1
|
Kušar A, Pravst I. Exploitation of the traditional evidence for botanical health claims on foodstuffs in Europe. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.104936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
2
|
Pinho-Gomes AC, Kaur A, Scarborough P, Rayner M. Are the Eatwell Guide and Nutrient Profiling Models Consistent in the UK? Nutrients 2021; 13:2732. [PMID: 34444892 PMCID: PMC8401171 DOI: 10.3390/nu13082732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/26/2021] [Accepted: 08/06/2021] [Indexed: 11/24/2022] Open
Abstract
A nutrient profiling model (NPM) was developed in 2005 in the UK to regulate the marketing of foods to children. It was revised in 2018, but the new version has not been finalised. The Eatwell Guide (EWG) is the UK's official food-based dietary guidelines. The aim of this study was to evaluate the agreement between the 2005 and 2018 versions of the NPM and the EWG. Using recent National Diet and Nutrition Surveys, we estimated the healthiness of individual diets based on an EWG dietary score and a NPM dietary index. We then compared the percentage of agreement and Cohen's kappa for each combination of the EWG score and NPM index across the range of observed values for the 2005 and 2018 versions. A total of 3028 individual diets were assessed. Individuals with a higher (i.e., healthier) EWG score consumed a diet with, on average, a lower (i.e., healthier) NPM index both for the 2005 and 2018 versions. Overall, there was good agreement between the EWG score and the NPM dietary index at assessing the healthiness of representative diets of the UK population, when a low cut-off for the NPM dietary index was used, irrespective of the version. This suggests that dietary advice to the public is broadly aligned with NPM-based food policies and vice-versa.
Collapse
Affiliation(s)
- Ana-Catarina Pinho-Gomes
- Faculty of Life Sciences & Medicine, School of Population Health & Environmental Sciences, King’s College London, London WC2R 2LS, UK;
- The George Institute for Global Health, London W12 0BZ, UK
- Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK; (A.K.); (P.S.)
| | - Asha Kaur
- Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK; (A.K.); (P.S.)
| | - Peter Scarborough
- Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK; (A.K.); (P.S.)
| | - Mike Rayner
- Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK; (A.K.); (P.S.)
| |
Collapse
|
3
|
Kušar A, Žmitek K, Lähteenmäki L, Raats MM, Pravst I. Comparison of requirements for using health claims on foods in the European Union, the USA, Canada, and Australia/New Zealand. Compr Rev Food Sci Food Saf 2021; 20:1307-1332. [PMID: 33565710 DOI: 10.1111/1541-4337.12716] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 12/07/2020] [Accepted: 01/05/2021] [Indexed: 12/01/2022]
Abstract
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.
Collapse
Affiliation(s)
- Anita Kušar
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
| | - Katja Žmitek
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia.,VIST - Higher School of Applied Sciences, Ljubljana, Slovenia
| | - Liisa Lähteenmäki
- MAPP Centre, Department of Management, Aarhus University, Aarhus V, Denmark
| | - Monique M Raats
- Food, Consumer Behaviour and Health Research Centre, University of Surrey, Guildford, Surrey, UK
| | - Igor Pravst
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia.,VIST - Higher School of Applied Sciences, Ljubljana, Slovenia.,Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
4
|
Corroon J, MacKay D, Dolphin W. Labeling of Cannabidiol Products: A Public Health Perspective. Cannabis Cannabinoid Res 2020; 5:274-278. [PMID: 33381640 DOI: 10.1089/can.2019.0101] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: Interest in the therapeutic use of cannabidiol (CBD) has reached a fever-pitch in recent months, as CBD-containing products appear everywhere from online retailers to grocery stores and gas stations. The widespread availability of hemp-derived CBD products is confounding given that CBD is a U.S. Food and Drug Administration (FDA)-approved drug, and thus precluded from being added to food and beverages, or included in dietary supplements. The use by manufacturers of disease-related claims on marketing materials and product labels, along with the federal legalization of hemp in December 2018, has created political pressure on FDA to promulgate regulations. Conclusions: Accurate and informative labeling of hemp and hemp-derived CBD products is an important public health issue. FDA-regulated product labels are considered an essential tool for protecting consumers and enabling informed decision-making. Untruthful or unsubstantiated health-related claims, and unallowed Drug Claims, in marketing materials and on labels of CBD products may create harm by enticing consumers to forgo more evidence-based medical interventions. Furthermore, missing or inaccurate labeling of the amount of CBD, delta-9 tetrahydrocannabinol (THC), and potentially harmful contaminants such as pesticides, naturally-occurring yeast and mold or heavy metals may result in harm and/or lack of efficacy. Manufacturers of these products may reasonably be expected to understand and adhere to FDA regulations for labeling and marketing of food, dietary supplements and drugs, both over-the-counter (OTC) and prescription, even though FDA has interpreted federal law as excluding them from these categories. As manufacturers prepare for forthcoming regulations, a better understanding of the basic framework for FDA labeling and marketing regulations for food, dietary supplements and drugs is warranted.
Collapse
Affiliation(s)
- Jamie Corroon
- The Center for Medical Cannabis Education, Del Mar, California, USA
- Helfgott Research Institute, National University of Natural Medicine (NUNM), Portland, Oregon, USA
| | - Douglas MacKay
- Scientific and Regulatory Affairs, CV Sciences, Inc., San Diego, California, USA
| | - William Dolphin
- Communications Department, Americans for Safe Access, Washington, District of Columbia, USA
- Graduate School of Education and College of Arts and Sciences, University of Redlands, Redlands, California, USA
| |
Collapse
|
5
|
Cogan PS. Reality and Legality: Disentangling What Is Actual from What Is Tolerated in Comparisons of Hemp Extracts with Pure CBD. J Diet Suppl 2020; 17:527-542. [DOI: 10.1080/19390211.2020.1790710] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- P. S. Cogan
- Department of Pharmaceutical Sciences, Regis University School of Pharmacy, Denver, Colorado, USA
| |
Collapse
|
6
|
Sussman RL, McMahon AT, Neale EP. An Audit of the Nutrition and Health Claims on Breakfast Cereals in Supermarkets in the Illawarra Region of Australia. Nutrients 2019; 11:nu11071604. [PMID: 31311152 PMCID: PMC6683094 DOI: 10.3390/nu11071604] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 07/01/2019] [Accepted: 07/09/2019] [Indexed: 01/09/2023] Open
Abstract
Nutrition and health claims can promote healthier food choices but may lead to consumer confusion if misused. Regular monitoring of claims is therefore required. This study aimed to explore the prevalence of nutrition and health claims carried on breakfast cereals in supermarkets, and to assess claim compliance with regulations. Nutrition and health claims on breakfast cereal products across five supermarkets in the Illawarra region of New South Wales, Australia, were recorded in a cross-sectional audit. Prevalence of claim type and claim compliance was determined. Claims were compared across categories of breakfast cereal. Almost all (95.7%) products audited carried at least one nutrition or health claim; nutrition content (n = 1096) was more prevalent than health claims (n = 213). Most claims (91.6%) were compliant with regulations. Additionally, claim prevalence and type differed according to breakfast cereal category, with the highest proportion of claims appearing on ‘health and wellbeing’ and ‘muesli’ products. There is a high prevalence of nutrition and health claims on breakfast cereals, with most claims compliant with regulations. Research should investigate consumer interpretation of claims and the impact of applying nutrient profiling for all claims to assist consumers to make informed health choices.
