Comparison of Sales From Vending Machines With 4 Different Food and Beverage Messages: A Randomized Trial.

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.

Mammalian and avian species quantification in homogenized foods: real time PCR and digital PCR as tools for label compliance controls.

Currently food fraud and authenticity of products composition are topics of great concern; ingredients quantification could allow to identify small amounts of contaminats or voluntary addition of improper components. Many molecular methods are available for species identification in foodstuffs but, for a better application, they should not be affected by the interference of other ingredients. The main purpose of this work was to verify the Real Time PCR and the Digital PCR (dPCR) quantification performances on baby food samples, specifically selected for their high miscibility to limit variability; chicken was selected as target to verify the performance of quantification of methods after having spiked the same quantity in different baby foods. The other aims were: (1) to verify a constant genome copies ratio existence between mammalian and avian species (2) to verify the dPCR performance, set up on housekeeping, to quantify mammalian and avian species in commercial products. Digital PCR showed fewer differences respect to Real Time PCR, at the same 15% w/w chicken spiking level. Despite the constant difference between mammalian and avian genome copies, in samples with the same spiking weight, the confidence intervals increasing towards the extreme values, made impossible to use genome copies ratio as a sort of correction factor between species. Finally, the dPCR system using the myostatin housekeeping gene to determine the chicken content seemed reliable to verify the labelling compliance in meat-based commercial products.

Factors associated with food label use: focus on healthy aspects of orthorexia and orthorexia nervosa.

PURPOSE: This study aimed to investigate the potential relationships between the use of different section of food label, and healthy and pathological aspects of orthorexia among adults. METHODS: This cross-sectional study was conducted using an online survey (n = 1326). Inclusion criteria were being 19-64 years and graduated from at least primary school. Pregnant and lactating women were excluded. Data were collected using questionnaire including socio-demographic variables, lifestyle factors, body weight and height, frequency of reading different sections of food label ("always", "when buying a food for the first time", "when comparing similar packaged foods", "rarely", "never"), food label literacy, and Teruel Orthorexia Scale. Participants were categorized as nutrition facts panel-users, ingredients list-users or claim-users if they read at least one item from the relevant parts. RESULTS: The proportions of nutrition facts, ingredients list, and claims sections users were 72.3%, 76.3%, and 79.9%, respectively. Both healthy and pathological aspects of orthorexia were associated with reading food labels. The healthy orthorexia had the strongest association with using the ingredients list (OR 1.76, 95% CI 1.41-2.20), whereas the orthorexia nervosa showed the highest association with using nutrition facts panel (OR 1.48, 95% CI 1.20-1.81). While women, physically active participants and those with higher food label literacy were more likely to use all sections of food labels; older age, having children, and chronic disease increased the likelihood of using claims and ingredients list (p < 0.05). Besides, following a diet was associated with higher use of nutrition facts and ingredients list (p < 0.05). CONCLUSIONS: The study demonstrates that food label users have higher orthorexia tendencies compared to non-users. Of the food label sections, healthy orthorexia showed the strongest association with use of the list of ingredients, while pathological orthorexia showed the strongest association with use of the nutrition facts panel. LEVEL OF EVIDENCE: Level V, cross-sectional study.

Fruitful changes? Exploring household fruit purchase decisions following comprehensive food policy regulations in Chile.

Changes in unprocessed healthy food purchases associated with the implementation of comprehensive food policy remain understudied. This study analyzes whether, following the announcement, modification, and implementation of Chile's Food Labeling and Advertising law targeting highly processed food (occurring in 2012, 2015, and 2016, respectively), households improved their fruit purchase decisions: purchase participation (i.e., buying likelihood) and purchase quantity. Expenditure data from a representative sample of Chilean households were employed, covering two consecutive survey waves conducted in 2011/2012 and 2016/2017. After controlling for socioeconomic factors (e.g., prices and income), results indicate that only purchase participation increased, providing weak support for positive spillover effects of a comprehensive food policy on fruit purchases. Subsample analyses reveal that this increase was driven by college-educated, childless, and low-income households and was stronger for sweeter and more convenient fruits. Considering that households in Chile do not meet health recommendations for daily fruit intake, additional policy efforts targeting healthy, unprocessed food consumption could be considered.

