Association between nutritional literacy and nutrition label use in Chinese community residents.

Introduction: Nutritional literacy (NL) has a critical influence on food choices. The objective of the present study was to examine the association of NL with nutrition label use. Methods: A cross-sectional study was conducted in Bengbu, China. In total, 955 adults were interviewed using a questionnaire designed for the present study to collect information on demographics, lifestyle, nutrition label use, and NL. Binary logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (CI) for nutrition label use and its predictive variables. Results: In total, 40.4% of the participants reported looking at nutrition label when purchasing prepackaged foods. NL was significantly positively associated with nutrition label use and specifically with checking nutrition facts table, purported nutrition benefits and purported health benefits. In terms of specific facets of NL, nutrition knowledge, applying skills, and critical skills were associated with nutrition label use. After stratification by monthly income and education, the association between NL and nutrition label use was discovered only in individuals with low monthly income. Additionally, nutrition knowledge was associated with nutrition label use only in adults with high education level, whereas applying skills were associated with nutrition label use only in those with low education level. Conclusion: The use of nutrition label remains low among Chinese community residents, especially the purported nutritional benefits and purported health benefits. NL is positively associated with nutrition label use, especially with respect to functional and critical NL, with differences based on socioeconomic status. The findings highlight the need for NL interventions targeting individuals with different levels of education and income to encourage use of nutrition label in China.

Influence of ultra-processed food in the diet of South Indian young adults: an explanatory mixed method study.

PURPOSE: To determine the contribution of ultra-processed foods (UPFs) to overall macronutrient intake and their association with anthropometric measurements, and to explore the perceptions regarding UPF consumption among young adults in Puducherry, India. METHODS: This study included 630 participants from three colleges selected using multistage cluster sampling. Following the demonstration of portion estimation, dietary data from previous day were collected using a Google Form-based tool. The participant's anthropometric measures were taken. Food items were classified into NOVA groups and intake analysis was performed using DietSoft software. The participants with low and high consumption were identified and focus group discussions were conducted in each group using criterion sampling. RESULTS: Of all the participants, 178 (28.3%) were overweight or obese. UPF contributed 9.3% of total energy intake and 2.8% protein, 9.9% fat, and 9.9% carbohydrates. The most consumed UPFs were biscuits, wafers (25%), and potato chips(16.2%). No significant association was found between anthropometric measures and UPF consumption. Qualitative findings revealed four major themes, further explained using the socio-ecological framework. CONCLUSION: UPF consumption in the region was lower than that reported in other global and Indian studies. While our study did not find a significant association between UPF consumption and anthropometric measures, there is a concerning shift from traditional diets to increased UPF reliance, driven by convenience and commercial factors. Addressing this is crucial for healthier choices and combating non-communicable diseases during this pivotal life stage.

Nutritional Data on Selected Food Products Consumed in Oman: An Update of the Food Composition Table and Use for Future Food Consumption Surveys.

Food composition data in the Eastern Mediterranean Region countries are often lacking, obsolete, or unreliable. The study aims to provide reliable nutrient data on food products consumed in Oman in order to evaluate their nutritional quality, the consistency of the nutrition labeling and claims, and, ultimately, the use for food consumption surveys and update the current food composition database. Contents of fat, fatty acids, carbohydrates, protein, sugars, and sodium were chemically analyzed in 221 foods and beverages. Products were classified according to their nutritional composition and the extent of processing and coded according to the FoodEx2 system. Labels and laboratory values were compared using the tolerance levels of the European Union. Results indicate that the nutrition labeling aligns with the values obtained in the laboratory, with the exception of 6.3% discrepancies in TFA content, where the reported values are higher than the appropriate reference values. The most frequent category (71.5%) was ultra-processed foods. In terms of inconsistencies in the nutritional claims, 5.1% of food products with claims did not comply with the statement "sugar-free" or "low salt". Our study provides evidence to support the necessity of comprehensive recommendations for consumers and food industries, which are aimed at enhancing the nutritional quality of products and augmenting consumer awareness.

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.

Impact of food swap recommendations on dietary choices in an online supermarket: A randomized controlled trial.