Collapse
Affiliation(s)
- Romi L Sussman
- School of Medicine, University of Wollongong, Wollongong 2522, New South Wales, Australia
| | - Anne T McMahon
- School of Health and Society, University of Wollongong, Wollongong 2522, New South Wales, Australia
| | - Elizabeth P Neale
- School of Medicine, University of Wollongong, Wollongong 2522, New South Wales, Australia.
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong 2522, New South Wales, Australia.
| |
Collapse
|
7
|
The relationship between food label use and dietary intake in adults: A systematic review. Appetite 2019; 138:280-291. [DOI: 10.1016/j.appet.2019.03.025] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 03/22/2019] [Accepted: 03/22/2019] [Indexed: 11/19/2022]
|
8
|
|
9
|
Berhaupt-Glickstein A, Hooker NH, Hallman WK. Qualified Health Claim Language affects Purchase Intentions for Green Tea Products in the United States. Nutrients 2019; 11:E921. [PMID: 31022930 PMCID: PMC6521090 DOI: 10.3390/nu11040921] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 04/20/2019] [Accepted: 04/22/2019] [Indexed: 11/17/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Amanda Berhaupt-Glickstein
- Department of Nutritional Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901-2882, Canada.
| | - Neal H Hooker
- John Glenn College of Public Affairs, The Ohio State University, Columbus, OH 43210, Canada.
| | - William K Hallman
- Department of Human Ecology, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901-8520, Canada.
| |
Collapse
|
10
|
Ramírez AS, Arellano Carmona K. Beyond fatalism: Information overload as a mechanism to understand health disparities. Soc Sci Med 2018; 219:11-18. [PMID: 30342382 PMCID: PMC6240483 DOI: 10.1016/j.socscimed.2018.10.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 10/03/2018] [Accepted: 10/12/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Fatalism - beliefs about the causes and controllability of disease - has been negatively associated with prevention behaviors. Fatalism has been suggested as a mechanism for health disparities because ethnic minorities are especially likely to hold fatalistic beliefs. However, the construct has been criticized: Fatalism fails to account for structural barriers to health faced by vulnerable populations that also score highly on measures of fatalism. Another critique suggests that operationalizations of fatalism expose communication failures: "Fatalism" rather reflects information overload from an environment riddled with misinformation and contradictions. This study aimed to expand understanding of one mechanism through which communication may contribute to disparities by considering the context of nutrition among bicultural Latinas, who face increased risk from dietary acculturation. METHOD Mixed-methods (semi-structured in-depth interview, survey) with Mexican-American women ages 18-29 (n = 24) in rural California. RESULTS Contrary to previous studies, the majority of this sample of Mexican-American women did not endorse fatalistic beliefs; most demonstrated clear understanding of the link between diet and risk of diseases: Diabetes and heart disease were understood to result from behaviors within one's control. Yet despite articulating links between diet and disease, participants felt overloaded and confused about conflicting information from public and interpersonal sources. Moreover, despite reporting feeling inundated with information, participants noted critical information gaps, distinguishing between information available and information needed. CONCLUSIONS We found minimal support for fatalistic beliefs among a sample of Mexican-American women, but considerable information overload and confusion, together with a desire for specific knowledge and skills. Results extend understanding of how communication may influence disparities: Information overload may be conflated with fatalism, challenging the notion that fatalism is a cultural belief. Moreover, inequalities in access to and ability to process information compound overload effects. We discuss opportunities to improve the clarity of communication about nutrition science and dietary recommendations.
Collapse
Affiliation(s)
- A Susana Ramírez
- School of Social Sciences, Humanities, and Arts, University of California, Merced 5200 North Lake Road, Merced, CA, 95343, USA.
| | - Kimberly Arellano Carmona
- School of Social Sciences, Humanities, and Arts, University of California, Merced 5200 North Lake Road, Merced, CA, 95343, USA.
| |
Collapse
|
11
|
González-Díaz C, Gil-González D, Álvarez-Dardet C. Scientific Evidence on Functional Food and Its Commercial Communication: A Review of Legislation in Europe and the USA. J Food Sci 2018; 83:2710-2717. [DOI: 10.1111/1750-3841.14359] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 08/27/2018] [Accepted: 08/29/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Cristina González-Díaz
- Dept. of Communication and Social Psychology; Univ. of Alicante; Carretera San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig Alicante Spain
| | - Diana Gil-González
- Dept. of Community Nursing, Preventive Medicine and Public Health and the History of Science; Univ. of Alicante; Carretera San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig Alicante Spain
- Public Health Research Group; Univ. of Alicante; Alicante Spain
- CIBER Epidemiología y Salud Pública (CIBERESP); Spain
| | - Carlos Álvarez-Dardet
- Dept. of Community Nursing, Preventive Medicine and Public Health and the History of Science; Univ. of Alicante; Carretera San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig Alicante Spain
- Public Health Research Group; Univ. of Alicante; Alicante Spain
- CIBER Epidemiología y Salud Pública (CIBERESP); Spain
| |
Collapse
|
12
|
Winklhofer-Roob BM, Faustmann G, Roob JM. Low-density lipoprotein oxidation biomarkers in human health and disease and effects of bioactive compounds. Free Radic Biol Med 2017; 111:38-86. [PMID: 28456641 DOI: 10.1016/j.freeradbiomed.2017.04.345] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 04/16/2017] [Accepted: 04/18/2017] [Indexed: 12/14/2022]
Abstract
Based on the significance of oxidized low-density lipoprotein (LDL) in health and disease, this review focuses on human studies addressing oxidation of LDL, including three lines of biomarkers, (i) ex vivo LDL resistance to oxidation, a "challenge test" model, (ii) circulating oxidized LDL, indicating the "current in vivo status", and (iii) autoantibodies against oxidized LDL as fingerprints of an immune response to oxidized LDL, along with circulating oxysterols and 4-hydroxynonenal as biomarkers of lipid peroxidation. Lipid peroxidation and oxidized LDL are hallmarks in the development of various metabolic, cardiovascular and other diseases. Changes further occur across life stages from infancy to older age as well as in athletes and smokers. Given their responsiveness to targeted nutritional interventions, markers of LDL oxidation have been employed in a rapidly growing number of human studies for more than 2 decades. There is growing interest in foods, which, besides providing energy and nutrients, exert beneficial effects on human health, such as protection of DNA, proteins and lipids from oxidative damage. Any health claim, however, needs to be substantiated by supportive evidence derived from human studies, using reliable biomarkers to demonstrate such beneficial effects. A large body of evidence has accumulated, demonstrating protection of LDL from oxidation by bioactive food compounds, including vitamins, other micronutrients and secondary plant ingredients, which will facilitate the selection of oxidation biomarkers for future human intervention studies and health claim support.
Collapse
Affiliation(s)
- Brigitte M Winklhofer-Roob
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University of Graz, Austria.
| | - Gernot Faustmann
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University of Graz, Austria; Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Austria
| | - Johannes M Roob
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Austria
| |
Collapse
|
13
|
Abstract
OBJECTIVE To determine the extent that Australian fast-food websites contain nutrition content and health claims, and whether these claims are compliant with the new provisions of the Australia New Zealand Food Standards Code ('the Code'). DESIGN Systematic content analysis of all web pages to identify nutrition content and health claims. Nutrition information panels were used to determine whether products with claims met Nutrient Profiling Scoring Criteria (NPSC) and qualifying criteria, and to compare them with the Code to determine compliance. SETTING Australian websites of forty-four fast-food chains including meals, bakery, ice cream, beverage and salad chains. SUBJECTS Any products marketed on the websites using health or nutrition content claims. RESULTS Of the forty-four fast-food websites, twenty (45 %) had at least one claim. A total of 2094 claims were identified on 371 products, including 1515 nutrition content (72 %) and 579 health claims (28 %). Five fast-food products with health (5 %) and 157 products with nutrition content claims (43 %) did not meet the requirements of the Code to allow them to carry such claims. CONCLUSIONS New provisions in the Code came into effect in January 2016 after a 3-year transition. Food regulatory agencies should review fast-food websites to ensure compliance with the qualifying criteria for nutrition content and health claim regulations. This would prevent consumers from viewing unhealthy foods as healthier choices. Healthy choices could be facilitated by applying NPSC to nutrition content claims. Fast-food chains should be educated on the requirements of the Code regarding claims.
