The combined effect of front-of-pack nutrition labels and health claims on consumers’ evaluation of food products

A Cross-Sectional Study of Sports Food Consumption Patterns, Experiences, and Perceptions amongst Non-Athletes in Australia

Sports foods are designed for athletes, yet their availability, type, and sales have increased over the past decade, likely driven by non-athlete use. This could lead to detrimental health outcomes via over/misuse or unwanted side effects. The aim of this study was to describe sports food consumption patterns and associated drivers, consumption reasons, perception of risks, and side effects experienced amongst non-athletes in Australia. In 2022, n = 307 non-athlete Australian adults (18-65 years) completed an online cross-sectional survey including closed-ended (consumption patterns, factors, and exercise participation) and open-ended questions (reasons for consumption, risk perception, and side effects experienced). Descriptive statistics (frequency and percent) described the sample. Ordinal logistic regression was used for univariate associations and a multivariate model was used to determine relationships between sports food consumption proxy and significant univariate associations. The themes were analysed via inductive thematic analysis using NVivo 14. Females consumed sports foods most frequently, 65% of participants consumed three or more sports foods, and participants with higher sports food consumption/frequency were less likely to perceive risks or experience side effects. The main reason for consumption was protein intake, digestion/stomach issues were the main perceived risks, and the main side effect was bloating. Despite understanding the risks and side effects, non-athlete consumers continue to use numerous sports foods, which appear to be influenced by sociodemographic factors and packaging labels. Tighter regulation of packaging-label information would ensure safer and more informed consumption.

Chinese consumers' psychology and behavior of the foods with nutrition claims based on AISAS model

Objective

We analyzed the impact of nutrition claims on Chinese consumer psychology and behavior process based on the theoretical framework of AISAS (Attention-Interest-Search-Action-Share) model.

Design

To adopt questionnaires to collect gender, age, income and other basic information of adult residents and a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree) to collect data on residents' attention to nutrition claims, interest in nutrition claims, search on nutrition claim information, purchasing behavior on food with nutrition claims, sharing information on food with nutrition claims. Then to study the relationship between the basic situation of residents and their attention, interest, search, food purchase behavior and sharing of nutrition claims by using exploratory factor analysis, reliability and validity test, structural equation modeling estimation and hypothesis testing.

Participants

Chinese adults.

Setting

Multi-stage stratified random sampling method was used to collect the valid online questionnaire of 630 Chinese adults from Central, North, East, South, Northwest, Southwest, and Northeast China.

Results

Younger adults and those with higher household incomes exhibited heightened attention to nutrition claims. Furthermore, consumers' attention to nutrition claims could be transformed into food information sharing through interest, information search, and food purchase. Consumers' interest in food with nutrition claims could be transformed directly into food purchase. Consumers' search for related information could be directly transformed into food information sharing.

Conclusion

Chinese consumers' age and household income could be included in the AISAS model for the foods with nutrition claims, and the consumers' action and share could transform from their interest and search.

Evaluating source credibility effects in health labelling using vending machines in a hospital setting

OBJECTIVES

Providing advice to consumers in the form of labelling may mitigate the increased availability and low cost of foods that contribute to the obesity problem. Our objective was to test whether making the source of the health advice on the label more credible makes labelling more effective.

METHODS AND MEASURES

Vending machines in different locations were stocked with healthy and unhealthy products in a hospital. Healthy products were randomly assigned to one of three conditions (i) a control condition in which no labelling was present (ii) a low source credibility label, "Lighter choices", and (iii) a high source credibility label that included the UK National Health Service (NHS) logo and name, "NHS lighter choices". Unhealthy products received no labelling. The outcome measure was sales volume.

RESULTS

There were no main effects of labelling. However, there were significant interactions between labelling, vending machine location and payment type. For one location and payment type, sales of products increased in the high credibility label condition compared to control, particularly for unhealthy products, contrary to expectations.

CONCLUSIONS

Our findings suggest that high source credibility health labels (NHS endorsement) on food either have little effect, or worse, can "backfire" and lead to effects opposite to those intended. The primary limitations are the limited range of source credibility labels and the scale of the study.

Consumer perceptions of nutrient content claims in Australia: A qualitative study

BACKGROUND

Nutrition and health claims influence consumer purchasing. Claims include content claims, which refer to the amount of a nutrient contained in a product, and health claims, which refer to health benefits of foods or nutrients in a product. Products that display a health claim must meet the Nutrient Profiling Scoring Criterion (NPSC). The present study aimed to explore consumer perceptions of content claims used on food and beverage labelling and advertisements.

METHODS

Semi-structured focus groups were conducted with Australian consumers. Analysis involved an inductive, reflexive approach to thematic analysis.

