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Villaverde P, Tolentino-Mayo L, Cruz-Casarrubias C, Salgado JC, Aburto TC, Barquera S. Hypothetical impact of the Mexican front-of-pack labeling on intake of critical nutrients and energy. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:124. [PMID: 37941048 PMCID: PMC10631037 DOI: 10.1186/s41043-023-00462-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 10/27/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Since 2020 in Mexico, front-of-pack warning labels (FOPWL) have been implemented in processed products. Evidence supports warning labels allow consumers to identify unhealthy products. We aimed to evaluate the hypothetical impact of the FOPWL regulation on the Mexican population's intake of critical nutrients and energy, based on the replacement of food and beverages using 4 hypothetical scenarios which represented the phases of the regulation. METHODS Dietary data were collected using a standardized 24-h dietary recall from the 2016 Mexican National Health and Nutrition Survey (n = 4184). To evaluate the hypothetical impact of FOPWL, the nutritional content of critical nutrients in processed products was evaluated according to the Mexican Official Standard 051 (NOM-051). Then, we replaced products with several warning labels (WL) with those with a fewer number of them or with non-processed food. For the replacement, 4 hypothetical scenarios were established: scenario 1: the current consumption of the Mexican Population, scenario 2: the replacement during the first phase of the norm, scenario 3: the replacement in the second phase and scenario 4: the replacement in the last phase. We estimated the means, confidence intervals (CI 95%), and the mean percentage change of energy, saturated fat, trans-fat, added sugars, and sodium intake during the second, third, and the fourth scenarios. RESULTS According to the norm, in the second scenario, the majority of the products presented a label for energy (52.6%) whereas in the third (56.4%) and fourth (61.2%) scenarios were for sodium. In contrast, trans-fat was the least labeled nutrient in all the scenarios (from 2.1 to 4.1%). In the fourth scenario, we observed a reduction of the intake of energy intake to 15.4% as well as saturated fat (- 20%, CI 95% - 18.4; - 21.6), trans-fat (- 8.2%, CI 95% - 6.4; - 10.1) and sodium (- 12.7%, CI 95% - 11.3; - 14.1). The most important reduction was observed for added sugars intake (until - 54.1%, CI 95% - 51; - 57.1). CONCLUSIONS FOPWL could be an effective strategy to decrease energy consumption and nutrients of concern. If consumers use the FOPWL, it would be an important change in critical nutrients intake. These results support that FOPWL might help the Mexican population to choose healthier nutrition alternatives.
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Affiliation(s)
- Paola Villaverde
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Lizbeth Tolentino-Mayo
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico.
| | - Carlos Cruz-Casarrubias
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Juan C Salgado
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
- National Council of Humanities, Science and Technology, Mexico. Av. de los Insurgentes Sur 1582, Crédito Constructor, Benito Juárez, 03940, Mexico City, CDMX, Mexico
| | - Tania C Aburto
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
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Saavedra-Garcia L, Taboada-Ramirez X, Hernández-Vásquez A, Diez-Canseco F. Marketing techniques, health, and nutritional claims on processed foods and beverages before and after the implementation of mandatory front-of-package warning labels in Peru. Front Nutr 2022; 9:1004106. [PMID: 36407533 PMCID: PMC9666783 DOI: 10.3389/fnut.2022.1004106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/06/2022] [Indexed: 08/06/2023] Open
Abstract
In June 2019, mandatory front-of-package warning labels (FOPL) were implemented in Peru. The aim of the study was to describe changes in marketing strategies on packaging: marketing techniques (MT), health claims (HC), and nutritional claims (NC) on the packaging of products frequently consumed by children before and after the FOPL implementation. Product photos were taken pre- (March 2019) and post-implementation (March-October 2020) in three supermarkets in Lima, Peru. Following INFORMAS protocols and Peruvian Technical Norms, the presence of MT, HC, and NC was assessed on all package sides. Products were classified as "high-in" and "not high-in" based on the regulation threshold for critical nutrients. Differences in the proportion of products with each strategy in both periods were evaluated. Also, a subsample of products was matched according to the barcode and exact McNemar test was used to compare proportions of strategies pre/post-implementation. We included 883 and 1,035 products in pre- and post-implementation, respectively. In both periods, MT appeared on almost 70% of all products. The presence of HC increased significantly only for beverages (24.5-38.1%, p < 0.001). In both phases, NC were commonly used on beverages (>80%). Overall, the prevalence of "high-in" products using MT increased (73.6-82.1%, p = 0.007), while use of HC increased among "not high-in" products (32.9-41.6%, p < 0.001). There is a high frequency of MT on all products and NC on beverages. The increase in MT in "high-in" products may be an industry response to minimize the impact of the FOPL on food choices and sales. New regulatory aspects regarding labeling should be implemented to strengthen the current policy.
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Access to Healthy Wheat and Maize Processed Foods in Mexico City: Comparisons across Socioeconomic Areas and Store Types. Nutrients 2022; 14:nu14061173. [PMID: 35334830 PMCID: PMC8955009 DOI: 10.3390/nu14061173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/19/2022] [Accepted: 02/24/2022] [Indexed: 11/17/2022] Open
Abstract
The contributions of processed foods to the overweight and obesity problem in Latin America are well known. Engagement with the private and public sectors on possible solutions requires deeper insights into where and how these products are sold and the related implications for diet quality. This article characterizes the diversity of wheat and maize processed foods (WMPFs) available to consumers in Mexico City. Data were gathered across nine product categories at different points of sale (supermarkets, small grocery stores, convenience stores) in high and low socioeconomic (SE) areas. We assessed WMPFs based on Nutri-Score profile, price, and health and nutrition claims. Roughly 17.4% of the WMPFs were considered healthy, of which 62.2% were pastas and breads. Availability of healthy WMPFs was scarce in most stores, particularly in convenience stores Compared to supermarkets in the low SE area, those in the high SE area exhibited greater variety in access to healthy WMPFs across all product categories. In the low SE area, healthy WMPFs were priced 16–69% lower than unhealthy WMPFs across product categories. The extensive variety of unhealthy WMPFs, the limited stock of healthy WMPFs in most retail outlets, and the confusing health and nutrition claims on packaging make it difficult for urban consumers to find and choose healthy WMPFs.
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Katidi A, Pavlopoulou A, Vlassopoulos A, Kapsokefalou M. The Nutritional Composition of Natural and Organic Branded Food Products: A Cross-Sectional Analysis of the Greek Foodscape. Nutrients 2022; 14:nu14040808. [PMID: 35215458 PMCID: PMC8877405 DOI: 10.3390/nu14040808] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/08/2022] [Accepted: 02/11/2022] [Indexed: 01/27/2023] Open
Abstract
Modern consumers turn to foods marketed as ‘natural/organic’ in their pursuit of healthier options. However, research that links such claims made on pack with improved nutritional composition is limited. The current analysis used data from all packaged foods available in the Hellenic Food Thesaurus (n = 4002), sold in Greece from 09/2020 to 01/2021, to map the prevalence of packaged foods sold under a ‘natural/organic’ claim and to compare their nutritional composition against food group matched conventional counterparts. Statistical analysis was carried out using IBM SPSS Statistics®. Overall, ‘free from’ was the most commonly used claim (12.3%), followed by ‘natural/pure’ (9.1%), ‘fresh’ (4.6%), and ‘bio/organic’ (3.3%). Statistically significant differences between the nutritional composition of natural/organic and conventional foods were only found in 5 out of the 13 food categories and in 9 out of 39 subcategories. Being labelled as natural/organic was linked to improved nutritional composition for prepared foods and yogurts, while for breakfast cereal, there was a mixed effect with lower carbohydrate content but higher energy and fat content. Jams labelled as natural/organic had higher energy and total sugar content. Overall, evidence of an association between being labelled as natural/organic and having an improved nutritional composition was extremely rare.
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Labelling Assessment of Greek "Quality Label" Prepacked Cheeses as the Basis for a Branded Food Composition Database. Nutrients 2022; 14:nu14010230. [PMID: 35011104 PMCID: PMC8747277 DOI: 10.3390/nu14010230] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/26/2021] [Accepted: 01/01/2022] [Indexed: 01/26/2023] Open
Abstract
A labelling assessment study of Greek prepacked “quality label” cheeses was conducted with a view to provide an overview of the whole category. In total, 158 prepacked products belonging to 19 “quality label” cheeses were identified in the Greek market. Among them, Feta had the highest share followed by Kasseri, Graviera Kritis, Kefalograviera and Ladotyri Mitilinis with 81, 16, 15, 11 and 9 products found in the market, respectively. For the rest of the 14 cheeses, the share was limited, ranging from 1 to 4. All labelling indications, nutritional information, claims and other labelling data were recorded and analysed in relation to their compliance against European food law requirements. The results of the analysis showed that for only 6 of the 19 cheeses, all products fully complied with EU labelling legislation. Among the 14 mandatory labelling requirements, the lowest overall compliance was observed for allergens declaration (65%). The analysis of the nutritional data showed a remarkable variability between cheeses and products. Differences in the nutritional characteristics were more pronounced among soft, semi-hard, hard and whey cheese. The above data were entered into an archival database. Application of global harmonisation and standardisation guidelines and tools lead to the initialisation of a branded food composition database (BFCD), conceptualising a specialised database for “quality label” foods.
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Potter C, Bastounis A, Hartmann-Boyce J, Stewart C, Frie K, Tudor K, Bianchi F, Cartwright E, Cook B, Rayner M, Jebb SA. The Effects of Environmental Sustainability Labels on Selection, Purchase, and Consumption of Food and Drink Products: A Systematic Review. ENVIRONMENT AND BEHAVIOR 2021; 53:891-925. [PMID: 34456340 PMCID: PMC8384304 DOI: 10.1177/0013916521995473] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This review assessed the effects of environmental labels on consumers' demand for more sustainable food products. Six electronic databases were searched for experimental studies of ecolabels and food choices. We followed standard Cochrane methods and results were synthesized using vote counting. Fifty-six studies (N = 42,768 participants, 76 interventions) were included. Outcomes comprised selection (n = 14), purchase (n = 40) and consumption (n = 2). The ecolabel was presented as text (n = 36), logo (n = 13) or combination (n = 27). Message types included: organic (n = 25), environmentally sustainable (n = 27), greenhouse gas emissions (n = 17), and assorted "other" message types (n = 7). Ecolabels were tested in actual (n = 15) and hypothetical (n = 41) environments. Thirty-nine studies received an unclear or high RoB rating. Sixty comparisons favored the intervention and 16 favored control. Ecolabeling with a variety of messages and formats was associated with the selection and purchase of more sustainable food products.
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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.
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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.)
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Nutritional marketing of plant-based meat-analogue products: an exploratory study of front-of-pack and website claims in the USA. Public Health Nutr 2021; 24:4430-4441. [PMID: 34176542 DOI: 10.1017/s1368980021002792] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To explore how some of the largest food companies involved in producing alternative proteins (AP) use health and nutrition claims to market their products. DESIGN We identified the largest food manufacturers, meat processors and AP companies selling plant-based AP products in the USA. Using publicly available data, we analysed the voluntary health and nutrition claims made on front-of-pack labels (FOPL) and company webpages. We also analysed company websites for further nutrition and health-related statements about their products or AP more generally. Claim classification was guided by the INFORMAS (International Network for Food and Obesity/Non-Communicable Diseases Research, Monitoring, and Action Support) taxonomy for health-related food labelling. SETTING USA. PARTICIPANTS Not applicable. RESULTS 1394 health and nutrition-related FOPL claims were identified on 216 products, including 685 nutrition claims and 709 'other health-related' claims. No FOPL health claims were identified. Most nutrient claims were for nutrients associated with meat, with 94 % of products carrying a protein claim and 30 % carrying a cholesterol claim. 74 % of products carried a GMO-free claim, and 63 % carried a plant-based claim. On their websites, some companies expanded on these claims or discussed the health benefits of specific ingredients. CONCLUSIONS Companies involved in this category appear to be using nutritional marketing primarily to position their products in relation to meat. There is a focus on nutrient and ingredient claims, with discussion of processing largely avoided. The findings highlight the challenges companies face in positioning AP products as healthy against the backdrop of debates about ultra-processed foods.
