1
|
Kim Y, Kim Y, Kim HJ. Impact of product packaging messages on consumer perceptions and choice: The role of health claims and bonus pack promotions. Appetite 2024; 200:107555. [PMID: 38878902 DOI: 10.1016/j.appet.2024.107555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 06/05/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
This study used mixed methods to explore the impact of front-of-package health claims and bonus pack messages on consumer evaluations. First, a comprehensive audit of cereal box packages at the world's largest retailer examined how these messages are presented in practice. It was found that negative claims are more frequent and positive claims are less frequent on products with a bonus pack message compared to those without. A subsequent experiment investigated how combinations of health claims and bonus pack messages influence consumer evaluations. It also found that health claims significantly influenced consumer preferences, while bonus pack messages diminished perceptions of food healthiness but increased perceived value. Pairing positive health claims with bonus pack messages, such as "Family Size," improved perceptions of healthiness. Moreover, positive health claims made products seem of lower value, whereas negative health claims did not affect perceived value. Health claims negatively affected value perceptions, even when paired with bonus pack messages like "Large Size." However, the negative effect of health claims on tastiness perceptions was mitigated with "Large Size". The study underscores the complexity of consumer decision-making, and offer insights for food marketers, emphasizing the need of a strategic approach in crafting health-related messaging and promotional strategies for product packaging.
Collapse
Affiliation(s)
- Youngjun Kim
- School of Business and Technology Management, KAIST, 291, Daehak-ro, Yuseong-gu, Daejeon, Republic of Korea
| | - Youngju Kim
- Chung-Ang University, 84, Heukseok-ro, Dongjak-gu, Seoul, Republic of Korea.
| | - Hye-Jin Kim
- School of Business and Technology Management, KAIST, 291, Daehak-ro, Yuseong-gu, Daejeon, Republic of Korea
| |
Collapse
|
2
|
Lang IM, Antonakos CL, Judd SE, Colabianchi N. Intake of Snacks and Sweets in a National Study of Built and Social Environments: the REasons for Geographic And Racial Differences in Stroke Study. J Nutr 2024; 154:2300-2314. [PMID: 38795742 DOI: 10.1016/j.tjnut.2024.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 05/16/2024] [Accepted: 05/20/2024] [Indexed: 05/28/2024] Open
Abstract
BACKGROUND Few national studies across the United States' rural-urban continuum examine neighborhood effects on snacks and sweets intake among adults. OBJECTIVES This study examines associations of urbanicity/rurality-tailored measures of food store availability and neighborhood socioeconomic status (NSES) with the intake of snacks and sweets in a national sample of middle and older age adults. METHODS This cross-sectional study used food frequency questionnaire data collected in the REasons for Geographic And Racial Differences in Stroke study (N = 21,204). What We Eat in America food group categorizations guided outcome classification into 1 main category (total snacks and sweets) and 4 subcategories (savory snacks and crackers; sweet bakery products; candy and desserts; nutrition bars and low-fat snacks and sweets). NSES and food store availability were determined using geographic information systems. Food store availability was characterized as geographic access to primary food stores (e.g., supermarkets, supercenters, and select food retailers) in urbanicity/rurality-tailored neighborhood-based buffers. Multiple linear regression was used to predict each outcome. RESULTS Living in neighborhoods with a high density of primary food stores was associated with 8.6%, 9.5%, and 5.8% lower intake of total snacks and sweets, sweet bakery products, and candy and desserts, respectively. Living in the highest NSES quartile was associated with 11.3%, 5.8%, and 18.9% lower intake of total snacks and sweets, savory snacks and crackers, and sweet bakery products, respectively. Depending on primary food store availability, higher household income was associated with significantly greater intake of nutrition bars and low-fat snacks and sweets. Living in a United States Department of Agriculture-defined food desert was not associated with intake. CONCLUSIONS In a geographically diverse sample of middle and older age United States adults, living in neighborhoods with no primary food stores or neighborhoods of low-SES was associated with higher intake of total snacks and sweets and subgroups of snacks and sweets.
Collapse
Affiliation(s)
- Ian-Marshall Lang
- School of Kinesiology, University of Michigan, Ann Arbor, MI, United States
| | - Cathy L Antonakos
- School of Kinesiology, University of Michigan, Ann Arbor, MI, United States
| | - Suzanne E Judd
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Natalie Colabianchi
- School of Kinesiology, University of Michigan, Ann Arbor, MI, United States; Institute for Social Research, University of Michigan, Ann Arbor, MI, United States.
| |
Collapse
|
3
|
Picard K, Mager DR, Senior PA, Richard C. Potassium-Based Sodium Substitutes Impact the Sodium and Potassium Content of Foods. J Ren Nutr 2024:S1051-2276(24)00097-9. [PMID: 38848804 DOI: 10.1053/j.jrn.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/15/2023] [Accepted: 05/30/2024] [Indexed: 06/09/2024] Open
Abstract
OBJECTIVE Potassium-based sodium substitutes (PBSS) can be used to replace sodium during food processing. How potassium and sodium content is associated with PBSS is not known. The objectives of the study were to describe the prevalence of PBSS by sodium content claim category and describe how PBSS are associated with sodium and potassium concentrations by sodium level. DESIGN AND METHODS This cross-sectional analysis used the July 2018 version of the United States Department of Agriculture's Branded Food Products Database. Products were divided into sodium content claim category and were analyzed for the presence of PBSS. Products with nonmissing values for sodium and potassium were grouped by sodium level and analyzed for the prevalence of PBSS to explore potassium and sodium concentration. Column proportion z-test with the Bonferroni correction was used to explore the occurrence of PBSS by sodium content claim category. Mann-Whitney U-test was used to assess differences in potassium and sodium concentrations across sodium levels and within levels by the presence/absence of PBSS. RESULTS The prevalence of PBSS in the categories "without a sodium content claim" (2.4%), "lightly salted" (0.5%), and "unsalted" claims (0.6%) were statistically significantly lower than prevalence of PBSS in the "sodium free" (9.5%), "low sodium" (10.3%), and "reduced sodium" claim categories (23.3%; all P < .01). Among the group of products with serving sizes more than 30 g containing PBSS, there was a 357 mg per serving higher median sodium concentration and a 160 mg per serving higher median potassium concentration compared to the group without PBSS (both P < .01). CONCLUSION In the "reduced sodium" claim category, a higher prevalence of PBSS was found compared to other sodium claim categories. The presence of PBSS was associated with higher potassium and sodium concentrations in foods.
Collapse
Affiliation(s)
- Kelly Picard
- Renal Services, Island Health Authority, Nanaimo, British Columbia, Canada.
| | - Diana R Mager
- Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Peter A Senior
- Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Caroline Richard
- Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Alberta, Canada.
| |
Collapse
|
4
|
Silva P, Araújo R, Lopes F, Ray S. Nutrition and Food Literacy: Framing the Challenges to Health Communication. Nutrients 2023; 15:4708. [PMID: 38004102 PMCID: PMC10674981 DOI: 10.3390/nu15224708] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/20/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
Nutrition and food literacy are two important concepts that are often used interchangeably, but they are not synonymous. Nutrition refers to the study of how food affects the body, while food literacy refers to the knowledge, skills, and attitudes necessary to make informed decisions about food and its impact on health. Despite the growing awareness of the importance of food literacy, food illiteracy remains a global issue, affecting people of all ages, backgrounds, and socioeconomic status. Food illiteracy has serious health implications as it contributes to health inequities, particularly among vulnerable populations. In addition, food literacy is a complex and multidisciplinary field, and there are numerous challenges to health communication that must be addressed to effectively promote food literacy and improve health outcomes. Addressing food illiteracy and the challenges to health communication is essential to promote health equity and improve health outcomes for all populations.
