Determinants of economic motivations for food choice: insights for the understanding of consumer behaviour.

Food consumption involves several dimensions, being some of them directly associated with the consumers' characteristics. The interrelationships between these domains impact consumer behaviour for food choice and the consequent decisions for food consumption. In these frameworks, economic motivations are determinant. On the other hand, the scientific literature highlights that the economic-based stimuli to choose food is still underexplored. In this perspective, the objective of this study was to assess the main sociodemographic and anthropometric determinants of the economic motivations for food choice. For that, a questionnaire survey was carried out involving 11,919 respondents from 16 countries. A validated questionnaire was used, translated into the native languages in all participating countries, using a back-translation process. First, the information obtained was assessed through factor analysis to reduce the number of variables associated with the economic motivations and to identify indexes. After, and considering the indexes obtained as dependent variables, a classification and regression tree analysis was performed. As main insights, it is highlighted that the main determinants of the economic motivations are country of residence, age, gender, civil state, professional activity, educational level, living environment, responsibility for buying food, weight, height, body mass index, healthy diets and physical exercise practices. Additionally, the results also reveal that economic motivations may be associated with two indexes, one related to convenience attitudes and the other to quality concerns. Finally, the younger persons and the women are the social groups more concerned with healthy diets and food quality. In conclusion, this work confirmed that food choice is to a high extent influenced by several sociodemographic and behavioural factors.

Influence of sociodemographic factors on eating motivations - modelling through artificial neural networks (ANN).

This study aimed at investigating the influence of some sociodemographic factors on the eating motivations. A longitudinal study was carried conducted with 11960 participants from 16 countries. Data analysis included t-test for independent samples or ANOVA, and neural network models were also created, to relate the input and output variables. Results showed that factors like age, marital status, country, living environment, level of education or professional area significantly influenced all of the studied types of eating motivations. Neural networks modelling indicated variability in the food choices, but identifying some trends, for example the strongest positive factor determining health motivations was age, while for emotional motivations was living environment, and for economic and availability motivations was gender. On the other hand, country revealed a high positive influence for the social and cultural as well as for environmental and political and also for marketing and commercial motivations.

Modelling of avoidance of food additives: a cross country study.

Food additives are strictly regulated and from technological point of view are useful ingredients. However, due to negative media news seeking for sensation, and sometimes irresponsible producer behaviour, utilisation of food additives generates consumer aversion, thus shopping rejection. The present study examines the factors that influence consumers' motives and attitudes towards the avoidance of food additives. On the basis of a questionnaire survey, a theoretical model was developed and applied by path analysis in three European countries (Hungary, Romania and Spain), respectively. Results suggested that even though the avoidance of food additives (action) can be modelled identically, it can be influenced by different measures based on the country's specific features. For the grounding of the shopping decisions towards the avoidance of food additives, it is important to decrease the perceived risk, to improve consumers' knowledge, as well as to take into consideration the peculiarities of the concerned countries.

The Quality of Romanian Breast Cancer Websites: a Five-Year Longitudinal Assessment.

The Internet has become an important source of overall health information and seems to be the second common source of information used by patients in the process of decision-making before breast surgery. The goal of this study was to monitor Romanian breast cancer websites and their quality over a period of 5 years. We evaluated a sample of 20 websites selected from Google's first search results pages using specific rating scores for e-health quality, completeness, accuracy, and potential risk, in 2011 and 2016, respectively. Only 15 (75%) of the websites in the 2011 sample were accessible in 2016 and only two (10%) retained real-life visibility (Google PageRank < 20). The mean quality scores at baseline (2011) and follow-up (2016), respectively, were as follows: e-health quality 3.80 vs. 4.05; completeness 4.23 vs. 5.43; accuracy 5.74 vs. 6.35; and potential risk score 7.60 vs. 7.30. All quality scores were low or, at best, modest and did not improve significantly over the 5-year period. The results of the study draw attention to the need for programs aiming to improve the ability of breast cancer patients to screen the online health resources and to better regulate the medical Internet to safeguard the best interest of health information seekers.

Wellness integrative profile 10 (WIP10) - an integrative educational tool of nutrition, fitness and health.

