Correction: Improving Nutrition and Activity Behaviors Using Digital Technology and Tailored Feedback: Protocol for the Tailored Diet and Activity (ToDAy) Randomized Controlled Trial.

[This corrects the article DOI: 10.2196/12782.].

Factors associated with frequent consumption of fast food among Australian secondary school students.

OBJECTIVE: To examine demographic and behavioural correlates of frequent consumption of fast food among Australian secondary school students and explore the associations between fast food consumption and social/environmental factors. DESIGN: Cross-sectional survey using a web-based self-report questionnaire. SETTING: Secondary schools across all Australian states and territories. PARTICIPANTS: Students aged 12-17 years participating in the 2012-2013 National Secondary Students' Diet and Activity survey (n 8392). RESULTS: Overall, 38 % of students surveyed reported consuming fast food at least weekly. Being male, residing in lower socio-economic areas and metropolitan locations, having more weekly spending money and working at a fast food outlet were all independently associated with consuming fast food once a week or more, as were several unhealthy eating (low vegetable intake and high sugary drink and snack food intake) and leisure (low physical activity and higher commercial television viewing) behaviours and short sleep duration. Frequent fast food consumption and measured weight status were unrelated. Students who agreed they go to fast food outlets with their family and friends were more likely to report consuming fast food at least weekly, as were those who usually 'upsize' their fast food meals and believe fast food is good value for money. CONCLUSIONS: These results suggest that frequent fast food consumption clusters with other unhealthy behaviours. Policy and educational interventions that reach identified at-risk groups are needed to reduce adolescent fast food consumption at the population level. Policies placing restrictions on the portion sizes of fast food may also help adolescents limit their intake.

Association of the LiveLighter mass media campaign with consumption of sugar-sweetened beverages: Cohort study.

ISSUE ADDRESSED: Evaluation of the behavioural impact of Western Australia's LiveLighter healthy weight and lifestyle campaign focussed on decreasing consumption of sugar-sweetened beverages (SSBs) using graphic imagery, as well as monitoring unintended consequences. METHODS: A cohort design with pre-campaign telephone survey of Western Australian adults aged 25-49 (Time 1 May/Jun 2013: N = 1504) undertaken and repeated following the campaign (Time 2 Aug/Sep 2013: N = 822). RESULTS: Post-campaign awareness was 67% with respondents in low socio-economic areas most likely to report viewing the campaign frequently. There was evidence of reduced SSB intake from baseline to follow-up among frequent (4+/week) SSB consumers (22% cf. 16%; P = 0.003) and some evidence among overweight (BMI 25+) weekly SSB consumers (56% cf. 48%; P = 0.013). There was also some evidence consumption of sweet food decreased (3+/week: 53% cf. 48%; P = 0.035) while fruit, vegetable and fast food consumption remained stable. Knowledge of potential health consequences of SSBs increased (70% cf. 82%; P < 0.001) with no change in knowledge of potential health consequences of overweight generally (86% cf. 89%). Importantly, there was no increase in endorsement of overweight stereotypes. CONCLUSIONS: The LiveLighter "Sugary Drinks" campaign positively impacted adults' knowledge and behaviour with regard to SSB consumption in a pattern specific to the campaign messaging and without adverse impact on weight-related stereotypes. SO WHAT?: Findings support the use of mass media for healthy lifestyle change. They suggest the public are receptive to undertaking the campaign's simple concrete lifestyle recommendation and provide an indication of the campaign dose required to achieve positive behaviour change.

Improving Nutrition and Activity Behaviors Using Digital Technology and Tailored Feedback: Protocol for the Tailored Diet and Activity (ToDAy) Randomized Controlled Trial.

