97.4%). The mean age of the population was 42.1 (SD = 7.6) years. Subjects predominantly had possibly inadequate NL (62.3%). The online NLit-Br total score was significantly associated with gender, age, and household income (p < 0.05). Women and individuals with higher incomes had a higher degree of NL. Subjects over 50 years old had a lower degree of NL. There was no significant association between the NLit-Br score and the participants' education. The NLit-Br online is a valid instrument to assess NL remotely. The population studied showed a high prevalence of inadequacy of the NL. Therefore, there is a need for targeted actions to improve the NL of bank employees.

Advantages of graphical nutrition facts label: faster attention capture and improved healthiness judgement

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.

Inducing consumers to use calorie information: a multinational investigation

OBJECTIVE

We identify individuals who set daily intake budgets and examine if an intervention making people estimate their calorie intake up to a certain point in the day helps those setting daily budgets to regulate their calorie intake for the remainder of the day, after high prior consumption.

DESIGN

We conducted an online experiment in five countries: Australia, China, Germany, India, and the UK (n = 3,032) using a 2 (setting calorie budget: yes vs. no, measured) x 2 (intervention: intake reminder vs. control, manipulated) between-subjects design, with the amount of prior consumption measured. Participants were contacted in the afternoon. Those in the intervention condition were asked to estimate their prior calorie intake on that day.

MAIN OUTCOME MEASURES

We measured the individual characteristics of those who set daily calorie budgets and the intended calorie intake for the remainder of the day.

RESULTS

Among people who set daily calorie budgets, the intervention reduced intended calorie intake for the remainder of the day by 176 calories if they had already consumed a high amount of calories that day.

CONCLUSION

A timely intervention to estimate one's calorie intake can lower additional intended calorie intake among those who set daily calorie budget.

The association between cognitive ability and body mass index: A sibling-comparison analysis in four longitudinal studies

BACKGROUND

Body mass index (BMI) and obesity rates have increased sharply since the 1980s. While multiple epidemiologic studies have found that higher adolescent cognitive ability is associated with lower adult BMI, residual and unobserved confounding due to family background may explain these associations. We used a sibling design to test this association accounting for confounding factors shared within households.

METHODS AND FINDINGS

We used data from four United States general youth population cohort studies: the National Longitudinal Study of Youth 1979 (NLSY-79), the NLSY-79 Children and Young Adult, the NLSY 1997 (NLSY-97), and the Wisconsin Longitudinal Study (WLS); a total of 12,250 siblings from 5,602 households followed from adolescence up to age 62. We used random effects within-between (REWB) and residualized quantile regression (RQR) models to compare between- and within-family estimates of the association between adolescent cognitive ability and adult BMI (20 to 64 years). In REWB models, moving from the 25th to 75th percentile of adolescent cognitive ability was associated with -0.95 kg/m2 (95% CI = -1.21, -0.69) lower BMI between families. Adjusting for family socioeconomic position reduced the association to -0.61 kg/m2 (-0.90, -0.33). However, within families, the association was just -0.06 kg/m2 (-0.35, 0.23). This pattern of results was found across multiple specifications, including analyses conducted in separate cohorts, models examining age-differences in association, and in RQR models examining the association across the distribution of BMI. Limitations include the possibility that within-family estimates are biased due to measurement error of the exposure, confounding via non-shared factors, and carryover effects.

CONCLUSIONS

The association between high adolescent cognitive ability and low adult BMI was substantially smaller in within-family compared with between-family analysis. The well-replicated associations between cognitive ability and subsequent BMI may largely reflect confounding by family background factors.

Perceptions toward Plant-Based Milk Alternatives among Young Adult Consumers and Non-Consumers in Denmark: An Exploratory Study

The objective of this study was to determine associations among plant-based milk alternatives (PBMAs), sources of information on the PBMAs used, and the consumption of PBMAs among Danish young adult consumers and non-consumers of PBMAs. An online survey was conducted in May 2019. A total of 341 participants (consumers: n = 171; non-consumers: n = 170) aged 16-35 years old completed the survey. Most consumers drank less than one glass of PBMAs per week, and oat drink was the most frequently consumed PBMAs. Oat drinks were primarily consumed with coffee/tea or porridge, while soy drinks were preferred to be consumed alone. Participants who perceived PBMAs as natural, good for health, tasty, or nutritionally equal to cow's milk were more likely to be consumers of PBMAs. Additionally, participants who perceived PBMAs as highly processed or artificial were less likely to be consumers of PBMAs. For consumers, the most used sources of information on PBMAs were package labeling, followed by social media. The study´s results can help to improve marketing campaigns concerning the Danish retail of PBMA, whereby nutritional and sensory characteristics of PBMAs are highlighted through social networks and marketing strategies with product package labeling.

