Multicomponent (bio)markers for obesity risk prediction: a scoping review protocol.

INTRODUCTION: Despite international efforts, the number of individuals struggling with obesity is still increasing. An important aspect of obesity prevention relates to identifying individuals at risk at early stage, allowing for timely risk stratification and initiation of countermeasures. However, obesity is complex and multifactorial by nature, and one isolated (bio)marker is unlikely to enable an optimal risk stratification and prognosis for the individual; rather, a combined set is required. Such a multicomponent interpretation would integrate biomarkers from various domains, such as classical markers (eg, anthropometrics, blood lipids), multiomics (eg, genetics, proteomics, metabolomics), lifestyle and behavioural attributes (eg, diet, physical activity, sleep patterns), psychological traits (mental health status such as depression) and additional host factors (eg, gut microbiota diversity), also by means of advanced interpretation tools such as machine learning. In this paper, we will present a protocol that will be employed for a scoping review that attempts to summarise and map the state-of-the-art in the area of multicomponent (bio)markers related to obesity, focusing on the usability and effectiveness of such biomarkers. METHODS AND ANALYSIS: PubMed, Scopus, CINAHL and Embase databases will be searched using predefined key terms to identify peer-reviewed articles published in English until January 2024. Once downloaded into EndNote for deduplication, CADIMA will be employed to review and select abstracts and full-text articles in a two-step procedure, by two independent reviewers. Data extraction will then be carried out by several independent reviewers. Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews and Peer Review of Electronic Search Strategies guidelines will be followed. Combinations employing at least two biomarkers from different domains will be mapped and discussed. ETHICS AND DISSEMINATION: Ethical approval is not required; data will rely on published articles. Findings will be published open access in an international peer-reviewed journal. This review will allow guiding future directions for research and public health strategies on obesity prevention, paving the way towards multicomponent interventions.

Investigating Italian Consumer Preferences for Different Characteristics of Provolone Valpadana Using the Conjoint Analysis Approach.

The objective of this paper was twofold. First, we estimated consumer preferences for an Italian cheese (Provolone Valpadana) with respect to several attributes and levels, such as price, origin certification, production system, 'free from' labelling, and brand. Second, we identified consumer clusters with similar preferences for various cheese characteristics. Preferences were estimated using the conjoint analysis method. Then, a cluster analysis was used to classify consumers into different (three) clusters followed by a market simulation. In all three clusters, the attribute most preferred by Italian consumers was the brand of the cheese: consumers preferred to purchase Provolone cheese having the lowest price, produced by Auricchio, bearing a European Union (EU) quality certification, produced organically, and non-lactose-free. The results of our study provide helpful information to food companies for better segmenting their market and targeting their consumers, as well as effectively promoting their products using brands, certifications as organic and lactose-free. This study contributes to the literature on consumer preference for the EU labelling scheme (voluntary and mandatory). To our knowledge, this is the first study to investigate this combination of multiple labels displayed on the front of Italian cheese packaging.

Personal and Psychological Traits Influencing the Willingness to Pay for Food with Nutritional Claims: A Comparison between Vice and Virtue Food Products.

Several studies have demonstrated the usefulness of nutritional claims (NCs) to help consumers make more informed food decisions. However, fewer studies have investigated the effect of personal and psychological consumer characteristics on their food purchase decision. Hence, the main aim of this study is to examine the impact of body image, emotional eating style, anxiety traits, and body mass index on consumer preferences for multiple NCs on the front of the package (FOP) of hedonic (potato chips) and utilitarian (toasted bread) products carrying the same NCs. Therefore, a real choice experiment (RCE) has been used and the willingness-to-pay-space model was estimated to analyse the interaction between personal and psychological characteristics and consumer preferences. The main finding suggests differences in purchase behaviour between potato chips and toasted bread. In particular, consumers are willing to pay more for toasted bread with one NC than potato chips with one NC. Moreover, personal and psychological consumer characteristics influence the purchase behaviour regarding food products with nutritional claims. However, only the anxiety trait appears to explain the differences between the selection of both types of food products. In line with this new evidence, we proposed some behavioural, political, and managerial implications.

Nutrition, Choice and Health-Related Claims.

