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Gonzales Santos M, Rosenthal A, Beatriz Araujo Martins I, de Alcantara M, Almeida Lima M, de Assis Carvalho R, Deliza R. Exploring the role of the general interest in health on the perceptions of Healthy, Industrialized, and Ultra-processed foods among Brazilians. Food Res Int 2024; 181:113992. [PMID: 38448090 DOI: 10.1016/j.foodres.2024.113992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/02/2024] [Accepted: 01/08/2024] [Indexed: 03/08/2024]
Abstract
Food processing includes operations that transform raw materials into new products, ensuring the preservation and supply of safe food; however, this view is not always understood by consumers who tend to associate any type of processing with something negative and harmful to health. Given this, the objective of this study was to explore the associations of Brazilian consumers in relation to healthy foods, industrialized foods, and ultra-processed foods, as well as to evaluate the role of socio-demographic characteristics and interest in health in these associations. To this end, 512 Brazilians completed a word association task on these three concepts and then answered a questionnaire about interest in health and socio-demographic issues. In general, participants associated "Healthy food" mainly with "Unprocessed products." Conversely, "Industrialized foods" and "Ultra-processed foods" were associated with "Processed products," "Negative perceptions," "Health harm," and "Industry". Despite this, it was found that "Industrialized foods" were also perceived positively, mainly due to convenience. Consumer associations were influenced (p ≤ 0.05) both by interest in health and by socio-demographic profile. Individuals with a high interest in health mainly associated "Industrialized foods" and "Ultra-processed foods" with the presence of preservatives, additives, and pesticides, and with diseases. As for those with low interest in health, there was a greater lack of knowledge of the concepts. Doubts and lack of knowledge were observed for "Industrialized foods" and "Ultra-processed foods," mainly among consumers with low educational level. The results indicate the need to develop communication strategies that reach consumers to facilitate understanding and, in this way, help them to make more conscious food choices.
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Affiliation(s)
- Mario Gonzales Santos
- Graduate Program of Food Science and Technology, Universidade Federal Rural do Rio de Janeiro, Rodovia BR 456, km 7, Seropédica, RJ, Brazil; Faculty of Technological Sciences, Universidad Nacional de Agricultura, Carretera a Dulce Nombre de Culmí, km 215, Barrio El Espino, Catacamas, Honduras.
| | - Amauri Rosenthal
- Embrapa Agroindústria de Alimentos, Av. das Américas 29501, CEP 23.020-470 Rio de Janeiro, RJ, Brazil
| | | | - Marcela de Alcantara
- PDJ/Faperj/Embrapa Agroindústria de Alimentos, Av. das Américas 29501 CEP 23.020-470 Rio de Janeiro, RJ, Brazil
| | - Mariah Almeida Lima
- Graduate Program of Food Science and Technology, Universidade Federal Rural do Rio de Janeiro, Rodovia BR 456, km 7, Seropédica, RJ, Brazil
| | - Raíssa de Assis Carvalho
- Graduate Program of Food Science and Technology, Universidade Federal Rural do Rio de Janeiro, Rodovia BR 456, km 7, Seropédica, RJ, Brazil
| | - Rosires Deliza
- Embrapa Agroindústria de Alimentos, Av. das Américas 29501, CEP 23.020-470 Rio de Janeiro, RJ, Brazil
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Alcaire F, Machín L, Curutchet MR, Giménez A, Ares G. Parent Experiences With Warning Labels After Policy Implementation in Uruguay. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:823-832. [PMID: 37804264 DOI: 10.1016/j.jneb.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 09/06/2023] [Accepted: 09/07/2023] [Indexed: 10/09/2023]
Abstract
OBJECTIVE To explore the perception and experiences of parents of children and adolescents during the first year of the mandatory implementation of nutritional warning labels in Uruguay. DESIGN Qualitative research based on semistructured interviews. SETTING Montevideo, Uruguay. PARTICIPANTS Twenty-eight parents of children and adolescents. PHENOMENON OF INTEREST Perception of and experiences with warning labels, a front-of-pack nutrition labeling scheme that has become increasingly popular in Latin America. ANALYSIS Content analysis of the transcripts based on a deductive-inductive approach. RESULTS Interview transcripts evidenced high awareness, acceptance, and understanding of warning labels among parents of children and adolescents. Most participants reported considering warnings for decision making and changing their purchase decisions because of their implementation, particularly when choosing foods for their children. They reported their children were aware of and understood warnings but did not tend to take them into account when choosing foods. CONCLUSIONS AND IMPLICATIONS Results from the present work contribute to the growing body of literature showing the effectiveness of warning labels. Lack of interest or perceived benefits and structural barriers emerged as key motives for not using the warnings when making purchasing decisions, suggesting the need to develop additional strategies to increase policy effectiveness.