Status of nutrition labeling knowledge, attitude, and practice (KAP) of residents in the community and structural equation modeling analysis

Objective

Unhealthy foods were a major contributor to the occurrence of chronic non-communicable diseases. The promotion of nutrition labeling in the community can effectively help residents to choose healthy foods, which plays an important role in the prevention of chronic diseases. However, the public awareness of this measure is not clear. Our study used a structural equation model based on the KAP theory to analyze the interaction mechanisms among knowledge, attitude, and practice and aimed to evaluate the relationships among nutrition knowledge, attitude, and practice of residents, which can provide the basis of policy formulation for nutrition education and behavior intervention.

Methods

We carried out a cross-sectional study from May 2022 to July 2022 in the "Community Health Service Center", and each "Community Service Station" in Yinchuan use a self-designed questionnaire and convenience sampling to evaluate resident nutrition labeling KAP status. This study adopted the structural equation modeling approach to analyze a survey of Chinese individuals through the cognitive processing model, interrelated nutrition knowledge, nutrition label knowledge, attitude, and practice.

Results

According to the principle of sample size estimation, a total of 636 individuals were investigated, with the ratio of male to female being 1:1.2. The average score of community residents' nutrition knowledge was 7.48 ± 3.24, and the passing rate was 19.4%. Most residents had a positive attitude toward nutrition labeling, but the awareness rate was only 32.7% and the utilization rate was 38.5%. Univariate analysis showed that women had higher knowledge scores than men (p < 0.05), and young people had higher scores than older adults (p < 0.05), and the difference was significant. Based on the KAP structural equation model (SEM), residents' nutrition knowledge will directly affect their attitude toward nutrition labeling. Attitude played a greater role as an indirect effect between knowledge and behavior, while trust limits residents' practice of nutrition labeling and then affects their practice. It could be explained that nutrition knowledge was the prerequisite for label reading behavior, and attitude was the intermediary effect.

Conclusion

The nutrition knowledge and nutrition labeling knowledge of respondents hardly directly support the practice of nutrition labeling, but it can influence the use behavior by forming a positive attitude. The KAP model is suitable for explaining residents' use of nutrition labeling in the region. Future research should focus on better understanding the motivations of residents to use nutrition labeling and the opportunity to use nutrition labeling in real-life shopping settings.

The influence of front-of-pack nutritional labels on eating and purchasing behaviors: a narrative review of the literature

BACKGROUND

Front-of-Pack Nutritional Labels are considered a useful tool to help consumers orient themselves in their food choices and direct their behavior toward a healthier diet. FOPNL development and use are part of a framework that includes cognitive, biological, hedonic and cultural aspects, able to affect consumers' eating and purchasing behavior.

AIM

Given the complexity of the matter, the aim of this narrative review is to analyze the combination of different factors that drive food choices and eating behaviors and to highlight some aspects that are not fully studied.

METHODS

The authors conducted the research using a top-down approach at first, followed by a bottom-up approach; starting with general considerations about the purchasing process, gradually narrowing the discussion to a specific sub-population, and finally extending the discussion back to more general reasonings about the direction to adopt in future, or at least to evaluate, for effective communication.

RESULTS

Biases and attitudes toward food products were found to regularly interfere with buying behavior patterns, making it impossible to standardize an average consumer. This reflects in current research, increasing the complexity of the topic. All determinants influencing food choices are often assessed individually rather than in a synergistic and multidimensional context, while the purchasing scenario is characterized by multiple stimuli to which the consumer is subjected. FOPNLs' impact on perceived healthiness has been studied in different conditions, but some population subgroups have not been sufficiently represented. In particular, the effect of FOPNLs on consumers suffering from eating disorders is understudied and needs further attention. Furthermore, some approaches can be compared to "negative nutrition" or "loss-framed communication", putting nutrients out of context, emphasizing losses more than gains and risking promoting negative feelings in consumers.

CONCLUSION

Due to the heterogeneity of studies, evidence on what works best in driving people to adopt lasting lifestyle changes is still mixed. Science communicators and policymakers should consider the possibility that a multi-component approach incorporating nutrition information and education may be a key strategy to promote consumers' self-consciousness and to support them in their cognitive efforts toward a healthy and sustainable diet.

LEVEL OF EVIDENCE

Level V, narrative review.