Collapse
|
14
|
Schoonees A, Young T, Volmink J. The advertising of nutritional supplements in South African women’s magazines: a descriptive survey. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2016. [DOI: 10.1080/16070658.2013.11734445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
15
|
Tan KYM, van der Beek EM, Chan MY, Zhao X, Stevenson L. Health claims on food products in Southeast Asia: regulatory frameworks, barriers, and opportunities. Nutr Rev 2016; 73:634-41. [PMID: 26269489 DOI: 10.1093/nutrit/nuv029] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Association of Southeast Asian Nations aims to act as a single market and allow free movement of goods, services, and manpower. The purpose of this article is to present an overview of the current regulatory framework for health claims in Southeast Asia and to highlight the current barriers and opportunities in the regulatory frameworks in the Association of Southeast Asian Nations. To date, 5 countries in Southeast Asia, i.e., Indonesia, Malaysia, the Philippines, Singapore, and Thailand, have regulations and guidelines to permit the use of health claims on food products. There are inconsistencies in the regulations and the types of evidence required for health claim applications in these countries. A clear understanding of the regulatory frameworks in these countries may help to increase trade in this fast-growing region and to provide direction for the food industry and the regulatory community to develop and market food products with better nutritional quality tailored to the needs of Southeast Asian consumers.
Collapse
Affiliation(s)
- Karin Y M Tan
- K.Y.M. Tan and M.Y. Chan are with the Human Nutrition Research Centre, Newcastle University, Singapore, Republic of Singapore. E.M.v.d.Beek is with Nutricia Research, Danone-Nutricia Early Life Nutrition, Singapore, Republic of Singapore. X.J. Zhao is with Nutricia Early Life Nutrition (Shanghai) Co., Ltd, Pudong, Shanghai, People's Republic of China. L. Stevenson is with the Nutrition & Health Research Group, Liverpool John Moores University, Aigburth, Liverpool, United Kingdom.
| | - Eline M van der Beek
- K.Y.M. Tan and M.Y. Chan are with the Human Nutrition Research Centre, Newcastle University, Singapore, Republic of Singapore. E.M.v.d.Beek is with Nutricia Research, Danone-Nutricia Early Life Nutrition, Singapore, Republic of Singapore. X.J. Zhao is with Nutricia Early Life Nutrition (Shanghai) Co., Ltd, Pudong, Shanghai, People's Republic of China. L. Stevenson is with the Nutrition & Health Research Group, Liverpool John Moores University, Aigburth, Liverpool, United Kingdom
| | - M Y Chan
- K.Y.M. Tan and M.Y. Chan are with the Human Nutrition Research Centre, Newcastle University, Singapore, Republic of Singapore. E.M.v.d.Beek is with Nutricia Research, Danone-Nutricia Early Life Nutrition, Singapore, Republic of Singapore. X.J. Zhao is with Nutricia Early Life Nutrition (Shanghai) Co., Ltd, Pudong, Shanghai, People's Republic of China. L. Stevenson is with the Nutrition & Health Research Group, Liverpool John Moores University, Aigburth, Liverpool, United Kingdom
| | - Xuejun Zhao
- K.Y.M. Tan and M.Y. Chan are with the Human Nutrition Research Centre, Newcastle University, Singapore, Republic of Singapore. E.M.v.d.Beek is with Nutricia Research, Danone-Nutricia Early Life Nutrition, Singapore, Republic of Singapore. X.J. Zhao is with Nutricia Early Life Nutrition (Shanghai) Co., Ltd, Pudong, Shanghai, People's Republic of China. L. Stevenson is with the Nutrition & Health Research Group, Liverpool John Moores University, Aigburth, Liverpool, United Kingdom
| | - Leo Stevenson
- K.Y.M. Tan and M.Y. Chan are with the Human Nutrition Research Centre, Newcastle University, Singapore, Republic of Singapore. E.M.v.d.Beek is with Nutricia Research, Danone-Nutricia Early Life Nutrition, Singapore, Republic of Singapore. X.J. Zhao is with Nutricia Early Life Nutrition (Shanghai) Co., Ltd, Pudong, Shanghai, People's Republic of China. L. Stevenson is with the Nutrition & Health Research Group, Liverpool John Moores University, Aigburth, Liverpool, United Kingdom
| |
Collapse
|
16
|
Aschemann-Witzel J, Grunert KG. Resveratrol and health from a consumer perspective: perception, attitude, and adoption of a new functional ingredient. Ann N Y Acad Sci 2015; 1348:171-9. [PMID: 26315295 DOI: 10.1111/nyas.12867] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Resveratrol is an ingredient widely researched, with growing evidence of health-promoting effects. However, the reactions of supplement or food consumers to resveratrol has not been researched, and the ingredient is yet unknown to most consumers. We used respective literature and our own resveratrol consumer studies with Danish and U.S. consumers to look at current findings and future research directions for three questions. (1) Which factors determine consumer interest in a yet unknown functional ingredient such as resveratrol? (2) How should resveratrol be marketed as a new functional ingredient to be understood and favorably perceived? (3) What could be the effects of adoption of an ingredient such as resveratrol on the healthy lifestyle of a consumer? Literature and first results indicate that personal relevance and familiarity are crucial factors; however, consumers show little interest in resveratrol and lack relevant knowledge, especially in Denmark. Favorable attitudes were explained by health outcome expectations, use of complementary and alternative medicine, and interest in the indulgence dimension of food. Nonscientifically phrased communication led to more favorable attitudes in Danish consumers; scientifically phrased communication, though, made U.S. consumers more likely to retain favorable attitudes in the presence of contradictory evidence. We discuss future research directions in different cultural backgrounds and market contexts and for different foods.
Collapse
Affiliation(s)
| | - Klaus G Grunert
- MAPP Centre-Research on Value Creation in the Food Sector, Aarhus University, Aarhus, Denmark
| |
Collapse
|
17
|
Wong AYT, Lai JMC, Chan AWK. Regulations and protection for functional food products in the United States. J Funct Foods 2015. [DOI: 10.1016/j.jff.2015.05.038] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
18
|
Aschemann-Witzel J, Grunert KG. Influence of ‘soft’ versus ‘scientific’ health information framing and contradictory information on consumers’ health inferences and attitudes towards a food supplement. Food Qual Prefer 2015. [DOI: 10.1016/j.foodqual.2015.01.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
19
|
Miller LMS, Cassady DL. The effects of nutrition knowledge on food label use. A review of the literature. Appetite 2015; 92:207-16. [PMID: 26025086 DOI: 10.1016/j.appet.2015.05.029] [Citation(s) in RCA: 201] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 04/08/2015] [Accepted: 05/24/2015] [Indexed: 10/23/2022]
Abstract
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.