BACKGROUND: Excess weight is a major risk factor for chronic diseases. In Australia, over 60% of adults are overweight or obese. The overconsumption of energy-dense nutrient-poor (EDNP) foods and low physical activity (PA) levels are key factors contributing to population obesity. New cost-effective approaches to improve population diet and PA behaviors are needed. OBJECTIVE: This 1-year randomized controlled trial (6-month intervention and 6-month follow-up) aims to investigate whether a tailored intervention using mobile technology can improve diet and PA behaviors leading to weight loss in adults (aged 18-65 years) who are overweight or obese and recruited through a social marketing campaign (LiveLighter). METHODS: All eligible participants will provide data on demographics and lifestyle behaviors online at baseline, 6 months, and 12 months. Using two-stage randomization, participants will be allocated into one of three conditions (n=200 per group): tailored feedback delivered via email at seven time points, informed by objective dietary (mobile food record app) and activity (wearable activity monitor) assessment; active control receiving no tailored feedback, but undergoing the same objective assessments as tailored feedback; and online control receiving no tailored feedback or objective assessments. Primary outcome measures at 6 and 12 months are changes in body mass, EDNP food and beverage consumption, and daily moderate-to-vigorous PA (measured via accelerometry). Secondary outcomes include change in fruit and vegetable consumption, daily sedentary behaviors, and cost effectiveness. RESULTS: Enrolment commenced in August 2017. Primary outcomes at 12 months will be available for analysis from September 2019. CONCLUSIONS: Tailored email feedback provided to individuals may deliver a cost-effective strategy to overcome existing barriers to improving diet and PA. If found to be successful and cost effective, upscaling this intervention for inclusion in larger-scale interventions is highly feasible. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12617000554369; https://www.anzctr.org.au /Trial/Registration/TrialReview.aspx?id=371325&isReview=true. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/12782.

Image-Based Dietary Assessment and Tailored Feedback Using Mobile Technology: Mediating Behavior Change in Young Adults.

Assessing the implementation of nutrition interventions is important to identify characteristics and dietary patterns of individuals who benefit most. The aim was to report on young adults' experiences of receiving dietary feedback text messaging intervention. Diet was captured using an image-based 4-day mobile food recordTM application (mFRTM) and assessed to formulate two tailored feedback text messages on fruit and vegetables and energy-dense nutrient-poor (EDNP) foods and beverages. At 6-months 143 participants completed a second mFRTM and a questionnaire evaluating the dietary feedback. Participants who agreed the text messages made them think about how much vegetables they ate were more likely to increase their intake by at least half a serve than those who disagreed [odds ratio (OR) = 4.28, 95% Confidence Interval (CI): 1.76 to 10.39]. Those who agreed the text messages made them think about how much EDNP foods they ate, were twice as likely to decrease their intake by over half a serve (OR = 2.39, 95%CI: 1.12 to 5.25) than those who disagreed. Undertaking detailed dietary assessment ensured the tailored feedback was constructive and relevant. Personal contemplation about vegetable and EDNP food intake appears to be a mediator of dietary change in young adults.

Regulation of alcohol marketing in Australia: A critical review of the Alcohol Beverages Advertising Code Scheme's new Placement Rules.

INTRODUCTION AND AIMS: Rules concerning the placement of alcohol advertisements (Placement Rules) were added to the industry-managed Alcohol Beverages Advertising Code Scheme in November 2017. This study aimed to critically review the Placement Rules and evaluate their ability to effectively regulate the placement of alcohol marketing and provide safeguards for young people in Australia. DESIGN AND METHODS: An established framework for evaluating the design of an effective self-regulatory system was applied to the substantive content of the Placement Rules and associated regulatory processes. Publicly available documents, including recent Alcohol Beverages Advertising Code Scheme determinations, informed the review. RESULTS: The objectives and key terms of the Placement Rules are inadequately defined and narrow in scope, resulting in the dismissal of almost all relevant complaints. Weaknesses identified in the regulatory processes include limited representation from external stakeholders in the development of the Placement Rules, a lack of transparency and independence in the Scheme's administration, and limited monitoring and enforcement options. DISCUSSION AND CONCLUSIONS: The Placement Rules are unlikely to reduce young people's exposure to alcohol marketing and hence fail to meet public health objectives. This review adds to the body of literature that demonstrates that industry-managed systems fail to effectively regulate alcohol marketing. Government intervention is needed if young people's wellbeing is to be prioritised.

The role of grandparents as providers of food to their grandchildren.