OBJECTIVE: To assess the educational impact and satisfaction of using Wellness Integrative Profile 10 both by specialists and clients in nutrition, health and fitness centres. METHODS: This cross-sectional study was conducted at 42 wellness centres in Romania during March-November 2016, where Wellness Integrative Profile 10 was implemented with no less than 3 months before the beginning of the study. Data was gathered through a 15-item questionnaire related to the educational impact of integrating 10 parameters regarding the level of health, nutrition and fitness of the subjects.. RESULTS: The questionnaire had a reliability Cronbach score of 0.777 for specialists and 0.705 for clients. The number of subjects who rated the satisfaction questionnaire WIP10 with maximum grade (5) were: 181.93(61.88%) specialists and 1,309.40(65.88%) clients. CONCLUSIONS: The implementation of Wellness Integrative Profile 10 will allow in the future to design customised and specialised programmes for health.

Knowledge about dietary fibre: a fibre study framework.

The objective of this work was to study the degree of knowledge about dietary fibre (DF), as influenced by factors such as gender, level of education, living environment or country. For this, a descriptive cross-sectional study was undertaken on a non-probabilistic sample of 6010 participants from 10 countries in different continents (Europe, Africa and America). The results showed that the participants revealed on average a positive but still low global level of knowledge, which alerts for the need to take some actions to further inform the population about DF and its role as a component of a healthy diet. The results also indicated differences between genders, levels of education, living environments and countries. The highest level of knowledge was revealed by the participants from female gender, with higher education and living in urban areas. Concerning the country, the best informed were the participants from Romania, followed by those from Portugal and Turkey while the least informed were from Egypt.

Human Papillomavirus Vaccine - Knowledge and Attitudes among Parents of Children Aged 10-14 Years: a Cross-sectional Study, Tîrgu Mures, Romania.

AIM: Romania ranks first in Europe in terms of mortality from cervical cancer, recording 6.3 times more deaths than the mean in EU countries. Although vaccination campaigns were launched by health officials in Romania, the acceptance rate remained insignificant and programmes were discontinued. A successful vaccination programme requires a high rate of acceptance and accurate information for health professionals and parents. The aim of the study was to evaluate the level of parental knowledge about human papilomavirus (HPV) infection and HPV vaccination including the information obtained from general practitioners and identification of barriers in implementing a vaccination strategy. METHODS: We performed a cross-sectional study using a self-administered questionnaire for the parents of pupils in grades 5-8, in three randomly selected secondary schools in Tîrgu Mures, Romania. RESULTS: We surveyed 918 parents. Of the respondents, 85.8% have heard of HPV infection. Most reported an average level of knowledge about HPV infection and HPV vaccination. The two main sources of information were specialized healthcare professionals (42.8% for HPV infection, 39.1% for HPV vaccination) and the Internet browsing (42.3% and 42.9%, respectively). Based on current knowledge, only one third of parents would have their child vaccinated against HPV infection. According to most parents surveyed, the main reasons for not wanting to have their child vaccinated is the fear of side effects; the vaccine is new and insufficiently studied; or parents do not know details about the vaccine. CONCLUSIONS: The parents showed the average level of knowledge about HPV infection and HPV vaccination. The implementation of an effective programme to increase the acceptance rate of HPV vaccination requires educational strategies aimed at involving parents and their children and supported by general practitioners and public health professionals.

Active Smoking and Associated Behavioural Risk Factors before and during Pregnancy - Prevalence and Attitudes among Newborns' Mothers in Mures County, Romania.

BACKGROUND AND AIM: Smoking before, during and after pregnancy leads to detrimental outcomes on maternal and foetal health and represents an important public health issue. This study aims to evaluate the prevalence and correlates of smoking before and during pregnancy in a sample of Romanian women. METHODS: A cross-sectional survey was conducted among mothers (N=1,278) in three maternity hospitals in Tirgu-Mures, Romania, immediately after childbirth, in 2014. We evaluated the prevalence of smoking before and during pregnancy and used binary logistic regression to assess the influence of socio-demographics and other health behaviour factors in three groups of women: non-smoking pregnant women, women who continued smoking during pregnancy, and smokers who quit during pregnancy. RESULTS: 30% of the interviewed mothers were smokers prior to pregnancy, of whom 43.3% continued smoking during pregnancy. Women with a family income of less than 100 Euro/month (OR=3.01, 95% CI: 1.02-8.83) and those who were unemployed (OR=13.2, 95% CI: 3.90-44.79) had increased odds of continued smoking versus quitting during pregancy in multivariable analyses. Women who continued smoking during pregnancy were also more likley to be of lower socioeconomic status than never smokers (OR=14.1, 95% CI: 4.97-39.6). CONCLUSIONS: A high percentage of women of reproductive age smoke and continue to smoke despite their knowledge about risks of smoking during pregnancy. Smoking prior to and during pregnancy is predominantly associated with lower socioeconomic status. Women with limited economic means should be a high priority target group for smoking cessation interventions.