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Cruz-Casarrubias C, Tolentino-Mayo L, Vandevijvere S, Barquera S. Estimated effects of the implementation of the Mexican warning labels regulation on the use of health and nutrition claims on packaged foods. Int J Behav Nutr Phys Act 2021; 18:76. [PMID: 34112183 PMCID: PMC8194035 DOI: 10.1186/s12966-021-01148-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 06/02/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The use of health and nutrition claims on front-of-pack labels may impact consumers' food choices; therefore, many countries have established regulations to avoid misinformation. This study describes the prevalence of health and nutrition claims on the front-of-pack of food products in retail stores in Mexico and estimate the potential effects of the Official Mexican Standards 051 (new regulation that includes specifications for implementing warning labels and other packaging elements such as health and nutrition claims on less healthy foods) on the prevalence of these claims. METHODS This is a cross-sectional study in which health and nutrition claims, nutrition information panels, and the list of ingredients of all foods and beverages available in the main retail stores in Mexico City were collected. The products were grouped by level of processing according to the NOVA food system classification. Claims were classified using the internationally harmonized INFORMAS taxonomy. According to the criteria of the new Mexican front-of-pack labelling regulation, the effect on the reduction on the prevalence of health and nutrition claims was estimated by type of food and by energy and nutrients of concern thresholds. RESULTS Of 17,264 products, 33.8% displayed nutrition claims and 3.4% health claims. In total, 80.8% of all products in the Mexican market were classified as "less healthy"; 48.2% of products had excess calories, 44.6% had excess sodium, and 40.7% excess free sugars. The new regulation would prevent 39.4% of products with claims from displaying health and nutrition claims (P < 0.001); the largest reduction is observed for ultra-processed foods (51.1%, P < 0.001). The regulation thresholds that resulted in the largest reduction of claims were calories (OR 0.62, P < 0.001) and non-sugar sweeteners (OR 0.54, P < 0.001). CONCLUSIONS The new Mexican front-of-pack labelling regulation will prevent most processed and ultra-processed foods from displaying health and nutrition claims and will potentially improve information on packaging for consumers.
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Affiliation(s)
- Carlos Cruz-Casarrubias
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Universidad No. 655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera. C.P, Cuernavaca, Morelos, 62100, Mexico
| | - Lizbeth Tolentino-Mayo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Universidad No. 655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera. C.P, Cuernavaca, Morelos, 62100, Mexico.
| | - Stefanie Vandevijvere
- Department of Epidemiology and Statistics, School of Population health, The University of Auckland, Auckland, New Zealand
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Universidad No. 655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera. C.P, Cuernavaca, Morelos, 62100, Mexico
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Prada M, Saraiva M, Viegas C, Cavalheiro BP, Garrido MV. Examining the Relationship between Sugar Content, Packaging Features, and Food Claims of Breakfast Cereals. Nutrients 2021; 13:nu13061841. [PMID: 34071159 PMCID: PMC8229424 DOI: 10.3390/nu13061841] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 01/14/2023] Open
Abstract
Excessive free-sugar intake has become highly prevalent in numerous countries, and Portugal is not the exception. One product category that contributes to the daily intake of free sugars is breakfast cereals. In the current work, we identified 289 exemplars from two major retailers in Portugal and collected information on their nutritional profile (e.g., sugar, salt, fiber per 100 g), price, packaging features, type of food claims present (e.g., statements about the composition, sensory features, the origin of the product), and ingredients list. Overall, the sugar content of breakfast cereals was high (Mean = 19.9 g), and less than 10% of the products complied with the current national guidelines (i.e., 5 g of sugar per 100 g of product). Sugar (or other sugar sources) was listed in the top three ingredients for over 85% of the products. On average, each product included about four claims (Mean = 3.9), and sugar content was lower when the claims were related to the product composition. Critically, the sugar content was particularly high for children-oriented products (Mean = 26.4 g). Correlation analysis showed that breakfast cereals with higher sugar content also were cheaper and had lower quantities of fiber, proteins, and salt. Our findings suggest the need to implement strategies to reduce sugar in this product category (e.g., incentivize manufacturers to reformulate products). Also, our results may inform strategies aimed at promoting consumers' awareness about the sugar content in breakfast cereals and other processed foods, facilitating healthier decision-making.
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Affiliation(s)
- Marília Prada
- Department of Social and Organizational Psychology, Iscte-Instituto Universitário de Lisboa, CIS_Iscte, Av. das Forças Armadas, Office AA110, 1649-026 Lisboa, Portugal; (M.S.); (B.P.C.); (M.V.G.)
- Correspondence: ; Tel.:+351-217-650-214
| | - Magda Saraiva
- Department of Social and Organizational Psychology, Iscte-Instituto Universitário de Lisboa, CIS_Iscte, Av. das Forças Armadas, Office AA110, 1649-026 Lisboa, Portugal; (M.S.); (B.P.C.); (M.V.G.)
| | - Claúdia Viegas
- Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Av. D. João II, Lote 4.69.0.1, Parque das Nações, 1990-096 Lisboa, Portugal;
- Centre for Tourism Research, Development and Innovation-Pòlo do Estoril, Avenida Condes de Barcelona, n.° 808, 2769-510 Estoril, Portugal
| | - Bernardo P. Cavalheiro
- Department of Social and Organizational Psychology, Iscte-Instituto Universitário de Lisboa, CIS_Iscte, Av. das Forças Armadas, Office AA110, 1649-026 Lisboa, Portugal; (M.S.); (B.P.C.); (M.V.G.)
| | - Margarida Vaz Garrido
- Department of Social and Organizational Psychology, Iscte-Instituto Universitário de Lisboa, CIS_Iscte, Av. das Forças Armadas, Office AA110, 1649-026 Lisboa, Portugal; (M.S.); (B.P.C.); (M.V.G.)
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Ogundijo DA, Tas AA, Onarinde BA. An assessment of nutrition information on front of pack labels and healthiness of foods in the United Kingdom retail market. BMC Public Health 2021; 21:220. [PMID: 33550987 PMCID: PMC7868120 DOI: 10.1186/s12889-021-10255-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/17/2021] [Indexed: 11/24/2022] Open
Abstract
Background Front of pack nutrition labelling is part of United Kingdom government’s programme of activities aiming to tackle diet-related diseases. There are several front of pack labelling formats available and they differ in the information they deliver. This study assessed the frequency of usage of front of pack food labelling systems on food products in the United Kingdom grocery market. It also measured the healthiness of some foods in the online market by categorising them according to their nutrient contents. Methods Five hundred food products in five categories [(1) cereals and cereal products, (2) dairy products, (3) beverages, (4) packaged meats and meat products, and (5) pre-packaged fruits and vegetables] from three main United Kingdom retail websites were investigated. A simple random sampling method was used for product selection according to the categories on the retailers’ websites. The healthiness of foods was also assessed by categorising them into ‘healthier’, ‘moderately healthy’ and ‘least healthy’ based on fat, saturated fat, salt and sugar contents. Results The total number of label types assessed comprises 19.6% of Guideline Daily Amounts or Reference Intakes and 43.8% had a combination of Traffic Light and Reference Intakes (hybrid label). Slightly over a quarter (27.4%) of products included nutritional information in a grid or table, 3.4% of the foods had two of any of the following: Health Logo, Reference Intakes and Traffic Light labels, and 5.8% did not have any Reference Intakes, Traffic Light, Health Logo or Hybrid label. Most of the foods assessed were manufactured in the United Kingdom with only 30.8% imported from 32 countries across four continents. Conclusions Traffic Light and Guideline Daily Amounts were the most used front of pack labelling formats on the assessed food product. A higher number of assessed products belonged to the “moderately healthy” and “healthier” categories than the “least healthy”. The imported foods that were found in the United Kingdom retail market showed that food choices could be made from the diverse food types.
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Affiliation(s)
- D A Ogundijo
- National Centre for Food Manufacturing, University of Lincoln, Holbeach, PE12 7PT, UK.
| | - A A Tas
- National Centre for Food Manufacturing, University of Lincoln, Holbeach, PE12 7PT, UK
| | - B A Onarinde
- National Centre for Food Manufacturing, University of Lincoln, Holbeach, PE12 7PT, UK
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Association Between Restaurant Menu Item Descriptions and Their Nutrient Content. Am J Prev Med 2021; 60:232-240. [PMID: 33482981 DOI: 10.1016/j.amepre.2020.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 08/18/2020] [Accepted: 08/21/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Item descriptions on restaurant menus often include claims about health and other attributes, and these are much less regulated than the language on packaged food labels. This study tests whether menu items with claims have different nutritional content from items without claims. METHODS Investigators compiled a data set of menu items, their claims, and their nutrition content using MenuStat. Data included 84,788 item-year observations at up to 96 of the top-selling restaurant chains from 2012 to 2018. Items were identified with general health, health-related ingredients, nutrient content, product sourcing, and vegan or vegetarian claims through a matching algorithm. Mixed-effects models were used to examine the effect of claims on calories, nutrients to limit (e.g., saturated fat and sodium), and other nutrients by dish types (sides, main dishes, desserts). RESULTS Most dishes with claims were lower in calories; however, items with claims were not consistently lower in other nutrients to limit (sodium, saturated fat, sugar, or trans fat). Vegan or vegetarian desserts had 128 mg (95% CI=20.9, 235.1) more sodium than desserts without this claim. Main and side dishes with claims had equivalent or higher sugar content than items without claims. Many items with claims were lower in saturated fat, especially main dishes with a nutrient content claim (-2.8 percentage points, 95% CI= -3.4, -2.2). CONCLUSIONS Items with claims were high in nutrients to limit. Additional efforts to increase transparency around excessive ingredients, such as the sodium warning labels, could be implemented by the restaurant industry.
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Scapin T, Fernandes AC, Curioni CC, Pettigrew S, Neal B, Coyle DH, Rodrigues VM, Bernardo GL, Uggioni PL, Proença RPC. Influence of sugar label formats on consumer understanding and amount of sugar in food choices: a systematic review and meta-analyses. Nutr Rev 2020; 79:788-801. [PMID: 33313917 DOI: 10.1093/nutrit/nuaa108] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
CONTEXT Reducing population intakes of sugar has become a focus of many national and international public health policies. Packaged foods and beverages are key contributors to sugar intakes, and food labels can be an effective tool to reduce sugar consumption. OBJECTIVE The aim of this systematic review was to examine the influence of sugar label formats on 2 outcomes: consumers' understanding of sugar information, and the amount of sugar in consumers' food choices. DATA SOURCES Scopus, Web of Science, PubMed, CAB Abstracts, SciELO, and the Cochrane Library databases were searched up until February 4, 2020. STUDY SELECTION Randomized experiments or quasi-experiments were included if they investigated the influence of sugar label formats on consumers' understanding of sugar information or on the amount of sugar in consumers' food choices. DATA EXTRACTION Data were extracted independently by 2 authors. Mean differences (MDs), standardized mean differences (SMDs), and odds ratios (ORs) plus 95%CIs were used to describe between-group differences for intervention label formats using random-effects models. RESULTS Twenty-three studies, which examined 39 comparisons, were included. Label formats using "high in sugar" interpretative texts (traffic light labels [MD 41.6; 95%CI 37.9-45.4] and warning signs [OR 1.33; 95%CI 1.0-1.78]) were most effective in increasing consumers' understanding of the sugar content in packaged foods. Health warning messages (SMD -0.32; 95%CI -0.43 to -0.22), graphical depictions of sugar content in teaspoons (SMD -0.32; 95%CI -0.48 to -0.17), and warning signs (SMD -0.24; 95%CI -0.35 to -0.13) were most effective for influencing consumers to choose products with lower sugar content. CONCLUSIONS Formats that provide an interpretation of sugar information, particularly those indicating if a product is high in sugar, were more helpful than only numerical information for improving consumer understanding and promoting food choices with less sugar. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42018081222.
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Affiliation(s)
- Tailane Scapin
- Nutrition Postgraduate Program, Nutrition in Foodservice Research Centre (NUPPRE), Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil.,The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Ana C Fernandes
- Nutrition Postgraduate Program, Nutrition in Foodservice Research Centre (NUPPRE), Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Cintia C Curioni
- Department of Social and Applied Nutrition, Institute of Nutrition, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Simone Pettigrew
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Bruce Neal
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Daisy H Coyle
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Vanessa M Rodrigues
- Nutrition Postgraduate Program, Nutrition in Foodservice Research Centre (NUPPRE), Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Greyce L Bernardo
- Nutrition Postgraduate Program, Nutrition in Foodservice Research Centre (NUPPRE), Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Paula L Uggioni
- Nutrition Postgraduate Program, Nutrition in Foodservice Research Centre (NUPPRE), Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Rossana P C Proença
- Nutrition Postgraduate Program, Nutrition in Foodservice Research Centre (NUPPRE), Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
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Are food and drink available in online and physical supermarkets the same? A comparison of product availability, price, price promotions and nutritional information. Public Health Nutr 2020; 24:819-825. [PMID: 33109282 DOI: 10.1017/s1368980020004346] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Online supermarkets are increasingly used both by consumers and as a source of data on the food environment. We compared product availability, nutritional information, front-of-pack (FOP) labelling, price and price promotions for food and drink products between physical and online supermarkets. DESIGN For physical stores, we collected data on price, price promotions, FOP nutrition labels and nutrition information from a random sample of food and drinks from six UK supermarkets. For online stores, we used foodDB, a research-ready dataset of over 14 million observations of food and drink products available in online supermarkets. SETTING Six large supermarket stores located near Oxford, UK. PARTICIPANTS General sample with 295 food and drink products, plus boost samples for both fruit and vegetables, and alcohol. RESULTS In the general sample, 85 % (95 % CI 80, 90 %) of products found in physical stores could be matched with an online product. Nutritional information found in the two settings was almost identical, for example, concordance correlation coefficient for energy = 0·995 (95 % CI 0·993, 0·996). The presence of FOP labelling and price promotions differed between the two settings (Cohen's kappa = 0·56 (95 % CI 0·45, 0·66) and 0·40 (95 % CI 0·26, 0·55), respectively). Prices were similar between online and physical supermarkets (concordance correlation coefficient > 0·9 for all samples). CONCLUSIONS Product availability, nutritional information and prices sourced online for these six retailers are good proxies of those found in physical stores. Price promotions and FOP labelling vary between the two settings. Further research should investigate whether this could impact on health inequalities.
