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Lambert L, Mann G, Knight S, Partacz M, Jurss MA, Eady M. Impact of Smart Snacks Intervention on College Students' Vending Selections. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:952-958. [PMID: 33798023 DOI: 10.1080/07448481.2021.1909048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVES To place Smart Snacks in vending machines and determine if different sales strategies affect Smart Snack selection. PARTICIPANTS University students living in resident halls. METHODS Vending machines included 50% Smart Snacks and 50% non compliant snacks. Three sales strategies targeted student selection of Smart Snacks: Reduced price, signage, and nutrition education activities. Three-way ANOVA was used for analysis. RESULTS There was a statistically significant three-way interaction on snack selection between sales strategy, study period, and snack type, F(4, 77) = 3.33, P = .01. There were no statistically significant simple two-way interaction between study period and sales strategy for either Smart Snack, F(1, 77) = 1.62, P = 0.18, or NC snack types, F(1, 77) = 2.02, P = 0.07. CONCLUSIONS Sales strategies did not affect Smart Snack selections. Advocates for healthier snacks in vending machines can align with university administrations to establish nutrient guidelines.
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Affiliation(s)
- Laurel Lambert
- Department of Nutrition and Hospitality Management, The University of Mississippi, University, Oxford, Mississippi, USA
| | - Georgianna Mann
- Department of Nutrition and Hospitality Management, The University of Mississippi, University, Oxford, Mississippi, USA
| | - Scott Knight
- Department of Nutrition and Hospitality Management, The University of Mississippi, University, Oxford, Mississippi, USA
| | - Megan Partacz
- Department of Nutrition and Hospitality Management, The University of Mississippi, University, Oxford, Mississippi, USA
| | - Mariana A Jurss
- Department of Nutrition and Hospitality Management, The University of Mississippi, University, Oxford, Mississippi, USA
| | - Matthew Eady
- Department of Nutrition and Hospitality Management, The University of Mississippi, University, Oxford, Mississippi, USA
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Lee KM, Dias GM, Boluk K, Scott S, Chang YS, Williams TE, Kirkpatrick SI. Toward a Healthy and Environmentally Sustainable Campus Food Environment: A Scoping Review of Postsecondary Food Interventions. Adv Nutr 2021; 12:1996-2022. [PMID: 33836531 PMCID: PMC8483956 DOI: 10.1093/advances/nmab026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/05/2021] [Accepted: 02/10/2021] [Indexed: 12/31/2022] Open
Abstract
Interventions are urgently needed to transform the food system and shift population eating patterns toward those consistent with human health and environmental sustainability. Postsecondary campuses offer a naturalistic setting to trial interventions to improve the health of students and provide insight into interventions that could be scaled up in other settings. However, the current state of the evidence on interventions to support healthy and environmentally sustainable eating within postsecondary settings is not well understood. A scoping review of food- and nutrition-related interventions implemented and evaluated on postsecondary campuses was conducted to determine the extent to which they integrate considerations related to human health and/or environmental sustainability, as well as to synthesize the nature and effectiveness of interventions and to identify knowledge gaps in the literature. MEDLINE (via PubMed), CINAHL, Scopus, and ERIC were searched to identify articles describing naturalistic campus food interventions published in English from January 2015 to December 2019. Data were extracted from 38 peer-reviewed articles, representing 37 unique interventions, and synthesized according to policy domains within the World Cancer Research Foundation's NOURISHING framework. Most interventions were focused on supporting human health, whereas considerations related to environmental sustainability were minimal. Interventions to support human health primarily sought to increase nutrition knowledge or to make complementary shifts in food environments, such as through nutrition labeling at point of purchase. Interventions to support environmental sustainability often focused on reducing food waste and few emphasized consumption patterns with lower environmental impacts. The implementation of integrated approaches considering the complexity and interconnectivity of human and planetary health is needed. Such approaches must go beyond the individual to alter the structural determinants that shape our food system and eating patterns.
