Acceptability of workplace choice architecture modification for healthy behaviours.

BACKGROUND: Altering the choice architecture of decision contexts can assist behaviour change, but the acceptability of this approach has sparked debate. Considering hypothetical interventions, people generally welcome the approach for promoting health, but little evidence exists on acceptance in the real world. Furthermore, research has yet to explore the implementers' perspective, acknowledging the multidimensionality of the acceptability construct. Addressing these knowledge gaps, this study evaluated the acceptability of a quasi-experimental implementation-effectiveness trial that modified the worksite choice architecture for healthy eating and daily physical activity. METHODS: Fifty-three worksites participated in the 12-month intervention and implemented altogether 23 choice architecture strategies (Mdn 3/site), including point-of-choice prompts and changes to choice availability or accessibility. Retrospective acceptability evaluation built on deductive qualitative content analysis of implementer interviews (n = 65) and quantitative analysis of an employee questionnaire (n = 1124). Qualitative analysis examined implementers' thoughts and observations of the intervention and its implementation, considering six domains of the Theoretical Framework of Acceptability: ethicality, affective attitude, burden, intervention coherence, opportunity costs, and perceived effectiveness. Quantitative analysis examined employees' acceptance (7-point Likert scale) of eight specific intervention strategies using Friedman test and mixed-effects logistic regression. RESULTS: Implementers considered the choice architecture approach ethical for workplace health promotion, reported mostly positive affective attitudes to and little burden because of the intervention. Intervention coherence supported acceptance through increased interest in implementation, whereas low perceived utility and high intensity of implementation reduced cost acceptance. Perceived effectiveness was mixed and varied along factors related to the implementer, social/physical work environment, employer, and employee. Employees showed overall high acceptance of evaluated strategies (Mdn 7, IQR 6.4-7), though strategies replacing unhealthy foods with healthier alternatives appeared less supported than providing information or enhancing healthy option availability or accessibility (p-values < 0.02). Greater proportion of male employees per site predicted lower overall acceptance (OR 4.4, 95% CI 1.2-16.5). CONCLUSIONS: Work communities appear to approve workplace choice architecture interventions for healthy eating and physical activity, but numerous factors influence acceptance and warrant consideration in future interventions. The study contributes with a theory-based, multidimensional evaluation that considered the perspectives of implementers and influenced individuals across heterogeneous real-world settings.

Nudging Toward Sustainable Food Consumption at University Canteens: A Systematic Review and Meta-Analysis.

INTRODUCTION: This systematic literature review and meta-analysis investigated the effectiveness of the nudging approach toward sustainable food consumption in the university canteen context. METHODS: The systematic literature search was carried out in 5 databases, Web of Science, PubMed, Scopus, ProQuest, and the Royal Library, identifying 14 eligible studies and selecting 9 articles containing adequate information for meta-analysis. The nudging strategies were classified using the typology of interventions in the proximal physical microenvironments framework that resulted in 5 different intervention types: availability, position, size, presentation, and information that belonged to either intervention class-altering properties or placement. RESULTS: The study identified presentation, availability, and information as the most promising nudge intervention for achieving sustainable food consumption at the university canteen or similar settings. Nudging by altering the properties had a small effect size (d = 0.16), and nudging by altering placement showed a medium effect size (d = 0.21). DISCUSSION: Nudging interventions implemented after understanding consumers' current behavior showed positive effectiveness toward sustainable food consumption rather than implementing random nudges. CONCLUSIONS AND IMPLICATIONS: It is important that future studies aim to achieve sustainable food consumption by understanding canteen user food preferences and food choice motives before designing a nudging strategy.

Vegan nutrition: a preliminary guide for health professionals.

Since the beginning of the 21st century, interest in vegan diets has been rapidly increasing in most countries. Misconceptions about vegan diets are widespread among the general population and health professionals. Vegan diets can be health-promoting and may offer certain important advantages compared to typical Western (and other mainstream) eating patterns. However, adequate dietary sources/supplements of nutrients of focus specific to vegan diets should be identified and communicated. Without supplements/fortified foods, severe vitamin B12 deficiency may occur. Other potential nutrients of focus are calcium, vitamin D, iodine, omega-3 fatty acids, iron, zinc, selenium, vitamin A, and protein. Ensuring adequate nutrient status is particularly important during pregnancy, lactation, infancy, and childhood. Health professionals are often expected to be able to provide advice on the topic of vegan nutrition, but a precise and practical vegan nutrition guide for health professionals is lacking. Consequently, it is important and urgent to provide such a set of dietary recommendations. It is the aim of this article to provide vegan nutrition guidelines, based on current evidence, which can easily be communicated to vegan patients/clients, with the goal of ensuring adequate nutrient status in vegans.

Associations among social engagement, meal-related behaviour, satisfaction with food-related life and wellbeing in Danish older adults living alone.

