Use of trans fat information on food labels and its determinants in a multiethnic college student population

Awareness, knowledge, and behaviors regarding trans unsaturated fatty acids in a sample of Lebanese adults

Lebanon is a country in the Middle East that had been witnessing nutrition transition to a westernized diet high in trans fats (TFs) and saturated fatty acids (TFAs) that had been linked to cardiovascular diseases and many other health issues. This study examines TF-related awareness, knowledge, and self-reported behaviors among a sample of Lebanese adults aged between 18 and 64 years, as well as their association with sociodemographic factors and anthropometric measurements. Using a multicomponent questionnaire, a cross-sectional study was conducted online, across all Lebanese regions based on a convenience sampling method (n = 401). Factors associated with TF-related awareness, knowledge, and behaviors were examined by multivariate linear regression analysis. The study highlighted specific gaps in TF-related awareness, knowledge, and behavioral practices as well as differences by sociodemographic factors. Most of the participants (36%) had heard of partly hydrogenated oils (PHOs) rather than TFs (49%). A higher proportion of respondents (54%) said they understood a little about TFs, the majority had inadequate knowledge about the foods that contain TFs, and 44% said they would not give up eating their favorite snack even if they knew it contains TFs. Overall, consumers' awareness and knowledge about TFs are rather low and the majority had fair behavioral practices. In addition, being a woman and having higher education level were significantly associated with higher levels of TFs awareness, knowledge, and behavior scores. Higher behavior scores were shown in older participants, married, and those who had part-time jobs, whereas having higher income and normal weight were significantly associated with higher awareness scores. These findings offer valuable insight into TF-related awareness, knowledge, and behaviors in a sample of Lebanese adults and provide key information that could spur the development of evidence-based TFs reduction interventions specific to the Middle East.

Knowledge, Awareness, and Practices among Consumers Regarding Trans-Fat: A Cross-Sectional Study

Introduction

Processed and preserved food items are the major source of dietary trans fat. Despite various legal provision, public awareness toward trans fats are limited.

Objective

To examine the awareness of participants about various aspects of trans fats and improving their knowledge through education.

Methods

A cross sectional pre- and posttest survey was conducted online through a webinar. The questionnaire has 11 questions about trans fats. Received responses were coded. Mean and frequency of continuous data were calculated. Chi-square or t-test were used to find the difference in pre and posttest.

Results

Eighty five out of 95 participants completed both pre- and posttest. The scores for each question were compared to find out awareness improvement. The question based on FSSAI showed 57% improvement while 50% in case of World Health Organization's REPLACE initiative. The difference of mean score of pretest (7.57 ± 1.8) and posttest (9.22 ± 1.37) was statistically significant.

Conclusion

Nutrition education and proper labelling of food items can improve the knowledge about food ingredients and food purchasing patterns. Proper enforcement and monitoring of food items labeling guidelines can be recommended.

Nutrition knowledge among university students in the UK: a cross-sectional study

OBJECTIVE

To investigate nutrition knowledge (NK) in university students, potential factors affecting knowledge and predictors of good NK.

DESIGN

A cross-sectional study was conducted in 2017-2018. The revised General Nutrition Knowledge Questionnaire was administered online to assess overall NK and subsections of knowledge (dietary recommendations, nutrient sources of foods, healthy food choices and diet-disease relationships). The Kruskal-Wallis test was used to compare overall NK scores according to sex, age, ethnicity, field of study, studying status, living arrangement, being on a special diet and perceived health. Logistic regression was performed to identify which of these factors were associated with a good level of NK (defined as having an overall NK score above the median score of the sample population).

SETTING

Two London-based universities.

PARTICIPANTS

One hundred and ninety students from various academic disciplines.

RESULTS

The highest NK scores were found in the healthy food choices (10 out of 13 points) and the lowest in the nutrient sources of foods section (25 out of 36 points). Overall NK score was 64 out of 88 points, with 46·8 % students reaching a good level of knowledge. Knowledge scores significantly differed according to age, field of study, ethnicity and perceived health. Having good NK was positively associated with age (OR = 1·05, (95 % CI 1·00, 1·1), P < 0·05), White ethnicity (OR = 3·27, (95 % CI 1·68, 6·35), P < 0·001) and health rating as very good or excellent (OR = 4·71, (95 % CI 1·95, 11·4), P < 0·05).

