Making healthy food choices using nutrition facts panels. The roles of knowledge, motivation, dietary modifications goals, and age

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.

Using the Nutrition Facts Label to Make Food Choices Is Associated with Healthier Eating among 8th and 11th-Grade Students: An Analysis of Statewide Representative Data from the 2019-2020 Texas School Physical Activity and Nutrition Survey

BACKGROUND

Nutrition labels are a tool to inform and encourage the public to make healthier food choices, but little information is available about use in multi-ethnic adolescent populations in the U.S. The purpose of this study was to examine associations between the level of nutrition label usage and healthy/unhealthy eating behaviors among a statewide representative sample of 8th and 11th-grade students in Texas.

METHODS

We analyzed cross-sectional associations between the Nutrition Facts label use and eating behaviors from a statewide sample of 8th and 11th-grade students in Texas, (n = 4730, weighted n = 710,731, mean age = 14.7 ± 1.6 years; 49% female, 51% Hispanic), who completed the 2019-2020 Texas School Physical Activity and Nutrition (TX SPAN) survey. Students self-reported their level of nutrition label usage to make food choices (5-point Likert scale from "Never" to "Always") and previous day consumption of 26 food items (13 healthy, 13 unhealthy). The 26 food items were used to calculate a Healthy Eating Index (HEI) score (0-100), a Healthy Foods Index (HFI) score (0-100), and an Unhealthy Foods Index (UFI) score (0-100). Weighted linear regression models were employed to examine the associations between self-reported use of nutrition labels to make food choices and HEI, HFI, and UFI scores. Marginal predicted means of HEI, HFI, and UFI scores were calculated post hoc from linear regression models. The odds of consuming specific individual food items for nutrition label usage were also calculated from weighted logistic regression models. All linear and logistic regression models were adjusted for grade, sex, Body Mass Index (BMI), race/ethnicity, economic disadvantage, and percentage of English language learners by school.

RESULTS

A total of 11.0% of students reported always/almost always using nutrition labels to make food choices, 27.9% reported sometimes using them, while 61.0% indicated they never/almost never used nutrition labels to make food choices. The average HEI score among students in the sample was 47.7 ± 5.9. Nutrition Facts label usage was significantly and positively associated with HEI (b = 5.79, 95%CI: 4.45, 7.12) and HFI (b = 7.28, 95%CI:4.48, 10.07), and significantly and negatively associated with UFI (b = -4.30, 95%CI: -6.25, -2.34). A dose-response relationship was observed between nutrition label usage and HEI, HFI, and UFI scores, such that the strength of these associations increased with each one-point increase in nutrition label usage. Students who reported using nutrition labels always/almost always to make food choices had significantly higher odds of consuming healthy foods including baked meat, nuts, brown bread, vegetables, whole fruit, and yogurt (ORrange = 1.31-3.07), and significantly lower odds of consuming unhealthy foods including chips, cake, candy, and soda (ORrange = 0.48-0.68) compared to students who reported never/almost never using the Nutrition Facts label.

CONCLUSIONS

Using the Nutrition Facts labels to make food choices is beneficially associated with healthy and unhealthy eating among 8th and 11th-grade students, although the proportion of students using nutrition labels to make their food choices was low. Public health efforts should be made to improve nutrition literacy and encourage nutrition label use among secondary students in the United States.

Nutrition facts labels: who is actually reading them and does it help in meeting intake recommendations for nutrients of public health concern?

BACKGROUND

Fiber, potassium and calcium are nutrients of public health concern and their intakes in the United States are alarmingly low. The usage of nutrition facts labels has been reported to increase the odds for dietary reference intake of fiber in some studies. The overall evidence, however, is mixed, as some studies suggested that nutrition facts panels have little to no effect on average measures of diet quality. Here, we investigated whether the usage of nutrition facts labels was associated with meeting U.S. intake recommendations for three nutrients of public health concern: fiber, potassium and calcium.

METHODS

We used cross-sectional multistage, stratified, clustered and probability sampling design data from the U.S. National Health and Nutrition Examination Surveys 2017-2020 cycle. The sample included 5,416 individuals aged 20 years or older, which may be extrapolated to represent 146,841,866 US Americans. Nutrient intakes were compared among individuals reading nutrition facts panels "frequently", "sometimes" or "rarely" using applied survey data analyses techniques (including multivariate logistic regression and marginsplots).

RESULTS

We observed substantial sociodemographic differences between the three groups. Frequent readers were significantly more likely to be female and had higher educational levels. On average, they were also significantly older as compared to rare readers. Fiber intake in g/d was highest in frequent readers (17.09) and lowest in rare readers (14.64). The proportion of participants that met dietary fiber intake recommendations was almost four times higher in the frequent readers group (12.69%) as compared to the rare readers group (3.69%). In a bivariate logistic regression model, frequent label reading significantly increased the odds for meeting the fiber recommendations in Dietary Guidelines for Americans (OR: 2.15, p < 0.001). Rarely reading labels decreased the odds (OR: 0.57, p = 0.003). These odds remained essentially unchanged after adjusting for sociodemographic covariates, diabetes status and body mass index (OR: 1.84, p = 0.004; and OR: 0.62, p = 0.022).

CONCLUSIONS

Nutrition facts panel reading associates with fiber intake. Our findings have potential implications for public health nutrition strategies that may center around educational work.

Weighing heavy: Heavy serving dishes increase food serving

The current work demonstrates that people serve themselves greater amounts of food when carrying heavier serving dishes. This effect occurs because increases in carried weight lower consumers' sensitivity to the weight of the food served. Decreased sensitivity to weight of food served in turn leads people to continue serving past the point where they would normally stop. The paper demonstrates this effect across two lab studies involving actual food serving (with a third lab study extending the outcomes to unhealthy food choices reported in the S1 Appendix). The studies also demonstrate liking for the food moderates the effect, such that carrying greater weight leads people to serve an increased amount of liked, but not of less well liked, foods. The findings extend prior research regarding the effects of dish weight on food judgment to provide a first demonstration of effects of weight not only on judgment but on behavior. In this, they help expand our understanding of the ways in which elements in the eating environment effects food consumption. In addition, the studies provide initial evidence for the mechanism behind the phenomenon: reduced sensitivity to weight. The research carries important implications for public well being, given that increases in serving sizes may contribute to obesity.

