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Chapple CI, Burnett AJ, Woods JL, Russell CG. A Cross-Sectional Study of Sports Food Consumption Patterns, Experiences, and Perceptions amongst Non-Athletes in Australia. Nutrients 2024; 16:1101. [PMID: 38674792 PMCID: PMC11053821 DOI: 10.3390/nu16081101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 03/28/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024] Open
Abstract
Sports foods are designed for athletes, yet their availability, type, and sales have increased over the past decade, likely driven by non-athlete use. This could lead to detrimental health outcomes via over/misuse or unwanted side effects. The aim of this study was to describe sports food consumption patterns and associated drivers, consumption reasons, perception of risks, and side effects experienced amongst non-athletes in Australia. In 2022, n = 307 non-athlete Australian adults (18-65 years) completed an online cross-sectional survey including closed-ended (consumption patterns, factors, and exercise participation) and open-ended questions (reasons for consumption, risk perception, and side effects experienced). Descriptive statistics (frequency and percent) described the sample. Ordinal logistic regression was used for univariate associations and a multivariate model was used to determine relationships between sports food consumption proxy and significant univariate associations. The themes were analysed via inductive thematic analysis using NVivo 14. Females consumed sports foods most frequently, 65% of participants consumed three or more sports foods, and participants with higher sports food consumption/frequency were less likely to perceive risks or experience side effects. The main reason for consumption was protein intake, digestion/stomach issues were the main perceived risks, and the main side effect was bloating. Despite understanding the risks and side effects, non-athlete consumers continue to use numerous sports foods, which appear to be influenced by sociodemographic factors and packaging labels. Tighter regulation of packaging-label information would ensure safer and more informed consumption.
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Affiliation(s)
- Celeste I. Chapple
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, VIC 3220, Australia
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Bou Fakhreddine L, Martínez MG, Sánchez M, Schnettler B. Consumers' willingness to pay for health claims during the COVID-19 pandemic: A moderated mediation analysis. JOURNAL OF AGRICULTURE AND FOOD RESEARCH 2023; 11:100523. [PMID: 36777477 PMCID: PMC9897873 DOI: 10.1016/j.jafr.2023.100523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/12/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic has posed a substantial threat to people's lives and raised health concerns. This research explores the mediating role of consumers' attitudes towards health claims in the relationship between consumers' interest in health claims and their willingness to pay (WTP) for health claims in extra virgin olive oil (EVOO). Additionally, we examine the moderation effect of COVID-19 risk perception in the relationship between consumers' interest in and attitudes towards health claims. Data were collected through an online survey in three countries: Spain, the UK and Chile. Findings confirm the mediating role of consumers' attitudes towards health claims. Furthermore, the relationship between consumers' interest and their attitudes towards health claims was stronger when COVID-19 risk perception was higher.
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Affiliation(s)
- Lara Bou Fakhreddine
- Department of Business, Public University of Navarra, Edificio Madroños, Campus Arrosadia, 31006, Pamplona, Spain
| | | | - Mercedes Sánchez
- Department of Business, Public University of Navarra, Edificio Madroños, Campus Arrosadia, 31006, Pamplona, Spain
| | - Berta Schnettler
- Facultad de Ciencias Agropecuarias y Medioambiente, Bioren-UFRO, Universidad de La Frontera, Chile
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Godden E, Thornton L, Avramova Y, Dens N. High hopes for front-of-pack (FOP) nutrition labels? A conjoint analysis on the trade-offs between a FOP label, nutrition claims, brand and price for different consumer segments. Appetite 2023; 180:106356. [PMID: 36309232 DOI: 10.1016/j.appet.2022.106356] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/13/2022] [Accepted: 10/21/2022] [Indexed: 12/15/2022]
Abstract
An increasing number of studies investigate the effect of front-of-pack (FOP) nutrition labels on consumer choice without considering differences in consumer preferences for product attributes. This study used a choice-based conjoint analysis to test consumers' preferences for four product attributes (5 levels of a FOP nutrition label, absence/presence of a nutrition claim, brand (unfamiliar, private label or premium) and 5 levels of price) when they coexist (n = 1156). As the consumer preferences showed distinct patterns (multimodality), consumers were subsequently clustered based on how a FOP nutrition label (Nutri-Score) influenced their food choices. Three consumer segments were identified, each valuing the Nutri-Score label differently. The label effectively seems to nudge one segment toward healthier choices (n = 456), while in contrast, another segment is unexpectedly steered toward unhealthier food choices by the label (n = 343). The third segment is only consistently nudged by the FOP label's extremes (n = 357). The segments also differ in their preferences for other product attributes (brand and price), health involvement, and self-reported understanding and use of the Nutri-Score, but not in the measured socio-demographic variables (age, sex, education, social class), dieting or smoking habits. In summary, consumers vary in their food label preferences, and studies that pool consumers may fail to capture these nuances, leading to biased results. This study shows that FOP labels do not steer all consumers toward healthier choices and may even have adverse effects for some. This suggests combining different policies and marketing strategies to reach all consumer segments.
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Affiliation(s)
- Elke Godden
- Faculty of Business and Economics, Department of Marketing, University of Antwerp, Belgium, Prinsstraat 13, 2000, Antwerp, Belgium.
| | - Lukar Thornton
- Faculty of Business and Economics, Department of Marketing, University of Antwerp, Belgium, Prinsstraat 13, 2000, Antwerp, Belgium.
| | - Yana Avramova
- Faculty of Business and Economics, Department of Marketing, University of Antwerp, Belgium, Prinsstraat 13, 2000, Antwerp, Belgium.
| | - Nathalie Dens
- Faculty of Business and Economics, Department of Marketing, University of Antwerp, Belgium, Prinsstraat 13, 2000, Antwerp, Belgium.
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Is it really a piece of cake to label Geographical Indications with the Nutri-Score? Consumers’ behaviour and policy implications. PLoS One 2022; 17:e0277048. [PMCID: PMC9671382 DOI: 10.1371/journal.pone.0277048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 10/18/2022] [Indexed: 11/19/2022] Open
Abstract
To improve the dietary habits of the population, the EU, within the Farm to Fork strategy (F2F), is strongly supporting the Nutri-Score (NS) Front Of Pack (FOP) label. Under the NS system, Geographical Indications (GIs) are generally scored as “unhealthy” food, given the predominance of products of animal origin among GIs which are, notoriously, high-fat products. This study aims to determine the impact of the NS label on consumers’ preferences for two Protected Designation of Origin (PDO) cheeses, in comparison with generic ones. A Discrete Choice Experiment (DCE) was conducted on 600 Italian consumers through the estimation of a Random Parameter Logit model. Results highlighted that Italian consumers are generally not familiar with the NS and perceive it as a positive characteristic of the product, even if it is signalling an unhealthy choice (D score). However, consumers aware of the Nutri-Score meaning are willing to pay less to buy a product considered “unhealthy” according to this system. Furthermore, we found that consumers who already knew the NS system have homogeneous behaviours in rejecting the product, independently of the association with a PDO certification. This result has important implications on the agri-food sector. If the Nutri-Score becomes mandatory in the EU, consumers might refuse many GIs due to their negative Nutri-Score values. However, the quality of these products is recognized and protected worldwide. In this vein, the GI policy could be questioned by the F2F strategy: both of them aims to reduce information asymmetry producing, at the same time, contrasting results. Within the Geographical Indication policy, the PDO and PGI goods are protected for their quality attributes, which are strictly linked to their geographical origin of the products and traditional know-how. However, the EU adoption of the Nutri-Score could damage these products, reducing their perceived quality/value.
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Do Individuals Use Nutrition Labels on Food Packages to Make Healthy Choices? Testing the Dual-Process Model in Two Laboratory-Based Experiments. Nutrients 2022; 14:nu14183732. [PMID: 36145108 PMCID: PMC9505394 DOI: 10.3390/nu14183732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 08/09/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022] Open
Abstract
Nutrition labels on food packages are designed to assist consumers in making healthy decisions. Based on the model of a dual-process system, the current study examined how people might be affected by nutrition labels and consuming contexts when making choices about healthy foods. Using four types of nutrition labels (i.e., the NuVal label, 5-Color nutrition label, traffic light label, and daily value label), participants were instructed to choose the healthier foods with or without time constraints in two experiments. In Experiment 1, participants were presented with pairs of foods accompanied by the same type of nutrition labels to measure the efficiency of their health evaluation. In Experiment 2, two types of labels with inconsistent nutritional information were presented to participants simultaneously to measure their preference regarding the nutrition labels. Findings of the current study support the notion that the traffic light label is advantageous in terms of both the efficiency of, and preferences regarding, nutrition judgment, especially with time constraints. When there was only one type of nutrition label, participants made decisions fastest and most accurately when observing the NuVal label, regardless of time constraints. Overall, the reliable interactions between the time constraints and patterns of nutrition labels have theoretical implications for the appeal-based heuristics and rational-based processing when making health-related food decisions.
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Pettigrew S, Coyle D, McKenzie B, Vu D, Lim SC, Berasi K, Poowanasatien A, Suya I, Kowal P. A review of front-of-pack nutrition labelling in Southeast Asia: Industry interference, lessons learned, and future directions. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2022; 3:100017. [PMID: 37384259 PMCID: PMC10305914 DOI: 10.1016/j.lansea.2022.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Front-of-pack nutrition labelling is an evidence-based nutrition intervention that is recommended by the World Health Organization and other health agencies as an effective non-communicable disease prevention strategy. To date, the types of front-of-pack labels that have been identified as being most effective have yet to be implemented in Southeast Asia. This has been partly attributed to extensive industry interference in nutrition policy development and implementation. This paper outlines the current state of food labelling policy in the region, describes observed industry interference tactics, and provides recommendations for how governments in Southeast Asia can address this interference to deliver best-practice nutrition labelling to improve diets at the population level. The experiences of four focal countries - Malaysia, Thailand, the Philippines, and Viet Nam - are highlighted to provide insights into the range of industry tactics that are serving to prevent optimal food labelling policies from being developed and implemented. Funding This research was supported by the United Kingdom Global Better Health Programme, which is managed by the United Kingdom Foreign, Commonwealth and Development Office and supported by PricewaterhouseCoopers in Southeast Asia.