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Affiliation(s)
- Florencia Alcaire
- Sensometrics and Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Pando, Canelones, Uruguay
| | - Leandro Machín
- Centro de Investigación Básica en Psicología, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay
| | | | - Ana Giménez
- Sensometrics and Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Pando, Canelones, Uruguay
| | - Gastón Ares
- Sensometrics and Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Pando, Canelones, Uruguay; Centro de Investigación Básica en Psicología, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay.
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Ares G, Antúnez L, Curutchet MR, Galicia L, Natero V, Giménez A, Otterbring T. Qualitative exploration of the reasons for not using nutritional warnings after policy implementation in Uruguay. Health Promot Int 2023; 38:6974787. [PMID: 36617288 DOI: 10.1093/heapro/daac174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Nutritional warnings have gained popularity, particularly in the region of the Americas, to facilitate the identification of products with excessive content of nutrients associated with non-communicable diseases and encourage healthier food choices. Although warnings have been shown to be effective, an in-depth understanding of the reasons why some consumers do not use them is still lacking. The aim of the present work was to explore self-reported use of nutritional warnings and to identify the reasons for not considering nutritional warnings for making food purchase decisions after policy implementation in Uruguay. A non-probabilistic sample of 858 Uruguayan participants was recruited using an advertisement on Facebook and Instagram. Through an online survey, self-reported use of nutritional warnings was asked using a closed-open ended questions. Participants who reported not considering warnings to make their purchase decisions were asked to explain the reasons why using an open-ended question. Responses were analysed using deductive coding, based on the Behavioural Drivers Model. Thirty seven percent of the participants stated that the warnings had not influenced their purchase decisions. Motives for not being influenced by the warnings were related to lack of interest, attitudes, lack of perceived self-efficacy, cognitive biases and limited rationality when making purchase decisions. In addition, structural barriers, such as availability, cost and trust in the food industry also emerged from participants' responses. Strategies to encourage the use of warnings should include communication campaigns and policies to address structural barriers related to the perceived availability and affordability of healthy foods.
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Affiliation(s)
- Gastón Ares
- Sensometrics and Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n. C.P. 91000, Pando, Canelones, Uruguay
| | - Lucía Antúnez
- Sensometrics and Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n. C.P. 91000, Pando, Canelones, Uruguay
| | | | - Luis Galicia
- Ministerio de Salud Pública, 18 de Julio 1892, CP 11200, Montevideo, Uruguay
| | - Virginia Natero
- Ministerio de Salud Pública, 18 de Julio 1892, CP 11200, Montevideo, Uruguay
| | - Ana Giménez
- Sensometrics and Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n. C.P. 91000, Pando, Canelones, Uruguay
| | - Tobias Otterbring
- Department of Management, School of Business and Law, University of Agder, Kristiansand, Norway
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Contreras-Manzano A, Jáuregui A, Vargas-Meza J, Nieto C, Granich-Armenta A, de Lourdes Alemán Escobar M, G-Olvera A, Cruz-Casarrubias C, Munguía A, Barquera S. Objective understanding of front of pack warning labels among Mexican children of public elementary schools. A randomized experiment. Nutr J 2022; 21:47. [PMID: 35864545 PMCID: PMC9306177 DOI: 10.1186/s12937-022-00791-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 05/31/2022] [Indexed: 01/28/2023] Open
Abstract