Food Knowledge for Better Nutrition and Health: A Study among University Students in Portugal

When students enter university, they suffer adaptations, including, usually, greater autonomy and responsibility for the choices they make. Therefore, it is crucial that they are well informed so as to make healthier food choices. The aim of this study was to determine whether sociodemographic characteristics, academic performance and lifestyle (tobacco and alcohol consumption) interfere with food literacy in university students. A quantitative, analytical, descriptive, transversal and correlational study was carried out, using quantitative data obtained through a questionnaire survey applied to a sample of 924 university students in Portugal. Food literacy was assessed through a scale of 27 items, distributed in three dimensions: D1-Literacy about food nutritional value and composition, D2-Literacy about labelling and food choice and D3-Literacy about healthy eating practices. Results showed no differences in food literacy according to sex or age. However, food literacy varied significantly with nationality, either globally (p = 0.006) or in the different dimensions evaluated (p-values of 0.005, 0.027 and 0.012 for D1, D2 and D3, respectively). In terms of academic achievement, the results showed no significant differences according to self-reported academic performance or even to the average classification obtained in the course. Regarding lifestyle variables, it was observed that alcohol consumption or smoking are not associated with food literacy, that is, food literacy does not vary significantly with these two lifestyle variables. In conclusion, food literacy in general and the dimensions evaluated are essentially constant among university students in Portugal, only varying for students from abroad. These results help to better perceive the food literacy levels for the population under study, university students, and that can be a valuable tool to better increase food literacy at these institutions as a way to better prepare for a healthier life and proper food habits that can enhance health in the long term.

Green consumers' behavioral intention and loyalty to use mobile organic food delivery applications: the role of social supports, sustainability perceptions, and religious consciousness

Consumer behavior in the food industry has undergone significant changes in recent years, largely driven by growing consumer awareness of environmental, technological, religious, and social concerns. As a result, organic food has emerged as a popular alternative to conventionally produced food. Many emerging nations, including Bangladesh, promote its consumption due to its perceived health and safety benefits. Despite this growing trend, there remains a need for more understanding of consumer behavior, particularly concerning their motivations for continuous purchases toward mobile organic food delivery applications. In order to fill this knowledge gap, this study looks at how six indirect predictors (emotional support, informational support, environmental consciousness, religious consciousness, trust, and technological consciousness) affect customer loyalty through the intention to use organic food. This study employed a purposive sampling technique (i.e., judgmental sampling) and collected data from 386 respondents across three cities in Bangladesh. Data analysis was conducted using SmartPLS 3 software. The study found that all predictors, except for technological consciousness, significantly influenced behavioral intention, which, in turn, significantly influenced loyalty. Additionally, the study revealed that the five predictors, excluding technological consciousness, indirectly influenced loyalty through behavioral intention. The results of this study add to the existing literature on organic food by extending social support theory to include consumers' primary motivations, such as environmental, religious, technological, and social consciousness, as predictors of loyalty to use mobile organic food delivery applications. The study highlights the importance of sustainable food consumption in promoting environmental protection, ensuring social justice, creating economic success, and providing valuable insights for implementers looking to expand the organic food market.

Graphical abstract

Application of selected neuroscientific methods in consumer sensory analysis: A review

Neuromarketing or consumer neuroscience is a relatively new market research subdiscipline that has gained popularity among consumer behavior scientists in the past two decades or so. It combines neurobiology with behavioral psychology to understand consumer behavior, more specifically about their decisions related to choices/preferences and purchase. The purpose of this review is to explore the potential of using neuroscientific methods for consumer sensory science research. By no means, this is an exhaustive review hindered by the fact that there are countless articles on neuromarketing and consumer neuroscience in the literature. The author has tried to show the applicability of neuroscientific methods in consumer sensory sciences, specifically electroencephalography and eye tracking, which could potentially "complement" the sensory methodologies to gain better consumer insight. Both these techniques are relatively inexpensive, portable, and minimally invasive techniques that are already being used by some sensory scientists. They could be incorporated with ease in the research portfolio of consumer sensory researchers who would like to use them to study consumer affect. It is recommended that the researchers use proper experimental design that takes into consideration the confounding variables as much as possible. The two methods mentioned before have been proven to be relatively reliable and repeatable. Lastly, these methods would also require ethical oversight because of the involvement of human subjects.

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.

Behaviour change interventions to promote health and well-being among older migrants: A systematic review

Background

Whether behaviour change interventions are effective for the maintenance of older migrants’ health and well-being is uncertain. A systematic review was conducted to assess evidence for the capacity of behaviour change techniques (BCTs) to promote the health and well-being of older migrants.

Methods

Electronic databases (Cochrane CENTRAL, Embase, Ovid MEDLINE and Web of Science) were searched systematically to identify relevant randomised controlled trials, pre–post studies and quasi-experimental studies published before March 2021. Additional articles were identified through citation tracking. Studies examining BCTs used to promote the health and/or well-being of older migrants were eligible. Two independent reviewers used the Behaviour Change Technique Taxonomy version 1 to extract data on BCTs. Data on intervention functions (IFs) and cultural adaption strategies were also extracted. Intervention contents (BCTs, IFs, culture adaption strategies) were compared across effective and ineffective interventions according to health and well-being outcome clusters (anthropometrics, health behaviour, physical functioning, mental health and cognitive functioning, social functioning and generic health and well-being).

Results

Forty-three studies (23 randomised controlled trials, 13 pre–post studies and 7 quasi-experimental studies) reporting on 39 interventions met the inclusion criteria. Thirteen BCTs were identified as promising for at least one outcome cluster: goal-setting (behaviour), problem-solving, behavioural contract, self-monitoring of behaviour, social support (unspecified), instruction on how to perform the behaviour, information about health consequences, information about social and environmental consequences, demonstration of the behaviour, social comparison, behavioural practice/rehearsal, generalisation of a target behaviour and addition of objects to the environment. Three BCTs (instruction on how to perform the behaviour, demonstration of the behaviour, and social comparison) and two IFs (modelling and training) were identified as promising for all outcome clusters.

Conclusions

Thirteen distinct BCTs are promising for use in future interventions to optimise health and well-being among older migrants. Future research should focus on the effectiveness of these BCTs (combinations) in various contexts and among different subgroups of older migrants, as well as the mechanisms through which they act. Given the scarcity of interventions in which cultural adaption has been taken into account, future behavioural change interventions should consider cultural appropriateness for various older migrant (sub)groups.

Trial registration

PROSPERO CRD42018112859.