Incidence of Urinary Infections and Behavioral Risk Factors.

This evaluation of the impact of behavioral risk factors on the incidence of urinary infections was based on a questionnaire in which 1103 respondents, predominantly women (883), participated. From the statistical processing of the data, it was observed that 598 of the respondents were of normal weight; the rest, more than half, were underweight or overweight (χ2 = 32.46, p < 0.001), with male respondents being predominantly overweight or obese (169 out of a total of 220). Most of the respondents were young (χ2 = 15.45, p < 0.001), under the age of 45 (840). According to the processed data, it was found that respondents in the age group of 26-35 years showed the greatest vulnerability to recurrent urinary infections, while the age group of 18-25 years recorded the highest number of responses related to the rare presence or even absence of episodes of urinary infections. A body weight-related vulnerability was also noted among the respondents; the majority of obese people declared that they face frequent episodes of urinary infections. Regarding diet quality, 210 respondents reported an adherence to an unhealthy diet, 620 to a moderately healthy diet, and 273 to a healthy diet. Of the respondents who adhered to a healthy diet, 223 were women (χ2 = 2.55, p = 0.279). There was a close connection between diet quality and the frequency of urinary infections: from the statistical processing of the data, it was observed that the highest percentage of respondents who rarely (57.14%) or never got urinary infections (29.30%) were among those who adhered to a healthy diet, and the highest percentage of those who declared that they often got urinary infections were among those with increased adherence to an unhealthy diet (χ2 = 13.46, p = 0.036). The results of this study highlight a strong impact of obesity, reduced consumption of fruit and vegetables, and sedentary lifestyle on the risk of recurring urinary infections.

Emotions and Food Consumption: Emotional Eating Behavior in a European Population.

Emotion can reflect in the perception of food consumption. An increase in food intake during emotional and psychological conditions may have a negative impact on human health. The aim of this cross-sectional study was to determine the associations between food consumption, emotional eating behavior, and emotional conditions such as stress, depression, loneliness, boredom eating, maintaining vigilance and alertness, and emotional food consolation. We used a Motivations for Food Choices Questionnaire (Eating Motivations, EATMOT) to determine the emotional aspects of food consumption in 9052 respondents living in 12 European countries between October 2017 and March 2018. Ordinal linear regression was used to identify the associations between the emotional eating behavior and emotional conditions such as stress, depression, loneliness, emotional consolation, and reasons to improve physical and psychological conditions. The regression models confirmed the associations between food consumption, emotional conditions, and emotional eating behavior. Associations were found between the emotional eating behavior and stress (odds ratio (OR) = 1.30, 95% confidence interval (CI) = 1.07-1.60, p = 0.010), depressive mood (OR = 1.41, 95% CI = 1.40-1.43, p < 0.001), loneliness (OR = 1.60, 95% CI = 1.58-1.62, p < 0.001), boredom (OR = 1.37, 95% CI = 1.36-1.39, p < 0.001), and emotional consolation (OR = 1.55, 95% CI = 1.54-1.57, p < 0.001). Emotional eating was associated with an effort to improve physical and psychological conditions, such as controlling body weight (OR = 1.11, 95% CI = 1.10-1.12, p < 0.001), keeping awake and alert (OR = 1.19, 95% CI = 1.19-1.20, p < 0.001) and consumption to feel good (OR = 1.22, 95% CI = 1.21-1.22, p < 0.001). In conclusion, emotions might provoke emotional eating behavior. The appropriate way to handle stress, depression, or other emotional states is important in conditions of being emotionally overwhelmed. The public should be educated on how to handle different emotional states. The focus should be moved somehow from emotional eating and the consumption of unhealthy food to healthy lifestyle practices, including regular exercise and healthy eating habits. Thus, it is necessary to halt these negative health effects on human health through public health programs.