Collapse
Affiliation(s)
- Lisa M Soederberg Miller
- Department of Human Ecology, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA.
| | - Diana L Cassady
- Department of Public Health Sciences, University of California, Davis, One Shields Avenue, MS-1C, Davis, CA 95616, USA
| |
Collapse
|
20
|
Abstract
Previous scholarship on novel foods, including functional foods, has suggested that they are difficult to categorise for both regulators and users. It is argued that they blur the boundary between ‘food' and ‘drug' and that uncertainties about the products create ‘experimental' or ‘restless' approaches to consumption. We investigate these uncertainties drawing on data about the use of functional foods containing phytosterols, which are licensed for sale in the EU for people wishing to reduce their cholesterol. We start from an interest in the products as material objects and their incorporation into everyday practices. We consider the scripts encoded in the physical form of the products through their regulation, production and packaging and find that these scripts shape but do not determine their use. The domestication of phytosterols involves bundling the products together with other objects (pills, supplements, foodstuffs). Considering their incorporation into different systems of objects offers new understandings of the products as foods or drugs. In their accounts of their practices, consumers appear to be relatively untroubled by uncertainties about the character of the products. We conclude that attending to materials and practices offers a productive way to open up and interrogate the idea of categorical uncertainties surrounding new food products.
Collapse
Affiliation(s)
- Kate Weiner
- Department of Sociological Studies, University of Sheffield , Elmfield, Northumberland Road, Sheffield S10 2TU, UK
| | - Catherine Will
- Department of Sociology, Freeman Building, University of Sussex , Brighton, BN1 9QE, UK . E-mail:
| |
Collapse
|
21
|
Nutrition labelling, marketing techniques, nutrition claims and health claims on chip and biscuit packages from sixteen countries. Public Health Nutr 2015; 19:998-1007. [DOI: 10.1017/s1368980015000658] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveFood packages were objectively assessed to explore differences in nutrition labelling, selected promotional marketing techniques and health and nutrition claims between countries, in comparison to national regulations.DesignCross-sectional.SettingChip and sweet biscuit packages were collected from sixteen countries at different levels of economic development in the EPOCH (Environmental Profile of a Community’s Health) study between 2008 and 2010.SubjectsSeven hundred and thirty-seven food packages were systematically evaluated for nutrition labelling, selected promotional marketing techniques relevant to nutrition and health, and health and nutrition claims. We compared pack labelling in countries with labelling regulations, with voluntary regulations and no regulations.ResultsOverall 86 % of the packages had nutrition labels, 30 % had health or nutrition claims and 87 % displayed selected marketing techniques. On average, each package displayed two marketing techniques and one health or nutrition claim. In countries with mandatory nutrition labelling a greater proportion of packages displayed nutrition labels, had more of the seven required nutrients present, more total nutrients listed and higher readability compared with those with voluntary or no regulations. Countries with no health or nutrition claim regulations had fewer claims per package compared with countries with regulations.ConclusionsNutrition label regulations were associated with increased prevalence and quality of nutrition labels. Health and nutrition claim regulations were unexpectedly associated with increased use of claims, suggesting that current regulations may not have the desired effect of protecting consumers. Of concern, lack of regulation was associated with increased promotional marketing techniques directed at children and misleadingly promoting broad concepts of health.
Collapse
|
22
|
Abstract
This chapter describes the various compounds that can act as prebiotic fibers: their structure, occurrence, production, and physiological effects (health effects) will be presented. The basis for the description is the latest definitions for dietary fibers and for prebiotics. Using as much as possible data from human studies, both the fiber and the prebiotic properties will be described of a variety of compounds. Based on the presented data the latest developments in the area of prebiotics, fibers and gut and immune health will be discussed in more detail as they show best what the potential impact of prebiotics on health of the human host might be.
Collapse
|
23
|
Corbo MR, Bevilacqua A, Petruzzi L, Casanova FP, Sinigaglia M. Functional Beverages: The Emerging Side of Functional Foods. Compr Rev Food Sci Food Saf 2014. [DOI: 10.1111/1541-4337.12109] [Citation(s) in RCA: 254] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Maria Rosaria Corbo
- Dept. of the Science of Agriculture; Food and Environment; Univ. of Foggia; Via Napoli 25 71122 Foggia Italy
| | - Antonio Bevilacqua
- Dept. of the Science of Agriculture; Food and Environment; Univ. of Foggia; Via Napoli 25 71122 Foggia Italy
| | - Leonardo Petruzzi
- Dept. of the Science of Agriculture; Food and Environment; Univ. of Foggia; Via Napoli 25 71122 Foggia Italy
| | - Francesco Pio Casanova
- Dept. of the Science of Agriculture; Food and Environment; Univ. of Foggia; Via Napoli 25 71122 Foggia Italy
| | - Milena Sinigaglia
- Dept. of the Science of Agriculture; Food and Environment; Univ. of Foggia; Via Napoli 25 71122 Foggia Italy
| |
Collapse
|
24
|
Turner MM, Skubisz C, Pandya SP, Silverman M, Austin LL. Predicting visual attention to nutrition information on food products: the influence of motivation and ability. JOURNAL OF HEALTH COMMUNICATION 2014; 19:1017-1029. [PMID: 24555542 DOI: 10.1080/10810730.2013.864726] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Obesity is linked to numerous diseases including heart disease, diabetes, and cancer. To address this issue, food and beverage manufacturers as well as health organizations have developed nutrition symbols and logos to be placed on the front of food packages to guide consumers to more healthful food choices. In 2010, the U.S. Food and Drug Administration requested information on the extent to which consumers notice, use, and understand front-of-package nutrition symbols. In response, this study used eye-tracking technology to explore the degree to which people pay visual attention to the information contained in food nutrition labels and front-of-package nutrition symbols. Results indicate that people with motivation to shop for healthful foods spent significantly more time looking at all available nutrition information compared to people with motivation to shop for products on the basis of taste. Implications of these results for message design, food labeling, and public policy are discussed.
Collapse
Affiliation(s)
- Monique Mitchell Turner
- a Department of Prevention and Community Health , George Washington University , Washington , District of Columbia , USA
| | | | | | | | | |
Collapse
|
25
|
Gebele C, Tscheulin DK, Lindenmeier J, Drevs F, Seemann AK. Applying the concept of consumer confusion to healthcare: development and validation of a patient confusion model. Health Serv Manage Res 2014; 27:10-21. [PMID: 25595013 DOI: 10.1177/0951484814546959] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
As patient autonomy and consumer sovereignty increase, information provision is considered essential to decrease information asymmetries between healthcare service providers and patients. However, greater availability of third party information sources can have negative side effects. Patients can be confused by the nature, as well as the amount, of quality information when making choices among competing health care providers. Therefore, the present study explores how information may cause patient confusion and affect the behavioral intention to choose a health care provider. Based on a quota sample of German citizens (n = 198), the present study validates a model of patient confusion in the context of hospital choice. The study results reveal that perceived information overload, perceived similarity, and perceived ambiguity of health information impact the affective and cognitive components of patient confusion. Confused patients have a stronger inclination to hastily narrow down their set of possible decision alternatives. Finally, an empirical analysis reveals that the affective and cognitive components of patient confusion mediate perceived information overload, perceived similarity, and perceived ambiguity of information.
