Influence of nutritional knowledge on the use and interpretation of Spanish nutritional food labels

"We know what we should be eating, but we don't always do that." How and why people eat the way they do: a qualitative study with rural australians

BACKGROUND

There is evidence that most people are aware of the importance of healthy eating and have a broad understanding regarding types of food that enhance or detract from health. However, greater health literacy does not always result in healthier eating. Andreasen's Social Marketing Model and Community-Based Social Marketing both posit that, in order to change health behaviours, it is crucial to understand reasons for current behaviours and perceived barriers and benefits to improved behaviours. Limited research has been conducted, however, that explores these issues with general populations. This study aimed to help address this gap in the evidence using a qualitative methodology.

METHODS

Three group discussions were conducted with a total of 23 participants: (1) young women aged 18-24 with no children; (2) women aged 35-45 with primary school aged children; and (3) men aged 35-50 living with a partner and with pre- or primary school aged children. The discussions took place in a regional centre of Victoria, Australia. Transcriptions were thematically analysed using an inductive descriptive approach and with reference to a recent integrated framework of food choice that identified five key interrelated determinants: food- internal factors; food- external factors; personal-state factors; cognitive factors; and sociocultural factors.

RESULTS

We found that food choice was complex, with all five determinants evident from the discussions. However, the "Social environment" sub-category of "Food-external factors", which included family, work, and social structures, and expectations (or perceived expectations) of family members, colleagues, friends, and others, was particularly prominent. Knowledge that one should practice healthy eating, which falls under the "Cognitive factor" category, while seen as an aspiration by most participants, was often viewed as unrealistic, trumped by the need and/or desire for convenience, a combination of Food-external factor: Social environment and Personal-state factor: Psychological components.

CONCLUSIONS

We found that decisions regarding what, when, and how much to eat are seen as heavily influenced by factors outside the control of the individual. It appears, therefore, that a key to improving people's eating behaviours is to make it easy to eat more healthfully, or at least not much harder than eating poorly.

Investigating the Effect of Consumers' Knowledge on Their Acceptance of Functional Foods: A Systematic Review and Meta-Analysis

Inconsistent results published in previous studies make it difficult to determine the precise effect of consumer knowledge on their acceptance of functional foods. We conducted a systematic review and meta-analysis by identifying and collecting relevant literature from three databases. Of the 1050 studies reviewed, we included 40 in the systematic review and 18 in the meta-analysis. Based on the focus of each included study, we operationally defined knowledge as knowledge of the functional food concept, nutritional-related knowledge, and knowledge of specific functional products. Results from the systematic review indicate that most participants from the included studies had low knowledge, especially nutrition-related knowledge associated with consuming functional foods, and were generally not familiar with the concept of functional foods. Results from the meta-analysis generated a summary effect size (r = 0.14, 95% CI [0.05; 0.23]), measured by the correlation coefficient r, which indicates a small positive relationship exists between consumers' level of knowledge and their acceptance of functional foods. Results from our study demonstrate the importance of increasing consumers' functional foods knowledge to improve their acceptance of such products. Agricultural and health communicators, educators, and functional foods industry professionals should prioritize increasing consumers' knowledge through their communications, marketing, and programmatic efforts.

The relationship between nutrition and physical activity knowledge and body mass index-for-age of school-aged children in selected schools in Ghana

BACKGROUND

Nutrition knowledge contributes significantly to the nutritional status and habits of individuals as it influences their food consumption. And body mass index (BMI) of individuals. Recent data suggests a relationship between nutrition and physical activity knowledge, attitude, practices, and anthropometric indices of Ghanaian children.

OBJECTIVE

To determine the relationship between nutrition and physical activity knowledge and using BMI-for-age of school-aged children.

METHODS

A cross-sectional study involving 591 school-aged children (8-13 years) chosen at random from schools in Ghana's Ho Municipality. Socio-demographic information was gathered. Data on nutrition and physical activity knowledge, attitude, and practice were also collected using structured questionnaires. BMI was calculated after weight and height were measured.

