Prevalence and Factors Associated with Nutrition Label Use among Selected Filipino Adults

@#Objective. This study has been conducted to determine the prevalence of nutrition label use and the factors associated with it among adults in selected communities in Los Baños, Laguna. Methods. This is an analytical cross-sectional study, which conducted face-to-face interview using a developed questionnaire, among 440 adults in the top four barangays with highest population in Los Baños, Laguna using twostage sampling design. In the first stage, three puroks were randomly selected in each barangay, while households were selected using systematic sampling in the second stage. An eligible adult in each selected household was invited to participate in the study. Results. Study findings revealed that nutrition label use among adults in the selected communities was 87.73%. Factors found to be associated with nutrition label use were: 1) intention to use nutrition label (OR: 4.37; 95% CI: 1.77–10.82), 2) enough perceived time-spent on shopping (OR: 2.16; 95% CI: 1.17–4.01), and 3) searching for specific information (OR: 4.77; 95% CI: 2.55–8.93). Conclusion. These study findings can be used in promoting and increasing nutrition label use in the country and serve as basis for improvement of nutrition labeling policies. Moreover, this study can serve as a reference in the development and strategy-planning of interventions and programs especially in promoting healthy diets.

Prevalence and Factors Associated with Nutrition Label Use among Selected Filipino Adults

Objective@#This study has been conducted to determine the prevalence of nutrition label use and the factors associated with it among adults in selected communities in Los Baños, Laguna. @*Methods@#This is an analytical cross-sectional study, which conducted face-to-face interview using a developed questionnaire, among 440 adults in the top four barangays with highest population in Los Baños, Laguna using twostage sampling design. In the first stage, three puroks were randomly selected in each barangay, while households were selected using systematic sampling in the second stage. An eligible adult in each selected household was invited to participate in the study. @*Results@#Study findings revealed that nutrition label use among adults in the selected communities was 87.73%. Factors found to be associated with nutrition label use were: 1) intention to use nutrition label (OR: 4.37; 95% CI: 1.77–10.82), 2) enough perceived time-spent on shopping (OR: 2.16; 95% CI: 1.17–4.01), and 3) searching for specific information (OR: 4.77; 95% CI: 2.55–8.93).@*Conclusion@#These study findings can be used in promoting and increasing nutrition label use in the country and serve as basis for improvement of nutrition labeling policies. Moreover, this study can serve as a reference in the development and strategy-planning of interventions and programs especially in promoting healthy diets.

¿Cuál es el impacto de contar con un etiquetado frontal de alimentos?: síntesis rápida de evidencia / What is the impact of having front-of-package food labeling?: rapid evidence synthesis

ANTECDENTES Y OBJETIVO Considerando las tendencias de sobrepeso y obesidad a nivel nacional, el Ministerio de Salud ha impulsado acciones que permitan mejorar la salud de la población. Una de estas intervenciones es el cambio al etiquetado de los alimentos envasados. En este contexto, el Departamento de Nutrición y Alimentos solicita esta síntesis de evidencia con el objetivo de evaluar el impacto de los etiquetados frontales de alimentos en la población. METODOLOGÍA Se formuló una estrategia de búsqueda para ser utilizada en 5 bases de datos con el objetivo de identificar revisiones sistemáticas que abordaran la pregunta formulada. Se utiliza la metodología certeza de la evidencia GRADE. Se incluyeron etiquetados frontales de alimentos que reportaran elementos no saludables o un conjunto de elementos saludables y no saludables, excluyendo los artículos que consideraran etiquetas que únicamente mostraran elementos saludables. RESULTADOS Se utilizan 4 revisiones sistemáticas -El etiquetado de tipo porcentaje diario de ingesta (GDA) con semáforo no incidiría en el consumo de calorías ni en la elección de productos más saludables, al comparar con GDA sin colores. -En comparación a un producto sin etiquetado, los alimentos con etiquetado de semáforo múltiple probablemente inducen a elecciones más saludables, mientras que no generarían cambios en el consumo de calorías, la intención de compra y la comprensión de la información nutricional. -Al elegir entre 2 alimentos, los productos con etiquetado de semáforo múltiple probablemente son más elegidos, en comparación a los productos con etiquetado de GDA, no existe diferencias en el consumo de calorías. -El etiquetado de tipo GDA con semáforo probablemente genere una mayor proporción de elecciones saludables, en comparación a los productos sin etiquetado, mientras que el consumo de calorías no se vería afectado. -El etiquetado con semáforo único serían elegidos en una mayor proporción que los alimentos con etiquetado de tipo GDA. -El uso de un etiquetado de alimentos de tipo semáforo múltiple y de semáforo único podrían aumentar la proporción de elecciones saludables, en comparación al etiquetado de tipo panel de información. -El formato de etiquetado de tipo semáforo único ayuda a los consumidores a identificar el producto más saludable.

