Making salt-reduced products more appealing to consumers: impact of front-of-pack messages on liking and table salt use over time

Incentives to Reduce Salt Intake Resulting From Women's Experiences: A Qualitative Study

INTRODUCTION

Over consumption of salt adversely affects health and is associated with some diseases. Salt over consumption has been reported to be higher in Asian countries including Iran. This research aimed to identify the facilitative factors of reduced salt consumption among 20-65 year-old women to develop effective educational interventions. Methods: This research used qualitative content analysis. We included 42 (31 women aged 20-65 years residing in Hamidia, Yazd and 11 healthcare providers) using Purposeful sampling method. Data were collected through focal group discussions (three groups of 6) and in-depth semi-structured individual interviews with 24 Participants. Data analysis was done using Graneheim and Lundman's approach. Results: Motivators and facilitators were extracted. The former consisted of sub-categories: physical fitness and healthcare, obtaining others' approval, family cooperation and support, internal motivators, contextual motivators and healthcare staff support. Sub-categories of the latter were gaining more information from different instructions, willingness to acquire self-protection skills and nutritional advice. These factors affected to reduce the salt intake among women. Conclusion: In the light of the qualitative results of motivating and facilitating factors, it is essential to enhance internal motivators and increase access to information via different communicative channels in community including schools, medical care providers and public associations. It is also necessary to pave the way for more family and medical staff support, provide appropriate educational and advertising programs, raise women's awareness and change their attitude and behavior with this concern.

An assessment of nutrition information on front of pack labels and healthiness of foods in the United Kingdom retail market

Background

Front of pack nutrition labelling is part of United Kingdom government’s programme of activities aiming to tackle diet-related diseases. There are several front of pack labelling formats available and they differ in the information they deliver. This study assessed the frequency of usage of front of pack food labelling systems on food products in the United Kingdom grocery market. It also measured the healthiness of some foods in the online market by categorising them according to their nutrient contents.

Methods

Five hundred food products in five categories [(1) cereals and cereal products, (2) dairy products, (3) beverages, (4) packaged meats and meat products, and (5) pre-packaged fruits and vegetables] from three main United Kingdom retail websites were investigated. A simple random sampling method was used for product selection according to the categories on the retailers’ websites. The healthiness of foods was also assessed by categorising them into ‘healthier’, ‘moderately healthy’ and ‘least healthy’ based on fat, saturated fat, salt and sugar contents.

Results

The total number of label types assessed comprises 19.6% of Guideline Daily Amounts or Reference Intakes and 43.8% had a combination of Traffic Light and Reference Intakes (hybrid label). Slightly over a quarter (27.4%) of products included nutritional information in a grid or table, 3.4% of the foods had two of any of the following: Health Logo, Reference Intakes and Traffic Light labels, and 5.8% did not have any Reference Intakes, Traffic Light, Health Logo or Hybrid label. Most of the foods assessed were manufactured in the United Kingdom with only 30.8% imported from 32 countries across four continents.

Conclusions

Traffic Light and Guideline Daily Amounts were the most used front of pack labelling formats on the assessed food product. A higher number of assessed products belonged to the “moderately healthy” and “healthier” categories than the “least healthy”. The imported foods that were found in the United Kingdom retail market showed that food choices could be made from the diverse food types.

Is a Consumer Perception of Salt Modification a Sensory or a Behavioural Phenomenon? Insights from a Bread Study

Salt plays a major role in food manufacturing and affects the technological and sensory properties of foods. At the same time, high dietary salt intake increases the risk of cardiovascular diseases and represents a considerable public health concern. In many populations, bread is a major contributor to salt intake and is therefore targeted by health policies recommending salt reduction reformulations. However, producers are often reluctant to reduce salt content due to fears of potential negative effects on consumer acceptability and drops in sales. The present work aims to assess the effect of salt content on consumers’ hedonic liking and perception of saltiness intensity, as well as the interaction of these two. The study was conducted using two market-leading bread types (white and multigrain) and bread samples with the national average (reference), reduced (−15%) and increased (+10%) salt levels. A sensory evaluation study (n = 200) was done including a questionnaire on attitudes and behaviour regarding bread and salt, enabling the exploration of individual differences in reactions to modified levels of salt content. The latter only affected hedonic liking for the multigrain sample with 15% salt reduction but not for others, which discloses the importance of the bread matrix; and it did not affect the perception of saltiness intensity. Penalty analysis revealed that perceived non-optimal saltiness results in significantly penalised hedonic liking scores. Segmentation based on perceived saltiness disclosed the explanatory importance of underlying consumer behaviour dimensions which should be considered in designing bread reformulations.

Front of pack nutritional labelling schemes: a systematic review and meta-analysis of recent evidence relating to objectively measured consumption and purchasing

BACKGROUND

Front of pack labelling (FOPL) provides visible nutritional information and appears to influence knowledge and reformulation. However, a recent Cochrane review found limited and inconsistent evidence for behaviour change. The present review aimed to examine studies published subsequent the Cochrane review, focusing on prepackaged foods, examining the impact of FOPL on purchasing and consumption.

METHODS

Controlled experimental/intervention and interrupted time series (ITS) studies were included, with no age/geography restrictions. Exposures were FOPL with objectively measured consumption/purchasing outcomes. Thirteen databases were searched (January 2017 to April 2019) and forward citation searching was undertaken on the included studies. Purchasing data from experimental studies were meta-analysed. Two series of meta-analyses were undertaken; combined FOPL versus no-FOPL and specific FOPL scheme versus no-FOPL. Outcomes were sugar (g 100 g^-1 ), calories (kcal 100 g^-1 ), saturated fat (g 100 g^-1 ) and sodium (mg 100 g^-1 ).

RESULTS

We identified 14 studies, reporting consumption (experimental; n = 3) and purchasing (n = 8, experimental; n = 3, ITS). Meta-analysis of experimental studies showed sugar and sodium content of purchases was lower for combined FOPL versus no-FOPL (-0.40 g sugar 100 g^-1 , P < 0.01; -24.482 mg sodium 100 g^-1 , P = 0.012), with a trend for lower energy and saturated fat (-2.03 kcal 100 g^-1 , P = 0.08; -0.154 g saturated fat 100 g^-1 , P = 0.091). For specific FOPL, products purchased by 'high in' FOPL groups had lower sugar (-0.67 g sugar 100 g^-1 , P ≤ 0.01), calories (-4.43 kcal 100 g^-1 , P < 0.05), sodium (-33.78 mg 100 g^-1 , P = 0.01) versus no-FOPL; Multiple Traffic Light had lower sodium (-34.94 mg 100 g^-1 , P < 0.01) versus no-FOPL. Findings regarding consumption were limited and inconsistent. FOPL resulted in healthier purchasing in ITS studies.

CONCLUSIONS

This review provides evidence from experimental and 'real-life' studies indicating that FOPL encourages healthier food purchasing. PROSPERO CRD42019135743.