Investigation of the 1-week effect of traffic light nutrition labeling on diet selection among Japanese university students: a randomized controlled trial.

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.

Applying the theory of behavioral choice to plant-based dietary intentions.

Improving understanding of the intention to choose plant-based food is an important element of climate change mitigation. A cross-sectional survey of 454 North American adults was used to predict their dietary-change intentions from the theory of planned behavior (TPB) and the more-recently proposed theory of behavioral choice (TBC). The TPB accounted for 65 percent of the variance in intentions and the TBC accounted for a significantly greater (80 percent) proportion of variance. The strongest predictors of intention were the TBC's sense of obligation, attitude-values-affect (AVA), and habit, and the TBP's social norms. Five interactions also contributed in small but significant ways toward the accounting of the participants' food-choice intentions. Policy implications are discussed.

Nutrition facts labels: who is actually reading them and does it help in meeting intake recommendations for nutrients of public health concern?

BACKGROUND: Fiber, potassium and calcium are nutrients of public health concern and their intakes in the United States are alarmingly low. The usage of nutrition facts labels has been reported to increase the odds for dietary reference intake of fiber in some studies. The overall evidence, however, is mixed, as some studies suggested that nutrition facts panels have little to no effect on average measures of diet quality. Here, we investigated whether the usage of nutrition facts labels was associated with meeting U.S. intake recommendations for three nutrients of public health concern: fiber, potassium and calcium. METHODS: We used cross-sectional multistage, stratified, clustered and probability sampling design data from the U.S. National Health and Nutrition Examination Surveys 2017-2020 cycle. The sample included 5,416 individuals aged 20 years or older, which may be extrapolated to represent 146,841,866 US Americans. Nutrient intakes were compared among individuals reading nutrition facts panels "frequently", "sometimes" or "rarely" using applied survey data analyses techniques (including multivariate logistic regression and marginsplots). RESULTS: We observed substantial sociodemographic differences between the three groups. Frequent readers were significantly more likely to be female and had higher educational levels. On average, they were also significantly older as compared to rare readers. Fiber intake in g/d was highest in frequent readers (17.09) and lowest in rare readers (14.64). The proportion of participants that met dietary fiber intake recommendations was almost four times higher in the frequent readers group (12.69%) as compared to the rare readers group (3.69%). In a bivariate logistic regression model, frequent label reading significantly increased the odds for meeting the fiber recommendations in Dietary Guidelines for Americans (OR: 2.15, p < 0.001). Rarely reading labels decreased the odds (OR: 0.57, p = 0.003). These odds remained essentially unchanged after adjusting for sociodemographic covariates, diabetes status and body mass index (OR: 1.84, p = 0.004; and OR: 0.62, p = 0.022). CONCLUSIONS: Nutrition facts panel reading associates with fiber intake. Our findings have potential implications for public health nutrition strategies that may center around educational work.

The Influence of Front-of-Package Nutrition Labeling on Consumer Behavior and Product Reformulation.

Countries worldwide have implemented mandatory or voluntary front-of-package nutrition labeling systems. We provide a narrative review of (a) real-world evaluations of front-of-package nutrition labels that analyze objective sales data and (b) studies that objectively assess product reformulation in response to a front-of-package nutrition label implementation. We argue that there is sufficient scientific evidence to recommend that governments implement mandatory front-of-package nutrition labeling systems to improvepopulation health. We also present a conceptual framework to describe front-of-package label influence and provide recommendations for the optimal label design, emphasizing that labeling systems should be highly visible and salient, be simple and easy to understand, leverage automatic associations, and integrate informational and emotional messaging. The existing research suggests that Guideline Daily Amount labels should be avoided and that the Health Star Rating and Nutri-Score systems are promising but that systems with warning labels like the one in Chile are likely to produce the largest public health benefits.

Not only diet quality and physical activity but also snacking and skipping meals could be related with menstrual disorders in PCOS.