Scientific evidence shows that food consumption is one of the main causes that increases the risk of developing a non-communicable disease (NCD) [...].

Spanish Consumer Purchase Behaviour and Stated Preferences for Yoghurts with Nutritional and Health Claims.

Nutritional and health claims are a useful tool for promoting healthier food choices and prevent non-communicable disease[s] (NCDs). Exhaustive literature that has investigated consumer evaluation of the presence of nutritional and/or health claim(s) during the decision-making process suggests that consumers' sensitivity towards nutritional claims (NCs) and health claims (HCs) are still fragmented and should be further investigated. Our objective is to study the relationship between choice behaviour, attitudes and socio-demographic characteristics in order to evaluate the effectiveness of consumer characteristics in predicting Spanish consumers' choice of products with NCs and HCs. A discrete choice experiment for yoghurt was conducted on a sample of 218 Spanish consumers, stratified by age, gender, education level, and income. Applying a latent class approach has enabled us to identify a niche of individuals, sensitive of NCs and HCs and to characterize them with respect to the rest of population. Results suggest that consumers positively valued most claims, however, the valuation was heterogeneous, and three consumer segments were identified: 'health-claims oriented', 'nutritional- and health-claim oriented' and 'indifferent'. The results supply insights for the development of more targeted promotion campaigns, as well as for further actions in food marketing.

Testing Emotional Eating Style in Relation to Willingness to Pay for Nutritional Claims.

In face of the high prevalence of non-communicable diseases, nutritional claims represent a useful tool to help people to make healthier food choices. However, recent research notes that when some people experience an intense emotional state, they increase their food consumption, particularly of energy-dense and sweet foods. In consequence, this study aims to assess whether emotional eating (EE) style influences the purchase of food products carrying these claims. To this end, a real choice experiment (RCE) was conducted with 306 participants who were asked to evaluate different types of toast. An error component random parameter logit (ECRPL) was used to analyze their preferences for reduced-fat and low-salt claims toast and the effects of the variation of the EE score on individual preferences. Findings of this study suggest that emotional eating negatively impacts purchasing behavior related to nutritional claims. In particular, a decrease of the willingness to pay between 9% and 16% for every unit of toast with nutritional claims was noted when an increase of EE individual score was registered. In this regard, to increase the effectiveness of the nutritional claims, policymakers and private sectors should consider the management of individuals' emotional states in designing public health policies and marketing strategies, respectively.

Consumer preferences for nutritional claims: An exploration of attention and choice based on an eye-tracking choice experiment.

Nutritional claim (NC) requirements on food packages are among the most important and influential EU policy measures related to diet and have the capacity to promote healthy eating. This study combines a discrete choice experiment (DCE) method with eye-tracking (ET) technology to assess consumer preferences for multiple NCs in yogurt selection and explores the relationships between the NC preferences and the visual attention paid to these claims and the visual attention and choice decisions. The results indicate that the low-sugar NC was the least-preferred claim in all the models. Overall, the presence of NCs generally increases visual attention in terms of fixation count, which may be linked to an increased likelihood of affecting the final decision to purchase yogurts with NCs.

Prevalence of relevant nutritional claims related to prevention of obesity in Spanish market / Prevalencia de las declaraciones nutricionales en la prevención de la obesidad en el mercado español

Introduction: Although previous studies have provided relevant information regarding the progress in the implementation of Regulation (EC) No 1924/2006 of the European Union. So far it not determined the prevalence of relevant nutrition claims in preventing obesity in the Spanish market. Objective: To determine the prevalence of relevant nutritional claims related to prevent the obesity in the Spanish market. Material and methods: A database with 9 food product categories and it nutritional claims was created. Three supermarket chains were included because they represent the 40% of market share. Only the nutritional claims that mention nutrients related obesity was considered. Results: A total of 4,568 products were examined and a total of 900 nutrition claims were found in 20% of the products found. The most frequent nutrients referred in the nutritional claims were fat (42%), sugar (32%), dietary fibre (20%) and salt (6%). Conclusions: In accordance with previous studies, findings reported a low prevalence of nutritional claims indicating that agrifood sector should include more nutritional claims to help consumers making better food choices.