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Botelho AM, Milbratz de Camargo A, Medeiros KJ, Irmão GB, Dean M, Fiates GMR. Supermarket Circulars Promoting the Sales of 'Healthy' Foods: Analysis Based on Degree of Processing. Nutrients 2020; 12:nu12092877. [PMID: 32967108 PMCID: PMC7551930 DOI: 10.3390/nu12092877] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 02/08/2023] Open
Abstract
The health and wellness food sector grew 98% from 2009 to 2014 in Brazil, the world's fourth-biggest market. The trend has reached supermarket circulars, which recently started to feature whole sections advertising health and wellness-enhancing foods. This study identified food items advertised in circulars' specific sections of two Brazilian supermarket chains (one regional, one national) during a 10-week period. Foods were classified according to degree of food processing and presence/type of claims on their front-of-pack (FoP) labels. Comparison between groups of Unprocessed/Minimally Processed foods vs. Ultra-processed foods and presence/type of claims employed Pearson chi-square test. From the 434 alleged health and wellness-enhancing foods advertised, around half (51.4%) were classified as Ultra-processed. Presence of reduced and increased nutrient-content claims was significantly higher in labels of Ultra-processed foods. Most frequent claims addressed sugar and fibre content. Brazilian supermarket circulars were found to be promoting the sale of Ultra-processed foods in their health and wellness sections, leading to a situation that can mislead the consumer and bring negative health outcomes.
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Affiliation(s)
- Alyne Michelle Botelho
- Graduate Program in Nutrition, Nutrition in Foodservice Research Centre, Federal University of Santa Catarina, University Campus João David Ferreira Lima-Trindade, Florianópolis, SC 88040-900, Brazil; (A.M.B.); (A.M.d.C.); (K.J.M.); (G.B.I.)
| | - Anice Milbratz de Camargo
- Graduate Program in Nutrition, Nutrition in Foodservice Research Centre, Federal University of Santa Catarina, University Campus João David Ferreira Lima-Trindade, Florianópolis, SC 88040-900, Brazil; (A.M.B.); (A.M.d.C.); (K.J.M.); (G.B.I.)
| | - Kharla Janinny Medeiros
- Graduate Program in Nutrition, Nutrition in Foodservice Research Centre, Federal University of Santa Catarina, University Campus João David Ferreira Lima-Trindade, Florianópolis, SC 88040-900, Brazil; (A.M.B.); (A.M.d.C.); (K.J.M.); (G.B.I.)
| | - Gabriella Beatriz Irmão
- Graduate Program in Nutrition, Nutrition in Foodservice Research Centre, Federal University of Santa Catarina, University Campus João David Ferreira Lima-Trindade, Florianópolis, SC 88040-900, Brazil; (A.M.B.); (A.M.d.C.); (K.J.M.); (G.B.I.)
| | - Moira Dean
- Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Belfast BT9 5DL, UK;
| | - Giovanna Medeiros Rataichesck Fiates
- Graduate Program in Nutrition, Nutrition in Foodservice Research Centre, Federal University of Santa Catarina, University Campus João David Ferreira Lima-Trindade, Florianópolis, SC 88040-900, Brazil; (A.M.B.); (A.M.d.C.); (K.J.M.); (G.B.I.)
- Correspondence:
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Vergeer L, Ahmed M, Franco-Arellano B, Mulligan C, Dickinson K, Bernstein JT, Labonté MÈ, L’Abbé MR. Methodology for the Determination of Fruit, Vegetable, Nut and Legume Points for Food Supplies without Quantitative Ingredient Declarations and Its Application to a Large Canadian Packaged Food and Beverage Database. Foods 2020; 9:foods9081127. [PMID: 32824211 PMCID: PMC7465889 DOI: 10.3390/foods9081127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 11/23/2022] Open
Abstract
Nutrient profiling (NP) models are useful tools for objectively and transparently quantifying the nutritional quality of packaged foods and beverages. Many NP models incorporate ingredients beneficial for health (e.g., fruits, vegetables, nuts, legumes (FVNL)) in addition to less healthful nutrients or components, assigning points based on the proportion of the product that contains FVNL ingredients. However, with food labelling in most countries lacking mandatory quantitative ingredient declarations (QUIDs), there is potential for the estimation of FVNL points to be ambiguous and inconsistent. The purpose of this article was to describe the development and application of methodology for estimating FVNL points for products without QUIDs, based on the position of FVNL components within the ingredients list. Using this method, FVNL points were calculated for packaged foods and beverages in the University of Toronto Food Label Information Program 2017 database (n = 17,337). Distributions of FVNL points were examined overall and by food category. This study provides evidence of the feasibility of this method in distinguishing between products with differing amounts of FVNL ingredients. This method will be valuable for researchers and policymakers in ensuring consistent, objective and reproducible estimations of FVNL points—and consequently, assessments of product healthfulness—for food supplies without QUIDs.
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Affiliation(s)
- Laura Vergeer
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.V.); (M.A.); (B.F.-A.); (C.M.); (K.D.); (J.T.B.); (M.-È.L.)
| | - Mavra Ahmed
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.V.); (M.A.); (B.F.-A.); (C.M.); (K.D.); (J.T.B.); (M.-È.L.)
| | - Beatriz Franco-Arellano
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.V.); (M.A.); (B.F.-A.); (C.M.); (K.D.); (J.T.B.); (M.-È.L.)
| | - Christine Mulligan
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.V.); (M.A.); (B.F.-A.); (C.M.); (K.D.); (J.T.B.); (M.-È.L.)
| | - Kacie Dickinson
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.V.); (M.A.); (B.F.-A.); (C.M.); (K.D.); (J.T.B.); (M.-È.L.)
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5001, Australia
| | - Jodi T. Bernstein
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.V.); (M.A.); (B.F.-A.); (C.M.); (K.D.); (J.T.B.); (M.-È.L.)
| | - Marie-Ève Labonté
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.V.); (M.A.); (B.F.-A.); (C.M.); (K.D.); (J.T.B.); (M.-È.L.)
- Centre Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods, Laval University, Québec City, QC G1V 0A6, Canada
| | - Mary R. L’Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.V.); (M.A.); (B.F.-A.); (C.M.); (K.D.); (J.T.B.); (M.-È.L.)
- Correspondence: ; Tel.: +1-416-946-7545
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Franco-Arellano B, Vanderlee L, Ahmed M, Oh A, L'Abbé M. Influence of front-of-pack labelling and regulated nutrition claims on consumers’ perceptions of product healthfulness and purchase intentions: A randomized controlled trial. Appetite 2020; 149:104629. [DOI: 10.1016/j.appet.2020.104629] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 02/03/2020] [Accepted: 02/09/2020] [Indexed: 01/17/2023]
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Downs SM, Ahmed S, Fanzo J, Herforth A. Food Environment Typology: Advancing an Expanded Definition, Framework, and Methodological Approach for Improved Characterization of Wild, Cultivated, and Built Food Environments toward Sustainable Diets. Foods 2020; 9:E532. [PMID: 32331424 PMCID: PMC7230632 DOI: 10.3390/foods9040532] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/01/2020] [Accepted: 04/10/2020] [Indexed: 02/07/2023] Open
Abstract
The food environment is a critical place in the food system to implement interventions to support sustainable diets and address the global syndemic of obesity, undernutrition, and climate change, because it contains the total scope of options within which consumers make decisions about which foods to acquire and consume. In this paper, we build on existing definitions of the food environment, and provide an expanded definition that includes the parameter of sustainability properties of foods and beverages, in order to integrate linkages between food environments and sustainable diets. We further provide a graphical representation of the food environment using a socio-ecological framework. Next, we provide a typology with descriptions of the different types of food environments that consumers have access to in low-, middle-, and high-income countries including wild, cultivated, and built food environments. We characterize the availability, affordability, convenience, promotion and quality (previously termed desirability), and sustainability properties of food and beverages for each food environment type. Lastly, we identify a methodological approach with potential objective and subjective tools and metrics for measuring the different properties of various types of food environments. The definition, framework, typology, and methodological toolbox presented here are intended to facilitate scholars and practitioners to identify entry points in the food environment for implementing and evaluating interventions that support sustainable diets for enhancing human and planetary health.
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Affiliation(s)
- Shauna M. Downs
- Department of Urban-Global Public Health, School of Public Health, Rutgers University, Newark, NJ 07102, USA;
| | - Selena Ahmed
- Sustainable Food Systems Program, Department of Health and Human Development, Montana State University, Bozeman, MT 59717, USA
| | - Jessica Fanzo
- Berman Institute of Bioethics, Nitze School of Advanced International Studies and Bloomberg School of Public Health, Johns Hopkins University, Washington, DC 21205, USA;
| | - Anna Herforth
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard, University Boston, MA 02125, USA;
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Nutritional Content, Labelling and Marketing of Breakfast Cereals on the Belgian Market and Their Reformulation in Anticipation of the Implementation of the Nutri-Score Front-Of-Pack Labelling System. Nutrients 2020; 12:nu12040884. [PMID: 32218115 PMCID: PMC7230794 DOI: 10.3390/nu12040884] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/20/2020] [Accepted: 03/23/2020] [Indexed: 12/27/2022] Open
Abstract
Objective: Breakfast cereals are frequently consumed in Belgium, especially among children. We investigated the nutritional content, labelling and marketing of breakfast cereals and the changes in nutrient content and reformulation in anticipation of the implementation of the Nutri-Score front-of-pack label. Design: Pictures were taken of cereal packages. The WHO-Europe nutrient profiling tool was used to classify cereals into ‘permitted’/‘not-permitted’ to be marketed to children, while the nutritional quality was assessed using Nutri-Score. The proportion of cereals with nutrition and health claims and/or promotional characters on the front-of-pack was compared between permitted and not-permitted cereals and between different Nutriscore categories using Chi-squared tests. The average nutrient contents per 100g were compared between 2017 and 2018 using paired t-tests. Setting: Belgium. Participants: All breakfast cereals in the major supermarkets (n = 7) in 2017 and 2018. Results: Overall, 330 cereals were included. About 77.2% of cereals were not permitted to be marketed to children but, of those, 22.0% displayed promotional characters. More claims (68.9% of all claims) were found on ‘not-permitted’ compared with ‘permitted’ cereals, particularly nutrition claims. Most claims were displayed on cereals with the allocated Nutri-Score A (42.0%) and C (37.0%). A significant reformulation of cereals was found between 2017 and 2018, with reductions in total sugar (−5%) (p < 0.001) and sodium (−20%) (p = 0.002) and increases in fibre (+3%) (p = 0.012) and proteins (+2%) (p = 0.002). Conclusion: Breakfast cereals on the Belgian market are predominantly unhealthy and frequently carry claims and promotional characters. Minimal reformulation occurred over one year. Policy recommendations include restrictions on claims and marketing for not-permitted cereals.
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20
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Improving Nutrition Information in the Eastern Mediterranean Region: Implementation of Front-Of-Pack Nutrition Labelling. Nutrients 2020; 12:nu12020330. [PMID: 31991939 PMCID: PMC7071186 DOI: 10.3390/nu12020330] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 01/10/2020] [Accepted: 01/19/2020] [Indexed: 11/22/2022] Open
Abstract
The provision of simplified nutrition information, in a prominent place on the front of food packages, is recommended as an important element of comprehensive strategies to tackle the burden of death and disease caused by unhealthy diets. There is growing evidence that front-of-pack nutrition labels are preferred by consumers, are more likely to be looked at or noticed than nutrition labelling on the back or side of packages and can help consumers to better identify healthier and less healthy products. This review summarizes current implementation of front-of-pack nutrition labelling policies in the countries of the WHO Eastern Mediterranean Region. Implementation of front-of-pack nutrition labelling in the Eastern Mediterranean Region remains limited, but three types of scheme were identified as having been implemented or at an advanced stage of development by governments in six countries. Through a review of reviews of existing research and evidence from country implementation, the authors suggest some pointers for implementation for other countries in the Region deciding to implement front-of-pack nutrition labelling policies.