CONCLUSIONS

Future health-promoting interventions should focus on increasing knowledge of specific nutrition areas and consider the personal and academic factors affecting NK in university students.

Faith in Fat: A Multisite Examination of University Students' Perceptions of Fat in the Diet

Despite recent relaxation of restrictions on dietary fat consumption in dietary guidelines, there remains a collective "fear of fat". This study examined college students' perceptions of health among foods with no fat relative to foods with different types of fats (unsaturated and saturated). Utilizing a multisite approach, this study collected data from college students at six university dining halls throughout the United States. Data were available on 533 students. Participants were 52% male and consisted largely of first-year students (43%). Across three meal types, the no-fat preparation option was chosen 73% of the time, the unsaturated fat option was selected 23% of the time, and the saturated fat option was chosen 4% of the time. Students chose the no-fat option for all meal types 44% of the time. Findings suggest that college students lack knowledge regarding the vital role played by the type and amount of fats within a healthy diet. Nutrition education and food system reforms are needed to help consumers understand that type of fat is more important than total amount of fat. Efforts across various sectors can encourage incorporating, rather than avoiding, fats within healthy dietary patterns.

Nutrition Facts Panels: Who Uses Them, What Do They Use, and How Does Use Relate to Dietary Intake?

BACKGROUND

Nutrition labels are a low-cost tool with the potential to encourage healthy eating habits.

OBJECTIVE

To investigate correlates of frequent Nutrition Facts label use, describe the types of label information most often used, and measure how label use relates to dietary intake in young adults.

DESIGN

Cross-sectional population-based study of young adults participating in Project Eating and Activity in Teens and Young Adults-IV.

PARTICIPANTS/SETTING

Surveys and food frequency questionnaires were completed during 2015-2016 by young adults (N=1,817; weighted sample=49% women) aged 25 to 36 years.

MAIN OUTCOME MEASURES

Nutrition Facts label use, frequency of using specific information on labels, and dietary intake.

STATISTICAL ANALYSES PERFORMED

Relative risks and adjusted means were used to examine how demographic, behavior, and weight-related factors were associated with Nutrition Facts panel use, and how label use related to dietary outcomes. Associations with P values <0.05 were considered statistically significant.

RESULTS

Approximately one-third (31.4%) of participants used Nutrition Facts labels "frequently." Use was significantly higher for women; for participants with high education and income; among those who prepared food regularly; among those who were physically active; among those with a weight status classified as overweight; and among those who were trying to lose, gain, or maintain weight. Label components used most often included sugars (74.1%), total calories (72.9%), serving size (67.9%), and the ingredient list (65.8%). Nutrition Facts label users consumed significantly more fruits, vegetables, and whole grains and fewer sugar-sweetened beverages, compared with nonusers. Nutrition Facts label users ate significantly more frequently at sit-down restaurants but less frequently at fast-food restaurants compared with nonusers.

CONCLUSIONS

Although Nutrition Facts label use was associated with markers of better dietary quality in a population-based sample of young adults, only one-third of participants used labels frequently. Methods to improve label use should be studied, particularly through leveraging weight- or health-related goals (eg, interest in making healthier food choices), and meeting consumer preferences concerning label content.