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Affiliation(s)
- Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, 1 King St Newtown NSW 2042, Sydney, Australia
| | - Daisy Coyle
- The George Institute for Global Health, University of New South Wales, 1 King St Newtown NSW 2042, Sydney, Australia
| | - Briar McKenzie
- The George Institute for Global Health, University of New South Wales, 1 King St Newtown NSW 2042, Sydney, Australia
| | - Duong Vu
- Alive & Thrive Southeast Asia, FHI 360, 7F, Opera Business Center, 60 Ly Thai To Street, Hanoi, Vietnam
| | - Shiang Cheng Lim
- RTI International Malaysia, Unit 5.2 & 5.3, Level 5, Nucleus Tower, Jalan PJU 7/6, Mutiara Damansara Petaling Jaya, Selangor, 47820, Malaysia
| | - Kyra Berasi
- Global Health Advocacy Incubator, 1400 I (Eye) Street NW, Suite 1200, Washington, DC 20005, USA
| | - Amphika Poowanasatien
- FHI360, Asia Pacific Regional Office, 19th Floor, Tower 3, Sindhorn Building, 130-132 Wireless Road, Kwaeng Lumpini, Khet Phatumwan, Bangkok 10330 Thailand
| | - Inthira Suya
- FHI360, Asia Pacific Regional Office, 19th Floor, Tower 3, Sindhorn Building, 130-132 Wireless Road, Kwaeng Lumpini, Khet Phatumwan, Bangkok 10330 Thailand
| | - Paul Kowal
- Better Health Programme Southeast Asia, 7 Straits View, Marina One, Singapore, 018936
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Nutri-Score: Awareness, Perception and Self-Reported Impact on Food Choices among French Adolescents. Nutrients 2022; 14:nu14153119. [PMID: 35956296 PMCID: PMC9370257 DOI: 10.3390/nu14153119] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/22/2022] [Accepted: 07/27/2022] [Indexed: 02/04/2023] Open
Abstract
To date, no studies have evaluated the appropriation of the front-of-pack Nutri-Score labeling among adolescents, although they are both consumers and buyers of food products. Therefore, the objectives of the present study were (1) to assess Nutri-Score awareness, perception and self-reported impact on food choices in French adolescents and (2) to identify the determinants associated with higher Nutri-Score awareness and self-reported impact on food choices. A web-based survey was conducted in November 2021 among 1201 adolescents. Multivariate logistic models were used to evaluate the relationships between individual factors and Nutri-Score awareness and self-reported impact on food choices. Almost all the adolescents reported to know the Nutri-Score (97.0%) and more than 9 out of 10 considered this logo easy to understand and easy to identify on food packages. Finally, 54% self-reported that the label had already impacted their food choices. Girls (2.28 (1.09−4.77), p = 0.028) and the 15−17-year-olds (3.12 (1.32−7.35), p = 0.0094) were more likely to be aware of the label compared with their respective counterparts (i.e., boys and the 11−14-year-olds). Regarding the impact of food choices, the use of the Nutri-Score by the parents was the most determinant criterion (7.74 (5.74−10.42), p < 0.0001). Thus, promotion campaigns should target both adolescents and parents.
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Singh SK, Taillie LS, Gupta A, Bercholz M, Popkin B, Murukutla N. Front-of-Package Labels on Unhealthy Packaged Foods in India: Evidence from a Randomized Field Experiment. Nutrients 2022; 14:nu14153128. [PMID: 35956305 PMCID: PMC9370292 DOI: 10.3390/nu14153128] [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: 05/04/2022] [Revised: 06/09/2022] [Accepted: 06/11/2022] [Indexed: 02/01/2023] Open
Abstract
Policies to require front-of-package labels (FOPLs) on packaged foods may help Indian consumers to better identify foods high in nutrients of concern, including sugar, saturated fat, and sodium, and discourage their consumption, which are outcomes that are critical for preventing rises in diet-related non-communicable disease. The objective was to test whether FOPLs helped Indian consumers identify “high-in” packaged foods and reduce intentions to purchase them. We conducted an in-person randomized experiment (n = 2869 adults between ages 18 and 60 years old) in six states of India in 2022. Participants were randomized to one of five FOPLs: a control label (barcode), warning label (octagon with “High in [nutrient]”), Health Star Rating (HSR), Guideline Daily Amount (GDA), or traffic light label. Participants then viewed a series of packaged foods high in sugar, saturated fat, or sodium with the assigned FOPL, and rated product perceptions and label reactions. Fewer than half of participants in the control group (39.1%) correctly identified all products high in nutrient(s) of concern. All FOPLs led to an increase in this outcome, with the biggest differences observed for the warning label (60.8%, p < 0.001), followed by the traffic light label (54.8%, p < 0.001), GDA (55.0%, p < 0.001), and HSR (45.0%, p < 0.01). While no FOPLs led to a reduction in intentions to purchase the packaged foods, the overall pattern of results suggested that warning labels are the most effective FOPL to help Indian consumers identify unhealthy foods.
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Affiliation(s)
- S. K. Singh
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Deemed University, Mumbai 400088, India
- Correspondence: (S.K.S.); (L.S.T.)
| | - Lindsey Smith Taillie
- Department of Nutrition, Gillings School of Global Public Health, Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA;
- Correspondence: (S.K.S.); (L.S.T.)
| | - Ashish Gupta
- Vital Strategies, New York, NY 27599, USA; (A.G.); (N.M.)
| | - Maxime Bercholz
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA;
| | - Barry Popkin
- Department of Nutrition, Gillings School of Global Public Health, Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA;
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Pettigrew S, Jongenelis M, Jones A, Hercberg S, Julia C. An 18-country analysis of the effectiveness of five front-of-pack nutrition labels. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2022.104691] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Hoteit M, Yazbeck N, Al-Jawaldeh A, Obeid C, Fattah HA, Ghader M, Mohsen H. Assessment of the knowledge, attitudes and practices of Lebanese shoppers towards food labeling: The first steps in the Nutri-score roadmap. F1000Res 2022; 11:84. [PMID: 35721597 PMCID: PMC9194517 DOI: 10.12688/f1000research.75703.2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/21/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Food labeling is a fundamental educational tool for advocating for public awareness. It emphasizes knowledge of the nutrient content of food and thus directs the choice towards the healthiest food products. This cross-sectional survey aimed to assess the knowledge, attitudes, and practices (KAP) regarding nutrition label use in Lebanon through a valid questionnaire. Methods: Overall, 768 participants (mean age: 30.8 ±12, males: 60.2%) were recruited randomly between February and May 2020. We used word of mouth and social media to recruit our sample population. Results: Social media was the most accessed tool to attain nutrition information by responders (39.8%). More than half the participants expressed positive attitudes to check information related to sugars (66.4%), vitamins (64.9%), total fats (61.7%), proteins (59.1%), and calories (58.7%) on the food label. Expiry date, price, and brand name were the top three considerations while reading food labels. About half (46.5%) reported to “always” look at the food label. Responders reported reading labels related primarily to sugars (44.3%), calories (38.8%), and total fats (36.8%). The optimal total KAP score was 46; our findings revealed a mean KAP score of 14.46 ±7 (31.4%). When categorizing the KAP scores, 15% had high scores, and 85% scored low. Spearman’s coefficients showed positive correlations between knowledge-attitude, knowledge-practice, and attitude-practice scores, with p<0.001. The regression analysis revealed that gender, age, BMI, residency area, educational level, university degree, health and diet statuses, and activity level were significant predictors of the KAP score. Being on a diet had the highest odds (OR=3.107, CI=1.904-5.072, p<0.001). Conclusion: The low awareness of food labels leads Lebanese people to choose unhealthy food options. A planned educational program is recommended to ease the interpretation of these labels.
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Affiliation(s)
- Maha Hoteit
- Faculty of Public Health, Lebanese University, Beirut, 961, Lebanon
- PHENOL research group (Public HEalth Nutrition prOgram-Lebanon), Faculty of Public Health, Lebanese University, Beirut, 961, Lebanon
- Lebanese University Nutrition Surveillance Center (LUNSC), Lebanese Food Drugs and Chemical Administrations, Lebanese University, Beirut, Lebanon
| | - Nour Yazbeck
- Faculty of Public Health, Lebanese University, Beirut, 961, Lebanon
- PHENOL research group (Public HEalth Nutrition prOgram-Lebanon), Faculty of Public Health, Lebanese University, Beirut, 961, Lebanon
- Lebanese University Nutrition Surveillance Center (LUNSC), Lebanese Food Drugs and Chemical Administrations, Lebanese University, Beirut, Lebanon
| | - Ayoub Al-Jawaldeh
- World Health Organization Regional Office for the Eastern Mediterranean, World Health Organization, Cairo, 11371, Egypt
| | - Cecile Obeid
- Faculty of Nursing and Health Sciences, Notre Dame University, Zouk Mosbeh, Lebanon
| | | | - Marwa Ghader
- Faculty of Public Health, Lebanese University, Beirut, 961, Lebanon
| | - Hala Mohsen
- Faculty of Public Health, Lebanese University, Beirut, 961, Lebanon
- PHENOL research group (Public HEalth Nutrition prOgram-Lebanon), Faculty of Public Health, Lebanese University, Beirut, 961, Lebanon
- Lebanese University Nutrition Surveillance Center (LUNSC), Lebanese Food Drugs and Chemical Administrations, Lebanese University, Beirut, Lebanon
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Impact of front-of-pack labels on the perceived healthfulness of a sweetened fruit drink: a randomised experiment in five countries. Public Health Nutr 2022; 25:1094-1104. [PMID: 34726144 PMCID: PMC9991717 DOI: 10.1017/s1368980021004535] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Front-of-pack (FOP) nutrition labelling is a globally recommended strategy to encourage healthier food choices. We evaluated the effect of FOP labels on the perceived healthfulness of a sweetened fruit drink in an international sample of adult consumers. DESIGN Six-arm randomised controlled experiment to examine the impact of FOP labels (no label control, Guideline Daily Amounts (GDA), Multiple Traffic Lights, the Health Star Ratings (HSR), Health Warning Labels, and 'High-in' Warning Labels (HIWL)) on the perceived healthfulness of the drink. Linear regression models by country examined healthfulness perceptions on FOP nutrition labels, testing for interactions by demographic characteristics. SETTING Online survey in 2018 among participants from Australia, Canada, Mexico, United Kingdom (UK) and United States. PARTICIPANTS Adults (≥18 years, n 22 140). RESULTS Compared with control, HIWL had the greatest impact in lowering perceived healthfulness (β from -0·62 to -1·71) across all countries. The HIWL and the HSR had a similar effect in Australia. Other labels were effective in decreasing the perceived healthfulness of the drink within some countries only, but to a lower extent. The GDA did not reduce perceived healthfulness in most countries. In the UK, the effect of HIWL differed by age group, with greater impact among older participants (> 40 years). There were no other variations across key demographic characteristics. CONCLUSIONS HIWL, which communicates clear, non-quantitative messages about high levels of nutrients of concern, demonstrated the greatest efficacy to decrease the perceived healthfulness of a sweetened fruit drink across countries. This effect was similar across demographic characteristics.
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Yin X, Ye L, Xin X, Xiang L, Yu Y, Yan R, Wen K, Tian M, Jones A, Pettigrew S, Liu W, Yang Y, Zhang J. Key Stakeholder Perspectives on Introducing a Front-of-Pack Labelling Scheme on Packaged Foods in China: A Qualitative Study. Nutrients 2022; 14:nu14030516. [PMID: 35276875 PMCID: PMC8840240 DOI: 10.3390/nu14030516] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 01/19/2022] [Accepted: 01/21/2022] [Indexed: 01/17/2023] Open
Abstract
Front-of-pack (FoP) labelling on foods is recommended by the World Health Organization (WHO) to address the growing global burden of diet-related noncommunicable diseases (NCDs), but this policy has not yet been implemented in China. The aim of this study was to ascertain key stakeholders’ views on barriers and facilitators to developing a feasible and acceptable FoP labelling policy in the Chinese context. Semistructured interviews were used to elicit opinions from diverse representatives in roles of FoP labelling policy influence. Participants were identified by purposive and snowball sampling. The Consolidated Framework for Implementation Research (CFIR) was adopted to facilitate data collection and analysis. Themes and subthemes were generated using deductive and inductive approaches. Thirty participants were interviewed. The major barriers were the absence of national contextual analysis, perceived complexity of the process of policy development, disagreement on a preferred FoP labelling format, cost for the food industry, low priority compared to food safety policies, lack of existing regulatory framework or authorised nutrient profiling system, limited knowledge of FoP labelling, and the lack of planning and engagement with stakeholders. Facilitators included existing prerequisites, experiences and lessons from the pilot, policy coherence with Healthy China 2030, and support from external agents (e.g., WHO). Further efforts are required to develop and collate evidence to demonstrate the scientific, legal, and political feasibility of introducing effective FoP labelling.