RESULTS

Six focus groups involving 26 participants were conducted. Four main interconnected themes were generated: (1) complex factors influence food choice; (2) content claim scepticism; (3) the difference between content and health claims is unclear; and (4) the regulation of content claims is not common knowledge. Content claims were used, although generally viewed through a lens of scepticism and mistrust, and seen as a promotional tool for the food industry. Product complexity appeared to increase content claim use as a result of consumer uncertainty of the content of complex products, such as ultraprocessed foods. Most participants were aware that content and health claims were in some way regulated. Overall, they did not know further detail, including the relevant regulatory body.

CONCLUSIONS

For content claims to support the consumer they need to be accurate and their use limited to healthier foods. This can be achieved by requiring products with content claims to meet NPSC thresholds, as required for products making health claims.

The Effects of Social Distance and Front-of-Package Claims on Healthy Food Selection: Moderating Role of Perceived Importance of Eating Healthily

Applying construal level theory, this study examined how social distance (thinking of self/children), front-of-package (FOP) claim type (nutrient/health/control), and perceived importance of eating healthily (low/high) impact consumer responses (attitudes/purchase intent) to healthier food products through an online experiment with 171 U.S. parents from low-to-mid socio-economic households. Participants were randomly assigned to view controlled images of healthier foods with packaging that bore different claim types for real and fictitious brands. Results revealed that when choosing for themselves, consumer attitudes were more positive when the healthier food package carried a nutrient (vs. health) claim, however, control claims received the most positive evaluations. When choosing for children, attitudes were more positive when the package carried a health (vs. nutrient/control) claim. Attitudes toward healthier foods were higher for consumers with high (vs. low) perceived importance of eating healthily when the package bore a nutrient claim, however, their attitudes did not significantly differ when the package bore a health/control claim. Purchase intent for healthier foods was higher for consumers with high (vs. low) perceived importance of healthy eating when shopping for self; whereas, when shopping for children, purchase intent did not significantly differ between consumers who varied in perceived importance of eating healthily.

Consumers' willingness to pay for health claims during the COVID-19 pandemic: A moderated mediation analysis

The COVID-19 pandemic has posed a substantial threat to people's lives and raised health concerns. This research explores the mediating role of consumers' attitudes towards health claims in the relationship between consumers' interest in health claims and their willingness to pay (WTP) for health claims in extra virgin olive oil (EVOO). Additionally, we examine the moderation effect of COVID-19 risk perception in the relationship between consumers' interest in and attitudes towards health claims. Data were collected through an online survey in three countries: Spain, the UK and Chile. Findings confirm the mediating role of consumers' attitudes towards health claims. Furthermore, the relationship between consumers' interest and their attitudes towards health claims was stronger when COVID-19 risk perception was higher.

Sports foods are not all they shake up to be. An audit of formulated supplementary sports food products and packaging in Australian retail environments

Objective

To determine store availability, total number of products, and types of Formulated Supplementary Sports Foods in Australia, along with their stated nutrition content, sweeteners added, total number, and type of claims displayed on the packaging.

Design

A cross-sectional, visual product audit of mainstream retailers.

Setting

Supermarkets, pharmacies, health food stores, and gym/fitness centres.

Results

A total of 558 products were captured in the audit, 275 of which displayed the correct mandatory packaging attributes. Three categories of products were identified, based on the dominant nutrient. Only 184 products appeared to display the correct energy value based on the listed macronutrient content (protein, fat, carbohydrate, dietary fibre). The stated nutrient content was highly variable across all product subcategories. Nineteen different sweeteners were identified, with most foods containing only one (38.2%) or two (34.9%) types. The predominant sweetener was stevia glycosides. Packages displayed multiple claims, with a maximum of 67 and minimum of 2 claims. Nutrition content claims were most frequently displayed (on 98.5% of products). Claims included regulated, minimally regulated and marketing statements.

Conclusion

Sports food consumers should be provided with accurate and detailed on pack nutrition information, to ensure informed choices are made. However, this audit showed multiple products which did not conform to current standards, appeared to provide inaccurate nutrition information, contained multiple sweeteners, and displayed an overwhelming number of on-pack claims. The increase in sales, availability, and products available in mainstream retail environments, could be impacting both intended consumers (athletes), and general non-athlete population. The results indicate underperformance in manufacturing practices which preference marketing over quality and stronger regulatory approaches are needed to protect consumer health and safety, and to prevent misleading consumers.

