Influence of Mothers' Nutrition Knowledge and Attitudes on Their Purchase Intention for Infant Cereal with No Added Sugar Claim

Sugar labeling information and online marketing strategies for hand-shaken tea drinks in northern Taiwan

Background

Sugar-sweetened beverages (SSBs) are the main cause of excessive sugar intake and increased health risks. Food companies usually use social media to market SSBs in order to increase consumers' purchase intentions. To reduce excessive added sugar consumption from hand-shaken tea drinks, Taiwan has implemented a mandatory policy requiring clear sugar content labeling. This study aimed to investigate the sugar label information and online marketing strategies for hand-shaken tea drinks in northern Taiwan.

Methods

In this cross-sectional study, content analysis was employed to investigate the sugar labeling information and the current situation of online marketing in hand-shaken tea drink brands based in northern Taiwan. Seventy-two hand-shaken tea drink brands' stores were visited to record their sugar labeling presentation methods, with brands lacking labeling, presenting incomplete labeling, or not offering customized sugar levels being excluded, resulting in 60 brands being chosen for the subsequent data collection process. The sugar and energy contents in 1,581 hand-shaken tea drinks were recorded and calculated. Subsequently, the sugar contents were assessed in accordance with World Health Organization (WHO) sugar recommendations (25 g/day), warning label criteria, and Taiwan's regulations for low-sugar packaged beverages. Seven brands that had high online impressions were further selected and their marketing strategies in 560 Facebook posts were analyzed.

Results

The presentation methods of labeling varied among the 60 brands, and only 42 brands had obvious and easily accessible labeling. The most common labeling presentation method was posters (n = 28). After converting the sugar content of half-sugar and low-sugar hand-shaken tea drinks, it was found that 60.2% of half-sugar beverages and 13.0% of low-sugar beverages exceeded 25 g of sugar per cup. Over 90% of brands had Facebook and Instagram accounts. The top marketing strategies for tea drink brands on Facebook were specific beverage information, brand information, and nutrition and health marketing. Most posts promoted sugar-sweetened beverages.

Conclusion

Not all hand-shaken tea drink brands in this study followed Taiwan's labeling regulations. Moreover, high sugar contents in hand-shaken tea drinks labeled as half-sugar and low-sugar could potentially lead people to unconsciously consume excessive amounts of sugar. Future research should explore the impact of online marketing strategies on SSBs consumption behavior and ways to mitigate it among the Taiwanese public.

Do nutrition knowledge, food preferences, and habit strength moderate the association between preference for intuition and deliberation in eating decision-making and dietary intake?

An intuitive style in eating decision-making, for example, basing decisions on one's gut feeling, has been related to a less healthy diet, whereas deliberately deciding what to eat, such as making plans about eating behavior, has been related to a healthier diet. The present study investigated whether nutrition knowledge, food preferences, and habit strength for healthy and unhealthy eating moderate these relationships. In total, 1245 participants took part in a preregistered cross-sectional online survey. Results revealed that neither nutrition knowledge, nor liking of healthy or unhealthy foods, nor habit strength for healthy or unhealthy eating interacted with the preference for intuition or deliberation in eating decision-making in affecting dietary intake (βs ≤ |.06|; ts ≤ |2.11|; ps ≥ .035). Instead, including the potential moderating variables in analyses rendered the effect of a preference for intuition largely non-significant. In contrast, the positive effect of a preference for deliberation was largely stable even when including the potential moderating variables. Thus, the present study confirms the general health-promoting effect of a preference for deliberation in eating decision-making. In contrast, results speak in favor of a generally minor role of a preference for intuition for healthy or unhealthy eating.

Awareness of nutrition and health knowledge and its influencing factors among Wuhan residents

Background

Nutrition and health knowledge play a crucial role in promoting healthy dietary behaviors, and have been found to be related to sociodemographic characteristics. However, the existing evidence is limited and inconsistent. We aimed to evaluate the awareness level of nutrition and health knowledge and its influencing factors among Wuhan residents, and to provide scientific basis for carrying out targeted nutrition education programmes.