The Healthy Eater’s Idea and Related Behavior of a Healthy Diet—A Case Study with Kombucha Drinkers

Consumers’ demand for ‘healthy’ food is growing at a fast pace. Beverages are one of the fastest-growing segments in the healthy food market. Kombucha is a product with a rapid market growth and is considered a ‘healthy beverage’. Kombucha drinkers (n = 296) in the contiguous United States (U.S.) were targeted to investigate differences in the various consumer segments regarding the healthy eater’s behavior, namely—(1) healthy diet stage-of-change attitudes, (2) healthy eating criteria, and (3) label information usage. An online survey questionnaire was used as a data collection tool. The data were analyzed via chi-square tests and multiple correspondence analysis (MCA). The majority of kombucha consumers were health-conscious and kombucha fitted into their view of a healthy diet. The female, older, western U.S. residents, and higher-educated consumers were more likely to take action and maintain a healthier diet. Healthy eaters’ idea of a healthy diet was very similar to that of the general population. Kombucha consumers focused mainly on sugar/calories and natural/organic ingredients. Additional investigations to expand the understanding of the healthy eater’s behavior with actual kombucha samples are needed in the future.

Individual Differences in Digital Game-Based Supply Chains Management Learning: Evidence from Higher Vocational Education in Taiwan

This study aims to investigate the differences in the learning path and value between students of different genders and educational backgrounds in digital game-based learning in Taiwan’s higher vocational education. A game-based digital Supply Chains Learning System was used to explore the value network based on “system attributes—learning consequences—target value” from the perspective of the student. To investigate the research question, this study conducted a cross-analysis of differences in gender and education background. Findings from the study revealed that irrespective of gender and educational background in higher vocational education in Taiwan, students developed distinctively different learning paths, values, and emphasis from specific system attributes. These findings will not only enable trainers and educators to learn more about the differences in learning by individuals but will also serve as useful guidelines for the improvement of the teaching strategy used by digital games developers.

Dietary Lifestyle of Clinical Nutrition Students Compared with That of Age-Matched Non-Medical Students

Background:

There is an assumption that clinical nutrition (CLN) students should have better nutritional and health statuses and practice healthier lifestyles than other students. However, the effect of pursuing nutritional studies on student dietary lifestyle is not well known.

Objective:

To investigate differences in nutritional status between CLN-major and Administration/Humanities-major (AHM) students as well as determine their sources of health and nutrition-related information.

Method:

This is a descriptive and cross-sectional study that CLN and AHM (mainly English and Arabic majors) students were recruited. Anthropometric measurements were taken, and a questionnaire was administered to assess their dietary lifestyle.

Results:

In total, 160 female students (CLN, 86; AHM, 74) participated in the study. Most students from both groups (>44%) were within the normal body mass index (BMI) range (18.5–24.9 kg/m2); no CLN students had class II or III obesity. No significant difference in BMI between the two groups was observed. CLN students tended to consume breakfast and snacks more than AHM students. Daily fruit and vegetable consumption was significantly higher among CLN than AHM students. No significant difference was found in fried food or water intake between the two groups. CLN students were more involved in high-intensity exercise than their counterparts.

Conclusion:

Our findings suggest that health status and dietary lifestyle among CLN students are influenced by their study major. Obesity is less prevalent, and consumption of healthy foods, such as fruits and vegetables, is higher among CLN students. Future studies investigating the long-term effect of studying CLN on lifestyle and social relations with family and friends are warranted.

Americans' Perspectives on Online Media Warning Labels

Americans are pervasively exposed to social media, news, and online content. Some of this content is designed to be deliberately deceptive and manipulative. However, it is interspersed amongst other content from friends and family, advertising, and legitimate news. Filtering content violates key societal values of freedom of expression and inquiry. Taking no action, though, leaves users at the mercy of individuals and groups who seek to use both single articles and complex patterns of content to manipulate how Americans consume, act, work, and even think. Warning labels, which do not block content but instead aid the user in making informed consumption decisions, have been proposed as a potential solution to this dilemma. Ideally, they would respect the autonomy of users to determine what media they consume while combating intentional deception and manipulation through its identification to the user. This paper considers the perception of Americans regarding the use of warning labels to alert users to potentially deceptive content. It presents the results of a population representative national study and analysis of perceptions in terms of key demographics.

The Effect of the "Colorful Eating Is Healthy Eating" Long-Term Nutrition Education Program for 3- to 6-Year-Olds on Eating Habits in the Family and Parental Nutrition Knowledge

Background: Effective strategies for improving eating habits and dietary intake in preschoolers are essential for reducing the risk of chronic non-infectious diseases in later life. The aim of this study was to evaluate the effect of long-term nutrition education for 3- to 6-year-olds on parental nutrition knowledge. Methods: The study was conducted as part of the “Colorful Eating is Healthy Eating” nutrition education program that has been implemented in kindergartens in Lublin since 2016. A total of 11 kindergartens were involved in this stage of the program, and 733 parents consented to participate in the project. The study was divided into three stages. In the first stage all parents completed a questionnaire containing 54 items. In the next stage, 211 children from four randomly selected kindergartens participated in the “Colorful Eating Is Healthy Eating” educational program that lasted 7 months. In the third stage of the study, the parents of children who had completed the 7-month educational program and the parents of control group children once again completed the questionnaire. Results: A positive outcome of the educational program was that it contributed to a decrease in the consumption of sweetened hot beverages (p = 0.005) and an increase in water intake (p = 0.001). The nutrition education program was also successful in reducing the consumption of sweets. Children’s education improved the parents’ knowledge about dietary sources of fiber and the recommended fiber intake, and it contributed to the awareness that breakfast is the most important meal of the day. The program did not enhance the parents’ knowledge about snacking between meals or the role of sweetened beverages in dental caries, overweight and obesity. Conclusions: Long-term multi-stage nutrition education for children aged 3 to 6 years can be helpful in shaping families’ eating habits and improving parental nutrition knowledge. However, the program was less effective in eliminating the respondents’ preference for sweet-tasting foods.