Nudging towards sustainable dining: Exploring menu nudges to promote vegetarian meal choices in restaurants.

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.

Benchmarking online food delivery applications against menu labelling laws: a cross-sectional observational analysis.

OBJECTIVE: It is unknown how well menu labelling schemes that enforce the display of kilojoule (kJ) labelling at point-of-sale have been implemented on online food delivery (OFD) services in Australia. This study aimed to examine the prevalence of kJ labelling on the online menus of large food outlets with more than twenty locations in the state or fifty locations nationally. A secondary aim was to evaluate the nutritional quality of menu items on OFD from mid-sized outlets that have fewer locations than what is specified in the current scheme. DESIGN: Cross-sectional analysis. Prevalence of kJ labelling by large food outlets on OFD from August to September 2022 was examined. Proportion of discretionary ('junk food') items on menus from mid-sized outlets was assessed. SETTING: Forty-three unique large food outlets on company (e.g. MyMacca's) and third party OFD (Uber Eats, Menulog, Deliveroo) within Sydney, Australia. Ninety-two mid-sized food outlets were analysed. PARTICIPANTS: N/A. RESULTS: On company OFD apps, 35 % (7/23) had complete kJ labelling for each menu item. In comparison, only 4·8 % (2/42), 5·3 % (2/38) and 3·6 % (1/28) of large outlets on Uber Eats, Menulog and Deliveroo had complete kJ labelling at all locations, respectively. Over three-quarters, 76·3 % (345/452) of menu items from mid-sized outlets were classified as discretionary. CONCLUSIONS: Kilojoule labelling was absent or incomplete on a high proportion of online menus. Mid-sized outlets have abundant discretionary choices and yet escape criteria for mandatory menu labelling laws. Our findings show the need to further monitor the implementation of nutrition policies on OFD.

Effects of red meat taxes and warning labels on food groups selected in a randomized controlled trial.

BACKGROUND: High consumption of red and processed meat contributes to both health and environmental harms. Warning labels and taxes for red meat reduce selection of red meat overall, but little is known about how these potential policies affect purchases of subcategories of red meat (e.g., processed versus unprocessed) or of non-red-meat foods (e.g., cheese, pulses) relevant to health and environmental outcomes. This study examined consumer responses to warning labels and taxes for red meat in a randomized controlled trial. METHODS: In October 2021, we recruited 3,518 US adults to complete a shopping task in a naturalistic online grocery store. Participants were randomly assigned to one of four arms: control (no warning labels or tax), warning labels only (health and environmental warning labels appeared next to products containing red meat), tax only (prices of products containing red meat were increased 30%) or combined warning labels + tax. Participants selected items to hypothetically purchase, which we categorized into food groups based on the presence of animal- and plant-source ingredients (e.g., beef, eggs, pulses), meat processing level (e.g., processed pork versus unprocessed pork), and meat species (e.g., beef versus pork). We assessed the effects of the warning labels and tax on selections from each food group. RESULTS: Compared to control, all three interventions led participants to select fewer items with processed meat (driven by reductions in processed pork) and (for the tax and warning labels + tax interventions only) fewer items with unprocessed meat (driven by reductions in unprocessed beef). All three interventions also led participants to select more items containing cheese, while only the combined warning labels + tax intervention led participants to select more items containing processed poultry. Except for an increase in selection of pulses in the tax arm, the interventions did not affect selections of fish or seafood (processed or unprocessed), eggs, or plant-based items (pulses, nuts & seeds, tofu, meat mimics, grains & potatoes, vegetables). CONCLUSIONS: Policies to reduce red meat consumption are also likely to affect consumption of other types of foods that are relevant to both health and environmental outcomes. TRIAL REGISTRATION: NCT04716010 on www. CLINICALTRIALS: gov .

A randomized controlled trial to test the effects of displaying the Nutri-Score in food advertising on consumer perceptions and intentions to purchase and consume.

