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1.
JAMA Netw Open ; 7(5): e249438, 2024 May 01.
Article in English | MEDLINE | ID: mdl-38717775

ABSTRACT

Importance: Point-of-sale food messaging can encourage healthier purchases, but no studies have directly compared multiple interventions in the field. Objective: To examine which of 4 food and beverage messages would increase healthier vending machine purchases. Design, Setting, and Participants: This randomized trial assessed 13 months (February 1, 2019, to February 29, 2020) of vending sales data from 267 machines and 1065 customer purchase assessments from vending machines on government property in Philadelphia, Pennsylvania. Data analysis was performed from March 5, 2020, to November 8, 2022. Interventions: Study interventions were 4 food and beverage messaging systems: (1) beverage tax posters encouraging healthy choices because of the Philadelphia tax on sweetened drinks; (2) green labels for healthy products; (3) traffic light labels: green (healthy), yellow (moderately healthy), or red (unhealthy); or (4) physical activity equivalent labels (minutes of activity to metabolize product calories). Main Outcomes and Measures: Sales data were analyzed separately for beverages and snacks. The main outcomes analyzed at the transaction level were calories sold and the health status (using traffic light criteria) of each item sold. Additional outcomes were analyzed at the monthly machine level: total units sold, calories sold, and units of each health status sold. The customer purchase assessment outcome was calories purchased per vending trip. Results: Monthly sales data came from 150 beverage and 117 snack vending machines, whereas 1065 customers (558 [52%] male) contributed purchase assessment data. Traffic light labels led to a 30% decrease in the mean monthly number of unhealthy beverages sold (mean ratio [MR], 0.70; 95% CI, 0.55-0.88) compared with beverage tax posters. Physical activity labels led to a 34% (MR, 0.66; 95% CI, 0.51-0.87) reduction in the number of unhealthy beverages sold at the machine level and 35% (MR, 0.65; 95% CI, 0.50-0.86) reduction in mean calories sold. Traffic light labels also led to a 30-calorie reduction (b = -30.46; 95% CI, -49.36 to -11.56) per customer trip in the customer purchase analyses compared to physical activity labels. There were very few significant differences for snack machines. Conclusions and Relevance: In this 13-month randomized trial of 267 vending machines, the traffic light and physical activity labels encouraged healthier beverage purchases, but no change in snack sales, compared with a beverage tax poster. Corporations and governments should consider such labeling approaches to promote healthier beverage choices. Trial Registration: ClinicalTrials.gov Identifier: NCT06260176.


Subject(s)
Beverages , Food Dispensers, Automatic , Humans , Food Dispensers, Automatic/statistics & numerical data , Beverages/economics , Philadelphia , Male , Female , Consumer Behavior/statistics & numerical data , Commerce , Adult , Food Labeling/methods , Snacks , Food/economics
2.
BMC Public Health ; 24(1): 1332, 2024 May 17.
Article in English | MEDLINE | ID: mdl-38760787

ABSTRACT

BACKGROUND: Acute Coronary Syndrome is the most common heart disease and the most significant cause of death and disability-adjusted life years worldwide. Teaching a healthy eating style is one preventive measure to prevent the disease's recurrence. This study aimed to determine the effect of healthy nutrition education with the help of traffic light labels on food selection, preference, and consumption in patients with acute coronary syndrome. METHODS: This randomized, single-blinded clinical trial was conducted with 139 participants (66 in the intervention group and 73 in the control group) from January 2021 to August 2021 in Shaheed Rajaie Hospital, Tehran, Iran. The control group received standard training. The intervention group, besides this, received additional bedside training with an educational poster on traffic light labels from the research team during their final hospitalization days. Data were collected using a researcher-made questionnaire on food selection, preference, and consumption. RESULTS: The Brunner-Munzel test showed no significant difference between the two groups in terms of selection (P = 0.127), preference (P = 0.852), and food consumption (P = 0.846) in the baseline, while after the intervention, there were significant differences in selection (P > 0.001), preference (P > 0.001), and consumption (p < 0.004). Comparing the difference between the two groups in the difference between the before and after scores for selection (p < 0.001), preference (p < 0.001), and food consumption (p = 0.011) with the Brunner-Munzel test indicated a significant difference in all outcome variables. CONCLUSIONS: Teaching healthy eating styles with the help of traffic light labels affected food selection, preference, and consumption and led to healthier diets in these patients. CLINICAL TRIAL REGISTRATION NUMBER: Clinical trial registration: It was prospectively registered in the Iran Clinical Trials Registration Center on this date 30/10/2020 (IRCT20200927048857N1).


