Public Perceptions of Food Contamination Risks: A Simulation Experiment on the Psychological Impact of Incident Severity and Intentionality.

How do consumers perceive risks associated with food contamination? How do they respond to foodborne illness outbreaks and food recalls resulting from food contamination? We report findings from an experiment (N = 1,010) in which participants were exposed to a simulated news report on a food contamination incident that had led to a foodborne illness outbreak and voluntary food recalls. Two characteristics of the food contamination incident were experimentally manipulated - severity (i.e., how serious the consequences of the incident were) and intentionality (i.e., whether the incident was caused by an accident or an intentional act to harm). We found that higher severity generally led to higher risk perceptions and risk-reduction intentions. A contamination incident attributed to an intentional act to harm, as opposed to an accident, caused greater intentions to temporarily reduce consumption of the contaminated food and to seek out more information, but only when incident severity was relatively low. Implications of these findings for effectively communicating food contamination risks are discussed.

Health Disparities in Calorie Knowledge and Confidence Among the U.S. Adult Population.

PURPOSE: Obesity prevalence has reached an all-time high in the US, affecting >40% of the population. This study's objective was to evaluate associations between demographics and self-reported calorie knowledge and self-perceived confidence in calorie knowledge ("calorie confidence"). The relationships between body mass index (BMI) and calorie knowledge and confidence were also explored. METHODS: We analyzed data from participants (n = 2171) in the crosssectional, nationally representative 2019 FDA Food Safety and Nutrition Survey using logistic regression to estimate adjusted odds ratios (AORs) and confidence intervals (95% CIs) for associations between BMI and calorie knowledge (correct/incorrect), calorie confidence (confident/not confident), and demographic characteristics, and the Wald chi square test to evaluate relationships between BMI and both calorie knowledge and confidence. RESULTS: Many of the same subgroups were more likely than others to report lack of calorie knowledge and lack of confidence in knowing the typical daily calorie intake needed to maintain a healthy weight [respective AORs (95% CIs): age (years), >60 vs 51-60, 1.7 (1.1-2.5), and 1.4 (1.0-2.0); sex, male vs female, 1.7 (1.3-2.3), and 1.7 (1.3-2.1); race/ethnicity, non-Hispanic Black vs non-Hispanic white, 3.4 (2.1-5.5), and 2.4 (1.6-3.8); education, ≤high school vs college grad, 1.5 (1.0- 2.3), and 1.9 (1.3-2.7)]. BMI was significantly correlated with calorie confidence (P = .047), such that those reporting less confidence were more likely overweight or obese [underweight/healthy (BMI < 25): 29%, overweight (25 ≤ BMI < 30): 34%, obese (BMI ≥ 30): 37%]. CONCLUSION: In certain demographic subgroups associations between calorie knowledge and confidence differed. Tailored education and outreach for these groups may help to address these disparities.

Influence of Risk Severity and Intentionality on Perceptions of Food Contamination Risks among Pregnant Women: An Experimental Investigation.

Given the potential for severe health consequences of consuming contaminated foods during pregnancy, effective communication of food contamination risks to pregnant women is especially important. This study examines pregnant women's risk perceptions and intentions to adopt risk-reduction behaviors following exposure to a simulated news story about a food contamination incident. The news story was experimentally manipulated to depict the severity of the incident as high or low and the cause of the incident as accidental or intentional. Results showed that both severity and intentionality of the incident elevated pregnant women's perceptions of getting sick as well as their intentions to temporarily reduce consumption of the contaminated food product and to seek more information. Implications of these findings for effectively communicating food contamination risks to pregnant women are discussed.

Pet Ownership and Pet Type Influence Food Safety in the Home: Evidence from a National Survey.

ABSTRACT: Physical contact between humans and their pets increases the potential for zoonotic disease transmission. This study used the 2016 U.S. Food and Drug Administration (FDA) Food Safety Survey to compare the food handling behaviors of pet owners and non-pet owners, because poor food handling and hygiene habits can increase the likelihood of disease transmission from animals to humans. Results show that both pet ownership and pet type were important in predicting food safety behaviors. After controlling for sociodemographic factors included in this study (gender, age, household income, household size, and race or ethnicity), pet ownership was significantly associated with overall food safety practices and, more specifically, with better hand washing behaviors, kitchen cleaning, and ownership and use of a food thermometer, as well as a greater awareness of foodborne pathogens. Cat owners and cat-dog owners had better overall food safety practices and better hand washing behaviors compared with those of dog owners. After controlling for sociodemographic variables, there were no significant associations between pet ownership and perception of risks associated with unsafe food handling practices.