The increasing reliance on grandparents as a source of childcare means that child dietary intake, child obesity, and child health may be increasingly influenced by grandparents' food provision. Although calls have been made for research that explores the role of grandparents in shaping children's eating behaviours, results of research assessing the types of foods provided by grandparents have been limited in focus to fruit and vegetables or energy-dense nutrient-poor foods. In addition, research assessing the determinants of food provision is lacking. Such information is important in identifying targets for education programs that aim to improve grandparents' food provision practices. Accordingly, the present study assessed the extent to which Australian grandparents are providing meals and snacks for their grandchildren, the types of foods and beverages being provided, and the determinants of provision. Grandparents providing regular childcare (i.e., ≥3 h every week) to at least one grandchild aged 3-14 years were recruited (n = 1076; 60% female; age = 65.07 years (SD = 6.68)). Results revealed that a majority of grandparents (82%) reported providing their grandchild with snacks. Nearly one-fifth (18%) of grandparents reported providing breakfast, lunch, dinner, and snacks. The provision of main meals occurred one to three times a week and snack provision occurred two to six times a week. Although grandparents generally provided a healthy food environment, practices were found to differ by the sociodemographic characteristics (sex, age, and socioeconomic status) of grandparent caregivers and by the sex and age of the grandchild in their care. Results suggest that grandparents should be considered crucial to efforts to increase healthy eating in children and address childhood obesity.

Results of a long-term follow-up evaluation of an Australian adult nutrition education program.

BACKGROUND AND OBJECTIVES: To assess persistence of improvements in nutrition-related attitudes and behaviours 2-4 years after attending an adult nutrition education program (FOODcents). METHODS AND STUDY DESIGN: A link to an online survey was sent to 407 past FOODcents participants. The survey replicated items included in previous FOODcents evaluation surveys. In total, 87 responses were received (response rate 21%). Analyses were conducted on matched responses across 3 time points: pre, post, and follow-up. RESULTS: Improvements since baseline were maintained in confidence to buy healthy foods on a budget and a range of dietary behaviours (e.g., increased consumption of vegetables, legumes, and wholegrain products; greater use of the nutrition information available on food packages; and decreased consumption of soft drinks). There were two primary areas in which improvements were not maintained over time: reported intake of fruit and frequency of consumption of fast food. CONCLUSIONS: The results suggest that adult nutrition education can be effective in encouraging individuals to alter their food shopping processes and modify their diets. The tendency for some behavioural outcomes to be worse at follow-up than at baseline indicates that marketplace factors such as food promotion and availability may be influencing these specific dietary behaviours. This rare longitudinal study of the effects of adult nutrition education shows that this form of intervention has the potential to produce lasting improvements in attitudes and behaviours. However, such programs cannot be expected to produce large and lasting effects without support from population-level nutrition policies and programs that address macro-environmental factors that influence dietary behaviours.

The effect of chronic disease warning statements on alcohol-related health beliefs and consumption intentions among at-risk drinkers.

Informing drinkers of the health risks associated with alcohol consumption via warning statements located on alcohol products can increase their capacity to make healthier choices. This study assessed whether exposing at-risk drinkers to warning statements relating to specific chronic diseases increases the extent to which alcohol is believed to be a risk factor for those diseases and influences consumption intentions. Australians drinking at levels associated with long-term risk of harm (n = 364; 72% male) completed an online survey assessing their drinking habits, beliefs in the link between alcohol and various diseases and drinking intentions. Respondents were then exposed to one of five statements advising of the potential risks associated with alcohol consumption (either cancer, liver damage, diabetes, mental illness or heart disease). Beliefs and drinking intentions were reassessed. Significant increases in the extent to which alcohol was believed to be a risk factor for diabetes, heart disease, mental illness and cancer were found. With the exception of the liver damage and heart disease statements, exposure to each statement was associated with a significant reduction in consumption intentions. Warning statements advising of the specific chronic diseases associated with alcohol consumption can produce favourable changes in drinking intentions among at-risk drinkers.

Vegetable and fruit intake in Australian adolescents: Trends over time and perceptions of consumption.

The consumption of vegetables and fruit during adolescence is crucial to ensuring adequate intake of the nutrients required to meet the rapid growth that characterises this developmental period. However, significant reductions in vegetable and fruit intake during adolescence have been observed making the promotion of consumption an important health promotion challenge. To monitor progress in this population segment toward meeting recommended intake levels and identifying at-risk groups, the present study assessed changes in Australian adolescents' vegetable and fruit consumption over time and identified the demographic factors associated with meeting recommendations. As individuals who are aware of their diet deficiencies are likely to be more receptive to healthy eating interventions, the present study also assessed adolescents' perceptions of the adequacy of their vegetable and fruit intake and identified the demographic factors associated with correctly perceiving fruit and vegetable intake to be inadequate. Two cross-sectional samples of Western Australian secondary school students aged 12-17 years were surveyed in 2009-2010 (n = 1501) and 2012-2013 (n = 1406). Only 14% of students at Wave 1 and 13% at Wave 2 met the recommended guidelines for vegetable intake while 68% and 71% met the guidelines for fruit intake. Females had significantly greater odds of failing to meet guidelines for vegetable intake than males. Only 50% of students correctly identified their vegetable and fruit intake to be inadequate. The observed very low levels of compliance with vegetable intake recommendations suggest that addressing deficiencies in vegetable consumption should be a primary focus of future nutrition interventions. Efforts should also be made to increase adolescents' perceptions of the inadequacy of their intake to optimise the effectiveness of schemes designed to improve vegetable and fruit consumption in this population segment.