Awareness, use and understanding of nutrition labels among adults from five countries: Findings from the 2018-2020 International Food Policy Study

Few studies have compared the effects of different front-of-package label (FOPL) systems in the 'real world'. This study assessed adults' awareness, use and understanding of nutrition facts labels (NFLs) and nationally implemented FOPLs such as Health Star Ratings (HSR), Traffic lights, and Guideline Daily Amounts (GDAs) in five countries, including before and after implementation of Mexico's warning FOPLs in 2020. Data were from the International Food Policy Study, an annual repeat cross-sectional study conducted in 2018-2020 among adults (N=64,032) in Australia, Canada, Mexico, the UK and the US. Self-reported awareness, use, and understanding of NFLs (in all five countries) and FOPLs (in Australia, Mexico, and UK) were assessed over time, between countries, and between NFLs and FOPLs. Most respondents in all countries reported seeing their country's NFLs (awareness) 'often' or 'all the time' across all three years, with one third to half of respondents using NFLs 'often' or 'all the time' (Australia: 43-45%; Canada: 47-50%; Mexico: 36-39%; UK: 32-34%; US: 47-49%), and approximately one half to two thirds finding NFLs 'easy' or 'very easy to understand' (56-57%; 67-69%; 51-54%; 48-51%; 70-71%). In 2020, awareness, use and self-reported understanding of the Warning FOPLs in Mexico were highest among all countries with a FOPL (p<0.001), whereas awareness and use were lowest for Australia's HSR (p<0.001). In countries with FOPLs, self-reported understanding was higher for FOPLs than NFLs, except for the GDA FOPL in Mexico. Only modest changes were observed over time. Warning FOPLs were associated with greater levels of self-reported awareness, use and understanding among adults compared to NFLs and GDA-based FOPLs. FOPLs implemented on a voluntary basis, such as Australia's HSR, may be less likely to be seen and used.

Influence of nutrition claims on different models of front-of-package nutritional labeling in supposedly healthy foods: Impact on the understanding of nutritional information, healthfulness perception, and purchase intention of Brazilian consumers

Nutrition claims are positive information about foods, which are widely used as a marketing strategy on labels. On the contrary, front-of-package nutritional labeling (FoPNL) aims to make it easier for consumers to understand the nutritional composition of foods and favor healthy food choices. However, the concomitant presence of nutrition claims and FoPNL may hinder the understanding, judgment, and choices of consumers at the moment of purchase. Therefore, the objective of this study was to evaluate the influence of nutrition claims on the efficacy of FoPNL models in the understanding of nutritional information, healthfulness perception, and purchase intention of Brazilian consumers. It was an experimental cross-sectional study carried out using an online questionnaire, with a total of 720 participants randomly divided into four FoPNL conditions: control, octagon, triangle, and magnifying glass. Each participant looked at 12 food packages, which were produced following the factorial design: (i) food category (cereal bar, whole grain cookies, and snacks); (ii) product type (containing one critical nutrient × containing two critical nutrients); and (iii) nutrition claims (present × absent). The comprehension of nutritional information was evaluated through the identification of excessive nutrients, and the healthfulness perception and purchase intention were evaluated using a seven-point scale. The results indicated that the presence of FoPNL increased the understanding of the information and reduced healthfulness perception and purchase intention. The presence of nutrition claims influenced the three outcomes, decreasing the probability of understanding information about food composition by 32% (OR 0.68, 95% confidence interval 0.58–0.78, p &lt; 0.01) and significantly increasing (p &lt; 0.05) average health scores (1.95–2.02) and purchase intention (2.00–2.05). Nonetheless, the interaction “FoPNL × claims” was not significant, which indicated that claims act independently. All FoPNL models were more effective than the control. For the least healthful type of product (two nutrients in excess), the octagon and triangle models were superior to the magnifying glass, regarding the outcome of healthfulness perception. The results prove the efficacy of FoPNL in consumer understanding and judgment. Despite the positive effects of FoPNL, it did not cancel the positivity bias generated by the claims.

Uncovering the Effect of European Policy-Making Initiatives in Addressing Nutrition-Related Issues: A Systematic Literature Review and Bibliometric Analysis on Front-of-Pack Labels

The last decades have been marked by the introduction of front-of-pack labels (FoPL) as an institutional corrective action against obesity and nutrition-related illnesses. However, FoPL-related policy-making initiatives issued by the European Union evolved over time and led to a diversity of labels with different effects on consumers’ decisions. As a result, the extant literature adapted to the regulative scenario over the years and investigated the effects of the labels, creating consensus on some topics while being fragmented on others. Similarly, policy-makers adapted some regulations to the evidence supported by the research. With the aim to systematize the overall structure and evolution of the literature on FoPL, investigate the presence of a consensus on specific topics through a co-citation analysis, and examine the evolution of the consensus and co-citation networks over the years and potential research gaps, we report the results of bibliometric and co-citation analyses and a systematic literature review involving 170 papers and a selection of 49 articles published in the last months, for a total of 219 articles, analysed according to three timespans (Period 1 (1989–2011); Period 2 (2012–2016) and Period 3 (2017–2022)). Our findings highlight the interplay of policy development and FoPL research, the presence of few self-reinforcing and well-established co-citation networks based on validated evidence in the literature and the presence of alternative emerging theories that offer different and valid perspectives overlooked by mainstream co-citation research networks.

