Developing Nutrition Label Reading Skills: A Web-Based Practice Approach.

BACKGROUND: Nutrition labels offer the information needed to follow Dietary Guidelines for Americans, yet many individuals use labels infrequently or ineffectively due to limited comprehension and the effort required to use them. OBJECTIVE: The objective of our study was to develop and test a Web-based label-reading training tool to improve individuals' ability to use labels to select more healthful foods. We were particularly interested in determining whether practice can lead to increased accuracy using labels as well as decreased effort, together reflecting greater efficiency. We compared a basic and an enhanced, prior-knowledge version of the tool that contained an additional component, a brief nutrition tutorial. METHODS: Participants were 140 college students with an average age of 20.7 (SD 2.1) years and education 14.6 (SD 1.2) years, who completed 3 sets of practice that were designed to teach them, through repetition and feedback, how to use nutrition labels to select more healthful products. Prior to training, participants in the prior-knowledge group viewed a multimedia nutrition presentation, which those in the basic group did not receive. Mixed-effects models tested for improvement in accuracy and speed with practice, and whether improvements varied by group. RESULTS: The training led to significant increases in average accuracy across the 3 practice sets (averaging 79% [19/24 questions], 92% [22/24], 96% [23/24] respectively, P<.001), as well as decreases in time to complete with mean (SD) values of 8.7 (2.8), 4.6 (1.8), and 4.1 (1.7) seconds, respectively. In block 3, the odds of a correct answer for the prior-knowledge group were 79% higher (odds ratio, OR=1.79, 95% CI 1.1-2.9) than those for the basic group (P=.02). There was no significant difference between the groups in block 2 (P=.89). CONCLUSIONS: Practice led to improvements in nutrition label reading skills that are indicative of early stages of automatic processing. To the extent that automatic processes are at the core of healthy habit change, this may be an efficient way to improve dietary decision-making.

Misunderstanding of Front-Of-Package Nutrition Information on US Food Products.

Front-of-package nutrition symbols (FOPs) are presumably readily noticeable and require minimal prior nutrition knowledge to use. Although there is evidence to support this notion, few studies have focused on Facts Up Front type symbols which are used in the US. Participants with varying levels of prior knowledge were asked to view two products and decide which was more healthful. FOPs on packages were manipulated so that one product was more healthful, allowing us to assess accuracy. Attention to nutrition information was assessed via eye tracking to determine what if any FOP information was used to make their decisions. Results showed that accuracy was below chance on half of the comparisons despite consulting FOPs. Negative correlations between attention to calories, fat, and sodium and accuracy indicated that consumers over-relied on these nutrients. Although relatively little attention was allocated to fiber and sugar, associations between attention and accuracy were positive. Attention to vitamin D showed no association to accuracy, indicating confusion surrounding what constitutes a meaningful change across products. Greater nutrition knowledge was associated with greater accuracy, even when less attention was paid. Individuals, particularly those with less knowledge, are misled by calorie, sodium, and fat information on FOPs.

Relationships among food label use, motivation, and dietary quality.

Nutrition information on packaged foods supplies information that aids consumers in meeting the recommendations put forth in the US Dietary Guidelines for Americans such as reducing intake of solid fats and added sugars. It is important to understand how food label use is related to dietary intake. However, prior work is based only on self-reported use of food labels, making it unclear if subjective assessments are biased toward motivational influences. We assessed food label use using both self-reported and objective measures, the stage of change, and dietary quality in a sample of 392 stratified by income. Self-reported food label use was assessed using a questionnaire. Objective use was assessed using a mock shopping task in which participants viewed food labels and decided which foods to purchase. Eye movements were monitored to assess attention to nutrition information on the food labels. Individuals paid attention to nutrition information when selecting foods to buy. Self-reported and objective measures of label use showed some overlap with each other (r=0.29, p<0.001), and both predicted dietary quality (p<0.001 for both). The stage of change diminished the predictive power of subjective (p<0.09), but not objective (p<0.01), food label use. These data show both self-reported and objective measures of food label use are positively associated with dietary quality. However, self-reported measures appear to capture a greater motivational component of food label use than do more objective measures.

Mechanisms underlying comprehension of health information in adulthood: the roles of prior knowledge and working memory capacity.

Prior knowledge, working memory capacity (WMC), and conceptual integration (attention allocated to integrating concepts in text) are critical within many contexts; however, their impact on the acquisition of health information (i.e. learning) is relatively unexplored.We examined how these factors impact learning about nutrition within a cross-sectional study of adults ages 18 to 81. Results showed that conceptual integration mediated the effects of knowledge and WMC on learning, confirming that attention to concepts while reading is important for learning about health. We also found that when knowledge was controlled, age declines in learning increased, suggesting that knowledge mitigates the effects of age on learning about nutrition.

Predictors of nutrition information comprehension in adulthood.

OBJECTIVE: The goal of the present study was to examine relationships among several predictors of nutrition comprehension. We were particularly interested in exploring whether nutrition knowledge or motivation moderated the effects of attention on comprehension across a wide age range of adults. METHODS: Ninety-three participants, ages 18-80, completed measures of nutrition knowledge and motivation and then read nutrition information (from which attention allocation was derived) and answered comprehension questions. RESULTS: In general, predictor variables were highly intercorrelated. However, knowledge, but not motivation, had direct effects on comprehension accuracy. In contrast, motivation influenced attention, which in turn influenced accuracy. Results also showed that comprehension accuracy decreased-and knowledge increased-with age. When knowledge was statistically controlled, age declines in comprehension increased. CONCLUSION: Knowledge is an important predictor of nutrition information comprehension and its role increases in later life. Motivation is also important; however, its effects on comprehension differ from knowledge. PRACTICE IMPLICATIONS: Health educators and clinicians should consider cognitive skills such as knowledge as well as motivation and age of patients when deciding how to best convey health information. The increased role of knowledge among older adults suggests that lifelong educational efforts may have important payoffs in later life.

Effects of an amino acid carbohydrate drink on exercise performance after consecutive-day exercise bouts.

This study examined the effect of amino acids in a carbohydrate beverage on cycling performance. Twelve male athletes (28.5 +/- 2.1 yr) cycled at 75% VO2peak for 90 min followed by a ride to exhaustion at 85% VO2peak, before (T1) and on 2 consecutive days (T2 and T3) after 2 weeks of supplementation with 3.6% carbohydrate plus 1% amino acids (AA) or 4.6% carbohydrate-only (CHO) isocaloric beverages. Muscle damage was assessed by plasma creatine kinase (CK), and muscle fatigue by changes in vertical jump pre- to postexercise. Muscle soreness, overall fatigue, and changes in mood state were assessed using questionnaires. Plasma CK was lower for AA in T3 (214.0 +/- 13.5 vs. 485.9 +/- 191.4 U/L immediately post, 213.9 +/- 13.1 vs. 492.0 +/- 199.4 U/L 5 hr post, and 194.9 +/- 17.9 vs. 405.9 +/- 166.6 U/L 24 hr postexercise in AA and CHO, respectively). Time to exhaustion decreased from T2 to T3 only in CHO (10.9 +/- 2.5 to 12.6 +/- 3.2 vs. 13.8 +/- 2.8 to 7.8 +/- 1.5 min in AA and CHO, respectively). Vertical-jump change from pre- to postexercise was greater in T3 for the CHO treatment. Total fatigue score and mood disturbance decreased significantly only with AA in T3. The addition of AA to a carbohydrate beverage after consecutive-day exercise bouts reduced muscle damage as indicated by CK levels, decreased fatigue, and maintained exercise performance compared with consuming carbohydrate alone.