Limiting trans Fats in Foods: Use of Partially Hydrogenated Vegetable Oils in Prepacked Foods in Slovenia

Consumption of industrially produced trans-fatty acids (TFAs) is a well-established health risk factor that correlates with the increased risk of developing cardiovascular disease. The recommended TFA intake is as low as possible, within the context of a nutritionally adequate diet. Different countries have introduced different measures to minimize the exposure of their population to TFAs. Previous data have shown that TFA content has significantly decreased in Western European countries, while this was not the case in many Central-Eastern European countries, including Slovenia. In the absence of regulatory requirements, a number of awareness campaigns were launched in Slovenia since 2015, with the common goal of lowering the use of partially hydrogenated oils (PHO), which are considered a major source of TFAs. To determine if this goal had been reached, we performed an assessment of the exposure of the population to prepacked foods containing PHOs in years 2015 and 2017. Altogether, data on the composition of 22,629 prepacked foods was collected from food labels, using a specifically developed smartphone application. Furthermore, the food categories with the most frequent use of PHOs were identified. The proportion of PHO-containing products was determined for each specific food category, and adjusted with the market share data. The results showed that in 2015, vegetable cream substitutes, soups, and biscuits were the categories with the highest penetration of declared PHO content. In 2017, the proportion of products with PHO decreased considerably. In vegetable cream substitutes the percentage of PHO containing items dropped from 30 down to 4%, in soups it decreased from 21 to 5%, in biscuits from 17 to 8%, and in crisps and snacks from 10 to 4%. However, PHO content remained notable among cakes, muffins, pastries, and biscuits. We can conclude that the voluntary guidelines and regular public communication of the risks related to the TFA consumption has had a considerable effect on the food supply, but did not result in sufficient removal of PHOs from foods.

Trans-Fatty Acids and Cardiovascular Disease: Urgent Need for Legislation

Hydrogenated oils containing trans-fatty acids (TFA) are used to produce margarine and various processed foods. TFA affect serum lipid levels, fatty acid metabolism, and endothelial function. High TFA intake is linked to increased all-cause mortality, coronary heart disease mortality, and cardiovascular disease (CVD) incidence. Denmark was the first country to introduce a law that limited TFA content in food; this action led to lower CVD mortality. So far 7 European countries have followed this practice, in a few others the food industry voluntarily reduced TFA use. The issue remains mostly unaddressed in the rest of the world. Legal TFA limits should be commonly established as they are the optimal solution considering both CVD prevention and the associated cost savings in public healthcare.

The Influence of Nutrition Label Placement on Awareness and Use among College Students in a Dining Hall Setting

BACKGROUND

Nutrition labels may be important predictors of dietary selections among college students; however, awareness and use are not well understood in this population.

OBJECTIVE

The aim of this work was to investigate the influence of label placement on label awareness and use, including influences over time. We also aimed to identify predictors of awareness and use, preferred label information, and reasons for label nonuse.

DESIGN

Cross-sectional surveys were administered in three 1-week waves over 3 months.

PARTICIPANTS/SETTING

Two thousand seven hundred twenty-nine students aged 18 years or older in four university dining halls.

INTERVENTION

Nutrition labels were placed on sneeze guards in two dining halls and directly in front of food in two comparator dining halls.

MAIN OUTCOME MEASURES

Label awareness and use were measured using 5-point Likert scales. Reasons for label nonuse and preferred types of information were assessed by response frequencies.

STATISTICAL ANALYSIS PERFORMED

Logistic regression was used to determine predictors of label awareness and use. To test for differences in information preferences between label users and nonusers, χ(2) tests were used.

RESULTS

Nutrition label awareness and use did not vary by label placement or over time. Awareness was related to being obese, having higher perceived stress, taking nutrition classes, having good/excellent eating habits, eating breakfast, tracking food intake, and exercising five or more times per week. Use was related to being a woman, being overweight, having higher perceived stress, having good/excellent eating habits, eating breakfast, tracking food intake, and exercising three or more times per week. Information preferences differed by use, but calories, fat, and protein were the most preferred pieces of information overall. Not caring, already having a good idea about nutrition information, and not having time were the top reasons for label nonuse.

CONCLUSIONS

Label awareness and use did not change with label placement or over time. Making labels easy to read and including preferred information may encourage greater awareness and use.

Artificial trans fat in popular foods in 2012 and in 2014: a market basket investigation in six European countries

OBJECTIVE

To minimise the intake of industrially produced trans fat (I-TF) and thereby decrease the risk of coronary heart disease (CHD), nearly all European countries rely on food producers to voluntarily reduce the I-TF content in food. The objective of this study was to monitor the change in presence of I-TF in biscuits/cakes/wafers in six countries in South-eastern Europe from 2012 to 2014, including two members of the European Union (Slovenia and Croatia).

