US Consumer Identification of the Health Benefits of Dietary Fiber and Consideration of Fiber When Making Food Choices

Let food be your medicine - dietary fiber

Dietary fiber (DF) cannot be digested and absorbed by the digestive tract, nor can it provide the energy needed to be burned for metabolic activities. Therefore, from the 1950s to the 1980s, DF received little attention in nutrition studies. With in-depth research and developments in global nutrition, people have gradually paid attention to the fact that DF occupies an essential position in the structure of nutrition, and it can ensure the healthy development of human beings. As early as 390 B.C., the ancient Greek physician Hippocrates proposed, "Let your food be your medicine, and your medicine be your food". This concept has been more systematically validated in modern scientific research, with numerous epidemiological studies showing that the dietary intake of DF-rich foods such as whole grains, root vegetables, legumes, and fruits has the potential to regulate the balance of the gut microbiota and thereby prevent diseases. However, the crosstalk between different types of DF and the gut microbiota is quite complex, and the effects on the organism vary. In this paper, we discuss research on DF and the gut microbiota and related diseases, aiming to understand the relationship between all three better and provide a reference basis for the risk reduction of related diseases.

Comparing the impact of simple and educational point-of-decision messages on nutritional choice outcomes

Emerging evidence suggests that point-of-decision messages may be an effective way to promote healthy food choices. Previous studies show improvements in overall nutritional quality, as well as increases in underconsumed food categories, such as fruits and vegetables, and underconsumed nutrients of public health concern, like dietary fiber. However, there have been multiple approaches used for delivering point-of-decision messages, including very brief messages that remind individuals to consider health during choice, as well as longer messages providing educational information about health benefits. While both approaches have demonstrated positive impacts on outcomes, there is no comparative evidence of the messages' effectiveness. In this study, we examine the impact of four messages on two nutritional attributes of cereals selected in a two-round pre- and post-message breakfast cereal choice exercise with numerous (n = 33) breakfast cereals available. Data were collected via an online survey of adult US residents recruited from the Prolific consumer panel. Three of the messages were simple reminder messages (taste, health, fiber), while there was additionally a longer fiber-focused messaging detailing the health benefits of fiber. Findings show that the simple messages outperformed the longer educational message, though there were some trade-offs between general health and fiber messages. The simple dietary fiber-focused message resulted in significantly higher dietary fiber content in cereals chosen than in any other messaging condition, while the general health message did not result in significantly higher measures of nutritional quality than the simple fiber message. The results of the study suggest that simpler messages may be more effective at increasing the nutritional quality of food choices. Additionally, messages focused on specific nutrients lead to significantly greater increases in the content of those nutrients.

Health Prompts Affect Consideration of Health but Not Intertemporal Preferences While Promoting Healthier Food Choices

Diet-related diseases impact populations across the globe. While intertemporal preferences-a fundamental preference for the distribution of benefits across time-have been used to explain low-quality food choices, the recent literature proposes another cause: inattention to the future implications (or opportunity costs) of the options faced. Food choices tend to become habitual to conserve cognitive resources, rather than carefully modeling future health impacts. Both low discount rates for future benefits and attention to future health impacts predict healthier decisions. While intertemporal preferences are stable, attention may provide an opportunity to intervene in the decision process to promote healthier decisions. In this study, we test the impact of a simple message that highlights health during food choice on the healthiness of the foods chosen and on health consideration and intertemporal preferences. Our results show that actively considering health outcomes and lower discount rates lead to healthier food choices. We find that messaging increases the consideration of health outcomes during food choice but does not affect intertemporal preferences, suggesting that simple prompts may be an effective way to promote decisions balancing short- and long-term benefits by drawing attention to the overlooked opportunity costs of choices.

Nutrition facts labels: who is actually reading them and does it help in meeting intake recommendations for nutrients of public health concern?

BACKGROUND

Fiber, potassium and calcium are nutrients of public health concern and their intakes in the United States are alarmingly low. The usage of nutrition facts labels has been reported to increase the odds for dietary reference intake of fiber in some studies. The overall evidence, however, is mixed, as some studies suggested that nutrition facts panels have little to no effect on average measures of diet quality. Here, we investigated whether the usage of nutrition facts labels was associated with meeting U.S. intake recommendations for three nutrients of public health concern: fiber, potassium and calcium.

METHODS

We used cross-sectional multistage, stratified, clustered and probability sampling design data from the U.S. National Health and Nutrition Examination Surveys 2017-2020 cycle. The sample included 5,416 individuals aged 20 years or older, which may be extrapolated to represent 146,841,866 US Americans. Nutrient intakes were compared among individuals reading nutrition facts panels "frequently", "sometimes" or "rarely" using applied survey data analyses techniques (including multivariate logistic regression and marginsplots).

RESULTS

We observed substantial sociodemographic differences between the three groups. Frequent readers were significantly more likely to be female and had higher educational levels. On average, they were also significantly older as compared to rare readers. Fiber intake in g/d was highest in frequent readers (17.09) and lowest in rare readers (14.64). The proportion of participants that met dietary fiber intake recommendations was almost four times higher in the frequent readers group (12.69%) as compared to the rare readers group (3.69%). In a bivariate logistic regression model, frequent label reading significantly increased the odds for meeting the fiber recommendations in Dietary Guidelines for Americans (OR: 2.15, p < 0.001). Rarely reading labels decreased the odds (OR: 0.57, p = 0.003). These odds remained essentially unchanged after adjusting for sociodemographic covariates, diabetes status and body mass index (OR: 1.84, p = 0.004; and OR: 0.62, p = 0.022).