Subject(s)
Acute Coronary Syndrome , Food Labeling , Food Preferences , Humans , Male , Female , Middle Aged , Iran , Food Labeling/methods , Food Preferences/psychology , Single-Blind Method , Health Education/methods , Aged , Diet, Healthy , Adult , Surveys and Questionnaires
3.
Appetite ; 198: 107376, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38670347

ABSTRACT

Food choice behavior plays a large role in achieving sustainability goals. Meat in particular has a negative environmental impact as compared with plant-based food - and is more frequently chosen in restaurant contexts. To increase plant-based meal choices in restaurants, we tested three nudges for menus that are likely to be implemented by restaurant owners: a hedonic label (e.g., artisanal vegetable burger), a chef's recommendation (specifying the vegetarian option as the chef's favorite), and a salience nudge (a box around the vegetarian option). In an online experiment, we showed participants (n = 513) in four conditions (no nudge, hedonic label, chef's recommendation, and salience nudge) five menus with four meal options each, one of which was vegetarian. We asked participants to choose a meal and subsequently to rate these meals on how tasty and indulgent they were (taste and indulgence attributions). We then revealed which nudge was used to the participants and asked how participants received it. Results show that the hedonic label and chef's recommendation nudge (but not the salience nudge) both increase vegetarian meal choices. The hedonic label increased participants' attributions of indulgence of the meal, but not of tastiness. This finding fits with restaurants' gastronomic, pleasure-seeking context and shapes future directions of labeling interventions, namely that indulgence attributions can be increased in vegetarian foods. Furthermore, the nudges were generally well accepted and participants' intention to return to the (virtual) restaurant was high. Finally, customers expected the hedonic label nudge to be more effective in promoting vegetarian food choices than the other two nudges, partially corresponding with our findings of actual effectiveness.


Subject(s)
Choice Behavior , Diet, Vegetarian , Food Preferences , Meals , Restaurants , Humans , Male , Female , Food Preferences/psychology , Diet, Vegetarian/psychology , Adult , Young Adult , Meals/psychology , Middle Aged , Menu Planning , Adolescent , Food Labeling/methods
4.
Appetite ; 197: 107291, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38485058

ABSTRACT

While contributing to the conservation of natural fish stocks, the aquaculture sector imposes environmental repercussions. The growing popularity of colour-graded eco-labels in promoting pro-environmental practices in food production underscores the need for scientific insights into consumer responses to such labels, particularly with the imminent prospect of a harmonized European labelling framework. The existing literature, although limited and divergent, advocates for real-life testing with fresh, perishable food products, emphasizing the inadequacy of standalone labels and the necessity for complementary measures. Furthermore, the mechanisms underlying how consumers process multi-coloured Front-of-Pack (FOP) labels remain ambiguous, with uncertainties regarding induced consumption shifts stemming from both deliberate information processing and less deliberate associations. This article presents findings from a randomized control trial conducted in a simulated fishmonger store in Derio, Bizkaia, Spain, involving 200 consumers. Participants selected various sea bass products out of multiple options. This task was subject to a 2 (Enviroscore: with vs without) x 2 (Supporting info on Enviroscore: with vs without) between-subject design, resulting in four treatment groups. A 16% increase in the likelihood of selecting lower-impact products was observed. Notably, this effect was evident only in the absence of supporting information on Enviroscore, and the observed impact could not be attributed to any indirect attention effect. In conclusion, Enviroscore exhibits potential in steering consumer choices toward more environmentally friendly aquaculture fish options, even in physical retail settings. However, these effects may be rooted in unconscious responses rather than deliberate environmental considerations, raising questions about the suitability of envisaged policy orientations encompassing disaggregated environmental, nutritional, animal welfare, and social welfare scores. Generalization of these findings warrants validation through further research encompassing a more comprehensive range of products.