Collapse
Affiliation(s)
- Christoph Gebele
- Department of Business Administration II, Marketing and Health Care Management, University of Freiburg, Freiburg, Germany
| | - Dieter K Tscheulin
- Department of Business Administration II, Marketing and Health Care Management, University of Freiburg, Freiburg, Germany
| | - Jörg Lindenmeier
- Department of Business Administration VI, Public and Non-Profit Management - Corporate Governance and Ethics, University of Freiburg, Freiburg, Germany
| | - Florian Drevs
- Department of Business Administration II, Marketing and Health Care Management, University of Freiburg, Freiburg, Germany
| | - Ann-Kathrin Seemann
- Department for Health Policy & Management, Emory University, Atlanta, GA, USA
| |
Collapse
|
26
|
Maubach N, Hoek J, Mather D. Interpretive front-of-pack nutrition labels. Comparing competing recommendations. Appetite 2014; 82:67-77. [PMID: 25038407 DOI: 10.1016/j.appet.2014.07.006] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 07/08/2014] [Accepted: 07/10/2014] [Indexed: 11/17/2022]
Abstract
Many stakeholders support introducing an interpretive front-of-pack (FOP) nutrition label, but disagree over the form it should take. In late 2012, an expert working group established by the New Zealand government recommended the adoption of an untested summary rating system: a Star label. This study used a best-worst scaling choice experiment to estimate how labels featuring the new Star rating, the Multiple Traffic Light (MTL), Daily Intake Guide (DIG), and a no-FOP control affected consumers' choice behaviours and product perceptions. Nutrient-content and health claims were included in the design. We also assessed whether respondents who used more or less information during the choice tasks differed in their selection patterns. Overall, while respondents made broadly similar choices with respect to the MTL and Star labels, the MTL format had a significantly greater impact on depressing preference as a food's nutritional profile became less healthy. Health claims increased rankings of less nutritious options, though this effect was less pronounced when the products featured an MTL. Further, respondents were best able to differentiate products' healthiness with MTL labels. The proposed summary Stars system had less effect on choice patterns than an MTL label and our findings highlight the need for policy makers to ensure that decisions to introduce FOP labels are underpinned by robust research evidence. These results suggest that the proposed summary Stars system will have less effect on shifting food choice patterns than interpretive FOP nutrition label featuring traffic light ratings.
Collapse
Affiliation(s)
- Ninya Maubach
- Department of Marketing, University of Otago, Dunedin 9054, New Zealand.
| | - Janet Hoek
- Department of Marketing, University of Otago, Dunedin 9054, New Zealand
| | - Damien Mather
- Department of Marketing, University of Otago, Dunedin 9054, New Zealand
| |
Collapse
|
27
|
Vijaykumar S, Lwin MO, Chao J, Au C. Determinants of food label use among supermarket shoppers: a Singaporean perspective. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2013; 45:204-12. [PMID: 23453423 DOI: 10.1016/j.jneb.2012.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Revised: 09/04/2012] [Accepted: 09/05/2012] [Indexed: 05/26/2023]
Abstract
OBJECTIVE Examining factors influencing food label use among Singapore's supermarket shoppers using the Theory of Planned Behavior. DESIGN A point-of-purchase survey among general shoppers in 2 supermarkets. SETTING Singapore, a country whose population is exposed to a wide range of food labeling formats because of the import-dependent nature of the food industry. PARTICIPANTS A total of 200 shoppers (Chinese [75.5%], Malays [8.5%], and Indians [7.0%]) participated in the survey. MAIN OUTCOME MEASURES Independent variables composed of attitudes and subjective norms (both 5-point Likert); perceived behavioral control and diet-health concern (both 5-point semantic differential); and knowledge (18-item index). Dependent variables were intention to use food labels (5-point differential scale) and actual use of food labels (19-item index). ANALYSIS Data were analyzed using descriptive statistics, mean analysis, and multivariate linear regression. RESULTS Low levels of knowledge and health literacy were found. Attitudes, subjective norms, and behavioral control differed significantly by age and ethnicity. Subjective norms and diet-health concern were significant predictors of intention to use food labels. CONCLUSIONS AND IMPLICATIONS Lack of knowledge but positive attitudes toward food labels make Singapore's consumers vulnerable to misusing or being misled by food label information. Demographic differences demonstrate the need to develop targeted educational interventions and enhance awareness of and ability to use food labels.
Collapse
Affiliation(s)
- Santosh Vijaykumar
- Center of Social Media Innovations for Communities, Nanyang Technological University, Singapore.
| | | | | | | |
Collapse
|
28
|
Gazing into the crystal ball: future considerations for ensuring sustained growth of the functional food and nutraceutical marketplace. Nutr Res Rev 2013; 26:12-21. [DOI: 10.1017/s0954422412000236] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Over the last decade the concept of functional foods and nutraceuticals (FFN) has gained support from various stakeholders including the food industry, scientific and academic community, government institutions or regulators, producers and consumers. However, as one begins to evaluate the global FFN industry, several issues emerge including (i) a lack of consensus across jurisdictions for acknowledging safe and efficacious FFN, (ii) challenges regarding the classification of novel food-derived bioactives as FFN or drugs, and (iii) a disconnect between nutrient requirements and dosages of FFN required to facilitate health benefits. The objectives of the present review are to discuss the role of existing stakeholders within the FFN marketplace and identify performance indicators for growth within the FFN sector. In addition, the following report provides feasible resolutions to present and future challenges facing the global FFN industry to ensure sustained long-term growth.
Collapse
|
29
|
Is category ‘A’ status assigned to soy protein and coronary heart disease risk reduction health claim by the United States Food and Drug Administration still justifiable? Trends Food Sci Technol 2013. [DOI: 10.1016/j.tifs.2012.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
|
30
|
Research and development for botanical products in medicinals and food supplements market. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:649720. [PMID: 23606886 PMCID: PMC3625613 DOI: 10.1155/2013/649720] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 03/05/2013] [Indexed: 11/18/2022]
Abstract
Botanical products sold in the health area are generally intended as drugs, medicinal products, food supplements or substances for therapeutic use. Use of botanicals for improving or to care human health has evolved independently in different countries worldwide. Regulatory issues regarding botanical products designed for the food supplements or medicinal market and their influence on research and development are discussed. European Union (EU) and United States (US) policies regulating these products are focused with comments on the legislations delivered during the last ten years and differences existing in rules between these countries are emphasized. Research and development on botanical products nowdays strongly influenced by the product destination in the market. Addressed and differentiated research for either food supplements or medicinal markets is necessary to purchase data really useful for assessment of safe and effective use for both the categories. The main objective is to catalyze interest of academic and companies' researchers on crucial aspects to be taken into account in the research for the development of botanical products.
Collapse
|
31
|
Affiliation(s)
- C.I. Onwulata
- USDA-ARS Eastern Regional Research Center, Wyndmoor, Pennsylvania 19038;
| |
Collapse
|
32
|
|
33
|
European consumers and health claims: attitudes, understanding and purchasing behaviour. Proc Nutr Soc 2012; 71:229-36. [PMID: 22385589 DOI: 10.1017/s0029665112000043] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
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.