RESULTS

Majority of the participants had poor knowledge on nutrition (46.6%) and physical activity (49.8%) even though more children in private schools (63.3%) had better (good and excellent) knowledge in nutrition than children from public schools (48.2%). Older children (11-13 years) had 'good' knowledge of physical activity (54.7%) as opposed to younger children. Males (59.5%) and children in private schools (66.3%) also had better overall scores in combined nutrition and physical activity knowledge than their female and public-school counterparts, respectively. Physical activity knowledge was significantly (p < 0.05) associated with the BMI-for-age categories. Nutrition knowledge (p < 0.05) and total nutrition and physical activity knowledge scores (p < 0.001) were weakly but positively associated with BMI-for-age.

CONCLUSION

The results suggest that BMI-for-age of the participants was positively correlated to the nutrition knowledge and the total nutrition and physical activity knowledge (NutPA).

The Relationship between Nutrition Knowledge and Nutrition Facts Table Use in China: A Structural Equation Model

Since 2013, China has implemented a nutrition label regulation that aims to provide essential nutrition information through nutrition facts tables labeled on the back of food packages. Yet, the relationship between people’s nutrition knowledge and their nutrition label use remains less clear. This study adopted the structural equation modeling approach to analyze a nationally representative survey of 1500 Chinese individuals through the cognitive processing model, interrelated nutrition knowledge, attention to nutrition information on the nutrition facts table, comprehension of nutrition information, food choice and dietary intake. It was found that nutrition knowledge positively influenced attention to nutrition information; a better comprehension of nutrition information, which could benefit healthier food choices, did not relate to a higher level of attention to that information; dietary intake was affected significantly by nutrition knowledge, but it had little impact on food choice. The results signify that nutrition knowledge hardly supports nutrition facts table use among the Chinese people, mainly due to incomprehensible labeled information. Therefore, it emphasizes the need to enhance people’s comprehension through front-of-package labels and corresponding smartphone applications.

Consumer Behavior at Supermarkets during Grocery Shopping in Saudi Arabia: A National Observational Study

BACKGROUND

Use of nutrition facts labels can be associated with healthier eating behaviors; however, consumers currently face difficulty understanding these labels or do not use them often. Thus, improving healthy grocery shopping behaviors among consumers might increase the overall health of the community.

AIM

The study aims to explore consumers' behavior during grocery shopping and measure their basic knowledge regarding food product labels.

METHOD

A national observational study (cross-sectional) was carried out on a convenience sample of Saudi Arabian residents aged 18 years and above. The data were obtained from all 13 administrative regions in Saudi Arabia at three different major supermarkets in each region. The data were analyzed using descriptive analysis, and binary logistic regression was used to investigate behavior variables.

RESULTS

A total of 12,675 participants were observed; of those, 52.2% did not interact with the product before putting it in their shopping cart. The study found that the production date (66.6%) and expiry date (51%) were the most frequently checked aspects of food labels; they were checked more frequently than nutrition facts (29%). Furthermore, there was a low level of dietary knowledge among consumers and a moderate level of believing food packages and media claims.

CONCLUSIONS

Our results suggest that the Saudi community's understanding of food product information is limited and greater awareness and community education campaigns are required to improve the use of nutritional labels and increase nutritional knowledge.

Analysis of Factors Influencing Food Nutritional Labels Use in Nanjing, China

A correct use of food nutrition la bels benefits consumers in pursuing balanced diets. As a result, we conducted interviews in Nanjing, China and randomly sampled 427 respondents. Further, we used both descriptive statistics and binary logistic regression to assess their perception of food nutrition label use. The results indicated that the current situation is not ideal in Nanjing. Only 7.26% of respondents use labeling consistently. Data on purchasing experience, comprehension, nutritional value, work sector, chronic disease, diet awareness, nutritional knowledge, and age were statistically significant. Conversely, taste and primary shopper categories negatively influenced food nutrition label use. In light of the above results, we propose policy recommendations to promote consumers' use of food nutrition labels. These are also beneficial in improving diet and relieving chronic diseases.

Nutrition-related knowledge and its determinants in middle-aged and older patients with type 2 diabetes

AIMS

To analyse nutrition-related knowledge and its determinants in middle-aged and older patients with T2D.

METHODS

In a cross sectional study, a total of 116 participants with T2D, aged 50-80 years, were recruited in primary health care. Data was collected by a self-reported questionnaire - the modified version of General Nutrition Knowledge Questionnaire (0-56 points). Sociodemographic data was also collected: gender, age, personal monthly income, living situation, education level, and marital status. One-way analysis of variance (ANOVA) was performed to assess differences in nutrition-related knowledge score among the different levels of sociodemographic characteristics.