Subject(s)
Cues , Food Preferences , Animals , Humans , Food Labeling/methods , Seafood , Choice Behavior , Fishes , Consumer Behavior , Nutritive Value
5.
Public Health ; 230: 138-148, 2024 May.
Article in English | MEDLINE | ID: mdl-38547760

ABSTRACT

OBJECTIVES: Front-of-pack warning labels may reduce consumption of sugar-sweetened beverages, potentially mitigating negative health outcomes. Comparisons between different warning label types to inform future research and policy directions are lacking. This study compared 27 warning labels across six message types for their potential to reduce sugar-sweetened beverage consumption. DESIGN AND METHODS: A national sample of regular soda (n = 2578) and juice (n = 1048) consumers aged 14-60 years participated in an online survey. Participants evaluated randomly allocated labels; one from each of six warning label sets (health-graphic, sugar-pictogram, sugar-text, exercise equivalents, health-text, energy information) on four measures of perceived effectiveness (PE: overall effectiveness, discourage from drinking, emotional response, persuasive potential). Participants could also provide open comments. A general linear model compared differences in mean scores across label sets for each measure of PE. RESULTS: PE ratings differed significantly between label sets. Labels clearly quantifying sugar content (sugar-teaspoons) received consistently high PE ratings, whereas 'high in sugar' labels did not. Health-graphic labels were rated highly across all PE measures except persuasive potential. Exercise labels only rated highly on persuasive potential. Health-text results were mixed, and energy labels were consistently low. CONCLUSIONS: Simple, factual labels were easily interpreted and perceived as most effective. Labels quantifying sugar content were consistently high performers and should be advanced into policy to help decrease overconsumption of sugar-sweetened beverages.


Subject(s)
Sugar-Sweetened Beverages , Humans , Sugars , Fruit and Vegetable Juices , Beverages , Food Labeling/methods
6.
Nutrients ; 16(6)2024 Mar 14.
Article in English | MEDLINE | ID: mdl-38542738

ABSTRACT

Although meat and meat products are important sources of protein in the human diet, consumption appears to be a predisposing factor in the onset of several civilisation diseases, particularly red meat and its products. One way to reduce diet-related diseases is to guide consumers towards consciously purchasing healthier foods by including a nutrition declaration on product labels, such as by using a "front-of-pack" (FOP) labelling system. This study aimed to determine the Nutri-Score classes for processed meat products, distinguish products that are potentially better for consumers, and determine whether the refined algorithm significantly contributed to a change in product classification. An analysis of the labels of 1700 products available on the Polish market indicated that most processed meat products qualified as class D and E. Comparing the refined Nutri-Score calculation algorithm with the original algorithm resulted in a slight change in product allocation. Poultry products were ranked more favourably than red meat products. The most significant change in product allocation (by 35.2%) was achieved by reducing salt content by 30% and fat content by 10%. Among the processed meat products, some are more highly ranked and are hence considered better from a nutritional perspective than others in that group.


Subject(s)
Meat Products , Humans , Poland , Food Labeling/methods , Nutritive Value , Diet , Consumer Behavior , Food Preferences
7.
Public Health Nutr ; 27(1): e63, 2024 Feb 01.
Article in English | MEDLINE | ID: mdl-38297466

ABSTRACT

OBJECTIVE: To compare the initial and the updated versions of the front-of-pack label Nutri-Score (related to the nutritional content) with the NOVA classification (related to the degree of food processing) at the food level. DESIGN: Using the OpenFoodFacts database - 129,950 food products - we assessed the complementarity between the Nutri-Score (initial and updated) with the NOVA classification through a correspondence analysis. Contingency tables between the two classification systems were used. SETTINGS: The food offer in France. PARTICIPANTS: Not applicable. RESULTS: With both versions (i.e. initial and updated) of the Nutri-Score, the majority of ultra-processed products received medium to poor Nutri-Score ratings (between 77·9 % and 87·5 % of ultra-processed products depending on the version of the algorithm). Overall, the update of the Nutri-Score algorithm led to a reduction in the number of products rated A and B and an increase in the number of products rated D or E for all NOVA categories, with unprocessed foods being the least impacted (-3·8 percentage points (-5·2 %) rated A or B and +1·3 percentage points (+12·9 %) rated D or E) and ultra-processed foods the most impacted (-9·8 percentage points (-43·4 %) rated A or B and +7·8 percentage points (+14·1 %) rated D or E). Among ultra-processed foods rated favourably with the initial Nutri-Score, artificially sweetened beverages, sweetened plant-based drinks and bread products were the most penalised categories by the revision of Nutri-Score while low-sugar flavoured waters, fruit and legume preparations were the least affected. CONCLUSION: These results indicate that the update of the Nutri-Score reinforces its coherence with the NOVA classification, even though both systems measure two distinct health dimensions at the food level.