Assessing Consumer Willingness to Pay for Nutritional Information Using a Dietary App

A healthy society is the foundation of development in every country, and one way to achieve a healthy society is to promote healthy nutrition. An unbalanced diet is one of the leading causes of noncommunicable diseases globally. If food was correctly selected and correctly consumed, both the problems of overeating and lack of nutrition could be largely solved while also decreasing public health costs. Interventions such as presenting necessary information and warning labels would help consumers make better food choices. Hence, providing nutritional information to consumers becomes essential. The present study investigates the importance of nutrition information labels on consumers' preferences by estimating their willingness to pay for features and information provided by a dietary software program (app). An application can easily display the information to the consumers and help them make informed food choices. A discrete choice experiment investigated consumers' preferences and willingness to pay to receive nutritional information. Mixed multinomial logit and latent class analysis were applied. The results showed the existence of heterogeneity in consumer preferences for different nutritional information provided by the application. Consumers are willing to pay more for salt and fat alerts. The results of this study allow for the analysis of consumers' interest in nutritional information. Such results are essential for the industry for future investments in similar applications that potentially could help consumers make better informed choices.

Effect of different front-of-package food labels on healthfulness perception of ultraprocessed food and intention to purchase the products- A randomised controlled trial

This study aimed to evaluate the effect of different labels on participants: identifying products high in nutrients of concern; identifying unhealthy products, and intention to purchase unhealthy products. This blinded randomised controlled trial included a representative sample of South African households (n = 1951). Per household we selected a member primarily responsible for food purchases. Participants were randomised into the Warning Label (WL), Guideline Dietary Amounts (GDA) or Multiple Traffic Light (MTL) arms. Each participant answered questions in a no label condition (control) followed by same questions in the label condition (experiment). Complete data were collected and analysed for 1948 participants (WL = 33.7%, GDA = 32.1% and MTL = 34.2%). The probability of correctly identifying products high in nutrients of concern and identifying products as being unhealthy was higher with the WL compared to the GDA or MTL for most items. There was no difference in performance between the GDA and the MTL when considering all items together. A higher percentage of participants reported a lower intention to purchase an unhealthy product after exposure to the WL compared to MTL for 5 out of 6 products; 2 out of 6 products for the WL compared to GDA and 2 out of 6 products for GDA compared to MTL. Compared to the control condition, exposure to each of the labels resulted in better identification of nutrients of concerns, unhealthy products and a lower intention to purchase when considering all specific outcome items together. The WL showed a higher potential to enable South African consumers to identify products high in nutrients of concern, identify unhealthy products and discourage purchasing of unhealthy products.

Consumers' Response to Sugar Label Formats in Packaged Foods: A Multi-Methods Study in Brazil

Providing information about the sugar content of packaged foods on product labels is an important strategy to lower consumers' sugar intake. This study assessed the effect of exposure to different sugar labels on consumers' understanding of the sugar content of foods and their food choices. In the first phase, five focus groups were conducted with a convenience sample of Brazilian adults to explore their perceptions about food labelling in general and sugar labelling in particular. Based on the qualitative results, four sugar label formats were developed and subsequently tested in a five-arm study on 1,277 adults via a randomised controlled online survey. The formats were: (i) no sugar information—control, (ii) total and added sugar content displayed in the Nutrition Information Panel (NIP), (iii) a front-of-package (FoP) octagonal warning for “high-in-sugar” products, (iv) a FoP magnifying glass warning for “high-in-sugar” products, and (v) a “high-in-sugar” warning text embedded on the NIP. Participants from the focus groups reported being confused about the meaning of “sugar” and “added sugar” on food labels and indicated that more interpretive labels, such as the FoP warnings, would help them choose products with low sugar content. In the experiment, all intervention sugar label formats improved participants' understanding of the sugar content of the tested food products, with the FoP warnings (iii and iv) showing the best results. While non-significant differences among label conditions were observed for food choices, the FoP octagonal warning prompted participants to choose high-in-sugar products less often. Given current public policy agendas aiming to reduce added sugar intake, there is a need to strengthen food labelling policies and nutrition disclosure policies that target the display of added sugar and build consumer awareness in using these tools to avoid high-in-sugar products.

Assessment of the knowledge, attitudes and practices of Lebanese shoppers towards food labeling: The first steps in the Nutri-score roadmap

Background: Food labeling is a fundamental educational tool for advocating for public awareness. It emphasizes knowledge of the nutrient content of food and thus directs the choice towards the healthiest food products.

This cross-sectional survey aimed to assess the knowledge, attitudes, and practices (KAP) regarding nutrition label use in Lebanon through a valid questionnaire.

Methods: Overall, 768 participants (mean age: 30.8 ±12, males: 60.2%) were recruited randomly between February and May 2020. We used word of mouth and social media to recruit our sample population.