Collapse
Affiliation(s)
- Paula Silva
- Laboratory of Histology and Embryology, Department of Microscopy, School of Medicine and Biomedical Sciences (ICBAS), University of Porto (U.Porto), Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal
- iNOVA Media Lab, ICNOVA-NOVA Institute of Communication, NOVA School of Social Sciences and Humanities, Universidade NOVA de Lisboa, 1069-061 Lisbon, Portugal
| | - Rita Araújo
- Departamento de Artes e Humanidades, Escola Superior de Comunicação, Administração e Turismo, Instituto Politécnico de Bragança, Campus do Cruzeiro—Avenida 25 de Abril, Cruzeiro, Lote 2, Apartado 128, 5370-202 Mirandela, Portugal;
| | - Felisbela Lopes
- Centro de Estudos de Comunicação e Sociedade, Instituto de Ciências Sociais, Universidade do Minho, Campus de Gualtar, 4710-057 Braga, Portugal;
| | - Sumantra Ray
- NNEdPro Global Institute for Food, Nutrition & Health, Cambridge CB4 0WS, UK;
- School of Biomedical Sciences, Ulster University at Coleraine, Coleraine BT52 1SA, UK
- Fitzwilliam College, University of Cambridge, Cambridge CB3 0DG, UK
| |
Collapse
|
5
|
Duffy E, Ng SW, Hall MG, Bercholz M, Rebolledo N, Musicus A, Taillie LS. Sociodemographic disparities in purchases of fruit drinks with policy relevant front-of-package nutrition claims. Public Health Nutr 2023; 26:1585-1595. [PMID: 37211358 PMCID: PMC10410375 DOI: 10.1017/s1368980023000691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 02/08/2023] [Accepted: 04/12/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVE Our objectives were to describe sociodemographic characteristics associated with the purchase of (1) any fruit drinks and (2) fruit drinks with specific front-of-package (FOP) nutrition claims. DESIGN Cross-sectional. SETTING USA. PARTICIPANTS We merged fruit drink purchasing data from 60 712 household-months from 5233 households with children 0-5 years participating in Nielsen Homescan in 2017 with nutrition claims data. We examined differences in predicted probabilities of purchasing any fruit drinks by race/ethnicity, income and education. We constructed inverse probability (IP) weights based on likelihood of purchasing any fruit drinks. We used IP-weighted multivariable logistic regression models to examine predicted probabilities of purchasing fruit drinks with specific FOP claims. RESULTS One-third of households with young children purchased any fruit drinks. Non-Hispanic (NH) Black (51·6 %), Hispanic (36·3 %), lower-income (39·3 %) and lower-educated households (40·9 %) were more likely to purchase any fruit drinks than NH White (31·3 %), higher-income (25·8 %) and higher-educated households (30·3 %) (all P < 0·001). In IP-weighted analyses, NH Black households were more likely to purchase fruit drinks with 'Natural' and fruit or fruit flavour claims (6·8 % and 3·7 %) than NH White households (4·5 % and 2·7 %) (both P < 0·01). Lower- and middle-income (15·0 % and 13·8 %) and lower- and middle-educated households (15·4 % and 14·5 %) were more likely to purchase fruit drinks with '100 % Vitamin C' claims than higher-income (10·8 %) and higher-educated households (12·9 %) (all P < 0·025). CONCLUSIONS We found a higher likelihood of fruit drink purchases in lower-income, lower-educated, NH Black and Hispanic households. Experimental studies should determine if nutrition claims may be contributing to disparities in fruit drink consumption.
Collapse
Affiliation(s)
- Emily Duffy
- Department of Nutrition, University of North Carolina at Chapel Hill Gillings School of Global Public Health and Carolina Population Center, 123 W Franklin St, Chapel Hill, NC27516, USA
| | - Shu Wen Ng
- Department of Nutrition, University of North Carolina at Chapel Hill Gillings School of Global Public Health and Carolina Population Center, 123 W Franklin St, Chapel Hill, NC27516, USA
| | - Marissa G Hall
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health and Carolina Population Center, and UNC Lineberger Comprehensive Cancer Center, School of Medicine, Chapel Hill, NC, USA
| | | | - Natalia Rebolledo
- Department of Nutrition, University of North Carolina at Chapel Hill Gillings School of Global Public Health and Carolina Population Center, 123 W Franklin St, Chapel Hill, NC27516, USA
| | - Aviva Musicus
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lindsey Smith Taillie
- Department of Nutrition, University of North Carolina at Chapel Hill Gillings School of Global Public Health and Carolina Population Center, 123 W Franklin St, Chapel Hill, NC27516, USA
| |
Collapse
|
6
|
Hallez L, Vansteenbeeck H, Boen F, Smits T. Persuasive packaging? The impact of packaging color and claims on young consumers' perceptions of product healthiness, sustainability and tastiness. Appetite 2023; 182:106433. [PMID: 36567019 DOI: 10.1016/j.appet.2022.106433] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 12/06/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
Following the increasing importance of healthiness and sustainability for many consumers, manufacturers increasingly try to give products a healthier or eco-friendlier image, for instance through packaging design. We conducted two experiments to investigate how visual (i.e., colors) and textual (i.e., claims) packaging elements shape perceptions of product healthiness, sustainability and tastiness. Additionally, the studies investigated whether these packaging elements impact the likelihood that these products are selected in a choice task. Study 1 (N = 202) had a mixed design, with packaging color (warm versus cool) and a nutrition claim (present versus absent) as within-subjects manipulations. Young consumers chose between four beverages, and subsequently evaluated these beverages. Study 2 (N = 211) had a similar design and procedure, but focused on the impact of an ecological claim on the evaluation of snacks. In line with our hypotheses, cool packaging colors (i.e., green and blue) increased perceptions that food and drinks were healthy and sustainable. However, in Study 1, cool packaging colors also resulted in lower tastiness expectations, and a lower likelihood that the product was selected. We also found that a simple nutrition/ecological claim made products seem overall healthier and more sustainable. Additionally, contrary to many previous studies, we did not find that these claims affected taste expectations. Our studies highlight the importance of package design as a factor that can influence perceptions of food and drink products.
Collapse
Affiliation(s)
- Lotte Hallez
- Institute for Media Studies, KU Leuven, Parkstraat 45 - box 3603, 3000, Leuven, Belgium.
| | - Helena Vansteenbeeck
- Institute for Media Studies, KU Leuven, Parkstraat 45 - box 3603, 3000, Leuven, Belgium.
| | - Filip Boen
- Physical Activity, Sports & Health Research Group, KU Leuven, Tervuursevest 101 - box 1500, 3001, Leuven, Belgium.
| | - Tim Smits
- Institute for Media Studies, KU Leuven, Parkstraat 45 - box 3603, 3000, Leuven, Belgium.
| |
Collapse
|
7
|
Koios D, Machado P, Lacy-Nichols J. Representations of Ultra-Processed Foods: A Global Analysis of How Dietary Guidelines Refer to Levels of Food Processing. Int J Health Policy Manag 2022; 11:2588-2599. [PMID: 35184508 PMCID: PMC9818109 DOI: 10.34172/ijhpm.2022.6443] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 01/15/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND As evidence grows about negative health impacts of ultra-processed foods (UPFs), nutrient-centred advice is contested, and food-based dietary guidelines are increasingly utilised. Previous analyses of dietary guidelines evaluated their potential impact on health and sustainability, but little research has been conducted to examine how the concept of UPFs is reflected in dietary advice for consumers. This paper systematically analyses whether and how UPFs are represented in dietary guidelines internationally. METHODS Based on a systematic online search, the consumer-targeted key messages of 106 dietary guidelines were identified and a qualitative content analysis was conducted. A coding framework was developed to classify messages as 'eat more' or 'eat less' according to the language used (eg, 'choose' vs 'avoid') and to differentiate between a focus on nutrients or food processing. Specific foods mentioned in 'eat less' guidelines were classified according to their level of processing using the NOVA framework. RESULTS 99% of guidelines utilised some type of nutrient-based message, either promoting 'positive' nutrients (eg, vitamins) or discouraging the consumption of 'negative' nutrients (mainly salt, sugar and fat). Explicit references to food processing were present in 45% of 'eat less' guidelines and 5% of 'eat more' guidelines. Implicit references (eg, promoting 'raw' or discouraging 'packaged' foods) were found in 43% of 'eat less' and 75% of 'eat more' guidelines. 53% of the specific foods referred to in 'eat less' advice were UPFs. CONCLUSION Overall, nutrient-based messages were more common than messages about processing levels. The majority of discouraged foods were UPFs, however some minimally processed foods were discouraged, which points to tensions and contradictions between nutrient- and processing-based dietary advice. As dietary guidelines begin to include advice about food processing, it is important to consider both consumer understanding of the terms used and their capacity to act on the advice.
Collapse
Affiliation(s)
- Daniela Koios
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Priscila Machado
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
| | - Jennifer Lacy-Nichols
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
8
|
Jürkenbeck K, Mehlhose C, Zühlsdorf A. The influence of the Nutri-Score on the perceived healthiness of foods labelled with a nutrition claim of sugar. PLoS One 2022; 17:e0272220. [PMID: 35976882 PMCID: PMC9385015 DOI: 10.1371/journal.pone.0272220] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 07/15/2022] [Indexed: 11/19/2022] Open
Abstract
High sugar intake in humans is associated with the development of overweight and other diet-related diseases. The World Health Organization and other health organizations recommend limiting the sugar intake to 10% of the total energy intake. There have been different approaches of front-of-pack labelling to reduce the amount of sugar in food products. Companies use nutrition claims to advertise the sugar content (e.g., without added sugar, 30% less sugar). Such nutrition claims can lead to false assumptions about the healthiness of foods and can lead to health-halo effects. Nutrition claims make products appear healthier than they really are, the aspect advertised in the nutrition claim is transferred to the entire food product. As a result, food products can be perceived as healthy even though they are not. Recently, the Nutri-Score was introduced in an increasing number of countries throughout Europe to provide consumers with an overview of the overall nutritional quality of a product. This study analyzes if the Nutri-Score can help to prevent health-halo effects caused by nutrition claims on sugar. Therefore, an online survey consisting of a split-sample design with more than 1,000 respondents was assessed. The results show that, depending on the initial perceived healthiness of a product, the Nutri-Score is able to prevent health-halo effects caused by claims on sugar. Making the Nutri-Score mandatory when using nutrition claims would be one possible way to reduce misperceptions about unhealthy food and reduce health-halo effects caused by claims on sugar.