Collapse
|
34
|
Fischer LM, Sutherland LA, Kaley LA, Fox TA, Hasler CM, Nobel J, Kantor MA, Blumberg J. Development and implementation of the guiding stars nutrition guidance program. Am J Health Promot 2012; 26:e55-63. [PMID: 22040397 DOI: 10.4278/ajhp.100709-qual-238] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE . To describe the collaborative process between a grocery retailer and a panel of nutrition experts used to develop a nutrition guidance system (Guiding Stars) that evaluates the nutrient profile of all edible products in the supermarket, and to report the results of the food and beverage ratings. DESIGN . A collaboration between a private retailer and members of the scientific community that led to the development of a scoring algorithm used to evaluate the nutritional quality of foods and beverages. SETTING/SUBJECTS . Northeast supermarkets (n = 160). MEASURES . Food and beverage nutrition ratings and distribution of stars across different grocery categories. ANALYSIS . Descriptive statistics for rating distributions were computed. T-tests were conducted to assess differences in mean nutrient values between foods with zero versus three stars or a dichotomized variable representing all foods with one to three stars. RESULTS . All edible grocery items (n = 27,466) were evaluated, with 23.6% earning at least one star. Items receiving at least one star had lower mean levels of sodium, saturated fat, and sugars and higher amounts of fiber than products not earning stars. CONCLUSION . The Guiding Stars system rates edible products without regard to brand or manufacturer, and provides consumers with a simple tool to quickly identify more nutritious choices while shopping. The low percentage of products qualifying for stars reflects poorly on the food choices available to Americans.
Collapse
Affiliation(s)
- Leslie M Fischer
- Department of Nutrition, School of Public Health, University of North Carolina, Chapel Hill, USA.
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Van Kleef E, Van Trijp JCM, Van Den Borne JJGC, Zondervan C. Successful development of satiety enhancing food products: towards a multidisciplinary agenda of research challenges. Crit Rev Food Sci Nutr 2012; 52:611-28. [PMID: 22530713 PMCID: PMC3662086 DOI: 10.1080/10408398.2010.504901] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In the context of increasing prevalence of overweight and obesity in societies worldwide, enhancing the satiating capacity of foods may help people control their energy intake and weight. This requires an integrated approach between various food-related disciplines. By structuring this approach around the new product development process, this paper aims to present the contours of such an integrative approach by going through the current state of the art around satiety enhancing foods. It portrays actual food choice as the end result of a complex interaction between internal satiety signals, other food benefits, and environmental cues. Three interrelated routes to satiating enhancement are to change the food composition to develop stronger physiological satiation and satiety signals, anticipate and build on smart external stimuli at the moment of purchase and consumption, and improve palatability and acceptance of satiety enhanced foods. Key research challenges in achieving these routes in the field of nutrition, food technology, consumer, marketing, and communication are outlined.
Collapse
Affiliation(s)
- E Van Kleef
- Wageningen University, Marketing & Consumer Behaviour Group, Wageningen, The Netherlands.
| | | | | | | |
Collapse
|
36
|
Abstract
In Europe, for authorisation of a health claim, applicants must follow the procedures in the legislation and in the guidelines for submission of a dossier set out by the European Food Safety Authority. The Functional Foods in Europe (FUFOSE) and Process for the Assessment of Scientific Support for Claims on Foods (PASSCLAIM) projects underpinned the laws and provided criteria against which the quality of the totality of the available data could be judged. Whereas the regulations and PASSCLAIM require an assessment of the extent to which cause and effect can be demonstrated between a food category, a food or constituent and a health benefit, the European Food Safety Authority requires conclusive evidence of cause and effect. This latter standard of proof and a focus on randomised controlled trials done on isolated components and using validated physiological biomarkers may not always be appropriate to assess nutrition science. The aims of this paper are to address the strengths and weaknesses of different sources of evidence that contribute to the totality of the available data, to undertake a critical examination of the application of a drug-like assessment model in evidence-based nutrition and to encourage research on new biomarkers of health and homeostatic adaptability. There is a need for (a) a robust and pragmatic scientific framework for assessing the strength, consistency and biological plausibility of the evidence, and (b) consumer understanding research on claims that use qualifying language and/or graphics to reflect the weight of evidence. Such scientific, policy and communication approaches are proportionate and could help stimulate academic research, promote fair trade and product innovation and contribute to consumer education about food and health.
Collapse
|
37
|
Abstract
EU legislation on nutrition and health claims made on foods (Regulation (EC) No. 1924/2006) specifies that health claims should be only authorised for use in the Community after a scientific assessment of the highest possible standard is carried out by the European Food Safety Authority (EFSA). This paper focuses on the scientific substantiation of health claims within the context of the EU Regulation. The evaluation of the substantiation of health claims is carried out by the EFSA Scientific Panel on Dietetic Products, Nutrition and Allergies (NDA). The EFSA has published extensive guidance to assist applicants in the preparation of applications for authorisations of health claims. This guidance summarises the general principles applied by the NDA Panel in the evaluation of health claims, including the scientific criteria for substantiation, as well as the scientific requirements for the substantiation of specific health claims. To date, the EFSA NDA Panel has concluded that a wide range of health claims has been substantiated. These include claims for many well-established functions of nutrients, as well as beneficial effects of foods and food constituents on a range of body functions. In addition, claims have been substantiated on the role of nutrients in growth and development of children and on the effects of nutrients and food constituents on reduction of risk factors for disease. EFSA evaluations and guidance have made an important contribution to the understanding of the scientific substantiation of health claims which will help to set new directions for research and will guide future innovation.
Collapse
|
38
|
Abstract
As long as health communications have existed in the USA, Americans have faced the task of sorting the agenda of the source from the advice it provides. That task has become more complicated as advances in the science of nutrition and the technology used to present it have heightened the complexity of nutrition communications. Getting consumers to adopt a healthier diet has been a protracted undertaking with limited successes along the way. The obesity epidemic has added urgency to this discourse: not only do we need to eat better, but most of us also need to eat less. This paper reviews the dynamics that have made the communication of accurate and actionable health behaviour information an ongoing challenge, and outlines strategies for moving ahead. It considers the interplay of four sets of factors: the evolutionary nature of the science on which recommendations are based; the many sources of communication about that science; the agendas or motivations of each source; and finally the multifaceted nature of consumers, the recipients of these communications. Communication alone has not been, and will not be, sufficient for consumers to adopt the behavioural changes endorsed by experts. Broad environmental interventions coupled with individual skills development will need to be part of the process. Ultimately, it is the consumer who decides what is for dinner. Media literacy will play a critical role in building consumer efficacy in sorting fact from fiction in order to select food for a healthful diet.
Collapse
|
39
|
Mariotti F, Kalonji E, Huneau JF, Margaritis I. Potential pitfalls of health claims from a public health nutrition perspective. Nutr Rev 2010; 68:624-38. [PMID: 20883420 DOI: 10.1111/j.1753-4887.2010.00322.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The European Union is implementing a new regulatory framework for nutrition and health claims (HCs) that will greatly impact the communication of health messages on foodstuffs. In particular, approved HCs will be included in a positive register of generic claims. In the currently available literature, assessment of the relevance of HCs has mainly been related to scientific substantiation, and the issue of relevance in terms of public health has tended to be overlooked. Interestingly, the new regulation states that claims must be well understood by the average consumer. This article delves beyond the issue of scientific substantiation of claims and reviews possible discrepancies between consumer perception/understanding of HCs and the public health nutrition reality, which can confuse or mislead the consumer and ultimately impact public health nutrition. Six pitfalls are described herein and a comprehensive overview of the critical examination of any HC is proposed.