One novel strategy to shift food choices in digital shopping environments is to automatically recommend healthier alternatives when an unhealthy choice is made. However, this raises the question which alternative products to recommend. This study assesses 1) whether healthier food swap recommendations are effective, even though the unhealthy choice was made in the presence of visible FOP nutrition labels, and 2) how the similarity of the alternatives influences the acceptance of food swap recommendations. Based on a pre-test, similarity of the recommendation was operationalized in terms of animal-based versus plant-based options. A randomized controlled trial (healthy food swap recommendation conditions: none, similar animal-based, dissimilar plant-based, or mixed animal- and plant-based) with 428 Dutch participants was conducted in a simulated online supermarket. Additional healthier food swap recommendations improved the nutritional quality of the final basket compared to only providing Nutri-Score nutrition labels (-1.7 mean FSA score, p < .001, medium Cohen's d = -0.48). Compared to the dissimilar condition, acceptance of an alternative was more likely in the mixed (odds-ratio = 2.78, p = .015) and in the similar condition (odds-ratio = 2.24, p = .048), but the nutritional quality of the final basket did not differ between treatment conditions. Individuals in treatment conditions who did not receive any recommendation (i.e. only made healthy choices) had higher Nutri-Score familiarity and general health interest than individuals who received recommendations. This suggests that for individuals with higher knowledge and motivation FOP nutrition labels were sufficient, whereas for individuals with lower knowledge and motivation additional food swap recommendations can improve dietary choices. Food swap recommendations may act as meaningful reminders by disrupting the automatic choice process and triggering individuals to rethink their (unhealthy) choice.

Factors Contributing to the Comprehensive Use of Food Labels in Jordan.

Food labels are low-cost, informational tools that can help curb the spread of diet-related non-communicable diseases. This study described consumers' knowledge, attitudes, and practices related to food labels in Jordan and explored the relationship between knowledge and attitude with comprehensive use of food labels. A cross-sectional, online survey assessed Jordanian adult consumers' ability to comprehend the nutritional contents of food labels (knowledge score), their attitudes towards food labels (attitude scale), and how frequently they used different parts of food labels (practice scale). Multivariate logistic regression models assessed predictors of comprehensive use of food labels. A total of 939 adults participated in the study. Total mean scores for the practice scale (14 questions), attitude scale (8 questions), and knowledge score (4 questions) were 49.50 (SD, 11.36; min, 5; max, 70), 29.70 (SD, 5.23; min, 5; max, 40), and 1.39 (SD, 1.33; min, 0; max, 4), respectively. Comprehensive users of food labels (26.4%) were more likely female, responsible for grocery shopping, and had higher mean knowledge and attitude scores. Jordanian consumers seem to have good practices and attitudes related to food label use but suboptimal knowledge regarding content. Future interventions should focus more on enhancing knowledge and awareness related to food labels.

Designing a new physical activity calorie equivalent food label and comparing its effect on caloric choices to that of the traffic light label among mothers: a mixed-method study.

Objective: We designed a new type of 'physical activity calorie equivalent' (PACE) food label in Iran to compare its effect with that of the traffic light food label (TLL) on caloric choices. Design: Mixed-method study. Participants: Mothers of school children between the ages of 6-12 years. Setting: In the qualitative phase, 10 focus group discussions (FGDs) were conducted with various groups of mothers, and two FGDs were conducted with food science and nutrition experts to design a new PACE label. In the quantitative phase, 496 mothers were randomly assigned to five groups: (1) no nutrition label, (2) current TLL, (3) current TLL + educational brochure, (4) PACE label, and (5) PACE label + brochure. Samples of dairy products, beverages, cakes, and biscuits were presented. ANOVA and multiple linear regressions were applied to examine the association between label types and calories of the selected products as our main outcome. Results: The mothers' perspectives were classified into two sub-themes, the PACE label's facilitators and barriers. The new PACE label's characteristics were divided into two subcategories: (a) appearance, and (b) nutritional information, including 14 codes. In the quantitative section, mean calories of the selected foods were lowest in the TLL + brochure group (831.77 kcal; 95% CI: 794.23-869.32), and highest in the PACE label group (971.61; 95% CI: 926.37-1016.84). Conclusion: The new PACE label was a combination of PACE, TLL, and warning labels. It did not significantly affect lower caloric choice, however, the TLL + brochure option was effective in choosing foods with fewer calories.Clinical trial registration: The study was registered in the Iranian Registry of Clinical Trials 23 (IRCT20181002041201N1).