BACKGROUND: Some research shows that advertising for high-fat, sugar, or salt (HFSS) products is contributing to a shift in consumer preferences toward products of poor nutritional quality, leading to unhealthy nutritional intakes that increase the risk of obesity and chronic diseases. A strategy of displaying simple and understandable nutritional information (like the front-of-pack nutrition label Nutri-Score) in food messages could be an aid to help guide consumers' choice towards healthier products. METHODS: A randomized controlled experiment was conducted on 27,085 participants randomly assigned to two experimental conditions or a control condition. In both experimental conditions (independent variable: advertising messages with vs. without the Nutri-Score), participants were exposed to advertisements for diversified food products with contrasting nutritional quality and belonging to nine different food categories. Participants were then asked questions about their perception, affective evaluation, and intentions to purchase and consume the products. In the control condition, they were not exposed to the advertisements. RESULTS: Overall, interaction effects between the two variables (1) the messages with vs. without the Nutri-Score and (2) the nutritional quality of products, were significant for all dependent variables, with effect sizes between large and medium. Overall, the better the products' nutritional quality, the more positive their perceptions, affective evaluations, and intentions to buy and consume them. When the Nutri-score was displayed in advertising messages (vs. when it was not), perceptions, affective evaluation, and behavioral intentions: (1) became more positive for products of good nutritional quality (Nutri-score A and B), (2) became more negative for products of poor nutritional quality (Nutri-score D and E), (3) changed little or not at all for products of intermediate nutritional quality (Nutri-Score C). CONCLUSIONS: This research is the first in the literature to demonstrate that displaying the Nutri-Score in advertising messages assists consumers in directing their choices towards healthier foods. Regulations mandating the display of the Nutri-Score in food advertising could be an effective public health measure.

Evaluating compliance with local and International Food Labelling Standards in urban Tanzania: a cross-sectional study of pre-packaged snacks in Dar Es Salaam.

BACKGROUND: Urbanization influences food culture, particularly in low- and middle-income countries where there is an increasing consumption of processed and pre-packaged foods. This shift is contributing to a rise in non-communicable diseases. Food labelling standards are crucial for regulating manufacturing practices and helping consumers make healthy food choices. We aimed to assess the compliance of local and imported pre-packaged snacks with Tanzanian and international labelling standards in Dar es Salaam, Tanzania. METHODOLOGY: A cross-sectional study was conducted on 180 snack products. A checklist based on Tanzanian and Codex labelling standards was used to evaluate adherence. We also examined factors influencing adherence, such as product origin, price, category, purchase location, and package size. RESULTS: The majority of the snacks demonstrated partial adherence to Tanzania (n = 97; 54%) and International (Codex) (n = 120; 67%) labelling standards. Imported products showed significantly better adherence to both Tanzanian (n = 46; 53%) and international (n = 42; 48%) standards. Notably, more than half (n = 110; 66.7%) of the products used English for labelling, and infrequently (n = 74; 41.4%) used the recommended World Health Organization Front-of-Pack Nutrition Labelling. Product category, origin, and package size were significantly associated with higher levels of international standard adherence (p < 0.05). CONCLUSION: The inadequate adherence to mandatory labelling standards and the scarce use of Swahili and FoPL highlight the need to strengthen labelling practices and potential challenges faced by consumers in understanding nutritional information. Thus, strengthening and emphasizing good labelling practices are urgently needed as we seek to address diet-related noncommunicable diseases.

A water-soluble label for food products prevents packaging waste and counterfeiting.

Sustainability, humidity sensing and product origin are important features of food packaging. While waste generated from labelling and packaging causes environmental destruction, humidity can result in food spoilage during delivery and counterfeit-prone labelling undermines consumer trust. Here we introduce a food label based on a water-soluble nanocomposite ink with a high refractive index that addresses these issues. By patterning the nanocomposite ink using nanoimprint lithography, the resultant metasurface shows bright and vivid structural colours. This method makes it possible to quickly and inexpensively create patterns on large surfaces. A QR code is also developed that can provide up-to-date information on food products. Microprinting hidden in the QR code protects against counterfeiting, cannot be physically detached or replicated and may be used as a humidity indicator. Our proposed food label can reduce waste while ensuring customers receive accurate product information.

Chilean Market Protein Shakes Composition.