CONCLUSIONS

Nutrition facts panel reading associates with fiber intake. Our findings have potential implications for public health nutrition strategies that may center around educational work.

Evaluating the relative impact of multiple healthy food choice interventions on choice process variables and choices

Fiscal tools-taxes and/or subsidies-are increasingly used to address diet-related health problems. However, some studies have found that these tools are markedly more effective if attention is drawn to the tax or subsidy, suggesting that the price change alone may go unnoticed in the complex food environments that consumers face. Interventions that prompt individuals to consider health during choice show promise for promoting healthy food choices in both simple laboratory settings and complex, real-world markets. In this pre-registered study, I examine the impact of dietary fiber health prompts and/or dietary fiber subsidies on the per-serving fiber content of foods chosen, the documented set of products considered, and (self-reported) nutrition information use by participants in an online supermarket setting. Participants were randomized to one of four conditions: 1) control, 2) subsidy, 3) fiber prompt, and 4) fiber prompt + subsidy. Results show that both the prompt and prompt + subsidy conditions significantly increase fiber content of foods chosen (with the latter having a larger effect). While all three interventions influence the probability of using nutrition information during food choice and affect the set of products that respondents consider relative to the control condition, the effects were larger for the prompt and prompt + subsidy conditions. A multiple mediation analysis illustrates that both direct and indirect (through the set of products considered and the use of fiber information during choice) pathways lead to the significant overall increase in fiber content of selected foods.

Consideration of nutrients of public health concern highlighted in the Dietary Guidelines for Americans 2020-2025 among a large sample of US primary shoppers

The objective of this research is to estimate the proportion of consumers who consider nutrients identified in the Dietary Guidelines for Americans 2020-2025 (DGA) as being of public health concern during food choice using a large, population-weighted sample of U.S. residents. A question was included in a bi-monthly survey of consumer scanner panel members, asking whether respondents considered each of eight nutrients in a check-all-that-apply format. Four of these nutrients are under-consumed nutrients, while three are nutrients to avoid. Calories was additionally included, as over-consumption of calories causes weight gain. Weighted mean proportions and 95% confidence intervals were estimated. The survey was administered to a population-weighted sample of 42,018 US consumers participating in a consumer scanner panel in May-June 2021 by an online survey firm that maintains the consumer panel. Over one-quarter of respondents considered none of the nutrients. Each under-consumed nutrient of public health concern was considered by less than 30% of respondents, ranging from a low of 14.5% for potassium (95%CI = 14.3-14.7%) to a high of 28.9% for dietary fiber (95%CI = 28.7-29.1%). Nutrients to be avoided were considered by higher percentages of the sample, ranging from 31.8% for saturated fats (95%CI = 31.6-32.0%) to 46.1% for added sugars (95%CI = 45.8-46.3%). Respondents considered an average of just over 2.4 total nutrients, with a greater focus on nutrients to avoid, including calories (weighted mean = 1.55), than under-consumed nutrients (weighted mean = 0.89). Over one-quarter of consumers considered no nutrients of public health concern. Consumers focused more on nutrients to avoid rather than under-consumed nutrients. Promoting increased awareness of important under-consumed nutrients may improve public health.

Is Better Knowledge about Health Benefits of Dietary Fiber Related to Food Labels Reading Habits? A Croatian Overview

The aim of this cross-sectional study was to determine the associations between health dietary patterns, knowledge, and consumption of dietary fiber (DF) with frequency of food label reading on food products with special reference to DF. The study was conducted in 2536 Croatian adults using an original questionnaire. Multiple linear regression models were used to assess associations between food label reading habits and predictor variables. Our study confirms the association between habits regarding the reading of labels on food products, especially in relation to information about DF with the sociodemographic factors of respondents, dietary food patterns and DF consumption, as well as knowledge and sources of information about DF. Women, individuals with a university-level education, and those living in an urban environment had more frequent labels used. Food habits as well as eating outside of the home were positive predictors while eating fast food was a negative predictor of food label reading. Knowledge about DF, especially about its health benefits, was also associated with food label reading. The interpretation of associations could help with the design of effective public health programs. Targeted education campaigns to educate and sensitize the population about food labeling and monitoring may improve general knowledge about healthy food and its benefits, which include indirect effects on the prevention of non-communicable chronic diseases.

Active Consideration of Future Health Can Be Prompted by Simple Health Messages and Improves Nutritional Quality of Food Choices

Many choices that people face daily have implications for future health and well-being. Choices about what foods to purchase and consume are one of the most frequent-and universal choices-that people must make. The ongoing rise of overweight and obesity rates-and associated diet-related diseases-in the US and many other countries illustrates the future health consequences of low-quality dietary choices. While a large body of research shows that individuals with a tendency to consider the future make a wide range of healthier decisions, research on limited attention and exogenous factors influencing choice suggests that attention to the future consequences of choices may vary from one choice scenario to the next. In this research, we examine the impact of active consideration of future health impacts during a hypothetical online food choice experiment on the nutritional quality of food choices and on choice process variables-the set of products people choose to select from and the use of nutrition information during choice-during an online food choice task. Next, we examine the impact of exposure to a short message about the health benefits of fiber on consideration of future health impacts and on the nutritional quality of choices. We find that active consideration of future health impacts significantly improves the nutritional quality of choices-particularly among processed food products-and makes people more likely to pay attention to healthy foods and use nutrition information. Exposure to a short health message significantly increases the likelihood that individuals consider future health impacts during choice, which promotes healthier choices overall.