How does the updated Nutri-Score discriminate and classify the nutritional quality of foods in a Norwegian setting?

BACKGROUND: The Nutri-Score is a candidate for the harmonized mandatory front-of-pack nutrition label enabling consumers in the European Union to make healthier food choices. Nutri-Score classifies foods (including beverages) from A (high nutritional quality) to E (low nutritional quality) based on the foods' qualifying and disqualifying components. We aimed to evaluate the updated Nutri-Score for foods (2022) and beverages (2023) in a Norwegian setting by exploring its ability to discriminate the nutritional quality of foods within categories. Additionally, we assessed Nutri-Scores' ability to classify foods in accordance with the Norwegian food-based dietary guidelines (FBDGs). METHODS: The updated Nutri-Score was calculated for 1,782 foods in a Norwegian food database. The discriminatory ability of the updated Nutri-Score was considered by exploring the distribution of Nutri-Score within categories of foods using boxplots and frequency tables, and by examining which qualifying and disqualifying components that contributed most to the Nutri-Score class. Accordance with the Norwegian FBDGs was assessed by exploring Nutri-Score for foods specifically mentioned in the guidelines. RESULTS: Overall, the updated Nutri-Score seemed to discriminate the nutritional quality of foods within categories, in a Norwegian setting. The foods' content of salt and the beverages' content of sugar were components contributing the most to Nutri-Scores' discriminatory ability. Furthermore, in most cases the updated Nutri-Score classified foods in accordance with the Norwegian FBDGs. However, there were minor inconsistencies in how Nutri-Score classified certain foods, such as the inabilities to discriminate between full-fat and low-fat/leaner cheeses, cremes and processed meats (sausages), and between whole grain and refined pasta/rice. CONCLUSIONS: We observed an overall acceptable discriminatory performance of the updated Nutri-Score in a Norwegian setting and in most cases the updated Nutri-Score classified foods in accordance with the Norwegian FBDGs. However, minor inconsistencies were observed. Together with the FBDGs, the updated Nutri-Score could be a useful tool in guiding consumers towards healthier food choices in Norway, but consumer evaluations are warranted to fully assess the performance of the updated Nutri-Score in a Norwegian context.

Development of nutrition label use scale for patients of coronary heart disease and examination of its reliability and validity.

Background: A proper evaluation on the intention of using nutrition label in patients with coronary heart disease (CHD) is crucial to design and formulate of behavior-based interventions. A valid and reliable instrument based on theoretical basis is needed to measure individual intention toward nutrition label use and identify underlying socio-cognitive factors. Object: To develop and test validity and reliability of the theoretically based nutrition label use (NLU) scale and to promote the use of nutrition labels in CHD patients. Methods: A questionnaire was developed based on the theory of planned behavior (TPB), empirical literatures, expert review and pilot tested. A total of 460 CHD patients in a hospital in Changsha were investigated using this questionnaire from April 2021 to August 2021. The items and dimensions in the scale were explored and confirmed using item-analysis, content validity, exploratory factor analytical (EFA), confirmatory factor analytical (CFA), internal consistency and split-half reliability tests. Results: A total of 33 items with 4 structural factors were identified, including 10 items of attitude, 6 items of subjective norm, 12 items of perceived behavior control, and 5 items of intention. The total variance explained by the EFA model was 68.563%. The model was further tested with CFA. The measurement model fitted the data well (Ratio of chi-square minimum and degree of freedom (CMIN/DF) =1.743, goodness of fit index (GFI) =0.814, incremental fit index (IFI) =0.946, Tuker-Lewis index (TLI) =0.940, the comparative fit index (CFI) =0.945, the root mean square error of approximation (RMSEA) =0.057). The content validation index (CVI) of the scale was 0.82, and the CVI of the items ranged from 0.8 to 1.00. The reliability of the scale was 0.976 (p < 0 0.001) using Cronbach's alpha and 0.937 (p < 0.001) using the split-half coefficient. Conclusion: The newly developed Nutrition Label Use Scale can serve as a valid and reliable tool to evaluate the nutrition label use of CHD patients.