The aim of this study was to clarify the associations between menstrual cycle disorders, food frequency intake, dietary habits, and physical activity levels in women with and without Polycystic Ovary Syndrome (PCOS). 114 women with PCOS and 341 without PCOS (CONTROL) participated in the study. They were also divided into women with menstrual disorders(MD), and those with regular cycle (RC). Each of them completed a medical and Kompan questionnaires. In women with PCOS and menstrual disorders (PCOS-MD), intake of wholemeal products, meat and meat products, fats and alcoholic beverages was higher in comparison to those in the control group with menstrual disorders (CONTROL-MD). Women in the PCOS-MD group also reported significantly more frequent snacking between meals, higher Pro-Healthy Diet Index (pHDI-14), and a lower level of physical activity at leisure time than CONTROL-MD. Women with PCOS differed from those in CONTROL due to a higher consumption of meat and meat products, fats, fruits and vegetables, juices and alcoholic beverages, and a lower intake of whitemeal products, sweets, and fruits. Women with PCOS more frequently snacked, but the number of their meals was also lower. In women with PCOS, menstrual disorders may be related not only with diet quality and physical activity but also with snacking and skipping meals.

From TVs to tablets: the relation between device-specific screen time and health-related behaviors and characteristics.

BACKGROUND: The purpose of this study was to examine whether extended use of a variety of screen-based devices, in addition to television, was associated with poor dietary habits and other health-related characteristics and behaviors among US adults. The recent phenomenon of binge-watching was also explored. METHODS: A survey to assess screen time across multiple devices, dietary habits, sleep duration and quality, perceived stress, self-rated health, physical activity, and body mass index, was administered to a sample of US adults using the Qualtrics platform and distributed via Amazon Mechanical Turk (MTurk). Participants were adults 18 years of age and older, English speakers, current US residents, and owners of a television and at least one other device with a screen. Three different screen time categories (heavy, moderate, and light) were created for total screen time, and separately for screen time by type of screen, based on distribution tertiles. Kruskal-Wallis tests were conducted to examine differences in dietary habits and health-related characteristics between screen time categories. RESULTS: Aggregate screen time across all devices totaled 17.5 h per day for heavy users. Heavy users reported the least healthful dietary patterns and the poorest health-related characteristics - including self-rated health - compared to moderate and light users. Moreover, unique dietary habits emerged when examining dietary patterns by type of screen separately, such that heavy users of TV and smartphone displayed the least healthful dietary patterns compared to heavy users of TV-connected devices, laptop, and tablet. Binge-watching was also significantly associated with less healthy dietary patterns, including frequency of fast-food consumption as well as eating family meals in front of a television, and perceived stress. CONCLUSIONS: The present study found that poorer dietary choices, as well as other negative health-related impacts, occurred more often as the viewing time of a variety of different screen-based devices increased in a sample of US adults. Future research is needed to better understand what factors among different screen-based devices might affect health behaviors and in turn health-related outcomes. Research is also required to better understand how binge-watching behavior contributes impacts health-related behaviors and characteristics.

Participating in a Food-Assisted Maternal and Child Nutrition and Health Program in Rural Guatemala Alters Household Dietary Choices.

BACKGROUND: Food assistance programs may alter food choices, but factors determining households' decisions regarding food acquisition, preparation, and consumption in the context of food aid are not well understood. OBJECTIVE: This study aimed to understand how the Programa Comunitario Materno Infantil de Diversificación Alimentaria (Mother-Child Community Food Diversification Program; PROCOMIDA), a food-assisted maternal and child health and nutrition program in rural Alta Verapaz, Guatemala, altered household food choices. METHODS: We conducted semistructured interviews and focus groups with 63 households in 3 participating (n = 32 households) and 3 control (n = 31) villages. A last-day food recall (without estimating quantities) and food-frequency questionnaire that used food cards assessed dietary choices. Qualitative analysis used thematic a priori and emergent coding; food group consumption frequencies were analyzed by using 2-level, logistic, mixed modeling, and chi-square testing while accounting for community clustering. RESULTS: Compared with control households, PROCOMIDA changed household food choices through a combination of providing food resources (with monthly food rations) and new knowledge and skills related to health and food (in the program's behavior change communication component) while reinforcing existing knowledge and beliefs. PROCOMIDA families consumed rice, red beans, and oil more frequently than did control families (differences of 2.20 (P < 0.001), 2.68 (P < 0.001), and 1.64 (P = 0.038) times/wk, respectively); these foods were in the rations. PROCOMIDA families also ate chicken, local plants, and some vegetables more frequently. The importance of these foods was emphasized in the behavioral change communication component; these foods may have been more accessible because provision of food rations freed resources. CONCLUSION: Our findings suggest that if a program provides food free of cost to rural indigenous families in the context of a maternal and child nutrition and health program, it may be important to include a well-designed behavioral change communication component to improve household food choices.

