Sustainable healthy eating behaviour of young adults: towards a novel methodological approach.

BACKGROUND: Food, nutrition and health policy makers are poised with two pertinent issues more than any other: obesity and climate change. Consumer research has focused primarily on specific areas of sustainable food, such as organic food, local or traditional food, meat substitution and/or reduction. More holistic view of sustainable healthy eating behaviour has received less attention, albeit that more research is emerging in this area. METHODS/DESIGN: This study protocol that aims to investigate young consumers' attitudes and behaviour towards sustainable and healthy eating by applying a multidisciplinary approach, taking into account economical, marketing, public health and environmental related issues. In order to achieve this goal, consumers' reactions on interactive tailored informational messages about sustainable from social, environmental and economical point of view, as well as healthy eating behaviour in a group of young adults will be investigated using randomized controlled trial. To undertake the objective, the empirical research is divided into three studies: 1) Qualitative longitudinal research to explore openness to adopting sustainable healthy eating behaviour; 2) Qualitative research with the objective to develop a sustainable healthy eating behaviour index; and 3) Randomised controlled trial to describe consumers' reactions on interactive tailored messages about sustainable healthy eating in young consumers. DISCUSSION: To our knowledge, this is the first randomised controlled trial to test the young adults reactions to interactive tailor made messages on sustainable healthy eating using mobile smartphone app. Mobile applications designed to deliver intervention offer new possibilities to influence young adults behaviour in relation to diet and sustainability. Therefore, the study will provide valuable insights into drivers of change towards more environmentally sustainable and healthy eating behaviours. TRIAL REGISTRATION: NCT02776410 registered May 16, 2016.

Consumers' health risk-benefit perception of seafood and attitude toward the marine environment: Insights from five European countries.

This research classifies European consumers into segments based on their health risk-benefit perception related to seafood consumption. The profiling variables of these segments are seafood consumption frequency, general attitude toward consuming fish, confidence in control organizations, attitude toward the marine environment, environmental concern and socio-demographics. A web-based survey was performed in one western European country (Belgium), one northern European country (Ireland) and three southern European countries (Italy, Portugal and Spain), resulting in a total sample of 2824 participants. A cluster analysis was performed based on risk-benefit perception related to seafood and the profiles of the segments were determined by a robust 2-way ANOVA analysis accounting for country effects. Although this study confirms consumers' positive image of consuming seafood, gradients are found in health risk-benefit perception related to seafood consumption. Seafood consumption frequency is mainly determined by country-related traditions and habits related to seafood rather than by risk-benefit perceptions. Segments with a higher benefit perception, irrespective of their level of risk perception, show a more positive attitude toward consuming seafood and toward the marine environment; moreover, they report a higher concern about the marine environment and have a higher involvement with seafood and with the marine environment. Consequently, information campaigns concentrating on pro-environmental behavior are recommended to raise the involvement with seafood and the marine environment as this is associated with a higher environmental concern. This research underpins that in such information campaigns a nationally differentiated rather than a pan-European or international information strategy should be aimed for because of significant cultural differences between the identified segments.

Consumer attitudes, knowledge, and consumption of organic yogurt.

The segment of organic products occupies an increasingly important place in dairy assortments. The European Union (EU) introduced a new EU organic logo in 2010 with the aim of harmonizing its organic sector and boosting consumer trust in organic food. This study focuses on organic yogurt and investigates consumer awareness and knowledge of the new EU logo. Consumers evaluate organic yogurt as superior compared with conventional yogurt on healthiness, environmental friendliness, quality, and safety. More frequent buyers of organic yogurt have a stronger belief that organic yogurt is superior. The willingness-to-pay for organic yogurt ranged from a premium of 15% for nonbuyers to 40% for habitual buyers, indicating the market potential for this product. A structural equations model reveals the positive association between knowledge, attitudes, and the frequency of purchasing and consuming organic yogurt. Nevertheless, consumer awareness of the EU organic logo remains rather low, which suggests a need for more effective information campaigns and marketing actions.