Smoothies Marketed in Spain: Are They Complying with Labeling Legislation?

There is no legal definition of a smoothie, so the European legislation applicable to its labeling is that of fruit juice. The smoothie market has grown in recent years, as it can include a wide variety of ingredients: fruits, fruit purees, honey, milk and vegetable milks, vegetables, herbs, cereals, cereal flours, seaweed, and crushed ice. In this study, 57 smoothies were reviewed. All of them were purchased in supermarkets and classified into eight types according to the main ingredients. Fifteen legal statements/items were reviewed on the pack labels: eleven mandatory and three optional. Moreover, nutrition labels, nutritional claims, images, marks, and other symbols were also reviewed. Only 22.8% of the samples complied with EU and Spanish labeling legislation. More incorrectness was related to the name of the food and the fruits included as main ingredients; other errors related to the allergy/intolerance statements, and some nutritional claims concerning vitamin C were also detected to a lesser extent. General advice is provided for consumers to interpret smoothie labels correctly. Lawmakers should amend legislation to accept the term "smoothie" as a legal name.

The estimated dietary and health impact of implementing the recently approved 'high in' front-of-package nutrition symbol in Canada: a food substitution scenario modeling study.

Background: Front-of-pack labeling (FOPL) has been identified as a cost-effective policy to promote healthy food environments and to help consumers make healthier food choices. Consumer surveys report that after implementation of mandatory 'high in' FOPL symbols between 30 and 70% of consumers choose or were willing to choose products with fewer 'high in' symbols. Health Canada has recently published FOPL regulations that will require prepackaged food and beverages that meet or exceed thresholds for sodium, total sugars, or saturated fat to display a 'high in' FOPL nutrition symbol. Objectives: The aims were to estimate the potential (1) dietary impact of substituting foods with similar foods that would display at least one less 'high in' symbol, and (2) the number of diet-related noncommunicable disease (NCD) deaths that could be averted or delayed due to estimated dietary changes. Methods: Baseline and counterfactual intakes of sodium, total sugars, saturated fats, and energy were estimated among Canadian adults (n = 11,992) using both available days of 24 h-recall data from the 2015 Canadian Community Health Survey-Nutrition (CCHS). Similar foods to those reported in CCHS that would display at least one less 'high in' symbol (n = 239) were identified using a Canadian branded food composition database. Based on current FOPL consumer research, identified foods were substituted for 30, 50, and 70% of randomly selected CCHS-Nutrition adult participants and for all adult participants. Potential health impacts were estimated using the Preventable Risk Integrated ModEl. Results: Mean dietary reductions of between 73 and 259 mg/day of sodium, 2.0 and 6.9 g/day of total sugars, 0.2 and 0.5 g/day of saturated fats, and 14 and 46 kcal/day of energy were estimated. Between 2,148 (95% UI 1,913-2,386) and 7,047 (95% UI 6,249-7,886) of deaths due to diet-related NCDs, primarily from cardiovascular diseases (70%), could potentially be averted or delayed if Canadians choose products with fewer 'high in' symbols. Conclusion: Results suggest that FOPL could significantly reduce sodium and total sugar intakes among Canadian adults, the consequences of which could avert or delay an important number of diet-related NCD deaths. These findings provide relevant data to support the importance of the impending FOPL regulations.

Nutritional quality of snacks and beverages sold through vending machines in a large Hispanic-serving urban college campus in the United States: A cross-sectional study.

Students from nutritionally-vulnerable neighborhoods face dietary challenges through built environment of college vending machines. In this cross-sectional study, snacks and beverages sold in vending machines for a 4-week period in a Bronx-based Hispanic-serving college were recorded. Nutritional information was recorded from nutrition labels. Proportion of low- and high-sodium foods, "smart snacks" with a limit of 200 kcal and 200 mg of sodium, and foods with added sugar were recorded. Snacks had significantly higher calories and sodium per serving (227 kcal, 208 mg) than beverages (132 kcal, 90 mg) (t-test, p < 0.001). Almost a third of the snacks (32%) qualified as "smart snacks" for calories and 62% qualified as "smart snacks" for sodium. Beverages contained less than half the number of ingredients as snacks. About 53% of beverages and almost 60% of snacks listed sugar among the first five ingredients. Results underscore the need for colleges to promote less-processed entities with less added sugar.