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Vandevijvere S, Mackay S, D'Souza E, Swinburn B. The first INFORMAS national food environments and policies survey in New Zealand: A blueprint country profile for measuring progress on creating healthy food environments. Obes Rev 2019; 20 Suppl 2:141-160. [PMID: 31483561 DOI: 10.1111/obr.12850] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/13/2019] [Accepted: 02/26/2019] [Indexed: 12/30/2022]
Abstract
The International Network for Food and Obesity/NCDs Research, Monitoring and Action Support aims to benchmark national food environments. This study proposes a blueprint country profile to measure progress on creating healthy food environments, based on the results of the first, comprehensive survey in New Zealand (NZ). We assessed the implementation of national food environment policies and food industry commitments to improve population nutrition and the strength and comprehensiveness of public sector settings' nutrition policies. The healthiness of the packaged food supply, including health-related labelling, was evaluated. Food environments were measured in 833 schools, 204 supermarkets, 1500 takeaway outlets, 28 hospitals, 70 sport centres, and around all NZ schools. Food swamps, defined as areas with high relative density of unhealthy food outlets, were identified, and food marketing to children on television, websites, social media and packages, in magazines, and in and around schools was measured. The cost differential between healthy and current household diets was calculated for different population groups. NZ's food environment profile is largely unhealthy, and there are inequalities in access to healthy food environments. It is anticipated that the proposed country profile can help other countries tackle unhealthy food environments through increasing accountability of governments and the industry.
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Affiliation(s)
- Stefanie Vandevijvere
- School of Population Health, Department of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
| | - Sally Mackay
- School of Population Health, Department of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
| | - Erica D'Souza
- School of Population Health, Department of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
| | - Boyd Swinburn
- School of Population Health, Department of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
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The food environment in Latin America: a systematic review with a focus on environments relevant to obesity and related chronic diseases. Public Health Nutr 2019; 22:3447-3464. [PMID: 31666140 DOI: 10.1017/s1368980019002891] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Food environments may be contributing to the rapid increase in obesity occurring in most Latin American (LA) countries. The present study reviews literature from LA that (i) describes the food environment and policies targeting the food environment (FEP); and (ii) analytic studies that investigate associations between the FEP and dietary behaviours, overweight/obesity and obesity related chronic diseases. We focus on six dimensions of the FEP: food retail, provision, labelling, marketing, price and composition. DESIGN Systematic literature review. Three databases (Web of Science, SciELO, LILACS) were searched, from 1 January 1999 up to July 2017. Two authors independently selected the studies. A narrative synthesis was used to summarize, integrate and interpret findings. SETTING Studies conducted in LA countries. PARTICIPANTS The search yielded 2695 articles of which eighty-four met inclusion criteria. RESULTS Most studies were descriptive and came from Brazil (61 %), followed by Mexico (18 %) and Guatemala (6 %). Studies were focused primarily on retail/provision (n 27), marketing (n 16) and labelling (n 15). Consistent associations between availability of fruit and vegetable markets and higher consumption of fruits and vegetables were found in cross-sectional studies. Health claims in food packaging were prevalent and mostly misleading. There was widespread use of marketing strategies for unhealthy foods aimed at children. Food prices were lower for processed relative to fresh foods. Some studies documented high sodium in industrially processed foods. CONCLUSIONS Gaps in knowledge remain regarding policy evaluations, longitudinal food retail studies, impacts of food price on diet and effects of digital marketing on diet/health.
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Harrington RA, Adhikari V, Rayner M, Scarborough P. Nutrient composition databases in the age of big data: foodDB, a comprehensive, real-time database infrastructure. BMJ Open 2019; 9:e026652. [PMID: 31253615 PMCID: PMC6609072 DOI: 10.1136/bmjopen-2018-026652] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Traditional methods for creating food composition tables struggle to cope with the large number of products and the rapid pace of change in the food and drink marketplace. This paper introduces foodDB, a big data approach to the analysis of this marketplace, and presents analyses illustrating its research potential. DESIGN foodDB has been used to collect data weekly on all foods and drinks available on six major UK supermarket websites since November 2017. As of June 2018, foodDB has 3 193 171 observations of 128 283 distinct food and drink products measured at multiple timepoints. METHODS Weekly extraction of nutrition and availability data of products was extracted from the webpages of the supermarket websites. This process was automated with a codebase written in Python. RESULTS Analyses using a single weekly timepoint of 97 368 total products in March 2018 identified 2699 ready meals and pizzas, and showed that lower price ready meals had significantly lower levels of fat, saturates, sugar and salt (p<0.001). Longitudinal analyses of 903 pizzas revealed that 10.8% changed their nutritional formulation over 6 months, and 29.9% were either discontinued or new market entries. CONCLUSIONS foodDB is a powerful new tool for monitoring the food and drink marketplace, the comprehensive sampling and granularity of collection provides power for revealing analyses of the relationship between nutritional quality and marketing of branded foods, timely observation of product reformulation and other changes to the food marketplace.
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Affiliation(s)
- Richard Andrew Harrington
- Nuffield Department of Population Health, University of Oxford Nuffield Department of Population Health, Oxford, UK
| | - Vyas Adhikari
- Nuffield Department of Population Health, University of Oxford Nuffield Department of Population Health, Oxford, UK
| | - Mike Rayner
- Nuffield Department of Population Health, University of Oxford Nuffield Department of Population Health, Oxford, UK
| | - Peter Scarborough
- Nuffield Department of Population Health, University of Oxford Nuffield Department of Population Health, Oxford, UK
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Franco-Arellano B, Kim MA, Vandevijvere S, Bernstein JT, Labonté MÈ, Mulligan C, L'Abbé MR. Assessment of Packaged Foods and Beverages Carrying Nutrition Marketing against Canada's Food Guide Recommendations. Nutrients 2019; 11:E411. [PMID: 30781351 PMCID: PMC6412409 DOI: 10.3390/nu11020411] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 02/10/2019] [Accepted: 02/13/2019] [Indexed: 02/07/2023] Open
Abstract
Canadians' food purchases consist largely of packaged processed and ultra-processed products, which typically fall outside the "core" foods recommended by Canada's Food Guide (CFG). Almost half of packaged products in Canada carry nutrition marketing (i.e., nutrient content and health claims). This study assessed whether packaged foods carrying nutrition marketing align with recommendations outlined in the 2007 CFG. Label data (n = 9376) were extracted from the 2013 Food Label Information Program (FLIP). Label components (including nutrition marketing) were classified using the International Network for Food and Obesity/NCDs Research, Monitoring and Action Support (INFORMAS) labelling taxonomy. The Health Canada Surveillance Tool (HCST) was used to assess the alignment of products to CFG. Each food or beverage was classified into one of five groups (i.e., Tier 1, Tier 2, Tier 3, Tier 4, "Others"). Products in Tier 1, 2 or water were considered "in line with CFG". Most products in the analyzed sample were classified as Tier 2 (35%) and Tier 3 (27%). Although foods with nutrition marketing were significantly more likely to align to CFG recommendations (p < 0.001), many products not "in line with CFG" still carried nutrition marketing. This study provides important baseline data that could be used upon the implementation of the new CFG.
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Affiliation(s)
- Beatriz Franco-Arellano
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
| | - Min Ah Kim
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada.
| | - Stefanie Vandevijvere
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland 1010, New Zealand.
| | - Jodi T Bernstein
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
| | - Marie-Ève Labonté
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
- School of Nutrition & Institute of Nutrition and Functional Foods, Laval University, Québec, QC G1V 0A6, Canada.
| | - Christine Mulligan
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
| | - Mary R L'Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
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Devenish G, Golley R, Mukhtar A, Begley A, Ha D, Do L, Scott JA. Free Sugars Intake, Sources and Determinants of High Consumption among Australian 2-Year-Olds in the SMILE Cohort. Nutrients 2019; 11:E161. [PMID: 30642136 PMCID: PMC6356352 DOI: 10.3390/nu11010161] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 01/09/2019] [Accepted: 01/09/2019] [Indexed: 11/17/2022] Open
Abstract
In the first 2 years of life, it is important to limit exposure to foods high in free sugars, in order to lay foundations for lifelong eating patterns associated with a reduced risk of chronic disease. Intake data at this age is limited, so compliance with recommendations is not known. This analysis describes free sugars intakes, food sources and determinants of high consumption among Australian children at 2 years of age. Free sugars intakes were estimated using a customized Food Frequency Questionnaire, and median usual free sugars intake at 2 years was 22.5 (Interquartile Range (IQR) 12.8⁻37.7) g/day, contributing a median 8% of the estimated energy requirement (EER). Based on the EER, most children (71.1%) exceeded the World Health Organization recommendation that <5% of energy should come from free sugars, with 38% of participants exceeding the <10% recommendation. Children from households with the greatest socioeconomic disadvantage were more likely to exceed the 10% recommendation (Prevalence Ratio (PR) 1.44, 95% Confidence Interval (95% CI) 1.13⁻1.84), and be in the top tertile for free sugars intake (PR 1.58, 95% CI 1.19⁻2.10) than the least disadvantaged. Main sources of free sugars were non-core foods, such as fruit juice, biscuits, cakes, desserts and confectionery; with yogurt and non-dairy milk alternatives the two notable exceptions. Improved efforts to reduce free sugars are needed from the introduction of solid food, with a particular focus on fruit juice and non-core foods.
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Affiliation(s)
- Gemma Devenish
- School of Public Health, Curtin University, Perth 6102, Australia.
| | - Rebecca Golley
- College of Nursing and Health Sciences, Flinders University, Adelaide 5000, Australia.
| | - Aqif Mukhtar
- School of Public Health, Curtin University, Perth 6102, Australia.
| | - Andrea Begley
- School of Public Health, Curtin University, Perth 6102, Australia.
| | - Diep Ha
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide 5000, Australia.
| | - Loc Do
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide 5000, Australia.
| | - Jane A Scott
- School of Public Health, Curtin University, Perth 6102, Australia.
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The prevalence and audience reach of food and beverage advertising on Chilean television according to marketing tactics and nutritional quality of products. Public Health Nutr 2018; 22:1113-1124. [PMID: 30486917 DOI: 10.1017/s1368980018003130] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE In the light of Chile's comprehensive new restriction on unhealthy food marketing, we analyse food advertising on Chilean television prior to the first and final phases of implementation of the restriction. DESIGN Content analysis of marketing strategies of 6976 advertisements, based on products' nutritional quality. Statistical analysis of total and child audience reached using television ratings data. SETTING Advertising from television aired between 06.00 and 00.00 hours during two random composite weeks across April-May 2016 from the four broadcast and four cable channels with the largest youth audiences. RESULTS Food ads represented 16 % of all advertising; 34 % of food ads featured a product high in energy, saturated fats, sugars and/or salt (HEFSS), as defined by the initial regulation. HEFSS ads were seen by more children and contained more child-directed marketing strategies than ads without HEFSS foods. If HEFSS advertising was restricted only in programmes where 20 % are children aged 4-12 years, 31 % of children's and 8 % of the general audience's HEFSS advertising exposure would be reduced. The newest 06.00-22.00 hours restriction captures 80 % of all audience exposure. CONCLUSIONS HEFSS advertising was seen by a large proportion of children before Chile's regulation. Chile's first implementation based on audience composition should reduce a third of this exposure and its second restriction across the television day should eliminate most of the exposure. The current study is a crucial first step in evaluating how Chile's regulation efforts will impact children's diets and obesity prevalence.
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Pulker CE, Trapp GSA, Foulkes-Taylor F, Scott JA, Pollard CM. The extent and nature of supermarket own brand foods in Australia: study protocol for describing the contribution of selected products to the healthfulness of food environments. Nutr J 2018; 17:95. [PMID: 30359258 PMCID: PMC6201490 DOI: 10.1186/s12937-018-0404-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 10/14/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While public health experts have identified food environments as a driver of poor diet, they also hold great potential to reduce obesity, non-communicable diseases, and their inequalities. Supermarkets are the dominant retail food environment in many developed countries including Australia. The contribution of supermarket own brands to the healthfulness of retail food environments has not yet been explored. The aim of this protocol is to describe the methods developed to examine the availability, nutritional quality, price, placement and promotion of supermarket own brand foods within Australian supermarkets. METHODS Photographic audits of all supermarket own brand foods present in three major food retail outlets were conducted. Two researchers conducted the supermarket audits in Perth, Western Australia in February 2017. Photographs showing the location of the in-store product display, location of products on shelves, use of display materials, and front-of-pack and shelf-edge labels were taken for each supermarket own brand food present. An electronic filing system was established for photographs from each of the supermarkets and an Excel database constructed. The following data were extracted from the photographs: front-of-pack product information (e.g. product and brand name, pack weight); packaging and label design attributes (e.g. country of origin; marketing techniques conveying value for money and convenience); shelf-edge label price and promotion information; placement and prominence of each product; and nutrition and health information (including supplementary nutrition information, nutrition and health claims, and marketing statements and claims). Nutritional quality of each product was assessed using the principles of the Australian Guide to Healthy Eating, the NOVA classification of level of food processing, and the Health Star Rating score displayed on the front-of-pack. DISCUSSION Approximately 20,000 photographic images were collected for 3940 supermarket own brand foods present in this audit: 1812 in the Woolworths store, 1731 in the Coles store, and 397 in the IGA store. Analysis of findings will enable researchers to identify opportunities for interventions to improve the contribution of supermarket own brands to healthful retail food environments. This protocol is unique as it aims to investigate all aspects of retail food environments and address the contribution of supermarket own brands.