The Relationship between Nutrition Knowledge and Nutrition Facts Table Use in China: A Structural Equation Model

Since 2013, China has implemented a nutrition label regulation that aims to provide essential nutrition information through nutrition facts tables labeled on the back of food packages. Yet, the relationship between people’s nutrition knowledge and their nutrition label use remains less clear. This study adopted the structural equation modeling approach to analyze a nationally representative survey of 1500 Chinese individuals through the cognitive processing model, interrelated nutrition knowledge, attention to nutrition information on the nutrition facts table, comprehension of nutrition information, food choice and dietary intake. It was found that nutrition knowledge positively influenced attention to nutrition information; a better comprehension of nutrition information, which could benefit healthier food choices, did not relate to a higher level of attention to that information; dietary intake was affected significantly by nutrition knowledge, but it had little impact on food choice. The results signify that nutrition knowledge hardly supports nutrition facts table use among the Chinese people, mainly due to incomprehensible labeled information. Therefore, it emphasizes the need to enhance people’s comprehension through front-of-package labels and corresponding smartphone applications.

Protection from ‘Fake News’: The Need for Descriptive Factual Labeling for Online Content

So-called ‘fake news’—deceptive online content that attempts to manipulate readers—is a growing problem. A tool of intelligence agencies, scammers and marketers alike, it has been blamed for election interference, public confusion and other issues in the United States and beyond. This problem is made particularly pronounced as younger generations choose social media sources over journalistic sources for their information. This paper considers the prospective solution of providing consumers with ‘nutrition facts’-style information for online content. To this end, it reviews prior work in product labeling and considers several possible approaches and the arguments for and against such labels. Based on this analysis, a case is made for the need for a nutrition facts-based labeling scheme for online content.

Effects of Statistical and Narrative Health Claims on Consumer Food Product Evaluation

This research aims at exploring the underlying mechanisms how consumers respond to statistical and narrative health claims when they evaluate food products. Moreover, personality traits and product-related information are also incorporated to discuss their effects on the relationship between message types and consumers’ food product evaluation. The results indicate that statistical health claims are more persuasive than narrative health claims. In addition, the results show that individuals’ health knowledge, NFC moderate the relationship between message types and product evaluation. It argues that individuals with limited health knowledge evaluate food product more favorably when statistical health claims are used, while individuals with more health knowledge evaluate food product more favorably when narrative health claims are used. Moreover, it reveals that individuals with high NFC evaluate food product more favorably when statistical health claims are used, while individuals with low NFC evaluate food product more favorably when narrative health claims are used.

Nutrition label processing in the past 10 years: Contributions from eye tracking approach

Healthy eating plays a critical role in preventing diet-related chronic diseases. To promote healthy eating, nutrition labels have been mandated to certain foods in many countries. To test how different designs of nutrition labels affect consumer behavior, eye tracking technique has been increasingly used to overcome the limitations of subjective report which are susceptible to different biases and a poor indicator of nutrition label use in reality. In this review, we reviewed 45 eye-tracking studies on nutrition label processing. Besides a summary of eye tracking methodology, we found three emerged topics from these studies: attention capture, nutrition label comprehension and food choice. Overall, updated designs of nutrition labels improve attention capture and nutrition label comprehension, but it does not necessarily lead to healthier food choices. The discrepancy between attention capture and food choice also indicate potential limitation in promoting healthy food choice via the indirect attention route (exposure - attention - nutrition label processing - food choice). Instead, actual food choice may be a consequence of a direct heuristic route and modulated by person-, product- and context-related factors. These findings can not only guide future studies, but also have implications on making nutrition label policy and improving human health in eastern developing countries.

Can the updated nutrition facts label decrease sugar-sweetened beverage consumption?

Sugar-sweetened beverages are the primary source of added sugar consumption in the U.S, and the Food and Drug Administration recently updated the Nutrition Facts Label to communicate the amount of added sugars in manufactured food. The changes to the Nutrition Facts Label (NFL) is concurrent with some cities implementing policies that place an excise tax on sugar-sweetened beverages. While sugar-sweetened beverages taxes may be effective at changing quantity demanded, the updated NFL has the potential to shift the demand curve by decreasing friction and mental gaps associated with the communication of nutrition information. We conducted a randomized control trial using eye tracking technology to determine if the updated NFL garnered more visual attention or affected beverage choice. Participants were also exposed to an information intervention to determine if the updated NFL affected choice after receiving information about added sugars. We found that consumers were more visually attentive to nutrition information displayed by the updated NFL; however, viewing the updated label did not affect choice of beverages nor did it improve the effectiveness of the dietary information on subsequent choices.

Perceptual salience influences food choices independently of health and taste preferences

Background

Making decisions about food is a critical part of everyday life and a principal concern for a number of public health issues. Yet, the mechanisms involved in how people decide what to eat are not yet fully understood. Here, we examined the role of visual attention in healthy eating intentions and choices. We conducted two-alternative forced choice tests of competing food stimuli that paired healthy and unhealthy foods that varied in taste preference. We manipulated their perceptual salience such that, in some cases, one food item was more perceptually salient than the other. In addition, we manipulated the cognitive load and time pressure to test the generalizability of the salience effect.

Results

Manipulating salience had a powerful effect on choice in all situations; even when an unhealthy but tastier food was presented as an alternative, healthy food options were selected more often when they were perceptually salient. Moreover, in a second experiment, food choices on one trial impacted food choices on subsequent trials; when a participant chose the healthy option, they were more likely to choose a healthy option again on the next trial. Furthermore, robust effects of salience on food choice were observed across situations of high cognitive load and time pressure.

Conclusions

These results have implications both for understanding the mechanisms of food-related decision-making and for implementing interventions that might make it easier for people to make healthy eating choices.

The impact of social capital on physical activity and nutrition in China: the mediating effect of health literacy

Background

Physical activity and good nutrition are important behavioral factors in promoting health and preventing disease. It is important to understand the factors affecting physical activity and nutrition. The purpose of this study was to explore whether social capital has an effect on physical activity and nutrition, and whether health literacy plays a mediating role between social capital and physical activity as well as nutrition.

Methods

This cross-sectional study was performed in a certain district of Shanghai in March and April 2017. Data was collected using a self-reported questionnaire, which included questions on sociodemographic characteristics, social capital, health literacy and health-promoting lifestyle profile-II. Health-promoting lifestyle profile-II measures the behaviours or habits of physical activity and healthy nutrition. An explore factor analysis of the principal components with varimax rotation was carried out on the social capital scale. Descriptive statistics was used to summarize the sociodemographic of participants. Mediation analysis was performed using the bootstrapping tests to examine whether health literacy mediate the relationship between social capital and physical activity as well as nutrition.