Soda or VitaSoda: How Product Name Influences Perceptions of Snack Food Healthfulness and the Moderating Role of Nutrition Facts Labels.

Many parts of a food package label can influence consumers' product judgments. In this study we investigate how strategic product naming influences consumers' perceptions of snack food products' healthfulness and nutritional content by focusing on snack food names that include (versus do not include) the noun "vita." We also analyze how the effects of product naming are moderated by viewing the Nutrition Facts labels (NFLs). In an online experiment, participants (N = 3,049) were presented with mock packages of snack foods and given the opportunity to view the NFL. Results showed that products including "vita" in their name were perceived as more healthful than those that did not include "vita" in their name, even though their nutritional content was the same. Additionally, vita snack foods (compared to regular snack foods) were rated as significantly higher in nutrients to promote, such as fiber, vitamin D, calcium, vitamin C, and potassium and lower in nutrients to limit, such as calories, sugar, and saturated fat. Viewing the NFL appeared to mitigate the effects of product naming.

Nutrient Content Claims: How They Impact Perceived Healthfulness of Fortified Snack Foods and the Moderating Effects of Nutrition Facts Labels.

Nutrient content claims (NCCs) may inflate perceived healthfulness of nutritionally poor foods. The aim of this study is to experimentally test the effects of NCCs on consumers' perceptions of fortified snack foods in terms of the presence of both healthful and less healthful nutrients, as well as their intentions to consume such products. It also explores the potential moderating effects of reading Nutrition Facts Labels (NFL) on the influence of NCCs. Data for this study were collected through a web-based experiment (N = 5,076). Results indicated that the presence of an NCC on a fortified snack food product increased perceived healthfulness of that product, perceptions of the presence of healthful nutrients, and intentions to consume the product. The presence of NCCs also decreased perceptions of the presence of certain less healthful nutrients. Reading the NFL had mixed effects on the impact of NCCs.

Vitamin-Fortified Snack Food May Lead Consumers to Make Poor Dietary Decisions.

BACKGROUND: The US Food and Drug Administration's (FDA's) fortification policy discourages the fortification of certain foods, including sugars and snack foods such as cookies, candies, cakes, chips, and carbonated beverages, yet manufacturers sometimes add vitamins and minerals to snack foods. OBJECTIVE: To assess whether vitamin-fortified snack foods affect consumers' information-seeking, purchase decisions, and product-related health perceptions. DESIGN: For this experimental study, participants were randomly assigned to study conditions to compare products that varied in product type, nutrition profile, and fortification and nutrient claim status. Data were collected via an online consumer panel. PARTICIPANTS/SETTING: US adults aged 18 years and older were randomly selected from Research Now's e-panel online household panel. Data were collected during fall 2014 (N=5,076). INTERVENTION: Participants were randomly assigned to one of 24 conditions: two products (vegetable chip/potato chip), two nutrition profiles (healthier/less healthy), two fortification scenarios (not fortified/fortified), and three nutrient claim conditions (two no claim/one with claim). The design was not balanced; claims were not shown on products that were not vitamin fortified. MAIN OUTCOME MEASURES: Outcome measures were information-seeking (viewed the Nutrition Facts label), purchase decisions, perception of product healthfulness, and correct selection of product with the healthier nutrient profile. STATISTICAL ANALYSIS PERFORMED: Logistic regression was used to test all models. Analyses was adjusted for general label use, consumes product, health status, age, sex, level of education, presence of children in the household, and race/ethnicity. RESULTS: When the snack food carried a nutrient claim for vitamin fortification, participants were 1) less likely to look for nutrition information on the Nutrition Facts label, 2) more likely to select the product for purchase, 3) more likely to perceive the product as healthier, and 4) less likely to correctly choose the healthier product. CONCLUSIONS: Snack foods that have been vitamin-fortified may cause consumers to make poor dietary decisions.

Mapping Sources of Food Safety Information for U.S. Consumers: Findings From a National Survey.