RESULTS

Questions on general dietary recommendations, dietary behaviors to reduce cardiovascular disease and cancer are the items with higher proportion of correct answers. On the other hand, health problems related with lower intake of fruit, vegetables and fiber and knowledge about antioxidants vitamins presented the lower proportion of correct answers. Higher scores were found among those with lower age, higher personal monthly income, and higher education.

CONCLUSIONS

Middle-aged and older patients with T2D showed alarming deficits on nutrition-related knowledge. Age, personal monthly income, and education level were observed as major determinants of nutrition-related knowledge.

TRIAL REGISTRATION

NCT02631902.

The association of parents' behaviors related to salt with 24 h urinary sodium excretion of their children: A Spanish cross-sectional study

BACKGROUND

Sodium intake is excessive among Spanish children, but the salt use behaviors of parents and children are unknown. This study aims to determine behaviors related to salt intake in both schoolchildren and parents and the relationship between parental behaviors and 24 h urinary sodium excretion (UNa-24h) in children.

SUBJECTS AND METHODS

A convenience sample was taken from a cross-sectional analysis. Parents completed a self-reported questionnaire about their behaviors related to salt, and their responses were compared with the UNa-24h of their own children. The median test was used to identify differences in UNa-24h according to behaviors. Logistic regression was used to assess the relationship between the behaviors of parents and high sodium excretion in the children and the risk of children's use of table salt, adjusting for age, sex, and BMI. Multinomial logistic regression models, adjusted by the covariates, were used to study the children's salt preferences.

RESULTS

A total of 329 schoolchildren from different Spanish provinces were included in the study (mean age: 9.0 ± 1.2 years, 157 girls). The majority of families (parents mean age: 42.0 ± 5.2 years) reported adding salt to food during cooking (92%), and 59% of them never looked at the sodium content on food labels. However, none of these behaviors were related to UNa-24h (p > 0.05). The use of iodized salt (53%), the presence of a salt shaker on the table (6%), and the use of table salt by fathers (57%), mothers (52%) or children (17%) increased the odds (p < 0.05) of children having a higher UNa-24h. Checking sodium content on food labels and the use of table salt by the children or father was associated with a lower preference for salty foods (p < 0.05).

CONCLUSIONS

It is important to make parents aware of the relationship between their behaviors regarding the use of discretionary salt and their children's sodium intake. Our data suggest that salt-specific education programs on how to reduce salt both in-home and outside the home should be implemented to improve behavior skills related to salt consumption in parents and children.

Perceptions Towards Healthy Diet of the Portuguese According to Area of Work or Studies

Introduction

A healthy diet is crucial for the maintenance of health. Therefore, the aim of this work is to evaluate the perceptions towards a healthy diet among the participants with work or studies in areas related to diet and nutrition and those who did not.

Methods

Anonymous questionnaire data was collected in a cross-sectional study on a non-probabilistic sample of 902 participants living in Portugal.

Results

The results showed that the participants’ perceptions were, in general, compliant with a healthy diet. However, significant differences were found between gender (p=0.004), between the different civil state groups (p=0.016), between the participants who were responsible for buying their own food and those who were not and also regarding the living environment. The variable area of work or studies also showed significant differences (p=0.001), so that people who had work or studies related to agriculture obtained a higher score. Regarding this variable, the mean values of nutrition and agriculture areas were not statistically different between them, but were statistically different from the mean values of psychology and health areas. The participants who had work or studies in areas showing diet and nutrition-related issues achieved a higher mean score (0.72±0.35) when compared to the participants who did not (0.58±0.30).

Conclusion

However, despite the results, it is important to continue developing campaigns that better communicate nutritional aspects, so that people can increase their knowledge on this subject.

