How Consumers in the UK and Spain Value the Coexistence of the Claims Low Fat, Local, Organic and Low Greenhouse Gas Emissions

This study investigates the substitution and complementary effects for beef mince attributes drawing on data from large choice experiments conducted in the UK and Spain. In both countries, consumers were found to be willing to pay a price premium for the individual use of the labels "Low Fat" (UK: €3.41, Spain: €1.94), "Moderate Fat" (UK: €2.23, Spain: €1.57), "Local" (UK: €1.54, Spain: €1.61), "National" (UK: €1.33, Spain: €1.37), "Organic" (UK: €1.02, Spain: €1.09) and "Low Greenhouse Gas Emissions (GHG)" (UK: €2.05, Spain: €0.96). The results showed that consumers in both countries do not treat desirable food attributes as unrelated. In particular, consumers in Spain are willing to pay a price premium for the use of the labels "Local", "Organic" and "Low GHG" on beef mince that is also labelled as having low or moderate fat content. By contrast, consumers in the UK were found to discount the coexistence of the labels "Low Fat" and "Organic", "Low Fat" and "Low GHG" and "Moderate Fat" and "Low GHG". The results, however, suggest that in the UK the demand for beef mince with moderate (low) fat content can be increased if it is also labelled as "Organic" or "Low GHG" ("Local").

The availability and cost of healthier food alternatives

BACKGROUND

Many people, especially low-income consumers, do not successfully follow dietary recommendations to eat more whole grains and less fat and added sugar. The food environment may have a significant impact on the choice by low-income consumers to eat healthier foods, as both the availability and price of healthier food items may limit their ability to eat a healthier diet. We investigated the cost and availability of a standard market basket of foods, and a healthier basket that included low-fat meat and dairy and whole grain products.

METHODS

Market-basket surveys were conducted in 25 stores in Los Angeles and Sacramento. Stores were selected from neighborhoods that were varied by income and surveyed three times from September 2003 to June 2004. The average cost of a standard market basket (based on the U.S. Department of Agriculture's Thrifty Food Plan [TFP]) and a healthier market basket was calculated from these prices and compared using a standard t-test to determine if they were significantly different from each other. The analysis was conducted in 2005.

RESULTS

In neighborhoods served by smaller grocery stores, access to whole-grain products, low-fat cheeses, and ground meat with <10% fat is limited. Among all items that were unavailable, 64% were in small grocery stores. For the 2-week shopping list, the average TFP market-basket cost was $194, and the healthier market-basket cost was $230. The average cost of the healthier market basket was more expensive by $36 due to higher costs of whole grains, lean ground beef, and skinless poultry. The higher cost of the healthier basket is equal to about 35% to 40% of low-income consumers' food budgets of $2410 a year.

CONCLUSIONS

The lack of availability in small grocery stores located in low-income neighborhoods, and the higher cost of the healthier market basket may be a deterrent to eating healthier among very low-income consumers. Public policies should take the food environment into account in order to develop successful strategies to encourage the consumption of healthier foods.

Technical constraints in the development of reduced-fat bakery products

The present study was funded by the Ministry of Agriculture, Fisheries and Food, its aim being to identify the technical barriers to the development of reduced-fat alternatives for bakery products. Using National Food Survey (Ministry of Agriculture, Fisheries and Food, 1998) statistics on dietary consumption within the home, biscuits, cakes and pastries were identified as contributing significant amounts of fat to the population's dietary intake. Face-to-face interviews were conducted with contacts in the technical community of the baking industry, who were usually working in technical and new-product development functions. A discussion guide was developed to cover the main lines of enquiry. The companies selected were ingredient suppliers (eight), manufacturers (twelve) and retailers (four) and so represented each step of the food supply chain. In brief, results showed that current labelling rules were too stringent, and constrained development of reduced-fat bakery products. Products with lower fat levels are harder to make due to altered handling and processing properties. Their quality is usually poorer than standard products, particularly for flavour, texture and mouthfeel. The perception of freshness is reduced and product shelf-life may consequently be shorter. For the product developer, there are relatively few ingredients that can be used in place of fat, and knowledge of how they work is limited, which inhibits product development. There is no identifiable source of technical knowledge in this field. Consumers perceive reduced-fat bakery products to be of lower quality and are generally unwilling to pay higher prices than for standard products.

Clinical and cost outcomes of medical nutrition therapy for hypercholesterolemia: a controlled trial

OBJECTIVE

To compare the results and cost-effectiveness of a cholesterol lowering protocol implemented by registered dietitians with cholesterol lowering advice by physicians.