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Affiliation(s)
- Kirsten M Lee
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Goretty M Dias
- School of Environment, Enterprise and Development, University of Waterloo, Waterloo, Ontario, Canada
| | - Karla Boluk
- Recreation and Leisure Studies, University of Waterloo, Waterloo, Ontario, Canada
| | - Steffanie Scott
- Geography and Environmental Management, University of Waterloo, Waterloo, Ontario, Canada
| | - Yi-Shin Chang
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Tabitha E Williams
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Sharon I Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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Patel AI, Hecht CE, Cradock A, Edwards MA, Ritchie LD. Drinking Water in the United States: Implications of Water Safety, Access, and Consumption. Annu Rev Nutr 2020; 40:345-373. [PMID: 32966189 DOI: 10.1146/annurev-nutr-122319-035707] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Recent water quality crises in the United States, and recognition of the health importance of drinking water in lieu of sugar-sweetened beverages, have raised interest in water safety, access, and consumption. This review uses a socioecological lens to examine these topics across the life course. We review water intakes in the United States relative to requirements, including variation by age and race/ethnicity. We describe US regulations that seek to ensure that drinking water is safe to consume for most Americans and discuss strategies to reduce drinking water exposure to lead, a high-profile regulated drinking water contaminant. We discuss programs, policies, and environmental interventions that foster effective drinking water access, a concept that encompasses key elements needed to improve water intake. We conclude with recommendations for research, policies, regulations, and practices needed to ensure optimal water intake by all in the United States and elsewhere.
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Affiliation(s)
- Anisha I Patel
- Division of General Pediatrics, Stanford University, Palo Alto, California 94305, USA
| | - Christina E Hecht
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Berkeley, California 94704, USA;
| | - Angie Cradock
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, USA
| | - Marc A Edwards
- Department of Civil and Environmental Engineering, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - Lorrene D Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Berkeley, California 94704, USA;
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The effects of nudges on purchases, food choice, and energy intake or content of purchases in real-life food purchasing environments: a systematic review and evidence synthesis. Nutr J 2020; 19:103. [PMID: 32943071 PMCID: PMC7500553 DOI: 10.1186/s12937-020-00623-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 09/08/2020] [Indexed: 01/24/2023] Open
Abstract
Background Adults with a low socioeconomic position (SEP) are more likely to engage in unhealthy diets as compared to adults with high SEP. However, individual-level educational interventions aiming to improve food choices have shown limited effectiveness in adults with low SEP. Environmental-level interventions such as nudging strategies however, may be more likely to benefit low SEP groups. We aimed to review the evidence for the effectiveness of nudges as classified according to interventions in proximal physical micro-environments typology (TIPPME) to promote healthy purchases, food choice, or affecting energy intake or content of purchases, within real-life food purchasing environments. Second, we aimed to investigate the potentially moderating role of SEP. Methods We systematically searched PubMed, EMBASE, and PsycINFO until 31 January 2018. Studies were considered eligible for inclusion when they i) complied with TIPPME intervention definitions; ii) studied actual purchases, food choice, or energy intake or content of purchases, iii) and were situated in real-life food purchasing environments. Risk of bias was assessed using a quality assessment tool and evidence was synthesized using harvest plots. Results From the 9210 references identified, 75 studies were included. Studies were generally of weak to moderate quality. The most frequently studied nudges were information (56%), mixed (24%), and position nudges (13%). Harvest plots showed modest tendencies towards beneficial effects on outcomes for information and position nudges. Less evidence was available for other TIPPME nudging interventions for which the harvest plots did not show compelling patterns. Only six studies evaluated the effects of nudges across levels of SEP (e.g., educational level, food security status, job type). Although there were some indications that nudges were more effective in low SEP groups, the limited amount of evidence and different proxies of SEP used warrant caution in the interpretation of findings. Conclusions Information and position nudges may contribute to improving population dietary behaviours. Evidence investigating the moderating role of SEP was limited, although some studies reported greater effects in low SEP subgroups. We conclude that more high-quality studies obtaining detailed data on participant’s SEP are needed. Registration This systematic review is registered in the PROSPERO database (CRD42018086983).