Methods

By stratified random sampling, residents aged 18-64 in Wuhan were selected for self-administered questionnaire survey. We adopted the structured questionnaire to investigate respondents' sociodemographic characteristics, nutrition and health knowledge, and the way to acquire knowledge. Among them, nutrition and health knowledge includes the following four parts: dietary guidelines recommendations, food and nutrients, nutrition and disease prevention, and nutrition skills. Chi-square tests were used to analyze the associations between total awareness rate and sociodemographic characteristics. Multiple linear regression models were used to analyze the influencing factors of nutrition and health awareness.

Results

A total of 33,436 valid questionnaires were obtained, with a response rate of 97.8%. The total awareness rate was 20.4%, with the highest in nutrition and disease prevention (72.7%) and the lowest in nutrition skills (46.3%). Responders aged 35-44 (23.3%), females (22.8%), educational workers (24.8%), obtaining a master's degree or above (34.1%), living in downtown area (23.1%), and without a history of chronic disease (24.6%) were more likely to have higher awareness rates (all p < 0.001). The multiple linear regression models showed that age, gender, education level, occupation, residential address, and the history of chronic disease were the potential factors affecting individual nutrition awareness.

Conclusion

The total awareness rate of nutrition and health knowledge among Wuhan residents was not optimistic. Besides, our findings suggested that sociodemographic characteristics are closely related to nutrition awareness, which may provide important clues for carried out nutrition education campaigns.

Does the medium matter? Comparing the effectiveness of videos, podcasts and online articles in nutrition communication

Videos and podcasts have become popular in nutrition communication. However, it is unclear whether they are more effective than online texts in conveying knowledge and promoting behavioural intentions. Based on the Cognitive Theory of Multimedia Learning, it was hypothesised that videos are more effective than podcasts or texts in communicating nutrition-related information. In addition, differences in behaviour change intentions were explored. The pre-registered online experiment used a 3 (medium: video, podcast and text) × 3 (topic: diet and climate change, sugar content, and nudging) between-subjects design with 320 participants who were randomly assigned to the conditions. After receiving the respective content, the participants' intention to change their behaviour accordingly and their knowledge about all topics were assessed. A mixed Analysis of Variance revealed a significant interaction of topic and knowledge, indicating that knowledge was higher for the topic that participants were assigned to, compared to the two topics they received no information about. There were no differences in knowledge or intention for the three media. Videos, podcasts and texts are equally suitable for conveying nutrition knowledge and may also be equally beneficial for promoting intention. Communicators may thus base their choice of medium on considerations like available resources and preferences of the target group.

University Students' Knowledge and Perceptions About Concepts, Recommendations, and Health Effects of Added Sugars

It is recommended to limit added sugars to below 10% of the daily energy intake, as excessive consumption has been associated with several chronic non-communicable diseases. This exploratory qualitative study used focus groups to investigate the knowledge and perception of Brazilian university students about added sugars concepts, consumption recommendations, and health effects. Focus groups were led by a moderator using a semi-structured discussion guide. The focus groups were recorded, transcribed verbatim, and subjected to thematic analysis. Five focus groups were conducted with a total of 32 participants (50% women, mean age 23 years). Participants could not distinguish added sugars from sugars naturally present in foods and were unaware of the health impacts associated with excessive added sugar consumption, except for the risk of diabetes. Although most participants reported limiting sugar consumption, they had no knowledge of official consumption recommendations. Given that current public policy agendas aim to reduce added sugar intake, there is a need to strengthen strategies for disseminating information on added sugar concepts, recommendations, health effects and how to identify them in the foods products.