Which Front-of-Package Nutrition Label Is Better? The Influence of Front-of-Package Nutrition Label Type on Consumers' Healthy Food Purchase Behavior.

To help consumers understand the healthfulness of food and make healthy food choices, manufacturers are increasingly providing front-of-package nutrition labels. However, not all types of front-of-package nutrition labels can promote consumers' healthy food purchase behavior. We explored the impact of front-of-package nutrition label type on the consumer purchase behavior of healthy food through three experiments. The results show that evaluative (vs. objective) front-of-package nutrition labels can improve consumer purchase intention and willingness to pay for healthy food. The spokesperson type moderates the influence of front-of-package nutrition labels on consumers' healthy food purchase behavior. Specifically, when the spokesperson type is a typical consumer, consumers are more willing to buy healthy foods with evaluative nutrition labels than those with objective nutrition labels. When the spokesperson type is a star, consumers are more willing to buy healthy food with objective nutrition labels (vs. evaluative nutrition labels). Finally, this study provides feasible suggestions for marketers to select appropriate front-of-package nutrition labels.

Estimating the dietary and health impact of implementing front-of-pack nutrition labeling in Canada: A macrosimulation modeling study.

Background: Front-of-pack labeling (FOPL) has been identified as a cost-effective policy to promote healthy diets. Health Canada has recently published FOPL regulations that will require food and beverages that meet or exceed set thresholds for sodium, sugars, or saturated fat to display a 'high in' symbol on the front of the package. Although a promising measure, its potential impact on dietary intakes and health have not yet been estimated in Canada. Objective: This study aims to estimate (1) the potential dietary impact of implementing a mandatory FOPL among Canadian adults; and (2) the number of diet-related non-communicable disease (NCD) deaths that could be averted or delayed due to these estimated dietary changes. Methods: Baseline and counterfactual usual intakes of sodium, total sugars, saturated fats, and calories were estimated among Canadian adults (n = 11,992) using both available days of 24 h recalls from the 2015 Canadian Community Health Survey-Nutrition. The National Cancer Institute method was used to estimate usual intakes, and adjusted for age, sex, misreporting status, weekend/weekday, and sequence of recall. Estimated counterfactual dietary intakes were modeled from reductions observed in experimental and observational studies that examined changes in sodium, sugars, saturated fat, and calorie content of food purchases in the presence of a 'high in' FOPL (four counterfactual scenarios). The Preventable Risk Integrated ModEl was used to estimate potential health impacts. Results: Estimated mean dietary reductions were between 31 and 212 mg/day of sodium, 2.3 and 8.7 g/day of total sugars, 0.8 and 3.7 g/day of saturated fats, and 16 and 59 kcal/day of calories. Between 2,183 (95% UI 2,008-2,361) and 8,907 (95% UI 8,095-9,667) deaths due to diet-related NCDs, mostly from cardiovascular diseases (~70%), could potentially be averted or delayed by implementing a 'high in' FOPL in Canada. This estimation represents between 2.4 and 9.6% of the total number of diet-related NCD deaths in Canada. Conclusion: Results suggest that implementing a FOPL could significantly reduce sodium, total sugar, and saturated fat intakes among Canadian adults and subsequently prevent or postpone a substantial number of diet-related NCD deaths in Canada. These results provide critical evidence to inform policy decisions related to implementing FOPL in Canada.

Front-of-Pack Nutrition Labels: Comparing the Nordic Keyhole and Nutri-Score in a Swedish Context.

The extent to which different front-of-pack nutrition labels (FOPNLs) agree or contradict each other has been insufficiently investigated. Considering the 2020 proposal from the European Commission to create a harmonized FOPNL, the aim of this study was to assess agreements and disagreements between two FOPNL schemes-the Keyhole and the Nutri-Score-in a Swedish context. The current Keyhole criteria and the updated Nutri-Score 2022 algorithm were applied to 984 food items and their nutrient compositions, obtained from the food database of the Swedish Food Agency. Agreements (Keyhole-eligible and Nutri-Score A or B; or not Keyhole-eligible and Nutri-Score C, D, or E) and disagreements (Keyhole-eligible and Nutri-Score C, D, or E, or not Keyhole-eligible and Nutri-Score A or B) were calculated as percentages for all items and by food group. An agreement was found for 81% of included items. The lowest level of agreement was found for the groups of flour, grains, and rice (62% agreement) and for plant-based meat and fish analogues (33% agreement). There is generally a good level of agreement between the Keyhole and the Nutri-Score for food items on the Swedish market. Large disagreements found for plant-based meat and fish analogues, and products based on cereals/grains, highlight important considerations for the development of a harmonized FOPNL within Europe.