Results: Social media was the most accessed tool to attain nutrition information by responders (39.8%). More than half the participants expressed positive attitudes to check information related to sugars (66.4%), vitamins (64.9%), total fats (61.7%), proteins (59.1%), and calories (58.7%) on the food label. Expiry date, price, and brand name were the top three considerations while reading food labels. About half (46.5%) reported to “always” look at the food label. Responders reported reading labels related primarily to sugars (44.3%), calories (38.8%), and total fats (36.8%). The optimal total KAP score was 46; our findings revealed a mean KAP score of 14.46 ±7 (31.4%). When categorizing the KAP scores, 15% had high scores, and 85% scored low. Spearman’s coefficients showed positive correlations between knowledge-attitude, knowledge-practice, and attitude-practice scores, with p<0.001. The regression analysis revealed that gender, age, BMI, residency area, educational level, university degree, health and diet statuses, and activity level were significant predictors of the KAP score. Being on a diet had the highest odds (OR=3.107, CI=1.904-5.072, p<0.001).

Conclusion: The low awareness of food labels leads Lebanese people to choose unhealthy food options. A planned educational program is recommended to ease the interpretation of these labels.

Effect of Warning Labels on Consumer Motivation and Intention to Avoid Consuming Processed Foods

Nutritional warnings (NWs) as a front-of-package label were implemented as a public policy aiding consumers with recognizing processed foods with high levels of critical nutrients (sodium, saturated fats, carbohydrates, and calories). However, in spite of this tool being well positioned in consumer decision making, there is little extant knowledge about the relationship between the message sent by NW, nutritional knowledge, consumer motivation, and the intention to avoid consuming processed foods. To understand these dimensions’ relations, a theoretical model was created and subsequently tested through structural equations. We applied a survey to 807 home food purchasing decision makers. The results show that the direct effect of NW messages raises the intention to avoid processed foods, while eating motivation is negative in its direct effect on the same avoidance intention. However, the message sent by NWs had a mediating effect between the intentions to avoid processed food and eating motivation but showed no such effect on nutritional knowledge. This suggests that the message sent by NWs was able to turn negative eating motivation into positive eating motivation to avoid processed foods. In conclusion, NWs help mitigate eating motivations, as well as boost the intention to avoid processed foods.

Responsible Marketing in the Traffic Light Labeling of Food Products in Ecuador: Perceptions of Cuenca Consumers

Responsible marketing (RM) helps companies make products that improve people’s lives and is in line with public policies that provide a positive impact on society; an example of this is traffic light nutritional labelling (TLNL). Ecuador was a pioneer in Latin America in the mandatory implementation of TLNL. For this reason, this research aimed to analyze RM in the TLNL of food products from the perception of consumers in the urban area of Cuenca, Ecuador. Specifically, the research aimed to answer: What is the degree of consumer understanding of TLNL in the urban area of Cuenca, Ecuador? A cross-sectional investigation was undertaken, with 384 surveys conducted. A chi-square test (χ2) was performed, which showed the relationship between variables reflecting RM knowledge and the understanding and use of TLNL. An ordinal logit model (OLM) was applied, showing that the variables of education, knowledge of labeling, and knowledge of marketing were associated with a greater probability of having some level of understanding of TLNL. Finally, a binomial logit model (BLM) revealed that the variables of income level, knowledge of TLNL, illnesses, confidence in TLNL, the influence of COVID-19 on eating habits, and knowledge of marketing were associated with people being more likely to use TLNL. RM is present in the TLNL through the clear and understandable dissemination of information.

The Effectiveness of Product Sustainability Claims to Mitigate Negative Electronic Word of Mouth (N-eWOM)

The purpose of this study is to investigate the role of negative electronic word-of-mouth (N-eWOM) messages on attitudes, subjective norms, perceived behavior control (PBC), and the intention to purchase sustainable dairy products. This study also investigates the moderating role of product sustainability claims to reduce the effect of N-eWOM on customers. It comprises two experiments on college students (n = 120; 90) who have at least two accounts on different social media platforms. We use both qualitative and quantitative techniques. The model was developed and tested on data collected from questionnaires. The results of Study 1 suggest that N-eWOM reduces purchase intentions, attitudes, subjective norms, and PBC. High N-eWOM reduces purchase intention more than the low N-eWOM. Study 2 found that with high N-eWOM, product sustainability claims (congruent or incongruent) moderate the effect of N-eWOM on attitudes, subjective norms, PBC, and purchase intention. Purchase intention is higher when a product sustainability claim is congruent. These novel findings contribute to our understanding of ways to mitigate the impact of N-eWOM by taking preventive actions, such as making product sustainability claims.