A process and outcome evaluation of an in-class vegetable promotion program.

OBJECTIVE: Nutrition interventions that target both fruits and vegetables are effective in increasing fruit consumption, but have been limited in their ability to improve vegetable intake. To address the low proportion of children meeting vegetable intake guidelines, approaches specifically targeting vegetables are needed. This paper reports on a mixed-method analysis of a 10-week vegetable promotion pilot project that aimed to increase vegetable intake as part of the existing Crunch&Sip in-class fruit and vegetable break program. DESIGN: The intervention was designed to promote vegetable consumption through the implementation of vegetable-focused resources, including curriculum resources and parent education materials. Teachers completed pre- and end-of-intervention surveys. Process measures related to the use of resources and teachers' perceptions of barriers to implementation. The outcome evaluation included measures of children's vegetable consumption during Crunch&Sip breaks and teachers' attitudes and confidence relating to educating students about the benefits of consuming vegetables. SUBJECTS: Twenty-one Western Australian primary schools already participating in the Crunch&Sip program participated in the pilot intervention and evaluation. Coverage included 35 primary school teachers representing 818 students aged 4-11 years. RESULTS: The proportion of children bringing vegetables for Crunch&Sip more than doubled over the 10-week intervention (21% vs 46%; p < 0.001). Improvements were observed in teachers' perceived knowledge about the nutritional benefits of vegetables (p = 0.001) and confidence to educate students about the benefits of vegetable consumption (p = 0.028). CONCLUSIONS: Preferentially promoting vegetable consumption as part of an existing school-based nutrition program may be an effective strategy to increase children's vegetable intake.

Physical activity and screen-based recreation: Prevalences and trends over time among adolescents and barriers to recommended engagement.

Adolescence is a critical time for disengagement from physical activity making young people a priority group for interventions. To determine whether existing initiatives are working in this population segment and help inform future programs, the present study sought to (i) examine prevalences and trends in physical activity and screen-based recreation among Australian adolescents and (ii) identify the barriers to adolescents meeting recommended guidelines. Two cross-sectional representative samples of Western Australian secondary school students aged 12 to 17years were surveyed in 2009-2010 (n=1505) and 2012-2013 (n=1406). Around a quarter (24%) of boys and just 9% of girls reported engaging in the recommended 60min of physical activity per day in 2012-2013. A minority (13% of boys, 17% of girls) adhered to guidelines for time spent engaging in screen-based recreation (≤2h of electronic media use for entertainment). These findings were comparable to 2009-2010 prevalence levels. Multivariable logistic regression analyses conducted on data from the most recent wave found individual-level barriers to be significantly associated with lower odds of meeting physical activity guidelines in both boys (Adj. OR=0.52, 95% CI=0.38, 0.72) and girls (Adj. OR=0.41, 95% CI=0.25, 0.66). The consistently high proportion of adolescents not meeting physical activity recommendations over time suggests that current efforts to increase physical activity may be failing to have an impact on population-level trends in compliance. While initiatives to improve the built environment may reduce barriers at the environmental level, these initiatives risk having little impact on physical activity if individual level barriers remain unaddressed.

Investigating Single- Versus Multiple-Source Approaches to Communicating Health Messages Via an Online Simulation.

