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Cavalcanti MB, Silva IDCGD, Lamarca F, de Castro IRR. Research on commercial milk formulas for young children: A scoping review. MATERNAL & CHILD NUTRITION 2024:e13675. [PMID: 38956436 DOI: 10.1111/mcn.13675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 07/04/2024]
Abstract
A scoping review of publications about commercial milk formulas intended for or consumed by children 12-36 months (CMF 12-36) was conducted. This review aimed to comprehensively map the existing literature, identify key concepts in the field and understand its evolution through time. A total of 3329 articles were screened and 220 were included, published between 1986 and 2024. Most works were published after 2016 (70.0%) and in high-income countries (71.8%). Original studies were the vast majority (81.8%) of publications. Most publications dealt with feeding practices or analysed the composition and/or contamination of specific products (44.1% and 35.9%), but since the late 2000s, publications about marketing, policy, legislation, and consumer perception started to appear. Most published works (65.5%) did not focus exclusively on CMF 12-36 and included formulas for other demographics or other foods. About half of the works (55.5%) did not consider CMF 12-36 to be a breast milk substitute. We found 81 distinct product denominations used to refer to CMF 12-36, Growing Up Milk was the most common (25.9%). CMF industry was involved in 41.8% of all analysed works, and industry participation and funding were not always clearly informed (22.5% lacked a conflict of interest statement, and 25.5% did not present any information about funding). In the last decade, publications about CMF 12-36 have increased in volume and diversified in scope and subject matter. CMF-industry participation has always been and still is present in the field, so possible vested interests should be taken into account when appreciating the literature.
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Affiliation(s)
| | | | - Fernando Lamarca
- Department of Applied Nutrition, Institute of Nutrition, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Kim D, Kim SY, Yoo R, Choo J, Yang H. Innovative AI methods for monitoring front-of-package information: A case study on infant foods. PLoS One 2024; 19:e0303083. [PMID: 38753840 PMCID: PMC11098498 DOI: 10.1371/journal.pone.0303083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 04/19/2024] [Indexed: 05/18/2024] Open
Abstract
Front-of-package (FOP) is one of the most direct communication channels connecting manufacturers and consumers, as it displays crucial information such as certification, nutrition, and health. Traditional methods for obtaining information from FOPs often involved manual collection and analysis. To overcome these labor-intensive characteristics, new methods using two artificial intelligence (AI) approaches were applied for information monitoring of FOPs. In order to provide practical implementations, a case study was conducted on infant food products. First, FOP images were collected from Amazon.com. Then, from the FOP images, 1) the certification usage status of the infant food group was obtained by recognizing the certification marks using object detection. Moreover, 2) the nutrition and health-related texts written on the images were automatically extracted based on optical character recognition (OCR), and the associations between health-related texts were identified by network analysis. The model attained a 94.9% accuracy in identifying certification marks, unveiling prevalent certifications like Kosher. Frequency and network analysis revealed common nutrients and health associations, providing valuable insights into consumer perception. These methods enable fast and efficient monitoring capabilities, which can significantly benefit various food industries. Moreover, the AI-based approaches used in the study are believed to offer insights for related industries regarding the swift transformations in product information status.
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Affiliation(s)
- Dohee Kim
- Kim Jaechul Graduate School of Artificial Intelligence, KAIST, Daejeon, Republic of Korea
| | - Seo-Young Kim
- Advanced Institute of Convergence Technology, Suwon, Republic of Korea
- Department of Agricultural Biotechnology, Seoul National University, Seoul, Republic of Korea
| | - Ra Yoo
- Advanced Institute of Convergence Technology, Suwon, Republic of Korea
| | - Jaegul Choo
- Kim Jaechul Graduate School of Artificial Intelligence, KAIST, Daejeon, Republic of Korea
| | - Hee Yang
- Department of Food and Nutrition, Kookmin University, Seoul, Republic of Korea
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Demonte F, Bruno DP, Nessier MC, Zapata ME. [Digital marketing of commercial infant formula in Argentina: a digital ethnographic study]. Salud Colect 2024; 20:e4776. [PMID: 38896420 DOI: 10.18294/sc.2024.4776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/09/2024] [Indexed: 06/21/2024] Open
Abstract
Although evidence of the benefits of breastfeeding is widespread, there are several challenges to initiate and sustain it. Infant formula companies use marketing strategies that violate existing regulations, contributing to its early abandonment. We explore the digital marketing exposure of infant formulas in Argentina by analyzing people's interactions with brands and the traces of these interactions in conversations engaged in Facebook groups during 2022, from a qualitative approach based on digital ethnography. Results show that companies deploy regulatory avoidance tactics and seek contact with mothers. Users do not interact with the accounts but are exposed to their strategies given the correlation between product attributes present in advertising with their motivations and aspirations. The mediators between marketing and mothers are medical professionals, used as marketing resources. We conclude that authorities should promote new agreements on the practices of medical professionals and develop regulations taking into account digital environments.