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Affiliation(s)
- Claire Elizabeth Pulker
- School of Public Health, Curtin University, Kent Street, GPO Box U1987, Perth, Western Australia, 6845, Australia. .,Curtin University, School of Public Health, Kent Street, Bentley, Western Australia, 6012, Australia.
| | - Georgina S A Trapp
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia, 6872, Australia.,School of Population and Global Health, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia
| | - Frances Foulkes-Taylor
- School of Public Health, Curtin University, Kent Street, GPO Box U1987, Perth, Western Australia, 6845, Australia
| | - Jane Anne Scott
- School of Public Health, Curtin University, Kent Street, GPO Box U1987, Perth, Western Australia, 6845, Australia
| | - Christina Mary Pollard
- School of Public Health, Curtin University, Kent Street, GPO Box U1987, Perth, Western Australia, 6845, Australia.,East Metropolitan Health Service, Kirkman House, 20 Murray Street, East Perth, Western Australia, 6004, Australia
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Industry use of ‘better-for-you’ features on labels of sugar-containing beverages. Public Health Nutr 2018; 21:3335-3343. [DOI: 10.1017/s1368980018002392] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveTo examine the ways in which sugar-containing beverages are being portrayed as ‘better-for-you’ (BFY) via features on product labels.DesignCross-sectional audit of beverage labels.SettingAdelaide, Australia. Data on beverage labels were collected from seventeen grocery stores during September to November 2016.SubjectsThe content of 945 sugar-containing beverages labels were analysed for explicit and implicit features positioning them as healthy or BFY.ResultsThe mean sugar content of beverages was high at 8·3 g/100 ml and most sugar-containing beverages (87·7 %) displayed features that position them as BFY. This was most commonly achieved by indicating the beverages are natural (76·8 %), or contain reduced or natural energy/sugar content (48·4 %), or through suggesting that they contribute to meeting bodily needs for nutrition (28·9 %) or health (15·1 %). Features positioning beverages as BFY were more common among certain categories of beverages, namely coconut waters, iced teas, sports drinks and juices.ConclusionsA large proportion of sugar-containing beverages use features on labels that position them as healthy or BFY despite containing high amounts of sugar.
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Brownbill AL, Braunack-Mayer A, Miller C. Health Star Ratings: What's on the labels of Australian beverages? Health Promot J Austr 2018; 30:114-118. [PMID: 30156049 DOI: 10.1002/hpja.197] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 08/24/2018] [Indexed: 11/12/2022] Open
Abstract
ISSUE ADDRESSED The Health Star Rating (HSR) System provides a useful tool to communicate health and nutrition messages to consumers. Given the large contribution from sugar-containing beverages to sugar intake in the Australian diet and the adverse health outcomes associated with frequent consumption, it is important to investigate how the HSR System is displayed on beverages. Our research measured and compared the presence of the HSR System on the labels of sugar-containing and sugar-free beverages in Australia. METHODS We conducted a survey of the labels on 762 ready-to-drink (≤600 mL) nondairy/nonalcoholic beverages, sampled from 17 South Australian supermarkets in late 2016. We measured the presence of a star rating icon or an energy-only icon (which is an option of the HSR System for beverages). RESULTS The HSR System was observed on 35.3% of beverages, with only 6.8% displaying a star rating icon and 28.5% displaying an energy-only icon. When present (n = 52), star rating icons were almost universally 5 stars (94.2%), and of these, they were predominantly displayed on 100% juices (85.7%). Almost all beverages with a star rating contained high amounts of sugar; only three sugar-free beverages displayed a star rating. CONCLUSION We found that there are low uptake and limited use of the HSR System on beverages. SO WHAT?: The HSR System on beverages could better achieve its objectives if the energy-only icon were removed from the graphic options, the algorithm were adjusted so that 100% juices cannot display a 5-star rating, and the System were made mandatory.
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Affiliation(s)
- Aimee L Brownbill
- School of Public Health, The University of Adelaide, Adelaide, SA, Australia.,Population Health, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Annette Braunack-Mayer
- School of Public Health, The University of Adelaide, Adelaide, SA, Australia.,School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Caroline Miller
- School of Public Health, The University of Adelaide, Adelaide, SA, Australia.,Population Health, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
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Franco-Arellano B, Labonté MÈ, Bernstein JT, L'Abbé MR. Examining the Nutritional Quality of Canadian Packaged Foods and Beverages with and without Nutrition Claims. Nutrients 2018; 10:E832. [PMID: 29954102 PMCID: PMC6073495 DOI: 10.3390/nu10070832] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 06/22/2018] [Accepted: 06/24/2018] [Indexed: 11/17/2022] Open
Abstract
Nutrient content claims, health claims, and front-of-pack symbols (henceforth referred to as “nutrition claims” in the present study) are often found on food labels in Canada. However, it is currently unknown whether foods and beverages (F&Bs) carrying nutrition claims have a more favourable nutritional profile than those without such claims. This study examined differences in the global nutritional quality, as determined by the Food Standards Australia New Zealand Nutrient Profiling Scoring Criterion (FSANZ-NPSC), of Canadian F&B bearing nutrition claims as compared to those without, as well as in their nutritional composition. Data (n = 15,184) was obtained from the University of Toronto 2013 Food Label Information Program. Forty-two percent of F&Bs carrying nutrition claims (n = 2930/6990) were found to be ineligible to carry claims based on the FSANZ-NPSC, in comparison to 66% of F&Bs without (n = 5401/8194, p < 0.001). Sugars and sweets, and miscellaneous products were the food categories with larger proportions of foods carrying nutrition claims not meeting the FSANZ-NPSC eligibility criteria. F&Bs with nutrition claims had fewer calories, less saturated fat, sodium, and sugar, and higher content of protein and fibre than comparable products without nutrition claims (p < 0.05 in all cases). In conclusion, nearly half of F&Bs carrying nutrition claims in Canada did not meet the FSANZ-NPSC threshold, although Canadian products carrying nutrition claims have an overall “healthier” profile than their counterparts without such claims.
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Affiliation(s)
- Beatriz Franco-Arellano
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 3E2, Canada.
| | - Marie-Ève Labonté
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 3E2, Canada.
- Institute of Nutrition and Functional Foods, Laval University, Québec, QC G1V 0A6, Canada.
| | - Jodi T Bernstein
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 3E2, Canada.
| | - Mary R L'Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 3E2, Canada.
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Cost-Effectiveness of Product Reformulation in Response to the Health Star Rating Food Labelling System in Australia. Nutrients 2018; 10:nu10050614. [PMID: 29757979 PMCID: PMC5986494 DOI: 10.3390/nu10050614] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 05/01/2018] [Accepted: 05/10/2018] [Indexed: 01/15/2023] Open
Abstract
The Health Star Rating (HSR) system is a voluntary front-of-pack labelling (FoPL) initiative endorsed by the Australian government in 2014. This study examines the impact of the HSR system on pre-packaged food reformulation measured by changes in energy density between products with and without HSR. The cost-effectiveness of the HSR system was modelled using a proportional multi-state life table Markov model for the 2010 Australian population. We evaluated scenarios in which the HSR system was implemented on a voluntary and mandatory basis (i.e., HSR uptake across 6.7% and 100% of applicable products, respectively). The main outcomes were health-adjusted life years (HALYs), net costs, and incremental cost-effectiveness ratios (ICERs). These were calculated with accompanying 95% uncertainty intervals (95% UI). The model predicted that HSR-attributable reformulation leads to small changes [corrected] in mean population energy intake (voluntary: -0.98 kJ/day; mandatory: -11.81 kJ/day). [corrected]. These are likely to result in changes in mean body weight (voluntary: -0.01 kg [95% UI: -0.012 to -0.006]; mandatory: -0.11 kg [95% UI: -0.14 to -0.07, and HALYs gained [corrected] (voluntary: 4207 HALYs gained [corrected] [95% UI: 2438 to 6081]; mandatory: 49,949 HALYs gained [95% UI: 29,291 to 72,153]). The HSR system [corrected] could be considered cost-effective relative to a willingness-to-pay threshold of A$50,000 per HALY (incremental cost effectiveness ratio for voluntary: [corrected] A$1728 per HALY [95% UI: dominant to 10,445] and mandatory: A$4752 per HALY [95% UI: dominant to 16,236]).
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Carter P, Bignardi G, Hollands GJ, Marteau TM. Information-based cues at point of choice to change selection and consumption of food, alcohol and tobacco products: a systematic review. BMC Public Health 2018; 18:418. [PMID: 29587686 PMCID: PMC5872569 DOI: 10.1186/s12889-018-5280-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 03/08/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Reducing harmful consumption of food, alcohol, and tobacco products would prevent many cancers, diabetes and cardiovascular disease. Placing information-based cues in the environments in which we select and consume these products has the potential to contribute to changing these behaviours. METHODS In this review, information-based cues are defined as those which comprise any combination of words, symbols, numbers or pictures that convey information about a product or its use. We specifically exclude cues which are located on the products themselves. We conducted a systematic review of randomised, cluster- randomised, and non-randomised controlled trials to assess the impact of such cues on selection and consumption. Thirteen studies met the inclusion criteria, of which 12 targeted food (most commonly fruit and vegetables), one targeted alcohol sales, and none targeted tobacco products. RESULTS Ten studies reported statistically significant effects on some or all of the targeted products, although studies were insufficiently homogenous to justify meta-analysis. Existing evidence suggests information-based cues can influence selection and consumption of food and alcohol products, although significant uncertainty remains. CONCLUSIONS The current evidence base is limited both in quality and quantity, with relatively few, heterogeneous studies at unclear or high risk of bias. Additional, more rigorously conducted studies are warranted to better estimate the potential for these interventions to change selection and consumption of food, alcohol and tobacco products. TRIAL REGISTRATION PROSPERO. 2016; CRD42016051884 .