DESIGN

Three large supermarkets were visited in each of the six capitals in 2012. Pre-packaged biscuits/cakes/wafers were bought if the products contained more than 15 g of total fat per 100 g of product and if partially hydrogenated oil or a similar term was disclosed at the beginning of the ingredients list. These same supermarkets were revisited in 2014 and the same collection procedure was followed. All foods were subsequently analysed for total fat and trans fat in the same laboratory.

RESULTS

The number of packages bought in the six countries taken together was 266 in 2012 and 643 in 2014. Some were identical, and therefore only 226 were analysed in 2012 and 434 in 2014. Packages with less than 2% of fat from I-TF went up from 69 to 235, while products with more than 2% (illegal in Denmark) doubled from an average of 33 to an average of 68 products for the six countries, with considerable variation across countries. The per cent of I-TF in total fat decreased slightly, from a mean (SD) of 22 (13) in 2012 to 18 (9) in 2014.

CONCLUSIONS

The findings suggest that voluntary reduction of I-TF in foods with high amounts is an ineffective strategy in several European countries. Alternative strategies both within and outside the European Union are necessary to protect all subgroups of the populations against an increased risk of CHD.

Correlates of nutrition label use among college students and young adults: a review

OBJECTIVE

Nutrition labels are an essential source for consumers to obtain nutrition-related information on food products and serve as a population-level intervention with unparalleled reach. The present study systematically reviewed existing evidence on the correlates of nutrition label use among college students and young adults.

DESIGN

Keyword and reference searches were conducted in PubMed, EBSCO, PsycInfo, Cochrane Library and Web of Science. Inclusion criteria included: study design (randomized controlled trial, cohort study, pre-post study or cross-sectional study); population (college students and young adults 18-30 years old); main outcome (nutrition label use); article type (peer-reviewed publication); and language (English).

SETTING

College/university.

SUBJECTS

College students and young adults.

RESULTS

Sixteen studies based on data from college surveys in four countries (USA, UK, Canada, South Korea) were identified from keyword and reference search. Reported prevalence of nutrition label use varied substantially across studies; a weighted average calculation showed 36·5 % of college students and young adults reported using labels always or often. Females were more likely to use nutrition labels than males. Nutrition label use was found to be associated with attitudes towards healthy diet, beliefs on the importance of nutrition labels in guiding food selection, self-efficacy, and nutrition knowledge and education.

CONCLUSIONS

The impact of nutrition labelling on food purchase and intake could differ by population subgroups. Nutrition awareness campaigns and education programmes may be important mechanisms for promoting nutrition label use among college students and young adults. Future research is warranted to assess the role of label use on improved dietary decisions.

Students' perspectives on promoting healthful food choices from campus vending machines: a qualitative interview study

Background

Increasing the healthfulness of campus food environments is an important step in promoting healthful food choices among college students. This study explored university students’ suggestions on promoting healthful food choices from campus vending machines. It also examined factors influencing students’ food choices from vending machines.

Methods

Peer-led semi-structured individual interviews were conducted with 43 undergraduate students (33 females and 10 males) recruited from students enrolled in an introductory nutrition course in a large national university in the United Arab Emirates. Interviews were audiotaped, transcribed, and coded to generate themes using N-Vivo software.

Results

Accessibility, peer influence, and busy schedules were the main factors influencing students’ food choices from campus vending machines. Participants expressed the need to improve the nutritional quality of the food items sold in the campus vending machines. Recommendations for students’ nutrition educational activities included placing nutrition tips on or beside the vending machines and using active learning methods, such as competitions on nutrition knowledge.

Conclusions

The results of this study have useful applications in improving the campus food environment and nutrition education opportunities at the university to assist students in making healthful food choices.