Subject(s)
Food Labeling , Sweetening Agents , Humans , Nutritive Value , Food Labeling/methods , Food Handling , Food Quality
8.
Nutrients ; 16(4)2024 Feb 16.
Article in English | MEDLINE | ID: mdl-38398868

ABSTRACT

Public health policies have been widely utilized to improve population nutrition, such as the newly announced front-of-pack labels (FOPLs) that will be applied to Canadian prepackaged foods to help consumers make healthier selections. However, research on similar health logos in the food service sector has been limited. This study explores the potential application of FOPL-style health logos in the food service sector and its impact on consumer behaviors. A survey was conducted among 1070 Canadians to assess their awareness, perception, and support for health logos on restaurant menus. The results indicate that while participants value healthy food options when dining out, taste, price, and convenience remain the primary factors influencing their choices. Most participants were unaware of existing FOPL policies and demonstrated mixed responses regarding the influence of similar health logos on their restaurant selection. However, a majority expressed a desire to see FOPL-style health logos on menus, and nutrient profile ratings and logos indicating nutrient limitations or encouragements were listed as preferred health logos. Notably, females indicated higher supportiveness for FOPL-style health logos on menus and individuals with food allergies exhibited higher agreement in the likelihood of eating at a restaurant displaying labels. Additionally, findings revealed that FOPL-style health logos alone may not significantly deter consumers from purchasing labelled menu items, especially if price is affected. Overall, this study highlights the need for further understanding consumer perceptions to effectively develop and implement FOPL initiatives in the food service sector.


Subject(s)
Food Labeling , Food Preferences , North American People , Female , Humans , Food Labeling/methods , Canada , Food , Consumer Behavior , Nutritive Value , Choice Behavior
9.
BMC Public Health ; 24(1): 381, 2024 02 05.
Article in English | MEDLINE | ID: mdl-38317163

ABSTRACT

BACKGROUND: The method of displaying nutrition information labels on the front of food packaging (FOP: Front of Pack) has been implemented worldwide to prevent lifestyle-related diseases. This study aimed to investigate whether the use of the UK's Traffic Light Food (TLF) label, known as the FOP label, influences the dietary choices of Japanese youth and promotes healthy dietary choices. METHODS: Diet selection was performed for one week each during the baseline and intervention periods. During the intervention period, TLF labels were displayed on meal images of the intervention group. Participants chose what they would like to have for dinner of the day from 15 images. Each meal was scored based on the color of the nutrition label, and a comparison between groups was made to determine whether TLF labeling influenced meal selection for dinner. The psychological stress caused by the presence or absence of nutrition labels and nutritional components when choosing meals was also evaluated. RESULTS: A total of 69 participants were randomly assigned to two groups. Dietary choice scores indicated that the TLF-labeled group made significantly healthier dietary choices than the unlabeled group. Additionally, the TLF-labeled group showed a significant increase in the percentage of people conscious of nutritional components when choosing meals. Furthermore, a significant increase in the number of people conscious of protein, a nutritional ingredient not indicated on the TLF label, was observed. During the test period, no difference in psychological stress caused by the presence and absence of the TLF labels was observed. CONCLUSIONS: The use of TLF labels also encouraged healthy dietary choices among Japanese university students. The use of FOP nutrition labels should be considered in Japan to prevent lifestyle-related diseases through healthy dietary choices. TRIAL REGISTRATION: UMIN Clinical Trials Registry Number: UMIN000047268. Registered March 23, 2022.


Subject(s)
Food Labeling , Health Behavior , Adolescent , Humans , Food Labeling/methods , Japan , Universities , Nutritive Value , Choice Behavior , Consumer Behavior , Diet , Food Preferences/psychology , Students
10.
Health Res Policy Syst ; 22(1): 20, 2024 Feb 07.
Article in English | MEDLINE | ID: mdl-38326884

ABSTRACT

In the context of the European Commission's proposal for the harmonization of front-of-pack nutrition labels (FoPLs) across the European Union scheduled for 2023, Portugal's position on the preferred format to be adopted remains unclear. Our study aims to (1) describe the context of the political decision regarding FoPL's implementation in Portugal, (2) identify and characterize the actors involved in the debate and (3) evaluate their influence in the decision-making process and their position on the various formats of FoPLs considered. A document review complemented by a qualitative study with eight experts revealed the actors involved in the implementation of FoPLs in Portugal. The stakeholder theory was used to qualify their level of influence on the decision. To complement the experts' analysis, the views of 1014 Portuguese consumers on stakeholders' influence were collected via an online questionnaire. The results show a strong mobilization of the Portuguese Ministry of Health on the issue through the production of several technical and scientific reports. The background of the political decision related to FoPLs in Portugal highlights the commitment of some influential stakeholders in favour of the traffic light format, including one of the major Portuguese retailers, Continente. Nevertheless, in the face of public support for the Nutri-Score from a growing number of actors, Portugal has not yet adopted a specific format, partly due to some resistance from the agricultural sector. Portugal, by lack of consensus and agenda setting, is now awaiting formal harmonization of FoPLs by the European Commission. This study provides useful insights for public policy actors when promoting interventional measures.


