Association between nutrition self-efficacy, health locus of control and food choice motives in consumers in nine European countries.

We investigated associations between food choice motives and psychological determinants of dietary health behaviour change (nutrition self-efficacy, NS-E, and health locus of control, HLoC) among 9381 participants (18-65 years, 49.4% females) from nine European countries. Price was the highest rated food choice motive. Higher importance of all motives was associated with higher NS-E and with higher Internal HLoC. Relationships between food choice motives and External HLoC were also in the expected direction in showing negative associations with Health, Natural Content, Weight Control, Mood and Sensory Appeal. Higher External HLoC was also associated with perceived greater importance of 'external' motives Ethical Concern, Familiarity and Convenience. Relationships between External HLoC and food choice motives were not all in the expected direction. Price was unrelated to External HLoC. Females rated the importance of all motives higher than males. People with less education ascribed greater importance to Price in motivating food choices. Together, these findings imply that self-efficacy and health locus of control should be considered along with motivations for food choice in dietary health promotion.

A Survey of Breastfeeding Attitudes and Health Locus of Control in the Nigerian Population.

OBJECTIVES: Breastfeeding is important to infant health and survival in sub-Saharan Africa. To promote breastfeeding effectively, understanding of psychological factors associated with infant feeding choices is required. This study investigated breastfeeding attitudes and health locus of control (HLoC) in a Nigerian community sample. METHODS: Men and women (N = 400) (71% female; mean age 34.2 years/ range 18-86 years) were recruited through community groups in Nigeria. Self-report survey by questionnaire measured breastfeeding attitudes using the Iowa Infant Feeding Attitude Scale (IIFAS) and health locus of control using the Multidimensional Health Locus of Control Scale (MHLoCs). RESULTS MEAN: IIFAS scores (mean = 57.7; sd = 7.8) became less favourable with increasing age (p = 0.02). Men had higher IIFAS scores (mean = 58.6; sd = 7.6) than women (mean = 56.6; sd = 8.0) indicating more favourable attitudes toward breastfeeding (p = 0.02). Women scored higher than men on external chance HLoC (ECHLoC) (p = 0.003) and external powerful others HLoC (EPHLoC) (p = 0.02). Increasing age was associated with higher scores on ECHLoC (p < 0.01) and EPHLoC (p < 0.01). Multiple linear regression analysis was significant (p < 0.001) and explained 7.8% of variance in breastfeeding attitude. Lower IIFAS scores, reflecting more negative attitudes to breastfeeding, were associated with higher ECHLoC (p < 0.01) and EPOHLoC (p < 0.05). Higher IIFAS scores, reflecting more positive attitudes to breastfeeding, were associated with greater IHLoC (p < 0.01). Neither age nor gender were associated with IIFAS scores in the final model. CONCLUSIONS: This implies a need to explore health locus of control when promoting positive attitudes to breastfeeding and supporting families in breastfeeding advocacy.

SIGNIFICANCE: What is already known? Infant feeding decisions are made in a social context and influenced by significant others. Yet, most studies of breastfeeding attitudes have exclusively considered women of childbearing age and mostly in Western cultures. What this study adds? This study meets a need to understand societal attitudes to breastfeeding in diverse cultures. The research also tests the theory that health-related locus of control (H-RLoC) will be related to breastfeeding attitudes. Knowledge of societal attitudes toward breastfeeding and of HRLoC will help to inform effective breastfeeding promotions that are tailored to the specific needs of Nigerian people.

Sex and age differences in attitudes and intention to adopt personalised nutrition in a UK sample.

AIM: There has been an increase in the development of technologies that can deliver personalised dietary advice. Devising healthy, sustainable dietary plans will mean taking into consideration extrinsic factors such as individual social circumstances. The aim of this study was to identify societal groups more or less receptive to and likely to engage with personalised nutrition initiatives. SAMPLE AND METHODS: Volunteers were recruited via a social research agency from within the UK. The resultant sample (N = 1061) was 49% female, aged 18-65 years. RESULTS: MANOVA (Tukey HSD applied) indicated that females and younger people (aged 18-29 years) had more favourable attitudes and were more likely to intend to adopt personalised nutrition. There were no differences in attitude toward or intention to adopt personalised nutrition between different education levels, income brackets or occupational groups. CONCLUSION: These results imply that females and younger people may be most likely to adopt personalised nutrition in the future. Initiatives to promote healthy eating should target males and older people.