DESIGN

Six month randomized controlled trial, cost-effectiveness analysis. Subjects included 90 ambulatory care patients (60 men, 30 women), age range 21 to 65 years, with hypercholesterolemia and not taking hypolipidemic drugs. Patients were randomly assigned to receive medical nutrition therapy (MNT) from dietitians using a NCEP based lowering protocol or usual care (UC) from physicians. Outcome measures were plasma lipid profiles, dietary intake, weight, activity, patient satisfaction, and costs of MNT. Changes from baseline for each variable of interest were compared between treatment groups using analysis of covariance controlling for baseline value of the variable and gender.

RESULTS

MNT achieved a 6% decrease in total and LDL cholesterol levels at 3 and 6 months compared with a 1% increase and a 2% decrease in both values at 3 and 6 months with UC (P<.001 and P<.05, respectively). Weight loss (1.9 vs 0 kg, P<.001) and dietary intake of saturated fat (7% of energy vs 10%, P<.001) were better in the MNT than the UC group. The additional costs of MNT were $217 per patient to achieve a 6% reduction in cholesterol and $98 per patient to sustain the reduction. The cost-effectiveness ratio for MNT was $36 per 1% decrease in cholesterol and LDL level.

APPLICATIONS/CONCLUSIONS

MNT from registered dietitians is a reasonable investment of resources because it results in significantly better lipid, diet, activity, weight, and patient satisfaction outcomes than UC.

[Role of diet in cardiovascular prevention]

Several dietary components increase the risk of ischemic cardiovascular disease: excess dietary cholesterol and fats (especially saturated fats with low mono- and polyunsaturated fatty acid content), deficiency of antioxidants, fibers. These dietary factors modify the levels and the physicochemical structure of plasma lipoproteins and consequently their metabolic activities. Some of them also modify platelet aggregation and endothelial function. To reduce the cardiovascular risk, different nutritional schemes have been proposed and applied in prevention studies. Mediterranean-type diet, or traditional Asian food provide a very favorable cost/effectiveness ratio. These diets must be associated with the usual measures for improving lifestyle (increased physical activity, reduction of smoking) and with drug treatment of major risk factors (dyslipidemia, hypertension, diabetes).

Avoiding revascularization with lifestyle changes: The Multicenter Lifestyle Demonstration Project

The Multicenter Lifestyle Demonstration Project was designed to determine if comprehensive lifestyle changes can be a direct alternative to revascularization for selected patients without increasing cardiac events. A total of 333 patients completed this demonstration project (194 in the experimental group and 139 in the control group). We found that experimental group patients were able to avoid revascularization for at least 3 years by making comprehensive lifestyle changes at substantially lower cost without increasing cardiac morbidity and mortality. These patients reported reductions in angina comparable with what can be achieved with revascularization.

Profitability and acceptability of fat- and sodium-modified hot entrees in a worksite cafeteria

OBJECTIVES

To compare the acceptability of fat- and sodium-modified entrees before and after implementation of a marketing program and to determine the effect offering and marketing these healthful entrees had on total cafeteria and entree sales in a worksite cafeteria.

DESIGN

The research was conducted in five phases, including sales data collection, acceptance testing of unmodified hot entrees, acceptance testing of modified entrees, and implementation of a marketing campaign for promoting low-fat, sodium-controlled food selections.

SETTING

The Kansas Farm Bureau and Affiliated Services (KFB) employee cafeteria.

SUBJECTS

KFB employees who ate lunch in the employee cafeteria and were willing to participate in the study.

MAIN OUTCOME MEASURES

Sales data (percent of customers purchasing a modified entree and sales of modified entree as a percent of total sales); nutrient analysis data (energy, grams of total fat, percent of energy from fat, milligrams of cholesterol, and milligrams of sodium); and acceptability data (11 characteristics were measured using a seven-point hedonic scale).

STATISTICAL ANALYSIS PERFORMED

General linear model analysis of variance was used to compare sales data from phases 1 to 5 and to compare acceptability data from phases 2 to 4.

RESULTS

No significant differences in sales data were observed during the 7-month study. No significant changes in overall acceptability were found for any entree. However, customers tended to rate overall acceptability higher when entrees were marketed as lower in fat and sodium.

APPLICATIONS/CONCLUSIONS

Customers in worksite cafeterias may be more willing to tolerate changes in flavor attributes when modified entrees are marketed as "healthful" and nutrition information is available.