Background Warning Labels (WL) highlight excessive amounts of critical nutrients in order to discourage consumption of unhealthful packaged food products. This study aimed to evaluate among Mexican school children, the objective understanding of traditional and numeric WL (aimed at small products) considered by the Mexican regulation, and whether cartoon characters influenced the understanding of WL. We also tested some communication strategies to facilitate the correct use of the WL. Methods We carried out a randomized experiment in July 2019 in public elementary schools from Morelos, Mexico. Participants aged 6–13 years, were randomly assigned to one of four groups: 1) Nutrient Facts Panel (NF) (n = 120), 2) Nutrient Facts Panel with cartoon characters (NF + C) (n = 83), considered the control groups, 3) Warning Labels (WL) (n = 109), and 4) Warning Labels with cartoon characters (WL + C) (n = 96). After allocation, children assigned to both WL groups (WL or WL + C), were randomly required to watch two posters simultaneously or a video explaining how to correctly interpret WLs. Logistic regression models adjusted by sex, age and cluster (school) were fitted. Results The percentage of children correctly choosing the healthiest or the unhealthiest option was higher for WL groups (56.8, 95%CI; 40.8–72.8) compared to NF groups (24.3, 95%CI; 20.4–28.3, p < 0.05). The understanding of traditional WL was higher (28.7, 95%CI: 22.8–35.4) than the numeric WL (19, 95%CI: 14.2–25.0, p < 0.05). But, correct answers for identifying healthy and unhealthy products were higher for numeric WL than for NF groups. Cartoon characters reduced the percentage of correct answers for choosing unhealthiest products (WL + C: 48.9, 95%CI: 25.6–72.4 vs WL: 58.7, 95%CI: 36.4–81.1, p < 0.05). The video was 2.23 times more helpful than the posters to the correct interpretation of the WL (p < 0.05). Conclusions In scholar Mexican children, traditional and numeric WL were useful to identify healthier and unhealthier packaged products in comparison to NF, suggesting that both WL formats may effectively communicate the excessive content of nutrients of concern among children. Cartoon characters may reduce the objective understanding of the WL, underscoring the need to regulate advertising directed to children along with the implementation of front-of-pack labeling. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-022-00791-z.
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Affiliation(s)
| | - Alejandra Jáuregui
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico.
| | - Jorge Vargas-Meza
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico
| | - Claudia Nieto
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico
| | - Adriana Granich-Armenta
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico
| | | | - Armando G-Olvera
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico
| | - Carlos Cruz-Casarrubias
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico
| | - Ana Munguía
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico
| | - Simón Barquera
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico
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Grummon AH, Brewer NT. Health Warnings and Beverage Purchase Behavior: Mediators of Impact. Ann Behav Med 2021; 54:691-702. [PMID: 32182336 DOI: 10.1093/abm/kaaa011] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND To reduce diet-related chronic disease, policymakers have proposed requiring health warnings on sugar-sweetened beverages (SSBs). Health warnings reduced purchases of these products by 22% in our recent randomized controlled trial, but the mechanisms remain unclear. PURPOSE We sought to identify the psychological mechanisms that explain why SSB health warnings affect purchase behavior. METHODS In 2018, we recruited 400 adult SSB consumers to complete a shopping task in a naturalistic convenience store laboratory in North Carolina, USA. We randomly assigned participants to either a health warning arm (all SSBs in the store displayed a text health warning) or to a control arm (SSBs displayed a control label). Participants selected items to purchase with cash. RESULTS Compared to control labels, health warnings elicited more attention, negative affect, anticipated social interactions, and thinking about harms (range of ds = 0.63-1.34; all p < .001). Health warnings also led to higher injunctive norms about limiting SSB consumption (d = 0.27, p = .008). Except for attention, all of these constructs mediated the effect of health warnings on SSB purchases (all p < .05). In contrast, health warnings did not influence other attitudes or beliefs about SSBs or SSB consumption (e.g., healthfulness, outcome expectations, and response efficacy). CONCLUSIONS Health warnings on sugar-sweetened beverages affected purchase behavior by eliciting negative emotions, increasing anticipated social interactions, keeping SSBs' harms at top of mind, and shifting norms about beverage consumption. Results are consistent with recent studies of why tobacco warnings influence quitting behavior, pointing toward a general framework for understanding how health warnings affect behavior. CLINICAL TRIALS REGISTRATION NCT #03511937.