The relation between prepregnancy maternal body mass index and total gestational weight gain with the characteristics of the newborns.

AIMS: To evaluate the relationship between the maternal body mass index (BMI) and total gestational weight gain (GWG) with the characteristics of newborns, taking into consideration the birth weight (BW), weight for age score (WfA), length for age (LfA), and weight for length (WfL), APGAR score, and premature delivery. METHODS: We conducted a study, from March 2015 to 2016. We included a number of 1218 pregnant women who delivered single babies, from three different hospitals that serve the entire Mures County and who met our inclusion criteria. RESULTS: We did not find significant differences regarding weight, length at birth, and gestational age, between girls and boys, neither between total GWG during pregnancy and the measured anthropometric parameters of the newborns, or between maternal GWG and gestational age of the newborns. We found a positive correlation between the mothers' BMI and the BW of the newborns (p =.03, r = 0.06, 95% CI = 0.0036-0.1169), but not between BMI and the birth length and nor with APGAR score. The statistical analysis showed a positive correlation between BMI and LfA (p = .01, r = 0.07, 95%CI = 0.0141-0.1269), but not with WfA and WfL. Women with higher BMI before getting pregnant showed significantly higher frequency of preterm delivery (p = .0078). We found a statistically significant correlation between GWG and BW (p<.0001). Excessive GWG correlates statistically significant with BW (p < .0001). CONCLUSIONS: We found a positive correlation between the mothers' BMI and excessive GWG and the BW of their newborns in women delivering a single baby. Women with higher BMI showed significantly higher frequency of preterm delivery.

Tobacco consumption among ninth-grade students in Chisinau, Moldova.

INTRODUCTION: The aim of this study was to evaluate the potential impact of the changes in the national legislation on tobacco consumption and the impact of the implementation of the National Tobacco Control Program on ninth-grade students in Chisinau, Moldova, during 2015 and 2018, as well as tobacco consumption behavior and exposure to pro- and anti-tobacco messages. METHODS: The study sample consisted of the ninth-grade students from 132 schools in Chisinau, Moldova. It included 20 randomly selected schools (3 gymnasiums and 17 high schools). Data were collected using a validated self-completed questionnaire, once in October-December 2015 (n=368) and repeated in February-April 2018 (n=819). The chi-squared test was applied to compare categorical variables between the 2015 and 2018 groups. RESULTS: The student participants had mean age of 14.8 ± 0.49 years (2015) and 14.9 ± 0.53 years (2018), and, by coincidence, both groups had 51.9% boys and 48.1% girls. However, despite the rather strict regulations on tobacco in Moldova, adolescents still report a significant increase in the prevalence of cigarette consumption in the last 30 days in the period from 2015 to 2018. In this period, anti-smoking messages increased significantly and were seen by students in shopping malls, supermarkets (35.1% in 2015 and 60.0% in 2018), cinemas (11.7% in 2015 and 36.5% in 2018), magazines and newspapers (19.3% in 2015 and 37.6% in 2018) (p<0.001). CONCLUSIONS: Tobacco consumption among ninth-grade pupils had increased between 2015 and 2018 in Chisinau, Moldova. Adolescents represent a critical subpopulation of smokers and tobacco control experts must concentrate their efforts to reduce their exposure to pro-smoking messages and increase their exposure to anti-smoking messages (via internet, sport events, etc.).

Demographic, Anthropometric and Food Behavior Data towards Healthy Eating in Romania.

BACKGROUND: Each country has specific social, cultural, and economic characteristics regarding the motivations for improving health. The aim of this study was to evaluate demographic characteristics, anthropometric data, and elements related to food behavior and health, as well as Romanians' motivations towards healthy eating. METHODS: This is a descriptive cross-sectional questionnaire based study enrolling 751 Romanian participants, which was carried out in in 2017-2018. RESULTS: We obtained a positive correlation between age and Body Mass Index, and this was maintained also when we analyzed the two genders separately, being, however, even stronger for women. The number of hours/day spent watching TV or in front of the computer was positively correlated with both age and BMI. In general, with aging, there is an increasing concern regarding the practice of a healthy diet. The higher education level was significantly associated with healthier choices. CONCLUSIONS: The study of the three dietary dimensions, food properties, health attitudes, and dietary behavior, vis-à-vis various disorders revealed that the group most concerned of their diet was those who suffered from cardiovascular disorders.