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Affiliation(s)
- Xuejun Yin
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia; (X.Y.); (A.J.); (S.P.)
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China; (L.Y.); (L.X.); (R.Y.)
| | - Lihong Ye
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China; (L.Y.); (L.X.); (R.Y.)
| | - Xin Xin
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China; (X.X.); (Y.Y.); (K.W.); (W.L.)
| | - Lin Xiang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China; (L.Y.); (L.X.); (R.Y.)
| | - Yue Yu
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China; (X.X.); (Y.Y.); (K.W.); (W.L.)
| | - Ruijie Yan
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China; (L.Y.); (L.X.); (R.Y.)
| | - Kehan Wen
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China; (X.X.); (Y.Y.); (K.W.); (W.L.)
| | - Maoyi Tian
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia; (X.Y.); (A.J.); (S.P.)
- School of Public Health, Harbin Medical University, Harbin 150088, China
- Correspondence: (J.Z.); (M.T.)
| | - Alexandra Jones
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia; (X.Y.); (A.J.); (S.P.)
| | - Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia; (X.Y.); (A.J.); (S.P.)
| | - Wei Liu
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China; (X.X.); (Y.Y.); (K.W.); (W.L.)
| | - Yuexin Yang
- Chinese Nutrition Society, Beijing 100022, China;
| | - Juan Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China; (L.Y.); (L.X.); (R.Y.)
- Correspondence: (J.Z.); (M.T.)
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Hoteit M, Yazbeck N, Al-Jawaldeh A, Obeid C, Fattah HA, Ghader M, Mohsen H. Assessment of the knowledge, attitudes and practices of Lebanese shoppers towards food labeling: The first steps in the Nutri-score roadmap. F1000Res 2022; 11:84. [DOI: 10.12688/f1000research.75703.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Food labeling is a fundamental educational tool for advocating for public awareness. It emphasizes knowledge of the nutrient content of food and thus directs the choice towards the healthiest food products. This cross-sectional survey aimed to assess the knowledge, attitudes, and practices (KAP) regarding nutrition label use in Lebanon through a valid questionnaire. Methods: Overall, 768 participants (mean age: 30.8 ±12, males: 60.2%) were recruited randomly between February and May 2020. We used word of mouth and social media to recruit our sample population. Results: Social media was the most accessed tool to attain nutrition information by responders (39.8%). More than half the participants expressed positive attitudes to check information related to sugars (66.4%), vitamins (64.9%), total fats (61.7%), proteins (59.1%), and calories (58.7%) on the food label. Expiry date, price, and brand name were the top three considerations while reading food labels. About half (46.5%) reported to “always” look at the food label. Responders reported reading labels related primarily to sugars (44.3%), calories (38.8%), and total fats (36.8%). The optimal total KAP score was 46; our findings revealed a mean KAP score of 14.46 ±7 (31.4%). When categorizing the KAP scores, 15% had high scores, and 85% scored low. Spearman’s coefficients showed positive correlations between knowledge-attitude, knowledge-practice, and attitude-practice scores, with p<0.001. The regression analysis revealed that gender, age, BMI, residency area, educational level, university degree, health and diet statuses, and activity level were significant predictors of the KAP score. Being on a diet had the highest odds (OR=3.107, CI=1.904-5.072, p<0.001). Conclusion: The low awareness of food labels leads Lebanese people to choose unhealthy food options. A planned educational program is recommended to ease the interpretation of these labels.
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Health Star Ratings and Beverage Purchase Intentions: A Study of Australian and New Zealand Hospitality Consumers. Foods 2021; 10:foods10112764. [PMID: 34829045 PMCID: PMC8617703 DOI: 10.3390/foods10112764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/05/2021] [Accepted: 11/08/2021] [Indexed: 11/23/2022] Open
Abstract
This study examines the effects of a health star rating system on the attitudes of consumers and their purchase intentions towards beverage products sold in hospitality venues. Previous studies linking health ratings to the food and beverages of consumers mainly focus on fast-moving consumer goods and retail purchasing. However, purchasing patterns in hospitality and foodservice environments are distinct as consumers may be less concerned about health and more interested in the dining experience. Thus, this research focuses on: (1) whether the presence of health star ratings on beverage products influences the willingness of consumers to purchase in the context of the hospitality industry, and (2) identifying the demographic and psychographic factors influencing these behavioural intentions. Using Ordinary Least Squares regression to analyse data from an e-survey of 1021 consumers in Australia and New Zealand, the study found that health star ratings do have an impact on the willingness of consumers to purchase healthy beverages. Specifically, psychographic segmentation around ‘health goals’ is far more pertinent to understanding purchase behaviour in a hospitality setting than age, gender, income, or country. The findings present new insights into the importance of health star labelling on beverages and the purchase intentions of consumers.
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15
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Holford DL, Juanchich M, Sirota M. Characteristics of quantifiers moderate the framing effect. JOURNAL OF BEHAVIORAL DECISION MAKING 2021. [DOI: 10.1002/bdm.2251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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16
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Mazzù MF, Romani S, Baccelloni A, Gambicorti A. A cross-country experimental study on consumers' subjective understanding and liking on front-of-pack nutrition labels. Int J Food Sci Nutr 2021; 72:833-847. [PMID: 33657942 DOI: 10.1080/09637486.2021.1873918] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Different Front-of-Pack (FOP) nutritional labels have been implemented in order to increase consumers' awareness of food nutritional quality and encourage healthier choices. However, few studies have analysed the effects of FOPLs on consumers' subjective understanding and liking across different socio-cultural contexts. This study tests the effect that the new enriched informative label NutrInform Battery and the summary label Nutri-Score have on subjective comprehension and liking across 2776 respondents of seven European countries (France, Germany, Greece, Italy, Portugal, Romania and Spain). Main effects regarding socio-demographic differences are also explored according to extant literature and highlighting significant effects of education and income. This study therefore extends the current research on subjective understanding and liking with a cross-country analysis. Findings suggest that NutrInform Battery can help consumers in understanding information in a relevant way, obtaining the highest performance across countries and showing limited impact of socio-cultural differences.
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Affiliation(s)
| | - Simona Romani
- Department of Business and Management, Luiss University, Rome, Italy
| | - Angelo Baccelloni
- Department of Business and Management, Luiss University, Rome, Italy
| | - Antea Gambicorti
- Department of Business and Management, Luiss University, Rome, Italy
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17
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Dereń K, Dembiński Ł, Wyszyńska J, Mazur A, Weghuber D, Łuszczki E, Hadjipanayis A, Koletzko B. Front-Of-Pack Nutrition Labelling: A Position Statement of the European Academy of Paediatrics and the European Childhood Obesity Group. ANNALS OF NUTRITION AND METABOLISM 2021; 77:23-28. [PMID: 33631759 DOI: 10.1159/000514336] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 01/11/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Due to the growing risk of obesity and related diseases in the population of children, effective preventive measures are of great importance. Front-of-pack (FOP) nutrition labelling may contribute to health promotion by increasing consumer awareness on the nutritional qualities of packaged foods and purchasing decisions, and it may stimulate food providers to improve the composition of products. SUMMARY Appropriate labelling should enable customers to make healthy choices quickly and intuitively. Key Messages: The European Academy of Paediatrics and the European Childhood Obesity Group makes an appeal to European Union legislators to immediately introduce a mandatory, uniform, and interpretative FOP nutrition labelling system.
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Affiliation(s)
- Katarzyna Dereń
- Medical College of Rzeszow University, University of Rzeszów, Rzeszów, Poland, .,European Childhood Obesity Group (ECOG), Bruxelles, Belgium,
| | - Łukasz Dembiński
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland.,European Academy of Paediatrics (EAP), Geneva, Switzerland
| | - Justyna Wyszyńska
- Medical College of Rzeszow University, University of Rzeszów, Rzeszów, Poland.,European Childhood Obesity Group (ECOG), Bruxelles, Belgium
| | - Artur Mazur
- Medical College of Rzeszow University, University of Rzeszów, Rzeszów, Poland.,European Childhood Obesity Group (ECOG), Bruxelles, Belgium.,European Academy of Paediatrics (EAP), Geneva, Switzerland
| | - Daniel Weghuber
- European Childhood Obesity Group (ECOG), Bruxelles, Belgium.,Department of Pediatrics, Obesity Research Unit and Division of Pediatric Gastroenterology, Hepatology and Nutrition, Paracelsus Medical University, Salzburg, Austria
| | - Edyta Łuszczki
- Medical College of Rzeszow University, University of Rzeszów, Rzeszów, Poland
| | - Adamos Hadjipanayis
- European Academy of Paediatrics (EAP), Geneva, Switzerland.,School of Medicine, European University Cyprus, Engomi, Cyprus.,Paediatric Department, Larnaca General Hospital, Larnaca, Cyprus
| | - Berthold Koletzko
- Dr. von Hauner Children's Hospital, University Hospital, LMU - Ludwig-Maximilians-Universität Munich, Munich, Germany
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18
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Enriquez JP, Archila-Godinez JC. Social and cultural influences on food choices: A review. Crit Rev Food Sci Nutr 2021; 62:3698-3704. [PMID: 33427479 DOI: 10.1080/10408398.2020.1870434] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Human food choices (FC) influence food production systems. Agriculture is responsible for feeding the entire population, and somehow generates different types of environmental degradation. Consumers play a decisive role in consumption trends because FC has shaped habits and behaviors. Food is an expression of people's identity, values, and lifestyle. The objective of this article is to analyze the factors that influence FC and to consider intervention strategies used to work on improving behaviors and FC. The influence of socio-cultural aspects, such as cultural capital, social stratifications, and the inequalities could possibly trigger consumers' FC. The effects of different factors such as foodscapes, social environments, tastes, and even nutritional information, have generated that, the consumer chooses a product under pressure or makes an uninformed choice that generally is unhealthy. Restricting food accessibility generates a reactive but non-aware action, so it is necessary to work creating a sustainable food culture, with the first step of consumers being self-aware of their current FC.
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Affiliation(s)
- Jean Pierre Enriquez
- Master Program in Sustainable Tropical Agriculture, Graduate Department, Zamorano University, Tegucigalpa, Honduras
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19
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Cooper SL, Butcher LM, Scagnelli SD, Lo J, Ryan MM, Devine A, O’Sullivan TA. Australian Consumers Are Willing to Pay for the Health Star Rating Front-of-Pack Nutrition Label. Nutrients 2020; 12:E3876. [PMID: 33352995 PMCID: PMC7765932 DOI: 10.3390/nu12123876] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 12/13/2020] [Accepted: 12/15/2020] [Indexed: 11/22/2022] Open
Abstract
The Australia and New Zealand Ministerial Forum on Food Regulation has supported the recommendations set out in the 2019 Health Star Rating System Five Year Review Report. Specifically, the forum supported, in principle, Recommendation 9, to mandate the Health Star Rating if clear uptake targets were not achieved while the system is voluntary. Given that mandatory labelling is being considered, it is important to investigate how much consumers value the Health Star Rating in order to understand potential consumer uptake and inform industry. The aim of this study was to assess consumers' valuation of the Health Star Rating system by analysing their willingness to pay for a packaged food product with the Health Star Rating label, utilising a double-bounded dichotomous choice contingent valuation approach. The results indicate that almost two-thirds of Australian household grocery shoppers were willing to pay more for a product with the Health Star Rating, on average up to an additional 3.7% of the price of the product. However, public health nutrition benefits associated with consumers' willingness to pay more for products with the Health Star Rating is currently limited by the lack of guarantee of the systems' accuracy. Given consumer support, a well validated and comprehensive Health Star Rating labelling system can potentially improve health outcomes, cost effectiveness and reduce environmental impacts.
