Beverage milk consumption patterns in the United States: Who is substituting from dairy to plant-based beverages?

Assessment of Milk and Beverage Intake Trends During Preschool Age and Modeling the Nutritional Impact of Replacing Nondairy Caloric Beverages with Milk

Background

Milk provides essential crucial public health nutrients, including 3-4 nutrients of public health concern, yet dairy consumption has declined over time, leading most Americans to fall short of meeting Dietary Guidelines recommendations.

Objectives

To investigate milk and beverage consumption trends in preschool-age children, along with nutrient intakes from beverages, and to analyze the potential impact of replacing nondairy beverages with milk through isocaloric substitution.

Methods

Data from the National Health and Nutrition Examination Survey 2001-2018 for children aged 1-5 y (n = 4696) were used, and milk and other beverages intakes were estimated from the first 24-h in-person dietary recall. Nutrient intakes were determined using the United States Department of Agriculture's food and nutrient database for dietary studies. Changes in nutrient intakes of children aged 2-5 y were modeled assuming isocaloric substitution with milk of all nondairy beverages consumed during lunch and dinner combined. Sample-weighted analyses were performed using SAS 9.4, and significance was set at P < 0.01.

Results

With the increasing age of children, the intake of milk decreased, whereas the intake of energy, caloric beverages excluding milk, and sugar-sweetened beverages increased. Daily intakes of energy, protein, fat, saturated fatty acids (SFA), calcium, magnesium, potassium, sodium, vitamin A, folate, vitamin B-12, and vitamin D from caloric beverages including milk decreased with age, whereas the daily intake of fiber and added sugar increased with age. With the isocaloric replacement of nondairy caloric beverages with milk at lunch and dinner among children aged 2-5 y, intake of protein, fat, SFAs, calcium, magnesium, potassium, sodium, vitamin A, folate, vitamin B-12, and vitamin D increased, whereas for intake of carbohydrate, fiber, total sugar, and added sugar decreased.

Conclusions

The current findings indicate that increased efforts are needed to reverse the decrease in milk intake over time and as preschool children age and provide additional evidence to support specific dietary recommendations for milk.

Driving Factors Influencing the Decision to Purchase Plant-Based Beverages: A Sample from Türkiye

In recent years, the trend toward plant-based beverages has continued to grow rapidly. This study aimed to assess the effects of sociodemographic characteristics and knowledge about plant-based beverages, subjective norms, perceived price, environmental protection, animal welfare, availability, and trust on attitudes and buying behavior toward these products. This study was conducted online using a two-part questionnaire prepared by considering the literature. This study included 935 participants, and our findings confirmed that the variable of environmental protection affects the attitude toward these products (β= 0.095; p = 0.007). Furthermore, gender, income level, lactose intolerance, and bloating due to cow's or sheep's milk influenced actual buying behavior (p < 0.05; p < 0.001). These findings indicate that people's increased environmental protection awareness will positively influence attitudes towards plant-based beverages and that individuals who do not experience lactose intolerance and bloating due to cow's or goat's milk will have lower actual buying behavior. It was also determined that individuals with lower incomes bought more plant-based beverages. In conclusion, plant-based beverage marketers need to take into account individuals' sociodemographic characteristics and environmental protection awareness when planning their marketing strategies.

Assessment of Beverage Trends and Replacing Nondairy Caloric Beverages with Milk at Meals across Childhood Improves Intake of Key Nutrients at Risk of Inadequate Consumption: An NHANES Modeling Study

Background

Milk is a key source of important nutrients including the nutrients of public health concern. However, most Americans do not meet current (dairy) United States Department of Agriculture (USDA) dietary guideline recommendations, and the intake has been declining.

Objective

The aim of this study was to investigate milk and beverage intake trends and nutrient intakes from these products in United States children aged 6-18 y and to model the effect of isocaloric substitution of nondairy beverages with milk.

Methods

Data from National Health and Nutrition Examination Survey (NHANES) 2001-2018 for children age 6-8 (N = 4696), 9-13 (N = 8117) and 14-18 y (N = 8514) were used with milk and other beverage intakes determined from the first 24-h in-person dietary recall. Nutrient intake was determined using the NHANES cycle-specific total nutrient intake files. Nutrient modeling was performed by isocaloric substitution with milk of all nondairy beverages consumed during lunch and dinner meals combined. Sample-weighted analyses were performed using SAS 9.4.