Subject(s)
Consumer Behavior , Food Labeling , Humans , Food Labeling/methods , Portugal , European Union , Surveys and Questionnaires
11.
Adv Physiol Educ ; 48(2): 180-185, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38174371

ABSTRACT

Reading nutrition facts labels is a competency for which training is given in several nutrition education programs, especially in obesity outreach workshops. The Top Trumps-style card game is commonly used in obesity prevention educational programs to engage participants in reading nutrition facts labels; however, the success of TV cooking shows among children and teenagers has not been explored for educational purposes. This paper is a descriptive study of developing a gamified activity as part of the one-time outreach workshop facilitated by the Obesity and Comorbidities Research Center (OCRC) in Brazil. By playing the MestreChef Nutritional (MCN) game, participants followed similar rules as the corresponding TV cooking show. They were challenged to decide to select food items, calculate dietary food intake, and prepare a recipe to visualize the proportion of macronutrients contained in daily diets. The analysis of the nutritional dietary table completed by participants revealed to be a rich source of information, and we identified in our cohort that selecting an adequate number of food items and making healthy food choices was not concerning. However, their lack of competency in performing mathematical reasoning, particularly in calculating serving sizes and converting grams of macronutrients into calories, was evident. Moreover, facilitators of the workshops agreed that the MCN game presents definitively more didactic effectiveness and playability than the Foods Top Trumps, a former game used in the outreach workshops. The MCN game nourishes the engagement of the participants in learning nutrition-related concepts and may be an efficient didactic resource to improve nutrition knowledge in outreach activities when an alternative method is required to stimulate reading nutrition facts labels.NEW & NOTEWORTHY Reading nutrition facts labels is a typical activity promoted in obesity prevention educational programs. By playing the MestreChef Nutritional, participants can immerse in the context of a food TV show game to have the first contact with reading nutrition facts labels for a learning purpose. However, the game can reveal the participant's limitations in mathematical reasoning despite the didactic potential of the game in promoting obesity-related physiology concepts.


Subject(s)
Diet , Health Education , Adolescent , Child , Humans , Health Education/methods , Food Labeling/methods , Energy Intake , Obesity/prevention & control , Health Knowledge, Attitudes, Practice
12.
Nutr Rev ; 82(3): 374-388, 2024 Feb 12.
Article in English | MEDLINE | ID: mdl-37604108

ABSTRACT

Front-of-package (FOP) labels have been adopted in many countries to battle the obesity pandemic and its serious health consequences by providing clearer and easier-to-understand nutrition and health information. The effectiveness of FOP labels has been generally confirmed, with some contextual and individual factors modifying their effectiveness. Existing theories (eg, the dual-process theory) and shifting priorities for self-control, provide some explanations for the FOP label effect. However, the cognitive and neural mechanisms underlying the processing of FOP labels remain unknown. Here, a new model, namely, the neural model of FOP label processing, has been proposed to fill this gap by providing an integrated account of FOP label processing while simultaneously considering multiple important situational and individual factors in the same framework. This neural model is built on the core eating network (ie, the ventral reward pathway and the dorsal control pathway) for food cue processing and actual food consumption. The new model explains how FOP labels may facilitate attention, influence the core eating network, and thus alter food choices. It also demonstrates how motivation may modify FOP label processing in 2 ways: affecting attention (the indirect way) and changing the process of evaluating the food (the direct way). It further explains how some contextual and individual factors (eg, ego depletion, time pressure, and health knowledge) influence the process. Thus, the neural model integrates evidence from behavioral, eye-tracking, and neuroimaging studies into a single, integrated account, deepening understanding of the cognitive and neural mechanisms of FOP label processing. This model might facilitate consensus on the most successful FOP label. Moreover, it could provide insights for consumers, food industries, and policy makers and encourage healthy eating behaviors.