A Study on Vitamin C Content of Nutrition Emphasized Products / 대한지역사회영양학회지

OBJECTIVES: Vitamin C has various functions such as antioxidative effect and supporting absorption of iron (Fe). Aim of this present study was to provide vitamin C nutrition information and to briefly evaluate absorption interaction of vitamin C and Fe content of vitamin C emphasized products. METHODS: Vitamin C emphasized foods including beverages, cereal, snacks, chocolate products, other cocoa products, and sugary products were examined by HPLC. Fe contents in samples after dry-ashing were examined by ICP. RESULTS: Vitamin C content ranges in various products tested were the following: beverages (n=11) 20.15 ± 0.08~845.41 ± 6.07 mg, cereal (n=11) 52.50 ± 0.23~262.50 ± 0.07 mg, snacks (n=1) 50.00 ± 0.25 mg, chocolate products (n=1) 311.73 ± 2.44 mg, other cocoa products (n=1) 311.73 ± 2.44 mg, other sugary products (n=2) 52.50 ± 0.23~262.50 ± 0.07 mg. Vitamin C (n=27) analysis values ranged from 82 to 450% of the labeled value. Vitamin C content in vitamin C emphasized food (n=6) was estimated 7.7 times~56.6 times more than Fe content. CONCLUSIONS: Analyzed samples ranged more than 80% of the labeled value in vitamin C emphasized products, which complied with food labeling regulation. But, beverages (n=3), cereal (n=4), chocolate products (n=1) were 2 times more than the labeled value. To provide accurate nutrition information, food manufactures should supervise nutrition labeling and understand the interactions between nutrients. Also, consumer should decide about the adequate amount of nutrient intake by thoroughly checking nutrition labeling.

Análise do teor de sódio em rótulos de mortadelas comercializadas no Brasil / Sodium contents in labelson the mortadellas sold in Brazil

Os objetivos do trabalho foram avaliar o teor de sódio informado no rótulo de mortadelas disponíveis comercialmente no Brasil, comparar com a atual recomendação de consumo e estimar a contribuição da ingestão diária de sódio. Os rótulos nutricionais de 130 amostras de mortadelas (tradicional;com e sem toucinho; tubular; bologna; tipo bologna; bologna light; de ave; defumada; italiana e especial), foram avaliados quanto ao teor de sódio. Não foi observada diferença (p > 0,05) no teor de sódio entre os diferentes tipos de mortadelas. Entretanto, houve grande variação nos conteúdos de sódio entre as marcas para o mesmo produto. As amostras de mortadela com toucinho e italiana apresentaram, respectivamente, os maiores e menores valores de contribuição da ingestão diária, considerando-se um consumo de 50 e 100 g/dia. Das mortadelas de ave, 8,7 % foram classificadas na categoria de teor moderado de sódio (121 a 600 mg/100 g), enquanto 100 % das demais variedades apresentaram alto teor (> 601 mg/100 g). A maioria das mortadelas comercializadas no Brasil apresenta alto teor de sódio, bem como grande variabilidade de valores entre as marcas do produto, o que contribui para uma elevada ingestão diária de sódio.