The Source of Protein or Its Value? Consumer Perception Regarding the Importance of Meat(-like) Product Attributes

Food product attributes may significantly influence the general perception of the product itself, as well as the willingness for its consumption. Assessment of the product is based on customers’ beliefs and individual preferences. Because meat-like products are presented as meat substitutes providing sufficient protein values, the present study aimed to determine the effect of protein source and labelling pointing at high protein content on the evaluation of the product. The experimental online study was conducted with a group of 552 respondents. Four versions of product packaging were designed and tested. These packages differed in the presence or absence of the Nutrition Claim and the presence of the text indicating the vegetable or meat origin of the product. Data collected in the experiment were analyzed using a 2 × 2 ANOVA. The study revealed that the source of protein (plant vs. animal) appears to shape consumers’ perception of the product as more eco-friendly (F (1.518) = 38.681, p < 0.001, η2 = 0.069), natural (F (1.518) = 15.518, p < 0.001, η2 = 0.029), and healthy (F (1.518) = 25.761, p < 0.001, η2 = 0.047). Moreover, labelling including a “high-protein” Nutrition Claim increases the willingness to consume the product (F (1.518) = 4.531, p = 0.034, η2 = 0.009), and provides the impression of it being more eco-friendly (F (1.518) = 6.658, p = 0.01, η2 = 0.012) and of a higher quality (F (1.518) = 7.227, p = 0.007, η2 = 0.014). The obtained results may have theoretical significance by improving the understanding of factors determining the perception of food products and the use of meat substitutes.

An Exploratory Study of the Purchase and Consumption of Beef: Geographical and Cultural Differences between Spain and Brazil

Beef consumption and production in Spain and Brazil are different with the consumption of beef in Brazil being three times higher than in Spain. In addition, there are variations in the economic value of production and in the traceability system. Therefore, the aim of this research was to understand the purchasing and consumption patterns using the customer behavior analysis technique of focus groups, which analyzed motivations for the consumption of beef, classifying their preferences by the intrinsic and extrinsic attributes at the time of purchase. The key aspect of the consumption of beef, both for Spanish and Brazilian consumers, was personal satisfaction/flavor. Spanish consumers were more conscious than Brazilians of the beneficial and harmful qualities that meat provides. The presence of fat was the factor that most restricted intake in both countries. The most important intrinsic attributes for Spanish and Brazilian consumers were the visual aspects of the meat: color, freshness, and the quantity and disposition of fat. The most important extrinsic characteristics were the price and expiration date. Spanish consumers see packaged meat as convenient and safe, although it is considered by Brazilians to be over-manipulated. The traceability certification on the label provides credibility to the product for the Spanish but only partially for Brazilians.

Sugar-Sweetened Beverage Reduction Policies: Progress and Promise

Evidence showing the effectiveness of policies to reduce the consumption of sugar-sweetened beverages (SSBs) is growing. SSBs are one of the largest sources of added sugar in the diet and are linked to multiple adverse health conditions. This review presents a framework illustrating the various types of policies that have been used to reduce SSB exposure and consumption; policies are organized into four categories (financial, information, defaults, and availability) and take into consideration crosscutting policy considerations (feasibility, impact, and equity). Next, for each category, we describe a specific example and provide evidence of impact. Finally, we discuss crosscutting policy considerations, the challenge of choosing among the various policy options, and important areas for future research. Notably, no single policy will reduce SSB consumption to healthy levels, so an integrated policy approach that adapts to changing market and consumption trends; evolving social, political, and public health needs; and emerging science is critical.

Added value of physical food products as a stimulus during interviewing

Semi-structured interviews are an often-used method for researching consumer perceptions of food products. However, understanding detailed and in-depth how consumers perceive food products is challenging for researchers because it could be difficult for consumers to express their motives and perceptions. In our previous studies using semi-structured interviews, this difficulty to express perceptions was also recognized, especially when concepts like naturalness, sustainability and healthiness were discussed. However, in both studies physical food products were used as stimuli and there was an indication that there might be differences in the number and type of answers given before and after the use of these stimuli products. Therefore, the current research aimed at showing effects and the possible value of using physical food stimuli products during semi-structured interviews. Two different studies were used to reach this aim, one study about the health perception of mothers and the other study about the naturalness, sustainability and healthiness perception of adolescents, both using snack products as physical stimuli. In both studies, the use of physical stimuli products appeared to be effective and useful. The comparison of the answers with and without stimuli products showed that using stimuli products provides more, and more detailed answers on the perception of the products. Therefore, the results of this study could serve as a guideline on the use of food stimuli products during semi-structured interviews.