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Affiliation(s)
- Flavia Demonte
- Posdoctora en Ciencias Sociales. Investigadora Adjunta, Consejo Nacional de Investigaciones Científicas y Técnicas, con sede en Escuela Interdisciplinaria de Altos Estudios Sociales, Universidad Nacional de San Martín, Buenos Aires, Argentina
| | - Daniela Paola Bruno
- Posdoctora en Ciencias Sociales. Investigadora, Instituto de Investigaciones Gino Germani, Facultad de Ciencias Sociales, Universidad de Buenos Aires. Investigadora, Facultad de Periodismo y Comunicación Social, Universidad Nacional de la Plata, Ciudad Autónoma de Buenos Aires, Argentina
| | - María Celeste Nessier
- Magíster en Ciencias de la Nutrición. Coordinadora de proyectos, Centro de Estudios en Nutrición Infantil "Dr. Alejandro O´Donnell", Ciudad Autónoma de Buenos Aires, Argentina
| | - María Elisa Zapata
- Doctora en Nutrición Humana. Directora, Centro de Estudios de Nutrición Infantil "Dr. Alejandro O´Donnell", Ciudad Autónoma de Buenos Aires, Argentina
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Richter APC, Grummon AH, Falbe J, Taillie LS, Wallace DD, Lazard AJ, Golden SD, Conklin JL, Hall MG. Toddler milk: a scoping review of research on consumption, perceptions, and marketing practices. Nutr Rev 2024; 82:425-436. [PMID: 37203416 PMCID: PMC10859688 DOI: 10.1093/nutrit/nuad057] [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] [Indexed: 05/20/2023] Open
Abstract
Toddler milk is an ultra-processed beverage consisting primarily of powdered milk, caloric sweeteners, and vegetable oil. Pediatric health authorities do not support the use of toddler milk, and emerging evidence suggests that toddler-milk marketing practices may mislead consumers. However, studies have not synthesized the extent of toddler-milk marketing practices or how these practices affect parents' decisions about whether to serve toddler milk. We aimed to summarize the literature about toddler milk to identify what is known about: (1) parents' toddler-milk purchasing and feeding behaviors, (2) toddler-milk marketing, and (3) how marketing practices influence parents' beliefs and perceptions about toddler milk. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), we systematically searched 8 databases (PubMed, APA PsycINFO, Scopus, Cochrane Central, Embase, CINAHL, Communication & Mass Media Complete, and Business Source Premier). We identified 45 articles about toddler milk. Studies were conducted in 25 countries across 6 continents. Five types of findings emerged: (1) consumption and feeding behaviors, (2) demographic correlates of toddler-milk purchasing and consumption, (3) misperceptions and beliefs, (4) increased sales, and (5) increased marketing and responses to marketing. The included articles suggested that toddler-milk sales are growing rapidly worldwide. Findings also revealed that toddler-milk packages (eg, labels, branding) resemble infant formula packages and that toddler-milk marketing practices may indirectly advertise infant formula. Purchasing, serving, and consumption of toddler milk were higher in Black and Hispanic populations than in non-Hispanic White populations, and parents with higher educational attainment and income were more likely to offer toddler milk to their children. Findings suggest a need for policies to prevent cross-marketing of toddler milk and infant formula, reduce provision of toddler milk to infants and toddlers, and prevent caregivers from being misled about toddler-milk healthfulness.