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Affiliation(s)
- Anna H Grummon
- Harvard Center for Population and Development Studies, Harvard T. H. Chan School of Public Health, Cambridge, MA, USA.,Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
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Heimburg DV, Cluley V. Advancing complexity-informed health promotion: a scoping review to link health promotion and co-creation. Health Promot Int 2021; 36:581-600. [PMID: 32810227 DOI: 10.1093/heapro/daaa063] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
A complexity-informed approach has recently been proposed as a hopeful revolution for health promotion (HP), requesting appropriate ways of tackling the complexities of health, equity and well-being. In addition, co-creation has gained traction as an approach to tackle complexity. HP and co-creation are established concepts that have long been enacted in practice. Although each concept is premised on similar approaches to value-creation such as participation and collaboration, little has been done to link the two approaches. To advance complexity-informed HP, this scoping review presents findings from peer-reviewed articles, published in English, between 2009 and March 2020. Articles were identified through searches of academic databases. Twenty-seven articles met the inclusion criteria, explicitly linking HP and co-creation. Included articles were charted by descriptive information and main focus, and advanced by a thematic analysis. Four themes suggest a potential avenue for advancing complexity-informed HP: (i) dealing with complexity, (ii) value creation, (iii) the value of the values and (iv) benefits and challenges. While current links between HP and co-creation are scarce they are increasing and promising. Based on the findings from the review, propositions to advance complexity-informed HP is outlined and discussed. Overall it is argued that co-creation and HP are mutually beneficial concepts, providing a framework for participative, collaborative, context-sensitive and knowledge-based practice that reflects the complex nature of health. More research is needed to highlight potential and challenges of integrating co-creation in HP, especially related to health equity and sustainable development.
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Affiliation(s)
- Dina von Heimburg
- Faculty of Social Sciences, Nord University, PO Box 1490, 8049 Bodø, Norway
| | - Victoria Cluley
- Cass Business School, City, University of London, 108 Bunhill Row, London, EC1Y 8TZ
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Health gains through loss frames: Testing the effectiveness of message framing on citizens' use of nutritional warnings. Appetite 2021; 166:105469. [PMID: 34146646 DOI: 10.1016/j.appet.2021.105469] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/15/2021] [Accepted: 06/11/2021] [Indexed: 01/17/2023]
Abstract
The aim of the present work was twofold: (i) to evaluate the effect of nutritional warnings and health-related packaging cues (nutrient claim and images of natural foods) on consumers' food choices, and (ii) to evaluate the influence of two types of messages (gain-framed and loss-framed) aimed at encouraging the use of such warnings and packaging cues on food choices. A total of 510 participants were recruited using an advertisement on Facebook and Instagram targeted at Uruguayan adult users. Participants were randomly allocated to one of three experimental groups: control (n = 167), loss-framed messages (n = 177) and gain-framed messages (n = 166). Then, they completed a choice-conjoint task involving packages of crackers differing in three variables: nutritional warnings (present vs. absent), nutrient claim (present vs. absent) and images of seeds and wheat (present vs. absent). Warnings were the most relevant package element driving choices, even when participants were not exposed to any type of message. Exposure to loss-framed messages led to changes in the relative importance attached to the package characteristics, whereas gain-framed messages did not. Graphic pieces conveying messages encouraging the use of nutritional warnings by stressing the negative consequences of excessive consumption of sugar, fat, and sodium increased the relative importance attached to nutritional warnings and decreased the relative importance attached to health-related cues (nutrient claims and images of seeds and wheat). These results suggest that public awareness campaigns aimed at encouraging citizens to use nutritional warnings should emphasize the negative health consequences of excessive intake of sugar, fat, and sodium.
