Health claims: Consumers’ matters

Health-enhancing foods: barriers to consumers' choice in Iran

Given the growing market for health-enhancing or functional foods in Iran, the consumption rate is low. Identifying and understanding the causes is key for future decisions and interventions in the market. So, the present study was designed to provide this knowledge in Iran. The study was conducted in Tehran, the capital of Iran, between May and September 2014. In total, 105 people participated in this qualitative research, including 40 production/supply/health authority stakeholders and 65 consumer stakeholders (44 housewives and 21 employed women). The sampling strategy was the purposive method with maximum diversity, and snowball sampling was used to identify key stakeholders. The social marketing framework was used for analyzing the participants' views and experiences. To collect data, semi-structured focus group discussions and in-depth interviews were conducted. Data collection and content analysis were performed simultaneously, using MAXQDA® software. Categorization of the findings based on social marketing mix showed that the most important barriers to the consumption of functional dairy products were undesirable sensory and non-sensory characteristics, lack of physical and economic access to the product, the existence of product competitors in the market and inappropriate promotion strategies. Furthermore, personal barriers identified as a new dimension and included lack of knowledge about the product and its benefits, a negative attitude toward the product and personal taste and preference. Understanding these barriers might contribute to design and implement effective and appropriate interventions to increase the consumption of these products among consumers.

A Cross-Sectional Audit of Nutrition and Health Claims on Dairy Yoghurts in Supermarkets of the Illawarra Region of New South Wales, Australia

Health and nutrition claims are used by consumers to guide purchasing decisions. In consequence, monitoring and evaluation of such claims to ensure they are accurate and transparent is required. The aim of this study was to investigate the use of nutrition and health claims on dairy-yoghurt products within select Australian supermarkets and assess their compliance with the revised Food Standards Code (FSC). Nutrition, health, and related claims on yoghurt products were assessed in a cross-sectional audit of five supermarkets in the Illawarra region of New South Wales. Claim prevalence, type, and compliance were assessed and products were compared against current rating measures. A total of n = 340 dairy yoghurt products were identified. Most products (97.9%) carried at least one nutrition and/or health claim, with nutrition-content claims (93.9%) the most prevalent. Most products (n = 277) met the nutrient profiling scoring criterion; while 87.9% of products did not carry the health star rating. Almost all claims surveyed (97.4%) were compliant with the FSC. Health and nutrition claims are highly prevalent across yoghurt categories, with the majority of these compliant with regulations. The ambiguity surrounding the wording and context of claims challenges researchers to investigate consumers’ interpretations of health messaging within the food environment.

Comparison of requirements for using health claims on foods in the European Union, the USA, Canada, and Australia/New Zealand

Nutrition is recognized as one of the leading factors influencing the growing incidence of noncommunicable diseases. Despite society experiencing a global rise in obesity, specific populations remain at risk of nutrient deficiencies. The food industry can use health claims to inform consumers about the health benefits of foods through labeling and the broader promotion of specific food products. As health claims are carefully regulated in many countries, their use is limited due to considerable investments required to fulfill the regulatory requirement. Although health claims represent a driving force for innovation in the food industry, the risk of misleading of consumers need to be avoided. The health claim scientific substantiation process must be efficient and transparent in order to meet the needs of companies in the global market, but should be based on strong scientific evidence and plausible mechanisms of actions, to ensure highest level of consumer protection. The objective of this review is to compare the possibilities for using health claims on foods in the European Union, the USA, Canada, and Australia and New Zealand. In particular, we focused on differences in the classification of claims, on the scientific substantiation processes and requirements for health claims use on foods in the selected regions. Reduction of disease risk (RDR) claims are associated with relatively similar procedures and conditions for use, whereas several notable differences were identified for other types of claims. In all cases, RDR claims must be approved prior their introduction to the market, and only a few such claims have been authorized. Much greater differences were observed concerning other types of claims.