PURPOSE: To assess whether exposing drinkers to information about the alcohol-cancer link via multiple and diverse sources in an online simulation produces larger improvements in attitudes and intentions relative to exposure to a single source of information. DESIGN: Experimental; unequal randomization with respondents allocated to either the single-source (20%) or multiple-source condition (80%). Alcohol-related behavioral intentions were assessed preexposure and postexposure. SETTING: Australia. PARTICIPANTS: A total of 2087 drinkers consuming alcohol at least twice per month. MEASURES: Scales were used to assess attitudes toward the messages (believability, convincingness, and personal relevance) and behavioral intentions (extent to which participants believed that they should and would reduce their alcohol consumption and their intention to consume 5 or more drinks in a single session). ANALYSIS: Hierarchical linear regression. RESULTS: Source condition was significantly associated with all 3 attitudinal variables ( P < .001). Those exposed to an alcohol warning statement from multiple sources found the message more believable, convincing, and personally relevant compared to those exposed to a warning statement via a single source. They also reported significantly greater change preexposure to postexposure on the 2 behavioral beliefs that they should (Δ M = 0.25 vs Δ M = 0.09) and would (Δ M = 0.23 vs Δ M = 0.00) reduce their current alcohol consumption ( P < .001). Further, those in the multiple-source condition reported reduced intentions to consume 5 or more standard drinks in a single sitting (Δ M = 0.21 vs Δ M = 0.14; P < .001). CONCLUSION: Findings from the online simulation provide support for the suggestion that integrated approaches involving the combination of multiple sources to deliver a message produce superior outcomes compared to relying on a single source (eg, warning labels on alcoholic beverages).

Assessing parents' receptiveness to a vegetable-focussed in-school nutrition intervention.

OBJECTIVE: Crunch&Sip is an Australian school-based initiative designed to increase the consumption of fruit, vegetables, and water among primary school children. To address the significant deficiencies in children's vegetable intake, the present study aimed to examine the responsiveness of parents (the main providers of food for Crunch&Sip) to a modified version of the program that focuses primarily on vegetable consumption. PARTICIPANTS: A total of 329 Western Australian parents completed an online questionnaire examining their support for a vegetable focus for Crunch&Sip and any perceived barriers, motivators, and facilitators. RESULTS: Most (80%) parents were supportive of a shift to a vegetable focus for Crunch&Sip. Belief in the effectiveness of Crunch&Sip at improving children's attitudes towards vegetables and increasing children's vegetable consumption was found to be significantly associated with levels of support. The most commonly nominated motivator was to improve their children's eating habits and the main facilitator was the perceived ability of teachers and peers to influence children's food consumption behaviours. Identified potential barriers included the difficulties associated with providing a variety of vegetables, maintaining freshness, and the preparation time required. The primary suggested strategy to overcome these barriers was for schools to conduct education sessions to provide information about vegetable provision options. CONCLUSIONS AND IMPLICATIONS: The results suggest that parents can be supportive of school-based nutrition programs that specifically encourage the consumption of vegetables but they may require guidance to reduce the identified barriers related to vegetable provision.

Drinkers' identification with varying alcohol consumption prototypes.

INTRODUCTION AND AIMS: Efforts to reduce excessive alcohol consumption need to take into account drinkers' perceptions of their risk of alcohol-related harm. The aim of the present study was to profile adult Australian drinkers according to their self-identification with various drinker prototypes to determine the extent to which these prototypes are associated with perceived and actual risk of alcohol-related harm. DESIGN AND METHODS: A large web panel provider disseminated an online survey to a national sample of 2168 drinkers aged 18+ years who consumed alcohol at least twice per month. Respondents reported whether they considered themselves to be a light, occasional, social, heavy or binge drinker. The nominated category was compared with perceived and actual risk of alcohol-related harm. RESULTS: The prototype most commonly nominated by respondents was 'social drinker' (45%), and the least common was 'binge drinker' (7%). Although the heaviest drinkers in terms of actual reported consumption typically selected prototypes indicative of harmful consumption, many of those selecting prototypes indicative of moderate consumption were at risk of alcohol-related harm. DISCUSSION AND CONCLUSIONS: Many adult drinkers may be unaware of their risk of alcohol-related harm. The results suggest that there may be a need to recalibrate Australian drinkers' perceptions of high-risk drinking. [Pettigrew S, Jongenelis MI, Pratt IS, Slevin T, Chikritzhs T. Drinkers' identification with varying alcohol consumption prototypes. Drug Alcohol Rev 2017;36:464-467].

Potential in-class strategies to increase children's vegetable consumption.

