U.S. adults noticing and using menu calorie information: Analysis of the National Cancer Institute's Health Information National Trends Survey Data.

FDA's Menu Labeling Final Rule requires covered establishments provide calorie information on menus or menu boards, among other requirements. This study describes correlates of noticing and using menu calorie information in a nationally representative sample of U.S. adults before implementation of the Final Rule in May 2018. Data from the 2018 National Cancer Institute Health Information National Trends Survey was used to assess noticing menu calorie information, using menu calorie information to change menu ordering behavior, and knowledge of daily calorie needs. Regression analysis of weighted data tested associations between individual characteristics and noticing and using menu calorie information. Nearly half of adults (44%) reported noticing menu calorie information. Women, younger individuals, those who seek health information, individuals with a BMI ≥ 30, and those with higher education or higher income were more likely to report noticing menu calorie information. Among adults who reported noticing menu calorie information, three-quarters responded by ordering less (e.g., fewer calories), which equates to about one-third of the population. About 36% of women and 42% of men lacked calorie knowledge. Men with, versus without, calorie knowledge were twice as likely to report noticing menu calorie information (adjusted OR 2.23 95% CI 1.51, 3.29). Findings suggest behavioral response to menu calorie information varies and most individuals who notice the information respond by ordering less in ways that could reduce caloric intake. Future analyses could compare noticing and using menu calorie information before and after menu labeling implementation to assess the effect of policy on population behaviors.

Rationale, Procedures, and Response Rates for the 2015 Administration of NCI's Health Information National Trends Survey: HINTS-FDA 2015.

The National Cancer Institute (NCI) developed the Health Information National Trends Survey (HINTS) to monitor population trends in cancer communication practices, information preferences, health risk behaviors, attitudes, and cancer knowledge. The U.S. Food and Drug Administration (FDA) recognized HINTS as a unique data resource for informing its health communication endeavors and partnered with NCI to field HINTS-FDA 2015. HINTS-FDA 2015 was a self-administered paper instrument sent by mail May 29 to September 8, 2015, using a random probability-based sample of U.S. postal addresses stratified by county-level smoking rates, with an oversampling of high and medium-high smoking strata to increase the yield of current smokers responding to the survey. The response rate for HINTS-FDA 2015 was 33% (N = 3,738). The yield of current smokers (n = 495) was lower than expected, but the sampling strategy achieved the goal of obtaining more former smokers (n = 1,132). Public-use HINTS-FDA 2015 data and supporting documentation have been available for download and secondary data analyses since June 2016 at http://hints.cancer.gov . NCI and FDA encourage the use of HINTS-FDA for health communication research and practice related to tobacco-related communications, public knowledge, and behaviors as well as beliefs and actions related to medical products and dietary supplements.

Associations between self-reported weight management methods with diet quality as measured by the Healthy Eating Index-2005.

OBJECTIVE: We examine the relationship between weight management practices and diet quality. METHOD: Regressions were used to analyze the associations between self-reported weight management methods and diet quality, as measured by the Healthy Eating Index-2005 (HEI-2005), of 1,933 respondents who tried to lose or not gain weight in the 2003-2004 National Health and Nutrition Examination Survey (NHANES). The regressions controlled for sociodemographics, lifestyle behaviors, and other health-related behaviors and perceptions. RESULTS: Including both switching to foods with lower calories and exercise in weight management was associated with better diet quality, i.e., a higher total HEI-2005 score and higher scores in eight of the twelve HEI-2005 components than including neither method. The eight components included six components on fruit, vegetables and grains, milk, and calories from solid fat, alcohol beverages, and added sugars. Similar but smaller associations were also found among those who reported including either switching to foods with lower calories or exercise. CONCLUSIONS: Based on self-reported data, the findings suggest that including switching to lower calorie foods and exercise in weight management, as recommended by the Dietary Guidelines for Americans (DGA), is associated with diet quality that is more consistent with the key diet-related advice of the DGA.

Changes in fat contents of US snack foods in response to mandatory trans fat labelling.

OBJECTIVE: Impact of mandatory trans fat labelling on US snack food introductions is examined. DESIGN: Using label information, lipid ingredients and fat profiles are compared pre- and post-labelling. SETTING: Key products in the US snack food industry contribute significant amounts of artificial trans fat. Industry efforts to reformulate products to lower trans fat may alter the overall fat profile, in particular saturates. SUBJECTS: Composition data for more than 5000 chip and cookie products introduced for sale between 2001 (pre-labelling) and 2009 (post-labelling) were analysed. RESULTS: One-way ANOVA was used to test for significant changes in saturated fat content per serving and the ratio of saturated to total fat. The shares of chip and cookie introductions containing partially hydrogenated vegetable oil declined by 45 and 42 percentage points, respectively. In cookies, there was an increase of 0·49 (98 % CI 0·01, 0·98) g in the average saturated fat content per 30 g serving and an increase of 9 (98 % CI 3, 15) % in the average ratio of saturated to total fat. No statistically significant changes in fat content were observed in chips. CONCLUSIONS: This research suggests that, holding other factors constant, the policy has resulted in a decreased use of partially hydrogenated vegetable oil in chip products without a corresponding increase in saturated fat content, but led to significantly higher levels of saturated fat and ratio of saturated fat to total fat in cookie products.

Do dietary intakes affect search for nutrient information on food labels?

Nutrition labels on food packages are designed to promote and protect public health by providing nutrition information so that consumers can make informed dietary choices. High levels of total fat, saturated fat and cholesterol in diets are linked to increased blood cholesterol levels and a greater risk of heart disease. Therefore, an understanding of consumer use of total fat, saturated fat, and cholesterol information on food labels has important implications for public health and nutrition education. This study explores the association between dietary intakes of these three nutrients and psychological or demographic factors and the search for total fat, saturated fat, and cholesterol information on food labels. Psychology literature suggests a negative association between intakes of these nutrients and probability of search for their information on food labels. Health behavior theories also suggest perceived benefits and costs of using labels and perceived capability of using labels are associated with the search behavior. We estimate the relationship between label information search and its predictors using logistic regressions. Our samples came from the 1994-1996 Continuing Survey of Food Intakes by Individuals and Diet and Health Knowledge Survey conducted by the United States Department of Agriculture. Results suggest that search for total fat, saturated fat, and cholesterol information on food labels is less likely among individuals who consume more of the three nutrients, respectively. The search is also related to perceived benefits and costs of using the label, perceived capability of using the label, knowledge of nutrition and fats, perceived efficacy of diets in reducing the risk of illnesses, perceived importance of nutrition in food shopping, perceived importance of a healthy diet, and awareness of linkage between excessive consumption of the nutrients and health problems. These findings suggest encouraging search of food label information among consumers with unhealthy dietary habits would need innovative approaches. Yet, nutrition education can be instrumental in encouraging this search by stimulating motivation and providing technical help.