Artificial Intelligence in Functional Food Ingredient Discovery and Characterisation: A Focus on Bioactive Plant and Food Peptides

Scientific research consistently demonstrates that diseases may be delayed, treated, or even prevented and, thereby, health may be maintained with health-promoting functional food ingredients (FFIs). Consumers are increasingly demanding sound information about food, nutrition, nutrients, and their associated health benefits. Consequently, a nutrition industry is being formed around natural foods and FFIs, the economic growth of which is increasingly driven by consumer decisions. Information technology, in particular artificial intelligence (AI), is primed to vastly expand the pool of characterised and annotated FFIs available to consumers, by systematically discovering and characterising natural, efficacious, and safe bioactive ingredients (bioactives) that address specific health needs. However, FFI-producing companies are lagging in adopting AI technology for their ingredient development pipelines for several reasons, resulting in a lack of efficient means for large-scale and high-throughput molecular and functional ingredient characterisation. The arrival of the AI-led technological revolution allows for the comprehensive characterisation and understanding of the universe of FFI molecules, enabling the mining of the food and natural product space in an unprecedented manner. In turn, this expansion of bioactives dramatically increases the repertoire of FFIs available to the consumer, ultimately resulting in bioactives being specifically developed to target unmet health needs.

Labeling Nutrition-Sensitive Food Chains: A Consumer Preference Analysis of Milk Products

While nutrition-sensitive value-chain approaches are strongly advocated, studies on consumer preferences for such interventions are lacking. This study aims to fill this gap by examining a nutrition-sensitive chain labeling scheme, using the Ugandan dairy sector as a case. A survey was conducted among 250 consumers, primarily eliciting perceptions of the importance of a nutrition-sensitive chain label compared to nutrition claims/facts. In addition, a choice-based conjoint experiment was designed with nutrition label, brand, fat content, and price as attributes. Findings show that nutrition-sensitive chain labeling was more positively perceived by consumers than by nutrition claims/facts. Ordered logistic regression analysis indicated that BMI, nutrition knowledge, and label use influenced consumers' perceived importance of a nutrition-sensitive chain label relative to sex, age, children, and milk purchase frequency for nutrition claims/facts. This is confirmed by the higher utilities for the nutrition-sensitive chain label in our conjoint experiment. Future research should focus on the integration of nutrition-sensitive chain labeling with existing labels in a way that promotes candid interpretation by consumers. Industrial and policy actors in the agri-food sector can use these findings to innovate and regulate appropriate labeling schemes in the context of nutrition-sensitive value chains.

Supermarket Circulars Promoting the Sales of 'Healthy' Foods: Analysis Based on Degree of Processing

The health and wellness food sector grew 98% from 2009 to 2014 in Brazil, the world's fourth-biggest market. The trend has reached supermarket circulars, which recently started to feature whole sections advertising health and wellness-enhancing foods. This study identified food items advertised in circulars' specific sections of two Brazilian supermarket chains (one regional, one national) during a 10-week period. Foods were classified according to degree of food processing and presence/type of claims on their front-of-pack (FoP) labels. Comparison between groups of Unprocessed/Minimally Processed foods vs. Ultra-processed foods and presence/type of claims employed Pearson chi-square test. From the 434 alleged health and wellness-enhancing foods advertised, around half (51.4%) were classified as Ultra-processed. Presence of reduced and increased nutrient-content claims was significantly higher in labels of Ultra-processed foods. Most frequent claims addressed sugar and fibre content. Brazilian supermarket circulars were found to be promoting the sale of Ultra-processed foods in their health and wellness sections, leading to a situation that can mislead the consumer and bring negative health outcomes.

Nutrition, hedonic or environmental? The effect of front-of-pack messages on consumers' perception and purchase intention of a novel food product with multiple attributes

The present study aims to assess the effect of different Front-Of-Pack messages on consumer perception, willingness to buy and willingness to pay for a new food product, with multiple attributes, such as particular nutritional information, sensory characteristics, and a potentially positive environmental impact. Furthermore, this study explores the differences between consumers based on their individual latent traits in order to evaluate how these factors affect the willingness to buy the new product, as well as to outline a profile of target consumers attracted by innovative food products. A consumer survey was conducted on a representative sample of 1250 Italian consumers, using a between-subject design with different Front-Of-Pack messages as stimuli. Messages were related to different attributes: nutrition, environmental impact, hedonic characteristics, and process innovation. Empirical findings show that Front-Of-Pack messages do not directly affect consumer willingness to buy, but they do influence consumer perception of the product. The most effective message is the nutrition one. Consumer willingness to buy is particularly influenced by product perception and by their novelty seeking orientation in consumption. Furthermore, consumers were segmented through hierarchical clustering based on their novelty seeking orientation. The results obtained provide valuable suggestions for the design of new products' labeling and for the outline of the profile of potential target customers for innovative food products.