OBJECTIVE: The Crunch&Sip programme is a school-based nutrition initiative designed to increase the fruit, vegetable and water intakes of primary-school children. In recognition of the notable deficits in children's vegetable consumption, the present study explored the receptivity of school staff to a realignment of the Crunch&Sip programme to feature a primary focus on vegetable consumption. This involved investigating school staff members' perceptions of relevant barriers, motivators and facilitators. DESIGN: A multi-method approach was adopted that involved four focus groups and a survey (administered in paper and online formats) containing a mixture of open- and closed-ended items. SETTING: Western Australia. SUBJECTS: Staff from Western Australian schools participated in the focus groups (n 37) and survey (n 620). RESULTS: School staff were strongly supportive of modifying the Crunch&Sip programme to focus primarily on children's vegetable consumption and this was generally considered to be a feasible change to implement. Possible barriers identified included children's taste preferences and a perceived lack of parental support. Suggested strategies to overcome these barriers were education sessions for parents and children, teachers modelling vegetable consumption for their students and integrating vegetable-related topics into the school curriculum. CONCLUSIONS: School staff are likely to support the introduction of school-based nutrition programmes that specifically encourage the consumption of vegetables. Potential barriers may be overcome through strategies to engage parents and children.

Factors associated with high consumption of soft drinks among Australian secondary-school students.

OBJECTIVE: To examine demographic and behavioural correlates of high consumption of soft drinks (non-alcoholic sugar-sweetened carbonated drinks excluding energy drinks) among Australian adolescents and to explore the associations between high consumption and soft drink perceptions and accessibility. DESIGN: Cross-sectional self-completion survey and height and weight measurements. SETTING: Australian secondary schools. SUBJECTS: Students aged 12-17 years participating in the 2012-13 National Secondary Students' Diet and Activity (NaSSDA) survey (n 7835). RESULTS: Overall, 14 % of students reported consuming four or more cups (≥1 litres) of soft drinks each week ('high soft drink consumers'). Demographic factors associated with high soft drink consumption were being male and having at least $AU 40 in weekly spending money. Behavioural factors associated with high soft drink consumption were low fruit intake, consuming energy drinks on a weekly basis, eating fast foods at least once weekly, eating snack foods ≥14 times/week, watching television for >2 h/d and sleeping for <8 h/school night. Students who perceived soft drinks to be usually available in their home, convenient to buy and good value for money were more likely to be high soft drink consumers, as were students who reported usually buying these drinks when making a beverage purchase from the school canteen/vending machine. CONCLUSIONS: High soft drink consumption clusters with other unhealthy lifestyle behaviours among Australian secondary-school students. Interventions focused on reducing the availability of soft drinks (e.g. increased taxes, restricting their sale in schools) as well as improved education on their harms are needed to lower adolescents' soft drink intake.

Health communication implications of the perceived meanings of terms used to denote unhealthy foods.

BACKGROUND: Using appropriate terminology in nutrition education programs and behaviour change campaigns is important to optimise the effectiveness of these efforts. To inform future communications on the topic of healthy eating, this study explored adults' perceptions of the meaning of four terms used to describe unhealthy foods: junk food, snack food, party food, and discretionary food. METHODS: Australian adults were recruited to participate in an online survey that included demographic items and open-ended questions relating to perceptions of the four terms. In total, 409 respondents aged 25-64 years completed the survey. RESULTS: 'Junk food' was the term most clearly aligned with unhealthiness, and is therefore likely to represent wording that will have salience and relevance to many target audience members. Snack foods were considered to include both healthy and unhealthy food products, and both snack foods and party foods were often described as being consumed in small portions. Despite being used in dietary guidelines, the term 'discretionary food' was unfamiliar to many respondents. CONCLUSIONS: These results demonstrate that different terms for unhealthy foods can have substantially different meanings for audience members. A detailed understanding of these meanings is needed to ensure that nutrition guidance and health promotion campaigns use appropriate terminology.

Adults and children prefer a plate food guide relative to a pyramid.

BACKGROUND AND OBJECTIVES: This study explored attitudes toward two food guides currently being widely used in Australia: the Healthy Eating Pyramid and the Australian Guide to Healthy Eating Plate. METHODS AND STUDY DESIGN: Ten focus groups were conducted with adults (aged 18+ years) and children (aged 10-17 years) across various locations in Perth, Western Australia. The discussions focused on liked and disliked aspects of each food guide and the implications for participants' perceptions of their relative usefulness. RESULTS: When asked to state their preference, a large majority of participants nominated the plate as their preferred nutrition guide. The style of presentation used for the plate was reportedly clearer and more aesthetically pleasing. The plate was also perceived to be more complex while the pyramid was considered by adults to be more child-friendly. CONCLUSIONS: This study provides information on consumers' reactions to different food guides and the implications for perceived relevance and utility.