Results

Between ages 6-8 and 14-18 y, daily intake of milk and flavored milk decreased by 10% and 62%, respectively, while daily intake of caloric beverages excluding milk increased by 96%. Daily intake from caloric beverages and milk combined decreased for fiber, protein, fat, saturated fat, calcium, magnesium, potassium, vitamin A, and vitamin D and increased for energy, carbohydrates, added sugars, and folate between ages 6-8 y and 14-18 y. Isocaloric substitution of all caloric nondairy beverages at meals with milk (using nutrient contribution of USDA milk, not further specified (NFS)) resulted in increases in protein, fat, saturated fat, calcium, magnesium, potassium, sodium, vitamin A, folate, vitamin B12, and vitamin D and decreases in carbohydrate, fiber, and added sugar.

Conclusion

These findings provide additional evidence to support dietary recommendations for milk, and efforts should be made on behalf of leading health professionals and childhood meal programs to highlight milk as a beverage of choice in children and adolescents.

Human Milk, Infant Formula, and Other Milks Fed to Infants and Toddlers in the United States, NHANES 2007-2018

BACKGROUND

For the first time, the 2020-2025 Dietary Guidelines for Americans provide specific guidance regarding the types of foods and beverages that should be offered in the first 2 years of life. Milk, in various forms (eg, human milk, infant formula, and cow's milk) contributes a large proportion of key nutrients to the diets of infants and toddlers in the United States.

OBJECTIVE

The aim of this study was to determine the types of milk (human milk, infant formula, and other milk) fed to US infants and toddlers in the past 12 years and to describe trends over time.

DESIGN

This was a cross-sectional analysis of 2-day, 24-hour dietary recalls.

PARTICIPANTS/SETTING

Data from the 2007-2018 National Health and Nutrition Examination Survey were used for these analyses. Infants and toddlers aged 0 through 23.9 months with 2 days of dietary recall data (n = 3,079) were included.

MAIN OUTCOME MEASURES

The main outcome was proportion of infants and toddlers fed different milk types.

STATISTICAL ANALYSES PERFORMED

Survey-adjusted weighted percentages were used to report sociodemographic characteristics and the proportion of subjects fed each milk type category by age group and survey cycles. Binary and multinomial logistic regressions were used to assess differences in subject characteristics by age groups.

RESULTS

Sociodemographic characteristics did not differ by age group. The proportion of infants aged 0 to <6 months fed infant formula only was 60.2% in 2007-2012 and 44.8% in 2013-2018. The proportion of infants aged 6 to <12 months fed partially hydrolyzed infant formula only was 7.3% in 2007-2012 and 13.1% in 2013-2018. In toddlers (>12 months old), cow's milk was the predominant milk type in both 2007-2012 and 2013-2018.

CONCLUSIONS

The percentage of infants fed any human milk increased over the past decade. Unsweetened cow's milk was the most predominate milk type consumed among toddlers.

Consumer willingness to pay for shelf life of high-temperature, short-time-pasteurized fluid milk: Implications for smart labeling and food waste reduction

Food waste in the United States was valued at $285 billion in 2019, representing 70% of all food surplus; dairy and eggs alone represented 15.90% of food surplus. Milk is the fifth most consumed beverage in the United States, and therefore its contribution to food waste has significant economic and environmental ramifications. Smart labels that provide precise spoilage information for fluid milk may help reduce food waste in fluid milk, but it is unclear if consumers will accept or pay for this novel technology. This paper examines consumer preferences for high temperature, short time pasteurized fluid milk shelf life and smart date labels and tests how information about the environmental impact of fluid milk food waste affects consumers' acceptance and willingness to pay. We used a choice-based conjoint study administered in an online survey, along with a between-subject experiment to measure preferences under different information treatments about the environmental impact of food waste. Our results suggest that consumers' valuations of extended shelf life and an ecolabel is positive; however, using the smart label creates disutility for consumers, thereby hindering acceptance of new labeling technology that may facilitate food waste reduction in the milk industry. These findings imply that retailers should find alternative means to enhance the communication of precise shelf life information and its role in reducing food waste.