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Affiliation(s)
- Sheri L. Cooper
- School of Health and Human Sciences, Gold Coast Campus, Southern Cross University, Southern Cross Drive, Bilinga, QLD 4225, Australia
| | - Lucy M. Butcher
- School of Health and Medical Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia; (L.M.B.); (A.D.); (T.A.O.)
- Foodbank WA, 23 Abbott Road, Perth Airport, WA 6105, Australia
| | - Simone D. Scagnelli
- School of Business and Law, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia; (S.D.S.); (M.M.R.)
| | - Johnny Lo
- School of Science, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia;
| | - Maria M. Ryan
- School of Business and Law, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia; (S.D.S.); (M.M.R.)
| | - Amanda Devine
- School of Health and Medical Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia; (L.M.B.); (A.D.); (T.A.O.)
| | - Therese A. O’Sullivan
- School of Health and Medical Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia; (L.M.B.); (A.D.); (T.A.O.)
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20
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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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21
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Egnell M, Talati Z, Galan P, Andreeva VA, Vandevijvere S, Gombaud M, Dréano-Trécant L, Hercberg S, Pettigrew S, Julia C. Objective understanding of the Nutri-score front-of-pack label by European consumers and its effect on food choices: an online experimental study. Int J Behav Nutr Phys Act 2020; 17:146. [PMID: 33213459 PMCID: PMC7678195 DOI: 10.1186/s12966-020-01053-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 11/09/2020] [Indexed: 01/19/2023] Open
Abstract
Background The effectiveness of Front-of-Pack nutrition Labels (FoPLs) may be influenced by national context. In light of the ongoing efforts to harmonize FoPLs across Europe, this study aimed to compare the effectiveness of five FoPLs (Health Star Rating system, Multiple Traffic Lights, Nutri-Score, Reference Intakes, Warning symbols) on consumer understanding and food choice in 12 European countries. Methods In 2018–2019, for three food categories, approximately 1000 participants per country were asked to select which food they would prefer to purchase between three products with distinct nutritional quality profiles, and then to rank the products by nutritional quality. Participants (N = 12,391 in total) completed these tasks first with no FoPL and then, after randomization to one of the five FoPLs, with a FoPL on the food packages. Associations between FoPLs and change in (i) nutritional quality of food choices and (ii) ability to correctly rank the products by nutritional quality were assessed with logistic regression models adjusted for sociodemographic and lifestyle characteristics of participants, conducted overall and by country. Findings Compared with the Reference Intakes, the Nutri-Score (OR = 3.23[2.75–3.81]; p < 0.0001), followed by the Multiple Traffic Lights (OR = 1.68[1.42–1.98]; p < 0.0001), was the most effective FoPL in helping consumers identify the foods’ nutritional quality, overall and in each of the 12 countries. Differences between FoPLs regarding food choice modifications were smaller, but the effect of the Nutri-Score seemed slightly higher in eliciting healthier food choices overall compared with the Reference Intakes, followed by the Warning symbols, the Multiple Traffic Lights and the Health Star Rating system. Interpretation In the context of FoPL harmonization in Europe, these findings from an online experiment provide insights into the Nutri-Score’s effectiveness on European consumers. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-020-01053-z.
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Affiliation(s)
- Manon Egnell
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, 93000, France.
| | - Zenobia Talati
- School of Psychology, Curtin University, Kent St, Bentley, WA, 6102, Australia
| | - Pilar Galan
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, 93000, France
| | - Valentina A Andreeva
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, 93000, France
| | - Stefanie Vandevijvere
- Scientific Institute of Public Health (Sciensano), J.Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Marion Gombaud
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, 93000, France
| | - Louise Dréano-Trécant
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, 93000, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, 93000, France.,Department of Public Health, Hôpitaux Universitaires Paris Seine-Saint-Denis (AP-HP), Bobigny, 93000, France
| | - Simone Pettigrew
- The George Institute for Global Health, Newtown NSW, Sydney, 2042, Australia
| | - Chantal Julia
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, 93000, France.,Department of Public Health, Hôpitaux Universitaires Paris Seine-Saint-Denis (AP-HP), Bobigny, 93000, France
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22
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Gabor AM, Stojnić B, Ban Ostić D. Effects of different nutrition labels on visual attention and accuracy of nutritional quality perception – Results of an experimental eye-tracking study. Food Qual Prefer 2020. [DOI: 10.1016/j.foodqual.2020.103948] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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23
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Blitstein JL, Guthrie JF, Rains C. Low-Income Parents' Use of Front-of-Package Nutrition Labels in a Virtual Supermarket. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:850-858. [PMID: 32475704 DOI: 10.1016/j.jneb.2020.04.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To examine the impact front-of-package nutrition labels (FOPLs) have on decision-making abilities among low-income parents in a virtual supermarket. DESIGN A 4-by-2 experimental design with 3 FOPLs (summary, nutrient-specific, hybrid) and a no-FOPL comparison. Within the FOPL condition, participants either shopped with a time limit (10 minutes) or with no time limit. SETTING A web-based, 3-dimensional virtual supermarket. PARTICIPANTS Parents (n = 1,452) from low-income households with at least 1 child aged 4-12 years. MAIN OUTCOMES MEASURED Index derived from the United Kingdom's Nutrient Profiling Model that summarized the overall nutrient profile of the participant's shopping basket. ANALYSIS Analysis of covariance with post hoc estimations (pairwise) of condition means adjusted for multiple comparisons. RESULTS All FOPLs led to healthier nutrient profiles than the no-FOPL condition (P < .001). Simple FOPLs (ie, summary, hybrid) led to healthier nutrient profiles than nutrient-specific FOPLs (P = .02 and P < .001, respectively). Among parents exposed to simple FOPLs, those under time pressure made less healthy choices than those who were not under time pressure (P = .05 and P = .03, respectively). Time pressure did not affect parents exposed to nutrient-specific FOPLs (P = .69). CONCLUSIONS AND IMPLICATIONS Front-of-package nutrition labels can aid parents in selecting healthier products. Simple FOPLs provide greater utility for selecting healthier products than FOPLs that present an array of nutrient information. Time pressure can influence how parents interact with different types of label information.
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Affiliation(s)
| | - Joanne F Guthrie
- Economic Research Service, US Department of Agriculture, Washington, DC
| | - Caroline Rains
- Public Health Research Division, RTI International, Research Triangle Park, NC
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24
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Nemergut J, Mokrý S. Influence of packaging attributes on perception of juice: Eye-tracking study. POTRAVINARSTVO 2020. [DOI: 10.5219/1267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Today, consumers are increasingly aware of the impact that the fast and stressful way of life has on their health. They focus not only on physical activity, but also on a diet filled with fruits and vegetables. As a result, they often choose a tasty alternative which is one of the main sources of vitamins and nutrients - fruit juices. However, these products are often labeled as drinks with high amounts of sugar. Therefore, it is very important for these drinks to be perceived by the consumers as healthy and tasty, which is one of the most important features of their packages. Their goal is to appeal to customers, catch their attention and make them buy the product. One of the most convenient methods to study how packages appeal to customers is the eye-tracking method. The aim of this article is to find out how different attributes of packages can influence customers’ perception of the juice. The research was carried out in a form of eye-tracking experiment (A/B testing), which involved 38 participants at the age from 20 to 29 (generation Y). Results showed that lower color saturation significantly reduces the attention of individual packages and also reduces the influence of craving the juice as opposed to brighter colors. The importance of information on the back side was also confirmed, since moving the information from back to the front side did not show any significant decrease of the back side's attention span. Last but not least, it has been found out that the image type used on the orange juice package holds importance too, since photography of oranges led to a higher craving of the juice in comparison to the illustration of oranges. However, it was not proven that photographs of oranges held a higher attention span compared to the illustrations. The article contains demonstrable proof of individual package attributes' influence on how generation Y consumers perceive the juice.
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25
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Gillon-Keren M, Kaufman-Shriqui V, Goldsmith R, Safra C, Shai I, Fayman G, Berry E, Tirosh A, Dicker D, Froy O, Gordon E, Chavia Ben-Yosef A, Nitsan L, Altman H, Blaychfeld-Magnazi M, Endevelt R. Development of Criteria for a Positive Front-of-Package Food Labeling: The Israeli Case. Nutrients 2020; 12:E1875. [PMID: 32585990 PMCID: PMC7353345 DOI: 10.3390/nu12061875] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/14/2020] [Accepted: 06/19/2020] [Indexed: 02/06/2023] Open
Abstract
Efforts to shape the food environment are aimed at reducing diet-related co-morbidities. Front-of-package labeling (FOPL) may support the consumers to make an informed decision at the point of purchase and encourage industry to reformulate food products. The Israeli Ministry of Health (MOH) implemented a unique FOPL system, using two colors: A mandatory warning (red) label alongside a voluntary positive (green) label. An independent Scientific Committee, from academia, the healthcare system, and MOH was appointed to determine the core principles for the positive FOPL. The criteria were based on the Mediterranean diet principles, with adjustments to the Israeli dietary habits, focusing on the health advantages of the food and considering its processing level. The food products eligible for positive FOPL are foods in their natural form or with added spices or herbs, or those that underwent minimal processing, with no food additives. Based on population consumption data, 19.8% of food products were eligible for positive FOPL; of them, 54% were fruits and vegetables, 20% dairy, and 14% grains. An evaluation plan is needed to assess the degree of acceptance of the positive FOPL by the industry, retailers, and the public, and its impact on food consumption and on public health.
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Affiliation(s)
- Michal Gillon-Keren
- Institute of Endocrinology and Diabetes, Schneider Children’s Medical Center, Petah Tikva 4920235, Israel; (M.G.-K.); (G.F.)
- Faculty of Sciences, Kibbutzim College of Education Technology and the Arts, Tel Aviv 6250769, Israel
| | - Vered Kaufman-Shriqui
- Department of Nutrition Sciences, School of Health Sciences, Ariel University, Ariel 40700, Israel;
| | - Rebecca Goldsmith
- Nutrition Division, Ministry of Health, Jerusalem 9101002, Israel; (R.G.); (C.S.); (L.N.); (H.A.); (M.B.-M.)
| | - Carmit Safra
- Nutrition Division, Ministry of Health, Jerusalem 9101002, Israel; (R.G.); (C.S.); (L.N.); (H.A.); (M.B.-M.)
| | - Iris Shai
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel;
| | - Gila Fayman
- Institute of Endocrinology and Diabetes, Schneider Children’s Medical Center, Petah Tikva 4920235, Israel; (M.G.-K.); (G.F.)
