The impact of price reductions on individuals' choice of healthy meals away from home

Effectiveness of nutrition education in enhancing knowledge and attitude of pupils on choice of school mid-day meal in Ibadan, Nigeria

Children's food choices affect their nutritional health, development, and well-being. In Nigeria, school lunch is generally unregulated; the food menu is usually at the discretion of individual vendors forcing pupils to make unsupervised food choices. This study examined the effectiveness of 6-week nutrition education in enhancing pupils' knowledge and attitude on the school mid-day meal choices in Ibadan, Nigeria. A pre-test/post-test, quasi-experimental study was conducted with 100 pupils in 4th and 5th grades in public primary schools. Multistage sampling was used to select the participants. A nutrition education module and a questionnaire were used to collect the data. Frequency counts and t-test were used for statistical analysis. Findings revealed the following dietary pattern: 44 of the pupils preferred junk food (mean 41.5, SD = 12.9), 37 were inclined toward protein-rich food (mean 37.7, SD = 12.5), 32 favored food items dense in carbohydrates (mean 34.4, SD = 9.5), and 11 showed a preference toward food with high vitamins and minerals (mean 28.4, SD = 7.5). Nutrition knowledge (t = 6.4, df = 99, p < .05); (pre-test: X¯ = 20.9 and SD = 1.0; post-test: X¯ = 22.8, SD = 2.8) and attitude toward choice of meal showed statistically significant differences (t = 4.9, df = 99, p < .05; pre-test: X¯ = 13.5 and SD = 6.8; post-test: X¯ = 18.2, SD = 7.2). We recommend that the Ministry of Education should prepare a standard lunch menu for all schools and the school authorities should enforce it through the schools' food vendors.

Exploring Purchasing Determinants for a Low Fat Content Salami: Are Consumers Willing to Pay for an Additional Premium?

Consumers today are increasingly moving toward healthier lifestyles and food purchasing habits. This new awareness has also prompted the meat industry, usually indicted for the use of harmful compounds and ingredients such as additives, salt, and fat, to introduce innovative measures to meet demand. This study aims to assess consumer willingness to pay an additional price premium (APP) for a healthy salami by identifying which factors are more likely to have an effect on the willingness to purchase, such as socio-demographic and product and market-related attributes. An Ordered Logit model has been applied to define factors influencing consumers' willingness to pay for a low-fat salami. Results show a favorable consumer acceptance of reduced-fat salami conveyed by the willingness of consumers to pay an additional price for this product and confirm that the health awareness of consumers is an important driving force in cured meat marketing strategies.

Spontaneous Variety-Seeking Meal Choice in Business Canteens Impedes Sustainable Production

Sustainable meal choices in the out-of-home catering market are essential to attaining the Sustainable Development Goals. This study investigated consumers’ acceptance of different features that help service providers to work more sustainably. For this purpose, data of a choice experiment and a supporting online questionnaire were analyzed using latent class analysis (LCA) and the data of n = 373 employees. Examined attributes in the choice experiment were menu variety, menu type, ordering system, ingredients and price. LCA led to four consumer segments: variety seekers (27.6%), spontaneous decisionmakers—vegetarian (25.7%), spontaneous decisionmakers—meat (24.1%) and vegetarians/vegans (22.6%). Results showed that consumers in all four segments expected to have the choice between different menus in company canteens. Moreover, they preferred spontaneous choice to preordering. Both preferences hamper sustainable production and consumption in the catering sector.

Systematic Review on International Salt Reduction Policy in Restaurants

As the catering sector has increasingly contributed to population-level salt intake, many countries have begun developing salt-reduction strategies for restaurants. This paper aims to provide an overview of global salt reduction policies in restaurants. Scientific papers and website materials were systematically searched from Web of Science, Science Direct, and PubMed, as well as official websites of government departments and organizations. A total of 78 full-text papers and grey literature works were included. From 58 countries and regions, 62 independent policies were identified, 27 of which were mandatory (3 with fines). The most common strategy was menu labeling, which was a component of 40 policies. Target setting (n = 23) and reformulation (n = 13) of dishes were also widely implemented. Other salt-reduction strategies included education campaign, chef training, toolkits delivery, table salt removal, media campaign, and government assistance such as free nutrition analysis and toolkits distribution. Most policies focused on chain restaurants. Evaluations of these policies were limited and showed inconsistent results, and more time is needed to demonstrate the clear long-term effects. Attention has been paid to salt reduction in restaurants around the world but is still at its early stage. The feasibility and effectiveness of the strategies need to be further explored.

Modelling the Effect of Compliance with Nordic Nutrition Recommendations on Cardiovascular Disease and Cancer Mortality in the Nordic Countries

The objective of this study is to estimate the number of deaths attributable to cardiovascular diseases and diet-related cancers that could be prevented or delayed in the Nordic countries, i.e., Sweden, Denmark, Finland, Norway, and Iceland, if adults adhere to the Nordic Nutrition Recommendations (NNR). A sex- and age-group specific epidemiological macro-simulation model was used to estimate the preventable deaths due to the differences between country specific actual intake and recommended intake of changes in food components. Data included in the model are a baseline scenario (actual dietary intake), a counterfactual scenario (recommended intake), and age-and sex-specific mortality for cardiovascular and diet-related cancer diseases, together with the total population risk of a specific year. Monte Carlo analyses with 5000 iterations were performed to produce the 95% uncertainty intervals. The model predicts that Iceland would benefit the most by adhering to the NNR, followed by Finland. In all the Nordic countries, the highest benefit would be achieved by adhering to the fruits and vegetable intakes, except Denmark, where a lower recommended intake of salt would provide the highest benefit. For men, fruits and vegetables could have saved more lives compared to other dietary components for all the Nordic countries, while for women, dietary fiber was the most prominent factor, except in Iceland. The Nordic Council should consider policies for promoting healthy eating according to the needs of each country.