A Comprehensive Analysis of the Nutritional Composition of Plant-Based Drinks and Yogurt Alternatives in Europe

Concerns for human and planetary health have led to a shift towards healthier plant-based diets. Plant-based dairy alternatives (PBDA) have experienced exponential market growth due to their lower environmental impact compared to dairy products. However, questions have arisen regarding their suitability as dairy substitutes and their role in food-based dietary guidelines (FBDG). Our study aimed to analyse the nutritional profiles of leading PBDA across Europe and compare them with their dairy counterparts. We examined the nutritional profiles of 309 unflavoured PBDA representing the European market leaders, including 249 plant-based drinks (PBD) and 52 plant-based alternatives to yogurt (PBAY). PBD and PBAY, excluding coconut varieties, were low in saturated fat (<1 g per serving). Seventy percent of PBDA were unsweetened, and most had sugar levels comparable to dairy. Except for soya varieties, PBDA protein levels were lower than dairy. Organic PBDA lacked micronutrients due to legal restrictions on fortification. Among non-organic PBDA, 76% were fortified with calcium, 66% with vitamin D, and 60% with vitamin B12. Less than half were fortified with vitamin B2, and a few with iodine (11%) and vitamin A (6%). PBAY were less frequently fortified compared to PBD. PBDA displayed a favourable macronutrient profile despite lower protein levels, which would be compensated for by other protein-dense foods in a usual mixed diet. Enhancing fortification consistency with dairy-associated micronutrients would address concerns regarding PBDA's integration into FBDG. Our analysis supports the inclusion of fortified PBDA in environmentally sustainable FBDG for healthy populations.

The cheese paradox: How do vegetarians justify consuming non-meat animal products?

Researchers interested in animal ethics have proposed the 'meat paradox' - psychological discomfort arising from people's affinity for animals and conflicting desire to consume their flesh. Yet what can be said about the psychology of consuming an animal's non-meat products, in an age where most beings in these industries are harmed, and ultimately killed? Non-meat animal products (NMAPs) such as eggs and dairy entail the same, and perhaps even worse ethical issues as meat yet receive disproportionately less critical attention. Therefore, unlike meat, very little is known about the psychology of egg and dairy consumption. This study looks at vegetarians to address this gap, because they are more likely to show empathetic concern for animals than meat-eaters, yet actively choose to include these products in their diet, a conflict ripe for exploration. Interview data were analysed via thematic analysis, finding that vegetarians perceive robust ethical issues with NMAPs but give various justifications pertaining to personal benefits and social norms. Cognitive dissonance was evident and participants used various strategies to resolve it. This paper expands research on food psychology and animal ethics and may also be used to inform NMAP reduction strategies, an important pursuit in the quest for a more sustainable and compassionate world.

“Got Milk Alternatives?” Understanding Key Factors Determining U.S. Consumers’ Willingness to Pay for Plant-Based Milk Alternatives

Milk is an important dairy product in U.S. food retail. Lifestyle changes toward climate-conscious consumption, animal welfare, and food safety concerns have increased the popularity of plant-based milk alternatives. This study is focused on such beverages and provides insights and best practice recommendations for marketing managers in the U.S. food retail sector. An online survey was distributed to explore factors explaining the intentions of U.S. consumers to purchase and pay a premium for plant-based milk alternatives. Food curiosity and food price inflation were identified as relevant for both willingness to buy and willingness to pay a price premium. In addition, animal welfare concerns and the green and clean product image of plant-based alternatives were relevant to the willingness to pay a premium for plant-based milk.

Personal bias in nutrition advice: A survey of health professionals' recommendations regarding dairy and plant-based dairy alternatives

Objective

To examine the association between health professionals' personal dietary behaviors and their professional nutrition recommendations on dairy and plant-based dairy alternatives.

Methods

A cross-sectional survey of 331 U.S. health professionals examined willingness to recommend dairy and/or plant-based dairy alternatives to patients across personal milk preference, and dietary pattern.

Results

Plant-based milk preference (OR 4.52; p < 0.001) and following a vegetarian dietary pattern (OR 1.91; p = 0.019) were associated with greater odds of recommending plant-based dairy alternatives to patients. Plant-based milk preference (OR 0.16; p < 0.001), following a vegetarian dietary pattern (OR 0.45; p = 0.009), and considering one's diet to be "plant-based" (OR 0.41; p = 0.005) were associated with lessor odds of recommending dairy to patients. Dietetics professionals were more likely than all other health professionals to recommend both dairy and plant-based dairy alternatives to patients.