Food choice motives, attitude towards and intention to adopt personalised nutrition.

OBJECTIVE: The present study explored associations between food choice motives, attitudes towards and intention to adopt personalised nutrition, to inform communication strategies based on consumer priorities and concerns.Design/SettingA survey was administered online which included the Food Choice Questionnaire (FCQ) and items assessing attitudes towards and intention to adopt personalised nutrition. SUBJECTS: Nationally representative samples were recruited in nine EU countries (n 9381). RESULTS: Structural equation modelling indicated that the food choice motives 'weight control', 'mood', 'health' and 'ethical concern' had a positive association and 'price' had a negative association with attitude towards, and intention to adopt, personalised nutrition. 'Health' was positively associated and 'familiarity' negatively associated with attitude towards personalised nutrition. The effects of 'weight control', 'ethical concern', 'mood' and 'price' on intention to adopt personalised nutrition were partially mediated by attitude. The effects of 'health' and 'familiarity' were fully mediated by attitude. 'Sensory appeal' was negatively and directly associated with intention to adopt personalised nutrition. CONCLUSIONS: Personalised nutrition providers may benefit from taking into consideration the importance of underlying determinants of food choice in potential users, particularly weight control, mood and price, when promoting services and in tailoring communications that are motivationally relevant.

Application of Behavior Change Techniques in a Personalized Nutrition Electronic Health Intervention Study: Protocol for the Web-Based Food4Me Randomized Controlled Trial.

BACKGROUND: To determine the efficacy of behavior change techniques applied in dietary and physical activity intervention studies, it is first necessary to record and describe techniques that have been used during such interventions. Published frameworks used in dietary and smoking cessation interventions undergo continuous development, and most are not adapted for Web-based delivery. The Food4Me study (N=1607) provided the opportunity to use existing frameworks to describe standardized Web-based techniques employed in a large-scale, internet-based intervention to change dietary behavior and physical activity. OBJECTIVE: The aims of this study were (1) to describe techniques embedded in the Food4Me study design and explain the selection rationale and (2) to demonstrate the use of behavior change technique taxonomies, develop standard operating procedures for training, and identify strengths and limitations of the Food4Me framework that will inform its use in future studies. METHODS: The 6-month randomized controlled trial took place simultaneously in seven European countries, with participants receiving one of four levels of personalized advice (generalized, intake-based, intake+phenotype-based, and intake+phenotype+gene-based). A three-phase approach was taken: (1) existing taxonomies were reviewed and techniques were identified a priori for possible inclusion in the Food4Me study, (2) a standard operating procedure was developed to maintain consistency in the use of methods and techniques across research centers, and (3) the Food4Me behavior change technique framework was reviewed and updated post intervention. An analysis of excluded techniques was also conducted. RESULTS: Of 46 techniques identified a priori as being applicable to Food4Me, 17 were embedded in the intervention design; 11 were from a dietary taxonomy, and 6 from a smoking cessation taxonomy. In addition, the four-category smoking cessation framework structure was adopted for clarity of communication. Smoking cessation texts were adapted for dietary use where necessary. A posteriori, a further 9 techniques were included. Examination of excluded items highlighted the distinction between techniques considered appropriate for face-to-face versus internet-based delivery. CONCLUSIONS: The use of existing taxonomies facilitated the description and standardization of techniques used in Food4Me. We recommend that for complex studies of this nature, technique analysis should be conducted a priori to develop standardized procedures and training and reviewed a posteriori to audit the techniques actually adopted. The present framework description makes a valuable contribution to future systematic reviews and meta-analyses that explore technique efficacy and underlying psychological constructs. This was a novel application of the behavior change taxonomies and was the first internet-based personalized nutrition intervention to use such a framework remotely. TRIAL REGISTRATION: ClinicalTrials.gov NCT01530139; https://clinicaltrials.gov/ct2/show/NCT01530139 (Archived by WebCite at http://www.webcitation.org/6y8XYUft1).