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Affiliation(s)
- Patrice Carter
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Giacomo Bignardi
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | | | - Theresa M. Marteau
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
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Front-of-package nutrition labelling policy: global progress and future directions. Public Health Nutr 2018; 21:1399-1408. [PMID: 29559017 DOI: 10.1017/s1368980018000010] [Citation(s) in RCA: 167] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Allen S, de Brauw A. Nutrition sensitive value chains: Theory, progress, and open questions. GLOBAL FOOD SECURITY-AGRICULTURE POLICY ECONOMICS AND ENVIRONMENT 2018. [DOI: 10.1016/j.gfs.2017.07.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Crockett RA, King SE, Marteau TM, Prevost AT, Bignardi G, Roberts NW, Stubbs B, Hollands GJ, Jebb SA. Nutritional labelling for healthier food or non-alcoholic drink purchasing and consumption. Cochrane Database Syst Rev 2018; 2:CD009315. [PMID: 29482264 PMCID: PMC5846184 DOI: 10.1002/14651858.cd009315.pub2] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Nutritional labelling is advocated as a means to promote healthier food purchasing and consumption, including lower energy intake. Internationally, many different nutritional labelling schemes have been introduced. There is no consensus on whether such labelling is effective in promoting healthier behaviour. OBJECTIVES To assess the impact of nutritional labelling for food and non-alcoholic drinks on purchasing and consumption of healthier items. Our secondary objective was to explore possible effect moderators of nutritional labelling on purchasing and consumption. SEARCH METHODS We searched 13 electronic databases including CENTRAL, MEDLINE and Embase to 26 April 2017. We also handsearched references and citations and sought unpublished studies through websites and trials registries. SELECTION CRITERIA Eligible studies: were randomised or quasi-randomised controlled trials (RCTs/Q-RCTs), controlled before-and-after studies, or interrupted time series (ITS) studies; compared a labelled product (with information on nutrients or energy) with the same product without a nutritional label; assessed objectively measured purchasing or consumption of foods or non-alcoholic drinks in real-world or laboratory settings. DATA COLLECTION AND ANALYSIS Two authors independently selected studies for inclusion and extracted study data. We applied the Cochrane 'Risk of bias' tool and GRADE to assess the quality of evidence. We pooled studies that evaluated similar interventions and outcomes using a random-effects meta-analysis, and we synthesised data from other studies in a narrative summary. MAIN RESULTS We included 28 studies, comprising 17 RCTs, 5 Q-RCTs and 6 ITS studies. Most (21/28) took place in the USA, and 19 took place in university settings, 14 of which mainly involved university students or staff. Most (20/28) studies assessed the impact of labelling on menus or menu boards, or nutritional labelling placed on, or adjacent to, a range of foods or drinks from which participants could choose. Eight studies provided participants with only one labelled food or drink option (in which labelling was present on a container or packaging, adjacent to the food or on a display board) and measured the amount consumed. The most frequently assessed labelling type was energy (i.e. calorie) information (12/28).Eleven studies assessed the impact of nutritional labelling on purchasing food or drink options in real-world settings, including purchases from vending machines (one cluster-RCT), grocery stores (one ITS), or restaurants, cafeterias or coffee shops (three RCTs, one Q-RCT and five ITS). Findings on vending machines and grocery stores were not interpretable, and were rated as very low quality. A meta-analysis of the three RCTs, all of which assessed energy labelling on menus in restaurants, demonstrated a statistically significant reduction of 47 kcal in energy purchased (MD -46.72 kcal, 95% CI -78.35, -15.10, N = 1877). Assuming an average meal of 600 kcal, energy labelling on menus would reduce energy purchased per meal by 7.8% (95% CI 2.5% to 13.1%). The quality of the evidence for these three studies was rated as low, so our confidence in the effect estimate is limited and may change with further studies. Of the remaining six studies, only two (both ITS studies involving energy labels on menus or menus boards in a coffee shop or cafeteria) were at low risk of bias, and their results support the meta-analysis. The results of the other four studies which were conducted in a restaurant, cafeterias (2 studies) or a coffee shop, were not clearly reported and were at high risk of bias.Seventeen studies assessed the impact of nutritional labels on consumption in artificial settings or scenarios (henceforth referred to as laboratory studies or settings). Of these, eight (all RCTs) assessed the effect of labels on menus or placed on a range of food options. A meta-analysis of these studies did not conclusively demonstrate a reduction in energy consumed during a meal (MD -50 kcal, 95% CI -104.41, 3.88, N = 1705). We rated the quality of the evidence as low, so our confidence in the effect estimate is limited and may change with further studies.Six laboratory studies (four RCTs and two Q-RCTs) assessed the impact of labelling a single food or drink option (such as chocolate, pasta or soft drinks) on energy consumed during a snack or meal. A meta-analysis of these studies did not demonstrate a statistically significant difference in energy (kcal) consumed (SMD 0.05, 95% CI -0.17 to 0.27, N = 732). However, the confidence intervals were wide, suggesting uncertainty in the true effect size. We rated the quality of the evidence as low, so our confidence in the effect estimate is limited and may change with further studies.There was no evidence that nutritional labelling had the unintended harm of increasing energy purchased or consumed. Indirect evidence came from five laboratory studies that involved mislabelling single nutrient content (i.e. placing low energy or low fat labels on high-energy foods) during a snack or meal. A meta-analysis of these studies did not demonstrate a statistically significant increase in energy (kcal) consumed (SMD 0.19, 95% CI -0.14to 0.51, N = 718). The effect was small and the confidence intervals wide, suggesting uncertainty in the true effect size. We rated the quality of the evidence from these studies as very low, providing very little confidence in the effect estimate. AUTHORS' CONCLUSIONS Findings from a small body of low-quality evidence suggest that nutritional labelling comprising energy information on menus may reduce energy purchased in restaurants. The evidence assessing the impact on consumption of energy information on menus or on a range of food options in laboratory settings suggests a similar effect to that observed for purchasing, although the evidence is less definite and also of low quality.Accordingly, and in the absence of observed harms, we tentatively suggest that nutritional labelling on menus in restaurants could be used as part of a wider set of measures to tackle obesity. Additional high-quality research in real-world settings is needed to enable more certain conclusions.Further high-quality research is also needed to address the dearth of evidence from grocery stores and vending machines and to assess potential moderators of the intervention effect, including socioeconomic status.
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Affiliation(s)
- Rachel A Crockett
- Division of Psychology, University of Stirling, Stirling, UK, FK9 4LA
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Declaration of nutrition information on and nutritional quality of Thai ready-to-eat packaged food products. Public Health Nutr 2018; 21:1409-1417. [PMID: 29317011 DOI: 10.1017/s1368980017003792] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The present study assessed the nutrition information displayed on ready-to-eat packaged foods and the nutritional quality of those food products in Thailand. DESIGN In March 2015, the nutrition information panels and nutrition and health claims on ready-to-eat packaged foods were collected from the biggest store of each of the twelve major retailers, using protocols developed by the International Network for Food and Obesity/Non-communicable Diseases Research, Monitoring and Action Support (INFORMAS). The Thai Nutrient Profile Model was used to classify food products according to their nutritional quality as 'healthier' or 'less healthy'. RESULTS In total, information from 7205 food products was collected across five broad food categories. Out of those products, 5707 (79·2 %), 2536 (35·2 %) and 1487 (20·6 %) carried a nutrition facts panel, a Guideline Daily Amount (GDA) label and health-related claims, respectively. Only 4691 (65·1 %) and 2484 (34·5 %) of the products that displayed the nutrition facts or a GDA label, respectively, followed the guidelines of the Thai Food and Drug Administration. In total, 4689 products (65·1 %) could be classified according to the Thai Nutrient Profile Model, of which 432 products (9·2 %) were classified as healthier. Moreover, among the 1487 products carrying health-related claims, 1219 (82·0 %) were classified as less healthy. Allowing less healthy food products to carry claims could mislead consumers and result in overconsumption of ready-to-eat food products. CONCLUSIONS The findings suggest effective policies should be implemented to increase the relative availability of healthier ready-to-eat packaged foods, as well as to improve the provision of nutrition information on labels in Thailand.
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Talati Z, Pettigrew S, Neal B, Dixon H, Hughes C, Kelly B, Miller C. Consumers' responses to health claims in the context of other on-pack nutrition information: a systematic review. Nutr Rev 2017; 75:260-273. [PMID: 28371913 DOI: 10.1093/nutrit/nuw070] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 10/21/2016] [Indexed: 01/04/2023] Open
Abstract
Context The presence of health claims on food packaging can positively bias consumers' evaluations of foods. This review examined whether cognitive biases endure when other sources of nutrition information [the nutrition facts panel (NFP) and front-of-pack labels] appear on-pack with health claims. The following databases were searched: Web of Science, Ovid, Google Scholar, ScienceDirect, Scopus, ProQuest, and Wiley Online Library. The search terms ("health claim*" OR "nutri* claim") AND ("food label*" OR "front of pack") were used to identify studies. Twenty-four studies that examined health claims and front-of-pack labels or the NFP were included. The NFP can reduce bias, but only if consumers view it and interpret it correctly, which often does not occur. Front-of-pack labels show greater promise in reducing bias created by health claims. These findings are relevant to policymakers who are considering the effectiveness of mandating an NFP and/or a front-of-pack label alongside health claims.
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Affiliation(s)
- Zenobia Talati
- Z. Talati and S. Pettigrew are with the School of Psychology and Speech Pathology, Curtin University, Bentley, Western Australia, Australia. B. Neal is with The George Institute for Global Health, Sydney, New South Wales, Australia. H. Dixon is with the Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia. C. Hughes is with the Cancer Council, Sydney, New South Wales, Australia. B. Kelly is with the School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia. C. Miller is with the South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia. C. Miller is with the University of Adelaide, Adelaide, South Australia, Australia
| | - Simone Pettigrew
- Z. Talati and S. Pettigrew are with the School of Psychology and Speech Pathology, Curtin University, Bentley, Western Australia, Australia. B. Neal is with The George Institute for Global Health, Sydney, New South Wales, Australia. H. Dixon is with the Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia. C. Hughes is with the Cancer Council, Sydney, New South Wales, Australia. B. Kelly is with the School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia. C. Miller is with the South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia. C. Miller is with the University of Adelaide, Adelaide, South Australia, Australia
| | - Bruce Neal
- Z. Talati and S. Pettigrew are with the School of Psychology and Speech Pathology, Curtin University, Bentley, Western Australia, Australia. B. Neal is with The George Institute for Global Health, Sydney, New South Wales, Australia. H. Dixon is with the Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia. C. Hughes is with the Cancer Council, Sydney, New South Wales, Australia. B. Kelly is with the School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia. C. Miller is with the South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia. C. Miller is with the University of Adelaide, Adelaide, South Australia, Australia
| | - Helen Dixon
- Z. Talati and S. Pettigrew are with the School of Psychology and Speech Pathology, Curtin University, Bentley, Western Australia, Australia. B. Neal is with The George Institute for Global Health, Sydney, New South Wales, Australia. H. Dixon is with the Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia. C. Hughes is with the Cancer Council, Sydney, New South Wales, Australia. B. Kelly is with the School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia. C. Miller is with the South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia. C. Miller is with the University of Adelaide, Adelaide, South Australia, Australia
| | - Clare Hughes
- Z. Talati and S. Pettigrew are with the School of Psychology and Speech Pathology, Curtin University, Bentley, Western Australia, Australia. B. Neal is with The George Institute for Global Health, Sydney, New South Wales, Australia. H. Dixon is with the Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia. C. Hughes is with the Cancer Council, Sydney, New South Wales, Australia. B. Kelly is with the School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia. C. Miller is with the South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia. C. Miller is with the University of Adelaide, Adelaide, South Australia, Australia
| | - Bridget Kelly
- Z. Talati and S. Pettigrew are with the School of Psychology and Speech Pathology, Curtin University, Bentley, Western Australia, Australia. B. Neal is with The George Institute for Global Health, Sydney, New South Wales, Australia. H. Dixon is with the Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia. C. Hughes is with the Cancer Council, Sydney, New South Wales, Australia. B. Kelly is with the School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia. C. Miller is with the South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia. C. Miller is with the University of Adelaide, Adelaide, South Australia, Australia
| | - Caroline Miller
- Z. Talati and S. Pettigrew are with the School of Psychology and Speech Pathology, Curtin University, Bentley, Western Australia, Australia. B. Neal is with The George Institute for Global Health, Sydney, New South Wales, Australia. H. Dixon is with the Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia. C. Hughes is with the Cancer Council, Sydney, New South Wales, Australia. B. Kelly is with the School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia. C. Miller is with the South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia. C. Miller is with the University of Adelaide, Adelaide, South Australia, Australia
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Franco-Arellano B, Bernstein JT, Norsen S, Schermel A, L'Abbé MR. Assessing nutrition and other claims on food labels: a repeated cross-sectional analysis of the Canadian food supply. BMC Nutr 2017; 3:74. [PMID: 32153852 PMCID: PMC7050703 DOI: 10.1186/s40795-017-0192-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 08/16/2017] [Indexed: 11/10/2022] Open
Abstract
Background In 2010, nutrition claims were investigated in Canadian foods; however, many nutrition and other claims have been introduced since then. This study aimed to determine: i) the proportion of foods carrying claims in 2013, ii) the types and prevalence of nutrition claims (nutrient content claims, health claims, general health claims) and other claims displayed on labels in 2013, iii) and trends in use of nutrition claims between 2010 and 2013. Methods Repeated cross-sectional analysis of the University of Toronto Food Label Information Program (FLIP) of Canadian foods (2010/11 n = 10,487; 2013 n = 15,342). Regulated nutrition claims (nutrient content, health claims) were classified according to Canadian regulations. A decision tree was used to classify non-regulated general health claims (e.g., front-of-pack claims). Other claims (e.g., gluten-free) were also collected. Proportions of claims in 2013 were determined and χ2 was used to test significant differences for different types of claims between 2010 and 2013. Results Overall, 49% of products in 2013 displayed any type of claim and 46% of foods in FLIP 2013 carried a nutrition claim (nutrient content claim, health claim, general health claim). Meal replacements and fruits/fruits juices were the categories with the largest proportion of foods with claims. At least one approved nutrient content claim was carried on 42.9% of products compared to 45.5% in 2010 (p < 0.001). Health claims, specifically disease risk reduction claims, were slightly lower in 2013 (1.5%) compared to 1.7% in 2010 (p = 0.225). General health claims, specifically front-of-pack claims, were carried on 20% of foods compared to 18.9% in 2010 (p = 0.020). Other claims, specifically gluten-free, were present on 7.3% of foods. Conclusions Nutrition and other claims were used on half of Canadian prepackaged foods in 2013. Many claims guidelines and regulations have been released since 2010; however, little impact has been seen in the prevalence of such claims in the food supply. Claims related to nutrients of public health priority, such as sugars and sodium, were not commonly used on food labels. Monitoring trends in the use of nutrition and other claims is essential to determine if their use on food labels reflects public health objectives, or instead are being used as marketing tools.