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Gidlöf K, Ares G, Aschemann-Witzel J, Otterbring T. Give us today our daily bread: The effect of hunger on consumers’ visual attention towards bread and the role of time orientation. Food Qual Prefer 2021. [DOI: 10.1016/j.foodqual.2020.104079] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Athletic abs or big bellies: The impact of imagery, arousal levels, and health consciousness on consumers’ attitudes towards plant-based protein products. Food Qual Prefer 2021. [DOI: 10.1016/j.foodqual.2020.104067] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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The drivers, trends and dietary impacts of non-nutritive sweeteners in the food supply: a narrative review. Nutr Res Rev 2020; 34:185-208. [PMID: 33148371 DOI: 10.1017/s0954422420000268] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Poor diets, including excess added sugar consumption, contribute to the global burden of disease. Subsequently, many nutrition policies have been implemented to reduce added sugar intake and improve population health, including taxes, education, labelling and environmental interventions. A potential consequence of these policy actions is the substitution of added sugars with non-nutritive sweeteners (NNS) in a variety of foods and beverages. NNS are used to reduce the energy and sugar content of foods and beverages while maintaining their palatability. Evidence of the toxicological risks of NNS is inconsistent, though concerns have been raised over the potential substitution effects of ultra-processed foods containing NNS for whole foods. This review aimed to provide an overview of current NNS food supply and consumption patterns, assess added sugar-reduction policies and their impact on NNS, and determine the impact of NNS on food choice, energy intake and diet quality. NNS are widely available in a variety of products, though most commonly in carbonated beverages, dairy products, confectionery, table-top sweeteners and fruit drinks. However, the longitudinal trends of different product categories, and differences between geographies and economy-income levels, require further study. Few studies have examined NNS consumption trends globally, though an increase in NNS consumption in beverages has been observed in some regions. Research examining how the increased availability of low-sugar, NNS-containing products affects global dietary patterns is limited, particularly in terms of their potential substitution effects.
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Ares G, Machín L, Vidal L, Otterbring T, Aschemann-Witzel J, Curutchet MR, Bove I. Uruguayan Citizens' Perception of Messages to Promote Healthy Eating Through the Use of Nutritional Warnings. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:918-927. [PMID: 32631789 DOI: 10.1016/j.jneb.2020.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/26/2020] [Accepted: 05/30/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To explore the specific type of messages people consider most appropriate for a mass communication campaign aimed to promote healthy eating in the context of the implementation of nutritional warnings. DESIGN Online study including multiple-choice and open-ended questions. SETTING Uruguay, 1 of the Latin American countries with the highest prevalence of overweight and obesity. PARTICIPANTS A total of 859 participants were recruited using social media. They were diverse in terms of gender, age, educational level, socioeconomic status, and self-reported body mass index. PHENOMENON OF INTEREST Participants were presented with 3 series of messages and were asked to select the 1 they perceived as the most appropriate and to provide a brief explanation for their selection. ANALYSIS Descriptive statistics for the multiple-choice questions and inductive coding for the responses to the open-ended questions. RESULTS Participants tended to prefer messages that conveyed a cue to action for achieving changes to their perceived ability to make healthful food choices. Although messages related to the promotion of informed food choices were the most frequently preferred, messages related to negative health consequences and health benefits were also selected repetitively. CONCLUSIONS AND IMPLICATIONS Communication campaigns aimed at promoting healthy eating through the use of nutritional warnings could include different contents to target specific segments with different motivations.
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Affiliation(s)
- Gastón Ares
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Pando, Canelones, Uruguay; Centro de Investigación Básica en Psicología, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay.