This research examines the sources from which U.S. consumers obtain their food safety information. It seeks to determine differences in the types of information sources used by U.S. consumers of different sociodemographic background, as well as the relationships between the types of information sources used and food safety risk perceptions. Analyzing the 2010 Food Safety Survey (N = 4,568) conducted by the U.S. Food and Drug Administration, we found that age, gender, education, and race predicted the use of different sources for food safety information. Additionally, use of several information sources predicted perceived susceptibility to foodborne illnesses and severity of food contamination. Implications of the findings for food safety risk communication are discussed.

Prevalence of self-reported food allergy in U.S. adults: 2001, 2006, and 2010.

BACKGROUND: Epidemiologic evidence indicates that food allergies are increasing in the population. Information on a change in self-reported food allergy (srFA) in adults over time is lacking. OBJECTIVE: To report the prevalence of srFA and compare differences at three time points over a decade. METHODS: We analyzed srFA and reported physician-diagnosed food allergy in >4000 U.S. adults who participated in the 2010 U.S. Food and Drug Administration Food Safety Survey. Information on causative food(s), reaction severity characteristics, and various diagnostic factors was also analyzed. We compared 2010 Food Safety Survey data with 2006 and 2001 data, and highlighted relevant differences. RESULTS: SrFA prevalence increased significantly, to 13% in 2010 and 14.9% in 2006 compared with 9.1% in 2001 (p < 0.001). Physician diagnosed food allergy was 6.5% in 2010, which was not significantly different compared with 7.6% in 2006 and 5.3% in 2001. SrFA increased in both men and women, non-Hispanic white and black adults, 50-59 year olds, and in adults with a high school or lower education. In 2010, milk, shellfish, and fruits were the most commonly reported food allergens, similar to 2001. Also, in 2010, 15% of reactions reportedly required a hospital visit and 8.4% were treated with epinephrine. Minor differences in reaction severity characteristics were noted among the surveys. CONCLUSIONS: Analysis of survey results indicates that the prevalence of srFA increased among U.S. adults from 2001 to 2010 and that adults are increasingly self-reporting FAs without obtaining medical diagnosis. Improved education about food allergies is needed for this risk group.

Infant feeding practices and reported food allergies at 6 years of age.

OBJECTIVE: The goal of this study was to identify the frequency of physician-diagnosed food allergies among 6-year-old US children and study the impact of exclusive breastfeeding and complementary food introduction on this frequency. METHODS: Data were analyzed from children who participated in the Infant Feeding Practices Study II Year 6 Follow-Up Study (Y6FU). Children with probable food allergy (pFA) were defined as children with report of physician-diagnosed food allergy at age 6 years. Subgroups of pFA included children who were not diagnosed before 1 year of age (new pFA) and those with atopic risk factors (high risk). RESULTS: Prevalence of total pFA in the Y6FU was 6.34%. The majority of these children had new pFA and high-risk factors. Higher maternal education, higher family income, family history of food allergy, and reported eczema before 1 year of age were significantly associated with higher odds of total or new pFA. Exclusive breastfeeding duration and timing of complementary food introduction were not significantly associated with total pFA. However, exclusive breastfeeding of ≥4 months compared with no breastfeeding was marginally associated with lower odds of new pFA (adjusted odds ratio: 0.51; P = .07); this effect was not observed with high-risk children. CONCLUSIONS: Analysis of infant and maternal variables in the Y6FU cohort of US children revealed that socioeconomic and atopic factors were the main predictors of pFA at age 6 years. Exclusive breastfeeding of ≥4 months may have a preventive effect on development of pFA after 1 year of age in non high-risk children.

Self-reported hand washing behaviors and foodborne illness: a propensity score matching approach.

Hand washing is a simple and effective but easily overlooked way to reduce cross-contamination and the transmission of foodborne pathogens. In this study, we used the propensity score matching methodology to account for potential selection bias to explore our hypothesis that always washing hands before food preparation tasks is associated with a reduction in the probability of reported foodborne illness. Propensity score matching can simulate random assignment to a condition so that pretreatment observable differences between a treatment group and a control group are homogenous on all the covariates except the treatment variable. Using the U.S. Food and Drug Administration's 2010 Food Safety Survey, we estimated the effect of self-reported hand washing behavior on the probability of self-reported foodborne illness. Our results indicate that reported washing of hands with soap always before food preparation leads to a reduction in the probability of reported foodborne illness.