Advantages of graphical nutrition facts label: faster attention capture and improved healthiness judgement.

Consumers have to rely on the traditional back-of-package nutrition facts label (NFL) to obtain nutrition information in many countries. However, traditional NFLs have been criticised for their poor visualisation and low efficiency. This study redesigned back-of-package NFLs integrated with bar graphs (black or coloured) to visually indicate nutrient reference values (NRVs). Two eye movement studies were performed to evaluate the ergonomic advantages of the graphical NFLs. Our findings suggested that the newly designed NFLs led to faster and better healthiness evaluation performance. The newly designed graphical labels led to a shorter time to first fixation duration and offered a higher percentage of fixation time in the nutrient reference values region compared with that observed using traditional text labels. Nowadays, many chronic diseases are associated with poor eating habits, therefore, the importance of visualisation design to nudge healthier food choices could be paid more attention to by policymakers and food manufacturers.Practitioner summary: To improve the ergonomic design of traditional nutrition facts panel (NFL), this study assessed a newly designed graphical NFL. The results showed that graphical NFL captured consumers' attention faster and improved their healthiness judgement. Moreover, a brief nutrition education can improve consumers' attention and understanding of nutrition information.

Assessing Consumer Willingness to Pay for Nutritional Information Using a Dietary App.

A healthy society is the foundation of development in every country, and one way to achieve a healthy society is to promote healthy nutrition. An unbalanced diet is one of the leading causes of noncommunicable diseases globally. If food was correctly selected and correctly consumed, both the problems of overeating and lack of nutrition could be largely solved while also decreasing public health costs. Interventions such as presenting necessary information and warning labels would help consumers make better food choices. Hence, providing nutritional information to consumers becomes essential. The present study investigates the importance of nutrition information labels on consumers' preferences by estimating their willingness to pay for features and information provided by a dietary software program (app). An application can easily display the information to the consumers and help them make informed food choices. A discrete choice experiment investigated consumers' preferences and willingness to pay to receive nutritional information. Mixed multinomial logit and latent class analysis were applied. The results showed the existence of heterogeneity in consumer preferences for different nutritional information provided by the application. Consumers are willing to pay more for salt and fat alerts. The results of this study allow for the analysis of consumers' interest in nutritional information. Such results are essential for the industry for future investments in similar applications that potentially could help consumers make better informed choices.

The influence of front-of-pack nutritional labels on eating and purchasing behaviors: a narrative review of the literature.

BACKGROUND: Front-of-Pack Nutritional Labels are considered a useful tool to help consumers orient themselves in their food choices and direct their behavior toward a healthier diet. FOPNL development and use are part of a framework that includes cognitive, biological, hedonic and cultural aspects, able to affect consumers' eating and purchasing behavior. AIM: Given the complexity of the matter, the aim of this narrative review is to analyze the combination of different factors that drive food choices and eating behaviors and to highlight some aspects that are not fully studied. METHODS: The authors conducted the research using a top-down approach at first, followed by a bottom-up approach; starting with general considerations about the purchasing process, gradually narrowing the discussion to a specific sub-population, and finally extending the discussion back to more general reasonings about the direction to adopt in future, or at least to evaluate, for effective communication. RESULTS: Biases and attitudes toward food products were found to regularly interfere with buying behavior patterns, making it impossible to standardize an average consumer. This reflects in current research, increasing the complexity of the topic. All determinants influencing food choices are often assessed individually rather than in a synergistic and multidimensional context, while the purchasing scenario is characterized by multiple stimuli to which the consumer is subjected. FOPNLs' impact on perceived healthiness has been studied in different conditions, but some population subgroups have not been sufficiently represented. In particular, the effect of FOPNLs on consumers suffering from eating disorders is understudied and needs further attention. Furthermore, some approaches can be compared to "negative nutrition" or "loss-framed communication", putting nutrients out of context, emphasizing losses more than gains and risking promoting negative feelings in consumers. CONCLUSION: Due to the heterogeneity of studies, evidence on what works best in driving people to adopt lasting lifestyle changes is still mixed. Science communicators and policymakers should consider the possibility that a multi-component approach incorporating nutrition information and education may be a key strategy to promote consumers' self-consciousness and to support them in their cognitive efforts toward a healthy and sustainable diet. LEVEL OF EVIDENCE: Level V, narrative review.