Study about Food Choice Determinants According to Six Types of Conditioning Motivations in a Sample of 11,960 Participants.

Many aspects linked to personal characteristics, society and culture constitute some of the motivators that drive food choice. The aim of this work was to determine in what extent the eating behaviors of individuals are shaped by six different types of determinants, namely: health, emotions, price and availability, society and culture, environment and politics, and marketing and commercials. This is a descriptive cross-sectional study, involving a non-probabilistic sample of 11,960 participants from 16 countries. The objective of this work was to validate the questionnaire, so as to make it suitable for application in different contexts and different countries. For that, six scales were considered for validation by confirmatory factor analysis with structural equation modelling. The obtained results showed that the six individual scales evaluated presented good or very good fitting indices, with saturation in goodness-of-fit index in all cases. The values of chi-square ratio were 6.921 (for health), 0.987 (environment), 0.610 (emotions) and 0.000 in the remaining cases (convenience, society, marketing). Furthermore, the fit was perfect, with saturation for all indices, in three of the six models (convenience, society and marketing). The results of this wok allowed the validation of the six scales, and the assessing of different types of factors that can influence food choices and eating behaviors, namely in the categories: health, emotions, price and availability, society and culture, environment and politics, and marketing and commercials.

[Quality of life of consumers following a gluten-free diet. Results of a questionnaire survey in Hungary and Romania]. / A gluténmentesen táplálkozó fogyasztók életminosége. Magyarországi és romániai kérdoíves felmérés eredményei.

Introduction and aim: With the rising consumer's health awareness, especially towards patients with celiac disease, gluten has become a food ingredient to be avoided by many people expecting various positive health effects. The strict adherence of diet requires serious abandonments and lifestyle changes that affect directly their quality of life. The aim of the present study was to recognise the quality of life of Hungarian and Romanian consumers following a gluten-free diet as well as to explore the negative effects on them. Method: An online questionnaire survey was conducted upon 1155 Hungarian and Romanian respondents. Results: For gluten-free consumers, self-control was relatively easy to overcome, but their lifestyle was negatively affected by social events and dining out. In addition, diet adherence was a burden from both lifestyle and financial point of view. For Hungarian consumers, external factors such as price, choice, taste and availability of products had become a major obstacle, while Romanian ones were more likely to be affected by internal factors (product information, diet knowledge, lifestyle, self-control). Mandatory labelling of substances and products causing allergies and intolerances has achieved its purpose, as it has made it easier for consumers on diet to choose food and increased their confidence. Conclusions: The study points out that dieters' quality of life can be enhanced not only by general actions (improving the preparedness of out-of-home meal services and rationalising the price of products), but also through country-specific community intervention. Orv Hetil. 2019; 160(25): 980-986.

[Knowledge of the young people in Mures county concerning alimentary additives in the menu]. / Cunostinte ale tinerilor mureseni legate de consumul de aditivi alimentari din meniu.

AIM: To monitore knowledges and attitudes regarding food additives in a representative sample of Mures students. METHODS: We used a questionnaire of 27 questions related to nutritional behaviour, types of food and beverages with food additives used frequently in the menu and also knowledges regarding food additives. We choose a groups of 185 students from Targu-Mures University of Medicine, in 2007. RESULTS: Knowledges regarding food additives are impressive in our group and showing interest for this matter also. From our subjects 55.14% are avoiding food products and beverages with additives, especially girls from urban area (p < 0.00006). An important percentage (9.72%) of students are associating over admitted limits of additive food products daily (ham, sweets, dairy, jam, canned food)e; 20% of them are consuming also beverages and instant tea types with more additives involved. CONCLUSIONS: The motives to avoid food additives are related to cancer and gastric toxicity causes.

[Evaluation of iron, fluoride and iodine concentrations in underground water in some counties in Romania]. / Evaluarea concentratiei de fier, fluor si iod din apa subterani din câteva judete ale României.