The impact of school-based social media and online technology on oral health education for individuals with disability.

AIM: To evaluate the impact of school-based online communication methods on the oral health-related behavirs of individuals with disability. METHOD: A prospective interventional study was conducted on 154 students (age 3-22 years) with various disabilities attending educational centers. A clinical examination was carried out before and after a school-based online educational program. Online in-person sessions were held for the participants, and educational videos were shared with parents and teachers over social media. The clinical examination included the Special Olympics HAS form, (1) Oral Hygiene Index-Simplified (OHI-S) (2) and the Modified Frankl Behavior Index. (3) Dietary and oral hygiene habits were collected via parent-administered questionnaires. RESULTS: Improvements in behavior in a dental setting (p < .001), oral hygiene levels (p < .001) and dietary choices (p < .001) were observed throughout the study. CONCLUSION: Oral health education online modalities can be used effectively by dental professionals to educate individuals with disabilities and their carers regularly, thus helping improve oral health and rapport with dental professionals.

Determination of the relationship between body composition and nutritional habits and chronotype in healthy Turkish adults.

This cross-sectional study aims to determine the relationship between chronotype characteristics, dietary habits, and body composition in 110 adults, of which 75.5% are female, residing in Mersin, Türkiye. Data collection included a descriptive information form, the Morningness-Eveningness Scale for assessing chronotype, a detailed 24-hour dietary record for evaluating dietary intake, and Bioelectrical Impedance Analysis for accurate anthropometric measurements of body composition. The evening types had higher BMI, body weight, waist circumference, hip circumference, total fat mass, and lower body water ratio than the morning types. Positive correlations were found between sleep duration and body mass index, total fat mass, and fat percentage. The evening types tended to skip breakfast more frequently and had higher energy intake during dinners and snacks. Additionally, the evening types consumed more lipids, carbohydrates, sodium, and saturated and polyunsaturated fatty acids. These findings suggest that chronotype influences anthropometric measurements, nutritional habits, and meal energy distribution. These findings highlight the importance of considering chronotype characteristics to understand how body composition and dietary patterns interact, underscoring the need for customized interventions to promote healthier lifestyles.

Motivations Behind Lifestyle Changes.

Lifestyle modification has been demonstrated as a powerful tool in combating the morbidity and mortality of disease. Due to lack of training or education not enough physicians are discussing lifestyle changes with patients. The objective of this study was to determine what influenced participants to make lifestyle changes, and if it was a physician, what was said or done to motivate that decision. Inclusion criterion was participants were enrolled in a program dedicated to dietary modifications. One hundred participants were surveyed. Eighty-eight percent were over the age of 50; 78% were female; 92% were White; and 70% had a bachelor's degree or higher. Sixty-eight percent felt they had not been educated by their health care provider about nutrition; 41% of participants felt information provided was the most impactful statement; 60% of participants noted that their medical diagnosis had a moderate to significant impact on their decision to make a lifestyle change. This study emphasizes that dietary modifications are not being discussed enough to alter the health decisions of patients in the clinical setting. Furthermore, it is paramount physicians take into account patient motivations when discussing lifestyle changes, as well as the role that proper patient education plays in motivating patients to make a change.