Qualified Health Claim Language affects Purchase Intentions for Green Tea Products in the United States

Qualified health claims (QHC) describe diet-disease relationships and summarize the quality and strength of evidence for a claim. Companies assert that QHCs increase sales and take legal action to ensure claims reflect their interests. Yet, there is no empirical evidence that QHCs influence consumers. Using green tea as a case study, this study investigated the effects of QHCs on purchase intentions among adults 55 years and older living in the US. An online survey using a between-subjects design examined QHCs about the relationship between green tea and the reduced risk of breast and/or prostate cancer or yukichi fruit juice and the reduced risk of gastrocoridalis, a fictitious relationship. QHCs written by a green tea company generated greater perceptions of evidence for the relationship, greater confidence in green tea and cancer, and increased purchase intentions for green tea than other QHCs. Factors that mitigated the claim's effects on purchase intentions are: Race/ethnicity; age; importance of health claims; supplement use; health; worry about health/becoming sick with cancer; worry that led to dietary change; green tea consumption; and familiarity with the green tea-cancer. Consumers who made health-related dietary change in the past year and consider health claims important indicated greater purchase intentions than others.

Deciphering the consumer behaviour facets of functional foods: A literature review

This paper presents a systematic literature review of studies investigating various facets of consumer behaviour towards functional foods. It focuses on published international research on functional food attitude and behaviour from across the world. Research papers (n = 112) that were identified were coded in terms of study type, variables studied, product type, participant profile, research methodology and analysis details, as well as results and implications for future research. Results provide a systematic overview of the context in which behaviour towards functional foods have been examined in the past and provide a synthesis of findings in four categories of determinants, namely (1) Personal Factors, (2) Psychological Factors, (3) Cultural & Social Factors, and (4) Factors relating to the functional food product. A reference model for the relationships between these factors and behaviour of consumers is derived.

Nutrition and health claims in products directed at children via television in Spain in 2012

OBJECTIVE

To describe the use of nutrition and health claims in products directed at children via television in Spain and to analyse their nutrient profile.

METHODS

A cross-sectional study of television food advertisements over 7 days in five Spanish television channels popular among children. The products were classified as core, non-core or miscellaneous, and as either healthy or less healthy, according to the United Kingdom Nutrient Profile Model. We registered all claims contained on the product (packaging and labelling) and its advertisement. We calculated the frequency distributions of health and nutrition claims.

RESULTS

During the 420hours of broadcasting, 169 food products were identified, 28.5% in the dairy group and 60.9% in the non-core category. A total of 53.3% of products contained nutrition claims and 26.6% contained health claims; 62.2% of the products with claims were less healthy. Low-fat dairy products were the food category containing the highest percentage of health and nutrition claims.

CONCLUSION

Over half of all food products marketed to children via television in Spain made some type of nutrition or health claim. Most of these products were less healthy, which could mislead Spanish consumers.

Consumers' Exposure to Nutrition and Health Claims on Pre-Packed Foods: Use of Sales Weighting for Assessing the Food Supply in Slovenia

Insights into the use of health-related information on foods are important for planning studies about the effects of such information on the consumer’s understanding, purchasing, and consumption of foods, and also support further food policy decisions. We tested the use of sales data for weighting consumers’ exposure to health-related labeling information in the Slovenian food supply. Food labeling data were collected from 6342 pre-packed foods available in four different food stores in Slovenia. Consumers’ exposure was calculated as the percentage of available food products with particular food information in the food category. In addition, 12-month sales data were used to calculate sales weighted exposure as a percentage of sold food products with certain food information in the food category. The consumer’s in-store and sales-weighted exposure to nutrition claims was 37% and 45%, respectively. Exposure to health claims was much lower (13%, 11% when sales-weighted). Health claims were mainly found in the form of general non-specific claims or function claims, while children’s development and reduction of disease risk claims were present on only 0.1% and 0.2% of the investigated foods, respectively. Sales data were found very useful for establishing a reliable estimation of consumers’ exposure to information provided on food labels. The high penetration of health-related information on food labels indicates that careful regulation of this area is appropriate. Further studies should focus on assessing the nutritional quality of foods labeled with nutrition and health claims, and understanding the importance of such labeling techniques for consumers’ food preferences and choices.