AIM: To compare the underground water mineral composition in iron, fluorine and iodine from different sources, with variable locations in Romania. METHODS: It is a lab study based on Hanna Instruments C99 colorimeter used for our tests, that follows the levels of mineral parameters from water samples from several underground water supplie sources from 10 different romanian counties. RESULTS: It were significant differences between sources from different counties, and also from different sources in the same county, regarding minerals levels in water and also comparing to admitted levels. The most various data were related to fluorine and iodine levels in water samples and risk of exposure by deficiency. CONCLUSION: It is important to know the importance of supply water monitoring, to evaluate both the drinking water quality parameters and mineral composition, in order to estimate the influence on health status of long shut consumer population.

[Chemoresistance of mycobacteria in a group of patients with tuberculosis from Mures county]. / Chimiorezistenta micobacteriilor la un lot de pacienti mureseni cu tuberculoza.

AIM: We studied tuberculosis drug-resistance cases related to risk factors involved, in Mures district. METHODS: We used clinical files of 91 patients with tuberculosis drug resistance from 2006 at all, diagnosed during 2002-2006 at the Ambulatory department of Tuberculosis Clinic in Tg. Mures town and cities nearby. RESULTS. Mycobacterium drug resistance is more frequent at men (96.8%), because of multiple tuberculosis risk factors involved, also is more frequent in rural areas (52.8%) because of low access to medical services. Drug resistance rate have a direct growing related to number of treatments made before, at patients with therapeutic failure and chronic cases. In our study, first year was dominated by single drug resistance to NIH, with a decrease in 2004 and no cases in 2006; and also multi-drug resistance was placed on the first place by frequency in 2006. CONCLUSIONS: We sustain the needs to intensify the general efforts on tuberculosis early diagnosis, also to increase the medical education on all levels, government financial support and trained staff a good monitoring program during tuberculosis evolution in specific centers of diagnostic and treatment of multi-drug resistance cases in Mures district.

Human Papillomavirus (HPV) Infection and HPV Vaccination: Assessing the Level of Knowledge among Students of the University of Medicine and Pharmacy of Tîrgu Mures, Romania.

Human papillomavirus (HPV) infection, a causative factor for cervical cancer, remains a topic of great interest. About 80% of sexually active women are at risk of acquiring an HPV infection at some point in life, the peak incidence of infection having been identified in young women. The aim of the study was to assess the knowledge and attitudes of medical students about sexually transmitted diseases, HPV infection, HPV vaccinations, and student sexual behavior. A transversal study was conducted using a questionnaire on students on the 1st and 6th year at the Faculty of Medicine of Tîrgu Mures University, Romania. The study resulted in 522 fully completed questionnaires. The percentage of students who had heard about HPV was 82.1% in the 1st year and 99.1% in the 6th year of medical school, but the level of knowledge was different: 62% of senior students had a good or very good level of knowledge, whereas 55.1% of first year students had little knowledge on the topic. About 75% of 6th year students would vaccinate their child against HPV, compared with only 52.4% of 1st year students (P<0.001). The level of knowledge about HPV infection among students in their first year of medical school is rather low, significantly lower compared to 6th year students, which suggests acquiring some basic information in this area since the first year of college or even high school.

[Prevalence of tuberculosis in Mures County, Romania, 2006-2008]. / Prevalenta tuberculozei în judetul Mures si în tara în perioada 2006-2008.

UNLABELLED: The aim of this study is analysis of tuberculosis prevalence in Mures county for a period of three years (2006-2008). MATERIAL AND METHOD: We monitored the prevalence of tuberculosis cases in the Mures area recorded at Tg. Mures TB Dispensary, the new cases and readmitted cases, chronic or abandonment, separately for children and adults, evolving for 2006-2008, data compared with national registration. RESULTS: From 2006 to 2008, frequency of TB illness in our area decreased instead of the share of patients with positive results (BK+) which have increased, associated with an amplified risk. In our study the assessment during the three years showed a decrease of the total number of TB cases, instead of increased frequency of new cases of acute than those of chronic, increased cases of adults against children and cases of failed healing. Number of new cases of TB in Mures urban areas, by years, showed the same decreasing trend for cities monitored, except Tg. Mures where the number of new cases recorded in 2008 was higher than in 2006. CONCLUSION: TB control programs in order to be effective, must be conducted throughout the all country, to be permanent, to the satisfaction of the population and to integrated structure of community health.