Importance of Health Claims in the Adoption of New Breakfast Cereal Products in the UK

Regular breakfast consumption has the potential to prevent the prevalence of NCDs and to improve the nutritional profile of diets. Given consumers' interest in improving their diets, food suppliers are interested in introducing new cereal products making different health claims to capture consumers' attention. The purpose of this study is threefold: first, it aims to understand whether UK food suppliers are working to increase the availability of breakfast cereals with healthy and nutritious attributes; second, it explores which companies are leading the launch of these products; and third, it assesses to what extent health and nutrition claims made by breakfast cereals have an impact on their market success. The study employs an assembled database combining data from Mintel Global New Products Database (GNPD) and Kantar Worldpanel Dataset (KWDS) for the UK. A hazard-based duration model was used to analyse the success of the new products launched in the UK market in 2011 following them up to 2015. Our results reveal that UK suppliers broadened the number of breakfast cereals on offer in the period 2000 to 2018, with a particular focus on multigrain cereals, porridge and granola. Health and nutrition claims were added to 27% of these products. Although consumers welcome healthy alternatives such as muesli, the impact of positional claims on the success of newly developed breakfast cereals is claim-specific. No clear pattern regarding the impact of health and nutrition claims is identified. However, other elements such as celiac-friendly ingredients and UK origin do have a positive impact on the success of breakfast cereals.

Health claims and information sources in relation to bean consumption in older adults

Bean consumption can reduce chronic disease risk and improve diet quality; however, bean consumption among North Americans is low. Since health claims and other information sources could increase bean consumption, their exploration is warranted, particularly among older adults, a population well positioned to benefit. The purpose of this study was to explore bean consumption among older adults (≥65 years old) in relation to health claims and other information sources. A mixed-methods explanatory sequential study design utilizing a between strategy data collection approach was used. Community-dwelling older adults (n = 250; 76.0% female) completed a validated researcher-administered questionnaire to explore bean consumption, awareness and reading of health claims, the likelihood of health claims influencing bean consumption, and current and preferred sources of nutrition and/or health information regarding beans. The questionnaire was followed up with 10 semi-structured focus groups (n = 46; 76.1% female). Awareness of nutrient content, nutrient function, therapeutic and disease risk reduction claims was reported by 94.4%, 64.0%, 79.6% and 77.2% of participants, respectively. Among those aware, these health claims were read by 91.5%, 85.6%, 87.9% and 88.6% of participants, respectively. The prevalence of bean consumption was 51.2% and participants (46.8%) most frequently indicated that all health claims would equally increase their likelihood of bean consumption. Participants (72.0%) reported that they would like more information about the nutrition and/or health properties of beans, with their most common preferred sources including food labels (54.8%), brochures (51.2%) and the internet (47.2%). This research advances the literature on how health claims relate to eating behaviour and can inform regulatory and food industry scientists about consumer perception to bean health claims, and healthcare professionals about preferred information sources for their clients.

An Audit of the Nutrition and Health Claims on Breakfast Cereals in Supermarkets in the Illawarra Region of Australia

Nutrition and health claims can promote healthier food choices but may lead to consumer confusion if misused. Regular monitoring of claims is therefore required. This study aimed to explore the prevalence of nutrition and health claims carried on breakfast cereals in supermarkets, and to assess claim compliance with regulations. Nutrition and health claims on breakfast cereal products across five supermarkets in the Illawarra region of New South Wales, Australia, were recorded in a cross-sectional audit. Prevalence of claim type and claim compliance was determined. Claims were compared across categories of breakfast cereal. Almost all (95.7%) products audited carried at least one nutrition or health claim; nutrition content (n = 1096) was more prevalent than health claims (n = 213). Most claims (91.6%) were compliant with regulations. Additionally, claim prevalence and type differed according to breakfast cereal category, with the highest proportion of claims appearing on ‘health and wellbeing’ and ‘muesli’ products. There is a high prevalence of nutrition and health claims on breakfast cereals, with most claims compliant with regulations. Research should investigate consumer interpretation of claims and the impact of applying nutrient profiling for all claims to assist consumers to make informed health choices.

Relative Impact of Nutritional Warnings and Other Label Features on Cereal Bar Healthfulness Evaluations

OBJECTIVE

To investigate the relative influence of nutritional warnings and 2 marketing strategies commonly used in food labels, nutrient claims, and fruit images on consumers' healthfulness judgments.