The perceived impact of the National Health Service on personalised nutrition service delivery among the UK public.

Personalised nutrition (PN) has the potential to reduce disease risk and optimise health and performance. Although previous research has shown good acceptance of the concept of PN in the UK, preferences regarding the delivery of a PN service (e.g. online v. face-to-face) are not fully understood. It is anticipated that the presence of a free at point of delivery healthcare system, the National Health Service (NHS), in the UK may have an impact on end-user preferences for deliverances. To determine this, supplementary analysis of qualitative data obtained from focus group discussions on PN service delivery, collected as part of the Food4Me project in the UK and Ireland, was undertaken. Irish data provided comparative analysis of a healthcare system that is not provided free of charge at the point of delivery to the entire population. Analyses were conducted using the 'framework approach' described by Rabiee (Focus-group interview and data analysis. Proc Nutr Soc 63, 655-660). There was a preference for services to be led by the government and delivered face-to-face, which was perceived to increase trust and transparency, and add value. Both countries associated paying for nutritional advice with increased commitment and motivation to follow guidelines. Contrary to Ireland, however, and despite the perceived benefit of paying, UK discussants still expected PN services to be delivered free of charge by the NHS. Consideration of this unique challenge of free healthcare that is embedded in the NHS culture will be crucial when introducing PN to the UK.

Obesity, whole blood serotonin and sex differences in healthy volunteers.

BACKGROUND: Obesity is a growing problem throughout Europe, where the rate has more than doubled over the past 20 years. Reduced circulating serotonin may contribute to the development of obesity. This study aimed to explore associations between whole blood (WB) serotonin concentrations and anthropometric measures. METHODS: Healthy adult volunteers (N = 68) gave whole blood samples for measurement of WB serotonin, and underwent BMI waist circumference (WC) and waist-to-hip ratio (WHR) assessment as well as DEXA (dual energy X-ray absorptiometry) scans for anthropometric parameters. Student's t-tests determined differences in WB serotonin and anthropometric measures between sexes. Partial Pearson's correlations were carried out on anthropometric measures and WB serotonin. RESULTS: For the whole sample, WB serotonin was significantly negatively correlated with BMI, WC, WHR as well as android, gynoid and total % body fat. Analysis by sex showed significant negative correlations between WB serotonin and android, gynoid as well as total fat in males, but not in females. CONCLUSION: This dichotomy between the sexes implies that there may be sex differences in the way that serotonin interplays with the development of obesity and body fat distribution.

Knowledge of food production methods informs attitudes toward food but not food choice in adults residing in socioeconomically deprived rural areas within the United Kingdom.

OBJECTIVE: Understand food choice, from the perspective of people residing in socioeconomically deprived rural neighborhoods. METHODS: Focus groups (n = 7) were undertaken within a community setting involving 42 adults (2 males and 40 females) recruited through voluntary action groups. Data were recorded, transcribed verbatim, and content analyzed. RESULTS: Attitudes to food and health were influenced by knowledge of food production and processing. Healthful foods were considered those which were fresh and unprocessed, and taste was taken as an indicator of how the food had been produced. Despite negative views of food production, processed foods were consumed. Explanations for this tension between what people wanted to eat (unprocessed food) and what they actually chose to eat (processed food) were attributed to lifestyle compression. CONCLUSIONS AND IMPLICATIONS: Dietary health promotion initiatives targeted at deprived rural dwellers should consider perceived issues regarding food production and processing that may influence views on food.

Supplemented zinc does not alter mood in healthy older European adults--a randomised placebo-controlled trial: the Zenith study.