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Seyedhamzeh S, Nedjat S, Hosseini H, Shakibazedeh E, Viera AJ, Dorosty Motlagh A. Potential effect of different nutritional labels on food choices among mothers: a study protocol. BMC Public Health 2020; 20:294. [PMID: 32138775 PMCID: PMC7059293 DOI: 10.1186/s12889-020-8411-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 02/26/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The prevalence of non-communicable diseases (NCDs) is increasing in the world. Healthy food choice and adequate physical activity are key factors in preventing NCDs. Food labeling is a strategy that can inform consumers to choose healthier foods at the point of purchase. In this study, we intend to examine the status of existing labels and to clarify their strengths and weaknesses. Then, for the first time in Iran, we will design a type of physical activity equivalent calorie label and will test it on some food groups of packaged products including dairy products, sweetened beverages, cakes, and biscuits. METHODS This study will be conducted in two phases. In phase 1, nutrition fact labels and traffic light labels will be assessed through focus group discussions and interviews among different groups of mothers, industrialists and nutrition and food industry specialists as to determine strengths and weaknesses of the current labels on packaged products. Then, the initial layout of the physical activity calorie equivalent label will be drawn with respect to the viewpoints received from mothers. Thereafter, we will include the scientific opinions to it for creating the first draft of our new label. In phase 2, a total of 500 mothers of students 6-12 years old randomly assigned to five groups. The study groups will be as follows: (1) without nutrition label group, (2) current traffic light label group, (3) current traffic light label group in which, a brochure will be used to inform mothers, (4) physical activity calorie equivalent label group, and (5) physical activity calorie equivalent label group in which a brochure will be used to inform mothers. Some samples of dairy products, beverages, cakes, and biscuits will be presented. ANOVA and multiple linear regressions will be used to examine the association between the label type and the main consequence (energy of the selected products) and secondary outcome (time). DISCUSSION The effect of the new food labels will be evaluated based on the differences between the calories of selected food groups. TRIAL REGISTERATION Iranian Registery of Clinical Trials [IRCT]20,181,002,041,201 N1.
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Affiliation(s)
- Shirin Seyedhamzeh
- Department of Community Nutrition [DCN], School of Nutritional Sciences and Dietetics [SNSD], Tehran University of Medical Sciences [TUMS], Tehran, Iran.,Students' Scientific Research Center, TUMS, Tehran, Iran
| | | | - Hedayat Hosseini
- Department of Food Sciences & Technology, National Nutrition &Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Anthony J Viera
- Department of Community and Family Medicine, Duke University, Durham, NC, USA
| | - Ahmadreza Dorosty Motlagh
- DCN, SNSD, TUMS, No 44, Hojjat-dost Alley, Naderi Street, Keshavarz Boulevard, Tehran, 1416-643931, Iran.
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Examining the Efficacy of a 'Feasible' Nudge Intervention to Increase the Purchase of Vegetables by First Year University Students (17-19 Years of Age) in British Columbia: A Pilot Study. Nutrients 2019; 11:nu11081786. [PMID: 31382395 PMCID: PMC6722732 DOI: 10.3390/nu11081786] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 07/30/2019] [Accepted: 08/01/2019] [Indexed: 11/16/2022] Open
Abstract
In the transition from high school to university, vegetable consumption tends to deteriorate, potentially influencing immediate and longer-term health outcomes. Nudges, manipulation of the environment to influence choice, have emerged as important to behavior change goals. This quasi-experimental pilot study examined the impact of a contextually feasible evidence-informed nudge intervention on food purchasing behavior of older adolescents (1st year students) in a university residence cafeteria in British Columbia, Canada. A co-design process with students and staff identified a student relevant and operationally feasible nudge intervention; a placement nudge, fresh vegetables at the hot food table, combined with a sensory and cognitive nudge, signage encouraging vegetable purchase). Using a 12-week single-case A-B-A-B design, observations of the proportion of vegetables purchased were used to assess intervention efficacy. Data analysis included visual trend inspection, central tendency measures, data overlap, variability and latency. Visual trend inspection showed a positive trend when nudges were in place, which was more apparent with female purchases and during the first intervention (B) phase. However, further analysis showed lack of baseline stability, high variability across phases and overlapping data, limiting efficacy conclusions. Menu choices, staff encouragement, term timing and student finances are other potential influences. Further 'real world' nudge research is needed.