The effects of nutrition knowledge on food label use. A review of the literature

Nutrition information on food labels is an important source of nutrition information but is typically underutilized by consumers. This review examined whether consumer nutrition knowledge is important for communication of nutrition information through labels on packaged foods. A cognitive processing model posits that consumers with prior knowledge are more likely to use label information effectively, that is, focus on salient information, understand information, and make healthful decisions based on this information. Consistent with this model, the review found that nutrition knowledge provides support for food label use. However, nutrition knowledge measures varied widely in terms of the dimensions they included and the extensiveness of the assessment. Relatively few studies investigated knowledge effects on the use of ingredient lists and claims, compared to nutrition facts labels. We also found an overreliance on convenience samples relying on younger adults, limiting our understanding of how knowledge supports food label use in later life. Future research should 1) investigate which dimensions, or forms, of nutrition knowledge are most critical to food label use and dietary decision making and 2) determine whether increases in nutrition knowledge can promote great use of nutrition information on food labels.

"I rarely read the label": Factors that Influence Thai Consumer Responses to Nutrition Labels

BACKGROUND

This qualitative study employed the Knowledge-Attitude-Behaviour (KAB) model and Health Belief Model (HBM) to investigate factors influencing Thai consumer decision making about use of nutrition labels. Labels include both Nutrition Information Panels (1998-) and Guideline Daily Amounts labels (2011-).

METHOD

In-depth interviews were conducted with 34 participants representing two socio-demographic extremes in Thailand--"urban Bangkok" (university educated consumers) and "provincial Ranong" (non-university educated consumers). An integrated KAB-HBM model was used to devise in-depth interviews for a qualitative study using 20 open-ended questions and samples of food package labels. Additional questions arose from the interviews and they lasted 30-45 minutes and were video recorded. The analysis identified recurring themes using Atlas.ti software.

RESULTS

Most participants (n=25) were aware of nutrition labels but a much smaller number (n=10) used and derived any benefit from them. Nutrition label users were classified into 4 groups: A) competent user; B) confused user; C) aware non-user; D) unaware non-user. Better educated participants were better at understanding nutrition labels but not more likely to use labels. Belief that nutrition influences health increased likelihood of using nutrition labels to make decisions about food. Being well-educated and motivated by health concerns increased likelihood of attention to nutrition labels.

CONCLUSION

Results are discussed with a view to increasing the use of nutrition labels by Thai consumers. Our findings, drawing on a combination of the KAB and HBM models, can contribute to strategies motivating consumers to use nutrition labels and can provide useful insights for developing promotional strategies.

Tracing artificial trans fat in popular foods in Europe: a market basket investigation

OBJECTIVE

To minimise the intake of industrial artificial trans fat (I-TF), nearly all European countries rely on food producers to voluntarily reduce the I-TF content in food. The objective of this study was to investigate the effect of this strategy on I-TF content in prepackaged biscuits/cakes/wafers in 2012-2013 in 20 European countries.

DESIGN

The I-TF content was assessed in a market basket investigation. Three large supermarkets were visited in each capital, and in some countries, three additional ethnic shops were included.

RESULTS

A total of 598 samples of biscuits/cakes/wafers with 'partially hydrogenated vegetable fat' or a similar term high on the list of ingredients were analysed, 312 products had more than 2% of fat as I-TF, exceeding the legislatively determined I-TF limit in Austria and Denmark; the mean (SD) was 19 (7)%. In seven countries, no I-TF was found, whereas nine predominantly Eastern European countries had products with very high I-TF content, and the remaining four countries had intermediate levels. Of the five countries that were examined using the same procedure as in 2006, three had unchanged I-TF levels in 2013, and two had lower levels. The 18 small ethnic shops examined in six Western European countries sold 83 products. The mean (SD) was 23 (12)% of the fat as I-TF, all imported from countries in Balkan. In Sweden, this type of food imported from Balkan was also available in large supermarkets.

CONCLUSIONS

The findings suggest that subgroups of the population in many countries in Europe still consume I-TF in amounts that increase their risk of coronary heart disease. Under current European Union (EU) legislation, the sale of products containing I-TF is legal but conflicts with the WHO recommendation to minimise the intake of I-TF. An EU-legislative limit on I-TF content in foods is expected to be an effective strategy to achieve this goal.