Collapse
Affiliation(s)
- Kristin Jürkenbeck
- Department of Agricultural Economics and Rural Development, Marketing of Food and Agricultural Products, University of Goettingen, Goettingen, Germany
| | - Clara Mehlhose
- Department of Agricultural Economics and Rural Development, Marketing of Food and Agricultural Products, University of Goettingen, Goettingen, Germany
| | - Anke Zühlsdorf
- Department of Agricultural Economics and Rural Development, Marketing of Food and Agricultural Products, University of Goettingen, Goettingen, Germany
| |
Collapse
|
9
|
Musicus AA, Hua SV, Moran AJ, Duffy EW, Hall MG, Roberto CA, Dillman Carpentier FR, Sorscher S, Wootan MG, Smith Taillie L, Rimm EB. Front-of-package claims & imagery on fruit-flavored drinks and exposure by household demographics. Appetite 2022; 171:105902. [PMID: 34968559 PMCID: PMC8821268 DOI: 10.1016/j.appet.2021.105902] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 11/11/2021] [Accepted: 12/23/2021] [Indexed: 01/08/2023]
Abstract
Young children regularly consume sugary fruit drinks, in part because parents may falsely believe they are healthful due to front-of-package (FOP) claims and imagery. The goal of this study was to assess: 1) the prevalence of FOP claims/imagery on fruit-flavored beverages purchased by U.S. households with 0-5-year-olds, and 2) proportional differences in beverages purchased with FOP claims/imagery across household demographic groups. A content analysis of FOP claims/imagery (e.g., nutrient claims, fruit imagery) on beverages (n = 1365) purchased by households with 0-5-year-olds was conducted by linking beverage sales with FOP marketing data. Results were merged with purchasing data from a nationally representative sample of households (FoodAPS), and survey-weighted logistic regression was used to assess differences in the proportions of 100% juices and fruit drinks with specific FOP claims/imagery purchased by household race/ethnicity, income, and SNAP/WIC participation. The most common claims on fruit-flavored beverages included nutrient claims (fruit drinks: 73%; 100% juices: 68%; flavored waters: 95%), which most commonly highlighted vitamin C (35-41% across beverage categories) and the absence of sugar (31-48%). Most beverages also contained implied-natural claims (fruit drinks: 60%; 100% juices: 64%; flavored waters: 95%) and natural imagery (fruit drinks: 97%; 100% juices: 96%; flavored waters: 73%). A large proportion of fruit drinks and 100% juices purchased by households across all demographic groups contained FOP claims and imagery, with a few minor differences between racial/ethnic groups. In conclusion, most fruit drinks, 100% juices, and flavored waters purchased by households with 0-5-year-olds contained FOP claims and imagery that may lead consumers to believe the beverages are healthy and natural. FDA regulations should ensure parents are not misled by this marketing.
Collapse
Affiliation(s)
- Aviva A Musicus
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Sophia V Hua
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Alyssa J Moran
- Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emily W Duffy
- Department of Nutrition, Gillings School of Global Public Health; Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
| | - Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health; Carolina Population Center, And Lineberger Comprehensive Cancer Center; University of North Carolina, Chapel Hill, NC, USA
| | - Christina A Roberto
- Department of Medical Ethics & Health Policy, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | | | - Sarah Sorscher
- Center for Science in the Public Interest, Washington, DC, USA
| | | | - Lindsey Smith Taillie
- Department of Nutrition, Gillings School of Global Public Health; Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
| | - Eric B Rimm
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
10
|
Duran AC, Mialon M, Crosbie E, Jensen ML, Harris JL, Batis C, Corvalán C, Taillie LS. [Soluciones relacionadas con el entorno alimentario para prevenir la obesidad infantil en América Latina y en la población latina que vive en Estados Unidos]. Obes Rev 2021; 22 Suppl 5:e13344. [PMID: 34708531 DOI: 10.1111/obr.13344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Ana Clara Duran
- Núcleo de Estudos e Pesquisas em Alimentação (NEPA), Universidade Estadual de Campinas, Campinas, Brasil.,Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, São Paulo, Brasil
| | - Melissa Mialon
- Trinity Business School, Trinity College Dublin, Dublín, Irlanda
| | - Eric Crosbie
- School of Community and Health Sciences, University of Nevada, Reno, Nevada, EE. UU
| | - Melissa Lorena Jensen
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, Connecticut, EE. UU.,Escuela de Nutrición, Universidad de Costa Rica, San José, Costa Rica
| | - Jennifer L Harris
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, Connecticut, EE. UU
| | - Carolina Batis
- CONACYT, Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Camila Corvalán
- Instituto de Nutricion y Tecnologia de los Alimentos, Universidad de Chile, Santiago, Chile
| | - Lindsey Smith Taillie
- Department of Nutrition, Gillings School of Global Public Health, and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, Carolina del Norte, EE. UU
| |
Collapse
|
11
|
Martini D, Del Bo’ C, Serafini M, Porrini M, Pellegrini N, Angelino D. Breakfast Cereals Carrying Fibre-Related Claims: Do They Have a Better Nutritional Composition Than Those without Such Claims? Results from the Food Labelling of Italian Products (FLIP) Study. Foods 2021; 10:foods10092225. [PMID: 34574336 PMCID: PMC8467444 DOI: 10.3390/foods10092225] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 01/15/2023] Open
Abstract
Nutrition claims (NCs) on food packaging are, from one side, an informative tool about the nutritional characteristics of the product. From another side, they could bias the consumer in perceiving such products as healthier than those without claims. In order to investigate whether products with NCs have a better nutritional composition that those without claims, the present study aimed to compare the nutrition facts of 376 breakfast cereals, with and without fibre-related NCs, available in 13 Italian retailer online stores. Among these products, 73 items claimed to be a "source of fibre" and 109 "high in fibre". In addition to a higher fibre content, products "high in fibre" showed higher protein and fat contents but lower carbohydrate, sugar and salt contents compared to both "source of fibre" and without fibre-related NC items. Overall, a high variability in nutritional values was also observed within products with the same type of fibre-related NC. In conclusion, the results suggested that fibre-related NCs should not be considered as a marker of a better nutritional composition of breakfast cereals, and thus consumers should be educated to carefully read the entire nutritional information reported in the food labelling.
Collapse
Affiliation(s)
- Daniela Martini
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy; (D.M.); (C.D.B.); (M.P.)
| | - Cristian Del Bo’
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy; (D.M.); (C.D.B.); (M.P.)
| | - Mauro Serafini
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, 64100 Teramo, Italy; (M.S.); (D.A.)
| | - Marisa Porrini
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy; (D.M.); (C.D.B.); (M.P.)
| | - Nicoletta Pellegrini
- Department of Agricultural, Food, Environmental and Animal Sciences, University of Udine, 33100 Udine, Italy
- Correspondence: ; Tel.: +39-043-255-8183
| | - Donato Angelino
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, 64100 Teramo, Italy; (M.S.); (D.A.)
| | | |
Collapse
|
12
|
Soares AF, Honorio AR, Lima DCN, Tribst AAL. Sweet processed foods in Brazil: use of sugar and sweeteners, inclusion of sugar claims and impact on nutritional profile. Int J Food Sci Technol 2021. [DOI: 10.1111/ijfs.15178] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- André F. Soares
- Center for Food Studies and Research (NEPA) University of Campinas (UNICAMP) Albert Einstein, 291 Campinas Brazil
| | - Alice R. Honorio
- Center for Food Studies and Research (NEPA) University of Campinas (UNICAMP) Albert Einstein, 291 Campinas Brazil
| | - Diana C. Nunes Lima
- Federal Center for Technological Education Celso Suckow da Fonseca (CEFET/RJ) Voluntários da Pátria, 30 Valença Brazil
| | - Alline A. L. Tribst
- Center for Food Studies and Research (NEPA) University of Campinas (UNICAMP) Albert Einstein, 291 Campinas Brazil
| |
Collapse
|
13
|
Duran AC, Mialon M, Crosbie E, Jensen ML, Harris JL, Batis C, Corvalán C, Taillie LS. Food environment solutions for childhood obesity in Latin America and among Latinos living in the United States. Obes Rev 2021; 22 Suppl 3:e13237. [PMID: 34152071 PMCID: PMC8365715 DOI: 10.1111/obr.13237] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 12/23/2022]
Abstract
The food environment is a major contributor to unhealthy diets in children and, therefore, to the increasing rates of obesity. Acclaimed by scholars across the world, Latin American countries have been leaders in implementing policies that target different aspects of the food environment. Evidence on the nature and to what extent children are exposed and respond to unhealthy food environments in the region and among Latinos in the United States is, however, deficient. The objective of this review is to use the integrated International Network for Food and Obesity/noncommunicable diseases (NCDs) Research, Monitoring and Action Support (INFORMAS) framework to create healthy food environment to (i) compare the key elements of childhood obesity-related food environments in Latin America and for Latinos living in the United States; (ii) describe the evidence on solutions to improve childhood obesity-related food environments; and (iii) identify research priorities to inform solutions to fight childhood obesity in these populations. We found that an integrated body of evidence is needed to inform an optimal package of policies to improve food environments to which children in Latin America and Latino children in the United States are exposed and more efficiently translate policy solutions to help curb growing childhood obesity levels across borders.