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Affiliation(s)
- Beatriz Franco-Arellano
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, FitzGerald Building, 150 College Street, Rm 315, Toronto, ON M5S 3E2 Canada
| | - Jodi T Bernstein
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, FitzGerald Building, 150 College Street, Rm 315, Toronto, ON M5S 3E2 Canada
| | - Sheida Norsen
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, FitzGerald Building, 150 College Street, Rm 315, Toronto, ON M5S 3E2 Canada
| | - Alyssa Schermel
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, FitzGerald Building, 150 College Street, Rm 315, Toronto, ON M5S 3E2 Canada
| | - Mary R L'Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, FitzGerald Building, 150 College Street, Rm 315, Toronto, ON M5S 3E2 Canada
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Nieto C, Rincon-Gallardo Patiño S, Tolentino-Mayo L, Carriedo A, Barquera S. Characterization of Breakfast Cereals Available in the Mexican Market: Sodium and Sugar Content. Nutrients 2017; 9:nu9080884. [PMID: 28813010 PMCID: PMC5579677 DOI: 10.3390/nu9080884] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 07/27/2017] [Accepted: 08/03/2017] [Indexed: 12/31/2022] Open
Abstract
Preschool Mexican children consume 7% of their total energy intake from processed breakfast cereals. This study characterized the nutritional quality and labelling (claims and Guideline Daily Amount (GDA)) of the packaged breakfast cereals available in the Mexican market. Photographs of all breakfast cereals available in the 9 main food retail chains in the country were taken. The nutrition quality of cereals was assessed using the United Kingdom Nutrient Profiling Model (UKNPM). Claims were classified using the International Network for Food and Obesity/non-communicable Diseases Research, Monitoring and Action Support (INFORMAS) taxonomy and the GDA was defined according to the Mexican regulation, NOM-051. Overall, a total of 371 different breakfast cereals were analysed. The nutritional profile showed that 68.7% were classified as “less healthy”. GDAs and claims were displayed more frequently on the “less healthy” cereals. Breakfast cereals within the “less healthy” category had significantly higher content of energy, sugar and sodium (p < 0.001). Most of the claims were displayed in the “less healthy” cereals (n = 313). This study has shown that there is a lack of consistency between the labelling on the front of the pack and the nutritional quality of breakfast cereals.
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Affiliation(s)
- Claudia Nieto
- Instituto Nacional de Salud Pública, Av. Universidad 655, Col. Santa María Ahuacatitlán, Cuernavaca C.P 62100, Morelos, Mexico.
| | | | - Lizbeth Tolentino-Mayo
- Instituto Nacional de Salud Pública, Av. Universidad 655, Col. Santa María Ahuacatitlán, Cuernavaca C.P 62100, Morelos, Mexico.
| | - Angela Carriedo
- London School of Hygiene & Tropical Medicine, Keppel St, Bloomsbury, London WC1E 7HT, UK.
| | - Simón Barquera
- Instituto Nacional de Salud Pública, Av. Universidad 655, Col. Santa María Ahuacatitlán, Cuernavaca C.P 62100, Morelos, Mexico.
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Abstract
Objective To objectively evaluate voluntary nutrition and health claims and marketing techniques present on packaging of high-market-share ultra-processed foods (UPF) in Australia for their potential impact on public health. Design Cross-sectional. Setting Packaging information from five high-market-share food manufacturers and one retailer were obtained from supermarket and manufacturers’ websites. Subjects Ingredients lists for 215 UPF were examined for presence of added sugar. Packaging information was categorised using a taxonomy of nutrition and health information which included nutrition and health claims and five common food marketing techniques. Compliance of statements and claims with the Australia New Zealand Food Standards Code and with Health Star Ratings (HSR) were assessed for all products. Results Almost all UPF (95 %) contained added sugars described in thirty-four different ways; 55 % of UPF displayed a HSR; 56 % had nutrition claims (18 % were compliant with regulations); 25 % had health claims (79 % were compliant); and 97 % employed common food marketing techniques. Packaging of 47 % of UPF was designed to appeal to children. UPF carried a mean of 1·5 health and nutrition claims (range 0–10) and 2·6 marketing techniques (range 0–5), and 45 % had HSR≤3·0/5·0. Conclusions Most UPF packaging featured nutrition and health statements or claims despite the high prevalence of added sugars and moderate HSR. The degree of inappropriate or inaccurate statements and claims present is concerning, particularly on packaging designed to appeal to children. Public policies to assist parents to select healthy family foods should address the quality and accuracy of information provided on UPF packaging.
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Kaur A, Scarborough P, Rayner M. A systematic review, and meta-analyses, of the impact of health-related claims on dietary choices. Int J Behav Nutr Phys Act 2017; 14:93. [PMID: 28697787 PMCID: PMC5505045 DOI: 10.1186/s12966-017-0548-1] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 07/03/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Health-related claims are statements regarding the nutritional content of a food (nutrition claims) and/or indicate that a relationship exists between a food and a health outcome (health claims). Their impact on food purchasing or consumption decisions is unclear. This systematic review measured the effect of health-related claims, on pre-packaged foods in retail settings, on adult purchasing decisions (real and perceived). METHODS In September 2016, we searched MEDLINE, EMBASE, PsychINFO, CAB abstracts, Business Source Complete, and Web of Science/Science Citation Index & Social Science Citation Index for articles in English published in peer-review journals. Studies were included if they were controlled experiments where the experimental group(s) included a health-related claim and the control group involved an identical product without a health-related claim. Included studies measured (at an individual or population level); actual or intended choice, purchases, and/or consumption. The primary outcome was product choices and purchases, the secondary outcome was food consumption and preference. Results were standardised through calculating odds ratios and 95% confidence intervals (CI) for the likelihood of choosing a product when a health-related claim was present. Results were combined in a random-effects meta-analysis. RESULTS Thirty-one papers were identified, 17 of which were included for meta-analyses. Most studies were conducted in Europe (n = 17) and the USA (n = 7). Identified studies were choice experiments that measured the likelihood of a product being chosen when a claim was present compared to when a claim was not present, (n = 16), 15 studies were experiments that measured either; intent-rating scale outcomes (n = 8), consumption (n = 6), a combination of the two (n = 1), or purchase data (n = 1). Overall, 20 studies found that claims increase purchasing and/or consumption, eight studies had mixed results, and two studies found consumption/purchasing reductions. The meta-analyses of 17 studies found that health-related claims increase consumption and/or purchasing (OR 1.75, CI 1.60-1.91). CONCLUSION Health-related claims have a substantial effect on dietary choices. However, this finding is based on research mostly conducted in artificial settings. Findings from natural experiments have yielded smaller effects. Further research is needed to assess effects of claims in real-world settings. TRIAL REGISTRATION PROSPERO systematic review registration number: CRD42016044042 .
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Affiliation(s)
- Asha Kaur
- Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, England
| | - Peter Scarborough
- Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, England
| | - Mike Rayner
- Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, England
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Miklavec K, Pravst I, Raats MM, Pohar J. Front of package symbols as a tool to promote healthier food choices in Slovenia: Accompanying explanatory claim can considerably influence the consumer's preferences. Food Res Int 2016; 90:235-243. [PMID: 29195876 DOI: 10.1016/j.foodres.2016.10.052] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 10/26/2016] [Accepted: 10/30/2016] [Indexed: 10/20/2022]
Abstract
Many nutrition and/or health symbols were introduced in different countries in the past years and Slovenia is no exception. The objective of our study was to examine familiarity with and perception of the Protective Food symbol (PF symbol) in Slovenia and to investigate consumers' associations related to the symbol, and the influence of symbols' appearance on their preferences. The study was conducted through online questionnaire with incorporated word-association tasks and conjoint analysis; GfK consumer panel and social media (Facebook) were used for recruitment of Slovenian adults (n=1050; 534 men, 516 women). The majority (78%) of the participants reported they had previously seen the PF symbol, and 64% declared familiarity with it. Familiarity was verified using a word-association task in which we analysed the nature of the symbol's description, distinguishing the description of symbol's visual appearance or its meaning. In this task, 73% of the participants described the symbol's meaning with reference to health or a healthy lifestyle, confirming their familiarity with it. Women and those responsible for grocery shopping were significantly more familiar with the symbol. The impact of the symbol's appearance on consumers' preferences was investigated using conjoint analysis consisting of two attributes - three different symbols found on foods in Slovenia (PF symbol, Choices Programme symbol and Keyhole symbol), and accompanying worded claims. Although worded claims had less relative importance (29.5%) than the symbols (70.5%), we show that careful choice of the wording can affect consumers' preferences considerably. The lowest part-worth utility was observed without an accompanying claim, and the highest for the claim directly communicating health ("Protects your health"). The fact that most participants are well familiar with the PF symbol indicates the symbol's potential to promote healthier food choices, which could be further improved by an accompanying worded claim that clearly describes its meaning. In addition, the use of Facebook ads is shown to be a useful alternative recruitment method for research with consumers.
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Affiliation(s)
| | - Igor Pravst
- Nutrition Institute, Tržaška 40, 1000 Ljubljana, Slovenia.
| | - Monique M Raats
- Food, Consumer Behaviour and Health Research Centre, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom.
| | - Jure Pohar
- University of Ljubljana, Biotechnical Faculty, Jamnikarjeva 101, 1000 Ljubljana, Slovenia.
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Rodrigues VM, Rayner M, Fernandes AC, de Oliveira RC, Proença RPC, Fiates GMR. Nutritional quality of packaged foods targeted at children in Brazil: which ones should be eligible to bear nutrient claims? Int J Obes (Lond) 2016; 41:71-75. [PMID: 27677617 DOI: 10.1038/ijo.2016.167] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Revised: 08/12/2016] [Accepted: 08/30/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVES This study aimed to assess the nutritional quality of food products marketed at children, with and without nutrient claims, using two different approaches. METHODS Analyses were performed based on a data set with food composition and labelling data from every packaged food marketed at children sold in a major Brazilian supermarket (n=535). Foods were classified as 'healthier' and 'less healthy' according to the UK/Ofcom nutrient profile model and to the NOVA classification based on the level of food processing. Pearson's χ2 test was used to compare proportions between models. Agreement was assessed using Cohen's κ-statistic (P<0.05). RESULTS The NOVA model was stricter than the UK/Ofcom model, classifying more products as 'less healthy' (91.4%) compared with the nutrient profile-based model (75.0%; P<0.001). Agreement between models was 79.4% (k=0.30), because 72.9% (n=390) of products were categorised as 'less healthy' by both models, and 6.5% (n=35) as 'healthier'. Half of the food products marketed at children from the database (270; 50.5%) bore nutrient claims. From these products with nutrient claims, 95.9% (92.8-98.0) were classified as 'less healthy' by the NOVA model, whereas this percentage was 74.1% (68.4-79.2) according to the UK/Ofcom model (P<0.05). CONCLUSIONS The high number of foods with low nutritional quality being marketed at children via product packaging and nutrient claims should be of concern to policy makers wanting to improve children's diets and to tackle childhood obesity. The implementation of nutritional quality criteria to ensure that foods targeted at children should be eligible to bear nutrient claims on their labels could avoid a situation where claims mask the overall nutritional status of a food.
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Affiliation(s)
- V M Rodrigues
- Nutrition Graduate Programme (Programa de Pós-Graduação em Nutrição), Nutrition in Foodservice Research Centre (NUPPRE), Federal University of Santa Catarina (UFSC), Santa Catarina, Brazil.,British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - M Rayner
- British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - A C Fernandes
- Nutrition Graduate Programme (Programa de Pós-Graduação em Nutrição), Nutrition in Foodservice Research Centre (NUPPRE), Federal University of Santa Catarina (UFSC), Santa Catarina, Brazil
| | - R C de Oliveira
- Nutrition Graduate Programme (Programa de Pós-Graduação em Nutrição), Nutrition in Foodservice Research Centre (NUPPRE), Federal University of Santa Catarina (UFSC), Santa Catarina, Brazil
| | - R P C Proença
- Nutrition Graduate Programme (Programa de Pós-Graduação em Nutrição), Nutrition in Foodservice Research Centre (NUPPRE), Federal University of Santa Catarina (UFSC), Santa Catarina, Brazil
| | - G M R Fiates
- Nutrition Graduate Programme (Programa de Pós-Graduação em Nutrição), Nutrition in Foodservice Research Centre (NUPPRE), Federal University of Santa Catarina (UFSC), Santa Catarina, Brazil
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Abstract
Nutrition and health claims are displayed to influence consumers' food choices. This study assessed the extent and nature of nutrition and health claims on the front-of-pack of 'healthy' and 'less-healthy' packaged foods in New Zealand. Foods from eight categories, for which consumption may affect the risk of obesity and diet-related chronic diseases, were selected from the 2014 Nutritrack database. The internationally standardised International Network for Food and Obesity/Non-Communicable Diseases Research, Monitoring and Action Support (INFORMAS) taxonomy was used to classify claims on packages. The Nutrient Profiling Scoring Criterion (NPSC) was used to classify products as 'healthy' or 'less healthy'. In total, 7526 products were included, with 47 % (n 3557) classified as 'healthy'. More than one-third of products displayed at least one nutrition claim and 15 % featured at least one health claim on the front-of-pack. Claims were found on one-third of 'less-healthy' products; 26 % of those products displayed nutrition claims and 7 % featured health claims. About 45 % of 'healthy' products displayed nutrition claims and 23 % featured health claims. Out of 7058 individual claims, the majority (69 %) were found on 'healthy' products. Cereals displayed the greatest proportion of nutrition and health claims (1503 claims on 564 products), of which one-third were displayed on 'less-healthy' cereals. Such claims could be misleading consumers' perceptions of nutritional quality of foods. It needs to be explored how current regulations on nutrition and health claims in New Zealand could be further strengthened (e.g. using the NPSC for nutrition claims, including general health claims as per the INFORMAS taxonomy) to ensure consumers are protected and not misled.