The present study aimed at exploring associations among meal-related behaviour, social engagement factors, satisfaction with food-related life (SWFL) to assess food-related wellbeing and subjective wellbeing in Danish older adults living alone. Three hundred and eighty-eight older adults aged 65-75 years from six Danish municipalities completed an online or article-based survey addressing home cooking, commensality, loneliness, SWFL and subjective wellbeing. Home cooking frequency and self-perceived cooking skills were positively associated with SWFL but not with subjective wellbeing. Commensality was positively associated with SWFL but was not associated with subjective wellbeing. The level of loneliness was negatively associated with SWFL and with subjective wellbeing. Satisfaction with food-related life and subjective health status were positively associated with subjective wellbeing. Male and female respondents did not differ in meal-related behaviour, social engagement factors, SWFL and wellbeing. While the cross-sectional nature of this study does not allow for the direction of causality to be determined, these results suggest that older adults living alone could benefit from a higher frequency of home-cooked meals, a higher level of self-perceived cooking skills and commensality to support SWFL. A higher level of SWFL could, in turn, lead to a higher level of wellbeing.

A randomized trial testing the effectiveness of virtual reality as a tool for pro-environmental dietary change.

This study investigates the impact of an efficacy-focused virtual reality (VR) intervention designed according to instructional design principles on eating behavior. In the preregistered intervention study, psychology students were randomly assigned to nine seminar blocks. Employing parallel design, they were allocated to either a VR intervention to experience the environmental impact of food behavior (1) and alter the future by revising food choices (2) or to a passive control condition. The data from 123 participants (78% female, mean age 25.03, SD = 6.4) were analyzed to investigate the effect of the VR intervention on dietary footprint measured from 1 week before to 1 week after the intervention. The VR intervention decreased individual dietary footprints (d = 0.4) significantly more than the control condition. Similarly, the VR condition increased response efficacy and knowledge to a larger extent compared to the control. For knowledge, the effect persisted for 1 week. The VR intervention had no impact on intentions, self-efficacy, or psychological distance. Additional manipulation of normative feedback enhanced self-efficacy; however, manipulation of geographical framing did not influence psychological distance. This research received no financial support from any funding agency and was registered on 15/09/2021 at Open Science Foundation with the number https://doi.org/10.17605/OSF.IO/2AXF3 .

Food Desires and Hedonic Discrimination in Virtual Reality Varying in Product-Context Appropriateness among Older Consumers.

Immersive virtual reality (VR) videos can replicate complex real-life situations in a systematic, repeatable and versatile manner. New product development trajectories should consider the complexities of daily life eating situations. The creation of immersive contexts of a product with varying levels of appropriateness could be a useful tool for product developers in evaluating the extent to which context may influence food acceptance and eating behavior. This study explored virtual reality (VR) as an efficient context-enhancing technology through evaluations of protein-enriched rye breads and compared the effects of a VR-simulated congruent (VR restaurant) and incongruent (VR cinema) contexts on the acceptance in older consumers. A total of 70 participants were immersed in the two VR contexts and a neutral control context in a randomized order. The responses indicating the desire and liking for rye breads were measured, and the extent of immersion during context exposure was assessed by levels of the sense of presence and engagement. Immersive VR induced positive sensations of presence and a heightened level of engagement. The VR restaurant and neutral contexts were perceived as more appropriate for consuming rye breads and induced higher desire and liking for rye breads, which supported the notion of the alignment of congruent contexts with food desire and liking. The study provides new perspectives, practical methodologies, and discoveries in regard to the creation and application of VR-immersed contexts in food product evaluation. Moreover, it focused on a consumer segment (older consumers) that has seldom been investigated in previous relevant studies. The findings suggest that immersive VR technology, as a tool for evaluating contextual factors, is important for new product development. The good user experience among older consumers further indicated the potential value of VR as a context-enhancing tool for product development.

How Do Consumers Perceive Cultured Meat in Croatia, Greece, and Spain?

The meat production industry is one of the leading contributors of greenhouse gas emissions. Cultured meat presents itself as a potential eco- and animal-friendly meat substitute which has the potential to eradicate animal cruelty and reduce both the environmental footprint and the risk of zoonotic illnesses, while delivering a nutrient-dense product. The purpose of this study was to investigate how consumers perceive cultured meat and if the frequency of meat consumption is related to their intention of trying or purchasing cultured meat. Data were collected online in 2020 from Croatia, Greece, and Spain. Among the 2007 respondents, three segments were identified according to meat consumption and variety, plus an a priori identified group of "non-meat eaters". Sixty percent perceived cultured meat as kind to animals, 57% as unnatural, 45% as healthy and environmentally-friendly, 21% as disgusting, and only 16% as tasty. Although 47% of the respondents had not heard of cultured meat before, 47% would taste it and 41% would purchase it for the same price as conventional meat. This indicates that consumers from Croatia, Greece and Spain might be likely to purchase cultured meat if sold at an affordable price.