Low Healthy Diet Self-Efficacy and Intentions Associated with High Sweet Snacks and Sugar Sweetened Beverages Consumption among African American Adolescents Recruited from Low-Income Neighborhoods in Baltimore

Psychosocial factors may influence consumption patterns of sweet snacks and sugar sweetened beverages (SSB), which are potential risk factors for obesity among African American (AA) adolescents. We used multivariable linear and logistic regression models to examine cross-sectional associations among psychosocial factors, sweet snacks and SSB consumption, and BMI z-scores in 437 AA adolescents aged 9-14 years living in low-income neighborhoods in Baltimore City, U.S.A. Mean caloric intake from sugar was 130.64 ± 88.37 kcal. Higher sweet snacks consumption was significantly associated with lower self-efficacy (adjusted Odds Ratio (aOR) = 0.81; 95% CI = 0.71 to 0.93) and lower food intentions scores (0.43; 0.30 to 0.61). Higher SSB consumption was associated with lower outcome expectancies (aOR = 0.98; 95% CI = 0.96-0.99), lower self-efficacy (0.98; 0.96 to 0.99), and lower food intentions (0.91; 0.87 to 0.95). No significant association was found between SSB and sweet snacks consumption and weight status. Psychosocial factors may play a role in sugar consumption behaviors among AA adolescents in low-income neighborhoods. Further studies are needed to improve our understanding of causal mechanisms of this association.

Health-related marketing messages on product labels of commercial infant and toddler food packaging in Australia: a cross-sectional audit

Background

Proper nutrition in early childhood is essential to ensure optimal growth and development. Use of ‘better-for-you’ features on food packaging position products as healthier for children. This study aims to systematically explore the use of better-for-you labelling on infant and toddler food packaging.

Methods

A cross-sectional audit of health and nutrition claims, text and images used as ‘better-for-you’ features present on infant and toddler food packaging. Data on infant and toddler food packaging were collected from five large grocery stores in Adelaide, Australia in 2019. The content of 282 unique commercial products (n=215 infant foods, n=67 toddler foods) were analysed for explicit and implicit features positioning them as better-for-you, including health and nutrition claims as well as text and images representing ‘natural.’

Results

At least one feature of better-for-you positioning was identified on all food packaging coded. All products had characteristics coded as ‘natural’. Almost one-fifth (17%) of the products included statements in addition to mandatory allergen labelling that their products were ‘free from’ certain allergens, or gluten. One-third of the labels had statements related to enhancing development of taste, oro-motor skills and other aspects of childhood development. Of the fruit and vegetable-based infant foods displaying a sugar statement suggesting a low sugar content, 85% were sweetened with fruit puree.

Conclusions

The use of better-for-you features on infant and toddler food packaging is common and pervasive. Allergen-free and developmental claims are being used to position infant and toddler foods as better-for-you. Regulation of toddler food products separately from adult food is required, as is tighter regulation of the appropriate use of sugar and fruit puree statements on infant and toddler food packaging.

GM trust shaped by trust determinants with the impact of risk/benefit framework: the contingent role of food technology neophobia

The present study is comparative in natures that focus on understanding the factors that influence the GM food trust level in the BRA framework and food technology neophobia in China and the USA. For this purpose, we collected 300 and 350 valid responses, respectively, through a structured questionnaire. By carefully evaluating the above relationships, we found that trust determinants such as institutional trust, technology trust, information revealed with GM food vary across both datasets. However, GM knowledge has a better association with GM food trust in both cases. Apart from this, the food technology neophobia slightly moderates the benefits-risk perception of consumers and GM trust. This study guides the policymakers to enhance GM knowledge, as GM food is scientifically proven safe for health and environment and can be a financial incentive for the farmers. Further, the study also provides direction for corporate managers to design effective marketing and communication strategies in two different countries by investigating GM food trust's primary motivators in both nations.