The mix of good nutritional attitude and poor nutritional knowledge is associated with adequate intake of vitamin A and iron from wild fruits and vegetables among rural households in Acholi subregion of Northern Uganda

Nutritional knowledge and attitude of a population greatly affect intake of essential micronutrients. Much of the understanding on the impact of nutritional knowledge and attitude on nutrient intake has been derived from studies conducted among affluent societies using commercial food products. However, information on the link between status of nutritional knowledge and attitude on intake of essential nutrients from wild fruits and vegetables among rural communities is largely lacking. This study examined the status of nutritional knowledge and attitude associated with intake of vitamin A and iron from wild fruits and vegetables among rural households in Acholi subregion of northern Uganda. A cross-sectional study design making use of individual household questionnaire and proximate dietary recall of a calendar year consumption period involving 248 randomly selected rural households was applied. Results showed that households had good nutritional attitude but poor nutritional knowledge. Status of knowledge was dependent on nutrition training (p = 0.028; coefficient, β = 0.710) and age of the respondent (p = 0.044; β = -0.023), whereas status of attitude was predicted by age of the respondent (p = 0.014; β = 0.048). Consumption of wild fruits and vegetables contributed adequately to the dietary vitamin A and iron requirements of the households. The results have demonstrated that intake of vitamin A and iron from wild fruits and vegetables among rural households is associated with good nutritional attitude but poor nutritional knowledge. A concerted effort is necessary to improve household nutritional knowledge for better utilization of wild fruits and vegetables.

Nutrition Labelling Use and Higher Adherence to Mediterranean Diet: Results from the DiSA-UMH Study

The aim of this study was to identify determinants of the nutrition labelling (NL) use and explore its association with the adherence to Mediterranean Diet (MD) in Spanish health university students. We performed a cross-sectional analysis of the baseline data from 1026 university students aged 17-35 years enrolled in the DiSA-UMH (Dieta, Salud y Antropometría-Universidad Miguel Hernández) cohort study. Students were asked about their NL use by the following question: "Do you usually read the nutrition labelling of packaged foods?" (No, Yes). Dietary intake was assessed using a validated food frequency questionnaire and the adherence to MD was measured by relative Mediterranean Diet score (rMED). Socio-demographic, lifestyle, and anthropometric variables were also collected. Multiple logistic regression models were applied for the analysis. Fifty-eight percent of the students were NL users and were most likely to be women (Odds Ratio (OR): 1.38; 95% Confidence Interval (CI): 1.01-1.89), be older (OR per year: 1.08; 95% CI: 1.03-1.13), be physically active/very active (OR: 1.68; 95% CI: 1.17-2.41), and spend less time watching television (OR per hour: 0.84; 95% CI: 0.74-0.95). After adjusting for potential confounding factors, our findings suggested that those university students who had higher adherence to MD used NL greatly (OR per 2 points increase: 1.30; 95% CI: 1.18-1.43) and had a larger consumption of fish (OR per 100 g/day: 1.94; 95 CI: 1.38-2.71), vegetables (OR per 100 g/day: 1.15; CI 95%: 1.08-1.12), and fruits (OR per 100 g/day: 1.22; 1.11-1.34) and a smaller intake of meats (OR per 100 g/day: 0.76; 95% CI: 0.58-0.99). Our approach contributes to exploring the role of NL use as a suitable tool to make healthier food choices from a different wider perspective based on dietary patterns such as MD, which can also indicate an overall healthy lifestyle. Given the lack of research in Mediterranean areas, further studies focused on exploring the potential role of NL in promoting healthy dietary habits are required.

Nutrition knowledge assessment studies in adults: a systematic review

The objective of this study is to perform a systematic review of published studies that assessed nutrition knowledge in adults, focusing on the methodology and content of these studies. An article search was performed on the Medline, Lilacs, and SciELO databases. The search limits were human studies; English, Portuguese, and Spanish languages; and age (over 19). Inclusion criteria were: cross-sectional studies performed on individuals over 18 years old that assessed the general nutrition knowledge of participants. The methodological quality of the articles was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria. The initial search identified 3,623 articles. After reading the titles and the abstracts and applying the exclusion criteria, 25 articles were selected. The results showed that, in most studies, nutrition knowledge was associated with socioeconomic parameters and eating behaviour. Most studies belonged to class B (92%), meeting 50-80% of the STROBE criteria. The studies have revealed a greater tendency to assess the relationship of nutrition knowledge with sociodemographic and economic parameters.

Nutrition Label Use in a Latin American Middle-Income Country: Guatemala

BACKGROUND

Obesity has become a major public health issue in Latin America. Nutrition labels have been proposed as 1 strategy to address the obesity epidemic as they may encourage consumers to reassess their choices at point-of-purchase.