This study aimed at evaluating the sodium contents reported in labels on mortadellas commercially available in Brazil, also to compare with the current recommendation of its consumption, and toestimate the contribution of daily sodium intake. The sodium contents were evaluated in the nutrition labels on 130 samples of mortadella (traditional; with and without bacon; tubular; bologna, bologna type, bologna light; poultry; smoked; Italian and special varieties). No difference (p > 0.05) wasdetected in the sodium contents among the varied types of mortadellas. However, a wide variationin the sodium contents among the trade-marks of the same product wasfound. The mortadellawith bacon and the Italian type samples showed the highest and the lowest values for salt dailyintake contribution, respectively, considering a consumption of 50 to 100 g/day. Among the poultry mortadellas, 8.7 % were classified as moderate sodium contents (121 to 600 mg/100 g), while 100 % of the other varieties samples showed high sodium contents (> 601 mg/100 g). The majority of mortadellas sold in Brazil present high sodium contents and a wide variety of sodium quantities among the product trade-marks was detected, which contributes to the high sodium daily intake.

Factors associated with nutrition label use among female college students applying the theory of planned behavior

BACKGROUND/OBJECTIVES: Use of nutrition labels in food selection is recommended for consumers. The aim of this study is to examine factors, mainly beliefs explaining nutrition label use in female college students based on the Theory of Planned Behavior (TPB). SUBJECTS/METHODS: The subjects were female college students from a university in Seoul, Korea. The survey questionnaire was composed of items examining general characteristics, nutrition label use, behavioral beliefs, normative beliefs, corresponding motivation to comply, and control beliefs. The subjects (n = 300) responded to the questionnaire by self-report, and data from 275 students were analyzed using t-test or chi2-test. RESULTS: The results showed that 37.8% of subjects were nutrition label users. Three out of 15 behavioral beliefs differed significantly by nutrition label use. Nutrition label users agreed more strongly on the benefits of using nutrition labels including 'comparing and selecting better foods' (P < 0.001), 'selecting healthy foods' (P < 0.05). The negative belief of 'annoying' was stronger in non-users than in users (P < 0.001). Three out of 7 sources (parents, siblings, best friend) were important in nutrition label use. Twelve out of 15 control beliefs differed significantly by nutrition label use. These included beliefs regarding constraints of using nutrition labels (e.g., time, spending money for healthy foods) and lack of nutrition knowledge (P < 0.001). Perceived confidence in understanding and applying the specifics of nutrition labels in food selection was also significantly related to nutrition label use (P < 0.001). CONCLUSIONS: This study found that the beliefs, especially control beliefs, suggested in the TPB were important in explaining nutrition label use. To promote nutrition label use, nutrition education might focus on increasing perceived control over constraints of using nutrition labels, acquiring skills for checking nutrition labels, as well as the benefits of using nutrition labels and receiving support from significant others for nutrition label use.

Evaluation of nutrient and food intake status, and dietary quality in Korean adults according to nutrition label utilization: Based on 2010-2011 Korean National Health and Nutrition Examination Survey / 한국영양학회지