The role of nutrition knowledge in dietary adjustments during COVID-19 pandemic.

Knowledge/awareness significantly influences people's dietary choices, lifestyle, and inadvertently their health outcomes; hence it is imperative that people have correct information with regards to food and health. This study was undertaken to establish the role of nutrition knowledge on dietary choices and habits of people in Calabar, especially after the hard COVID-19 lockdown, and to ascertain if there was any positive or negative effect on the lifestyle of the people. It consisted of a cross-sectional survey in Calabar, Cross River State - Nigeria. An online questionnaire was prepared after sample size determination and its content validated. The questionnaire was designed to obtain data on the socio-economic status, participants' lifestyle, and changes in dietary intake/health before and during the COVID-19 lockdown, while the questionnaire link was in circulation for 6 weeks (April/May 2021). Descriptive statistics was used to define the proportion of responses for each question and Pearson's correlation was used to check for association between variables. Most participants were undergraduates depending on parents/sponsors. Financial decline appeared to have contributed to a post lockdown decrease in food consumption. Many (82.6%) respondents recorded high nutrition knowledge scores (NKS) and 83.1% of the respondents had high health scores. The results show that NKS influenced the kind of foods the respondents consumed frequently and there was a positive correlation between NKS consumption of fruits/vegetables. NKS had effect on their access to healthy foods and it varied significantly with respondent's total health score. No association existed between NKS and the reason for skipping meal - 'lack of time to prepare meals'. Nutrition knowledge and proper awareness, contributed significantly in dietary choices (regardless of limited resources), thus ensuring adequate nutrition and reduced health problems (most respondents recorded high health scores) during a pandemic. This study affirms the effectiveness of adequate nutrition education and awareness in ensuring healthy dietary choices, promoting optimal health, and reducing risks of diseases.

Eating habits and nutrition status of Nigerian school children in rural and urban areas (NigeriaLINX pilot project).

Background: Healthy eating habits during childhood have been identified as a foundational support for the growth, development, and intellectual well-being of schoolchildren and as a protection against diseases that affect learning and functional capacity. This study examined the eating habits of the previous day, weekly, and daily between Nigerian children in rural and urban elementary schools. Methods: Data were collected between March and May 2021 with an instrument extracted from the Health and Attainment of Pupils in a Primary Education Network Survey (HAPPEN survey). Participants for the study were school children (aged 7-13 years). The multistage sampling technique was used to draw samples from the target population. Two schools were randomly selected for the study (one in the urban area of Lagos and the other in the rural area of Ekiti state). A total of 214 healthy children (urban school = 118; rural school = 96). The survey was conducted online and on-site during the school hours. The data were analysed using frequency count, percent, mean, standard deviation, and independent t-test at p < 0.05 level of significant. Results: The result of the t-test showed that there are significant differences in the weekly consumption of soft drinks (p = 0.02), fizzy drinks (p = 0.00), sugary snacks (p = 0.00) and the consumption of fish (p = 0.00) by the rural and urban schoolchildren. Conclusions and recommendations: Based on the results, it was concluded that most of the children were relatively well fed with moderately healthy dietary choices. Urban children are making healthy dietary choices and few unhealthy choices. However, rural schoolchildren are making healthy dietary choices relative to affordable options. The government to urgently bridge the nutritional gap between urban and rural schoolchildren through food market intervention and school nutrition campaign.

Food Front-of-Pack Labelling and the Nutri-Score Nutrition Label-Poland-Wide Cross-Sectional Expert Opinion Study.