The Effect of an Online Sugar Fact Intervention: Change of Mothers with Young Children

Research indicates that high sugar intake in early childhood may increase risks of tooth decay, obesity and chronic disease later in life. In this sugar fact study, we explored whether an online intervention which focused on comprehensive and useful information about nutrition labels impacted mother’s choice of low sugar food. The intervention was developed on the basis of the theory of planned behavior. In total, 122 mothers were recruited. Mothers were divided into an online-only group and a plus group. Knowledge of sugar and nutrition labels, behavioral attitudes, perceived behavioral control, behavioral intentions and behavior towards purchasing low-sugar products with nutrition labels were collected. After the intervention, both groups exhibited significantly enhanced sugar and nutrition label knowledge, perceived behavioral control, behavioral intentions and behavior. Compared to the online-only group, knowledge, perceived behavioral control and behavior of the plus group significantly improved. After the intervention, about 40% of the plus group and 80% of the online-only group still did not know the World Health Organization (WHO) sugar recommendations. Understanding sugar recommendations and using nutrition labels are crucial to help people control calorie and sugar intake. Further research with a larger sample is warranted to evaluate the effects of the intervention on long-term changes in shopping behavior. More efficient and convenient nutrition education is required to increase public awareness of sugar recommendations and help people control calorie and sugar intake.

Sweet at birth, bitter in growth

Complementary feeding plays a primary role in the life of an infant, as long as the correct assumption of nutrients in terms of timing and quality is the key to a healthy growth. Since infants are totally dependent on their parents during complementary feeding, educational programmes and intervention plans are needed to educate parents and caregivers. As to this, children's sugar consumption throughout their life has been specifically investigated and several critical points have been detected, demonstrating how sugar intake should not be higher than necessary in children and should not include sweetened beverages in daily nutrition. The association between children's diet and the subsequent consequences in their later life has been extensively studied, pointing out how countries should invest in policies that aim at decreasing sugar intake and encouraging parents, as well as children, to a healthier behaviour. The aim of this article is to look at the problem from three different perspectives, the parents' one, the scientific one, and the paediatrician one, in order to offer a new insight on the future of complementary feeding.

Infant Cereals: Current Status, Challenges, and Future Opportunities for Whole Grains

Infant cereals play an important role in the complementary feeding period. The aim of this study was to review existing research about the quantity, type, and degree of infant cereal processing, with a special focus on whole grain infant cereals. Accumulating evidence shows many benefits of whole grain consumption for human health. Likewise, consumers are frequently linking the term whole grains to healthiness and naturality, and sustainable food production becomes a more important aspect when choosing an infant cereal brand. Whole grain cereals should be consumed as early as possible, i.e., during infancy. However, there are several challenges that food manufacturers are facing that need to be addressed. Recommendations are needed for the intake of whole grain cereals for infants and young children, including product-labeling guidelines for whole grain foods targeting these age stages. Another challenge is minimizing the higher contaminant content in whole grains, as well as those formed during processing. Yet, the greatest challenge may be to drive consumers' acceptance, including taste. The complementary feeding period is absolutely key in shaping the infant's food preferences and habits; therefore, it is the appropriate stage in life at which to introduce whole grain cereals for the acceptance of whole grains across the entire lifespan.

Marketing Strategy, Serving Size, and Nutrition Information of Popular Children's Food Packages in Taiwan

A content analysis was used to investigate the marketing strategies, serving size, and nutrition quality in Taiwan popular children’s snacks and drinks. A total of 361 snacks and 246 drinks were collected. It was found that 38.6% of snacks and 25.3% of drinks were child-targeted (CT) foods, and 78.1% and 85.4% of the snacks and drinks had health and nutrition marketing (HNM). Serving size was significantly positively correlated to calories among different food categories in this study. Only the CT breads, ready-to-eat cereals, and fruit/vegetable juice had smaller serving sizes than did the corresponding non-CT products. These CT products had significantly fewer calories than did the corresponding non-CT products. Approximately 30% of snacks and 18% of drinks had both CT and HNM. Moreover, 82.7% of CT snacks and 100.0% of CT drinks with HNM were high in sugar. About 95% of foods with no added sugar claim were high sugar. CT foods are not necessarily healthier than non-CT foods, even the CT food with HNM. Health professionals should help parents assess the nutrition quality of the popular children’s foods. Further research was needed to investigate the effect of these marketing strategies and serving size on children’s food consumption.