Associations of Knowledge, Attitude and Practices of Food Label on Cardiovascular Diseases (CVD) Risk amongst University Students in Selangor, Malaysia

Awareness, Knowledge, and Practices towards Reading Snack Food Labels among Malaysian Adolescents

This study aimed to determine the awareness, knowledge, and practices regarding food labels and factors that influence their use; a cross-sectional study was conducted among 200 Malaysian adolescents aged 10 to 19. Participants completed an online Food Label Use Questionnaire (FLUQ) that included demographic, nutrition knowledge, label use, and factors affecting label use. SPSS version 28.0 was used for data analysis. The results showed that 93% of adolescents correctly identified the consequences of over-consuming calories. Still, only 84.5% performed well on the nutrition use task, struggling to interpret calorie and carbohydrate amounts in certain foods. The main reasons for not using food labels were time constraints (45.5%), unattractive or confusing labels (36%), absence of labels on certain foods (33%), lack of health concerns (32%), and insufficient knowledge (27%). However, 90.5% of adolescents were concerned about product expiration dates and often read this information. Taste and price were the main reasons for referring to food labels, while time constraints were the main barrier to their use. In conclusion, practicing reading food labels can guide adolescents in making informed decisions about their food choices and portion intake. Awareness campaigns can aid in promoting healthy habits and empowering adolescents to make the right choices for their health.

Status of nutrition labeling knowledge, attitude, and practice (KAP) of residents in the community and structural equation modeling analysis

Objective

Unhealthy foods were a major contributor to the occurrence of chronic non-communicable diseases. The promotion of nutrition labeling in the community can effectively help residents to choose healthy foods, which plays an important role in the prevention of chronic diseases. However, the public awareness of this measure is not clear. Our study used a structural equation model based on the KAP theory to analyze the interaction mechanisms among knowledge, attitude, and practice and aimed to evaluate the relationships among nutrition knowledge, attitude, and practice of residents, which can provide the basis of policy formulation for nutrition education and behavior intervention.

Methods

We carried out a cross-sectional study from May 2022 to July 2022 in the "Community Health Service Center", and each "Community Service Station" in Yinchuan use a self-designed questionnaire and convenience sampling to evaluate resident nutrition labeling KAP status. This study adopted the structural equation modeling approach to analyze a survey of Chinese individuals through the cognitive processing model, interrelated nutrition knowledge, nutrition label knowledge, attitude, and practice.

Results

According to the principle of sample size estimation, a total of 636 individuals were investigated, with the ratio of male to female being 1:1.2. The average score of community residents' nutrition knowledge was 7.48 ± 3.24, and the passing rate was 19.4%. Most residents had a positive attitude toward nutrition labeling, but the awareness rate was only 32.7% and the utilization rate was 38.5%. Univariate analysis showed that women had higher knowledge scores than men (p < 0.05), and young people had higher scores than older adults (p < 0.05), and the difference was significant. Based on the KAP structural equation model (SEM), residents' nutrition knowledge will directly affect their attitude toward nutrition labeling. Attitude played a greater role as an indirect effect between knowledge and behavior, while trust limits residents' practice of nutrition labeling and then affects their practice. It could be explained that nutrition knowledge was the prerequisite for label reading behavior, and attitude was the intermediary effect.

Conclusion

The nutrition knowledge and nutrition labeling knowledge of respondents hardly directly support the practice of nutrition labeling, but it can influence the use behavior by forming a positive attitude. The KAP model is suitable for explaining residents' use of nutrition labeling in the region. Future research should focus on better understanding the motivations of residents to use nutrition labeling and the opportunity to use nutrition labeling in real-life shopping settings.

Analysis of Chinese Consumers' Nutrition Facts Table Use Behavior Based on Knowledge-Attitude-Practice Model

The nutrition facts table is a nutrition labeling tool designed to help consumers understand the nutritional content of food and make informed food choices. However, the utilization rate of the nutrition facts table has been low in China since its introduction in 2013. This study employed structural equation modeling to investigate consumers' knowledge, attitudes, and practices related to the nutrition facts table by using an online survey of 930 valid samples from 31 provinces in China based on the knowledge, attitude, practice (KAP) model. The analysis revealed that most respondents had a positive attitude, but not a good level of knowledge or practice in their use of the labeling. Respondents' knowledge about the nutrition facts table directly affected their attitude, through which it could then affect their practice, whereas knowledge played an indirect role in nutrition labeling use. The results confirmed that the KAP model is suitable for explaining consumers' use of nutrition labels in China, and that the first step to promoting labeling usage is to enrich consumers' knowledge on the nutrition facts table.

Global Cardiovascular Risk Profile of Italian Medical Students Assessed by a QR Code Survey. Data from UNIMI HEART SURVEY: Does Studying Medicine Hurt?

Background: Few studies to date have addressed global cardiovascular (CV) risk profile in a “protected” young population as that of medical school students. Objective: to assess CV traditional risk factors and global CV risk profile of Italian medical students throughout the six years of university. Methods: A cross-sectional survey accessible online via quick response (QR) code was conducted among 2700 medical students at the University of Milan, Italy. Data on baseline characteristics, traditional CV risk factors, diet, lifestyle habits, and perceived lifestyle variations were evaluated across different years of school. Results: Overall, 1183 students (mean age, 22.05 years; 729 women (61.6%)) out of 2700 completed the questionnaire (43.8% rate response). More than 16% of the students had at least 3 out of 12 CV risk factors and only 4.6% had ideal cardiovascular health as defined by the American Heart Association. Overweight, underweight, physical inactivity, sub-optimal diet, smoke history, and elevated stress were commonly reported. Awareness of own blood pressure and lipid profile increased over the academic years as well as the number of high-blood-pressure subjects, alcohol abusers, and students constantly stressed for university reasons. Moreover, a reduction in physical-activity levels over the years was reported by half of the students. Conclusion and Relevance: This study demonstrates that a “protected” population as that of young medical students can show an unsatisfactory cardiovascular risk profile and suggests that medical school itself, being demanding and stressful, may have a role in worsening of the lifestyle.