Are Front-of-Pack Labels a Health Policy Tool?

To stem the increasing incidence of non-communicable diseases (NCDs) and obesity, front-of-pack labels (FOPLs) have been developed since 1989. Whereas several countries have already adopted one voluntarily, the European Community wants to harmonize an FOPL system that will be mandatory for all member states. The purpose of this narrative review is to describe what could be achieved or not by FOPLs, and to discuss if there is enough evidence to establish whether such labels are effective in modifying purchasing behavior, in directing individual dietary patterns towards a healthy and sustainable diet, and in reformulating food products by the food industry. Non-directive FOPLs, which are still under study, appear to be informative and well-accepted by consumers even if they require a cognitive effort. Conversely, directive FOPLs are supported by several studies, but they are mostly conducted in simulated scenarios and/or performed as retrospective studies. Nevertheless, directive FOPLs are rated as an intuitive tool, and they have demonstrated a high capacity to help consumers rank food products as more or less healthy. In conclusion, directive and non-directive FOPLs convey different messages. No FOPL individually can be considered exhaustive in relation to all the objectives outlined in this narrative review, and therefore, the development of a model synthesizing both messages is advisable. Many questions remain open, such as the possibility of reformulating pre-packaged products, how to deal with traditional products, and the impact on the incidence of NCDs and obesity. In the light of the complexity of factors that condition consumption choices and health, none of the current FOPLs can be considered a health policy tool on its own. The possibility of development remains open, but as the state of the art, these tools do not seem to be able to achieve all the European Community goals together. We can speculate that they could meet these goals only if they are integrated into a multi-tiered, structured health policy intervention.

Organic food labels bias food healthiness perceptions: Estimating healthiness equivalence using a Discrete Choice Experiment

Individuals perceive organic food as being healthier and containing fewer calories than conventional foods. We provide an alternative way to investigate this organic halo effect using a mirrored method to Choice Experiments applied to healthiness judgments. In an experimental study (N = 415), we examined whether healthiness judgments toward a 200g cookie box are impacted by the organic label, nutrition information (fat and sugar levels), and price and determined the relative importance of these attributes. In particular, we assessed whether food with an organic label could contain more fat or sugar and yet be judged to be of equivalent healthiness to food without this label. We hoped to estimate the magnitude of any such effect. Moreover, we explored whether these effects were obtained when including a widely used system for labeling food healthiness, the Traffic Light System. Although participants' healthiness choices were mainly driven by the reported fat and sugar content, the organic label also influenced healthiness judgments. Participants showed an organic halo effect leading them to consider the organic cookie as healthy as a conventional one despite containing more fat and sugar. Specifically, they considered the organic cookie as equivalent in healthiness to a conventional one, although containing 14% more of the daily reference intake for sugar and 30% more for fat. These effects did not change when including the Traffic Light System. This effect of the organic label could have implications for fat and sugar intake and consequent impacts on health outcomes.

A Consumer Segmentation Study of Nutrition Information Seeking and Its Relation to Food Consumption in Beijing, China

The aim of this study is to identify consumer groups based on nutrition information-seeking behavior and how it relates to food consumption. Although the Chinese public can now access nutrition information through different channels, research on the segmentation of homogeneous consumer groups seeking nutrition information is lacking. This study closes this research gap and, in doing so, also shows how information seeking is related to dietary behavior. A questionnaire was sent out to a stratified random sample in Beijing, resulting in 448 responses. A cluster analysis using hierarchical methods was conducted, identifying four distinct consumer groups: Multi-Channel (27.43%), Mass Media (20.57%), Moderate (27.88%), and Uninterested (24.12%). The four segments differed significantly concerning food consumption frequencies, food literacy, and sociodemographic characteristics. Consumers who were more involved in nutrition information tended to eat healthier. Our findings indicate that nutrition information is worth promoting, but this kind of intervention is not a cure-all. Targeted interventions should focus on uninterested populations by providing non-informational nudging strategies to promote healthy eating behaviors. This study contributes to the identification of meaningful profiles for targeted interventions, particularly as regards uninterested or unreached consumers.