OBJECTIVE: Older people are vulnerable to zinc deficiency, which may impact upon their mood. This randomised, placebo-controlled, double-blind intervention study aimed to investigate the effect of oral zinc gluconate supplementation (15 mg/d; 30 mg/d; and placebo) on subjective mood (affect) in older Europeans. SUBJECTS: Healthy volunteers (n 387) aged 55-87 years were recruited. SETTING: Volunteers in Rome (Italy; n 108) and Grenoble (France; n 91) were aged 70-87 years and those in Coleraine (Northern Ireland; n 93) and Clermont-Ferrand (France; n 95) were aged 55-70 years. DESIGN: Mood was measured using the Positive and Negative Affect Scale on four occasions per day over 4 d at baseline, 3 and 6 months post-intervention. RESULTS: Mixed ANOVA indicated that neither positive nor negative affect altered in response to zinc (15 mg/d or 30 mg/d) compared to placebo in either the 55-70 years or the ≥70 years age group. CONCLUSIONS: These results suggest that zinc does not benefit mood in healthy older people.

Vitamin d status and indices of bone turnover in older European adults.

An increased rate of bone turnover increases risk of osteoporotic fracture later in life. The concentration of 25-hydroxyvitamin D that contributes to an elevated rate of bone turnover in older adults is unclear. The objective of this study was to investigate the associations between 25-hydroxyvitamin D and biochemical markers of bone turnover in an older, pan-European cohort. 25-hydroxyvitamin D and serum markers of bone-formation (osteocalcin and bone-specific alkaline phosphatase) were assessed by ELISA, while urinary markers of bone-resorption (pyridinoline and deoxypyridinoline) were assessed by HPLC. Six percent, 36 %, and 64 % of subjects had 25-hydroxyvitamin D concentrations < 25, < 50, and < 80 nmol/L throughout the year, respectively. 25-hydroxyvitamin D was significantly and inversely correlated with serum bone-specific alkaline phosphatase (r = 0.119; p = 0.022) and urinary pyridinoline (r = 0.207; p < 0.0001) and deoxypyridinoline (r = 0.230; p < 0.0001). Stratification on the basis of tertiles [T] of 25-hydroxyvitamin D (< 47.6 [T(1)]; 47.6 - 85.8 [T2]; > 85.8 [T3] nmol/L), showed that urinary pyridinoline and deoxypyridinoline were significantly lower in subjects in the 2(nd) and 3(rd) compared to the 1(st) tertile (p < 0.015). Low vitamin D status (< 50 nmol/L) was associated with an increased rate of bone turnover in this older pan-European cohort.

Attitudes toward genetic testing and personalised nutrition in a representative sample of European consumers.

Negative consumer opinion poses a potential barrier to the application of nutrigenomic intervention. The present study has aimed to determine attitudes toward genetic testing and personalised nutrition among the European public. An omnibus opinion survey of a representative sample aged 14-55+ years (n 5967) took place in France, Italy, Great Britain, Portugal, Poland and Germany during June 2005 as part of the Lipgene project. A majority of respondents (66 %) reported that they would be willing to undergo genetic testing and 27 % to follow a personalised diet. Individuals who indicated a willingness to have a genetic test for the personalising of their diets were more likely to report a history of high blood cholesterol levels, central obesity and/or high levels of stress than those who would have a test only for general interest. Those who indicated that they would not have a genetic test were more likely to be male and less likely to report having central obesity. Individuals with a history of high blood cholesterol were less likely than those who did not to worry if intervention foods contained GM ingredients. Individuals who were aware that they had health problems associated with the metabolic syndrome appeared particularly favourable toward nutrigenomic intervention. These findings are encouraging for the future application of personalised nutrition provided that policies are put in place to address public concern about how genetic information is used and held.

Salivary cortisol, stress and mood in healthy older adults: the Zenith study.