PURPOSE: This study was conducted in order to investigate nutrient and food intake status and dietary quality in Korean adults according to nutrition label utilization. METHODS: We analyzed data from the combined 2010-2011 KNHANES (Korean National Health and Nutrition Examination Survey). The analysis included 8190 adults aged 19 to 64 years. In this study, according to nutrition label utilization, we classified the subjects according to the "non-utilization of nutrition label (NUNL)" group (male, n = 2716, female, n = 3147), "identification of nutrition label (INL)" group (male, n = 143, female, n = 330), and "Utilization of nutrition label (UNL)" group (male, n = 363, female, n = 1491). Nutrient and food group intake, NAR (nutrient ad-equacy ratio), MAR (mean adequacy ratio), and INQ (index of nutritional quality) were analyzed using data from the 24-recall method. RESULTS: Results of this study showed that subjects in the NUNL group were significantly more likely to drink alcohol compared with the other two groups. The NUNL group showed a significantly higher frequency of consuming in-stant noodles, Soju (male), and carbonated drink (female) than the UNL group, whereas the NUNL group showed a sig-nificantly lower frequency of consuming milk, soymilk, and yogurt than the UNL group. In addition, regarding diet quality (NAR and INQ), significantly lower vitamin B2, vitamin C, and calcium was observed in the NUNL group compared with the UNL group. For both male and female, significantly higher MAR was observed in the UNL group than in the NUNL group. The NUNL group showed significantly lower consumption of milk compared to the UNL group. CONCLUSION: Good dietary practice such as referring to nutrition labels and its influence can affect the quality of nutritional intake and selection of food, while it can also provide basic data for specific nutrition education regarding use of nutrition labeling.

Assessment of Nutrition Label Education in Sixth Grade Elementary School Students

This study was conducted to assess the effects of nutrition label education in children. The students of three randomly selected sixth-grade classes at an elementary school participated, were classified into a control group, an indirect (written message to parents) education group, and a direct (teaching children) education group. Nutrition label education was conducted in the latter two groups but not in the control group. There were no significant differences between pretest and posttest scores for nutrition knowledge or in the dietary attitudes of the control group and indirect education group. Improvements in test scores for nutrition knowledge and dietary attitudes were observed only in the direct education group. There were significant positive changes in the indirect and direct education groups, such as selecting snacks (cookies) by considering the fat content. Moreover, after the lessons, the percentage of children who chose white milk (regular milk, calcium-enriched milk, and low-fat milk) significantly increased in the direct education group. This study suggests that conducting nutrition label education helps children improve their nutrition knowledge and leads to positive changes in dietary attitudes and eating behaviors. In particular, a direct nutrition education method is more effective than an indirect method such as a written message to parents. Therefore, it is suggested that systematic and constant 'nutrition label education' be performed by nutrition teachers in elementary schools to establish healthy eating habits based on choosing nutritious snacks and processed foods.

Reading and Understanding of Food & Nutrition Labels and Dietary Behaviors of Female Middle and High School Students

This study investigated the use and understanding of food and nutrition labels in 498 female adolescents (middle school students: MS 248, high school students: HS 250) in Gyeonggi-do. Fifty percent of the MS and 47.2% of the HS read food labels, and the most common reasons for reading labels were to find a product's expiration date and price. The food label information considered most important by the subjects was the name of the manufacturing company and expiration date. Over 80% of the subjects read nutrition labels. The MS read nutrition labels to find nutrients and their amounts in foods, while the HS read labels mostly in an effort to control body weight. These subjects gave more attention to calories and fat, the nutrients related to body weight, than to other nutrients. The subjects were highly aware of the necessity and positive effects of nutrition labels, because they believed labels could make it easier for them to choose healthy foods. However, scores for understanding nutrition labels showed the subjects failed to understand label information accurately. Generally, the MS showed better dietary behaviors than HS. But the HS had significantly higher scores than MS for the item "know relative weight with height." Those that read food labels had significantly better BMIs, dietary behaviors, and awareness and understanding of nutrition labels. There were significant positive relationships among awareness & understanding of nutrition labels and subjects' dietary behaviors. The study findings can be utilized to better plan nutrition education programs aiming to improve use and awareness of food and nutrition labels among adolescents.