Collapse
Affiliation(s)
- Ana Clara Duran
- Center for Food Studies and Research (NEPA)University of CampinasCampinasBrazil
- Center for Epidemiological Studies in Nutrition and HealthUniversity of São PauloSão PauloBrazil
| | - Melissa Mialon
- Trinity Business SchoolTrinity College DublinDublinIreland
| | - Eric Crosbie
- School of Community and Health SciencesUniversity of NevadaRenoNevadaUSA
| | - Melissa Lorena Jensen
- Rudd Center for Food Policy and ObesityUniversity of ConnecticutHartfordConnecticutUSA
- School of Nutrition, University of Costa RicaSan JoséCosta Rica
| | - Jennifer L. Harris
- Rudd Center for Food Policy and ObesityUniversity of ConnecticutHartfordConnecticutUSA
| | - Carolina Batis
- CONACYT, Health and Nutrition Research CenterNational Institute of Public HealthCuernavacaMexico
| | - Camila Corvalán
- Instituto de Nutricion y Tecnologia de AlimentosUniversity of ChileSantiagoChile
| | - Lindsey Smith Taillie
- Department of Nutrition, Gillings School of Global Public Health, and Carolina Population CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| |
Collapse
|
14
|
Mediano Stoltze F, Busey E, Taillie LS, Dillman Carpentier FR. Impact of warning labels on reducing health halo effects of nutrient content claims on breakfast cereal packages: A mixed-measures experiment. Appetite 2021; 163:105229. [PMID: 33789168 DOI: 10.1016/j.appet.2021.105229] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/19/2021] [Accepted: 03/20/2021] [Indexed: 11/15/2022]
Abstract
Chile recently implemented a food labeling law that requires packaged foods with sugar, saturated fats, sodium, and/or calorie content that exceeds government-defined thresholds to carry a front-of-package warning for each excessive nutrient. This law does not prohibit the use of nutrient content (NC) marketing claims on packages, as long as the claims do not directly contradict the warnings. Yet, having NC claims alongside nutrient warnings might send mixed messages confusing consumers about the overall healthiness of a product. The present study tests the co-occurrence of warning labels and NC claims in breakfast cereal packages on product perceptions and behavioral intentions of Chilean adults in a 3 (warnings: none, high calorie, high calorie/high sugar) × 3 (NC claims: none, fiber/wholegrain, low fat/cholesterol-free) mixed-measures experiment. Fiber-related claims had a main effect leading to more positive ratings of the product, compared to having no NC claims or fat-related claims. These positive ratings extended beyond perceptions of the fiber content to perceptions of overall healthiness, naturalness, quality, vitamin content, and intentions to purchase and recommend the product-a health halo effect. No significant interaction between warnings and NC claims was found. However, warnings had a main effect on perceptions irrespective of the presence of NC claims, with one warning significantly reducing ratings, dampening any halo effects, and two warnings further dampening any effects. These findings indicate that warning labels can mitigate, but not eliminate the influences of NC claims on consumer perceptions of product healthiness.
Collapse
Affiliation(s)
- Fernanda Mediano Stoltze
- Carolina Population Center and Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, CB# 3365, Chapel Hill, NC, 27599, USA.
| | - Emily Busey
- Carolina Population Center, University of North Carolina at Chapel Hill, CB# 8120, Chapel Hill, NC, 27514, USA.
| | - Lindsey Smith Taillie
- Carolina Population Center and Gillings School of Global Public Health, University of North Carolina at Chapel Hill, CB# 7400, Chapel Hill, NC, 27599, USA.
| | - Francesca R Dillman Carpentier
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, CB# 3365, Chapel Hill, NC, 27599, USA.
| |
Collapse
|
15
|
Taillie LS, Busey E, Stoltze FM, Dillman Carpentier FR. Governmental policies to reduce unhealthy food marketing to children. Nutr Rev 2021; 77:787-816. [PMID: 31329232 DOI: 10.1093/nutrit/nuz021] [Citation(s) in RCA: 106] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Reducing children's exposure to food marketing is an important obesity prevention strategy. This narrative review describes current statutory regulations that restrict food marketing; reviews available evidence on the effects of these regulations; and compares policy design elements in Chile and the United Kingdom. Currently, 16 countries have statutory regulations on unhealthy food marketing to children. Restrictions on television advertising, primarily during children's programming, are most common. Schools are also a common setting for restrictions. Regulations on media such as cinema, mobile phone applications, print, packaging, and the internet are uncommon. Eleven evaluations of policies in 4 jurisdictions found small or no policy-related reductions in unhealthy food advertising, in part because marketing shifted to other programs or venues; however, not all policies have been evaluated. Compared with the United Kingdom, Chile restricts marketing on more products, across a wider range of media, using more marketing techniques. Future research should examine which elements of food marketing policy design are most effective at reducing children's exposure to unhealthy food marketing.
Collapse
Affiliation(s)
- Lindsey Smith Taillie
- UNC Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Emily Busey
- UNC Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Fernanda Mediano Stoltze
- UNC Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | |
Collapse
|
16
|
Duffy EW, Hall MG, Dillman Carpentier FR, Musicus AA, Meyer ML, Rimm E, Smith Taillie L. Nutrition Claims on Fruit Drinks Are Inconsistent Indicators of Nutritional Profile: A Content Analysis of Fruit Drinks Purchased by Households With Young Children. J Acad Nutr Diet 2021; 121:36-46.e4. [PMID: 32978105 PMCID: PMC7752796 DOI: 10.1016/j.jand.2020.08.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 07/30/2020] [Accepted: 08/05/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Fruit drinks are the most commonly consumed sugar-sweetened beverage among young children. Fruit drinks carry many nutrition-related claims on the front of package (FOP). Nutrition-related claims affect individuals' perceptions of the healthfulness of products and purchase intentions, often creating a "health halo" effect. OBJECTIVE The aims of this study were to describe the prevalence of FOP nutrition-related claims on fruit drinks purchased by households with young children and to examine the association between claims and the nutritional profile of fruit drinks. DESIGN The sample included 2059 fruit drinks purchased by households with children 0 to 5 years old participating in Nielsen Homescan in 2017. FOP labels were obtained from 2 databases that contain bar code-level information on all printed material on product labels. A codebook was used to code for presence of FOP nutrition-related claims. The coded claims data were linked by bar code with Nutrition Facts label data. Claim type prevalence was calculated, and the association between claim types and median calories and total grams of sugar per 100 mL was analyzed using Wilcoxon rank-sum tests. The percentages of products containing noncaloric sweeteners (NCSs) with and without each claim type were also calculated and compared. RESULTS Almost all (97%) fruit drinks sampled had at least 1 nutrition-related FOP claim. Implied natural claims such as "natural flavors" were the most common (55% of products), followed by claims about the presence of juice or nectar (49%). Claims about vitamin C (33%), sugar (29%), and calories (23%) were also common. Fruit drinks with vitamin C, juice or nectar, fruit or fruit flavor, and overt natural claims were higher in calories and sugar and less likely to contain NCSs compared with products without these claims. Fruit drinks with calorie, sugar, NCS, implied natural, and other claims were lower in calories and sugar and more likely to contain NCSs compared with products without these claims. CONCLUSIONS Claims are prevalent on fruit drinks purchased by households with young children. This is concerning given prior research demonstrating that claims can mislead consumers. Regulatory actions such as requiring a warning or disclosure on drinks that contain added sugars or NCSs should be considered.
Collapse
Affiliation(s)
- Emily W Duffy
- University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC
| | - Marissa G Hall
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC
| | | | - Aviva A Musicus
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Michele L Meyer
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Eric Rimm
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Lindsey Smith Taillie
- University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC.
| |
Collapse
|
17
|
Angelino D, Rosi A, Ruggiero E, Nucci D, Paolella G, Pignone V, Pellegrini N, Martini D. Analysis of Food Labels to Evaluate the Nutritional Quality of Bread Products and Substitutes Sold in Italy: Results from the Food Labelling of Italian Products (FLIP) Study. Foods 2020; 9:foods9121905. [PMID: 33419252 PMCID: PMC7766686 DOI: 10.3390/foods9121905] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 12/12/2020] [Accepted: 12/17/2020] [Indexed: 02/07/2023] Open
Abstract
Bread is one of the most common staple foods, despite the increasing consumption of the so-called “bread substitutes”. The aim of the present work is to survey the nutritional quality intended as a nutrition declaration of 339 pre-packed bread products and 1020 bread substitutes sold in the major retailers present on the Italian market. Comparisons of energy, macronutrient, and salt content within product types, and between regular and gluten-free (GF) products and products with or without nutrition claim (NC) and health claim (HC) declarations, were performed. A high inter-product variability was detected. The median energy contents were 274 (interquartile range 255–289) and 412 (380–437) kcal/100 for bread products and substitutes, respectively. Irrespective of the category, GF products had lower amounts of energy than their gluten-containing counterpart (p < 0.001), whereas products carrying NC had lower energy, sugar and salt amounts than the products without these declarations on the pack (p < 0.001 for all). A strong positive correlation was observed between energy and carbohydrate in bread (rho = 0.73, p < 0.001), but not in substitutes (rho = 0.033, p = 0.29). The present work highlighted a high variability in the apparent nutritional quality of bread products and substitutes sold on the Italian market, and suggested that bread alternatives should not be considered tout court as substitutes from a nutritional point of view.