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Affiliation(s)
- Ana Paula C Richter
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Anna H Grummon
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
| | - Jennifer Falbe
- Department of Human Ecology, University of California (UC) Davis, Davis, California, USA
| | - Lindsey Smith Taillie
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Deshira D Wallace
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Allison J Lazard
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Shelley D Golden
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jamie L Conklin
- Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Fuchs GJ, Abrams SA, Amevor AA. Older Infant-Young Child "Formulas". Pediatrics 2023; 152:e2023064050. [PMID: 37860831 DOI: 10.1542/peds.2023-064050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 10/21/2023] Open
Abstract
The category of "formulas" directed at older infants and toddlers 6 to 36 months of age has increased in prominence over the last years but is characterized by lack of standardization in nomenclature and composition as well as questionable marketing practices. There has been uncertainty and misperception regarding some of the roles of these beverages in ensuring adequate childhood nutrition. The aim of this clinical report is to review the context, evidence, and rationale for older infant-young child formulas, followed by recommendations.
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Affiliation(s)
- George J Fuchs
- Department of Pediatrics, University of Kentucky College of Medicine and Department of Epidemiology, University of Kentucky College of Public Health, Lexington, Kentucky
| | - Steven A Abrams
- Department of Pediatrics, Dell Medical School at the University of Texas at Austin, Austin, Texas
| | - A Adjowa Amevor
- Beverly Knight Olsen Children's Hospital, Atrium Health, Macon, Georgia
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C Richter AP, W Duffy E, Higgins ICA, Barrington C, Martin SL, Aquilina KH, Avendaño-Galdamez MI, Hall MG. Toddler Milk Perceptions and Responses to Front-of-Package Claims and Product Warnings: A Qualitative Study of Caregivers of Toddlers. J Acad Nutr Diet 2023; 123:1568-1577.e3. [PMID: 37352928 PMCID: PMC10874641 DOI: 10.1016/j.jand.2023.06.281] [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: 08/29/2022] [Revised: 06/01/2023] [Accepted: 06/17/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND Toddler milk products are ultraprocessed milk-based beverages promoted for children aged 9 through 36 months. They often contain added sugars, which may contribute to unhealthy dietary habits. Aggressive promotion of toddler milk, particularly to the Latinx population, has likely led to rapid rises in sales. OBJECTIVE The study aims were to qualitatively explore caregivers' experiences with, beliefs about, and attitudes toward toddler milk; to explore caregivers' reactions to health claims and product warnings on toddler milk packaging; and explore whether perceptions of toddler milk differ by Latinx ethnicity. DESIGN Focus group discussions and in-depth interviews were conducted. PARTICIPANTS Fifteen online in-depth interviews and 4 online focus groups with US caregivers of children aged 9 through 36 months who reported serving toddler milk to their children were conducted in 2021. STATISTICAL ANALYSES PERFORMED Audio files were transcribed, coded, and analyzed in NVivo. A thematic analysis with a hybrid analytical approach of deductive and inductive coding was conducted. RESULTS Caregivers struggled to discern toddler milk from infant formula and perceived formula as a larger term that included toddler milk. Participants described offering toddler milk to their children for its convenience, nutritional profile, and perceived benefits tied to health claims present on the labels. Participants reported that health claims on toddler milk packaging attracted their attention; most participants did not express skepticism about the veracity of the claims. An "added sugar" warning increased understanding of the presence of added sugar in a toddler milk product. Latinx and non-Latinx participants largely reported similar perceptions, beliefs, and patterns of provision of toddler milk. CONCLUSIONS Health claims may lead caregivers to perceive toddler milk as a nutritionally adequate product. Research is needed to investigate caregiver-directed interventions for informing caregivers about the distinction between infant formula and toddler milk.
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Affiliation(s)
- Ana Paula C Richter
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
| | - Emily W Duffy
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
| | - Isabella C A Higgins
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
| | - Clare Barrington
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
| | - Stephanie L Martin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
| | - Kathryn H Aquilina
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; US Food and Drug Administration, Silver Spring, Maryland
| | | | - Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.