Conclusion

Health professionals' nutrition recommendations may reflect their personal nutrition choices. Improved nutrition training, focusing on evidence-based recommendations, reducing personal bias in practice, and routinely including registered dietitians on interprofessional healthcare teams may improve the quality of nutrition advice given to U.S. consumers.

Innovation

This paper is the first to examine if health professionals' personal health behaviors are associated with their health advice on dairy and/or plant-based dairy alternatives.

Nutritional assessment of plant-based beverages in comparison to bovine milk

Plant-based beverages (PBB) are often marketed and used by consumers as alternatives to ruminant milks, particularly bovine milk (hereafter referred to as milk). However, much research has established that there is variation in nutritional composition among these products, as well as demonstrating that they are largely not nutritional replacements for milk. A survey of the prices and nutrition labels of PBB available in New Zealand supermarkets was undertaken. Selected almond, coconut, oat, rice, and soy PBB products were then analyzed for nutritional content, including energy, fat, protein, amino acid, bioavailable amino acid, and trace element contents. Finally, the protein and calcium contents of well-mixed and unshaken products were analyzed to ascertain the impact of colloidal stability on nutrient content. All PBB groups were more expensive than milk on average, while their declared nutrient contents on package labels was highly variable within and between groups. Analyses of selected PBB revealed that soy products had the most similar proximate composition to milk, while all other PBB groups contained less than 1.1 g protein per 100 mL on average. Many PBB were fortified with calcium to a similar concentration as that in milk. Shaken and unshaken samples showed divergent protein and calcium content for several PBB products but had no effect on the composition of milk, indicating that the nutrient content of PBB at the point of consumption will be dependent on whether the product has been shaken. Only the soy PBB had comparable amino acid content and bioavailability to milk. Overall, our results demonstrate the diversity in composition and nutritional properties of PBB available in New Zealand. While the existent environmental footprint data on PBB shows that they generally have lower carbon emissions than milk, milk currently accounts for approximately 1% of the average New Zealand resident’s consumption-based emissions. Except for calcium-fortified soy PBB, none of the commercially available PBB had nutritional compositions that were broadly comparable to milk.

A Comparative Analysis of Plant-Based Milk Alternatives Part 2: Environmental Impacts

Human food production is the largest cause of global environmental changes. Environmental benefits could be achieved by replacing diets with a high amount of animal-sourced foods with more plant-based foods, due to their smaller environmental impacts. The objective of this study was to assess the environmental impacts of the three most common plant-based milk alternatives (PBMAs)—oat, soy, and almond drink—in comparison with conventional and organic cow milk. Life cycle assessments (LCA) were calculated by the ReCiPe 2016 midpoint method, in addition to the single issue methods “Ecosystem damage potential” and “Water scarcity index”. PBMAs achieved lower impact values in almost all 12 of the calculated impact categories, with oat drink and the organic soy drink being the most environmentally friendly. However, when LCA results were expressed per energy and by the protein content of the beverages, the ranking of the beverages, in terms of their environmental impacts, changed greatly, and the results of PBMAs approached those of milk, particularly with regard to the protein index. The study highlights the importance of considering a broader range of impact categories when comparing the impacts of PBMAs and milk.

Perspective: School Meal Programs Require Higher Vitamin D Fortification Levels in Milk Products and Plant-Based Alternatives-Evidence from the National Health and Nutrition Examination Surveys (NHANES 2001-2018)