| | - Leandro Machín
- Centro de Investigación Básica en Psicología, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay
| | - Leticia Vidal
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Pando, Canelones, Uruguay
| | | | | | - María R Curutchet
- Observatorio de Seguridad Alimentaria, Instituto Nacional de Alimentación, Montevideo, Uruguay
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Immediate effects of the implementation of nutritional warnings in Uruguay: awareness, self-reported use and increased understanding. Public Health Nutr 2020; 24:364-375. [PMID: 32782052 DOI: 10.1017/s1368980020002517] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess the effects of nutritional warnings during the first month after the date of full compliance by the food industry in Uruguay in terms of citizen awareness, self-reported use and ability to understand nutritional information. DESIGN The present work encompassed two online studies, conducted before (Study 1) and during the first month after the date of full compliance by the food industry (Study 2). An after-only design was used to assess awareness of the policy, exposure to nutritional warnings on food packages and self-reported use of warnings for making purchase decisions in Study 2. An after-only with control group experimental design was used to assess the effect of nutritional warnings on understanding of nutrition information in Studies 1 and 2. SETTING Uruguay, one of the Latin American countries, that has recently implemented nutritional warnings. PARTICIPANTS A non-probabilistic sample of 1772 participants was recruited using Facebook advertisements targeted at Uruguayan adult users. RESULTS High awareness and self-reported use of nutritional warnings during the first month after the date of full compliance in Uruguay were observed. In addition, the before and after comparison showed that the implementation of warnings increased citizens' ability to use nutritional information to compare products and to identify products with excessive content of sugar, fat, saturated fat and sodium. CONCLUSIONS The current study confirms results from experimental studies and provides additional evidence to support the implementation of nutritional warnings as one of the public policies that can contribute to tackle obesity and non-communicable diseases.
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Jáuregui A, Vargas-Meza J, Nieto C, Contreras-Manzano A, Alejandro NZ, Tolentino-Mayo L, Hall MG, Barquera S. Impact of front-of-pack nutrition labels on consumer purchasing intentions: a randomized experiment in low- and middle-income Mexican adults. BMC Public Health 2020; 20:463. [PMID: 32252716 PMCID: PMC7137298 DOI: 10.1186/s12889-020-08549-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 03/18/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Front-of-pack (FOP) nutrition labeling is a cost-effective strategy to help consumers make informed and healthier food choices. We aimed to investigate the effect of the FOP labels used in the Latin American region on consumers' shopping intentions when prompted to make their choices with specific nutrients-to-limit in mind among low- and middle-income Mexican adults (> 18 y). METHODS In this experimental study of an online simulated shopping situation participants (n = 2194) were randomly assigned to one of three labeling conditions: Guideline Daily Amounts (GDA), Multiple Traffic Lights (MTL), or red Warning Labels (WL). Participants were required to view a video explaining how to correctly interpret the assigned label. Primary outcomes were the overall nutritional quality (estimated using the Nutrient Profiling Scoring Criterion [NPSC] and NPSC baseline score) and mean energy and nutrient content of purchases. Secondary outcomes included shopping time variables. We also evaluated the impact of the labels across food categories (ready-made foods, dairy beverages, non-dairy beverages, salty snacks, and breakfast cereals) and sociodemographic subgroups. RESULTS The MTL and the WL led to a better overall nutritional quality of the shopping cart compared to the GDA (p < 0.05). According to the NPSC score, the WL led to a better nutritional quality across breakfast cereals and salty snacks compared to the GDA (p < 0.05); a similar effect was observed for the MTL among non-dairy beverages (p < 0.05). The MTL and the WL required shorter shopping times compared to GDA (p < 0.05). Across all labeling conditions, the nutritional quality of the shopping cart tended to be lower among those with low income, education and nutrition knowledge levels. CONCLUSION WL and MTL may foster healthier food choices in a faster way among low- and middle-income groups in Mexico. To produce an equitable impact among consumers of all socioeconomic strata, efforts beyond simply the inclusion of a communication campaign on how to use and interpret FOP labels will be required. TRIAL REGISTRATION clinicaltrials.gov. NCT04308408 Retrospectively registered March 16, 2020.
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Affiliation(s)
- Alejandra Jáuregui
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, CP. 62100 Cuernavaca, Morelos Mexico
| | - Jorge Vargas-Meza
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, CP. 62100 Cuernavaca, Morelos Mexico
| | - Claudia Nieto
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, CP. 62100 Cuernavaca, Morelos Mexico
| | - Alejandra Contreras-Manzano
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, CP. 62100 Cuernavaca, Morelos Mexico
| | - Nelson Zacarías Alejandro
- School of Public Health, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, CP. 62100 Cuernavaca, Mexico
| | - Lizbeth Tolentino-Mayo
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, CP. 62100 Cuernavaca, Morelos Mexico
| | - Marissa G. Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA
| | - Simón Barquera
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, CP. 62100 Cuernavaca, Morelos Mexico
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