Potential benefits of satiety to the consumer: scientific considerations

Foods and dietary patterns that enhance satiety may provide benefit to consumers. The aim of the present review was to describe, consider and evaluate research on potential benefits of enhanced satiety. The proposal that enhanced satiety could only benefit consumers by a direct effect on food intake should be rejected. Instead, it is proposed that there is a variety of routes through which enhanced satiety could (indirectly) benefit dietary control or weight-management goals. The review highlights specific potential benefits of satiety, including: providing appetite control strategies for consumers generally and for those who are highly responsive to food cues; offering pleasure and satisfaction associated with low-energy/healthier versions of foods without feeling 'deprived'; reducing dysphoric mood associated with hunger especially during energy restriction; and improved compliance with healthy eating or weight-management efforts. There is convincing evidence of short-term satiety benefits, but only probable evidence for longer-term benefits to hunger management, possible evidence of benefits to mood and cognition, inadequate evidence that satiety enhancement can promote weight loss, and no evidence on which consumers would benefit most from satiety enhancement. The appetite-reducing effects of specific foods or diets will be much more subtle than those of pharmaceutical compounds in managing hunger; nevertheless, the experience of pharmacology in producing weight loss via effects on appetite suggests that there is potential benefit of satiety enhancement from foods incorporated into the diet to the consumer.

Functional Foods in Macedonia: Consumers’ Perspective and Public Health Policy

Background: The objective of our study was to explore the knowledge, attitudes and practices of Macedonian consumers towards functional foods, to predict future trends and to assess the national public health policies encompassing the functional foods market.Methods: Total of 518 respondents aged 18+, from all regions in the country participated in the study. They were sampled through three-staged national representative sampling procedures. The questionnaire comprised questions regarding the level of information about functional foods, trust in health claims, frequency of consumption and knowledge and attitudes related to those foods. Statistical significance was determined at p<0.05.Results: Respondents aged 18-34 were more informed compared to the total population (22 and 16 % respectively, p<0.05). Most of the consumers consume these products once a day. Employed consumers were willing to increase daily consumption from 3 to 18 % (p<0.05). On average 65.1% of the statements assessing knowledge were answered correctly. On a scale from -3 to +3 functional foods were considered as very healthy (mean=2.03, SD=1.42).Conclusion: On average, Macedonian consumers have a positive attitude and high expectations of functional foods. Public health policies still lag when compared to comprehensive approach of the food industry in market placement of these products.

Health effects of olive oil polyphenols: recent advances and possibilities for the use of health claims

The Mediterranean diet and consumption of olive oil have been connected in several studies with longevity and a reduced risk of morbidity and mortality. Lifestyle, such as regular physical activity, a healthy diet, and the existing social cohesion in Southern European countries have been recognised as candidate protective factors that may explain the Mediterranean Paradox. Along with some other characteristics of the Mediterranean diet, the use of olive oil as the main source of fat is common in Southern European countries. The benefits of consuming olive oil have been known since antiquity and were traditionally attributed to its high content in oleic acid. However, it is now well established that these effects must also be attributed to the phenolic fraction of olive oil with its anti-oxidant, anti-inflammatory and anti-microbial activities. The mechanisms of these activities are varied and probably interconnected. For some activities of olive oil phenolic compounds, the evidence is already strong enough to enable the legal use of health claims on foods. This review discusses the health effects of olive oil phenols along with the possibilities of communicating these effects on food labels.

Consumers’ health-related motive orientations and reactions to claims about dietary calcium

Health claims may contribute to better informed and healthier food choices and to improved industrial competitiveness by marketing foods that support healthier lifestyles in line with consumer preferences. With the more stringent European Union regulation of nutrition and health claims, insights into consumers' health-related goal patterns and their reactions towards such claims are needed to influence the content of lawful claims. This study investigated how consumers' explicit and implicit health-related motive orientations (HRMOs) together with the type of calcium-claim (nutrition claim, health claim and reduction of disease risk claim) influence perceived credibility and purchasing intention of calcium-enriched fruit juice. Data were collected in April 2006 through a consumer survey with 341 Belgian adults. The findings indicate that stronger implicit HRMOs (i.e., indirect benefits of calcium for personal health) are associated with higher perceived credibility, which is not (yet) translated into a higher purchasing intention. Consumers' explicit HRMOs, which refer to direct benefits or physiological functions of calcium in the body-as legally permitted in current calcium-claims in the EU-do not associate with reactions to the claims. Independently of consumers' HRMOs, the claim type significantly affects the perceived credibility and purchasing intention of the product. Implications for nutrition policy makers and food industries are discussed.