Results

The explore factor analysis results showed that social capital has five dimensions, namely social participation, social support, social network, control over life and feelings about the community. There is a positive correlation between social capital, health literacy, physical activity and nutrition. The correlation coefficient varied from 0.135 to 0.594. Mediation analysis demonstrated health literacy played a partial mediating effect between social capital and physical activity as well as nutrition. In the relationship between physical activity and social capital, the indirect effect of health literacy accounted for 8.20 to 12.65% of the total effect. In the relationship between nutrition and social capital, the mediation effect of health literacy accounted for 4.93 to 12.71% of the total effect.

Conclusion

Social capital can promote physical activity and nutrition by disseminating health information. Enhancing the social capital of residents will help increase physical activity and develop healthy eating habits. Attention should also be paid to the improvement of residents’ health literacy.

Building Healthy Eating Knowledge and Behavior: An Evaluation of Nutrition Education in a Skill Training Course for Construction Apprentices

Background: Prior research has found poor health among construction workers is related to poor nutrition and low fruit and vegetable consumption. Promoting nutrition knowledge can improve dietary behaviors, but nutrition education among construction workers is limited. We evaluated the effectiveness of nutrition education on fruit and vegetable consumption among construction apprentices. In this pilot evaluative study, 36 construction apprentices enrolled in skill training programs received two 1.5-hour nutrition classes. Twelve questions addressing healthy eating knowledge and behavior were administered at baseline, after intervention, and at three months follow-up. After intervention, daily fruit consumption improved from baseline (mean (s.d.) =1.42 (0.55)) to post intervention (mean (s.d.) =1.72 (0.70)) (p < 0.05) and to three months follow-up (mean(s.d.) =1.94 (0.83)) (p > 0.05). After intervention, daily vegetable consumption improved from baseline (mean (s.d.) =1.67 (0.59)) to post intervention (mean (s.d.) =1.97 (0.74)) (p < 0.05) and to three months follow-up (mean (s.d.) = 2.19 (0.82)) (p > 0.05). Younger construction apprentices showed better healthy eating knowledge at post intervention and three months follow-up (p > 0.05). Working in normal hours showed better healthy eating knowledge at post intervention but not at three months follow up (p > 0.05). Both age groups and working hours did not show significant differences on healthy eating behaviour. Nutrition education implemented as a three-hour session within skill courses may possibly promote fruit and vegetable consumption among construction apprentices. Further research with control group is required to support the findings in this study.

A Randomized Controlled Trial Evaluating the Relative Effectiveness of the Multiple Traffic Light and Nutri-Score Front of Package Nutrition Labels

The objective of this trial was to test two promising front-of-pack nutrition labels, 1) the United Kingdom’s Multiple Traffic Lights (MTL) label and 2) France’s Nutri-Score (NS), relative to a no-label control. We hypothesized that both labels would improve diet quality but NS would be more effective due to its greater simplicity. We tested this hypothesis via an online grocery store using a 3 × 3 crossover (within-person) design with 154 participants. Outcomes assessed via within person regression models include a modified Alternative Healthy Eating Index (AHEI)-2010 (primary), average Nutri-Score, calories purchased, and singular measures of diet quality of purchase orders. Results show that both labels significantly improve modified AHEI scores relative to Control but neither is statistically superior using this measure. NS performed statistically better than MTL and Control based on average Nutri-Score, yet, unlike MTL it did not statistically reduce calories or sugar from beverages. This suggest that NS may be preferred if the goal is to improve overall diet quality but, because calories are clearly displayed on the label, MTL may perform better if the goal is to reduce total energy intake.

Who Buys Products with Nutrition and Health Claims? A Purchase Simulation with Eye Tracking on the Influence of Consumers' Nutrition Knowledge and Health Motivation

Nutrition and health claims are seen as a way of promoting healthy aspects of food. However, the results of previous studies have been contradictory regarding the effect of these claims on purchase. This study aims to achieve a better understanding of how the consumer characteristics ‘nutrition knowledge’ and ‘health motivation’ influence the purchase of products with nutrition and health claims and what role gaze behavior plays. We included gaze behavior in our analysis, as visual attention on the claims is a precondition to its influence on the purchase decision. In a close-to-realistic shopping situation, consumers could choose from three-dimensional orange juice packages labeled with nutrition, health, and taste claims. In total, the sample consisted of 156 consumers. The data were analyzed with a structural equation model (SEM), linking the purchase decision for products with claims to gaze data recorded with a mobile eye tracker and consumer and product-related variables collected via the questionnaire. Results showed that the variables in the SEM explained 31% (8%) of the variance observed in the purchase of products with a nutrition (health) claim. The longer a consumer looked at a specific claim, the more likely the consumer would purchase the respective product. The lower the price and the higher the perceived healthiness and tastiness of the product further heightened its likelihood of being purchased. Interestingly, consumers with higher nutrition knowledge and/or higher health motivation looked longer at the nutrition and health claims; however, these consumer characteristics did not show an effect on the purchase decision. Implications for policy makers and marketers are given.

Cognitive and Emotional Influences on Eating Behaviour: A Qualitative Perspective

Considering that individuals who are within a healthy weight range may experience different thoughts about food to those who are already overweight or obese triggers the need to understand the nature, challenges, and coping strategies of food-related thinking styles in this population in relation to those who are either overweight or obese. Analysis of 6 semi-structured qualitative interviews with individuals who are either at risk of being overweight (body mass index [BMI] = 23-24.99), or above a healthy weight (BMI ⩾ 25), revealed 3 overarching themes: (1) Why am I all about food? (2) Jekyll and Hyde, and (3) Emotional attachment to food. These findings highlighted a link between dieting and negative thinking, which foster unhealthy eating patterns. Therefore, intuitive eating may offer a useful alternative to re-establish a healthier relationship with food.

Assessment of an e-training tool for college students to improve accuracy and reduce effort associated with reading nutrition labels

Objective: Nutrition labels are often underutilized due to the time and effort required to read them. We investigated the impact of label-reading training on effort, as well as accuracy and motivation. Participants: Eighty college students (21 men and 59 women). Methods: The training consisted of a background tutorial on nutrition followed by three blocks of practice reading labels to decide which of two foods was the relatively better choice. Label-reading effort was assessed using an eye tracker and motivation was assessed using a 6-item scale of healthy food-choice empowerment. Results: Students showed increases in label-reading accuracy, decreases in label-reading effort, and increases in empowerment. Conclusions: The nutrition label e-training tool presented here, whether used alone or as part of other wellness and health programs, may be an effective way to boost students' label-reading skills and healthy food choices, before they settle into grocery shopping habits.