Collapse
Affiliation(s)
- Donato Angelino
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, 64100 Teramo, Italy;
| | - Alice Rosi
- Human Nutrition Unit, Department of Food and Drug, University of Parma, 43121 Parma, Italy;
| | - Emilia Ruggiero
- Department of Epidemiology and Prevention, IRCCS Neuromed, 86077 Pozzilli, Italy;
| | - Daniele Nucci
- Digestive Endoscopy Unit, Veneto Institute of Oncology IOV-IRCCS, 35100 Padua, Italy;
| | - Gaetana Paolella
- Department of Chemistry and Biology A. Zambelli, University of Salerno, 84084 Fisciano, Italy;
| | | | - Nicoletta Pellegrini
- Department of Agricultural, Food, Environmental and Animal Sciences, University of Udine, 33100 Udine, Italy
- Correspondence: ; Tel.: +39-0432-558183
| | - Daniela Martini
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy;
| | | |
Collapse
|
18
|
Understanding the Intersection of Race/Ethnicity, Socioeconomic Status, and Geographic Location: A Scoping Review of U.S. Consumer Food Purchasing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207677. [PMID: 33096828 PMCID: PMC7593902 DOI: 10.3390/ijerph17207677] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/08/2020] [Accepted: 10/19/2020] [Indexed: 01/11/2023]
Abstract
Disparities in diet quality persist in the U.S. Examining consumer food purchasing can provide unique insight into the nutritional inequities documented by race/ethnicity, socioeconomic status (SES), and geographic location (i.e., urban vs. rural). There remains limited understanding of how these three factors intersect to influence consumer food purchasing. This study aimed to summarize peer-reviewed scientific studies that provided an intersectional perspective on U.S. consumer food purchasing. Thirty-four studies were examined that presented objectively measured data on purchasing outcomes of interest (e.g., fruits, vegetables, salty snacks, sugar-sweetened beverages, Healthy Eating Index, etc.). All studies were of acceptable or high quality. Only six studies (17.6%) assessed consumer food purchases at the intersection of race/ethnicity, SES, or geographic location. Other studies evaluated racial/ethnic or SES differences in food purchasing or described the food and/or beverage purchases of a targeted population (example: low-income non-Hispanic Black households). No study assessed geographic differences in food or beverage purchases or examined purchases at the intersection of all three factors. Overall, this scoping review highlights the scarcity of literature on the role of intersectionality in consumer food and beverage purchasing and provides recommendations for future studies to grow this important area of research.
Collapse
|
19
|
An Assessment of Three Carbohydrate Metrics of Nutritional Quality for Packaged Foods and Beverages in Australia and Southeast Asia. Nutrients 2020; 12:nu12092771. [PMID: 32932799 PMCID: PMC7551443 DOI: 10.3390/nu12092771] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 01/08/2023] Open
Abstract
Carbohydrate quality is an aetiological factor of diet-related disease. Indices of carbohydrate quality featuring various ratios of carbohydrates-to-dietary fibre-to-sugar have been associated with improved product and/or diet quality in westernised countries. Carbohydrate intake is especially high in Asia Pacific. Thus, this study evaluated the ability of such carbohydrate metrics to discriminate the nutritional quality of carbohydrate-rich packaged foods and beverages in Australia, Malaysia, Singapore, Thailand and the Philippines, with an additional focus on beverages. This evaluation was conducted by comparing product nutritional composition and assessing products against three national nutrient profiling models. Results showed that Australia had the highest proportion of products meeting all metrics, compared to the Southeast Asian countries. Beverages had a low adherence to all metrics compared to solid foods. Across the five countries, both processed food and beverages meeting the metrics generally contained higher dietary fibre, protein, and certain vitamins and minerals whilst having lower energy, total sugars, free sugars, trans fat and cholesterol content compared to products not meeting the metrics. The metrics were also aligned with national nutrient profiling models to identify nutritious products. In conclusion, these metrics allowed us to discriminate product nutritional quality in the countries assessed and are applicable to beverages.
Collapse
|
20
|
Evaluation of nutritional quality of biscuits and sweet snacks sold on the Italian market: the Food Labelling of Italian Products (FLIP) study. Public Health Nutr 2020; 23:2811-2818. [PMID: 32635953 DOI: 10.1017/s1368980020000853] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The present study aimed at surveying the nutritional quality of prepacked biscuits and sweet snacks sold on the Italian market, and at identifying whether the product type and other information reported on the pack could discriminate the overall quality of products analysed. DESIGN Data on energy, nutrient and salt content of the products from two different categories of prepacked sweet cereal products (i.e. biscuits and sweet snacks) were collected from thirteen retailers present on the Italian market. Based on the product type, nutrition and health claim (NHC) and gluten-free (GF) declaration, a comparison of nutrient profile within each category was performed. SETTING This work is part of the Food Labelling of Italian Products (FLIP) study that aims at systematically investigating the overall quality of the prepacked foods sold on the Italian market. RESULTS A total of 1290 products were analysed (63 % biscuits and 37 % sweet snacks). After comparing different product types within each category, a high intra-type product variability was evidenced, which was more pronounced for biscuits. Overall, NHC-carrying products seemed to have a better nutrition profile than those without claims, except for salt content. Conversely, a comparison between GF and gluten-containing products did not show consistent results within the two categories analysed. CONCLUSIONS Due to the high intra-type variability within each category, the different characteristics and regulated information reported on the pack do not seem to be a clear marker of the overall nutritional quality of biscuits and snacks.
Collapse
|
21
|
Hall MG, Lazard AJ, Grummon AH, Mendel JR, Taillie LS. The impact of front-of-package claims, fruit images, and health warnings on consumers' perceptions of sugar-sweetened fruit drinks: Three randomized experiments. Prev Med 2020; 132:105998. [PMID: 31982477 PMCID: PMC7085890 DOI: 10.1016/j.ypmed.2020.105998] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 12/20/2019] [Accepted: 01/21/2020] [Indexed: 10/25/2022]
Abstract
We aimed to examine the impact of claims, fruit images, and health warnings on consumers' perceptions of fruit-flavored drinks with added sugar (i.e., "fruit drinks"). We conducted three 2x2x2 randomized experiments with online convenience samples of U.S. adults (Study 1 n = 2139 in 2018, current e-cigarette users and smokers; Study 2 n = 670 in 2018, current e-cigarette users; Study 3 n = 1006 in 2019, general sample). Participants viewed a fruit drink that differed in the presence of a "100% Vitamin C" claim, a fruit image, or a health warning. On average across the three studies, consumers who saw a claim on a fruit drink believed that the drink was more healthful than those who did not see the claim (mean average differential effect (ADE) = 0.66, p < .001); they were also more interested in consuming the drink (mean ADE = 0.38, p = .001). The health warning decreased perceived product healthfulness (mean ADE = -0.65, p < .001) and consumption interest (mean ADE = -0.49, p < .001). The fruit image had no effect on perceived product healthfulness (mean ADE = 0.03, p = .81) or purchase intentions (mean ADE = -0.04, p = .77). In Study 1 and Study 2, there were no interactions between claims, images, or warnings (all p > .05). In Study 3, the "100% Vitamin C" nutrition claim only increased perceived product healthfulness when the drink did not also have a health warning (interaction p < .05). These findings suggest that 100% Vitamin C claims increase the appeal of fruit drinks, whereas health warnings decrease the appeal. Together, these studies support policies to restrict marketing and require health warnings on sugar-sweetened beverage packaging.
Collapse
Affiliation(s)
- Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, United States of America; Lineberger Comprehensive Cancer Center, University of North Carolina, United States of America.
| | - Allison J Lazard
- Lineberger Comprehensive Cancer Center, University of North Carolina, United States of America; Hussman School of Media and Journalism, University of North Carolina, United States of America
| | - Anna H Grummon
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, United States of America; Carolina Population Center, University of North Carolina, United States of America
| | - Jennifer R Mendel
- Lineberger Comprehensive Cancer Center, University of North Carolina, United States of America
| | - Lindsey Smith Taillie
- Carolina Population Center, University of North Carolina, United States of America; Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, United States of America
| |
Collapse
|
22
|
Prevalence of Child-Directed Marketing on Breakfast Cereal Packages before and after Chile's Food Marketing Law: A Pre- and Post-Quantitative Content Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224501. [PMID: 31731577 PMCID: PMC6888536 DOI: 10.3390/ijerph16224501] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 11/10/2019] [Accepted: 11/13/2019] [Indexed: 12/22/2022]
Abstract
Food marketing has been identified as a contributing factor in childhood obesity, prompting global health organizations to recommend restrictions on unhealthy food marketing to children. Chile has responded to this recommendation with a restriction on child-directed marketing for products that exceed certain regulation-defined thresholds in sugars, saturated fats, sodium, or calories. Child-directed strategies are allowed for products that do not exceed these thresholds. To evaluate changes in marketing due to this restriction, we examined differences in the use of child-directed strategies on breakfast cereal packages that exceeded the defined thresholds vs. those that did not exceed the thresholds before (n = 168) and after (n = 153) the restriction was implemented. Photographs of cereal packages were taken from top supermarket chains in Santiago. Photographed cereals were classified as “high-in” if they exceeded any nutrient threshold described in the regulation. We found that the percentage of all cereal packages using child-directed strategies before implementation (36%) was significantly lower after implementation (21%), p < 0.05. This overall decrease is due to the decrease we found in the percentage of “high-in” cereals using child-directed strategies after implementation (43% before implementation, 15% after implementation), p < 0.05. In contrast, a greater percentage of packages that did not qualify as “high-in” used child-directed strategies after implementation (30%) compared with before implementation (8%), p < 0.05. The results suggest that the Chilean food marketing regulation can be effective at reducing the use of child-directed marketing for unhealthy food products.