Assessment of the knowledge, attitudes and practices of Lebanese shoppers towards food labeling: The first steps in the Nutri-score roadmap

Background: Food labeling is a fundamental educational tool for advocating for public awareness. It emphasizes knowledge of the nutrient content of food and thus directs the choice towards the healthiest food products. This cross-sectional survey aimed to assess the knowledge, attitudes, and practices (KAP) regarding nutrition label use in Lebanon through a valid questionnaire. Methods: Overall, 768 participants (mean age: 30.8 ±12, males: 60.2%) were recruited randomly between February and May 2020. We used word of mouth and social media to recruit our sample population. Results: Social media was the most accessed tool to attain nutrition information by responders (39.8%). More than half the participants expressed positive attitudes to check information related to sugars (66.4%), vitamins (64.9%), total fats (61.7%), proteins (59.1%), and calories (58.7%) on the food label. Expiry date, price, and brand name were the top three considerations while reading food labels. About half (46.5%) reported to “always” look at the food label. Responders reported reading labels related primarily to sugars (44.3%), calories (38.8%), and total fats (36.8%). The optimal total KAP score was 46; our findings revealed a mean KAP score of 14.46 ±7 (31.4%). When categorizing the KAP scores, 15% had high scores, and 85% scored low. Spearman’s coefficients showed positive correlations between knowledge-attitude, knowledge-practice, and attitude-practice scores, with p<0.001. The regression analysis revealed that gender, age, BMI, residency area, educational level, university degree, health and diet statuses, and activity level were significant predictors of the KAP score. Being on a diet had the highest odds (OR=3.107, CI=1.904-5.072, p<0.001). Conclusion: The low awareness of food labels leads Lebanese people to choose unhealthy food options. A planned educational program is recommended to ease the interpretation of these labels.

Effect of front-of-package labels on consumer product evaluation and preferences

Front-of-Package (FOP) labels highlight important nutrients and help consumers make informed decisions about food purchases. In this study, we investigated consumer comprehension, opinion, and preference associated with two different formats of FOP labels and compared consumer shopping behavior and general trends related to nutrition labeling. Consumer eye-tracking was used for measuring perceived understanding of nutritional information objectively. Results revealed that a color-coded FOP label would garner more attention than a black and white FOP label. Subjects found color-coded FOP labels more straightforward than black and white labels. Participants used the information provided on the FOP for shopping goals. Still, FOPs did not affect objective consumer attention to labels, and labeling schemes did not significantly affect participants' decisions. Participating subjects did use FOP labels instead of the nutrition facts panels. Still, FOP groups scored lower on a nutrition literacy quiz, indicating that their perceived and actual understanding of nutritional information differed. Our findings suggest that subjects pay attention to FOP labels but do not make decisions.

•

Front-of-Package (FOP) labels show important nutrients and help understand nutrition facts.

•

This study investigated FOP labels using eye-tracking to measure visual attention in consumers.

•

More educational campaigns are needed to assist in the comprehension of the FOP labels by consumers.

•

The study shows that the shopping goals affected visual attention to the nutritional facts on the FOP.

•

Our findings suggest that consumers do not use FOPs much in making purchase decisions.

Consumers’ Knowledge and Use of Nutritional Labelling Information in Lagos, Nigeria

Nutrition labelling is a topical issue, being a vital aid that shapes consumers’ food choices and could be an efficient tool for the prevention of consumer vulnerability to diet-related diseases such as cancer, high blood pressure, hypertension, and obesity. However, data on the public use of nutritional labels as an information source on nutritional properties of foods and health claims, especially as it relates to Nigeria, are not popular in the literature. This study seeks to examine consumers’ use of labelling information: knowledge; attitude, and practice. A cross-sectional study with the aid of a survey elicited information from 374 randomly selected shoppers in five shopping malls in Lagos State. Data were analysed using the T-test method. Findings show that while the majority of the respondents (70.6%) read the nutritional information, only 64.9% understand the information presented on food labels. The study also reveals that the majority of the respondents (57.5%) do not know that information on food labels should be presented in the English language before any other language as recommended by the National Agency Food and Drug Administration and Control (NAFDAC). While 57.9% of consumers have a positive attitude towards using food labels, 58% of the respondents’ buying decisions are influenced by food labels. The study concludes that consequent upon the importance of nutritional knowledge and wellbeing, consumers of Fast Moving Goods in Nigeria are beginning to consciously pay attention to nutritional labels. The study recommends that producers of Fast Moving Consumer Goods (FMCG) products in Nigeria should adopt the total disclosure of ingredients and nutritional content of their products. Also, regulatory bodies in charge of pre-packaged food products in Nigeria (NAFDAC) should go the whole way and make nutritional labelling mandatory.