Subject(s)
Consumer Behavior , Food Labeling , Humans , Food Labeling/methods , Food , Food Preferences/psychology , Attention , Choice Behavior , Nutritive Value
13.
J Acad Nutr Diet ; 124(1): 58-64.e1, 2024 01.
Article in English | MEDLINE | ID: mdl-37673335

ABSTRACT

BACKGROUND: Given growing interest in warning labels as a form of front-of-pack nutrition label, it is important to better understand the mechanisms via which these labels may exert their effects, especially among those making suboptimal food choices. OBJECTIVE: The study aim was to assess the extent to which consumers with the weakest outcomes for objective understanding and choice in no-label conditions were able to improve their understanding and choices after exposure to warning labels on food product options. DESIGN: Post-hoc analyses of the cross-sectional FOP-ICE (Front-of-Pack International Comparative Experimental) study data generated from an online survey that included simulated food choice and nutritional quality ranking scenarios. PARTICIPANTS/SETTING: Participants included 3,680 adults from the following 18 countries: Argentina, Australia, Belgium, Bulgaria, Canada, Denmark, France, Germany, Italy, Mexico, Netherlands, Poland, Portugal, Singapore, Spain, Switzerland, United Kingdom, and United States. INTERVENTION: Survey respondents selected their preferred product options and ranked foods according to their healthiness before and after exposure to mock breakfast cereal, cake, and pizza products displaying warning labels. MAIN OUTCOME MEASURES: Objective understanding and food choice were measured. STATISTICAL ANALYSES PERFORMED: Within each product category, analyses were conducted on respondents who initially incorrectly identified the healthiest option and/or selected the unhealthiest option as their preferred choice. Significant differences between proportions selecting each understanding and choice response option were assessed using 2-sample z tests for proportions. RESULTS: Salience of the warning labels was low; 46% reported noticing the labels while completing the survey. Just over one-third of those aware of the presence of warning labels were able to identify the least healthy option in the post-exposure condition. Approximately one-half reselected the least healthy option post exposure and just over one-fourth switched to the healthiest option. CONCLUSIONS: The results indicated that warning labels can assist some consumers to improve their food quality assessments and choices. However, design improvements could enhance the salience and interpretability of this label format.


Subject(s)
Choice Behavior , Consumer Behavior , Adult , Humans , Cross-Sectional Studies , Nutritional Status , Food Preferences , Nutritive Value , Food Labeling/methods
14.
Appetite ; 193: 107129, 2024 02 01.
Article in English | MEDLINE | ID: mdl-38008189

ABSTRACT

Calorie overconsumption has been proposed as a critical contributing factor to rising obesity rates. To combat this health issue, governments and policymakers have suggested implementing numerical caloric content labels. Alternatively, physical activity calorie equivalent (PACE) labels are being proposed as an easier-to-understand metric, representing the amount of physical activity required to burn off calorie content. This study examined individuals' ability to correctly estimate either the numerical caloric content or the PACE values of food images in an associative learning task. Moreover, it assessed whether this knowledge was learned and retained over time. One hundred and ninety-one participants were instructed to estimate either the numerical caloric content or PACE values of thirty food images. To facilitate learning, feedback on the correct number of calories or PACE values was provided during the first session (Time 1). To assess retention, people re-estimated numerical caloric content or PACE values of the same food pictures three days later (Time 2) and seven days later (Time 3), where feedback was not provided. Results showed that participants in both groups improved their estimations using feedback, with people being consistently more accurate when estimating numerical calorie content. Yet, our results also suggest that participants consolidated their knowledge of PACE values over time. Finally, our findings show that hunger moderates individuals' estimation ability, where hungrier people are less accurate than satiated ones. The results contribute to our understanding of how consumers process, estimate, and learn PACE labels versus numerical caloric content, and provide valuable information for researchers and policymakers to develop and implement nutritional labels as a health strategy.


Subject(s)
Energy Intake , Food , Humans , Learning , Food Preferences , Exercise , Food Labeling/methods
15.
Int J Food Sci Nutr ; 75(2): 185-196, 2024 Mar.
Article in English | MEDLINE | ID: mdl-37982330

ABSTRACT

The production and diversity of the supply of food products has grown exponentially in recent decades, along with the increase in cardiovascular diseases associated with poor diet. Among the factors, one of the most important is the lack of information for the consumer when purchasing. The present work evaluates the impact of implementing the traffic light labelling of foods in reducing deaths due to Noncommunicable Diseases (NCD). Econometric techniques of two-way effects panel data from 21 Ecuadorian provinces taken from official sources for the analysis period 2010-2019. For Ecuador, a favourable impact was found in the reduction of the NCD mortality rate, especially in the last three years; in 2017, it was reduced by 0.129%, in 2018 by 0.305%, and in 2019 by 0.289%. An implication of economic policy is the advertising regulation of products that may affect health, strengthening surveillance and sanctioning companies that fail to comply with the regulation.