Introducción: a pesar de que estudios anteriores han proporcionado información relevante respecto al avance en la aplicación del Reglamento (CE) n.o 1924/2006 de la Unión Europea, hasta ahora no se ha determinado la prevalencia de las declaraciones nutricionales relevantes en la prevención de la obesidad en el mercado español. Objetivo: determinar la presencia de las declaraciones nutricionales relevantes en la prevención de la obesidad en el mercado español. Materiales y métodos: se realizó un registro de productos alimenticios comercializados en 3 cadenas de distribución alimentaria que concentran el 40% del mercado. Se registró información nutricional de 9 categorías de productos representativos en la cesta de la compra de las familias españolas. Las declaraciones nutricionales analizadas hacen mención de los nutrientes que pueden contribuir o no al exceso de peso. Resultados: se examinó un total de 4.568 productos y se encontraron un total de 900 declaraciones nutricionales en el 20% de los productos analizados. Los nutrientes referidos en las declaraciones nutricionales encontrados con mayor frecuencia en las 9 categorías de productos fueron las grasas (42%), los azúcares (32%), la fibra alimentaria (20%) y la sal (6%). Conclusiones: al igual que en otros estudios realizados en España, nuestro estudio mostró una baja proporción de declaraciones nutricionales. Por lo tanto, para que estas cumplan su función informativa tanto la industria como la distribución alimentaria deben seguir trabajando por incluir más declaraciones en los alimentos que ofrecen. De esta manera facilitarán a los consumidores una mejor toma de decisiones alimentarias.

The Impact of Body Image on the WTP Values for Reduced-Fat and Low-Salt Content Potato Chips among Obese and Non-Obese Consumers.

The aim of this study is to assess the influence of body image on consumers' willingness to pay (WTP) for potato chips carrying nutritional claims among obese and non-obese people. About 309 non-clinical individuals participated in a Real Choice Experiment. They were recruited by a company and grouped in: (i) non-obese with good body image; (ii) non-obese with body image dissatisfaction; (iii) obese with good body image; (iv) obese with body image dissatisfaction. Results indicate differences in consumers' willingness to pay among consumer groups. Body image dissatisfaction of normal people did not influence the WTP for healthier chips. Obese people with body image dissatisfaction were willing to pay more for healthier chips (i.e., low-salt content potato chips) than normal ones with body image dissatisfaction. Examining the role of knowledge in the light of how this could impact on body image is relevant to improve the health status of individuals and their diet. Knowledge about nutrition could improve the body image of obese people.

Assessing Projection Bias in Consumers' Food Preferences.

The aim of this study is to test whether projection bias exists in consumers' purchasing decisions for food products. To achieve our aim, we used a non-hypothetical experiment (i.e., experimental auction), where hungry and non-hungry participants were incentivized to reveal their willingness to pay (WTP). The results confirm the existence of projection bias when consumers made their decisions on food products. In particular, projection bias existed because currently hungry participants were willing to pay a higher price premium for cheeses than satiated ones, both in hungry and satiated future states. Moreover, participants overvalued the food product more when they were delivered in the future hungry condition than in the satiated one. Our study provides clear, quantitative and meaningful evidence of projection bias because our findings are based on economic valuation of food preferences. Indeed, the strength of this study is that findings are expressed in terms of willingness to pay which is an interpretable amount of money.

Preferences for lamb meat: a choice experiment for Spanish consumers.

This paper analyzes consumers' preferences for different lamb meat attributes using a choice experiment. In particular, preferences for the type of commercial lamb meat ("Ternasco" and "Suckling") and the origin of production (locally produced "Ojinegra from Teruel") were evaluated. Moreover, we endogenously identify consumers' segments based on consumers' preferences for the analyzed attributes. Data come from a survey administrated in Spain during 2009. A latent class model was used to estimate the effect of the attributes on consumer utility, derive the willingness to pay and determine consumers' segments. Results suggest that consumers' preferences for both attributes are heterogeneous and two homogenous consumers' segments were detected. The largest segment (79%) did not value any of the analyzed attributes while the smaller one (21%) valued both of them positively. In particular, consumers in this second segment are willing to pay an extra premium for the "Ternasco" lamb meat, around double the premium they are willing to pay for the locally produced lamb meat "Ojinegra from Teruel".