The aims of this study were to investigate the relationship between salivary cortisol, stress and mood and to look at the circadian rhythms of positive (PA) and negative (NA) mood in older adults. The participants were 41 healthy adults aged 55-69 years, recruited in Northern Ireland as part of the European Commission-funded Zenith project. Salivary cortisol samples were obtained twice a day (2.30 p.m. and 10.30 p.m.) for 7 consecutive days in conjunction with momentary measures of positive (PA) and negative mood (NA), using PANAS and a trait measure of perceived stress (Perceived Stress Scale). Salivary cortisol levels were measured using an enzyme-linked immunoassay kit. Higher perceived stress levels were associated with lower afternoon PA (r=-0.46, p=0.003) and higher afternoon (r=0.43, p=0.007) and evening (r=0.45, p=0.004) NA. Lower afternoon PA was correlated with higher evening cortisol concentrations (r=-0.47, p=0.002). Greater afternoon PA variability was associated with higher evening cortisol concentrations (r=0.38, p=0.015). A high intra-class correlation between cortisol and positive mood was found (r=0.67, p=0.009). Previously established rhythms for positive and negative mood were confirmed. Interestingly, there was no association between salivary cortisol levels and perceived stress in these healthy older adults. Further, more extensive research is required to better understand the apparent interplay between these variables and ageing.

Taste acuity in response to zinc supplementation in older Europeans.

Taste acuity declines with age and may be dependent upon Zn status. The aim of the present double-blind, randomised controlled intervention trial has been to determine taste acuity in response to Zn supplementation (placebo, or 15 or 30 mg Zn/d). Healthy older European adults aged 70-87 years were recruited within Italy (Rome) (n 108) and France (Grenoble) (n 91) to the European Commission-funded Zenith project. A signal detection theory approach was adopted for taste assessment. The data were converted to R indices and analysed by repeated-measures ANOVA controlling for baseline taste acuity as well as serum and erythrocyte Zn. Serum Zn increased post-intervention, indicating compliance with the intervention. Results differed across geographical region. Salt taste acuity was greater in response to Zn (30 mg) than placebo post-intervention among those recruited in Grenoble. There was no apparent change in acuity for sweet, sour or bitter taste in response to Zn. Supplemented Zn may have potential to enhance salt taste acuity in those over the age of 70 years. Further research is required to determine if enhanced salt taste acuity is reflected in the eating experiences of older individuals.

Children talking: emerging perspectives and experiences of cigarette smoking.

Despite efforts to prevent the onset of smoking, the rate among older children remains high. In this article, the authors report on a longitudinal, qualitative study of 11 to 16-year-old children describing children's construction of what it means to be a smoker, the reasons given for children smoking, and their views of smoking behavior. Findings indicate that children adopt broad interpretations of what constitutes smoking behavior; although they strongly disapprove of children who smoke, they are less disapproving of older children or adult smokers and are increasingly tolerant of smoking behavior as they get older. Children's disapproval of smoking acts as a protective mechanism against smoking for younger participants. Participants' broad interpretation of what it means to be a cigarette smoker, their association of smoking with adulthood, and their increasing tolerance of and exposure to smoking behavior as they move into adolescence appears to increase susceptibility to becoming cigarette smokers.

The relationship between whole-blood serotonin and subjective mood in apparently healthy postmenopausal women.

The aim of this research has been to determine the degree to which biochemical indices of mood reflect subjective mood. Potential relationships between whole-blood (WB) serotonin (5-hydroxytryptamine, 5-HT) levels as determined by the positive and negative affect schedule (PANAS) have been explored in apparently healthy postmenopausal women (n=39). Partial correlations indicated that WB 5-HT was positively associated with positive affect (p=0.03). No association was apparent for negative affect. These findings indicate that WB 5-HT and positive affect are related in postmenopausal women.

Smoking and peer groups: results from a longitudinal qualitative study of young people in Northern Ireland.

Previous research has indicated that young people are under considerable social pressure to take up smoking. This study has therefore sought to explore and better understand the mechanisms through which peer-related social factors operate to encourage young people to smoke. Individual qualitative interviews were held with adolescent children aged 11-12 years (N = 102) within youth clubs based in economically deprived areas of Northern Ireland, and then followed up on two occasions during the subsequent 3 years (N = 51/39). The data implied that, although peers influence smoking uptake, this seldom happens through direct persuasion, but rather as the result of the young person striving to conform to the normative behaviour of the peer group with which they identify. The findings are consistent with social identity theory and self-categorization theory in that for both smoking and nonsmoking 14-year-olds smoking activity appears to provide a means through which to define social groups, to accentuate similarity within groups and differences between groups. In-group favouritism was expressed in the sharing of cigarettes within the in-group and in the negative stereotyping of out-group members. There was some evidence that group affiliation may be negotiated differently for boys and girls. These findings imply that successful intervention needs to reconsider the normative processes that encourage young people to smoke.