Subject(s)
Noncommunicable Diseases , Humans , Noncommunicable Diseases/epidemiology , Food Labeling/methods , Incidence , Sustainable Development , Food
16.
Am J Prev Med ; 66(2): 269-278, 2024 Feb.
Article in English | MEDLINE | ID: mdl-37813173

ABSTRACT

INTRODUCTION: A calorie-labeling policy for restaurant menus was implemented in 2018. Whether and how sexual-minority men use this information has not been evaluated. METHODS: The Men's Body Project, a 2020 cross-sectional survey study of 504 cisgender sexual-minority men (mean age=35.8±10.4 years, 71.0% White, 5.6% Asian, 14.3% Black, 9.1% another/multiple race identities) assessed respondents' awareness of calorie labels on restaurant menus and subsequent responses. Additional questions were asked about weight-change goals, body image, disordered eating behaviors, and muscle-enhancing supplement use. Analyses in 2022-2023 used multivariate logistic regression to assess the associations between noticing calories and weight- and muscularity-oriented behaviors and, among those who noticed calorie labels, whether participants reported using this information to order more or fewer calories. RESULTS: Approximately half of the participants reported noticing calorie labels. Those who did were more likely to report engaging in disordered eating behaviors (OR=2.03). Among participants who noticed menu labels, ordering fewer calories was the most frequent response, whereas 25% reported not changing the caloric content of their order. Many participants (21%) reported ordering both more and fewer calories, and this heterogeneous ordering pattern was associated with both disordered eating (OR=4.70) and muscle-enhancing behaviors (OR=9.42) compared with that among participants who did not report behaviors. Reporting weight-control efforts was associated with ordering fewer calories than participants not doing anything to change their weight (OR=2.53). CONCLUSIONS: Most participants noticed calorie labels on menus, and many reported subsequently ordering fewer calories. Disordered eating and muscle-enhancing behaviors were associated with behavior changes in response to calorie information.


Subject(s)
Food Labeling , Restaurants , Male , Humans , Adult , Middle Aged , Cross-Sectional Studies , Food Labeling/methods , Energy Intake , Food Preferences
17.
Appetite ; 192: 107097, 2024 01 01.
Article in English | MEDLINE | ID: mdl-37918526

ABSTRACT

Current research in food science has explored the influence of front-of-package (FOP) labeling systems on consumer decision-making, yielding mixed results. We suggest that these inconsistent findings regarding FOP labeling effectiveness stem from a failure to consider a pivotal individual-level variable: consumer susceptibility to FOP labeling (CSFL). In the present research, we define this focal construct and develop and psychometrically validate a seven-item instrument that captures the construct across six studies (N = 1134). The current research may assist in segmenting consumers based on their susceptibility to FOP labeling, thereby facilitating the creation of targeted interventions tailored to this individual difference. Notably, the CSFL scale is positively correlated with consumers' willingness to purchase food items with genuine, third-party FOP labels, but not products lacking labels or products with fictitious FOP labels. This supports the predictive validity of the scale in determining important consumption-related outcomes.


Subject(s)
Food Labeling , Food Preferences , Humans , Food Labeling/methods , Choice Behavior , Food , Consumer Behavior , Nutritive Value
18.
Appetite ; 193: 107167, 2024 02 01.
Article in English | MEDLINE | ID: mdl-38113983

ABSTRACT

Each year, 2.8 million people die because of comorbidities associated with being overweight. Snacking substantially contributes to people's calorie intake. One way to nudge consumers towards healthier alternatives is the implementation of nutritional labeling. This study reports on a controlled field experiment that evaluates the effect of two nutritional labels on free snack choices (n = 739). Participants at a conference could choose between nuts, cookies, and candy bars as a snack, presented at the bar at six different locations across 2 bar counters. The labels were set up in front of each snack in three conditions: no labeling (control), a calorie label, or a traffic light label (i.e., the Nutri-Score). The location of the snacks on the counter (Either side of the counter; Center, Right, Left) and the time-of-day (Morning (=reference) vs Afternoon) were statistically controlled for. The results show that calorie labels could not successfully nudge consumers toward healthier snack choices (nuts instead of candy bars or cookies). In contrast, the Nutri-Score label significantly increased the probability of choosing nuts over candy bars. The Nutri-Score also increased the chance of choosing nuts over cookies, but the difference was not significant. No prior studies to our knowledge have directly compared calorie labels to the Nutri-Score. This study suggests that the Nutri-Score label can be a more successful intervention than calorie labels to nudge consumers towards healthier choices in situations were free snacks are offered, like many modern workplaces. Changing snacking behavior is challenging and naturalistic field experiments like this one are needed to translate the theory from previous laboratory studies to real-life settings.