Explaining the effects of a point-of-purchase nutrition-information intervention in university canteens: a structural equation modelling analysis.

BACKGROUND: The importance of canteen meals in the diet of many university students makes the provision of simple point-of-purchase (POP) nutrition information in university canteens a potentially effective way to promote healthier diets in an important group of young adults. However, modifications to environments such as the posting of POP nutrition information in canteens may not cause an immediate change in meal choices and nutrient intakes. The present study aimed at understanding the process by which the POP nutrition information achieved its effects on the meal choice and energy intake, and whether the information was more effective in changing the meal choice of subgroups of university canteen customers. METHODS: The POP nutrition-information intervention used a one-group pretest-posttest design. A sample of 224 customers of two university canteens completed the baseline and 6-months follow-up surveys. A multi-group structural equation modelling analysis was used to test mediation effects of individual difference variables (liking, understanding and use of the information, subjective knowledge and attitude) on the energy intake from canteen meals, moderated by the objective nutrition knowledge and motivation to change diet. RESULTS: Significant relations were identified between liking of the information and its use on one hand and a positive effect in attitude towards healthy canteen meals on the other hand. Motivation to change diet and sufficient objective nutrition knowledge were required to maintain a recommended energy intake from canteen meals or to lead to a decrease in energy intake. Participants with greater objective nutrition knowledge had a greater understanding of the POP nutrition information which also resulted in a more effective use of the information. CONCLUSIONS: The results suggest that nutrition-information interventions may be more effective when using nutrition information that is generally liked by the target population in combination with an educational intervention to increase objective nutrition knowledge.

Food choice questionnaire revisited in four countries. Does it still measure the same?

This study focuses on the implementation of the food choice questionnaire (FCQ) across four countries. The first objective is to examine the degree to which the factor structure of the FCQ is invariant across different populations. The second objective is to analyse the motives for food choice in different countries. The cross-sectional sample of 1420 consumers consisted of Belgians (N=458), Hungarians (N=401), Romanians (N=229) and Filipinos (N=332). Data analyses included estimation of five multi-group confirmatory factor analysis models; calculation of mean importance ratings for each food choice factor across countries; ANOVA and Tukey post hoc tests; and a rank order test of most to least important factors within each country. The results confirm that the factorial structure of the FCQ is invariant with respect to factor configuration, factor loadings and item intercept. Sensory appeal is the most important factor among all European consumers, while health, convenience and price were all among the five most important factors shaping food choice in Belgium, Hungary and Romania. For Filipinos, the most important were health, price and mood. Sensory appeal ranked on the fourth place.

Association of overweight and obesity with interest in healthy eating, subjective health and perceived risk of chronic diseases in three European countries.

This paper analyses cultural differences in consumers' interest in healthy eating, subjective health and perceived risk of (chronic) diseases, and identifies the association between nutritional status (obesity and overweight) and the above mentioned variables as well as people's socio-demographic characteristics and health conditions that may influence food choice. Cross-sectional data were collected through a consumer survey (n=2400) in 2008 with samples representative for age and region in France, Poland and Spain. Body-mass-index (BMI) was inversely associated with education and positively associated with age. Women were less likely to be overweight than men. Subjective health was negatively associated with the likelihood of being obese. The likelihood of being obese decreased with higher perceived risk of suffering from stress and from cancer, whilst the likelihood of being overweight decreased with higher perceived risk of suffering from stress. Despite a tendency of lower interest in healthy eating among obese consumers, interest in healthy eating was not significantly associated with the likelihood of being obese or overweight after Holm-Bonferroni correction. The findings of this study suggest that health consequences and disease risks of excessive weight should be better communicated to European populations. Furthermore, factors associated with obesity such as subjective health and perceived risk of chronic diseases should be considered both at individual counselling and at public health policy levels.

Association between traditional food consumption and motives for food choice in six European countries.