Poor vitamin D status impairs bone growth and immune defense in school-aged children and adolescents, particularly in minorities. Vitamin D insufficiency/deficiency increases the risk of acute viral respiratory infection, underscoring the need for adequate vitamin D intakes during school sessions when viral exposure may be greatest. We studied available vitamin D-related survey data and published findings based on NHANES (2001-2018) to assess the dependency of vitamin D status {25-hydroxyvitamin D [25(OH)D]; in nmol/L} on vitamin D intake (μg/d) in elementary school-aged children (4-8 y), middle school children (9-13 y), and high school adolescents (14-18 y). We sought evidence supporting the need for school programs to facilitate vitamin D adequacy. Usual vitamin D intakes from food and beverages by children/adolescents (NHANES 2015-2018) examined at the 50th percentile intake by race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic) showed all age groups consumed less than half of the Estimated Average Requirement (EAR) for vitamin D (10 μg/d), independent of race/ethnicity. NHANES (2001-2010) analyses show evidence of lower vitamin D status in school-aged children that is linked to lower intakes of fortified milk varying over race/ethnicity and age. Adolescents had lower vitamin D status and milk intake than younger children. A total of 22-44% of vitamin D intakes occurred away from home, with larger percentages of total intakes at breakfast and lunch, at times consistent with school meals. Ever-present inadequate vitamin D intakes with a large percentage consumed away from home together with well-established benefits to growth, bone, and immune defense from enriched vitamin D-fortified milk in school intervention trials provide strong justification to require enriched vitamin D-fortified foods in school meals. An easy to implement plan for improving vitamin D intakes is possible through the FDA's amendment allowing higher vitamin D fortification levels of dairy and plant-based milk alternatives that could increase vitamin D intakes beyond the EAR with just 2 daily servings.

Plant-Based Dairy Alternatives: Consumers' Perceptions, Motivations, and Barriers-Results from a Qualitative Study in Poland, Germany, and France

Plant-based dairy substitutes have been gaining popularity in recent years, but consumer perspective on these products is still relatively unexplored. The purpose of the study was to investigate the potential of plant-based dairy alternatives, including consumers’ motives and the barriers to embracing this food category. A qualitative study (24 focus groups, 154 respondents) was conducted in three countries: Poland, Germany, and France. The study allowed us to describe the reasons for using dairy substitutes (curiosity, health reasons, influence of others), their perceived advantages, and the barriers to their use. The study also showed that the role of dairy differs between the surveyed countries and is related to culinary traditions. As a result, attitudes towards and motives for using dairy substitutes differ in the different countries.

Legumes and Legume-Based Beverages Fermented with Lactic Acid Bacteria as a Potential Carrier of Probiotics and Prebiotics

Fermentation is widely used in the processing of dairy, meat, and plant products. Due to the growing popularity of plant diets and the health benefits of consuming fermented products, there has been growing interest in the fermentation of plant products and the selection of microorganisms suitable for this process. The review provides a brief overview of lactic acid bacteria (LAB) and their use in fermentation of legumes and legume-based beverages. Its scope also extends to prebiotic ingredients present in legumes and legume-based beverages that can support the growth of LAB. Legumes are a suitable matrix for the production of plant-based beverages, which are the most popular products among dairy alternatives. Legumes and legume-based beverages have been successfully fermented with LAB. Legumes are a natural source of ingredients with prebiotic properties, including oligosaccharides, resistant starch, polyphenols, and isoflavones. These compounds provide a broad range of important physiological benefits, including anti-inflammatory and immune regulation, as well as anti-cancer properties and metabolic regulation. The properties of legumes make it possible to use them to create synbiotic food, which is a source of probiotics and prebiotics.

Bone Health in School Age Children: Effects of Nutritional Intake on Outcomes

The maximum rate of bone mass accumulation is during early adolescence. As such, a focus on optimizing mineral nutrition in school age children, defined here as approximately 5 to 15 years of age, is crucial to minimize the risk of bone loss that occurs later in life leading to osteoporosis and fractures. Optimizing bone mass in this age group requires attention to an overall healthy diet including adequate calcium, phosphorus, magnesium, and vitamin D. Special concerns may exist related to children who follow a restricted diet such as a vegan diet, those with intolerance or allergies to dairy, and those with chronic health conditions including young adolescents with eating disorders. Public policy messages should focus on positive aspects of bone health nutrition in this age group and avoid overly specific statements about the exact amounts of foods needed for healthy bones. In this regard, dietary recommendations for minerals vary between North America and Europe and these are higher than the values that may be necessary in other parts of the world. The management of many children with chronic illnesses includes the use of medications that may affect their bone mineral metabolism. Routine lab testing for bone mineral metabolism including the serum 25-hydroxyvitamin D level is not indicated, but is valuable for at-risk children, especially those with chronic illnesses.