OBJECTIVE

We sought to determine the knowledge and stated use of the nutrition label in Guatemala.

METHODS

Caregivers were randomly selected from public and private schools in Guatemala City. Caregivers were interviewed to assess knowledge and behaviors related to nutrition label use. Anthropometric measurements were measured using standardized procedures. Descriptive statistics and χ² test were used to determine the differences between school types.

RESULTS

Higher-income caregivers (88%) were more likely to be aware of nutrition labels, compared to those from low-income families (51%; P < .05). Furthermore, they were more likely to use it more frequently (42.2%) than their counterparts (18.3%; P = .03). Less than 50% of caregivers used nutrition labels for determining the amount of calories or nutritional content in a food portion, to compare nutrient content for different brands of the same food or to select products low in sugar, fat, and/or sodium.

CONCLUSIONS

Our results provide evidence of the need to further explore nutritional label use and design that can better inform caregivers in Guatemala and other middle-income countries. Furthermore, given that the nutrition labels were for the most part rarely used by the participants in our study and that there are low literacy rates, other straightforward, easy-to-use strategies to communicate nutrition information at the point-of-sale could be useful to explore.

Are Food Labels Effective as a Means of Health Prevention?

Chronic diseases related to unbalanced and unhealthy eating habits have definitely become one of the major issues of modern age, not only in western countries but also in those ones where rapid economic growth has increased global prosperity levels. In order to avoid medical systems to collapse under excessive costs, International and Public Organizations strongly support health policies that aim to make people shift towards wholesome dietary patterns, also encouraging the use of food-labels to choose healthier products. To evaluate the consumers’ knowledge and perception about food-labels a brief questionnaire was developed and shared on Facebook between January-March 2016. Most of the participants were young adults with higher education. They declared to do their shopping at least once a week, reading the food-labels quite often. Despite owing limited knowledge in basic nutrition principles and food-labelling they were generally able to recognize healthier products looking over their nutritional fact tables. Anyway, on average, what they care the most about the products they purchase is the global quality level rather than the nutritional values. In order to induce the whole population to use food label as an effective self-protection tool, more efforts should be done to improve their knowledge on nutrition fundamentals and basics about food labelling, because that would make them able to take safer and more conscious choices as regards their own health.

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

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

Interest of functional foods for low-income countries

PURPOSE OF REVIEW

To understand the interest of functional food in low-income countries by analyzing various necessary factors.

RECENT FINDINGS

Being on a low income would appear to relate most often to an unbalanced diet, both qualitatively and quantitatively, which may be damaging to health in the long term. Most chronic diseases of concern today are multifactorial in origin. For control, an approach in which medicines and nutrition are considered together and complement each other may produce most successful and cost-effective management of health risk factors and chronic diseases. Functional food may become an important player at the interface between pharma and nutrition, and merit attention from both public health and a marketing perspective.

SUMMARY

In general, the health benefit of functional food is well established and the attitude both to functional food and to their low socioeconomic consumers is positive.

Nutrition knowledge: application and perception of food labels among women

Knowing the level of consumers' nutritional knowledge is useful for promoting dietary habits. The aim of this study was to assess women's nutritional knowledge and their food label perception and their correlates. Three hundred and eighty Women referring to four large supermarkets in Shiraz were selected for this study. Data were collected through face-to-face interview. The NKQ questionnaire was used for designing the study questionnaire. The first part contained demographic characteristics and the second section encompassed questions related to nutritional knowledge of consumers about food components. The third part consisted of questions about labeling. Data were analyzed using SPSS 16. ANOVA and t-test were used for analyzing multi-variant variables. Chi-square test was used for evaluating the relationship between variables. 49.7% of the participants were healthy and others had chronic diseases. The mean score of the women's nutrition knowledge was 20.13 (from 24) and the average knowledge of women about food components were near 50%. Consumers' information about food labels application was less than 50% for all situations. The lowest use of labels was about low-salt labels and the highest for calorie content of foods. There was a significant relationship between educational status and food label use and also a significant relationship between information about added sugar and using low-sugar labels and between knowledge about low-salt foods and using low-salt labels. A significant relationship was also seen between knowledge about fat and cholesterol use for low fat foods. So, label application was correlated with educational level and nutritional knowledge of women.