This study investigates the association between traditional food consumption and motives for food choice in six European countries. Cross-sectional data were collected through the TRUEFOOD pan-European consumer survey (n = 4828) with samples representative for age, gender and region in Belgium, France, Italy, Norway, Poland and Spain. Importance attached to familiarity with a product is found to be strongly and positively associated with general attitude toward traditional food as well as traditional food consumption. The importance attached to convenience was negatively related to both general attitude toward traditional food and traditional food consumption, while the importance of weight control negatively influenced the general attitude. Natural content of food was positively associated with the attitude toward traditional food and traditional food consumption. The importance of price when purchasing food failed to be significantly related with general attitude and traditional food consumption both for the pooled sample as well as within each country except in Spain. The proposed model contributes to a better understanding of factors shaping the image and influencing the consumption of traditional foods in Europe. General attitude toward traditional foods, familiarity, and importance of food naturalness emerged as drivers for traditional food consumption. Importance attached to convenience and health acted as direct barriers to traditional food consumption, whereas importance of weight control emerged as an indirect barrier through lowering general attitude toward traditional foods.

Searching for a Measure Integrating Sustainable and Healthy Eating Behaviors.

Sustainable and healthy food-related behavior is high on the public policy and research agenda due to its potential to cope with negative environmental and health outcomes. There are several measures related to sustainability in food choices but there have not been many attempts to integrate sustainable and healthy eating (SHE) behaviors into one measurement instrument so far. Therefore, the main aim of this study was to identify how young adults interpret the SHE concept and to develop an instrument that measures a self-reported consumer's SHE behavior. The process of scale development involved an exploratory qualitative study and two quantitative studies. As a result of 20 individual in depth interviews with Polish young adults, 50 items were generated reflecting their perspective on principles of SHE (Study 1). Two samples were used in the scale validation process: n = 217 (Study 2) and n = 220 (Study 3). Via principal component analysis, reliability analysis, and confirmatory factor analysis, the final form of the scale was derived. The proposed 34-item scale offers insights into the most relevant aspects of SHE behaviors, grouped in eight factors: "healthy and balanced diet", "certification and quality labels", "meat reduction", "selection of local food", "choice of low fat food products", "avoidance of food waste" and purchase and consumption of food products that are respecting "animal welfare" and finally choice of "seasonal food". Although the developed scale can benefit from further refinement and validity testing in different cultural and social background, it is clear that the scale, as developed, can be a useful tool for researchers who are interested in the study of SHE behaviors.

Fish consumption and its motives in households with versus without self-reported medical history of CVD: a consumer survey from five European countries.

BACKGROUND: The purpose of this study was to explore the cross-cultural differences in the frequency of fish intake and in motivations for fish consumption between people from households with (CVD+) or without (CVD-) medical history of cardiovascular disease, using data obtained in five European countries. METHODS: A cross-sectional consumer survey was carried out in November-December 2004 with representative household samples from Belgium, the Netherlands, Denmark, Poland and Spain. The sample consisted of 4,786 respondents, aged 18-84 and who were responsible for food purchasing and cooking in the household. RESULTS: Individuals from households in the CVD+ group consumed fish more frequently in Belgium and in Denmark as compared to those in the CVD- group. The consumption of fatty fish, which is the main sources of omega-3 PUFA associated with prevention of cardiovascular diseases, was on the same level for the two CVD groups in the majority of the countries, except in Belgium where CVD+ subjects reported to eat fatty fish significantly more frequently than CVD- subjects. All respondents perceived fish as a very healthy and nutritious food product. Only Danish consumers reported a higher subjective and objective knowledge related to nutrition issues about fish. In the other countries, objective knowledge about fish was on a low level, similar for CVD+ as for CVD- subjects, despite a higher claimed use of medical information sources about fish among CVD+ subjects. CONCLUSION: Although a number of differences between CVD- and CVD+ subjects with respect to their frequency of fish intake are uncovered, the findings suggest that fish consumption traditions and habits - rather than a medical history of CVD - account for large differences between the countries, particularly in fatty fish consumption. This study exemplifies the need for nutrition education and more effective communication about fish, not only to the people facing chronic diseases, but also to the broader public. European consumers are convinced that eating fish is healthy, but particular emphasis should be made on communicating benefits especially from fatty fish consumption.