Front-of-pack labelling (FOPL) systems, such as the Nutri-Score, play a crucial role in promoting healthy diets and raising consumer awareness. Our study aimed to gather the opinions of Polish experts on the Nutri-Score and its relation to an ideal information system. We conducted a Poland-wide expert opinion study using a cross-sectional design survey with 75 participants, who had an average of 18 ± 13 years of experience and were mainly employed at medical and agricultural universities. The data were collected with the CAWI method. The results showed that the most important features of an FOPL system were clarity, simplicity, consistency with healthy eating recommendations, and the ability to objectively compare products within the same group. While more than half of the respondents believed that the Nutri-Score provides an overall assessment of a product's nutritional value and facilitates quick purchasing decisions, it falls short in helping consumers compose a balanced diet and cannot be applied to all product groups. The experts also expressed concerns about the system's ability to account for a product's degree of processing, full nutritional value and carbon footprint. In conclusion, Poland's current labelling system needs expansion, but the Nutri-Score requires significant and detailed changes and validation against national guidelines and expert expectations before implementation.

Dietary and Lifestyle Recommendations that Align Patient and Planetary Health.

Environmental factors such as air pollution and climate change have far-reaching implications for human health, and increasing evidence supports a link between planetary health and many common urological conditions. We summarize these links and outline the data for some dietary and lifestyle changes that have joint benefits for both urological and planetary health. PATIENT SUMMARY: Steps to reduce our impact on the environment can also reduce the risk of urological cancers (bladder, prostate, and kidney cancers), urinary tract infections, kidney stones, and erectile dysfunction, and may have a positive impact on sperm quality. Simple steps such as reducing meat and dairy consumption, increasing exercise levels (e.g. through active commuting), and supporting the preservation of greenspace can benefit both personal health and the environment.

Why They Eat What They Eat: Comparing 18 Eating Motives Among Omnivores and Veg*ns.

While the diets of most people include meat, millions of individuals follow a meat-free diet. But why do people eat what they eat? Here we explored differences and commonalities in the eating motives of omnivores and veg*ns (i.e., both vegetarians and vegans). Specifically, we compared mean levels and rank order of 18 eating motives in two samples (Study 1: 294 omnivores, 321 veg*ns; Study 2: 112 omnivores, 622 veg*ns). We found that omnivores were more motivated than veg*ns by the eating motives of Traditional Eating and Habits, while veg*ns were more motivated by Animal Protection and Environmental Protection. Differences among groups in Health were inconsistent across studies. Despite these differences in mean levels, the rank order of the eating motives was very similar: Two of the top four eating motives of both diet groups in both studies were Liking and Health, while Social Norms, Social Image, and Religion were among the four least important motives of both groups. Overall, while we did find differences in the absolute importance of certain motives, we also found striking similarities in the relative importance of eating motives, suggesting that including a wide range of eating motives could be beneficial when examining dietary behaviors.

"Vegan Teachers Make Students Feel Really Bad": Is Teaching Sustainable Nutrition Indoctrinating?

The transformation toward more sustainable food choices may be supported by an education for sustainable nutrition. In schools, biology teachers play a key role in educating students as sustainability change makers, as biology lessons provide various opportunities to deal with ESD-topics such as sustainable nutrition. Teachers' classroom practices may be influenced by their personal choices regarding sustainable nutrition. Additionally, students may see their teachers as role models for sustainable behavior. This presents the risk of students adopting teachers' beliefs and behaviors without reflection. Teaching sustainable nutrition is therefore in potential conflict with indoctrinating young people toward sustainable diets. To date, no studies have addressed the perceived risk of indoctrination in the context of teaching sustainable nutrition in relation to teachers' personal beliefs, behaviors, and teaching practices. Therefore, this study explored whether biology teachers themselves perceive a risk of indoctrination when teaching sustainable nutrition, and what methods they use for teaching it in a non-indoctrinating way. For this purpose, we conducted semi-structured interviews with seven in-service biology teachers from high schools in Germany. Data for this explorative qualitative study were collected from July to October 2021 using convenience sampling. These were analyzed by qualitative coding and content analysis. The preliminary results of this study show that participants recognize a high risk of indoctrination when teaching sustainable nutrition, primarily due to their own teaching actions, such as deciding whether to reveal their own dietary choices to students. While some participants believed teachers must be restrained, others thought that open communication about personal choices could benefit student decision-making skills. In terms of avoiding indoctrination when teaching sustainable nutrition, participants advocated for student-centered and multi-perspective teaching approaches. Based on the findings, initial implications for further research and teacher training are discussed.