Collapse
|
23
|
Bursey AS, Wiles NL, Biggs C. The nutrient quality and labelling of ready-to-eat snack foods with health and/or nutrition claims. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2019. [DOI: 10.1080/16070658.2019.1682242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Andrea Susan Bursey
- Dietetics and Human Nutrition, School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Nicola Laurelle Wiles
- Dietetics and Human Nutrition, School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Chara Biggs
- Dietetics and Human Nutrition, School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| |
Collapse
|
24
|
Ramírez AS, Arellano Carmona K. Beyond fatalism: Information overload as a mechanism to understand health disparities. Soc Sci Med 2018; 219:11-18. [PMID: 30342382 PMCID: PMC6240483 DOI: 10.1016/j.socscimed.2018.10.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 10/03/2018] [Accepted: 10/12/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Fatalism - beliefs about the causes and controllability of disease - has been negatively associated with prevention behaviors. Fatalism has been suggested as a mechanism for health disparities because ethnic minorities are especially likely to hold fatalistic beliefs. However, the construct has been criticized: Fatalism fails to account for structural barriers to health faced by vulnerable populations that also score highly on measures of fatalism. Another critique suggests that operationalizations of fatalism expose communication failures: "Fatalism" rather reflects information overload from an environment riddled with misinformation and contradictions. This study aimed to expand understanding of one mechanism through which communication may contribute to disparities by considering the context of nutrition among bicultural Latinas, who face increased risk from dietary acculturation. METHOD Mixed-methods (semi-structured in-depth interview, survey) with Mexican-American women ages 18-29 (n = 24) in rural California. RESULTS Contrary to previous studies, the majority of this sample of Mexican-American women did not endorse fatalistic beliefs; most demonstrated clear understanding of the link between diet and risk of diseases: Diabetes and heart disease were understood to result from behaviors within one's control. Yet despite articulating links between diet and disease, participants felt overloaded and confused about conflicting information from public and interpersonal sources. Moreover, despite reporting feeling inundated with information, participants noted critical information gaps, distinguishing between information available and information needed. CONCLUSIONS We found minimal support for fatalistic beliefs among a sample of Mexican-American women, but considerable information overload and confusion, together with a desire for specific knowledge and skills. Results extend understanding of how communication may influence disparities: Information overload may be conflated with fatalism, challenging the notion that fatalism is a cultural belief. Moreover, inequalities in access to and ability to process information compound overload effects. We discuss opportunities to improve the clarity of communication about nutrition science and dietary recommendations.
Collapse
Affiliation(s)
- A Susana Ramírez
- School of Social Sciences, Humanities, and Arts, University of California, Merced 5200 North Lake Road, Merced, CA, 95343, USA.
| | - Kimberly Arellano Carmona
- School of Social Sciences, Humanities, and Arts, University of California, Merced 5200 North Lake Road, Merced, CA, 95343, USA.
| |
Collapse
|
25
|
Do manufacturer ‘nutrient claims’ influence the efficacy of mandated front-of-package labels? Public Health Nutr 2018; 21:3354-3359. [DOI: 10.1017/s1368980018002550] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
AbstractObjectiveTo examine consumers’ ability to correctly interpret front-of-package (FOP) ‘high in’ warnings in the presence of a voluntary claim for the same or a different nutrient.DesignA between-group experimental task assigned respondents to view food products labelled as ‘high in sodium’, with a ‘reduced sodium’ claim positioned next to the warning, away from the warning or absent. A second experiment assigned participants to view a food product labelled as ‘high in sugar’, with a ‘reduced fat’ claim positioned next to the warning, away from the warning or absent. For both tasks, respondents were asked to identify whether the products were high in the indicated nutrient.SettingOnline survey (2016).SubjectsCanadians aged 16–32 years (n 1000) were recruited in person from five major cities in Canada.ResultsRespondents were less likely to correctly identify a product as ‘high in sodium’ when packages also featured a voluntary ‘reduced sodium’ claim, with a stronger effect when the claim was positioned away from the FOP symbol (P<0·001). The number of correct responses was similar across conditions when the nutrient claim was for a different nutrient than the one featured in the FOP ‘high in’ warning.ConclusionsThe findings demonstrate that the presence of a voluntary nutrient claim can undermine the efficacy of mandated FOP labels for the same nutrient. Countries considering nutrient-specific FOP warnings, including Canada, should consider regulations that would prohibit claims for nutrients that exceed the threshold for nutrient-specific FOP warnings.
Collapse
|
26
|
Franco-Arellano B, Labonté MÈ, Bernstein JT, L'Abbé MR. Examining the Nutritional Quality of Canadian Packaged Foods and Beverages with and without Nutrition Claims. Nutrients 2018; 10:E832. [PMID: 29954102 PMCID: PMC6073495 DOI: 10.3390/nu10070832] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 06/22/2018] [Accepted: 06/24/2018] [Indexed: 11/17/2022] Open
Abstract
Nutrient content claims, health claims, and front-of-pack symbols (henceforth referred to as “nutrition claims” in the present study) are often found on food labels in Canada. However, it is currently unknown whether foods and beverages (F&Bs) carrying nutrition claims have a more favourable nutritional profile than those without such claims. This study examined differences in the global nutritional quality, as determined by the Food Standards Australia New Zealand Nutrient Profiling Scoring Criterion (FSANZ-NPSC), of Canadian F&B bearing nutrition claims as compared to those without, as well as in their nutritional composition. Data (n = 15,184) was obtained from the University of Toronto 2013 Food Label Information Program. Forty-two percent of F&Bs carrying nutrition claims (n = 2930/6990) were found to be ineligible to carry claims based on the FSANZ-NPSC, in comparison to 66% of F&Bs without (n = 5401/8194, p < 0.001). Sugars and sweets, and miscellaneous products were the food categories with larger proportions of foods carrying nutrition claims not meeting the FSANZ-NPSC eligibility criteria. F&Bs with nutrition claims had fewer calories, less saturated fat, sodium, and sugar, and higher content of protein and fibre than comparable products without nutrition claims (p < 0.05 in all cases). In conclusion, nearly half of F&Bs carrying nutrition claims in Canada did not meet the FSANZ-NPSC threshold, although Canadian products carrying nutrition claims have an overall “healthier” profile than their counterparts without such claims.
Collapse
Affiliation(s)
- Beatriz Franco-Arellano
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 3E2, Canada.
| | - Marie-Ève Labonté
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 3E2, Canada.
- Institute of Nutrition and Functional Foods, Laval University, Québec, QC G1V 0A6, Canada.
| | - Jodi T Bernstein
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 3E2, Canada.
| | - Mary R L'Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 3E2, Canada.