Beef consumer segment profiles based on information source usage in Poland.

The main aim of this study was to identify market segments based on consumers' usage of information sources about beef and to investigate whether the use of information sources was associated with the type of information consumers were searching for, factors guiding their decision processes to buy beef and motives related to beef consumption. Data were collected in 2014 through a self-administered survey of 501 regular beef consumers. Three distinct clusters were identified: Enthusiast (38.5%), Conservative (43.1%) and Ultra Conservative (18.4%). This study revealed that culinary and personal sources of information on beef were the most frequently used. Taste, perceived healthiness and suitability to prepare many dishes were reported as primary motives to eat beef. These results show that communication channels such as culinary programs and opportunities provided by the development of labelling systems to guarantee beef quality should be considered when developing policies and strategies to increase beef consumption in Poland.

Individual and Environmental Factors Influencing Adolescents' Dietary Behavior in Low- and Middle-Income Settings.

OBJECTIVE: Given the public health importance of improving dietary behavior in chronic disease prevention in low- and middle-income countries it is crucial to understand the factors influencing dietary behavior in these settings. This study tested the validity of a conceptual framework linking individual and environmental factors to dietary behavior among Ecuadorian adolescents aged 10-16 years. METHODS: A cross-sectional survey was conducted in 784 school-going Ecuadorian adolescents in urban and rural Southern Ecuador. Participants provided data on socio-economic status, anthropometry, dietary behavior and its determining factors. The relationships between individual (perceived benefits and barriers, self-efficacy, habit strength, and a better understanding of healthy food) and environmental factors (physical environment: accessibility to healthy food; social environment: parental permissiveness and school support), and their association with key components of dietary behavior (fruit and vegetables, sugary drinks, breakfast, and unhealthy snack intake) were assessed using structural equation modeling. RESULTS: The conceptual model performed well for each component of eating behavior, indicating acceptable goodness-of-fit for both the measurement and structural models. Models for vegetable intake and unhealthy snacking showed significant and direct effects of individual factors (perceived benefits). For breakfast and sugary drink consumption, there was a direct and positive association with socio-environmental factors (school support and parental permissiveness). Access to healthy food was associated indirectly with all eating behaviors (except for sugary drink intake) and this effect operated through socio-environmental (parental permissiveness and school support) and individual factors (perceived benefits). CONCLUSION: Our study demonstrated that key components of adolescents' dietary behaviors are influenced by a complex interplay of individual and environmental factors. The findings indicate that the influence of these factors varied by type of dietary behavior.

Consumer perception versus scientific evidence about health benefits and safety risks from fish consumption.

OBJECTIVE: To investigate the gap between consumer perception and scientific evidence related to health benefits and safety risks from fish consumption. DESIGN: Consumer perceptions from a cross-sectional survey in March 2003 in Belgium were compared with scientific evidence based on a literature review. METHOD: A quota sampling procedure was used with age as quota control variable. Subjects completed a self-administered questionnaire including health benefit beliefs from fish, fish content and effect beliefs for nutrients and harmful substances. SUBJECTS: Adults (n=429), who were the main person responsible for food purchasing in the household (284 women; 145 men), aged 18-83 years, from different regional, education, family size and income groups. RESULTS: Fish is predominantly perceived as a healthy food that reduces risk for coronary heart disease, which corroborates scientific evidence. This perception is stronger among women than among men. In contrast with scientific evidence, 46% of the consumers believe that fish contains dietary fibre, whereas less than one-third is aware that fish contains omega-3 fatty acids and that this nutrient has a positive impact on human health. The gap between perception and evidence is larger among consumers with lower education. In general, consumers are better aware of the content and effect of harmful substances than of nutrients in fish. CONCLUSIONS: Despite conclusive evidence about the content and positive effect of omega-3 fatty acids in fish, related consumer awareness and beliefs are poor and often wrong. This study exemplifies the need for nutrition education and more effective communication about the health benefits of fish consumption.