A Meta-Analysis of Food Labeling Effects on Consumer Diet Behaviors and Industry Practices

CONTEXT

The influence of food and beverage labeling (food labeling) on consumer behaviors, industry responses, and health outcomes is not well established.

EVIDENCE ACQUISITION

PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Ten databases were searched in 2014 for studies published after 1990 evaluating food labeling and consumer purchases/orders, intakes, metabolic risk factors, and industry responses. Data extractions were performed independently and in duplicate. Studies were pooled using inverse-variance random effects meta-analysis. Heterogeneity was explored with I2, stratified analyses, and meta-regression; and publication bias was assessed with funnel plots, Begg's tests, and Egger's tests. Analyses were completed in 2017.

EVIDENCE SYNTHESIS

From 6,232 articles, a total of 60 studies were identified, including 2 million observations across 111 intervention arms in 11 countries. Food labeling decreased consumer intakes of energy by 6.6% (95% CI= -8.8%, -4.4%, n=31), total fat by 10.6% (95% CI= -17.7%, -3.5%, n=13), and other unhealthy dietary options by 13.0% (95% CI= -25.7%, -0.2%, n=16), while increasing vegetable consumption by 13.5% (95% CI=2.4%, 24.6%, n=5). Evaluating industry responses, labeling decreased product contents of sodium by 8.9% (95% CI= -17.3%, -0.6%, n=4) and artificial trans fat by 64.3% (95% CI= -91.1%, -37.5%, n=3). No significant heterogeneity was identified by label placement or type, duration, labeled product, region, population, voluntary or legislative approaches, combined intervention components, study design, or quality. Evidence for publication bias was not identified.

CONCLUSIONS

From reviewing 60 intervention studies, food labeling reduces consumer dietary intake of selected nutrients and influences industry practices to reduce product contents of sodium and artificial trans fat.

Effect of Educational Interventions on Understanding and Use of Nutrition Labels: A Systematic Review

The potential for nutrition labels to impact on population health is dependent on consumer ability to understand and use this information. Consumer understanding of this information varies across sociodemographic groups and with different label design formats. Labeling legislation requires consumer education on how to use nutrition labels, and recent mandatory changes to the Nutrition Facts Panel (NFP) are underway to improve comprehensibility. This review aimed to evaluate if educational programs can improve understanding and use of nutrition labels. Database searches were performed to identify interventions which delivered education on nutrition labels with outcomes measuring aspects of comprehension or use. A total of 17 studies were selected for review, including nine randomized and eight cohort studies. The majority of studies were conducted in the United States Study participants included school aged children, older adults, and those with diabetes within a range of intervention types involving taught sessions or web-based education. Whilst outcome measures were heterogenous, all studies reported a statistically significant improvement in one or more outcomes of participant understanding or use of nutrition labels. Aspects such as general nutrition knowledge, health literacy, and program delivery format warrant attention in future research. Education which optimizes comprehension and use of nutrition labels may have the potential to improve the impact of this information on dietary health.

No Impact of Calorie or Unit Information on Ad Libitum Alcohol Consumption

Aims

To investigate the impact of unit and calorie information on drinking behaviour in an ad libitum taste test paradigm.

Methods

In this experimental human laboratory study, participants were randomized to one of four conditions, balanced by gender, using a 2 (unit information: present vs. absent) × 2 (calorie information: present vs. absent) between-subjects design. The percentage of beer consumed during the taste test was the primary outcome measure.

Results

Among this largely undergraduate student population, we found no evidence that either unit or calorie information impacted alcohol consumption in an ad libitum taste test. A manipulation check indicated that few of the participants receiving either unit and/or calorie information could accurately recall the number of units and/or calories in the beverages provided to them, indicating low levels of engagement with this information. Analysis of qualitative reactions to calorie and unit labelling indicated possible negative unintended consequences of calorie and unit information, including using unit information to facilitate consumption of higher strength beverages, and calorie information to reduce food consumption prior to a drinking episode.

Conclusion

We find no evidence to support an effect of unit or calorie information, a public-health initiative supported by the alcohol industry, on drinking behaviour. It is possible that compulsory unit and calorie labelling, at least in the numeric format used here, would have no effect on alcohol intake and may even have some negative unintended consequences among certain populations.

Nutrient-specific system versus full fact panel: Testing the benefits of nutrient-specific front-of-package labels in a student sample

Current food labels include comprehensive nutritional information, but evaluations of their effects on judgments of nutritional quality and food choice are scarce. Building on previous empirical research that demonstrated that amount and complexity of information is negatively related to judgment accuracy, this study used an experimental design to evaluate nutritional information labels of varying complexity. Lens model analysis (Brunswik, 1952; Cooksey, 1996; Hammond, 1955; Stewart, 1976) was used to study the judgment process. Nutrition judgment accuracy was assessed by comparing nutrition judgments to a nutrition expert criterion (NuVal^®) in three package labeling conditions. The conditions were: no nutritional information highlighted; nutrients highly related to nutritional quality highlighted using a front-of-package (FOP) label; and nutrients unrelated to nutritional quality highlighted using a FOP label. Findings indicate a limited role of FOP labeling in increasing judgment accuracy, consistency of nutritional information usage, and food choice. Implications for understanding labeling efforts to improve food choices are discussed.

Consumer and product-specific characteristics influencing the effect of nutrition, health and risk reduction claims on preferences and purchase behavior - A systematic review

The research on nutrition, health, and risk reduction claims (NHR claims) shows a lack of consensus as to whether these claims have a positive or negative effect on consumer's preferences and purchase behavior. This issue has been highlighted by many authors. Therefore, a comprehensive literature review was performed to find reasons for contradictory results. First, a theoretical framework was developed which divided the determinants of the effects of NHR claims on consumers' preferences and purchase behavior into consumer and product-specific characteristics. Additionally, a categorization for the different NHR claim types was constructed to make the studies comparable. Afterwards, the scientific literature from the 1980s until May 2017 was scanned and 66 articles were found to be relevant. Consumer-specific characteristics such as nutrition knowledge, health motivation, familiarity, and socio-demographic characteristics were found to influence the NHR claim effect. Important product-specific characteristics were the perceived healthiness of the food product, the interaction between the product and the nutrient in the NHR claim, and the interaction between the claimed benefit and the NHR claim type. The consumer's nutrition knowledge and the product's perceived healthiness were deemed to be the most promising determinants for further investigation.

Do isolated packaging variables influence consumers' attention and preferences?