Food Skills Education and Low-Income Adults' Healthy Food Choices.

BACKGROUND: The Cooking Matters food skills education program equips low-income families with the skills and knowledge to shop for and cook healthy meals within budget and time constraints. AIMS: To explore whether participation in Cooking Matters is associated with healthier food choices using a 6-item scale, comprised of a variety of food categories. METHODS: Cooking Matters participants (n = 332) and a comparison group (n = 336) completed surveys at baseline, 3-, and 6-month follow-up. RESULTS: Cooking Matters participants experienced greater improvements in healthy choices overall (p < 0.0001) and for each of the six underlying items at 3 month follow-up. Improvements were sustained at 6-month follow-up overall and for all categories, except low-fat milk (p = 0.1168). DISCUSSION: Participation in Cooking Matters was associated with improvements in overall healthy food choices across a variety of food groups and maintained at 6-month follow-up. Enabling healthy food choices is an important step toward improved diet quality.

Sociodemographic Characteristics and Dietary Choices as Determinants of Climate Change Understanding and Concern in Saudi Arabia.

Climate change poses a global threat to public health. This study investigated the understanding of, and concern over, climate change in Saudi Arabia and examined the associations with sociodemographic characteristics and dietary choices. This cross-sectional study consisted of 280 participants recruited via an online survey. Of the study participants, 45% demonstrated a sufficient understanding of climate change, and 56% were highly concerned about climate change. Male sex, medium-high monthly income, high education, and governmental employees were determinants of sufficient understanding of and great concern over climate change. Participants who exhibited a high understanding of climate change score demonstrated significantly higher consumption of vegetables (3.47 ± 0.98) and vegetable oils (3.26 ± 1.07) than participants with a low understanding score (3.31 ± 0.96 and 3.00 ± 1.01, respectively) (p ≤ 0.01). Additionally, participants with higher concern of climate change scores exhibited lower consumption of red meat (p = 0.0001), poultry (p = 0.003), margarine (p = 0.02), and soy products (p = 0.04). The study revealed a poor understanding of, but great concern over, climate change. The intake of non-climate-friendly food was typically higher than that of climate-friendly food. These findings are critical for developing strategies to enhance awareness of climate change and encourage people to consume climate-friendly food to mitigate climate change and improve public health.

Dietary Choices of New Zealand Women during Pregnancy and Lactation.

Dietary recommendations during pregnancy and lactation have become increasingly complex, and sources of information more numerous but not always reliable, potentially causing confusion and unsafe choices. Women were recruited during pregnancy or within six months postpartum and completed questionnaires on dietary choices, food safety, and sources of nutrition information. Women (n = 458) from around New Zealand participated in the study. They consumed a wide range of foods and beverages and reported various dietary changes. In pregnancy, women commonly avoided alcohol (92%), raw milk products (86%), and raw, smoked, or pre-cooked seafood and fish (84%), and made changes due to food safety concerns. Influential advice was acquired from a range of sources including midwives (37%) and the New Zealand pregnancy and breastfeeding guidelines (25%) during pregnancy. Food avoidance was less common in lactation. However, fewer women consumed milk products during lactation (64%) than pregnancy (93%). Potentially unreliable sources were used more frequently in lactation including alternative health practitioners (26%) and family or friends (12%), and dietary changes were often made in response to infant symptoms without supporting evidence. This study highlighted a need for good communication of evidence-based recommendations to women, especially during lactation.

Getting a healthy start: The effectiveness of targeted benefits for improving dietary choices.

There is growing policy interest in encouraging better dietary choices. We study a nationally-implemented policy - the UK Healthy Start scheme - that introduced vouchers for fruit, vegetables and milk. We show that the policy has increased spending on fruit and vegetables and has been more effective than an equivalent-value cash benefit. We also show that the policy improved the nutrient composition of households' shopping baskets, with no offsetting changes in spending on other foodstuffs.