| |
Collapse
|
27
|
Serra-Majem L, Raposo A, Aranceta-Bartrina J, Varela-Moreiras G, Logue C, Laviada H, Socolovsky S, Pérez-Rodrigo C, Aldrete-Velasco JA, Meneses Sierra E, López-García R, Ortiz-Andrellucchi A, Gómez-Candela C, Abreu R, Alexanderson E, Álvarez-Álvarez RJ, Álvarez Falcón AL, Anadón A, Bellisle F, Beristain-Navarrete IA, Blasco Redondo R, Bochicchio T, Camolas J, Cardini FG, Carocho M, Costa MDC, Drewnowski A, Durán S, Faundes V, Fernández-Condori R, García-Luna PP, Garnica JC, González-Gross M, La Vecchia C, Leis R, López-Sobaler AM, Madero MA, Marcos A, Mariscal Ramírez LA, Martyn DM, Mistura L, Moreno Rojas R, Moreno Villares JM, Niño-Cruz JA, Oliveira MBPP, Palacios Gil-Antuñano N, Pérez-Castells L, Ribas-Barba L, Rincón Pedrero R, Riobó P, Rivera Medina J, Tinoco de Faria C, Valdés-Ramos R, Vasco E, Wac SN, Wakida G, Wanden-Berghe C, Xóchihua Díaz L, Zúñiga-Guajardo S, Pyrogianni V, Cunha Velho de Sousa S. Ibero⁻American Consensus on Low- and No-Calorie Sweeteners: Safety, Nutritional Aspects and Benefits in Food and Beverages. Nutrients 2018; 10:E818. [PMID: 29941818 PMCID: PMC6073242 DOI: 10.3390/nu10070818] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 06/07/2018] [Accepted: 06/20/2018] [Indexed: 02/07/2023] Open
Abstract
International scientific experts in food, nutrition, dietetics, endocrinology, physical activity, paediatrics, nursing, toxicology and public health met in Lisbon on 2⁻4 July 2017 to develop a Consensus on the use of low- and no-calorie sweeteners (LNCS) as substitutes for sugars and other caloric sweeteners. LNCS are food additives that are broadly used as sugar substitutes to sweeten foods and beverages with the addition of fewer or no calories. They are also used in medicines, health-care products, such as toothpaste, and food supplements. The goal of this Consensus was to provide a useful, evidence-based, point of reference to assist in efforts to reduce free sugars consumption in line with current international public health recommendations. Participating experts in the Lisbon Consensus analysed and evaluated the evidence in relation to the role of LNCS in food safety, their regulation and the nutritional and dietary aspects of their use in foods and beverages. The conclusions of this Consensus were: (1) LNCS are some of the most extensively evaluated dietary constituents, and their safety has been reviewed and confirmed by regulatory bodies globally including the World Health Organisation, the US Food and Drug Administration and the European Food Safety Authority; (2) Consumer education, which is based on the most robust scientific evidence and regulatory processes, on the use of products containing LNCS should be strengthened in a comprehensive and objective way; (3) The use of LNCS in weight reduction programmes that involve replacing caloric sweeteners with LNCS in the context of structured diet plans may favour sustainable weight reduction. Furthermore, their use in diabetes management programmes may contribute to a better glycaemic control in patients, albeit with modest results. LNCS also provide dental health benefits when used in place of free sugars; (4) It is proposed that foods and beverages with LNCS could be included in dietary guidelines as alternative options to products sweetened with free sugars; (5) Continued education of health professionals is required, since they are a key source of information on issues related to food and health for both the general population and patients. With this in mind, the publication of position statements and consensus documents in the academic literature are extremely desirable.
Collapse
Affiliation(s)
- Lluis Serra-Majem
- Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria 35016, Spain.
- Spanish Academy of Nutrition and Food Sciences (AEN), Barcelona 08029, Spain.
- Nutrition Research Foundation (FIN), University of Barcelona Science Park, Barcelona 08028, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid 28029, Spain.
| | - António Raposo
- Research Center for Biosciences and Health Technologies-CBIOS, Universidade Lusófona de Humanidades e Tecnologias, Lisboa 1749-024, Portugal.
| | - Javier Aranceta-Bartrina
- Spanish Academy of Nutrition and Food Sciences (AEN), Barcelona 08029, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid 28029, Spain.
- Spanish Society of Community Nutrition (SENC), Barcelona 08029, Spain.
- Department of Physiology, University of the Basque Country (UPV/EHU), Leioa (Bizkaia) 48940, Spain.
| | - Gregorio Varela-Moreiras
- Spanish Academy of Nutrition and Food Sciences (AEN), Barcelona 08029, Spain.
- Spanish Nutrition Foundation (FEN), Madrid 28010, Spain.
- Department of Pharmaceutical & Health Sciences, School of Pharmacy, CEU San Pablo University, Boadilla del Monte (Madrid) 28668, Spain.
| | - Caomhan Logue
- Nutritional Innovation Centre for Food & Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraines BT52 1SA, UK.
| | - Hugo Laviada
- Research Department of Metabolism and Nutrition, Medical School, Marist University of Merida, Mérida Yucatan 97300, Mexico.
| | - Susana Socolovsky
- Argentine Association of Food Technologists, Buenos Aires 1088, Argentina.
| | - Carmen Pérez-Rodrigo
- Spanish Academy of Nutrition and Food Sciences (AEN), Barcelona 08029, Spain.
- Spanish Society of Community Nutrition (SENC), Barcelona 08029, Spain.
- Department of Physiology, University of the Basque Country (UPV/EHU), Leioa (Bizkaia) 48940, Spain.
| | | | - Eduardo Meneses Sierra
- Mexican College of Internal Medicine, Mexico City 03910, Mexico.
- Hospital General de Especialidades del ISSSTE, Saltillo, Coahuila 25020, Mexico.
| | | | - Adriana Ortiz-Andrellucchi
- Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria 35016, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid 28029, Spain.
| | - Carmen Gómez-Candela
- Clinical Nutrition Department, La Paz University Hospital, Madrid 28046, Spain.
- Hospital La Paz Health Research Institute - IdiPAZ, Autonomous University of Madrid, Madrid 28046, Spain.
| | | | - Erick Alexanderson
- Nuclear Cardiology Department, Instituto Nacional de Cardiología "Ignacio Chávez, Tlalpan, Ciudad de Mexico 14080, Mexico.
- Phisiology Department, National Autonomous University of Mexico, Coyoacán, Ciudad de México 04510, Mexico.
- Mexican Society of Cardiology, México City 14080, Mexico.
| | | | - Ana Luisa Álvarez Falcón
- Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria 35016, Spain.
- Dr. Negrin University Hospital of Gran Canaria, Las Palmas de Gran Canaria 35010, Spain.
| | - Arturo Anadón
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Complutense University of Madrid, Madrid 28040, Spain.
| | - France Bellisle
- Nutritional Epidemiology Unit, University of Paris 13, Bobigny 93017, France.
| | | | - Raquel Blasco Redondo
- Regional Center for Sports Medicine of the Junta de Castilla y León, Valladolid 47011, Spain.
| | - Tommaso Bochicchio
- Facultad Mexicana de Medicina, La Salle University, Mexico 14000, D. F., Mexico.
- Mexican Transplant Institute, Cuernavaca, Morelos 62448, Mexico.
| | - José Camolas
- Serviço de Endocrinologia, Hospital de Santa Maria⁻CHLN, Lisboa 1649-035, Portugal.
| | - Fernando G Cardini
- Argentine Quality Institute-Instituto Argentino para la Calidad (IAPC), Ciudad Autónoma de Buenos Aires 1406, Argentina.
| | - Márcio Carocho
- Mountain Research Centre (CIMO), Polytechnic Institute of Bragança, Campus de Santa Apolónia, Bragança 5300-253, Portugal.
| | - Maria do Céu Costa
- ASAE-Autoridade de Segurança Alimentar e Económica, CBIOS/ECTS-The Biosciences Research Center and NICiTeS/ERISA⁻Núcleo de Investigação em Ciências e Tecnologias da Saúde, Grupo Lusófona, Lisboa 1749-024, Portugal.
| | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington-Center for Obesity Research, Seattle, WA 98195, USA.
| | - Samuel Durán
- Chilean College of Nutritionists, Universidad San Sebastian, Santiago 7500000, Chile.
| | - Víctor Faundes
- Nutrition and Food Technology Institute, University of Chile, Santiago 7830490, Chile.
| | | | - Pedro P García-Luna
- Andalusian Society of Endocrinology, Diabetes and Nutrition, Department of Endocrinology and Nutrition, Virgen del Rocio Hospital, Sevilla 41013, Spain.
| | | | - Marcela González-Gross
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid 28029, Spain.
- ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid, Madrid 28040, Spain.
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano 20133, Italy.
| | - Rosaura Leis
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid 28029, Spain.
- School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela 15782, Spain.
- Gastroenterology, Hepatology and Paediatric Nutrition Unit of the Santiago Clinical University Hospital, Santiago de Compostela 15706, Spain.
| | - Ana María López-Sobaler
- Department of Nutrition and Food Science, School of Pharmacy, Complutense University of Madrid (UCM), Madrid 28040, Spain.
| | | | - Ascensión Marcos
- Spanish Federation of Nutrition, Food and Dietetics Societies, Madrid 28918, Spain.
- Institute of Food Science, Technology and Nutrition (ICTAN); Spanish National Research Council (CSIC), Madrid 28040, Spain.
| | | | - Danika M Martyn
- Intertek, HERS, Cody Technology Park, Farnborough GU14 0LX, UK.
| | - Lorenza Mistura
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome 00178, Italy.
| | - Rafael Moreno Rojas
- Department of Food Science and Technology, University of Cordoba, Cordoba 14071, Spain.
| | | | - José Antonio Niño-Cruz
- Mexican Nephrological Research Institute, Mexico City 14080, Mexico.
- Departamento de Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan-Ciudad de México 14080, Mexico.
| | | | - Nieves Palacios Gil-Antuñano
- Department of Medicine, Endocrinology and Nutrition, Sport Medicine Center, AEPSAD, High Sports Council, Madrid 28040, Spain.
| | | | - Lourdes Ribas-Barba
- Nutrition Research Foundation (FIN), University of Barcelona Science Park, Barcelona 08028, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid 28029, Spain.
| | - Rodolfo Rincón Pedrero
- Departamento de Educación Médica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan-Ciudad de México 14080, Mexico.
| | - Pilar Riobó
- Endocrinology and Nutrition Department, Fundación Jiménez Díaz Hospital, IDC Salud, Madrid 28040, Spain.