- Israeli National Council of Diabetes, Ministry of Health, Tel Aviv 6744325, Israel
| | - Elliot Berry
- Braun School of Public Health, Hebrew University-Hadassah Medical School, Jerusalem 9222507, Israel;
| | - Amir Tirosh
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan 5266202, Israel;
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Dror Dicker
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
- Internal Medicine D, Hasharon Hospital, Rabin Medical Center, Petah Tikva 4937211, Israel
| | - Oren Froy
- The Institute of Biochemistry, Food Science and Nutrition, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 7610001, Israel;
| | - Eli Gordon
- Food Control Services, Ministry of Health, Tel Aviv 6473912, Israel; (E.G.); (A.C.B.-Y.)
| | - Anat Chavia Ben-Yosef
- Food Control Services, Ministry of Health, Tel Aviv 6473912, Israel; (E.G.); (A.C.B.-Y.)
| | - Lesley Nitsan
- Nutrition Division, Ministry of Health, Jerusalem 9101002, Israel; (R.G.); (C.S.); (L.N.); (H.A.); (M.B.-M.)
| | - Hava Altman
- Nutrition Division, Ministry of Health, Jerusalem 9101002, Israel; (R.G.); (C.S.); (L.N.); (H.A.); (M.B.-M.)
| | - Moran Blaychfeld-Magnazi
- Nutrition Division, Ministry of Health, Jerusalem 9101002, Israel; (R.G.); (C.S.); (L.N.); (H.A.); (M.B.-M.)
| | - Ronit Endevelt
- Nutrition Division, Ministry of Health, Jerusalem 9101002, Israel; (R.G.); (C.S.); (L.N.); (H.A.); (M.B.-M.)
- School of Public Health, University of Haifa, Haifa 3498838, Israel
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Oliveira D, De Steur H, Lagast S, Gellynck X, Schouteten JJ. The impact of calorie and physical activity labelling on consumer's emo-sensory perceptions and food choices. Food Res Int 2020; 133:109166. [PMID: 32466912 DOI: 10.1016/j.foodres.2020.109166] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 03/12/2020] [Accepted: 03/15/2020] [Indexed: 12/25/2022]
Abstract
Providing labelling information is one of the strategies used to help consumers make healthier choices. However, although the type of information has the potential to assist consumers, it is important to evaluate their sensory and emotional perceptions. Therefore, the objective of this study was to evaluate the effect of different labelling information on consumers' sensory and emotional perceptions and their choices, for three different products (potato chips, juice and yogurt). A total of 480 participants were randomly assigned to one of four information conditions (no information (blind), kilocalorie (kcal) information, physical activity (PA) information [duration of walking required to burn the kcal in the product], kcal + PA information). For each information condition, participants were provided with higher kcal and lower kcal equivalent food pairs and were required to choose one. The participants evaluated their overall liking using a 9-point hedonic scale and answered rate-all-that-apply (RATA) questions related to the sensory and emotional characteristics of the products. The results showed no significant impact of calorie and physical activity labelling on consumers' overall liking for juice and yogurt samples and no impact of PA information for chips. Significant differences in overall liking were found when comparing the blind condition with kcal and kcal + PA information, with lower acceptance of the chips samples when this information was presented. Although providing calorie and physical activity labelling had little impact on consumers' sensory and emotional perceptions, consumers perceived unhealthy attributes and negative emotions, such as fatty and guilty, when information was presented. The present work suggests that, although nutrition labelling may be presented as an important strategy to assist consumers, it is important to evaluate consumers' lifestyles, considering that non-dieters and those low and moderate in dietary restraint may not be impacted by this information.
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Affiliation(s)
- Denize Oliveira
- Department of Agricultural Economics, Ghent University, Coupure Links 653, 9000 Gent, Belgium.
| | - Hans De Steur
- Department of Agricultural Economics, Ghent University, Coupure Links 653, 9000 Gent, Belgium
| | - Sofie Lagast
- Department of Agricultural Economics, Ghent University, Coupure Links 653, 9000 Gent, Belgium
| | - Xavier Gellynck
- Department of Agricultural Economics, Ghent University, Coupure Links 653, 9000 Gent, Belgium
| | - Joachim J Schouteten
- Department of Agricultural Economics, Ghent University, Coupure Links 653, 9000 Gent, Belgium
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Egnell M, Galan P, Farpour-Lambert NJ, Talati Z, Pettigrew S, Hercberg S, Julia C. Compared to other front-of-pack nutrition labels, the Nutri-Score emerged as the most efficient to inform Swiss consumers on the nutritional quality of food products. PLoS One 2020; 15:e0228179. [PMID: 32107489 PMCID: PMC7046267 DOI: 10.1371/journal.pone.0228179] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 01/08/2020] [Indexed: 12/12/2022] Open
Abstract
Background Switzerland, like other high-income countries, is facing a major public health challenge with the increasing burden of non-communicable diseases. Discussions are currently on-going in Switzerland regarding the implementation of a Front-of-Pack nutrition label (FoPL) as a public health measure to guide consumers towards healthier food choices, and the Nutri-Score represents an alternative supported by multiple actors. To date, no studies have investigated the performance of the Nutri-Score among Swiss consumers. This study aimed to compare the response of Swiss consumers to five FoPLs (Health Star Rating system, Multiple Traffic Lights, Nutri-Score, Reference Intakes and Warning symbol) in terms of perception and understanding of these labels and effects on food choices. Methods In 2019, 1,088 Swiss consumers were recruited and asked to select one product from among a set of three foods with different nutritional profiles and then classify the products within the sets according to their nutritional quality. Tasks were performed in situations without a label and then with one of the five FoPLs–depending on the group in which they were randomized–on the pack. Finally, participants were questioned on their perceptions regarding the label to which they were exposed. Results All FoPLs were favorably perceived, with marginal differences between FoPLs. The Nutri-Score demonstrated the highest percentage of improvement in food choices and the highest overall performance in helping consumers rank the products according to their nutritional quality. Conclusion Overall, the Nutri-Score was the most efficient FoPL in informing Swiss consumers of the nutritional quality of food products, and as such could be a useful tool to improve food choices and reduce the burden of chronic diseases in Switzerland.
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Affiliation(s)
- Manon Egnell
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125, Inra, Cnam, Paris 13 University, Bobigny, France
- * E-mail:
| | - Pilar Galan
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125, Inra, Cnam, Paris 13 University, Bobigny, France
| | | | - Zenobia Talati
- School of Psychology, Curtin University, Bentley, WA, Australia
| | | | - Serge Hercberg
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125, Inra, Cnam, Paris 13 University, Bobigny, France
- Public health department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Chantal Julia
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125, Inra, Cnam, Paris 13 University, Bobigny, France
- Public health department, Avicenne Hospital, AP-HP, Bobigny, France
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Johnson SD, Blythe JM, Manning M, Wong GTW. The impact of IoT security labelling on consumer product choice and willingness to pay. PLoS One 2020; 15:e0227800. [PMID: 31978096 PMCID: PMC6980634 DOI: 10.1371/journal.pone.0227800] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 12/31/2019] [Indexed: 11/29/2022] Open
Abstract
The Internet of Things (IoT) brings internet connectivity to everyday electronic devices (e.g. security cameras and smart TVs) to improve their functionality and efficiency. However, serious security and privacy concerns have been raised about the IoT which impact upon consumer trust and purchasing. Moreover, devices vary considerably in terms of the security they provide, and it is difficult for consumers to differentiate between more and less secure devices. One proposal to address this is for devices to carry a security label to help consumers navigate the market and know which devices to trust, and to encourage manufacturers to improve security. Using a discrete choice experiment, we estimate the potential impact of such labels on participant’s purchase decision making, along with device functionality and price. With the exception of a label that implied weak security, participants were significantly more likely to select a device that carried a label than one that did not. While they were generally willing to pay the most for premium functionality, for two of the labels tested, they were prepared to pay the same for security and functionality. Qualitative responses suggested that participants would use a label to inform purchasing decisions, and that the labels did not generate a false sense of security. Our findings suggest that the use of a security label represents a policy option that could influence behaviour and that should be seriously considered.
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Affiliation(s)
- Shane D. Johnson
- Dawes Centre for Future Crime, University College London, London, England, United Kingdom
- * E-mail:
| | - John M. Blythe
- Dawes Centre for Future Crime, University College London, London, England, United Kingdom
| | - Matthew Manning
- ANU Centre for Social Research and Methods, The Australian National University, Canberra, Australia
| | - Gabriel T. W. Wong
- ANU Centre for Social Research and Methods, The Australian National University, Canberra, Australia
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29
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Front-of-package food labels: A narrative review. Appetite 2020; 144:104485. [DOI: 10.1016/j.appet.2019.104485] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 09/29/2019] [Accepted: 10/07/2019] [Indexed: 12/27/2022]
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Pettigrew S, Dana L, Talati Z. Enhancing the effectiveness of the Health Star Rating via presentation modifications. Aust N Z J Public Health 2019; 44:20-21. [DOI: 10.1111/1753-6405.12952] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 09/01/2019] [Accepted: 10/01/2019] [Indexed: 11/29/2022] Open
Affiliation(s)
- Simone Pettigrew
- School of PsychologyCurtin University Western Australia
- The George Institute for Global Health Sydney New South Wales
| | - Liyuwork Dana
- School of PsychologyCurtin University Western Australia
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Talati Z, Egnell M, Hercberg S, Julia C, Pettigrew S. Food Choice Under Five Front-of-Package Nutrition Label Conditions: An Experimental Study Across 12 Countries. Am J Public Health 2019; 109:1770-1775. [PMID: 31622139 DOI: 10.2105/ajph.2019.305319] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To determine which front-of-package label (out of 5 formats) is most effective at guiding consumers toward healthier food choices.Methods. Respondents from Argentina, Australia, Bulgaria, Canada, Denmark, France, Germany, Mexico, Singapore, Spain, the United Kingdom, and the United States took part in the Front-of-Pack International Comparative Experiment between April and July 2018. Respondents were shown foods of varying nutritional quality (with no label on package) and selected which they would be most likely to purchase. The same choice sets were then shown again with 1 of 5 randomly allocated labels on package (Health Star Rating (HSR), Multiple Traffic Lights (MTL), Nutri-Score, Reference Intakes, or Warning Label). We calculated an improvement score (from 11 100 valid responses) to identify the extent to which the labels produced healthier choices.Results. The most effective labels were the Nutri-Score and the MTL (mean improvement score = 0.09; 95% confidence interval [CI] = 0.07, 0.11), then the Warning Label (0.06; 95% CI = 0.04, 0.08), the HSR (0.05; 95% CI = 0.03, 0.07), and lastly the Reference Intakes (0.04; 95% CI = 0.02, 0.04).Conclusions. Well-designed, salient, and intuitive front-of-package labels can be effective on a global scale. Their impact is not bound to the country from which they originate.