Understanding the nutritional content of protein supplements is crucial for optimal nutritional planning among athletes and other people. Distribution of macronutrients and aminograms in the main products available in the national Chilean market remains unknown. A descriptive cross-sectional study was conducted to identify the main protein supplements available in the Chilean market. Information on macronutrients and aminograms from the nutritional labels of each product was extracted. The analysis considered the content per portion and per 100 g. Cluster analysis models and graphical representations were explored. Eighty protein shakes were assessed in the Santiago de Chile market. The median protein dosage was 32 g (range from 25 to 52), and the median energy value stood at 390 kcal (range from 312 to 514). The median protein content per 100 g of product was found to be 75 g (range from 42.5 to 97.2). The combined median concentration of amino acids was 4749.75 mg. Among these, the essential amino acid L-Tryptophan exhibited the lowest concentration at 1591.50 mg, while the conditional amino acid L-Glutamine had the highest median concentration at 17,336 mg. There was a significant prevalence of animal-derived products, placing specific emphasis on protein supplements that feature elevated levels of the amino acids L-Glutamine and L-Leucine.

Development of a Database of LanguaLTM and FoodEx2 Codes of 50 Ready-to-Eat Products.

Ready-to-eat (RTE) and ready-to-heat (RTH) dishes are food items that help save time, physical energy, and mental effort in all food-related activities. Convenience of use, variability of supply, and adaptability to different consumption occasions have led to an increase of acceptance among consumers through the years. Specialized databases can help in this context, where food composition databases can provide information and data to create sustainable nutritional models by reducing the now growing number of chronic diseases. This paper aims at developing a database of LanguaLTM and FoodEx2 codes of 50 food preparations and ready-to-eat dishes designed for consumption outside the home. LanguaLTM, as well as FoodEx2, are classification and description systems for indexing, in the sense of a systematic description, of foods based on a hierarchical model (parent-child relationship), thus facilitating the international exchange of data on food composition, consumption, assessing chronic and/or acute exposure to a certain agent, and not least the assessment of nutrient intake. The database, here presented, consists of the codes of fifty ready-to-eat products present on the market in Italy, obtained by using the two mostly commonly used and widely recognized coding systems: LanguaLTM and FoodEx2. This database represents a tool and a guideline for other compilers and users to apply coding systems to ready-to-eat products. Moreover, it can be represented a resource for several applications, such as nutritional cards, nutritional facts, food labels, or booklet and brochures for promotion of food products, to be used at health and food nutrition interface, useful for consumers, dieticians, and food producers.

[Comparison of DNA Extraction Methods for Processed Foods Containing Soybean or Maize].

Processed foods containing soybean or maize are subject to labeling regulations pertinent to genetically modified (GM) foods in Japan. To confirm the reliability of the labeling procedure of GM foods, the Japanese standard analytical methods (standard methods) using real-time PCR technique have been established. Although certain DNA extraction protocols are stipulated as standard in these methods, the use of other protocols confirmed to be equivalent to the existing ones was permitted. In this study, the equivalence testing of the techniques employed for DNA extraction from processed foods containing soybean or corn was conducted. In this study, the equivalence testing of the techniques employed for DNA extraction from processed foods containing soybean or maize was conducted. The silica membrane-based DNA extraction kits, GM quicker 4 and DNeasy Plant Maxi Kit (Maxi Kit), as an existing method were compared. GM quicker 4 was considered to be equivalent to or better than Maxi Kit.

[A Study on the Scientific Reliability of Notification Data in the Foods with Function Claims].

We conducted a comprehensive survey of Foods with Function Claims (FFC) submitted from April to August 2022 to examine the scientific reliability of the systematic review (SR), which is the basis for functional claims. The results of the review of 611 functional claims for 398 products showed that there were 121 functionally active substances and 87 health claims (Hc) that were labeled, with some functionally active substances having multiple functions. SRs, meta-analyses, and clinical studies were submitted as the basis of functionality for 87%, 10%, and 3% of the reports, respectively. Of these SRs, 39% of the SRs included a single paper. In 67% of the SRs with a single paper included, some of the authors of the included paper and the person who conducted the SR had the same affiliation, which raises concerns about conflicts of interest. The median of clinical trial participants in papers included for SR was relatively small, 38, and the smallest total number of SRs was 6. Thus, it was shown that there are many SRs for FFC that are based on only a single paper or a small-scale clinical trial and that lack reliability as scientific evidence.

Real-time monitoring of pork freshness using polyvinyl alcohol/modified agar multilayer gas-sensitive labels.