European consumers and health claims: attitudes, understanding and purchasing behaviour

Health claims on food products are often used as a means to highlight scientifically proven health benefits associated with consuming those foods. But do consumers understand and trust health claims? This paper provides an overview of recent research on consumers and health claims including attitudes, understanding and purchasing behaviour. A majority of studies investigated selective product-claim combinations, with ambiguous findings apart from consumers' self-reported generic interest in health claims. There are clear indications that consumer responses differ substantially according to the nature of carrier product, the type of health claim, functional ingredient used or a combination of these components. Health claims tend to be perceived more positively when linked to a product with an overall positive health image, whereas some studies demonstrate higher perceived credibility of products with general health claims (e.g. omega-3 and brain development) compared to disease risk reduction claims (e.g. bioactive peptides to reduce risk of heart disease), others report the opposite. Inconsistent evidence also exists on the correlation between having a positive attitude towards products with health claims and purchase intentions. Familiarity with the functional ingredient and/or its claimed health effect seems to result in a more favourable evaluation. Better nutritional knowledge, however, does not automatically lead to a positive attitude towards products carrying health messages. Legislation in the European Union requires that the claim is understood by the average consumer. As most studies on consumers' understanding of health claims are based on subjective understanding, this remains an area for more investigation.

Nutrient profiling and food label claims: evaluation of dairy products in three major European countries

BACKGROUND/OBJECTIVES

This study reviews commercially available dairy products with nutrition or health-related on-pack communication against selected nutrient profiling models. It aims to provide guidance on the model characteristics required to appropriately categorise products into those that are suitable for carrying claims, versus those whose overall nutritional composition does not support such product communication.

SUBJECTS/METHODS

More than 300 dairy products carrying claims were identified in Germany, France and the UK and evaluated against six existing nutrient profiling models. All models were assessed regarding their underlying principles, generated results and inter-model agreement levels.

RESULTS

In most cases, products failed the criteria of a given model because of too high levels of total fat, saturated fatty acids, sugars and/ or sodium. The Swedish Keyhole and the Smart Choices Program were the most restrictive models and showed the highest level of agreement. In general, the application of nutrient profiles helped to select products with significantly lower average levels of nutrients that are linked to chronic diseases when consumed in excess. However, calcium levels were also highly impacted in some cases.

CONCLUSIONS

A nutrient profiling model that targets saturated fatty acids, sugars and sodium can meaningfully and comprehensively identify dairy products with a favourable nutritional composition. However, thresholds have to be set carefully to not reduce the average calcium contribution of the category. The use of separate criteria for cheeses and other dairy products seems necessary to take into account intrinsic compositional differences.

Determinants of consumer understanding of health claims

The new EU regulation on nutrition and health claims states that claims can be permitted only if they can be expected to be understood by consumers. Investigating determinants of consumer understanding of health claims has therefore become an important topic. Understanding of a health claim on a yoghurt product was investigated with a sample of 720 category users in Germany. Health claim understanding was measured using open answers, which were subsequently content analysed and classified by comparison with the scientific dossier of the health claim. Based on this respondents were classified as safe, risky or other. In addition to the open questions on claim understanding, respondents rated a number of statements on claim interpretation for agreement and completed scales on interest in healthy eating, attitude to functional foods, and subjective knowledge on food and health. Results showed that respondents with a positive attitude to functional foods are more likely to be classified as risky with regard to their claim understanding, whereas respondents with negative or neutral attitudes are more likely to be classified into the other category. Implications for testing claim understanding are discussed.

Consumer perceptions of beef healthiness: results from a qualitative study in four European countries

Background

Consumer perception of the healthiness of beef is an important determinant of beef consumption. However, little is known about how consumers perceive the healthiness of beef. The aim of this study is to shed light on the associations between beef and health.

Methods

Eight focus group discussions were conducted in four European countries (France, UK, Germany, Spain), each consisting of seven to nine participants. A content analysis was performed on the transcripts of these discussions.

Results

Although beef was generally perceived as healthful, focus group participants expected positive as well as negative effects of beef consumption on their health. Labelled, branded, fresh and lean beef were perceived as signalling healthful beef, in contrast with further processed and packaged beef. Consumers felt that their individual choices could make a difference with respect to the healthiness of beef consumed. Focus group participants were not in favour of improving beef healthiness during processing, but rather focussed on appropriate consumption behaviour and preparation methods.

Conclusions

The individual responsibility for health implies that consumers should be able to make correct judgements about how healthful their food is. However, the results of this study indicate that an accurate assessment of beef healthiness is not always straightforward. The presented results on consumer perceptions of beef healthiness provide insights into consumer decision making processes, which are important for the innovation and product differentiation in the European beef sector, as well as for public health policy decisions related to meat consumption in general and beef consumption in particular.