Collapse
Affiliation(s)
- François Mariotti
- AgroParisTech, CRNH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior, F-75005 Paris, France.
| | | | | | | |
Collapse
|
40
|
Marinangeli CPF, Jones PJH. Functional food ingredients as adjunctive therapies to pharmacotherapy for treating disorders of metabolic syndrome. Ann Med 2010; 42:317-33. [PMID: 20486826 DOI: 10.3109/07853890.2010.484026] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Abstract Information regarding the use of functional foods and nutraceuticals (FFN) in combating disease is rarely communicated to health care practitioners as medicinal strategies for patients. Metabolic syndrome (MetS) is an ideal paradigm for demonstrating the therapeutic properties of FFN. Encompassing multiple etiologies, including atherogenic dyslipidemia, insulin resistance, and hypertension, MetS affects over a third of American adults. However, as disease-related risk factors accumulate over time, guidelines for treating disorders of MetS progressively de-emphasize the use of FFN. Using marine omega-3 fatty acids, plant sterols, fiber, and tomato extract as examples, the purpose of this review is to endorse FFN as long-term adjunctive therapies to pharmaceutical treatment for disorders and risk factors for MetS. An additional goal is to compare physiological and molecular targets of FFN against corresponding prescription medications. Results reveal that FFN are viable treatment strategies for disorders of MetS, complementing pharmacological interventions by targeting and improving the biological processes that foster the development of disease. Thus, efficacious FFN therapies should be emphasized throughout all stages of treatment as adjuncts to pharmacotherapy for disorders of MetS. Accordingly, new developments in FFN research must be implemented into clinical guidelines with the prospect of improving disease prognoses as accessories to prescription medications.
Collapse
Affiliation(s)
- Christopher P F Marinangeli
- The Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Manitoba, R3T 2N2, Canada
| | | |
Collapse
|
41
|
Sutherland LA, Kaley LA, Fischer L. Guiding stars: the effect of a nutrition navigation program on consumer purchases at the supermarket. Am J Clin Nutr 2010; 91:1090S-1094S. [PMID: 20147468 DOI: 10.3945/ajcn.2010.28450c] [Citation(s) in RCA: 148] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND To improve diet quality and overall population health, the need to develop nutritional rating systems that are comprehensive in scope and easy for the consumer to understand and use at the point-of-purchase has emerged. OBJECTIVE Our aim was to examine the effect of a comprehensive storewide supermarket point-of-purchase nutrition navigation intervention by using a shelf-label 3-tiered star icon on consumer food and beverage choices and their associated nutritional quality. DESIGN By using a natural experiment design, purchasing data from 2006 to 2008 were obtained from a Northeast supermarket chain with 168 stores located in northern New England and New York and examined at preimplementation and at 1- and 2-y follow-up periods. RESULTS The nutrition navigation system studied showed significant changes in food purchasing immediately after implementation, and these changes continued to be significant 1 and 2 y later. When the same 8-mo period (January-August) each year was compared, in 2006, 24.50% of items purchased earned a star rating; this proportion increased to 24.98% (P < 0.001) and 25.89% (P < 0.0001) at the 1- and 2-y follow-up periods, respectively. For a 4-wk period, 1 y after program implementation, consumers purchased significantly more ready-to-eat cereals with stars (eg, less added sugars and more dietary fiber) and fewer no-star, high-sugar, low-fiber cereals. CONCLUSION Increasing rates of obesity and declining diet quality for Americans strongly support the need for effective supermarket point-of-purchase programs, such as the Guiding Stars nutrition navigation program, that provide clear, concise, and simplified nutrition information to guide consumer food and beverage choices.
Collapse
Affiliation(s)
- Lisa A Sutherland
- Community Health Research Program, Hood Center for Children Families, and the Department of Pediatrics and Adolescent Medicine, Dartmouth Medical School, Lebanon, NH 03756, USA.
| | | | | |
Collapse
|
42
|
Downs JS, Loewenstein G, Wisdom J. Strategies for Promoting Healthier Food Choices. THE AMERICAN ECONOMIC REVIEW 2009; 99:159-164. [PMID: 29505205 DOI: 10.1257/aer.99.2.159] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
|
43
|
Appendino G, Taglialatela-Scafati O, Romano A, Pollastro F, Avonto C, Rubiolo P. Genepolide, a sesterpene gamma-lactone with a novel carbon skeleton from mountain wormwood (Artemisia umbelliformis). JOURNAL OF NATURAL PRODUCTS 2009; 72:340-344. [PMID: 19053512 DOI: 10.1021/np800468m] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The sesterpene gamma-lactone genepolide (5) has been isolated from a Swiss horticultural variety of mountain wormwood (Artemisia umbelliformis) developed as a thujones-free alternative to native Western Alps wormwoods for the production of liqueurs. Genepolide is the formal Diels-Alder adduct of the exomethylene-gamma-lactone costunolide (2) and the diene myrcene (6), two poorly reactive partners in cycloaddition reactions, and its structure was elucidated through a combination of spectroscopic methods. An investigation on the thermal stability of mixtures of 2 and 6, as well as considerations on the sensitivity of 2 to Brønsted and Lewis acids, suggests that 5 is a genuine natural product and that the Swiss chemotype of A. umbelliformis contains Diels-Alderase enzymatic activity that is lacking in native mountain wormwoods from Western Alps. Remarkable differences in thermal and acid-catalyzed reactions of the cyclodecadiene moiety of 2 and 5 suggest that quaternarization at C-11 has far-reaching effects on the reactivity of their homoconjugated medium-sized diene system. The wide occurrence of this structural motif in sesquiterpenoids makes this issue worth a systematic investigation.
Collapse
Affiliation(s)
- Giovanni Appendino
- Dipartimento di Scienze Chimiche, Alimentari, Farmaceutiche e Farmacologiche, Universita del Piemonte Orientale, Via Bovio 6, 28100 Novara, Italy.
| | | | | | | | | | | |
Collapse
|
44
|
Senok AC. Probiotics in the arabian gulf region. Food Nutr Res 2009; 53:1842. [PMID: 19266044 PMCID: PMC2651754 DOI: 10.3402/fnr.v53i0.1842] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2008] [Revised: 12/17/2008] [Accepted: 01/20/2009] [Indexed: 01/03/2023] Open
Abstract
Objective Available reports on adherence to recommended guidelines for labeling of probiotic products are based on assessment of these products in developed countries. In the Arabian Gulf region, there is a paucity of data on the characterization of probiotic products and an absence of local guidelines for their labeling. This study, carried out in the United Arab Emirates (UAE), represents the first evaluation of probiotic products available in the Arabian Peninsula. Methods Probiotic products were purchased over the counter from a variety of sources, including pharmacies, healthfood stores, and supermarkets across the UAE. All identified products were listed and information regarding type of product preparation and labeling information were recorded. Results A total of 37 probiotic products, 15 dairy-based and 22 non-dairy-based were identified. The dairy products comprised of 12 yogurts, two fermented milk products and one powdered baby formula. The majority of non-dairy products were in capsule form (n = 16). While all the non-dairy products gave information about the strain of probiotic microorganism and number present at time of manufacture, this information was provided for only one dairy-based product. Strains of Lactobacillus acidophilus were the most common probiotic organisms identified. However, one probiotic product listed Enterococcus faecalis (750 million viable bacteria per capsule) as a component. With the exception of one non-dairy-based product, all health-related claims were structure/function statements, according to the US Food and Drug Administration nomenclature. Conclusion These findings indicate that a wide variety of probiotic products are available in the Arabian Gulf. Development of guidelines for labeling of these probiotic products and use of structure/function statements and health claims should be addressed.