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Jung SE, Bice C. The Role of Self-Identity in Predicting College Students' Intention to Consume Fruits and Vegetables. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:173-181. [PMID: 30241705 DOI: 10.1016/j.jneb.2018.07.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 07/14/2018] [Accepted: 07/27/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To identify factors influencing intention to consume fruits and vegetables (F&V) among college students by applying the Theory of Planned Behavior with the inclusion of self-identity and past behavior. DESIGN Cross-sectional study conducted in 2017. SETTING Undergraduate classes at the University of Alabama. PARTICIPANTS A total of 343 undergraduate students, mean age 20.3 years, participated in the study. MAIN OUTCOME MEASURE(S) Participants completed validated instruments measuring Theory of Planned Behavior variables, past behavior, and self-identity. ANALYSIS Structural equation modeling was used to analyze the data. Overall chi-square goodness of fit, comparative fit index, root mean square error of approximation, and Tucker-Lewis Index were used to assess model fit. RESULTS Model fit indices showed that the hypothesized structural equation modeling model provided a good fit to the data (χ2 = 306.35; degrees of freedom = 104, root mean square error of approximation = 0.08; comparative fit index =0.95; Tucker-Lewis Index = 0.94). Self-identity was the most significant predictor of intention to consume fruits and vegetables, followed by attitude, past behavior, perceived behavioral control, and subjective norm among college students. CONCLUSIONS AND IMPLICATIONS Nutrition education advocating the role of increased F&V consumption in positive self-identity, such as handouts incorporating images relatable to college students, may increase college students' intention to consume F&V.
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Affiliation(s)
- Seung Eun Jung
- Department of Human Nutrition and Hospitality Management, University of Alabama, Tuscaloosa, AL.
| | - Crystal Bice
- University of Alabama/Pickens County Health Care Teaching County Partnership, Institute for Rural Health Research/College of Community Health Sciences, University of Alabama, Tuscaloosa, AL
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Lassen AD, Knuthsen P, Bysted A, Andersen EW. The Nutritional Quality of Lunch Meals Eaten at Danish Worksites. Nutrients 2018; 10:nu10101518. [PMID: 30332823 PMCID: PMC6213244 DOI: 10.3390/nu10101518] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 09/26/2018] [Accepted: 10/12/2018] [Indexed: 11/16/2022] Open
Abstract
Monitoring the nutritional environment is important to help inform future initiatives to improve access to healthy foods. The objective was to examine the nutritional quality of lunch meals eaten at 15 worksite canteens and then to compare with results from a study conducted 10 years before. The duplicate-portion-technique with subsequent chemical analysis was used to quantify 240 customers' lunch intake. Estimated mean energy intake was 2.1 MJ/meal (95% confidence interval (CI): 1.9 to 2.4 g/meal) and estimated energy density 599 kJ/100 g (95% CI 550 to 653 kJ/100 g). Energy density of the male participants' meals were significantly higher compared with the female participants' meals (+55 kJ/100 g, 95% CI: +12 to +98 kJ/100 g, p = 0.012), whereas no gender differences were found in macronutrient distribution or fruit and vegetable intake. Compared to the study conducted 10 years before several significant changes were observed, including an increase in mean estimated intake of fruit and vegetables (+38 g/meal, 95% CI: 19 to 57 g/meal, p < 0.001) and a decrease in energy density (-76 kJ/100 g, 95% CI: -115, -37 kJ/100 g, p < 0.001). In conclusion, this study suggests an equalization of gender differences in fruit and vegetable intake and a possible improvement in the nutritional quality of canteen lunch meals over a 10-year period.
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Affiliation(s)
- Anne D Lassen
- Division of Risk Assessment and Nutrition, National Food Institute, Technical University of Denmark, DK-2800 Lyngby, Denmark.
| | - Pia Knuthsen
- Division of Risk Assessment and Nutrition, National Food Institute, Technical University of Denmark, DK-2800 Lyngby, Denmark.
| | - Anette Bysted
- Research Group for Bioactives-Analysis and Application, National Food Institute, Technical University of Denmark, DK-2800 Lyngby, Denmark.
| | - Elisabeth W Andersen
- Danish Cancer Society Research Center, Statistics and Pharmacoepidemiology, DK-2100 Copenhagen, Denmark.