Barriers to consumption of plant-based beverages: A comparison of product users and non-users on emotional, conceptual, situational, conative and psychographic variables

Production and consumption practices that reduce the environmental burden of eating and drinking and promote global sustainability are of paramount interest. Against this background, we present a quantitative study of US adults' perceptions of selected non-alcoholic beverages including pairs of regular and plant-based alternatives (iced coffee/iced coffee with almond milk, fruit smoothie/fruit smoothie with soy milk and cow's milk/oat milk). Particular focus was directed to comparing product perceptions of consumers who never consumed these plant-based alternatives with those who did (n = 249 and n = 274), as a means for contextualising the barriers that hinder uptake among non-users. The data were collected via an online survey with a multi-response empirical strategy where the beverages were characterised using a large set of emotional, conceptual, situational, and attitudinal/behavioural variables. Fitting expectations, negative associations were dominant in the group of consumers who never consumed the plant-based beverage variants. However, these associations were product dependent and decreased in the order: oat milk, fruit smoothie with soy milk and iced coffee with almond milk. This pointed to a likely interplay of sensory properties, situational appropriateness and household routines. Food neophobia negatively influenced perceptions of less familiar products, including but not limited to plant-based beverages. While the research was limited to a small number of beverages and plant-based alternatives, it identified the important role that in-depth and product-specific investigations have in helping to uncover and overcome barriers to sustainable eating and drinking solutions.

Study of the Influence of Sociodemographic and Lifestyle Factors on Consumption of Dairy Products: Preliminary Study in Portugal and Brazil

Sociodemographic characteristics, including regional variations, have been associated with different food consumption patterns. Behavioral factors and lifestyle variables may also contribute to different food dietary trends. In this way, the present study intended to investigate the consumption habits of the most relevant types of dairy products around the world and relate them to sociodemographic factors, for example, age, sex, education and country as well as with some anthropometric and behavioral aspects, for example, body mass index, satisfaction with body weight and exercise or sedentary lifestyles. One other objective of the study was to categorize the lifestyles of the participants, according to measured variables linked with hours of inactivity or exercise, in order to use these as possible differentiating variables for the consumption of dairy products. The study involved a questionnaire survey undertaken on a non-probabilistic convenience sample of participants from Portugal (PT) and Brazil (BR), and participation was voluntary and anonymous. The data analysis involved different statistical techniques: basic statistics, chi-square tests, factor analysis, cluster analysis and tree classification analysis. The results showed that semi skimmed milk is never consumed by about half of the participants (47.4% for PT and 46.7 for BR), and those numbers increase for skimmed (64.8% for PT and 50.9% for BR), chocolate flavored milk (82.6% for PT and 65.6% for BR) and enriched milks (94.8% for PT and 85.3% for BR). Cheeses are also consumed in the two countries by small numbers of people. The number of participants consuming imported cheeses in both countries was particularly low (only 4.0% consume these more than once a week in both countries), suggesting national products may be preferred. It was further observed that those who consume cheese do it seldom (once a week) or sometimes (2–3 times per week). Butter is also consumed by only about half of the adult population (43.8% for PT and 49.5% for BR), but the percentage of those who never consume butter increases for skimmed butter (66.0% for PT and 82.6% for BR) and unsalted butter (70.2% for PT and 69.1% for BR). The consumption of yogurts also follows similar low consumption patterns. The most frequently consumed yogurt types in Portugal are liquid (30.5% consume regularly) and natural yogurts (34.8% consume regularly), while in Brazil the most frequent are creamy fruit pulp yogurt (14.4% consume regularly), liquid (13.7% consume regularly) and Greek type yogurt (10.2% consume regularly). A factor analysis and a cluster analysis established groups according to lifestyles, as follows: 1—Screeners, 2—Exercisers, 3—Travelers and 4—Others. These lifestyles were found to be influential in the consumption of dairy products for all classes of dairy tested: milk, cheese, yogurt and butter. For example, the screeners were found to consume more milk, more butter, more cheese and more yogurt. Additionally, other influential factors were age, sex, education, BMI and satisfaction with body weight. Nevertheless, country was not a meaningfully discriminant variable in relation to the other variables included in the classification analysis. The results concluded that, despite some small differences in the patterns of consumption of dairy products in both countries, the levels of consumption of dairy products are extremely low, for all classes studied (milk, cheese, yogurt or butter). Additionally, it was concluded that some factors are influential on the level of consumption of dairy products, and therefore decision makers can plan their interventions according to the characteristics of the targeted segments of the population, according to lifestyle, age, sex, education, BMI and satisfaction with body weight.