Analysis and Screening of Commercialized Protein Supplements for Sports Practice.

Recent years have seen a rise in the popularity of the consumption of sports-related supplements. However, the hypothesis is raised that it is necessary to analyze the quality aspects of these supplements in relation to the information provided on the label, to avoid associated risks and obtain the greatest possible benefit from their consumption. Therefore, the aim of this study has been to carry out an analysis or screening of the protein supplements that are currently marketed in Spain. We analyzed the labels of 52 protein sports supplements available both in physical stores and online. The analysis consisted of addressing three relevant aspects considering the labeling: (a) the legislative framework in which the supplements are marketed, (b) the quality of the protein, and (c) the presence of other ingredients according to the specifications of the label. In the legislative context, there do not seem to be any specific regulations to guarantee consumer protection, which can lead to unfair practices and misleading advertising. Most of the supplements analyzed to comply with the requirements of their current regulations. However, claims about their benefits that are not allowed under European legislation have been found in some of them. Regarding composition and according to label information, the supplements have been found to provide a sufficient dose of protein in terms of recommended protein intake per serving. Regarding the presence of other ingredients and according to the information on the label, most of them, except for egg supplements, contain other ingredients. Colostrum was also found in one of the supplements evaluated. The conclusions of the study reveal that, due to a lack of knowledge or misleading advertising practices, supplements are often not used properly. The information provided is essential for both professionals and consumers to avoid the risks associated with consumption, such as unintentional doping, interactions between ingredients that reduce the quality of the supplement, and consumption of supplements inappropriately, among others.

Understanding and Use of Nutrition Labels of Prepackaged Food by University Students: A Cross-Sectional Study in Chongqing, China.

OBJECT: The correct use of nutrition labels for prepackaged food helps university students develop healthy eating habits and prevent the occurrence of chronic non-communicable diseases. This study evaluates the understanding and use of nutrition labels of prepackaged food by university students in four different fields of study in Chongqing, China. METHODS: This cross-sectional study used an online survey platform conducted in July 2022 in colleges and universities in Chongqing, China. The convenience sampling method was used to select students in four different fields of study, including medicine, humanities, science and technology, and arts and sports. Ten questions were used to assess participants' understanding of nutrition labels. A score of six or above (60%) indicates that the respondent has a basic understanding of the nutritional labels of prepackaged food. Descriptive statistics and generalized linear models (GLMs) were used to assess participants' understanding and use of nutrition labels for prepackaged foods and their influencing factors. RESULTS: A total of 1262 valid questionnaires was collected. The average age of the participants was 21.8 years (SD: 2.43), 50.1% were male, 80.8% were ethnic Han, and 50.9% were from rural areas. Only 21.3% of the university students in Chongqing had a good understanding of the nutrition labels of prepackaged food, where medical students were the highest (39.9%) and science and engineering students were the lowest (15.6%). Gender, ethnicity, grade, major, and whether received courses related to nutrition were influential factors in the understanding and use of nutrition labels of prepackaged food. Medical students also had more positive attitudes toward nutritional labels of prepackaged food. CONCLUSIONS: Understanding and use of nutrition labels for prepackaged food by university students in Chongqing are unsatisfactory. Student's major was a significant influencing factor in nutrition label comprehension, with medical students having the greatest understanding. Based on these results, we suggest that nutrition and health courses should be popularized among non-medical students to narrow the differences between different fields of study. For university students in all fields of study, education and publicity of nutrition labels of prepackaged food are needed, not only in the classroom but also in daily life.