What Is on the Menu?-A Quantitative Analysis on Label Format among (Potential) Restaurant Guests and Restaurant Owners

About 20% of energy intake in the Netherlands is consumed out-of-home. Eating out-of-home is associated with higher energy intake and poorer nutrition. Menu labeling can be considered a promising instrument to improve dietary choices in the out-of-home sector. Effectiveness depends on the presentation format of the label and its attractiveness and usability to restaurant guests and restaurant owners. This exploratory study investigated which menu labeling format would be mostly appreciated by (a) (potential) restaurant guests (n386) and (b) the uninvestigated group of restaurant owners (n41) if menu labeling would be implemented in Dutch full-service restaurants. A cross-sectional survey design was used to investigate three distinct menu labeling formats: a simple health logo; (star) ranking and calorie information. Questionnaires were used as study tool. Ranking has been shown to be the most appreciated menu labeling format by both (potential) restaurant guests and owners. Statistical analysis showed that label preference of potential restaurant guests was significantly associated with age, possibly associated with level of education, and not associated with health consciousness. In summary, we found that ranking is the most appreciated menu label format according to both (potential) restaurant guests and restaurant owners, suggesting it to be a promising way to improve healthy eating out-of-home.

Assessment of Knowledge and Self-Reported Use of Nutrition Facts Labels, Nutrient Content, and Health Claims among Saudi Adult Consumers

Background

Few studies have investigated the knowledge and attitudes towards the nutrition facts label, the nutrient content and health claims (NHCs) among consumers from different countries/cultures.

Methods

This cross-sectional study assessed the knowledge and self-reported use of the nutrition facts label and NHCs among Saudi adults. A total of 722 participants were recruited using an online questionnaire.

Results

Total knowledge score was 5.8 ± 2.5/13 points (45%). Approximately, 18%, 77%, and 5% of the participants had low, medium, and high levels of knowledge, respectively. Participants were more knowledgeable on the nutrition facts label (2.6 ± 1.6/5 points) and health claims (2.7 ± 1.2/4 points) versus nutrient content claims (0.5 ± 0.7/4 points). The total use score was 20.1 ± 5.7/30 points (67%); approximately, 2%, 61%, and 37% of the participants were classified as low, medium, and high use level, respectively. Participants’ use of the nutrition facts label, nutrient content claims, and health claims was 10.0 ± 3.1/15, 6.5 ± 2.2/9, and 3.6 ± 1.8/6 points, respectively.

Conclusion

This study highlights the need for more education and public awareness programs to enhance consumer knowledge and use of the nutrition facts label and NHCs, and consequently lead to healthy dietary choices.

I Believe It Is Healthy-Impact of Extrinsic Product Attributes in Demonstrating Healthiness of Functional Food Products

Due to the high proportion of impulse purchases and the short time devoted to purchase decisions, packaging and other extrinsic attributes are becoming increasingly important in demonstrating the health benefits of a functional food item to consumers as plausibly as possible. Our research aims at identifying the role of extrinsic features (claims related to ingredients and health claims, organic or domestic origin, as well as the shape and color of packaging), gathered in the course of in-depth literature analysis, in the case of a functional smoothie. Our online consumer questionnaire was completed by 633 respondents, and the answers were assessed by choice based conjoint analysis. Our results show that each examined attribute plays a role in the assessment of health effects. The color blue has the biggest impact on making the consumer believe in the health benefits of the product. This is followed by the indication of organic origin, then the statement emphasizing the natural quality of the ingredients. The assessment of the specific extrinsic attributes is affected by consumers’ general health interest level, their involvement with food items, and their various demographic features.

Marketing Clues on the Label Raise the Purchase Intention of Genetically Modified Food

As more and more genetically modified foods (GMFs) must be labeled, adding more information to increase the willingness to buy genetically modified food has become the focus of scholars and enterprises. Most current studies have confirmed that the consumer attitudes and purchase intention toward GMFs are not good. This study aims to match consumers’ different information-processing mechanisms by adding marketing information clues and regulating their purchase intentions by contradictory attitudes towards GMFs. According to the interest demands of GMFs, the marketing clue information was divided into functional information and environmental information. Through two studies, we find that consumers are more inclined to environmental information than heuristic. Functional information is more attractive to males, and the young generation prefers ecological information. Consumers with high ambivalence towards genetically modified foods are more inclined to choose environmental attribute information.

Current use of nutrition facts tables and attitudes towards new red and green front-of-package labels among Israeli consumers

Front-of-package labels (FOPL) are designed to simplify nutrition information and to help consumers make healthier food choices. The Israeli government has implemented new regulations requiring mandatory red warning FOPL for high levels of sodium, sugar, or saturated fats. A voluntary green positive FOPL for products fitting the national nutritional recommendations was concurrently encouraged. In order to characterise adult consumers' current use of Nutrition Facts Tables (NFT) and their attitudes towards the new FOPL, a nationally representative cross-sectional telephone survey was conducted. Most of the 1,042 survey respondents reported frequent NFT use (76.2%) and intentions to purchase fewer red-labelled (81.1%) and more green-labelled products (85.0%). Consumers with higher BMI and lower education expressed higher intentions to use the new FOPL, but not higher current use of NFT. This finding suggests that these high-risk groups, which the new labels are meant to target, may indeed benefit from the new policy.