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Dastgerdizad H, Dombrowski RD, Bode B, Knoff KAG, Kulik N, Mallare J, Kaur R, Dillaway H. Community Solutions to Increase the Healthfulness of Grocery Stores: Perspectives of Immigrant Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6536. [PMID: 37569076 PMCID: PMC10418834 DOI: 10.3390/ijerph20156536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/28/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023]
Abstract
Grocery store environments are recognized as one of the most crucial community settings for developing and maintaining healthy nutritional behaviors in children. This is especially true for disadvantaged ethnic minority families, such as immigrants, who reside in the Detroit Metropolitan area and have historically experienced inequities that result in poor health outcomes. Rates of obesity and type II diabetes have affected Detroit 38% more than the rest of the state and nationwide. In 2019, almost 54% of children aged 0-17 in Metro Detroit lived in poverty, and 21.6% experienced food insecurity, compared with the state level of 14.2%. Moreover, nearly 50% of ethnic minority children in Metro Detroit consume sports drinks, and 70% consume soda or pop in an average week. The primary purpose of this study was to explore immigrant parents' perspectives on (1) how in-store Sugar-Sweetened Beverage (SSB) marketing impacts the purchasing behaviors of parents and the eating behaviors of toddlers, and the secondary objective was to (2) determine strategies to reduce SSB purchases and consumption within grocery environments from the viewpoints of immigrant parents. A qualitative multiple-case study design was used to achieve the aims of this study. Semi-structured individual interviews were completed with 18 immigrant parents of children aged 2 to 5 years old who were consumers in 30 independently owned full-service grocery stores within the immigrant enclaves of Detroit, Dearborn, Hamtramck, and Warren, Michigan. Three key thematic categories emerged from the parents' narratives. These themes were: (1) non-supportive grocery store environments; (2) acculturation to the American food environment; and (3) strategies to support reduced SSB consumption among young immigrant children. The findings of this study revealed widespread SSB marketing targeting toddlers within the participating independently owned grocery stores. Even if families with young children practiced healthy nutritional behaviors, the prices, placements, and promotion of SSBs were challenges to establishing and sustaining these healthy eating habits. The parents believed that planning and implementing retail-based strategies in collaboration with families and considering families' actual demands would assist in managing children's eating patterns and reducing early childhood obesity.
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Affiliation(s)
- Hadis Dastgerdizad
- Department of Public Health, University of South Carolina, Bluffton, SC 29909, USA
| | - Rachael D. Dombrowski
- Departments of Public Health and Kinesiology, College of Education, Health and Human Services, California State University-San Marcos, San Marcos, CA 92096, USA;
| | - Bree Bode
- Michigan Fitness Foundation, Lansing, MI 48314, USA;
| | - Kathryn A. G. Knoff
- Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA 22314, USA;
| | - Noel Kulik
- Center for Health and Community Impact, Division of Kinesiology, Health & Sport Studies, College of Education, Wayne State University, Detroit, MI 48202, USA;
| | - James Mallare
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI 48202, USA;
| | - Ravneet Kaur
- Division of Health Research and Evaluation, Department of Family and Community Medicine, College of Medicine, University of Illinois, Rockford, IL 61107, USA;
| | - Heather Dillaway
- Department of Sociology and Anthropology, Illinois State University, Normal, IL 61790, USA;
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Unar-Munguía M, Santos-Guzmán A, Mota-Castillo PJ, Ceballos-Rasgado M, Tolentino-Mayo L, Sachse Aguilera M, Cobo Armijo F, Barquera S, Bonvecchio A. Digital marketing of formula and baby food negatively influences breast feeding and complementary feeding: a cross-sectional study and video recording of parental exposure in Mexico. BMJ Glob Health 2022; 7:e009904. [PMID: 36343968 PMCID: PMC9594510 DOI: 10.1136/bmjgh-2022-009904] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/24/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND There is little evidence of the association between digital marketing of formula and baby food and infant and young child feeding (IYCF) practices. OBJECTIVE Assess parents' exposure to digital marketing of formula and baby food for children <2 years and its association with the purchase and IYCF practices in Mexico. METHODS Parents ≥18 years recruited from a market research panel completed an online survey (n=1074) and capture-on-screen (n=95) between December 2020 and January 2021. Logistic regressions were used to estimate the association between exposure to digital marketing of formula and baby foods with its purchase, motivation, consumption and IYCF practices. RESULTS Digital marketing of formula and baby food was self-reported by 93.9% of parents in the online survey and observed by 93.7% in the capture-on-screen. Recorded ads did not comply with the International Code of Marketing of Breast-milk Substitutes. Parents who self-reported seeing a higher versus lower number of ads were less likely to exclusive breast feed (OR=0.38; 95% CI: 0.19 to 0.78), and more likely to give mixed feeding (OR=2.59; 95% CI: 1.28 to 5.21), formula (OR=1.84; 95% CI: 1.34 to 2.53), processed foods (OR=2.31; 95% CI: 1.59 to 3.32) and sugary drinks (OR=1.66; 95% CI: 1.09 to 2.54). Higher exposure to ads was associated with a higher chance of purchasing products motivated by nutritional (OR=2.1; 95% CI: 1.32 to 3.28) and organic claims (OR=2.1; 95% CI: 1.21 to 3.72). CONCLUSIONS Digital marketing of formula and baby food may negatively influence IYCF and should be regulated to ensure children's nutrition and health.