Systematic review of dietary interventions with college students: directions for future research and practice

OBJECTIVE

To clarify directions for research and practice, research literature evaluating nutrition and dietary interventions in college and university settings was reviewed.

DESIGN

Systematic search of database literature.

SETTING

Postsecondary education.

PARTICIPANTS

Fourteen research articles evaluating randomized controlled trials or quasi-experimental interventions targeting dietary outcomes.

MAIN OUTCOME MEASURES

Diet/nutrition intake, knowledge, motivation, self-efficacy, barriers, intentions, social support, self-regulation, outcome expectations, and sales.

ANALYSIS

Systematic search of 936 articles and review of 14 articles meeting search criteria.

RESULTS

Some in-person interventions (n = 6) show promise in improving students' dietary behaviors, although changes were minimal. The inclusion of self-regulation components, including self-monitoring and goal setting, may maximize outcomes. Dietary outcomes from online interventions (n = 5) were less promising overall, although they may be more effective with a subset of college students early in their readiness to change their eating habits. Environmental approaches (n = 3) may increase the sale of healthy food by serving as visual cues-to-action.

CONCLUSIONS AND IMPLICATIONS

A number of intervention approaches show promise for improving college students' dietary habits. However, much of this research has methodological limitations, rendering it difficult to draw conclusions across studies and hindering dissemination efforts.

Consumer understanding and use of food and nutrition labeling in Turkey

OBJECTIVES

To determine patterns of food and nutrition labels use by Turkish consumers, and examine constraints on the use of this information.

DESIGN

Cross-sectional survey.

SETTING

Twenty-six regions of Turkey.

PARTICIPANTS

Consumers (n = 1,536), aged 12-56 years.

VARIABLES MEASURED

Level of interest in food and nutrition labels, the perceived sources of information about nutrition, the performance of the food industry at labeling, and sociodemographic factors.

ANALYSIS

Descriptive statistics and χ(2) statistics.

RESULTS

The uses of food labels and nutrition labels were reported, respectively, by 76.5% and 72.4% of participants. Nutrition label use was significantly associated with sex, age, marital status, educational level, and socioeconomic status (P < .001 for all variables). Barriers to the use of nutrition labels included: the lack of understanding of terms, symbols, and values; poor presentation of the information; and concerns about the accuracy of the information. Consumers who wished to use nutrition labels to make healthful choices demanded a standardized location and format for the labels, as well as simplified information conveyed with comprehensible terms and statements.

CONCLUSIONS AND IMPLICATIONS

New strategies to encourage the effective consumer use of food and nutrition labels should include educational programs and revision of the label format.

Food label use and food label skills among immigrants from the former Soviet Union

OBJECTIVE

To assess food label use and skills and to identify their correlates among immigrants from the former Soviet Union (FSU).

DESIGN/SETTING/PARTICIPANTS

Cross-sectional survey of a convenience sample of 200 FSU immigrants residing in New York City.

VARIABLES MEASURED

Food label use and skills; acculturation; and socioeconomic and psychosocial factors.

ANALYSIS

Chi-square tests and multivariate logistic regression analysis assessed relationships among the outcomes and socioeconomic and other characteristics.

RESULTS

Fifty-five percent reported using food labels always/often; only 32% had good label skills. FSU immigrants particularly had difficulty understanding servings per package and percent daily value. Food label use was significantly associated with factors such as positive attitude toward food labels, and importance of recommendations such as avoiding too much salt and saturated fat. However, these factors were not related to food label skills, which was positively associated with longer residency in the United States (> 7 y).

CONCLUSIONS AND IMPLICATIONS

There is a need for nutrition education among FSU immigrants to increase their food label use and skills to promote healthful food selection. Developers of new food labels should consider ways to present percent daily value and servings per package in a more consumer-friendly manner. Simplifying the presentation of this information could improve food label skills in FSU immigrants, among others.