Collapse
Affiliation(s)
- Abiola C Senok
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| |
Collapse
|
45
|
Abstract
As the health benefits of ingesting live bacteria become more evident, foods are now being produced that contain probiotic bacteria. The data to support label health claims for probiotic products are often difficult to provide. The experimental evidence to identify probiotic microorganisms and to demonstrate their efficacy in clinical trials is more challenging than for other potential functional foods because effects are mediated by living microorganisms and may therefore be influenced by the status of these microorganisms. Clinical trials to show efficacy are expensive. Obtaining appropriate samples is difficult. A scientific consensus is building to support the claim that the ingestion of certain probiotic bacteria reduces lactose intolerance and can reduce the duration of rotavirus diarrheas. Some probiotic bacteria have "generally accepted as safe" status; proof of the safety of any probiotic is essential. Japanese health regulatory officials, using their Foods for Specific Health Use system, have approved human health claims for over 20 probiotic products. On the other hand, at this time, no probiotic product is sold in Canada that carries a label health claim. This illustrates the considerable discrepancies across countries in perception of health effects of probiotics.
Collapse
Affiliation(s)
- Edward R Farnworth
- Food Research and Development Centre, Agriculture and Agri-Food Canada, Saint Hyacinthe, QC, Canada.
| |
Collapse
|
46
|
Abstract
Interest in the health effects of foods by both industry and consumers has put a spotlight on the role of health claims on foods in Canada. The current regulatory framework governing the use of different health claims on foods in Canada is described and compared with international approaches. Similarities were observed in how risk-reduction claims for serious diseases are managed in the United States, European Union and proposed by Food Standards Australia New Zealand, including the need for premarket authorization and the requirement for a high level of certainty based on the totality of evidence in substantiating this type of claim. However, approaches to permitting function claims other than those for the well-established functions of known nutrients are divergent among the jurisdictions compared. Canada also differs from other jurisdictions in not establishing core nutritional criteria for foods carrying disease risk-reduction claims. A brief overview of the status in Canada of a number of disease risk-reduction claims that have been approved in the United States, based on significant scientific agreement under the Nutrition Labeling and Education Act or through authoritative statements under the Food and Drug Administration Modernization Act, is also provided.
Collapse
Affiliation(s)
- Mary R L'abbé
- Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Canada.
| | | | | | | |
Collapse
|
47
|
Jew S, Vanstone CA, Antoine JM, Jones PJH. Generic and product-specific health claim processes for functional foods across global jurisdictions. J Nutr 2008; 138:1228S-36S. [PMID: 18492862 DOI: 10.1093/jn/138.6.1228s] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Worldwide consumer interest in functional foods and their potential health benefits has been increasing over the past 10 y. To respond to this interest, regulatory bodies have developed guidelines for assessing health claims on functional foods. The objective of this article is to investigate the type and amount of evidence needed in various jurisdictions on a worldwide basis to substantiate both generic and product-specific health claims. Two types of health claims were examined using separate case studies. Analysis of generic health claims was highlighted by (n-3) fatty acids and their relation to heart health; whereas examination of product-specific health claims was conducted using probiotics and their association with gastrointestinal well-being. Results showed a common core for use of convincing high-quality human data, especially in the form of randomized controlled trials (RCT), but there was significant variability in the type and amount of scientific evidence needed to substantiate health claims, both generic and product specific, across different jurisdictions. Product-specific claims tended to use human RCT as the main basis for claims, whereas generic claims tended to base their statements on a wider spectrum of literature.
Collapse
Affiliation(s)
- Stephanie Jew
- School of Dietetics and Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Quebec H9X 3V9, Canada
| | | | | | | |
Collapse
|
48
|
Abstract
Epidemiological investigations suggest that soy consumption may be associated with a lower incidence of certain chronic diseases. Clinical studies also show that ingestion of soy proteins reduces the risk factors for cardiovascular disease. This led to the approval of the food-labeling health claim for soy proteins in the prevention of coronary heart disease by the U.S. FDA in 1999. Similar health petitions for soy proteins have also been approved thereafter in the United Kingdom, Brazil, South Africa, the Philippines, Indonesia, Korea, and Malaysia. However, the purported health benefits are quite variable in different studies. The Nutrition Committee of the American Heart Association has assessed 22 randomized trials conducted since 1999 and found that isolated soy protein with isoflavones (ISF) slightly decreased LDL cholesterol but had no effect on HDL cholesterol, triglycerides, lipoprotein(a), or blood pressure. The other effects of soy consumption were not evident. Although the contributing factors to these discrepancies are not fully understood, the source of soybeans and processing procedures of the protein or ISF are believed to be important because of their effects on the content and intactness of certain bioactive protein subunits. Some studies have documented potential safety concerns on increased consumption of soy products. Impacts of soy products on thyroid and reproductive functions as well as on certain types of carcinogenesis require further study in this context. Overall, existing data are inconsistent or inadequate in supporting most of the suggested health benefits of consuming soy protein or ISF.
Collapse
Affiliation(s)
- Chao Wu Xiao
- Nutrition Research Division, Food Directorate, Health Products and Food Branch, Health Canada, 2203E Banting Research Centre, Ottawa, Canada.
| |
Collapse
|
49
|
Tapsell LC. Evidence for health claims: a perspective from the Australia-New Zealand region. J Nutr 2008; 138:1206S-9S. [PMID: 18492858 DOI: 10.1093/jn/138.6.1206s] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Establishing the evidence for health claims involves reviewing the available body of scientific knowledge and linking this to statements meaningful to consumers. This requires an understanding of scientific merit as well as consumer perceptions of health messages. Food Standards Australia New Zealand sets standards for current nutrient content claims and is close to approving a proposed new framework for all forms of nutrition and health claims on foods. This article discusses this proposed health claims standard in light of the challenges health claims pose to nutrition science. It critically describes the framework for the standard, reviews issues related to substantiation of claims, and provides commentary on the proposed assessment of evidence. This spectrum of permission reflects the use of food in health promotion, disease prevention, and early disease management when therapeutic agents may not be required. The position is consistent with an understanding that food delivers nutrients and bioactive substances at levels that support the improved health of the human organism in the early stages of the health-disease spectrum. Increasing knowledge of the role of food components and its intelligent application in dietary modification can result in this strategy playing a major role in disease prevention and early disease management. The amount of evidence required to enable health claim labeling should be based on a reasonable judgment and clear understanding of the role of nutrition in health and disease.
Collapse
Affiliation(s)
- Linda C Tapsell
- Smart Foods Centre, University of Wollongong, Wollongong NSW 2522 Australia.
| |
Collapse
|
50
|
Abstract
Government-approved health claims support dietary intervention as a safe and practical approach to improving consumer health and provide industry with regulatory guidelines for food product labels. Claims already allowed in the United States, United Kingdom, Sweden, and The Netherlands for reducing cholesterol through consumption of oat or barley soluble fiber provide a basis for review, but each country may have different criteria for assessing clinical evidence for a physiological effect. For example, the FDA-approved barley health claim was based on a petition that included 39 animal model studies and 11 human clinical trials. Since then, more studies have been published, but with few exceptions, clinical data continue to demonstrate that the consumption of barley products is effective for lowering total and LDL cholesterol. More research is needed to fully understand the mechanism of cholesterol reduction and the role of beta-glucan molecular weight, viscosity, and solubility. In an assessment of the physiological efficacy of a dietary intervention, consideration should also be given to the potential impact of physical and thermal food-processing treatments and genotypic variation in the barley source. New barley cultivars have been generated specifically for food use, possessing increased beta-glucan, desirable starch composition profiles, and improved milling/processing traits. These advances in barley production, coupled with the establishment of a government-regulated health claim for barley beta-glucan, will stimulate new processing opportunities for barley foods and provide consumers with reliable, healthy food choices.
Collapse
Affiliation(s)
- Nancy P Ames
- Cereal Research Centre, Agriculture and Agri-Food Canada, Winnipeg, Manitoba R3T 2M9, Canada.
| | | |
Collapse
|