Subject(s)
Food Labeling , Snacks , Adult , Humans , Food Labeling/methods , Food Preferences , Energy Intake , Research Design , Consumer Behavior , Choice Behavior , Nutritive Value
19.
J Health Popul Nutr ; 42(1): 124, 2023 Nov 08.
Article in English | MEDLINE | ID: mdl-37941048

ABSTRACT

BACKGROUND: Since 2020 in Mexico, front-of-pack warning labels (FOPWL) have been implemented in processed products. Evidence supports warning labels allow consumers to identify unhealthy products. We aimed to evaluate the hypothetical impact of the FOPWL regulation on the Mexican population's intake of critical nutrients and energy, based on the replacement of food and beverages using 4 hypothetical scenarios which represented the phases of the regulation. METHODS: Dietary data were collected using a standardized 24-h dietary recall from the 2016 Mexican National Health and Nutrition Survey (n = 4184). To evaluate the hypothetical impact of FOPWL, the nutritional content of critical nutrients in processed products was evaluated according to the Mexican Official Standard 051 (NOM-051). Then, we replaced products with several warning labels (WL) with those with a fewer number of them or with non-processed food. For the replacement, 4 hypothetical scenarios were established: scenario 1: the current consumption of the Mexican Population, scenario 2: the replacement during the first phase of the norm, scenario 3: the replacement in the second phase and scenario 4: the replacement in the last phase. We estimated the means, confidence intervals (CI 95%), and the mean percentage change of energy, saturated fat, trans-fat, added sugars, and sodium intake during the second, third, and the fourth scenarios. RESULTS: According to the norm, in the second scenario, the majority of the products presented a label for energy (52.6%) whereas in the third (56.4%) and fourth (61.2%) scenarios were for sodium. In contrast, trans-fat was the least labeled nutrient in all the scenarios (from 2.1 to 4.1%). In the fourth scenario, we observed a reduction of the intake of energy intake to 15.4% as well as saturated fat (- 20%, CI 95% - 18.4; - 21.6), trans-fat (- 8.2%, CI 95% - 6.4; - 10.1) and sodium (- 12.7%, CI 95% - 11.3; - 14.1). The most important reduction was observed for added sugars intake (until - 54.1%, CI 95% - 51; - 57.1). CONCLUSIONS: FOPWL could be an effective strategy to decrease energy consumption and nutrients of concern. If consumers use the FOPWL, it would be an important change in critical nutrients intake. These results support that FOPWL might help the Mexican population to choose healthier nutrition alternatives.


Subject(s)
Energy Intake , Food Labeling , Humans , Mexico/epidemiology , Food Labeling/methods , Nutrients , Sugars , Sodium
20.
Front Public Health ; 11: 1255023, 2023.
Article in English | MEDLINE | ID: mdl-37927852

ABSTRACT

Introduction: Extant studies have demonstrated the relationship between naturalness and healthiness, and the effectiveness of various food labels in influencing consumers' perception of food and subsequent food choices. However, little attention has been given to food producer labels. Methods: Drawing on Stimulation-Organism-Response theory, the current study explored the causal relationship between food producer labels and consumers' food choices. Three studies (562 participants) were employed to test the main effect, the mediating effect, and the moderating effect. Results: The results showed that: (1) food producer label could influence consumers' food choice, that is, produced-by-farmer label (vs. produced-by-enterprise label vs. control group) could significantly increase consumers' food choices, while there is no significant difference between produced-by-enterprise label and control group. (2) Perceived naturalness and standardization perception mediate the effects on consumers' food choices of food producer labels. (3) Food processing level moderates the effect of food producer label on consumers' food choices. Discussion: The current study enriches the research of food label and food choice, expands the application of Stimulation-Organism-Response theory in consumer behavior, and provides some practical suggestions for consumers, enterprise and policy-maker. Various kinds of experiments (online and offline) enhanced the conclusions' ecological validity. Finally, the limitations and future research are discussed.


Subject(s)
Farmers , Food Preferences , Humans , Food Labeling/methods , Health Status
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