The effect of food label cues on perceptions of quality and purchase intentions among high-involvement consumers with varying levels of nutrition knowledge

OBJECTIVE

To determine whether differences in nutrition knowledge affected how women (a high-involvement group) interpreted intrinsic cues (ingredient list) and extrinsic cues ("all natural" label) on food labels.

METHODS

A 2 (intrinsic cue) × 2 (extrinsic cue) × 2 (nutrition knowledge expert vs novice) within-subject factorial design was used. Participants were 106 female college students (61 experts, 45 novices). Dependent variables were perception of product quality and purchase intention.

RESULTS

As predicted by the elaboration likelihood model, experts used central route processing to scrutinize intrinsic cues and make judgments about food products. Novices used peripheral route processing to make simple inferences about the extrinsic cues in labels.

CONCLUSIONS AND IMPLICATIONS

Consumers' levels of nutrition knowledge influenced their ability to process food labels. The United States Food and Drug Administration should regulate the "all natural" food label, because this claim is likely to mislead most consumers.

Adolescent nutritional awareness and use of food labels: results from the National Nutrition Health and Examination Survey

Background

Awareness of federal nutrition programs and use of the nutrition facts label are associated with reduced risk for obesity and increased intake of fruits and vegetables. Relationships between nutrition programs, use of food labels and risk for overweight and obesity have rarely been evaluated in adolescents.

Methods

Using the National Health and Nutrition Examination Survey from 2005–6, we evaluated the frequency of nutrition awareness of USDA and CDC nutrition programs and use of food labels in adolescents. Risk for overweight (BMI ≥ 85-94th percentile) and obesity (BMI ≥ 95th percentile) was assessed in relation to nutrition awareness and label reading.

Results

Most adolescents (92.4%) were aware of the Food Guide Pyramid. Fewer (43.5%) were aware of the 5-A-Day Program, and even less (29.3%) were aware of the Dietary Guidelines for Americans. Less than 25% of adolescents decided which foods to purchase by reading material on the nutrition facts label. There were significant racial and ethnic differences in awareness of federal nutrition programs with Mexican-Americans having the lowest levels of awareness of the US Dietary Guidelines for Americans and the Food Guide Pyramid in comparison with other groups. Non-Hispanic whites had higher and African-American adolescents had lower frequencies of reading fat information on the nutrition label in comparison to Mexican-American and other Hispanics. Awareness of other nutrition programs or of other information on the nutrition facts label was not associated with increased or decreased risk for overweight or obesity.

Conclusions

Use of the nutrition facts panel information is low among US adolescents. Additionally, less than half of adolescents are aware of federal nutrition programs including the Dietary Guidelines for Americans. Future studies should evaluate avenues to make nutrition information more accessible to young Americans.

Knowledge, Attitude and Practice between Medical and Non-Medical Sciences Students about Food Labeling

BACKGROUND

Considering the significant role of consumers' awareness about food labels in making healthy food choices, this study was designed to assess the knowledge, attitude and prac¬tice of university students about food labeling.

METHODS

In this cross-sectional study, 332 students aged 18-25 yr in five different academic majors (including Nutrition, Public Health, Health Services Administration, Paramedical and En¬gineering) were asked to complete an approved questionnaire contained fifteen questions. The chi-square test was applied to examine the differences across various major groups.

RESULTS

89.2% of the students believed that food labels had effect on nutritional awareness. 77.4% were agreed with the usefulness of the food labels and 79.2% did not feel that nutrition claims on food label were truthful. For 84% of students, the expiry date and storage conditions information were the most important informational cues to appear on the food labels. From 47.6% of students who reported the use of nutrition facts label in their often or always shopping; only 32.3% used the information on labels to fit the food into their daily diet. Surprisingly, fatty acids were the least noteworthy items (1.9%) on nutrition facts labels. Regarding students' major, there was significant difference in their knowledge, attitude and practice about truth of the nutri¬tion claims, using food labels and importance of health claims (P<0.05).

CONCLUSION

Food labels were more useful tools for students and had an effect on their nutri-tional awareness. Designing and implementation of the educational programs in order to increase the level of knowledge about food labels is suggested.