Nutrition Label Use, Self-Efficacy, Snacking and Eating Behavior of Middle School Students in Kyunggi Area / 대한지역사회영양학회지

This study was designed to examine nutrition label use, self-efficacy, snacking and eating behaviors of middle school students, and to investigate if these characteristics were different by nutrition label use. A cross-sectional survey was conducted to 348 middle school students in Kyunggi, Korea. About a third of subjects read nutrition labels when they purchased snacks/packaged foods. Most nutrition label users were interested in reading information on calories, fat and trans-fat. Self-efficacy of eating/selecting snacks or general nutrition behavior was moderate (mean score: 44.4 out of 60), with significantly higher score in nutrition label users compared to nonusers (p < 0.001). Nutrition label users felt more confident in 9 items out of 15 items of self-efficacy, such as "taking fruits instead of cookies/candy for snack" (p < 0.001), "choosing milk instead of soft drink" (p < 0.01), "not having snacks after dinner" and "avoiding processed foods for snacks" (p < 0.05). Subjects had snacks 1.3 times a day, and nutrition label nonusers consumed snacks more frequently than the counterparts (p < 0.01). About 55% of nutrition label users and 64.7% of nonusers mainly purchased snacks for themselves (p < 0.05). Commonly purchased snacks by adolescents were ice cream, cookies/chips, breads and ramen. Major considerations in purchasing snacks were taste (46.9%) and price (34.6%). In selecting snacks, the influence of friends and parents was greater than the other sources. Based on eating frequency of snacks, nutrition label users were more likely to consume healthy snacks, such as fruit juices, vegetables, milk, yogurt, and potato/sweet potato than nonusers (p < 0.05). Eating behaviors measured by 15 items scored 33.6 out of 45. Nutrition label users showed better eating behaviors, such as "eating meals slowly", "eating foods cooked with plant oil", and "eating out less frequently" (p < 0.05). Study results showed that majority of adolescents did not read nutrition labels, selected snacks for themselves and had somewhat unhealthy foods for snacks. This study also showed the differences in self-efficacy, snacking and eating behaviors between nutrition label users and nonusers. In nutrition education, it is necessary to stress the importance and skills for reading nutrition labels. It is also needed to help adolescents to select healthy snacks and have desirable eating behaviors, as well as increasing self-efficacy.

Intake of Processed Foods and the Effects of Nutrition Label Education in 5th Grade Children

The effects of nutrition label education on the perception, nutrition knowledge, understanding and applicability of labeling for 81 5th grade students was assessed. Prior to the education, the students' purchasing behavior of processed food was assessed by self-administered questionnaires. The evaluation of subjects' perception and understanding on nutrition label was completed prior to and following four education sessions utilizing materials developed by Korea Food and Drug Administration and Korea Health Industry Development Institute. More than 90% and 15% of subjects purchased processed food weekly and daily, respectively. Considering the nutrition label became an important factor in food purchases following the education sessions. Perception of the value of nutrition label improved from 2.93 to 3.32, although the belief that nutrition labels contributed to the maintenance of good food intake was not significantly increased. The total nutrition knowledge score increased from 5.47 to 7.14 and understanding nutrients composition table was significantly improved (3.17 to 4.80). The results indicate that a school-based nutrition label education program might be an effective aid for adoption of healthier food choices by children.

Dietary Behavioral Correlates of Nutrition Label Use in Korean Women

This study describes the demographic and diet-related psychosocial correlates of nutrition label use, and examines the relationship between label use and diet. Self-reported dada from a population-based cross-sectional survey of 2073 Korean women aged 20 to 60 years were collected to identify demographic and health-related characteristics, belief on diet-disease relationship, awareness on importance of healthy eating practice and diet quality associated with label use. Label users, who are in the stage of action and maintenance (31.6%), were more likely to have belief on nutrient-disease relationship (in sodium, cholesterol, sugar and trans fat) and were more likely to have higher awareness of the importance of healthy eating practice compared with label nonusers, who are in the stage of precontemplation, contemplation and preparation. Label users were more likely to have higher dietary quality compared with label nonusers [odds ratio (OR) = 2.01; 95% confidence interval (CI): 1.66, 2.44](P < 0.001). Also, label use appeared to be associated with the consumption of diets that were higher vegetables and fruits, and lower in cholesterol. The findings of this study suggests that reading nutrition labels on food packages may improve food choices and enable healthful dietary practices.