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Barquera S, Pedroza-Tobias A, Medina C. Cardiovascular diseases in mega-countries: the challenges of the nutrition, physical activity and epidemiologic transitions, and the double burden of disease. Curr Opin Lipidol 2016; 27:329-44. [PMID: 27389629 PMCID: PMC4947537 DOI: 10.1097/mol.0000000000000320] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW There are today 11 mega-countries with more than 100 million inhabitants. Together these countries represent more than 60% of the world's population. All are facing noncommunicable chronic disease (NCD) epidemic where high cholesterol, obesity, diabetes, and cardiovascular diseases are becoming the main public health concerns. Most of these countries are facing the double burden of malnutrition where undernutrition and obesity coexist, increasing the complexity for policy design and implementation. The purpose of this study is to describe diverse sociodemographic characteristics of these countries and the challenges for prevention and control in the context of the nutrition transition. RECENT FINDINGS Mega-countries are mostly low or middle-income and are facing important epidemiologic, nutrition, and physical activity transitions because of changes in food systems and unhealthy lifestyles. NCDs are responsible of two-thirds of the 57 million global deaths annually. Approximately, 80% of these are in low and middle-income countries. Only developed countries have been able to reduce mortality rates attributable to recognized risk factors for NCDs, in particular high cholesterol and blood pressure. SUMMARY Mega-countries share common characteristics such as complex bureaucracies, internal ethnic, cultural and socioeconomic heterogeneity, and complexities to implement effective health promotion and education policies across population. Priorities for action must be identified and successful lessons and experiences should be carefully analyzed and replicated.
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Affiliation(s)
- Simon Barquera
- National Institute of Public Health, Cuernavaca, Morelos, Mexico
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von Philipsborn P, Stratil JM, Burns J, Busert LK, Pfadenhauer LM, Polus S, Holzapfel C, Hauner H, Rehfuess E. Environmental interventions to reduce the consumption of sugar-sweetened beverages and their effects on health. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2016. [DOI: 10.1002/14651858.cd012292] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Peter von Philipsborn
- Technical University Munich; Faculty of Medicine; Stuntzstrasse 12 81677 Munich Germany
| | - Jan M Stratil
- University of Tuebingen; Faculty of Medicine; Wilhelmstrasse 127 Tuebingen Germany 72076
| | - Jacob Burns
- Ludwig-Maximilians-University Munich; Institute for Medical Informatics, Biometry and Epidemiology; Marchioninistr. 15 Munich Bavaria Germany
| | - Laura K Busert
- Ludwig-Maximilians-University Munich; Institute for Medical Informatics, Biometry and Epidemiology; Marchioninistr. 15 Munich Bavaria Germany
| | - Lisa M Pfadenhauer
- Ludwig-Maximilians-University Munich; Institute for Medical Informatics, Biometry and Epidemiology; Marchioninistr. 15 Munich Bavaria Germany
| | - Stephanie Polus
- Ludwig-Maximilians-University Munich; Institute for Medical Informatics, Biometry and Epidemiology; Marchioninistr. 15 Munich Bavaria Germany
| | - Christina Holzapfel
- Technische Universität München Klinikum rechts der Isar; Institute for Nutritional Medicine; Munich Germany
| | - Hans Hauner
- Technische Universität München Klinikum rechts der Isar; Institute for Nutritional Medicine; Munich Germany
| | - Eva Rehfuess
- Ludwig-Maximilians-University Munich; Institute for Medical Informatics, Biometry and Epidemiology; Marchioninistr. 15 Munich Bavaria Germany
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Kaur A, Scarborough P, Hieke S, Kusar A, Pravst I, Raats M, Rayner M. The nutritional quality of foods carrying health-related claims in Germany, The Netherlands, Spain, Slovenia and the United Kingdom. Eur J Clin Nutr 2016; 70:1388-1395. [PMID: 27406158 PMCID: PMC5153454 DOI: 10.1038/ejcn.2016.114] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 05/24/2016] [Accepted: 05/26/2016] [Indexed: 01/30/2023]
Abstract
Backgroung/Objectives: Compares the nutritional quality of pre-packaged foods carrying health-related claims with foods that do not carry health-related claims. Subject/Methods: Cross-sectional survey of pre-packaged foods available in Germany, The Netherlands, Spain, Slovenia and the United Kingdom in 2013. A total of 2034 foods were randomly sampled from three food store types (a supermarket, a neighbourhood store and a discounter). Nutritional information was taken from nutrient declarations present on food labels and assessed through a comparison of mean levels, regression analyses and the application of a nutrient profile model currently used to regulate health claims in Australia and New Zealand (Food Standards Australia New Zealand's Nutrient Profiling Scoring Criterion, FSANZ NPSC). Results: Foods carrying health claims had, on average, lower levels, per 100 g, of the following nutrients, energy—29.3 kcal (P<0.05), protein—1.2 g (P<0.01), total sugars—3.1 g (P<0.05), saturated fat—2.4 g (P<0.001), and sodium—842 mg (P<0.001), and higher levels of fibre—0.8 g (P<0.001). A similar pattern was observed for foods carrying nutrition claims. Forty-three percent (confidence interval (CI) 41%, 45%) of foods passed the FSANZ NPSC, with foods carrying health claims more likely to pass (70%, CI 64%, 76%) than foods carrying nutrition claims (61%, CI 57%, 66%) or foods that did not carry either type of claim (36%, CI 34%, 38%). Conclusions: Foods carrying health-related claims have marginally better nutrition profiles than those that do not carry claims; these differences would be increased if the FSANZ NPSC was used to regulate health-related claims. It is unclear whether these relatively small differences have significant impacts on health.
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Affiliation(s)
- A Kaur
- British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - P Scarborough
- British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - S Hieke
- European Food Information Council (EUFIC), Brussels, Belgium
| | - A Kusar
- Nutrition Institute, Ljubljana, Slovenia
| | - I Pravst
- Nutrition Institute, Ljubljana, Slovenia.,Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - M Raats
- Food, Consumer Behaviour and Health Research Centre, University of Surrey, Surrey, UK
| | - M Rayner
- British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Comparison of the nutritional content of products, with and without nutrient claims, targeted at children in Brazil. Br J Nutr 2016; 115:2047-56. [PMID: 27040439 DOI: 10.1017/s0007114516001021] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Many children's food products highlight positive attributes on their front-of-package labels in the form of nutrient claims. This cross-sectional study investigated all retailed packaged foods (n 5620) in a major Brazilian supermarket, in order to identify the availability of products targeted at children, and to compare the nutritional content of products with and without nutrient claims on labels. Data on energy, carbohydrate, protein, fibre, Na and total and SFA content, along with the presence and type of nutrient claims, were obtained in-store from labels of all products. Products targeted at children were identified, divided into eight food groups and compared for their nutritional content per 100 g/ml and the presence of nutrient claims using the Mann-Whitney U test (P<0·05). Of the 535 food products targeted at children (9·5 % of all products), 270 (50·5 %) displayed nutrient claims on their labels. Children's products with nutrient claims had either a similar or worse nutritional content than their counterparts without nutrient claims. The major differences among groups were found in Group 8 (e.g. sauces and ready meals), in which children's products bearing nutrient claims had higher energy, carbohydrate, Na and total and SFA content per 100 g/ml than products without nutrient claims (P<0·05). This suggests that, to prevent misleading parents who are seeking healthier products for their children, the regulation on the use of nutrient claims should be revised, so that only products with appropriate nutrient profiles are allowed to display them.
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Hieke S, Kuljanic N, Pravst I, Miklavec K, Kaur A, Brown KA, Egan BM, Pfeifer K, Gracia A, Rayner M. Prevalence of Nutrition and Health-Related Claims on Pre-Packaged Foods: A Five-Country Study in Europe. Nutrients 2016; 8:137. [PMID: 26950149 PMCID: PMC4808866 DOI: 10.3390/nu8030137] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 01/28/2016] [Accepted: 02/25/2016] [Indexed: 11/16/2022] Open
Abstract
This study is part of the research undertaken in the EU funded project CLYMBOL ("Role of health-related CLaims and sYMBOLs in consumer behaviour"). The first phase of this project consisted of mapping the prevalence of symbolic and non-symbolic nutrition and health-related claims (NHC) on foods and non-alcoholic beverages in five European countries. Pre-packaged foods and drinks were sampled based on a standardized sampling protocol, using store lists or a store floor plan. Data collection took place across five countries, in three types of stores. A total of 2034 foods and drinks were sampled and packaging information was analyzed. At least one claim was identified for 26% (95% CI (24.0%-27.9%)) of all foods and drinks sampled. Six percent of these claims were symbolic. The majority of the claims were nutrition claims (64%), followed by health claims (29%) and health-related ingredient claims (6%). The most common health claims were nutrient and other function claims (47% of all claims), followed by disease risk reduction claims (5%). Eight percent of the health claims were children's development and health claims but these were only observed on less than 1% (0.4%-1.1%) of the foods. The category of foods for specific dietary use had the highest proportion of NHC (70% of foods carried a claim). The prevalence of symbolic and non-symbolic NHC varies across European countries and between different food categories. This study provides baseline data for policy makers and the food industry to monitor and evaluate the use of claims on food packaging.
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Affiliation(s)
- Sophie Hieke
- European Food Information Council, rue Paul-Emile Janson 6, 1000 Brussels, Belgium.
| | - Nera Kuljanic
- European Food Information Council, rue Paul-Emile Janson 6, 1000 Brussels, Belgium.
| | - Igor Pravst
- Nutrition Institute, Tržaška cesta 40, 1000 Ljubljana, Slovenia.
- Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, 1000 Ljubljana, Slovenia.
| | - Krista Miklavec
- Nutrition Institute, Tržaška cesta 40, 1000 Ljubljana, Slovenia.
| | - Asha Kaur
- British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, University of Oxford, Oxford OX3 7LF, UK.
| | - Kerry A Brown
- Food, Consumer Behaviour and Health Research Centre, University of Surrey, Guildford GU2 7XH, UK.
| | - Bernadette M Egan
- Food, Consumer Behaviour and Health Research Centre, University of Surrey, Guildford GU2 7XH, UK.
| | - Katja Pfeifer
- Institute for Consumer and Behavioural Research, Saarland University, 66123 Saarbrücken, Germany.
| | - Azucena Gracia
- Agrifood Research and Technology Centre of Aragon, 50059 Zaragoza, Spain.
| | - Mike Rayner
- British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, University of Oxford, Oxford OX3 7LF, UK.
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Pravst I, Kušar A. Consumers' Exposure to Nutrition and Health Claims on Pre-Packed Foods: Use of Sales Weighting for Assessing the Food Supply in Slovenia. Nutrients 2015; 7:9353-68. [PMID: 26569301 PMCID: PMC4663602 DOI: 10.3390/nu7115474] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 10/05/2015] [Accepted: 10/29/2015] [Indexed: 12/16/2022] Open
Abstract
Insights into the use of health-related information on foods are important for planning studies about the effects of such information on the consumer’s understanding, purchasing, and consumption of foods, and also support further food policy decisions. We tested the use of sales data for weighting consumers’ exposure to health-related labeling information in the Slovenian food supply. Food labeling data were collected from 6342 pre-packed foods available in four different food stores in Slovenia. Consumers’ exposure was calculated as the percentage of available food products with particular food information in the food category. In addition, 12-month sales data were used to calculate sales weighted exposure as a percentage of sold food products with certain food information in the food category. The consumer’s in-store and sales-weighted exposure to nutrition claims was 37% and 45%, respectively. Exposure to health claims was much lower (13%, 11% when sales-weighted). Health claims were mainly found in the form of general non-specific claims or function claims, while children’s development and reduction of disease risk claims were present on only 0.1% and 0.2% of the investigated foods, respectively. Sales data were found very useful for establishing a reliable estimation of consumers’ exposure to information provided on food labels. The high penetration of health-related information on food labels indicates that careful regulation of this area is appropriate. Further studies should focus on assessing the nutritional quality of foods labeled with nutrition and health claims, and understanding the importance of such labeling techniques for consumers’ food preferences and choices.
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Affiliation(s)
- Igor Pravst
- Nutrition Institute, Tržaška cesta 40, Ljubljana 1000, Slovenia.
| | - Anita Kušar
- Nutrition Institute, Tržaška cesta 40, Ljubljana 1000, Slovenia.
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