Psychological underpinnings of metabolic syndrome.

Metabolic syndrome (MS) is more common among socio-economically disadvantaged individuals and is associated with certain risky lifestyle practices. MS also appears to be triggered by adverse social circumstances and chronic stress. The present paper reviews accumulating evidence to imply that individuals who have certain personality and behaviour traits are particularly predisposed to develop MS, and brings together theories that relate to possible psychological mechanisms underlying MS. It considers how such factors might interact causally to encourage the development of MS. As part of the EU-funded LIPGENE Integrated Project, multi-level modelling will be undertaken to explore potential pathways to MS, taking into consideration the interplay between a range of psycho-social, demographic, cultural and lifestyle factors thought to contribute to the development of MS. Data will be gathered for this purpose from a representative sample of >50-year-olds living in Britain (n 1000) and Portugal (n 500). It is anticipated that this information will assist in the development and targetting of future intervention to prevent and treat MS in the normal population.

Vitamin E supplementation, cereal feed type and consumer sensory perceptions of poultry meat quality.

Lipid oxidation leads to meat spoilage and has been reported to cause adverse changes in the flavour and texture of poultry meat. Vitamin E has been found to be effective in delaying lipid oxidation. The aim of this study was to determine whether the vitamin E supplementation of chicken feed influences the consumers' perception of the quality of chicken meat under normal display and storage conditions. Untrained consumers (n 32) evaluated cooked breast meat from chickens (both corn fed and wheat fed) supplemented with 75,250 or 500 mg/kg vitamin E and after storage at 4 degrees C for 4 and 7 d. Factorial analysis found an interaction between vitamin E treatment and storage day upon the perceived juiciness (P=0.023) and tenderness (P=0.041) of the chicken meat. Perceptions of quality relative to vitamin E level were more evident on day 4 than day 7. When the two cereal types were compared, the time-related sub-group effects were observed only in meat from corn-fed chickens supplemented with either 75 or 250 mg/kg, which was perceived to be juicier (P=0.018) and more tender (P=0.020) than that supplemented at the 500 mg/kg level. These results imply that the two lower concentrations of vitamin E have some advantages over 500 mg/kg, but for optimal consumer acceptance of corn-fed chicken meat, we suggest that 250 mg/kg vitamin E should be added to corn-fed poultry feed. There was no evidence to suggest any advantages in changing the current amount of vitamin E (75 mg/kg) used to rear wheat-fed birds.

Flesh colour dominates consumer preference for chicken.

Existing research investigating interactions between visual and oral sensory cues has tended to use model food systems. In contrast, this study compared product quality assessments of corn-fed and wheat-fed chicken products among persons recruited in Northern Ireland. Three approaches have been adopted to investigate the effect of colour upon consumer choice of chicken: sensory assessment under normal lighting; focus group discussion; and sensory assessment under controlled lighting conditions. Initial consumer sensory assessment indicated that wheat-fed chicken was perceived to be tenderer and to have a more intense flavour than that which was corn-fed. Qualitative enquiry discerned that this was because consumers perceived the yellow colour of corn-fed chicken negatively. Yellow-coloured corn-fed chicken was therefore again compared with wheat-fed chicken in terms of flavour, texture and overall liking with the flesh colour disguised by means of controlled lighting. Quality ratings for corn-fed chicken were more positive when the yellow flesh colour was disguised, with corn-fed chicken judged to be tenderer than wheat-fed chicken and more flavoursome. This study illustrates the importance of using a combination of methods to gain insight into interactions between different sensory modalities in consumer quality judgements and adds to previous research on the importance of colour upon consumer choice of real foods.