Sex-based differences in food consumption: Foodborne Diseases Active Surveillance Network (FoodNet) Population Survey, 2006-2007.

BACKGROUND: This analysis used data from the most recent Foodborne Diseases Active Surveillance Network (FoodNet) Population Survey (May 2006 through April 2007) to examine differences in the consumption of various types of foods between men and women. METHODS: Participants were surveyed by telephone and asked whether or not they had consumed certain foods in the past 7 days, including the following "high-risk" foods commonly associated with foodborne illness: pink hamburger, raw oysters, unpasteurized milk, cheese made from unpasteurized milk, runny eggs, and alfalfa sprouts. Data were weighted to adjust for survey design and to reflect the age and sex distribution of the population under FoodNet surveillance. RESULTS: A total of 14 878 persons ≥ 18 years were interviewed, of whom 5688 (38%) were men. A higher proportion of men reported eating meat and certain types of poultry than women, whereas a higher proportion of women ate fruits and vegetables. A higher proportion of men than women reported consuming runny eggs (12% versus 8%), pink hamburger (7% versus 4%), and raw oysters (2% versus 0.4%). A higher proportion of women than men ate alfalfa sprouts (3% versus 2%). No differences by sex were observed for consumption of unpasteurized milk or cheese. CONCLUSIONS: Data from the FoodNet Population Surveys can be useful in efforts to design targeted interventions regarding consumption of high-risk foods. Moreover, understanding the background rates of food consumption, stratified by sex, may help investigators identify the kinds of foods likely to be associated with outbreaks in which a preponderance of cases occur among members of one sex.

Food safety perceptions and practices of older adults.

OBJECTIVES: Older adults are considered more vulnerable to foodborne illness due to lowered immune function. We compared the food safety perceptions and practices of older and younger adults and determined associations with demographic characteristics. METHODS: We focused on 1,317 participants > or = 60 years of age from the U.S. Food and Drug Administration's 2006 Food Safety Survey, a telephone survey of a nationally representative sample of American consumers. We used data on participants < 60 years of age to compare younger and older adults, and used Pearson's Chi-square tests to determine whether perceptions and practices differed by age, gender, level of education, living arrangement, and race/ethnicity. We conducted multiple logistic regression analysis to assess relationship of demographic characteristics and food safety perceptions with food safety practices of older adults. RESULTS: We found that adults > or = 60 years of age were more likely to follow recommended food safety practices than those < 60 years of age. Sixty-six percent of adults > or = 60 years of age reported eating potentially hazardous foods in the past year compared with 81% of adults < 60 years of age. Among people > or = 60 years of age, women, those with less education, and nonwhite individuals generally had better food safety practices and a greater awareness of food safety risk. CONCLUSIONS: These findings suggest that certain subsets of the older adult population are less likely to follow recommended food safety practices and, thus, are at greater risk of foodborne illness. Food safety education for older adults should target men and those with more education and higher incomes.

Effect of low-carbohydrate claims on consumer perceptions about food products' healthfulness and helpfulness for weight management.

OBJECTIVE: Evaluate effect of low-carbohydrate claims on consumer perceptions about food products' healthfulness and helpfulness for weight management. DESIGN: Experiment in which participants were randomly assigned 1 of 12 front-of-package claim conditions on bread or a frozen dinner. Seven of the 12 conditions also included Nutrition Facts (NF) information. SETTING: Internet. PARTICIPANTS: 4,320 members of a national on-line consumer panel. INTERVENTION: Exposure to images of a food package. MAIN OUTCOME MEASURES: Ratings on Likert scales about perceived healthfulness, helpfulness for weight management, and caloric content. ANALYSIS: Mean ratings by outcome measure, condition, and product were calculated. Ratings were also used as the dependent measure in analysis of variance models. RESULTS: Participants who saw front-of-package-only conditions rated products bearing low-carbohydrate claims as more helpful for weight management and lower in calories than the same products without a claim. Those who saw the bread with low-carbohydrate claims also rated it as more healthful than those who saw no claim. When the NF label was available and products had the same nutrition profile, participants rated products with low-carbohydrate claims the same as those with no claim. CONCLUSIONS AND IMPLICATIONS: Consumers who do not use the NF panel may interpret low-carbohydrate claims to have meaning beyond the scope of the claim itself.