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Affiliation(s)
- Zenobia Talati
- Zenobia Talati and Simone Pettigrew are with the School of Psychology, Curtin University, Bentley, Australia. Simone Pettigrew is also with The George Institute for Global Health, Sydney, Australia. Manon Egnell, Serge Hercberg, and Chantal Julia are with the Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm/Inra/Cnam/University Paris13, Bobigny, France. Serge Hercberg and Chantal Julia are also with the Public Health Department, Avicenne Hospital, Bobigny, France
| | - Manon Egnell
- Zenobia Talati and Simone Pettigrew are with the School of Psychology, Curtin University, Bentley, Australia. Simone Pettigrew is also with The George Institute for Global Health, Sydney, Australia. Manon Egnell, Serge Hercberg, and Chantal Julia are with the Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm/Inra/Cnam/University Paris13, Bobigny, France. Serge Hercberg and Chantal Julia are also with the Public Health Department, Avicenne Hospital, Bobigny, France
| | - Serge Hercberg
- Zenobia Talati and Simone Pettigrew are with the School of Psychology, Curtin University, Bentley, Australia. Simone Pettigrew is also with The George Institute for Global Health, Sydney, Australia. Manon Egnell, Serge Hercberg, and Chantal Julia are with the Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm/Inra/Cnam/University Paris13, Bobigny, France. Serge Hercberg and Chantal Julia are also with the Public Health Department, Avicenne Hospital, Bobigny, France
| | - Chantal Julia
- Zenobia Talati and Simone Pettigrew are with the School of Psychology, Curtin University, Bentley, Australia. Simone Pettigrew is also with The George Institute for Global Health, Sydney, Australia. Manon Egnell, Serge Hercberg, and Chantal Julia are with the Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm/Inra/Cnam/University Paris13, Bobigny, France. Serge Hercberg and Chantal Julia are also with the Public Health Department, Avicenne Hospital, Bobigny, France
| | - Simone Pettigrew
- Zenobia Talati and Simone Pettigrew are with the School of Psychology, Curtin University, Bentley, Australia. Simone Pettigrew is also with The George Institute for Global Health, Sydney, Australia. Manon Egnell, Serge Hercberg, and Chantal Julia are with the Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm/Inra/Cnam/University Paris13, Bobigny, France. Serge Hercberg and Chantal Julia are also with the Public Health Department, Avicenne Hospital, Bobigny, France
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Nieto C, Jáuregui A, Contreras-Manzano A, Arillo-Santillan E, Barquera S, White CM, Hammond D, Thrasher JF. Understanding and use of food labeling systems among Whites and Latinos in the United States and among Mexicans: Results from the International Food Policy Study, 2017. Int J Behav Nutr Phys Act 2019; 16:87. [PMID: 31623663 PMCID: PMC6798377 DOI: 10.1186/s12966-019-0842-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 08/16/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obesity and chronic diseases could be prevented through improved diet. Most governments require at least one type of food labeling system on packaged foods to communicate nutrition information and promote healthy eating. This study evaluated adult consumer understanding and use of nutrition labeling systems in the US and Mexico, the most obese countries in the world. METHODS Adults from online consumer panels in the US (Whites n = 2959; Latinos n = 667) and in Mexico (n = 3533) were shown five food labeling systems: 1. Nutrition Facts Table (NFT) that shows nutrients of concern per serving; 2. Guideline Daily Amounts (GDA) that shows levels of nutrients of concern; 3. Multiple Traffic-Light (MTL) that color codes each GDA nutrient (green = healthy; yellow = moderately unhealthy; red = unhealthy); 4. Health Star Rating System (HSR) that rates foods on a single dimension of healthiness; 5. Warning Label (WL) with a stop sign for nutrients present in unhealthy levels. Participants rated each label on understanding ("easy"/"very easy to understand" vs "difficult"/"very difficult to understand"), and, for NFTs and GDAs, frequency of use ("sometimes"/"often" vs "never"). Mixed logistic models regressed understanding and frequency of use on indicators of labeling systems (NFT = ref), testing for interactions by ethnicity (US Latinos, US Whites, Mexicans), while controlling for sociodemographic and obesity-related factors. RESULTS Compared to the NFT, participants reported greater understanding of the WL (OR = 4.8; 95% CI = 4.4-5.3) and lower understanding of the HSR (OR = 0.34, 95% CI = 0.31-0.37) and the MTL (OR = 0.56, 95% CI = 0.52-0.61), with similar patterns across ethnic subgroups. Participants used GDAs less often than NFTs (OR = 0.48; 95%CI = 0.41-0.55), with the greatest difference among US Whites (OR = 0.10; 95%CI = 0.07-0.14). CONCLUSIONS Understanding and use of the GDA was similar to that of the NFT. Whites, Latinos, and Mexicans consistently reported the best understanding for WLs, a FOPL that highlights unhealthfulness of a product. Therefore, a FOPL summary indicator, such as WLs, may be more effective in both the US and Mexico for guiding consumers towards informed food choices.
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Affiliation(s)
- Claudia Nieto
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col, Santa María Ahuacatitlán, 62100 Cuernavaca, Mexico
| | - Alejandra Jáuregui
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col, Santa María Ahuacatitlán, 62100 Cuernavaca, Mexico
| | - Alejandra Contreras-Manzano
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col, Santa María Ahuacatitlán, 62100 Cuernavaca, Mexico
| | - Edna Arillo-Santillan
- Population Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, 62100 Cuernavaca, Mexico
- School of Demography, ANU College of Arts and Social Sciences, The Australian National University, 9 Fellows Road Acton ACT 260, Canberra, Australia
| | - Simón Barquera
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col, Santa María Ahuacatitlán, 62100 Cuernavaca, Mexico
| | - Christine M. White
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1 Canada
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1 Canada
| | - James F. Thrasher
- Population Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, 62100 Cuernavaca, Mexico
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, 921 Assembly St, Columbia, SC 29208 USA
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Abstract
Background The U.S. Food and Drug Administration has begun a public process to redefine how companies are allowed to use the term “healthy” on food packages. Although the definition is formulated based on the latest consensus in nutrition and epidemiological research, it is also important to understand how consumers define and understand the term if it is to be behaviorally relevant. This research is an exploratory study designed to provide a descriptive account of consumers’ perceptions of and beliefs about the meaning of “healthy” food. Methods A nationwide U.S. sample of 1,290 food consumers was surveyed in December 2018. Respondents answered 15 questions designed to gauge perceptions of healthy food and to elicit preference for policies surrounding healthy food definitions. Responses are weighted to demographically match the population. Categorical variables have a sampling error of ±2.7%. Exploratory factor analysis is used to determine latent dimensions of health perceptions related to food type. Results Consumers were about evenly split on whether a food can be deemed healthy based solely on the foods’ nutritional content (52.1% believing as such) or whether there were other factors that affect whether a food is healthy (47.9% believing as such). Consumers were also about evenly split on whether an individual food can be considered healthy (believed by 47.9%) or whether this healthiness is instead a characteristic of one’s overall diet (believed by 52.1%). Ratings of individual food products revealed that “healthy” perceptions are comprised of at least three underlying latent dimensions related to animal origin, preservation, and freshness/processing. Focusing on individual macronutrients, perceived healthiness was generally decreasing in a food’s fat, sodium, and carbohydrate content and increasing in protein content. About 40% of consumers thought a healthy label implied they should increase consumption of the type of food bearing the label and about 15% thought the label meant they could eat all they wanted. Conclusions Results suggest consumer’s perceptions of “healthy,” which is primarily based on fat content, partially aligns with the FDA definition but also suggest consumers perceive the word as a broader and more nuanced concept that defies easy, uniform definition. Results highlight areas where nutrition education may be needed and suggest disclosures may need to accompany health claims so that consumers know what, precisely, is being communicated.
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Affiliation(s)
- Jayson L. Lusk
- Department of Agricultural Economics, Purdue University, West Lafayette, Indiana, United States of America
- * E-mail:
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34
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Egnell M, Talati Z, Gombaud M, Galan P, Hercberg S, Pettigrew S, Julia C. Consumers' Responses to Front-of-Pack Nutrition Labelling: Results from a Sample from The Netherlands. Nutrients 2019; 11:nu11081817. [PMID: 31390835 PMCID: PMC6723811 DOI: 10.3390/nu11081817] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 07/31/2019] [Accepted: 08/02/2019] [Indexed: 11/17/2022] Open
Abstract
Front-of-pack labels (FoPLs) are efficient tools for helping consumers identify healthier food products. Although discussions on nutritional labelling are currently ongoing in Europe, few studies have compared the effectiveness of FoPLs in European countries, including the Netherlands. This study aimed to compare five FoPLs among Dutch participants (the Health Star Rating (HSR) system, Multiple Traffic Lights (MTL), Nutri-Score, Reference Intakes (RIs), and Warning symbols) in terms of perception and understanding of the labels and food choices. In 2019, 1032 Dutch consumers were recruited and asked to select one product from among a set of three foods with different nutritional profiles, and then rank the products within the sets according to their nutritional quality. These tasks were performed with no label and then with one of the five FoPLs on the package, depending on the randomization arm. Finally, participants were questioned on their perceptions regarding the label to which they were exposed. Regarding perceptions, all FoPLs were favorably perceived but with only marginal differences between FoPLs. While no significant difference across labels was observed for food choices, the Nutri-Score demonstrated the highest overall performance in helping consumers rank the products according to their nutritional quality.
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Affiliation(s)
- Manon Egnell
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125 Inra, Cnam, Paris 13 University, 93000 Bobigny, France.
| | - Zenobia Talati
- School of Psychology, Curtin University, Kent St, Bentley, WA 6102, Australia
| | - Marion Gombaud
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125 Inra, Cnam, Paris 13 University, 93000 Bobigny, France
| | - Pilar Galan
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125 Inra, Cnam, Paris 13 University, 93000 Bobigny, France
| | - Serge Hercberg
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125 Inra, Cnam, Paris 13 University, 93000 Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, 93000 Bobigny, France
| | - Simone Pettigrew
- The George Institute for Global Health, Sydney, NSW 2042, Australia
| | - Chantal Julia
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125 Inra, Cnam, Paris 13 University, 93000 Bobigny, France
- Public Health Department, Avicenne Hospital, AP-HP, 93000 Bobigny, France
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Egnell M, Crosetto P, d'Almeida T, Kesse-Guyot E, Touvier M, Ruffieux B, Hercberg S, Muller L, Julia C. Modelling the impact of different front-of-package nutrition labels on mortality from non-communicable chronic disease. Int J Behav Nutr Phys Act 2019; 16:56. [PMID: 31307496 PMCID: PMC6631735 DOI: 10.1186/s12966-019-0817-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 07/09/2019] [Indexed: 01/09/2023] Open
Abstract
Background Front-of-Package nutrition labels (FoPLs) are intended to help reduce the incidence of nutrition-related non-communicable diseases through an improvement in diet quality. FoPLs have been shown to improve the nutritional quality of purchases and have been associated with improved diet quality, which is in turn associated with reduced risk of non-communicable diseases. However, the potential impact of FoPLs on reducing mortality from chronic diseases has never been estimated. Methods Data from a laboratory experimental economics test were used to investigate the effects of five different FoPLs (Nutri-Score, Health Star Rating system, Multiple Traffic lights, Reference intakes and SENS (Système d’Etiquetage Nutritionnel Simplifié)) on the nutritional quality of household purchases. The relative differences in nutrient content and composition of food purchases were then applied to dietary intakes using data from an observational study, thus yielding estimates for ‘reference’ and ‘labelled’ diets. A macro-simulation study using the PRIME model was then conducted to estimate the impact of the modification in dietary intake as a result of FoPL use on mortality from diet-related non-communicable diseases. Results The use of FoPLs led to a substantial reduction in mortality from chronic diseases. Approximately 3.4% of all deaths from diet-related non-communicable diseases was estimated to be avoidable when the Nutri-Score FoPL was used. The remaining FoPLs likewise resulted in mortality reduction, although to a lesser extent: Health Star Rating system (2.8%), Reference Intakes (1.9%), Multiple Traffic Lights (1.6%), and SENS (1.1%). Conclusions FoPLs have the potential to help decrease mortality from diet-related non-communicable diseases, and the Nutri-Score appears to be the most efficient among the five formats tested. Electronic supplementary material The online version of this article (10.1186/s12966-019-0817-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Manon Egnell
- Sorbonne Paris Cité Epidemiology and Statistics Research Centre (CRESS), U1153 Inserm, U1125, Inra, Cnam, University of Paris 13, Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France.