- Facultad de Medicina, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, Madrid 28049, Spain.
| | - Juan Rivera Medina
- Servicio de Gastroenterología, Hepatología y Nutrición del Instituto Nacional de Salud del Niño, Lima 15083, Peru.
- Departamento de Pediatría, Universidad Nacional Mayor de San Marcos, Lima 15083, Peru.
| | - Catarina Tinoco de Faria
- Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria 35016, Spain.
| | - Roxana Valdés-Ramos
- Faculty of Medicine, Autonomous University of the State of Mexico, Toluca 50180, Mexico.
| | - Elsa Vasco
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa 1649-016, Portugal.
| | - Sandra N Wac
- Nutrition and Public Health Working Group, Argentine Nutrition Society, La Plata, Buenos Aires 1900, Argentina.
| | | | - Carmina Wanden-Berghe
- Scientific and Educational Committee, Spanish Society of Parenteral and Enteral Nutrition (SENPE), Barcelona 08017, Spain.
| | - Luis Xóchihua Díaz
- Instituto Nacional de Pediatria, Sociedad Mexicana de Pediatria, Insurgentes Cuicuilco, Ciudad de México 04530, Mexico.
| | - Sergio Zúñiga-Guajardo
- Mexican Diabetes Federation, Mexico. Facultad de Medicina y Hospital Universitario de la Universidad Autónoma de Nuevo León, Monterrey 64630, Mexico.
| | | | | |
Collapse
|
28
|
Dunford EK, Taillie LS, Miles DR, Eyles H, Tolentino-Mayo L, Ng SW. Non-Nutritive Sweeteners in the Packaged Food Supply-An Assessment across 4 Countries. Nutrients 2018; 10:nu10020257. [PMID: 29495259 PMCID: PMC5852833 DOI: 10.3390/nu10020257] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 02/13/2018] [Accepted: 02/21/2018] [Indexed: 12/03/2022] Open
Abstract
Increased interest among consumers in the reduction of dietary sugar intake has led to the wider availability of food products containing non-nutritive sweeteners (NNS). However, the extent to which NNS are currently being used by manufacturers to sweeten processed food and beverage products, and how NNS may be displacing added sugars as a sweetener is unknown. The current study utilized branded food composition databases from Australia, Mexico, New Zealand and the US to determine the percentage of processed food and beverage products for which there are nutrition data containing NNS and to compare total sugar density (g per 100 mL for beverages and g per 100 g for foods) between products with and without NNS. Ordinary least squares regression at the country-product level was performed to examine associations between presence of NNS and total sugar. Across all countries, 5% of products contained at least one NNS, with the highest prevalence among beverages (22%). Mexico had the highest percentage of products with NNS (11%), as compared to the United States (US) (4%), New Zealand (1%), and Australia (<1%). The presence of NNS was associated with lower mean total sugar density among beverages (range across countries: 7.5 to 8.7 g per 100 mL) and among foods (23.2 to 25.5 g per 100 g). Products with both added sugar ingredients and NNS had a lower overall mean total sugar density when compared to products containing only added sugar ingredients. Due to paucity of data on sales and market shares across these countries, our results do not reflect the extent to which consumers purchase NNS containing products. Continued monitoring of NNS in the food supply, extension of work from these data, and inclusion of market shares of products will be important as more countries introduce policies to reduce sugar.
Collapse
Affiliation(s)
- Elizabeth K Dunford
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042, Australia.
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA.
| | - Lindsey Smith Taillie
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA.
- Department of Nutrition, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA.
| | - Donna R Miles
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA.
| | - Helen Eyles
- National Institute for Health Innovation, School of Population Health, Tamaki Campus, The University of Auckland, Auckland 1072, New Zealand.
| | - Lizbeth Tolentino-Mayo
- Nutrition and Health Research Center (CINyS), Instituto Nacional de Salud Pública (INSP), Universidad No. 655 Colonia Santa María Ahuacatitlán, 2100 Cuernavaca, Mexico.
| | - Shu Wen Ng
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA.
- Department of Nutrition, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA.
| |
Collapse
|
29
|
Do Nutrient-Based Front-of-Pack Labelling Schemes Support or Undermine Food-Based Dietary Guideline Recommendations? Lessons from the Australian Health Star Rating System. Nutrients 2018; 10:nu10010032. [PMID: 29303956 PMCID: PMC5793260 DOI: 10.3390/nu10010032] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 12/08/2017] [Accepted: 12/18/2017] [Indexed: 11/17/2022] Open
Abstract
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.
Collapse
|
30
|
Prevalence of child-directed and general audience marketing strategies on the front of beverage packaging: the case of Chile. Public Health Nutr 2017; 21:454-464. [DOI: 10.1017/s1368980017002671] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
AbstractObjectiveFront-of-package (FOP) marketing strategies of a wide variety of beverages were catalogued to examine the prevalence of each strategy prior to a sweeping Chilean restriction of child-directed marketing aimed at reducing obesity-related disease among Chile’s youth.DesignPhotographs of 1005 beverage packages were quantitatively content-analysed to code whether a variety of child-directed, health-oriented and other marketing strategies (e.g. sales promotions) were present on each product’s FOP. Strategies were then analysed based on beverages’ product category, total sugar, energy and tax status (beverages with added sugars are taxed at different rates).SettingPhotographs were taken in six urban supermarkets in Santiago, Chile, representing five different supermarket chains.ResultsBeverages using child-directed characters or nature/fruit references were higher in total sugar and beverages with child-directed characters or childhood/family references were higher in energy than beverages without these respective strategies. Of the beverages taxed at the highest rate (greatest amount of added sugars), 49 % used nutrition and health appeals and 80 % used nature or fruit appeals. Plain waters and plain milks were less likely than other selected product categories to use health-oriented appeals or multiple FOP strategies in combination.ConclusionsFOP marketing on beverages varied according to the nutritional quality of the product, with heavier use of health-oriented and child-directed strategies in less healthy products. Marketing activities warrant continued observation to evaluate how industry responds to new marketing restrictions as these restrictions are evaluated in the light of existing taxes and other regulatory efforts to improve diets and reduce obesity-related disease.
Collapse
|
31
|
Franco-Arellano B, Bernstein JT, Norsen S, Schermel A, L'Abbé MR. Assessing nutrition and other claims on food labels: a repeated cross-sectional analysis of the Canadian food supply. BMC Nutr 2017; 3:74. [PMID: 32153852 PMCID: PMC7050703 DOI: 10.1186/s40795-017-0192-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 08/16/2017] [Indexed: 11/10/2022] Open
Abstract
Background In 2010, nutrition claims were investigated in Canadian foods; however, many nutrition and other claims have been introduced since then. This study aimed to determine: i) the proportion of foods carrying claims in 2013, ii) the types and prevalence of nutrition claims (nutrient content claims, health claims, general health claims) and other claims displayed on labels in 2013, iii) and trends in use of nutrition claims between 2010 and 2013. Methods Repeated cross-sectional analysis of the University of Toronto Food Label Information Program (FLIP) of Canadian foods (2010/11 n = 10,487; 2013 n = 15,342). Regulated nutrition claims (nutrient content, health claims) were classified according to Canadian regulations. A decision tree was used to classify non-regulated general health claims (e.g., front-of-pack claims). Other claims (e.g., gluten-free) were also collected. Proportions of claims in 2013 were determined and χ2 was used to test significant differences for different types of claims between 2010 and 2013. Results Overall, 49% of products in 2013 displayed any type of claim and 46% of foods in FLIP 2013 carried a nutrition claim (nutrient content claim, health claim, general health claim). Meal replacements and fruits/fruits juices were the categories with the largest proportion of foods with claims. At least one approved nutrient content claim was carried on 42.9% of products compared to 45.5% in 2010 (p < 0.001). Health claims, specifically disease risk reduction claims, were slightly lower in 2013 (1.5%) compared to 1.7% in 2010 (p = 0.225). General health claims, specifically front-of-pack claims, were carried on 20% of foods compared to 18.9% in 2010 (p = 0.020). Other claims, specifically gluten-free, were present on 7.3% of foods. Conclusions Nutrition and other claims were used on half of Canadian prepackaged foods in 2013. Many claims guidelines and regulations have been released since 2010; however, little impact has been seen in the prevalence of such claims in the food supply. Claims related to nutrients of public health priority, such as sugars and sodium, were not commonly used on food labels. Monitoring trends in the use of nutrition and other claims is essential to determine if their use on food labels reflects public health objectives, or instead are being used as marketing tools.
Collapse
Affiliation(s)
- Beatriz Franco-Arellano
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, FitzGerald Building, 150 College Street, Rm 315, Toronto, ON M5S 3E2 Canada
| | - Jodi T Bernstein
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, FitzGerald Building, 150 College Street, Rm 315, Toronto, ON M5S 3E2 Canada
| | - Sheida Norsen
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, FitzGerald Building, 150 College Street, Rm 315, Toronto, ON M5S 3E2 Canada
| | - Alyssa Schermel
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, FitzGerald Building, 150 College Street, Rm 315, Toronto, ON M5S 3E2 Canada
| | - Mary R L'Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, FitzGerald Building, 150 College Street, Rm 315, Toronto, ON M5S 3E2 Canada
| |
Collapse
|