Developments in neuroscience have provided the opportunity to know unconscious consumer reactions and acknowledge direct measures of cognitive constructs like attention. Given the ever-increasing concern over packaging's contribution to creating a positive first impression, the current research seeks to examine consumers' attention and declarative preferences regarding the three main different packaging attributes as isolated variables: images, texts and colours. The experiment exposed participants (N = 40) to 63 stimuli, which were based on modifications of the three main packaging attributes of three products of three different food categories. This study used electroencephalogram (EEG) and eye-tracking (ET) to measure attention, and a declarative test was employed to examine preference. First, the results presented herein show that the presence of visual elements, either images or texts on packages, increased the participants' level of attention. Second, the results reveal that colour modifications do not have a significant effect on participants' neurophysiological attention levels. Third, the results demonstrated that the neurophysiological effects among the participants do not necessarily coincide with their subjective evaluations of preference. Hence, this study increases awareness of the relevance of combining traditional market research tools that rely on explicit consumer responses with neuroscientific techniques. These findings indicate, first of all, that more research is needed to ascertain the extent to which consumers' neurophysiological outcomes correspond to their declarative preferences and second, that neurophysiological methods should be given more attention in research.

Does Pregnancy Increase Use and Awareness of Nutrition Information in Food Labels?

Objectives This study aims to examine food label use, specific reading behaviors and the awareness of dietary recommendations among U.S. pregnant women in comparison to non-pregnant women. Methods A cross-sectional data analysis was conducted using a representative national sample of U.S. women aged 16 to 44 years from the National Health and Nutrition Examination Survey 2005-2006 (n = 1875). Food label users were defined as woman who used the Nutrition Facts panel when making a food choice in the frequency of always, most of the time, or sometimes. Pregnancy status was assessed in relation to food label use, specific reading behaviors and the awareness of dietary recommendations by conducting hierarchical multivariable logistic regression models including covariates of SES and perceived health and weight variables. Results The prevalence of using food labels at purchase greatly differs by SES, perceived health and weight variables, and awareness of dietary recommendations but not by pregnancy: 68.6% of pregnant and 66.1% of non-pregnant women used food labels in the U.S. However, after controlling for SES and perceived health and weight status, pregnant women are more likely to read food labels than their counterparts (OR = 1.43, 95% CI = 1.07-1.89). Pregnant women were less likely to check cholesterol (OR = 0.58, 95% CI = 0.44-0.77) and calories from fat content (OR = 0.61, 95% CI = 0.42-0.89), after adjusting for SES variables. Pregnant women may not have a higher awareness of dietary recommendations compared to non-pregnant women in the U.S. Conclusions While pregnancy itself is a factor that appears to encourage the reading of food labels, pregnancy does not encourage positive reading behaviors. The findings suggest a great need for prenatal nutrition education programs in the U.S.

An Evaluation of an eHealth Tool Designed to Improve College Students' Label-Reading Skills and Feelings of Empowerment to Choose Healthful Foods

Objective

College students are at risk for poor dietary choices. New skills can empower individuals to adopt healthful behaviors, yet eHealth tools designed to develop food-choice skills, such as label-reading skills, are uncommon. We investigated the effects of web-based label-reading training on college students’ perceptions of healthful food-choice empowerment.

Methods

Students completed label-reading training in which they practiced selecting the more healthful food using nutrition labels. We examined improvements in label-reading accuracy (correct healthfulness decisions) and perceptions of empowerment, using a 6-item scale. Repeated measures ANOVAs and paired-samples t-tests were used to examine changes in accuracy and empowerment across the training session.

Results

In addition to increases in label-reading accuracy with training, we found increases in healthful food-choice empowerment scores. Specifically, the proportion of correct (i.e., more healthful) food choices increased across the three blocks of practice (p = 0.04) and food-choice empowerment scores were about 7.5% higher on average after training (p < 0.001).

Conclusion and implications

Label-reading training was associated with increased feelings of empowerment associated with making healthful food choices. Skill focused eHealth tools may offer an important avenue for motivating behavior change through skill development.

Food perception at lunchtime does not depend on the nutritional and perceived characteristics of breakfast

Breakfast consumption can entail nutritional advantages positively affecting food choices. This study investigated the effect of minor changes in breakfast composition on the perceived attributes of foods, both at breakfast and at lunchtime. Four breakfasts were defined considering nutritional and perceptual factors. Three breakfasts varied just for a single cereal-based chocolate-containing food item, while a control breakfast mimicked fasting conditions. Breakfast perception was assessed before and after consumption. Subjects rated breakfast energy content on the basis of single items, while judged breakfast healthiness as a whole, suggesting that the combination of different ingredients can modify the perceived health value of foods. Additionally, 4 h after breakfast, a perceptual evaluation of lunch-related food images was performed, without differences among breakfasts. This study extends current knowledge on the relationship between subjective perceptual attributes and objective energy value and food composition, as well as on breakfast impact on food perception at lunchtime.

Maternal Attitudes, Normative Beliefs, and Subjective Norms of Mothers of 2- and 3-Year-Old Children

INTRODUCTION

This exploratory study examined maternal attitudes, normative beliefs, subjective norms, and meal selection behaviors of mothers of 2- and 3-year-old children.

METHODS

Guided by the Theory of Reasoned Action, we had mothers complete three surveys, two interviews, and a feeding simulation exercise. Data were analyzed using descriptive and bivariate statistics and multivariate linear regression.

RESULTS

A total of 31 mothers (50% Latino, 34% Black, 46.9% ≤ high school education, 31.3% poor health literacy) of 32 children (37.5% overweight/obese) participated in this study. Maternal normative beliefs (knowledge of U.S. Department of Agriculture recommendations) did not reflect actual U.S. Department of Agriculture recommendations. Collectively, regression models explained 13% (dairy) to 51% (vegetables) of the variance in behavioral intent, with normative belief an independent predictor in all models except grain and dairy.

DISCUSSION

Meal selection behaviors, on average, were predicted by poor knowledge of U.S. Department of Agriculture recommendations. Dietary guidance appropriate to health literacy level should be incorporated into well-child visits.

Benchmarks and Blinders: How Canadian Women Utilize the Nutrition Facts Table

PURPOSE

To better understand how consumers use the Nutrition Facts Table (NFT) in their everyday shopping decisions and food consumption habits.

METHODS

Thirteen Canadian females were interviewed about how they use the NFT in their food choices.