A Study on the Guideline Amounts of Sugar, Sodium and Fats in Processed Foods Met to Children's Taste

Currently, Korea is facing dramatic nutrition transition among children, which may increase risk of degenerative diseases due to excessive intakes of fats, sugars and sodium. Promotion of eating healthier foods among children is difficult because the present nutrition label is not easily understood. Therefore, to promote healthier foods this study was aimed at developing guidance of standard amounts of high, medium and low levels of sugars, sodium, fats and other components contained in foods or drinks that are promoted to or formulated for consumption by children. Multipronged approach was used to collecting information, including key word searches in Medline and other databases, internet searches, reports from world organization, and contact of key individuals who work in organizations. We reviewed dietary reference intakes for Koreans, nutrient reference values, nutrient content claims of nutrition labeling, guideline daily amounts of United Kingdom, dietary guidelines and consumption data of nutrients, and selected components for labeling. And we decided goals of guideline daily amounts for children and nutrient criteria to underpin the high, medium and low content of each component. Then we collected data on processed foods sold at 12 middle schools and 11 high schools in Seoul, and classified processed foods into food category. Sales per one student per day were in the order of snacks, breads, and non-carbonated drinks. One hundred forty five mostly consumed products were selected and classified into criteria of high, medium and low total fat or sodium. Eighty five (58.6%) were classified into high fat food and only 11 (7.6%) into high sodium food, in case that the base is chosen per 100 g or 100 mL. In conclusion, the nutrient criteria and choice of 100 g base, which we suggest in this study, need to be tested by simulation with more processed foods and refined in view of the practical issues suggested by stakeholders in future.

The Evaluation of Nutrients and Health Functional Elements Presented at Nutrition Labels of Various Beverages in the Market

On the basis of the increasing interest for the selection of beverages, this study aimed to evaluate the contents of nutrients and health functional elements in the beverages. Total 161 beverages that bear nutrition lable (NL) as nutrition table and health functional elements information were collected and classified to 8 groups. The evaluated nutrients that are obligatory for NL in Korea were total calorie, carbohydrate, protein, fat, and sodium. Presented values showed that milk & yogurt and soy milk are the most wholesome beverages while the total caloric contents also were higher among 8 groups. Sodium contents in soy milk were higher than any other groups. The caloric contents of other beverage groups come mainly from carbohydrate presumably simple sugar. The caloric content of sports drinks is the lowest but the sodium content is variable among products showing the range of 0 - 100 mg/100 ml. Nonobligatory nutrients for NL frequently expressed are Ca, Fe, vitamin C, folate, and dietary fiber. Their content per serving size does not exceed the tolerable upper intake level, however, habitual multiple intakes of certain product require attention for the prevention of overintakes. Many health functional elements as catechin, carnitine, polyphenol, and nucleic acids etc were listed in NL without presenting the content and their functions appear to be exaggerated compared to the known scientific evidence.

The Amount of Sodium in the Processed Foods, the Use of Sodium Information on the Nutrition Label and the Acceptance of Sodium Reduced Ramen in the Female College Students

The amount of sodium in the processed foods was evaluated by the information on the nutrition label. One-meal type foods as Ramen, Woodong, Naengmyon provide the most sodium reaching 30 - 70% DV per serving size. In Ramen not much difference was observed for the sodium content by food companies though each company provides various amount of sodium reducing as much as 25% DV. The proportion of female college students who read the nutrition information reached 62% but it remained 32% on the sodium information. They purchase low sodium foods rarely however their intention to buy low sodium foods increased up to 40% in condition that sodium information is given on the food label. Neverthless 50% of them would not buy low sodium food if the taste is undesirable. Low sodium ramen cooked with 80% soup-base was acceptable by the subjects. Majority of them responded the soup was rather salty indicating the reduction of sodium in ramyeon is possible.