DESIGN

Labels of cereal bars were designed according to a full factorial design with 3 2-level variables: images of fruit (with vs without), nutrient claims about the fiber content (with vs without), and nutritional warnings about excessive content of sugar and saturated fat (with vs without).

SETTING

Experiment conducted in Montevideo, Uruguay.

PARTICIPANTS

One hundred Uruguayan people, 75% female, aged 18-56 years.

MAIN OUTCOME MEASURES

Healthfulness perception and eye-tracking variables.

ANALYSIS

The researchers used ANOVA to evaluate the influence of the experimental design's variables on perceived healthfulness and eye-tracking measures.

RESULTS

Nutritional warnings caught participants' attention and reduced the amount of visual attention needed to evaluate healthfulness. Participants mainly relied on nutritional warnings to make healthfulness judgments.

CONCLUSIONS AND IMPLICATIONS

Findings of the current work confirm the potential of nutritional warnings to influence consumers' healthfulness perception, overriding the effect of other label cues used by the food industry to convey the concept of healthfulness.

Consumers' purchase decisions for products with nutrition and health claims: What role do product category and gaze duration on claims play?

Labeling food packages with nutrition and health claims is a widely used practice. This study aims to contribute to the literature by examining the gaze and purchase behavior of consumers regarding food products with nutrition and health claims. A close-to-realistic purchase situation with three-dimensional food packages with nutrition, health, and taste claims was simulated while the participants' eye movements were measured using head-mounted eye tracking glasses. In the purchase situation, two food categories with differing perceived healthiness were offered, orange juice and milk chocolate. In total, 156 consumers participated in this study which was undertaken in Germany. The findings indicate that each claim was noticed by at least 85% of the participants and health claims were looked at longer than nutrition or taste claims. Furthermore, when compared to other participants, the longer a participant looked at a specific claim, the more likely the participant was to purchase the respective product. Even though the product category had no effect on the gaze duration on claims, it affected the purchase behavior. Nutrition claims were preferred for orange juice while taste claims were preferred for milk chocolate. Health claims were preferred for neither. Marketers can benefit from this study, as it shows the gaze duration on claims influenced the purchase likelihood. Another important finding is that there are great differences between product categories regarding the type of claim consumers prefer.

The Response of More Health Focused and Less Health Focused People to a Physical Activity Calorie Equivalent Label on Discretionary Snack Foods

A Physical Activity Calorie Equivalent (PACE) label shows the minutes of physical activity required to burn off the caloric content of a particular food. This study investigated the influence of PACE labelling on liking and consumption of discretionary snack foods in a group of more health focused and less health focused consumers. Participants (n = 97) tasted and rated (i.e., liking, prospective consumption) a range of snack foods with or without a PACE label. Total sampling consumption was also measured. Participants completed a shortened version of the International Physical Activity Questionnaire and the General Health Interest Scale questionnaire. Paired samples t-test, independent samples t-tests, a General Linear Model and Chi-Square tests were used to check for statistical significance. For more health focused participants (n = 57), the PACE label decreased only liking (p = 0.02). The PACE label was not effective in reducing liking (p = 0.49), prospective consumption (defined as the amount of the sample participants thought that they could consume) (p = 0.10) or consumption (p = 0.41) of energy-dense discretionary snack foods for less health focused individuals (n = 40). The level of participants’ physical activity did not facilitate the influence of PACE labelling on liking, consumption or prospective consumption. The PACE label was found to not be effective among less health focused individuals or the overall sample population. Therefore, the PACE label may not be an effective labelling strategy to reduce the liking or consumption of discretionary snack foods.

A randomized trial assessing the effects of health claims on choice of foods in the presence of front-of-pack labels

Background

As a public health intervention, front-of-pack labels (FoPLs) have the potential to reach large numbers of consumers and promote healthier food choices. Of the different FoPLs, those that summarize a product's overall nutritional profile tend to be most effective in guiding healthier choices. However, information is lacking as to whether FoPLs are as effective when nutrient or health claims also appear on-pack.

Objective

The aim of this study was to examine how the choice of foods of varying levels of healthfulness (less healthy, moderately healthy, and healthier) is affected by the appearance of various FoPLs (Daily Intake Guide, Multiple Traffic Lights, Health Star Rating) when shown in combination with different claim conditions (no claim, nutrient claim, general-level health claim, and higher-level health claim).

Design

Adults and children (n = 2069) completed a discrete-choice experiment online. Respondents were shown 8 choice sets, each containing 4 alternatives of the same food type (cookies, cornflakes, pizza, or yogurt) of varying levels of healthfulness and were asked which product they would likely purchase (or they could select none). Respondents were randomly assigned to view 1 of the 3 FoPLs across all choice sets. Claim type and healthfulness varied within choice sets in accordance with a D-efficient design.