| | | | - Tania d'Almeida
- Sorbonne Paris Cité Epidemiology and Statistics Research Centre (CRESS), U1153 Inserm, U1125, Inra, Cnam, University of Paris 13, Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Cité Epidemiology and Statistics Research Centre (CRESS), U1153 Inserm, U1125, Inra, Cnam, University of Paris 13, Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Cité Epidemiology and Statistics Research Centre (CRESS), U1153 Inserm, U1125, Inra, Cnam, University of Paris 13, Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Bernard Ruffieux
- Inra, UMR 1215 GAEL, 38000, Grenoble, France.,Polytechnic Institute of Grenoble, 38031, Grenoble, France
| | - Serge Hercberg
- Sorbonne Paris Cité Epidemiology and Statistics Research Centre (CRESS), U1153 Inserm, U1125, Inra, Cnam, University of Paris 13, Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France.,Public Health Department, Avicenne Hospital, 93000, Bobigny, France
| | | | - Chantal Julia
- Sorbonne Paris Cité Epidemiology and Statistics Research Centre (CRESS), U1153 Inserm, U1125, Inra, Cnam, University of Paris 13, Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France.,Public Health Department, Avicenne Hospital, 93000, Bobigny, France
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Egnell M, Boutron I, Péneau S, Ducrot P, Touvier M, Galan P, Buscail C, Porcher R, Ravaud P, Hercberg S, Kesse-Guyot E, Julia C. Front-of-Pack Labeling and the Nutritional Quality of Students' Food Purchases: A 3-Arm Randomized Controlled Trial. Am J Public Health 2019; 109:1122-1129. [PMID: 31219721 DOI: 10.2105/ajph.2019.305115] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To assess the effects of the Nutri-Score label (relative to the Reference Intakes label or no label) on the nutritional quality of students' food purchases. Methods. A 3-arm randomized controlled trial was conducted in France in 2017; 2907 participants were randomized into 1 of the 3 study arms (Nutri-Score, Reference Intakes, no label) and invited to purchase groceries from an experimental Web-based supermarket. The main outcome was the overall nutritional quality of purchases, measured according to a modified version of the Food Standards Agency Nutrient Profiling System (FSAm-NPS/HCSP) score. Results. The mean (±SD) FSAm-NPS/HCSP score was lower in the Nutri-Score group (2.02 ±3.56) than in the Reference Intakes group (2.69 ±3.44), reflecting higher nutritional quality; however, there was no significant difference between the Nutri-Score and no-label (2.45 ±3.28) groups or between the Reference Intakes and no-label groups. Shopping cart content was lower in calories and saturated fatty acids and higher in fruits and vegetables in the Nutri-Score arm than in the other arms. Conclusions. The Nutri-Score label appeared to improve the nutritional composition of students' food purchases relative to the Reference Intakes label or no label.
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Affiliation(s)
- Manon Egnell
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Isabelle Boutron
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Sandrine Péneau
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Pauline Ducrot
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Mathilde Touvier
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Pilar Galan
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Camille Buscail
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Raphaël Porcher
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Philippe Ravaud
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Serge Hercberg
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Emmanuelle Kesse-Guyot
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
| | - Chantal Julia
- Manon Egnell, Sandrine Péneau, Mathilde Touvier, Pilar Galan, Camille Buscail, Serge Hercberg, Emmanuelle Kesse-Guyot, and Chantal Julia are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Nutritional Epidemiology Research Team, Paris 13 University, Bobigny, France. Isabelle Boutron, Raphaël Porcher, and Philippe Ravaud are with the Sorbonne Paris Cité Epidemiology and Statistics Research Center and the Centre d'épidémiologie clinique, Hôtel-Dieu Hospital, Paris, France. Pauline Ducrot is with Santé Publique France, National Public Health Agency, Saint-Maurice, France
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Coyle DH, Ndanuko R, Singh S, Huang P, Wu JH. Variations in Sugar Content of Flavored Milks and Yogurts: A Cross-Sectional Study across 3 Countries. Curr Dev Nutr 2019; 3:nzz060. [PMID: 31187086 PMCID: PMC6554456 DOI: 10.1093/cdn/nzz060] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 04/17/2019] [Accepted: 04/30/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The consumption of dairy products is encouraged at all life stages as a nutrient-rich component of the diet. However, many milk and yogurt products, particularly flavored varieties, may contain large amounts of free sugar. OBJECTIVES The aim of this paper was to evaluate the availability and sugar content of flavored milks and yogurts in supermarkets across 3 countries: Australia, England, and South. METHODS Nutrition information for flavored milks and yogurts was collected by trained researchers and supplemented by crowd-sourced data from a smartphone application. Data were extracted in April 2018 and 3724 milk and yogurt products were available for analysis. Mean sugar concentrations were compared across countries with the use of ANOVA followed by Tukey's post-hoc pairwise comparisons. Sugar concentrations were compared with the UK's "green" traffic-light classifications. RESULTS Approximately 74% (n = 2753) of all products were flavored. Flavored products contained nearly twice the average total sugar content of unflavored products, with substantial variability: mean total sugar was 9.1 g/100 mL (range: 4.3-15.0 g/100 mL) and 11.5 g/100 g (range: 0.1-22.6 g/100 g) for flavored milks and yogurts, respectively. Free sugars contributed an estimated 41% and 42% of total sugar in milks and yogurts, respectively. Flavored milks in England had ∼0.7 g/100 mL higher total sugar on average compared with Australia and South Africa (P ≤ 0.04), whereas flavored yogurts in South Africa had the lowest average total sugar (∼2 g/100 g lower than England and Australia; P < 0.001). Less than 4% of flavored products would receive a "green" rating under the UK traffic-light labeling scheme. CONCLUSIONS In Australia, England, and South Africa, flavored milks and yogurts are highly prevalent in the food supply and contain significantly higher concentrations of total and added sugars than unflavored products.
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Affiliation(s)
- Daisy H Coyle
- The George Institute for Global Health, Sydney, NSW, Australia
- University of New South Wales, Sydney, NSW, Australia
| | - Rhoda Ndanuko
- The George Institute for Global Health, Sydney, NSW, Australia
| | - Sarinda Singh
- The George Institute for Global Health, Sydney, NSW, Australia
| | - Polly Huang
- The George Institute for Global Health, Sydney, NSW, Australia
| | - Jason H Wu
- The George Institute for Global Health, Sydney, NSW, Australia
- University of New South Wales, Sydney, NSW, Australia
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Dana LM, Chapman K, Talati Z, Kelly B, Dixon H, Miller C, Pettigrew S. Consumers' Views on the Importance of Specific Front-of-Pack Nutrition Information: A Latent Profile Analysis. Nutrients 2019; 11:nu11051158. [PMID: 31126149 PMCID: PMC6566345 DOI: 10.3390/nu11051158] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/10/2019] [Accepted: 05/15/2019] [Indexed: 01/03/2023] Open
Abstract
Nutrition labelling can influence consumers’ assessments of food healthiness and their food choices. However, there is a lack of consensus about the optimal type and amount of nutrition information to provide on food packages. This study analysed consumers’ preferences for front-of-pack information relating to energy and various nutrients (sugar, saturated fat, sodium, fibre, carbohydrate, and protein). The aim was to identify discrete preference segments within the Australian market where the current Health Star Rating front-of-pack labelling system can be displayed with different levels of nutrition information. Adults (n = 1558) completed a survey assessing socio-demographics, self-reported nutrition knowledge, diet healthiness, special dietary requirements, and perceived importance of the provision of energy and nutrient information on the front of food packs. Latent profile analysis identified five consumer segments within the sample that ranged from groups exhibiting high levels of interest in various forms of nutrition information to one with very low interest and one with divergent scores according to whether nutrients were perceived as positive or negative for health. The results indicate that different forms of front-of-pack labelling featuring varying degrees of information about energy and specific nutrients are likely to be of interest and use to different market segments.
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Affiliation(s)
| | - Kathy Chapman
- School of Life and Environment Sciences, Faculty of Science, University of Sydney, Camperdown, NSW 2006, Australia.
- School of Medicine & Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
| | - Zenobia Talati
- School of Psychology, Curtin University, Kent St, Bentley, WA 6102, Australia.
| | - Bridget Kelly
- Early Start, School of Health and Society, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia.
| | - Helen Dixon
- School of Psychology, Curtin University, Kent St, Bentley, WA 6102, Australia.
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, VIC 3004, Australia.
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne VIC 3010, Australia.
| | - Caroline Miller
- Population Health Research Group, South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA 5000, Australia.
- School of Public Health, University of Adelaide, Adelaide, SA 5000, Australia.
| | - Simone Pettigrew
- School of Psychology, Curtin University, Kent St, Bentley, WA 6102, Australia.
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Niven P, Morley B, Dixon H, Martin J, Jones A, Petersen K, Wakefield M. Effects of health star labelling on the healthiness of adults' fast food meal selections: An experimental study. Appetite 2019; 136:146-153. [PMID: 30684644 DOI: 10.1016/j.appet.2019.01.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/09/2019] [Accepted: 01/21/2019] [Indexed: 10/27/2022]
Abstract
The addition of Health Star Rating (HSR) labelling to menus at fast food outlets is feasible, however how this would impact consumer menu selection remains unclear. The aim of this study was to test whether the addition of HSR labelling to kilojoule (kJ) labelling on menus at fast food outlets would prompt consumers to select healthier meals. Using a between-subjects experimental design, 1007 adults aged 18-49 were allocated to one of four menu labelling conditions: (i) no labelling; (ii) kilojoule labelling; (iii) HSR labelling; and (iv) kilojoule + HSR labelling. Respondents were presented with their assigned menu online and instructed to select an evening meal as they would at a fast food restaurant. The main analyses tested differences by menu labelling condition in the total mean kilojoule content and Nutrient Profiling Score (NPS) of respondents' evening meal selections using one-way ANOVA. The mean kilojoule content of meals did not differ significantly by menu labelling condition. However, respondents in the kilojoule + HSR labelling condition selected healthier meals (lower mean NPS) than those who viewed menu boards with kilojoule labelling only (M = 2.88 cf. M = 3.78, p = 0.046). In addition, in a post hoc per-protocol analysis of respondents who reported using menu labelling to assist their meal selection, respondents shown kilojoule + HSR menu labelling selected meals with a significantly lower kilojoule content compared to those shown HSR labelling only (4751 kJ cf. 5745 kJ, p = 0.038). Findings provide evidence that adding HSRs to kilojoule labelling on menu boards at fast food outlets has the potential to assist adults to make healthier evening meal selections.
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Affiliation(s)
- Philippa Niven
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Belinda Morley
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Helen Dixon
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia.
| | - Jane Martin
- Obesity Policy Coalition, Melbourne, Victoria, Australia
| | - Alexandra Jones
- The George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia; Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Kristina Petersen
- The George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia; The Pennsylvania State University, Department of Nutritional Sciences, University Park, PA, USA
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
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Health Star Rating in Grain Foods-Does It Adequately Differentiate Refined and Whole Grain Foods? Nutrients 2019; 11:nu11020415. [PMID: 30781440 PMCID: PMC6412646 DOI: 10.3390/nu11020415] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/03/2019] [Accepted: 02/07/2019] [Indexed: 01/02/2023] Open
Abstract
The Australian front-of-pack labelling system, Health Star Rating (HSR), does not include whole grain (WG) in its algorithm, but uses dietary fibre (DF), despite Dietary Guidelines recommending WG over refined grain (RG) foods. This study aimed to determine how effectively HSR differentiates WG and RG foods. Product label data were collected 2017–18 from bread, rice, pasta, noodles, flour and breakfast cereals (n = 1127). Products not displaying HSR, DF per 100 g, and %WG ingredients were excluded, leaving a sample of 441 products; 68% were WG (≥8 g/manufacturer serving). There was a significant difference (p < 0.001) in HSR between WG bread and breakfast cereal over RG varieties, yet the mean difference in stars depicted on the pack was only 0.4 for bread and 0.7 for breakfast cereal. There was no difference for rice (p = 0.131) or flour (p = 0.376). Median HSR also poorly differentiated WG. More WG foods scored 4–5 stars compared to RG, yet there was notable overlap between 3.5–5 stars. DF content between RG and WG subcategories was significantly different, however wide variation and overlap in DF highlights that this may not be a sufficient proxy measure, raising concerns that the HSR algorithm may not adequately communicate the benefits for consumers of swapping to WG foods.
