The Impact of the COVID-19 Pandemic on Public Interest in the Energy Labelling on Restaurant Menus.

No study has investigated the effect of the COVID-19 pandemic on the public's interest in using energy labelling on restaurant menus. This study explores the effects of the COVID-19 pandemic on the public interest in using energy labelling on restaurant menus and meal delivery applications and the impact of energy-labelling availability on food choices during the COVID-19 pandemic in Saudi Arabia. An online questionnaire was completed by 1657 participants aged ≥ 18 years. Before the COVID-19 pandemic, 32% of customers visited a restaurant 2-4 times/week. However, during the pandemic, 35% of customers visited a restaurant only once per week. There was no difference in interest in reading energy labelling or using meal delivery applications before and during the pandemic. During the COVID-19 pandemic, about 55% of restaurant customers reported that they had noticed energy labelling, with 42% of them being influenced by the energy-labelling information. Regarding energy information on food delivery applications, 40% of customers noticed energy labelling when using the applications, with 33% of them being affected by the energy labelling. Customer interest in reading about energy on restaurant menus during the pandemic did not change significantly from the level of interest before the pandemic. The interest expressed by the public in using the energy labelling was low both before and during the COVID-19 pandemic.

Regulating Obesity in Australia: Current Frameworks, Reflections upon the Impact of COVID-19 and Future Reform.

This article considers the legal and policy regulatory frameworks in Australia relevant to two of the key areas identified as central to managing and preventing obesity, namely, food labelling and junk food advertising. It does so against the backdrop of a global pandemic which resulted in a perfect storm: a global virus colliding with an obesity epidemic. The aetiology of the COVID-19 virus, and the isolation and shut down restrictions associated with combatting it, mean that introducing reforms in these key areas is, more than ever, a public health priority. This article provides important practical recommendations to modify legal and regulatory policy frameworks in the two key areas to address the obesity epidemic in Australia.

Why Don't You [Government] Help Us Make Healthier Foods More Affordable Instead of Bombarding Us with Labels? Maternal Knowledge, Perceptions, and Practices after Full Implementation of the Chilean Food Labelling Law.

Experimental and real-life evaluations show that the use of front-of-package warning labels (FoP) in unhealthy foods is well understood and can modify people's behaviors. However, it is unclear whether these effects remain in the long term because of the risk of message fatigue. The purpose of this study is to explore after four years of implementation of the Chilean Food Labelling law people's dietary behavior and FoP labels attention. Nine focus groups of mothers (7-10 people each) of children (2-14 yo) were conducted in Santiago, Chile, and macrocodes were developed, combining an iterative process of deductive and inductive thematic analyses. We found that mothers experienced labels' fatigue but also had greater knowledge about nutrition and appreciation for more natural foods. This greater knowledge about better nutrition interferes with the perception that healthier and less processed foods are financial and physically inaccessible. The key role of schools as an environment for promoting healthier diets in children was strengthened by the mothers. These results suggest that policies based on providing consumer information need reinforcement campaigns to maintain their effectiveness and that we also need to advance policies to improve access and affordability of healthy foods to ensure better diets.

"It's All Just Marketing", a Qualitative Analysis of Consumer Perceptions and Understandings of Nutrition Content and Health Claims in New Zealand.

Nutrition content and health claims are widely used globally on both food labels and in food advertising. This study explored how New Zealand consumers understand, perceive, and use nutrition content and health claims on food labels. A qualitative approach was used with semi-structured in-depth online interviews and in-person focus groups including 49 participants, aged ≥25 years responsible for household food shopping. Transcripts were analysed using reflexive thematic analysis using inductive coding, with development of five themes-(1) aware of claims but did not use, (2) mistrust and scepticism, (3) confusion and misinterpretation, (4) using claims to guide food choice, and (5) not all claims are equal. For theme 1, price and habit were found to be the most influential in driving food choice. Underlying theme 2 was the perception by most of nutrition and health claims as marketing. Scepticism was exacerbated when nutrient claims were displayed on inherently unhealthy products. However participants with specific dietary requirements did find claims helpful. Restricting nutrient claims to foods meeting a healthy nutrient profile aligned to the existing Health Star Rating system, education about regulation and supporting claims with more contextual information may increase trust, the perceived value of claims and therefore their utility.

Effects of Labelling and Increasing the Proportion of Lower-Energy Density Products on Online Food Shopping: A Randomised Control Trial in High- and Low-Socioeconomic Position Participants.

Reducing the energy density (ED) of product selections made during online supermarket food shopping has potential to decrease energy intake. Yet it is unclear which types of intervention are likely to be most effective and equitable. We recruited 899 UK adults of lower and higher socioeconomic position (SEP) who completed a shopping task in an online experimental supermarket. Participants were randomised in a 2 × 2 between-subjects design to test the effects of two interventions on the ED of shopping basket selections: labelling lower-ED products as healthier choices and increasing the relative availability of lower-ED products within a range (referred to as proportion). Labelling of lower-ED products resulted in a small but significant decrease (-4.2 kcal/100 g, 95% CIs -7.8 to -0.6) in the ED of the shopping basket. Increasing the proportion of lower-ED products significantly decreased the ED of the shopping basket (-17 kcal/100 g, 95% CIs -21 to -14). There was no evidence that the effect of either intervention was moderated by SEP. Thus, both types of intervention decreased the ED of foods selected in an online experimental supermarket. There was no evidence that the effectiveness of either intervention differed in people of lower vs. higher SEP.

Are food and drink available in online and physical supermarkets the same? A comparison of product availability, price, price promotions and nutritional information.

OBJECTIVE: Online supermarkets are increasingly used both by consumers and as a source of data on the food environment. We compared product availability, nutritional information, front-of-pack (FOP) labelling, price and price promotions for food and drink products between physical and online supermarkets. DESIGN: For physical stores, we collected data on price, price promotions, FOP nutrition labels and nutrition information from a random sample of food and drinks from six UK supermarkets. For online stores, we used foodDB, a research-ready dataset of over 14 million observations of food and drink products available in online supermarkets. SETTING: Six large supermarket stores located near Oxford, UK. PARTICIPANTS: General sample with 295 food and drink products, plus boost samples for both fruit and vegetables, and alcohol. RESULTS: In the general sample, 85 % (95 % CI 80, 90 %) of products found in physical stores could be matched with an online product. Nutritional information found in the two settings was almost identical, for example, concordance correlation coefficient for energy = 0·995 (95 % CI 0·993, 0·996). The presence of FOP labelling and price promotions differed between the two settings (Cohen's kappa = 0·56 (95 % CI 0·45, 0·66) and 0·40 (95 % CI 0·26, 0·55), respectively). Prices were similar between online and physical supermarkets (concordance correlation coefficient > 0·9 for all samples). CONCLUSIONS: Product availability, nutritional information and prices sourced online for these six retailers are good proxies of those found in physical stores. Price promotions and FOP labelling vary between the two settings. Further research should investigate whether this could impact on health inequalities.