Results

The probability of choosing a healthy product and avoiding an unhealthy product was greatest when only an FoPL (especially the Health Star Rating) appeared on-pack. The addition of a nutrient or health claim did not affect the likelihood of picking healthier products but did increase the likelihood of selecting less healthy foods across all FoPL conditions.

Conclusions

FoPLs are most effective in helping consumers make better food choices when nutrient and health claims are not present. Policies are required to control how nutrient and health claims are applied to less healthy foods. This trial was registered as ACTRN12617000015347 (www.anzctr.org.au/Trial/Resgistration/TrialReview.aspx?id=372055&isReview=true).

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 Nutrient-Based Front-of-Pack Labelling Schemes Support or Undermine Food-Based Dietary Guideline Recommendations? Lessons from the Australian Health Star Rating System

Food-based Dietary Guidelines (FBDGs) promote healthy dietary patterns. Nutrient-based Front-of-Pack Labelling (NBFOPL) schemes rate the 'healthiness' of individual foods. This study aimed to investigate whether the Australian Health Star Rating (HSR) system aligns with the Australian Dietary Guidelines (ADGs). The Mintel Global New Products Database was searched for every new food product displaying a HSR entering the Australian marketplace from 27 June 2014 (HSR system endorsement) until 30 June 2017. Foods were categorised as either a five food group (FFG) food or 'discretionary' food in accordance with ADG recommendations. Ten percent (1269/12,108) of new food products displayed a HSR, of which 57% were FFG foods. The median number of 'health' stars displayed on discretionary foods (2.5; range: 0.5-5) was significantly lower (p < 0.05) than FFG foods (4.0; range: 0.5-5), although a high frequency of anomalies and overlap in the number of stars across the two food categories was observed, with 56.7% of discretionary foods displaying ≥2.5 stars. The HSR system is undermining the ADG recommendations through facilitating the marketing of discretionary foods. Adjusting the HSR's algorithm might correct certain technical flaws. However, supporting the ADGs requires reform of the HSR's design to demarcate the food source (FFG versus discretionary food) of a nutrient.

Do Health Claims and Front-of-Pack Labels Lead to a Positivity Bias in Unhealthy Foods?

Health claims and front-of-pack labels (FoPLs) may lead consumers to hold more positive attitudes and show a greater willingness to buy food products, regardless of their actual healthiness. A potential negative consequence of this positivity bias is the increased consumption of unhealthy foods. This study investigated whether a positivity bias would occur in unhealthy variations of four products (cookies, corn flakes, pizzas and yoghurts) that featured different health claim conditions (no claim, nutrient claim, general level health claim, and higher level health claim) and FoPL conditions (no FoPL, the Daily Intake Guide (DIG), Multiple Traffic Lights (MTL), and the Health Star Rating (HSR)). Positivity bias was assessed via measures of perceived healthiness, global evaluations (incorporating taste, quality, convenience, etc.) and willingness to buy. On the whole, health claims did not produce a positivity bias, while FoPLs did, with the DIG being the most likely to elicit this bias. The HSR most frequently led to lower ratings of unhealthy foods than the DIG and MTL, suggesting that this FoPL has the lowest risk of creating an inaccurate positivity bias in unhealthy foods.

The types and aspects of front-of-pack food labelling schemes preferred by adults and children

There is strong interest in front-of-pack labels (FoPLs) as a potential mechanism for improving diets, and therefore health, at the population level. The present study examined Australian consumers' preferences for different types and attributes of FoPLs to provide additional insights into optimal methods of presenting nutrition information on the front of food packets. Much research to date has focused on two main types of FoPLs - those expressing daily intake values for specific nutrients and those utilising 'traffic light' colour coding. This study extends this work by: (i) including the new Health Star Rating system recently introduced in Australia and New Zealand; (ii) allowing a large sample of consumers to self-nominate the evaluation criteria they consider to be most important in choosing between FoPLs; (iii) oversampling consumers of lower socioeconomic status; and (iv) including children, who consume and purchase food in their own right and also influence their parents' food purchase decisions. A cross-sectional online survey of 2058 Australian consumers (1558 adults and 500 children) assessed preferences between a daily intake FoPL, a traffic light FoPL, and the Health Star Rating FoPL. Across the whole sample and among all respondent subgroups (males vs females; adults vs children; lower socioeconomic status vs medium-high socioeconomic status; normal weight vs overweight/obese), the Health Star Rating was the most preferred FoPL (44%) and the daily intake guide was the least preferred (20%). The reasons most commonly provided by respondents to explain their preference related to ease of use, interpretive content, and salience. The findings suggest that a simple to use, interpretive, star-based food label represents a population-based nutrition promotion strategy that is considered helpful by a broad range of consumers.