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Talati Z, Norman R, Kelly B, Dixon H, Neal B, Miller C, Pettigrew S. A randomized trial assessing the effects of health claims on choice of foods in the presence of front-of-pack labels. Am J Clin Nutr 2018; 108:1275-1282. [PMID: 30351342 DOI: 10.1093/ajcn/nqy248] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 08/21/2018] [Indexed: 01/18/2023] Open
Abstract
Background As a public health intervention, front-of-pack labels (FoPLs) have the potential to reach large numbers of consumers and promote healthier food choices. Of the different FoPLs, those that summarize a product's overall nutritional profile tend to be most effective in guiding healthier choices. However, information is lacking as to whether FoPLs are as effective when nutrient or health claims also appear on-pack. Objective The aim of this study was to examine how the choice of foods of varying levels of healthfulness (less healthy, moderately healthy, and healthier) is affected by the appearance of various FoPLs (Daily Intake Guide, Multiple Traffic Lights, Health Star Rating) when shown in combination with different claim conditions (no claim, nutrient claim, general-level health claim, and higher-level health claim). Design Adults and children (n = 2069) completed a discrete-choice experiment online. Respondents were shown 8 choice sets, each containing 4 alternatives of the same food type (cookies, cornflakes, pizza, or yogurt) of varying levels of healthfulness and were asked which product they would likely purchase (or they could select none). Respondents were randomly assigned to view 1 of the 3 FoPLs across all choice sets. Claim type and healthfulness varied within choice sets in accordance with a D-efficient design. Results The probability of choosing a healthy product and avoiding an unhealthy product was greatest when only an FoPL (especially the Health Star Rating) appeared on-pack. The addition of a nutrient or health claim did not affect the likelihood of picking healthier products but did increase the likelihood of selecting less healthy foods across all FoPL conditions. Conclusions FoPLs are most effective in helping consumers make better food choices when nutrient and health claims are not present. Policies are required to control how nutrient and health claims are applied to less healthy foods. This trial was registered as ACTRN12617000015347 (www.anzctr.org.au/Trial/Resgistration/TrialReview.aspx?id=372055&isReview=true).
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Affiliation(s)
| | - Richard Norman
- School of Public Health, Curtin University, Perth, Australia
| | - Bridget Kelly
- Early Start, School of Health and Society, University of Wollongong, Wollongong, Australia
| | - Helen Dixon
- Center for Behavioral Research in Cancer, Cancer Council Victoria, Melbourne, Australia
| | - Bruce Neal
- The George Institute for Global Health, University of New South Wales, Sydney, Australia.,School of Public Health, Imperial College London, London, United Kingdom
| | - Caroline Miller
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, Australia.,School of Public Health, University of Adelaide, Adelaide, Australia
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Egnell M, Talati Z, Hercberg S, Pettigrew S, Julia C. Objective Understanding of Front-of-Package Nutrition Labels: An International Comparative Experimental Study across 12 Countries. Nutrients 2018; 10:E1542. [PMID: 30340388 PMCID: PMC6213801 DOI: 10.3390/nu10101542] [Citation(s) in RCA: 124] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 10/15/2018] [Accepted: 10/16/2018] [Indexed: 11/16/2022] Open
Abstract
Front-of-Package labels (FoPLs) are efficient tools for increasing consumers' awareness of foods' nutritional quality and encouraging healthier choices. A label's design is likely to influence its effectiveness; however, few studies have compared the ability of different FoPLs to facilitate a consumer understanding of foods' nutritional quality, especially across sociocultural contexts. This study aimed to assess consumers' ability to understand five FoPLs [Health Star Rating system (HSR), Multiple Traffic Lights (MTL), Nutri-Score, Reference Intakes (RIs), and Warning symbol] in 12 different countries. In 2018, approximately 1000 participants per country were recruited and asked to rank three sets of label-free products (one set of three pizzas, one set of three cakes, and one set of three breakfast cereals) according to their nutritional quality, via an online survey. Participants were subsequently randomised to one of five FoPL conditions and were again asked to rank the same sets of products, this time with a FoPL displayed on pack. Changes in a participants' ability to correctly rank products across the two tasks were assessed by FoPL using ordinal logistic regression. In all 12 countries and for all three food categories, the Nutri-Score performed best, followed by the MTL, HSR, Warning symbol, and RIs.
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Affiliation(s)
- Manon Egnell
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125 Inra, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), 93000 Bobigny, France.
| | - Zenobia Talati
- School of Psychology, Curtin University, Kent St, Bentley, WA 6102, Australia.
| | - Serge Hercberg
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125 Inra, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), 93000 Bobigny, France.
- Public health department, Avicenne Hospital, AP-HP, 93000 Bobigny, France.
| | - Simone Pettigrew
- School of Psychology, Curtin University, Kent St, Bentley, WA 6102, Australia.
| | - Chantal Julia
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), U1153 Inserm, U1125 Inra, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), 93000 Bobigny, France.
- Public health department, Avicenne Hospital, AP-HP, 93000 Bobigny, France.
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Pulker CE, Trapp GSA, Scott JA, Pollard CM. Alignment of Supermarket Own Brand Foods' Front-of-Pack Nutrition Labelling with Measures of Nutritional Quality: An Australian Perspective. Nutrients 2018; 10:E1465. [PMID: 30304807 PMCID: PMC6213021 DOI: 10.3390/nu10101465] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 10/01/2018] [Accepted: 10/04/2018] [Indexed: 12/18/2022] Open
Abstract
Two voluntary front-of-pack nutrition labels (FOPNL) are present in Australia: the government-led Health Star Ratings (HSR) and food industry-led Daily Intake Guide (DIG). Australia's two largest supermarkets are key supporters of HSR, pledging uptake on all supermarket own brand foods (SOBF). This study aimed to examine prevalence of FOPNL on SOBF, and alignment with patterns of nutritional quality. Photographic audits of all SOBF present in three large supermarkets were conducted in Perth, Western Australia, in 2017. Foods were classified as nutritious or nutrient-poor based on the Australian Guide to Healthy Eating (AGTHE), NOVA level of food processing, and HSR score. Most (81.5%) SOBF featured FOPNL, with only 55.1% displaying HSR. HSR was present on 69.2% of Coles, 54.0% of Woolworths, and none of IGA SOBF. Half (51.3%) of SOBF were classified as nutritious using the AGTHE, but using NOVA, 56.9% were ultra-processed foods. Nutrient-poor and ultra-processed SOBF were more likely than nutritious foods to include HSR, yet many of these foods achieved HSR scores of 2.5 stars or above, implying they were a healthy choice. Supermarkets have a powerful position in the Australian food system, and they could do more to support healthy food selection through responsible FOPNL.
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Affiliation(s)
- Claire Elizabeth Pulker
- School of Public Health, Curtin University, Kent Street, GPO Box U1987, Perth 6845, Western Australia, Australia.
| | - Georgina S A Trapp
- Telethon Kids Institute, The University of Western Australia, P.O. Box 855, West Perth 6872, Western Australia, Australia.
- School of Population and Global Health, The University of Western Australia, 35 Stirling Highway, Crawley 6009, Western Australia, Australia.
| | - Jane Anne Scott
- School of Public Health, Curtin University, Kent Street, GPO Box U1987, Perth 6845, Western Australia, Australia.
| | - Christina Mary Pollard
- School of Public Health, Curtin University, Kent Street, GPO Box U1987, Perth 6845, Western Australia, Australia.
- East Metropolitan Health Service, Kirkman House, 20 Murray Street, East Perth 6004, Western Australia, Australia.
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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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Jones A, Shahid M, Neal B. Uptake of Australia's Health Star Rating System. Nutrients 2018; 10:nu10080997. [PMID: 30061512 PMCID: PMC6115967 DOI: 10.3390/nu10080997] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 07/26/2018] [Indexed: 12/01/2022] Open
Abstract
In June 2014, Australia and New Zealand adopted a voluntary front-of-pack nutrition labelling scheme in the form of the Health Star Rating (HSR) system. Our aim was to assess its uptake in Australia while a formal five-year review of the system is underway. Numbers and proportions of products eligible to carry a HSR were recorded each year between 2014 and 2017 as part of an annual survey of four large Australian retail outlets. Mean HSR values were determined for products that were and were not labelled with a HSR logo, and summary data presented overall, by HSR score, by major food category, and for leading manufacturers. Results show that uptake is increasing: HSR appeared on 4348/15,767 (28%) of eligible products in 2017 and has now appeared on 7922 products since implementation. Of those products displaying a HSR logo, more than three-quarters (76.4%) displayed a HSR of ≥3.0. Products displaying a HSR logo had a higher mean HSR (3.4), compared to products not displaying a HSR logo (2.7). Uptake was highest on convenience foods (44%), cereals (36.7%), and fruit and vegetable products (35.9%). More than 100 manufacturers were using the system, but retailers Coles, Woolworths and Aldi were together responsible for 54% of uptake. For all except Coles, Woolworths and Campbell Arnott’s, the mean HSR of products displaying a logo on pack was higher than products made by that manufacturer not showing a HSR logo. We conclude that to ensure the consistent and widespread uptake required for consumers to make informed food purchases, HSR should be made mandatory at the conclusion of the five-year review.
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Affiliation(s)
- Alexandra Jones
- The George Institute for Global Health, UNSW, Sydney, NSW 2042, Australia.
- Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia.
| | - Maria Shahid
- The George Institute for Global Health, UNSW, Sydney, NSW 2042, Australia.
| | - Bruce Neal
- The George Institute for Global Health, UNSW, Sydney, NSW 2042, Australia.
- Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia.
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College London, London SW7 2AZ, UK.
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Hamlin R, McNeill L. The Impact of the Australasian 'Health Star Rating', Front-of-Pack Nutritional Label, on Consumer Choice: A Longitudinal Study. Nutrients 2018; 10:nu10070906. [PMID: 30012941 PMCID: PMC6073628 DOI: 10.3390/nu10070906] [Citation(s) in RCA: 12] [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: 06/26/2018] [Revised: 07/10/2018] [Accepted: 07/11/2018] [Indexed: 12/01/2022] Open
Abstract
Front-of-pack (FoP) nutrition labels are a widely deployed tool in public good marketing. This article reports on a field experimental test of the impact of one of these systems, the Australasian Health Star Rating system (HSR), on consumer choice in the breakfast cereals category in New Zealand. This study forms part of a time-series replication stream of research on this topic. The research applied a 2 × 2 factorial design with multiple replications to retail food consumers exiting from supermarkets in New Zealand. The first part of the time series, undertaken shortly after the HSR’s initiation in 2014, indicated that the HSR was ineffective. Between 2014 and 2016, commercial brands in the category within New Zealand massively promoted the HSR as a basis for consumer choice. The research presented in this article forms part of the second part of the series, undertaken in 2016, using an identical experimental methodology to the 2014 study. The results indicate that the HSR may be beginning to influence consumer choice as it was predicted to, but the impact of the system is still small, and statistically sub-significant, relative to other consumer decision inputs presented on the package.
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Affiliation(s)
- Robert Hamlin
- Department of Marketing, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
| | - Lisa McNeill
- Department of Marketing, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
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