RESULTS

Different elements of the front of the package served different purposes. Health claims and health checks drew attention to the product, but were not highly trusted. Ingredient lists were used to find "real food." NFTs were considered important with each participant reporting an individualized strategy for using the NFT characterized by the application of benchmarks and blinders. The term "blinders" reflected only seeing and using one specific nutrient by assessing whether or not it exceeded a certain "benchmark" established by the participant. Therefore, the level of one specific nutrient determined the healthfulness of the product and the subsequent purchase/consumption decision.

CONCLUSIONS

Findings suggest that NFTs should be redesigned. Some ideas for redesign include only listing "unhealthy" nutrients, having serving sizes more congruent to what is eaten in a typical sitting, making it easier to identify when a food may be high in a nutrient, and providing ways to allow the NFT to be used to meet personal, individualized needs.

Developing Nutrition Label Reading Skills: A Web-Based Practice Approach

Background

Nutrition labels offer the information needed to follow Dietary Guidelines for Americans, yet many individuals use labels infrequently or ineffectively due to limited comprehension and the effort required to use them.

Objective

The objective of our study was to develop and test a Web-based label-reading training tool to improve individuals’ ability to use labels to select more healthful foods. We were particularly interested in determining whether practice can lead to increased accuracy using labels as well as decreased effort, together reflecting greater efficiency. We compared a basic and an enhanced, prior-knowledge version of the tool that contained an additional component, a brief nutrition tutorial.

Methods

Participants were 140 college students with an average age of 20.7 (SD 2.1) years and education 14.6 (SD 1.2) years, who completed 3 sets of practice that were designed to teach them, through repetition and feedback, how to use nutrition labels to select more healthful products. Prior to training, participants in the prior-knowledge group viewed a multimedia nutrition presentation, which those in the basic group did not receive. Mixed-effects models tested for improvement in accuracy and speed with practice, and whether improvements varied by group.

Results

The training led to significant increases in average accuracy across the 3 practice sets (averaging 79% [19/24 questions], 92% [22/24], 96% [23/24] respectively, P<.001), as well as decreases in time to complete with mean (SD) values of 8.7 (2.8), 4.6 (1.8), and 4.1 (1.7) seconds, respectively. In block 3, the odds of a correct answer for the prior-knowledge group were 79% higher (odds ratio, OR=1.79, 95% CI 1.1-2.9) than those for the basic group (P=.02). There was no significant difference between the groups in block 2 (P=.89).

Conclusions

Practice led to improvements in nutrition label reading skills that are indicative of early stages of automatic processing. To the extent that automatic processes are at the core of healthy habit change, this may be an efficient way to improve dietary decision-making.

Are Food Labels Effective as a Means of Health Prevention?

Chronic diseases related to unbalanced and unhealthy eating habits have definitely become one of the major issues of modern age, not only in western countries but also in those ones where rapid economic growth has increased global prosperity levels. In order to avoid medical systems to collapse under excessive costs, International and Public Organizations strongly support health policies that aim to make people shift towards wholesome dietary patterns, also encouraging the use of food-labels to choose healthier products. To evaluate the consumers’ knowledge and perception about food-labels a brief questionnaire was developed and shared on Facebook between January-March 2016. Most of the participants were young adults with higher education. They declared to do their shopping at least once a week, reading the food-labels quite often. Despite owing limited knowledge in basic nutrition principles and food-labelling they were generally able to recognize healthier products looking over their nutritional fact tables. Anyway, on average, what they care the most about the products they purchase is the global quality level rather than the nutritional values. In order to induce the whole population to use food label as an effective self-protection tool, more efforts should be done to improve their knowledge on nutrition fundamentals and basics about food labelling, because that would make them able to take safer and more conscious choices as regards their own health.

Salient nutrition labels increase the integration of health attributes in food decision-making

Every day, people struggle to make healthy eating decisions. Nutrition labels have been used to help people properly balance the tradeoff between healthiness and taste, but research suggests that these labels vary in their effectiveness. Here, we investigated the cognitive mechanism underlying value-based decisions with nutrition labels as modulators of value.

More specifically, we used a binary decision task between products along with two different nutrition labels to examine how salient, color-coded labels, compared to purely information-based labels, alter the choice process. Using drift-diffusion modeling, we investigated whether color-coded labels alter the valuation process, or whether they induce a simple stimulus-response association consistent with the traffic-light colors irrespective of the features of the item, which would manifest in a starting point bias in the model. We show that color-coded labels significantly increased healthy choices by increasing the rate of preference formation (drift rate) towards healthier options without altering the starting point. Salient labels increased the sensitivity to health and decreased the weight on taste, indicating that the integration of health and taste attributes during the choice process is sensitive to how information is displayed. Salient labels proved to be more effective in altering the valuation process towards healthier, goal-directed decisions.

Parental Nutrition Knowledge Rather Than Nutrition Label Use Is Associated With Adiposity in Children

OBJECTIVE

Determine how parental nutrition label use, label literacy, and nutrition knowledge may be associated with cardiovascular health in parents and their children.

DESIGN AND SETTING

Cross-sectional analyses of 2006 data from the Healthy Heart Project in Montreal, Canada.

PARTICIPANTS

Among community recruited families, parents were predominantly mothers (n = 127 [80%]; mean age, 45.0 years) and half of their children were female (44%; mean age, 12.5 years).

MAIN OUTCOME MEASURES

Blood pressure, lipids, and weight. Nutrition label use, label literacy, and nutrition knowledge among parents were collected using existing scales.

ANALYSES

Multivariable linear regression models.

RESULTS

Among parents, nutrition label use was associated with lower total cholesterol (B[SE] = -.53 [.20]; P = .009), lower low-density lipoprotein (B[SE] = -.57 [.21]; P = .007), and lower total cholesterol/high-density lipoprotein cholesterol ratio (B[SE] = -.82 [.30]; P = .008) but was not associated with adiposity. Among children, greater parental nutrition knowledge was associated with lower body mass index percentiles (B[SE] = -3.6 [1.49]; P = .02), lower waist circumference (B[SE] = -1.27 [.55]; P = .02), and lower percent body fat (B[SE] = -1.28 [.47]; P = .008). Parental nutrition label use or nutrition knowledge was not associated with children's lipids.

CONCLUSIONS AND IMPLICATIONS

Parents with greater nutrition label use had more favorable lipids, but children's lipids were unaffected. Children of parents with greater nutrition knowledge had lower adiposity. Further research on the correlates of label use and health is needed.