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Affiliation(s)
- Mishel Unar-Munguía
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Andrea Santos-Guzmán
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | | | - Lizbeth Tolentino-Mayo
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | | | - Simón Barquera
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Anabelle Bonvecchio
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
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Vilar‐Compte M, Hernández Cordero S, Castañeda‐Márquez AC, Rollins N, Kingston G, Pérez‐Escamilla R. Follow‐up and growing‐up formula promotion among Mexican pregnant women and mothers of children under 18 months old. MATERNAL & CHILD NUTRITION 2022; 18 Suppl 3:e13337. [PMID: 35293129 PMCID: PMC9113472 DOI: 10.1111/mcn.13337] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/06/2022] [Accepted: 02/08/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Mireya Vilar‐Compte
- Department of Public Health Montclair State University Montclair New Jersey USA
| | - Sonia Hernández Cordero
- Research Institute for Equitable Development (EQUIDE) Universidad Iberoamericana Mexico City Mexico
| | | | - Nigel Rollins
- Department of Maternal, Newborn, Child and Adolescent Health Geneva Switzerland
| | | | - Rafael Pérez‐Escamilla
- Department of Social and Behavioral Sciences Yale School of Public Health New Haven Connecticut USA
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Richter APC, Duffy EW, Smith Taillie L, Harris JL, Pomeranz JL, Hall MG. The Impact of Toddler Milk Claims on Beliefs and Misperceptions: A Randomized Experiment with Parents of Young Children. J Acad Nutr Diet 2022; 122:533-540.e3. [PMID: 34391941 PMCID: PMC8840993 DOI: 10.1016/j.jand.2021.08.101] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 08/05/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Toddler milk (ie, a nutrient-fortified milk-based drink marketed for children aged 12 to 36 months) has been marketed increasingly in the United States with structure/function claims on product packaging that are potentially misleading. OBJECTIVE This study examined how structure/function claims impact parents' beliefs and perceptions about a toddler milk product. DESIGN This was a 3-arm between-subjects randomized experiment. PARTICIPANTS A diverse sample of 2,190 US parents of children aged 1 to 5 years were chosen to take an online survey. INTERVENTION Participants were randomly assigned to view a toddler milk package with either an unrelated claim ("new and improved," ie, control condition), a "brain development" claim (ie, "brain" claim), or an "immunity-related" claim (ie, "immunity" claim). MAIN OUTCOME MEASURES Outcomes included perceptions, intentions, and beliefs about the toddler milk product. STATISTICAL ANALYSES PERFORMED Linear regression for continuous outcomes and logistic regression for dichotomous outcomes. RESULTS Parents who were exposed to the "brain" claim or the "immunity" claim were more likely to incorrectly believe that the toddler milk was as healthy or healthier than cow's milk compared with those who saw the control claim (89% for brain claim, 87% for immunity claim, and 79% for control; P < .001 for both comparisons). Parents exposed to either the brain or immunity claim had higher intentions to give the toddler milk to their child, higher perceived product healthfulness, and stronger beliefs that pediatricians would recommend the product compared with parents exposed to the control (all, P < .001). CONCLUSIONS These findings suggest that structure/function claims on toddler milk packaging may mislead parents and increase the appeal of toddler milk. Our findings support calls for public health policies to regulate marketing on toddler milk packaging.
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