Dysphagia-Related Health Information Improved Consumer Acceptability of Thickened Beverages

Most people tend to think that healthy foods do not taste good. This view could have a negative impact on the taste of the food that people eat for health. However, if health-related information is provided to avoid negative aspects, acceptability may improve. Thus, this study investigated changes in consumers’ sensory perception of thickened beverages before and after the provision of dysphagia-related health information. Sixty young (19–39 years old) and middle-aged (40–64 years old) consumers participated in two experiment sessions conducted one week apart. The first session proceeded without any information and the second provided information about dysphagia and the need for dietary modification before evaluation. Three beverages (orange juice, red bean water, and sports drink) were used in nectar-like (51–350 cP) and honey-like (351–1750 cP) forms; original beverage samples (0%) were used as the control. Consumers were asked about acceptability, liking the flavor, intensity, and general health interest (GHI). An analysis of variance was performed to show the change in flavor rating and acceptability between the two sessions. Although there were age-related differences in response to the samples, thickened beverages were rated as more acceptable, in terms of their characteristics (swallowing, viscosity, and mouthfeel) after the information was provided. There were no significant differences for the 0% samples. The mean GHI values were 3.97 ± 0.85 and 4.81 ± 0.68 for the young and middle-aged groups, respectively. High and low GHI groups were analyzed. The high GHI group showed significant differences in acceptability in the informed evaluation, whereas the low GHI group was not influenced by the information.

Performance and perception on front-of-package nutritional labeling models in Brazil

OBJECTIVE:

To evaluate the performance and perception of five models of front-of-package nutrition labeling (FOPNL) among Brazilian consumers.

METHODS:

Cross-sectional study, which applied an online questionnaire to 2,400 individuals, allocated randomly into six study groups: a control group and five others exposed to FOPNL (octagon, triangle, circle, magnifier and traffic light), applied to nine products. We evaluated the understanding of nutritional content, the perception of healthiness, the purchase intention and the perception of Brazilian consumers on the models.

RESULTS:

All FOPNL models increased the understanding of the nutritional content and reduced the perception of healthiness and purchase intention, when compared with the control group (41.3%). FOPNL warning models — octagon (62.4%), triangle (61.9%) and circle (61.8%) — performed significantly better than the traffic light (55.0%) regarding the understanding of the nutritional content. The performance of the magnifier (59.5%) was similar to the other four tested models, including the traffic light (55.0%), for understanding nutritional content. The individual analysis of the products suggests a better performance of warnings in relation to the magnifier and the traffic light for the perception of healthiness and purchase intention. Consumers were favorable to the presence of FOPNL, perceiving it as reliable to increase the understanding to nutritional information.

CONCLUSION:

FOPNL must be implemented on food labels in Brazil, considering that it increases the nutritional understanding, reduces the perception of healthiness and the purchase intention of products with critical nutrients. Warnings showed a better performance when compared with other models.

Visible sugar : Salient sugar information impacts health perception of fruit juices but only when motivated to be responsible and not when motivated to enjoy

The present study explores when consumers recognize the high sugar content of fruit juice and refrain from choosing it for themselves or their families. Fruit juice may be typically perceived as a healthy drink, despite its often high sugar content. We investigate the role of salience of sugar information and enjoyment and responsibility goals in perception and choice of fruit juices. We argue that sugar information needs to be salient to prevent this health halo effect, but that consumers also need to be in a motivational state that promotes processing of this information. In three experiments (N = 801), we manipulate the salience of the sugar content using a salient sugar label (or no explicit sugar label) as well as the activation of different goals (to enjoy versus to be responsible, in the context of choices for self versus significant others). Utilising a newly designed fictitious juice brand, salient sugar labels are effective in significantly raising awareness of sugar content in study 1. Consumers primed for responsibility consider fruit juice with salient sugar information unhealthier as compared to those primed for enjoyment in study 2. Further, in study 3, parents primed for responsibility perceive fruit juice with salient sugar information as unhealthier and less appealing in comparison to parents primed for enjoyment. The effects of responsibility and enjoyment primes on health perceptions are stronger when people think of responsibility or enjoyment of food in the context of their families rather than themselves. We discuss implications for theorizing, beverage marketing, and public policy.