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Lassen AD, Trolle E, Bysted A, Knuthsen P, Andersen EW. The Salt Content of Lunch Meals Eaten at Danish Worksites. Nutrients 2018; 10:nu10101367. [PMID: 30249979 PMCID: PMC6213428 DOI: 10.3390/nu10101367] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 09/20/2018] [Accepted: 09/21/2018] [Indexed: 11/24/2022] Open
Abstract
Monitoring levels of sodium (salt) in meals consumed out-of-home is needed to support effective implementation of salt-reduction strategies. The objective of the study was to examine lunch salt intake at 15 worksite canteens and to compare with results from a comparable study conducted 10 years before. A duplicate-portion-technique with subsequent chemical analysis was used to quantify 240 customers’ lunch salt intake. Estimated mean salt intake was 2.6 g/meal (95% Cl: 2.2 to 3.0 g/meal) and 0.78 g/100 g (95% Cl: 0.69 to 0.88 g/100 g). Salt intake measured both as g per meal and per 100 g was found to be significantly higher for male compared with female participants (+0.10 g/100 g, 95% Cl: +0.02 to +0.17 g/100 g, p = 0.011). Compared with the study conducted 10 years before, there was a significantly lower estimated salt intake of 0.5 g/meal (95% CI: −0.8 to −0.2 g/meal, p = 0.001), suggesting a possible reduction in canteen lunch salt intake during a 10-year period. Still, 40% of the meals exceeded the Nordic Keyhole label requirements of maximum 0.8 g salt per 100 g for ready meals. A further reduction of salt intake is warranted to comply with salt reduction targets.
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Affiliation(s)
- Anne D Lassen
- Division of Risk Assessment and Nutrition, National Food Institute, Technical University of Denmark, DK-2800 Lyngby, Denmark.
| | - Ellen Trolle
- Division of Risk Assessment and Nutrition, National Food Institute, Technical University of Denmark, DK-2800 Lyngby, Denmark.
| | - Anette Bysted
- Research Group for Bioactives ⁻ Analysis and Application, National Food Institute, Technical University of Denmark, DK-2800 Lyngby, Denmark.
| | - Pia Knuthsen
- Division of Risk Assessment and Nutrition, National Food Institute, Technical University of Denmark, DK-2800 Lyngby, Denmark.
| | - Elisabeth W Andersen
- Danish Cancer Society Research Center, Statistics and Pharmacoepidemiology, DK-2100 Copenhagen, Denmark.
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Abstract
OBJECTIVE The present research aimed to investigate the impact of the physical activity calorie equivalent (PACE) front-of-pack label on consumption, prospective consumption and liking of familiar and unfamiliar discretionary snack foods. DESIGN In a within-subject randomised design, participants tasted and rated liking (9-point hedonic scale) and prospective consumption (9-point category scale) of four different snack foods with four different labels (i.e. blank, fake, PACE, PACE doubled) and four control snack foods. The twenty snack foods were presented during two 45 min sessions (i.e. ten snack foods per session) which were separated by one week. The amount participants sampled of each snack food was measured. SETTING The study was conducted in the Centre for Advanced Sensory Sciences laboratory at Deakin University, Australia. SUBJECTS The participants were 153 university students (126 females, twenty-seven males, mean age 24·3 (sd 4·9) years) currently enrolled in an undergraduate nutrition degree at Deakin University. RESULTS When the PACE label was present on familiar snack foods, participants sampled 9·9 % (22·8 (sem 1·4) v. 25·3 (sem 1·5) g, P=0·03) less than when such label was not present. This was in line with a decreased prospective snack food consumption of 9·1 % (3·0 (sem 0·2) v. 3·3 (sem 0·2) servings, P=0·03). Such pattern was not seen in unfamiliar snacks. CONCLUSIONS The PACE label appears to be a promising way to decrease familiar discretionary snack food consumption in young, health-minded participants.
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