Accurate consumer perception of food packages should provide real-time feedback on any changes inside food packaging. Hence, a new multilayer gas-sensitive label (POA-12) was prepared using a layer-by-layer pouring method for simple, visual, and real-time detection of pork's freshness, while the front side was developed by immobilizing red carbon dots and fluorescein isothiocyanate in POA as indicator for volatile nitrogen, and the back side was created using bromothymol blue in POA as pH indicator. The swelling index of the multilayer gas-sensitive labels reduced from 159.19% to 148.36%, and the tensile strength increased from 25.52 MPa to 42.61 MPa. In addition, the POA-12 multilayer label showed a red-to-yellow fluorescence change as TVB-N increased from 6.84 to 31.4 and a yellow-brown-to-blue-green color change as pH increased from 5.74 to 7.24 when detecting pork samples. Thus, it provides dual-indicator monitoring that improves the accuracy and reliability of assessing the freshness of high-protein products.

Relación entre el conocimiento de los padres del etiquetado nutricional y el consumo de alimentos ultraprocesados con el estado nutricional de niños de 6 a 12 años / Relationship between parents' knowledge of nutritional labeling and the consumption of ultra-processed foods with the nutritional status of children aged 6 to 12 years

Fundamentos: La prevalencia del exceso de peso infantil ha ido incrementando cada año, lo cual está relacionado con diversos factores entre ellos se encuentra consumo de alimentos ultraprocesados. El objetivo fue determinar la relación existente entre el conocimiento de los padres acerca del etiquetado de información nutricional (etiquetado nutricional y al etiquetado frontal) y el consumo de alimentos ultraprocesados con el estado nutricional de escolares de 6 a 12 años. Métodos: Se realizó un estudio cuantitativo, observacional y transversal, en una muestra total de 255 padres y escolares. Se aplicaron dos cuestionarios para determinar el conocimiento del etiquetado nutricional de los padres y un cuestionario de frecuencia de consumo de alimentos ultraprocesados. Se hicieron mediciones antropométricas a los escolares. Resultados: Del total de los padres que participaron el 65,10% tenía un nivel de conocimiento bajo del etiquetado de información nutricional y el 80% un nivel de conocimiento deficiente del etiquetado frontal. Respecto a los escolares el 35,29% tuvieron un alto consumo de alimentos ultraprocesados, en el IMC se encontró que un 60,78% presentaban exceso de peso; acerca del perímetro abdominal (PAB) un 39,61% tenían un alto o muy alto riesgo cardio metabólico. Además, se encontró una relación significativa entre el conocimiento del etiquetado de información nutricional y el PAB (p<0,05), también se encontró una significancia estadística (p<0,01) entre el IMC y el PAB. Conclusiones: Existe relación significativa entre el conocimiento de etiquetado nutricional de los padres y el consumo de alimentos ultraprocesados sobre el estado nutricional de los escolares de 6 a 12 años. (AU)

Background: The prevalence of childhood excess weight has been increasing each year, which is related to various factors, including the consumption of ultra-processed foods. The objective was to determine the relationship between parents' knowledge about nutritional information labeling (nutritional labeling and front labeling) and the consumption of ultra-processed foods with the nutritional status of schoolchildren aged 6 to 12 years. Methods: A quantitative, observational and cross-sectional study was carried out in a total sample of 255 parents and schoolchildren. Two questionnaires were applied to determine parents' knowledge of nutritional labeling and a frequency of consumption of ultra-processed foods questionnaire. Anthropometric measurements were made to the schoolchildren. Results: Of the total number of parents who participated, 65.10% had a low level of knowledge of nutritional information labeling and 80% had a poor level of knowledge of front labeling. Regarding schoolchildren, 35.29% had a high consumption of ultra-processed foods, in the BMI it was found that 60.78% were overweight; Regarding PAB, 39.61% had a high or very high cardio-metabolic risk. In addition, a significant relationship was found between knowledge of nutritional information labeling and PAB (p<0.05), and a statistical significance (p<0.01) was also found between BMI and PAB. Conclusions: There is a significant relationship between parents' knowledge of nutritional labeling and the consumption of ultra-processed foods on the nutritional status of schoolchildren aged 6 to 12 years. (AU)