Are consumers willing to pay more for reformulated processed meat products in the context of the implementation of nutritional warnings? Case study with frankfurters in Chile

The aim of the present work was to assess consumers' willingness to pay for reformulated frankfurters in the context of the implementation of nutritional warnings. Images of frankfurter packages were designed using a fractional factorial design with 5 2-level variables: brand type, sodium reduction, saturated fat reduction, fibre claim and cholesterol claim. An online study with 548 consumers was implemented with Chilean participants, who were asked to indicate how much they would be willing to pay for each of the packages. Data were analysed using analysis of variance and hierarchical cluster analysis. Willingness to pay was significantly affected by brand type and sodium and fat reduction, whereas fibre and cholesterol claim did not have a significant effect. These results suggest that in the context of the implementation of nutritional warnings reformulation of processed meat products should focus on the reduction of key nutrients, although consumers may not be willing to pay a higher price for reformulated products.

Does Eating-Away-from-Home Increase the Risk of a Metabolic Syndrome Diagnosis?

Rising frequency of eating-away-from-home (EAFH) is suspected to be correlated with several non-communicable diseases. This study adopted the Chinese Health and Nutrition Survey (CHNS) 2009 data to investigate the association between being diagnosed with the metabolic syndrome (MetS) and EAFH at different ages. Results showed that the association between EAFH and MetS varied at different ages and differed for males and females. EAFH was positively associated with a higher risk of getting MetS for males, especially for those aged between 45 and 60; while it was negatively associated with the risk of getting MetS for young females (<45) (all p < 0.05). In particular, EAFH was associated with a lower risk of getting high serum triglycerides (TGs), abdominal adiposity, elevated blood pressure, and impaired fasting blood glucose for young females, while higher risk of high serum TGs, abdominal adiposity, elevated blood pressure, and impaired fasting blood glucose for middle-aged males (all p < 0.05). In addition, a higher frequency of EAFH was associated with a higher risk of abdominal adiposity and elevated blood pressure for older women, and a lower risk of elevated blood pressure, and impaired fasting blood glucose for younger men (all p < 0.05). Our study implies that heterogeneous target strategies for preventing MetS in different subpopulation should be considered.

Diving into the consumer nutrition environment: A Bayesian spatial factor analysis of neighborhood restaurant environment

Neighborhood restaurant environment (NRE) plays a vital role in shaping residents' eating behaviors. While NRE 'healthfulness' is a multi-facet concept, most studies evaluate it based only on restaurant type, thus largely ignoring variations of in-restaurant features. In the few studies that do account for such features, healthfulness scores are simply averaged over accessible restaurants, thereby concealing any uncertainty that attributed to neighborhoods' size or spatial correlation. To address these limitations, this paper presents a Bayesian Spatial Factor Analysis for assessing NRE healthfulness in the city of Kitchener, Canada. Several in-restaurant characteristics are included. By treating NRE healthfulness as a spatially correlated latent variable, the adopted modeling approach can: (i) identify specific indicators most relevant to NRE healthfulness, (ii) provide healthfulness estimates for neighborhoods without accessible restaurants, and (iii) readily quantify uncertainties in the healthfulness index. Implications of the analysis for intervention program development and community food planning are discussed.

Changing the restaurant food environment to improve cardiovascular health in a rural community: implementation and evaluation of the Heart of New Ulm restaurant programme

Objective

The goals of the present study were to: (i) describe the implementation of a programme to improve the restaurant food environment in a rural community; and (ii) describe how practices changed in community restaurants.

Design

The intervention included a baseline assessment of all community restaurants (n 32) and a report on how they could increase the availability and promotion of healthful options. The assessment focused on sixteen healthy practices (HP) derived from the Nutrition Environment Measures Survey for Restaurants. Restaurants were invited to participate at gold, silver or bronze levels based on the number of HP attained. Participating restaurants received dietitian consultation, staff training and promotion of the restaurant. All community restaurants were reassessed 1·5 years after baseline.

Setting

The restaurant programme was part of the Heart of New Ulm Project, a community-based CVD prevention programme in a rural community.

Subjects

All community restaurants (n 32) were included in the study.

Results

Over one-third (38 %) of community restaurants participated in the programme. At baseline, 22 % achieved at least a bronze level. This increased to 38 % at follow-up with most of the improvement among participating restaurants that were independently owned. Across all restaurants in the community, the HP showing the most improvement included availability of non-fried vegetables (63–84 %), fruits (41–53 %), smaller portions and whole grains.

Conclusions

Findings demonstrate successes and challenges of improving healthful food availability and promotion in a community-wide restaurant programme.