Plant-based food and protein trend from a business perspective: markets, consumers, and the challenges and opportunities in the future.

The food sector is increasingly turning toward sustainability issues. A sustainable food system should provide sufficient, nutritious food for all within limited natural resources. Plant-based food and proteins are a recent, growing trend setting out to contribute to this challenge. However, food industry stakeholders need to be aware of the challenges and opportunities. This paper reviews the trend from a business perspective. It outlines the global drivers, market trends, market data observations, and consumer behavior factors of relevance, and pinpoints the strengths, weaknesses, opportunities and threats (SWOT) for food sector companies. Findings suggest that the policy and market context is favorable in the near future, but that consumer beliefs, perception and understanding has to change further for the business opportunity to grow on a larger scale. More innovations are needed, in particular in the direction of meat-replacements that are healthy as well as clean label.

The Promotion of Eating Behaviour Change through Digital Interventions.

Diet-related chronic disease is a global health epidemic giving rise to a high incidence of morbidity and mortality. With the rise of the digital revolution, there has been increased interest in using digital technology for eating behavioural change as a mean of diet-related chronic disease prevention. However, evidence on digital dietary behaviour change is relatively scarce. To address this problem, this review considers the digital interventions currently being used in dietary behaviour change studies. A literature search was conducted in databases like PubMed, Cochrane Library, CINAHL, Medline, and PsycInfo. Among 119 articles screened, 15 were selected for the study as they met all the inclusion criteria according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) search strategy. Four primary digital intervention methods were noted: use of personal digital assistants, use of the internet as an educational tool, use of video games and use of mobile phone applications. The efficiency of all the interventions increased when coupled with tailored feedback and counselling. It was established that the scalable and sustainable properties of digital interventions have the potential to bring about adequate changes in the eating behaviour of individuals. Further research should concentrate on the appropriate personalisation of the interventions, according to the requirements of the individuals, and proper integration of behaviour change techniques to motivate long-term adherence.

Effect of Impulsivity Traits on Food Choice within a Nudging Intervention.

Food choices are often driven by impulsive tendencies rather than rational consideration. Some individuals may find it more difficult resisting impulses related to unhealthy food choices, and low self-control and high impulsivity have been suggested to be linked to these behaviors. Recent shifts have been made towards developing strategies that target automatic processes of decision-making and focus on adjusting the environment, referred to as nudging interventions. Therefore, the purpose of this study was to investigate the effect of impulsivity traits on food choices within a nudging intervention (increased perceived variety). A total of 83 adults participated in an experimental study consisting of a self-service intelligent buffet. Impulsivity traits were measured using the UPPS-P impulsivity scale. General linear models were fitted to evaluate the effect of the five impulsivity traits on the difference of salad consumption (g) between the control and intervention situations. Results showed that impulsivity does not affect food choices in this nudging situation, suggesting that nudging works independently of the participant's impulsivity score. Results also showed a significantly higher consumption of salad in the nudging versus the control setting (17.6 g, p < 0.05), suggesting that nudging interventions can be effective in significantly increasing total vegetable consumption across the whole impulsivity scale.

Assessing the Influence of Visual-Taste Congruency on Perceived Sweetness and Product Liking in Immersive VR.

This study was designed to assess whether the combined effect of taste-congruent and incongruent extrinsic visual cues presented in virtual reality (VR) influences the perception of sweetness and product liking. Three VR environments (sweet-congruent, sweet-incongruent, and neutral) were created based on the evidence in existing literature. Participants tasted the same beverage in three VR environments and evaluated the environment and beverage liking, as well as perceived taste intensity (sweetness, sourness, and bitterness), congruency, comfort, and environment vividness. Frontal EEG alpha asymmetry (FAA) was also recorded as a complementary physiological measurement of overall liking. The results showed that the perceived sweetness of the beverage was significantly elevated in a sweet-congruent environment versus the other environments. Visual-taste congruency did not seem to have an effect on beverage liking and overall liking, whereas an increase in environment liking was found in the incongruent environment versus the other environments. These findings confirmed the significant influence of taste-specific visual cues on flavour perception, while the successful use of VR in the study provided insight into future applications of taste-specific VR environment in the modulation of flavour perception and sugar reduction.

The Multifaceted Dimensions of Food Choice and Nutrition.

The Special Issue "Food Choice and Nutrition" deals with the relationship between the food choices of different population groups or consumer segments and its impact on the nutritional status, improvement of dietary quality, food and nutrition-related behaviour, food preferences, taste education, sensory characteristics of foods and their role in consumer choice, etc [...].

Physical fitness in community-dwelling older adults is linked to dietary intake, gut microbiota, and metabolomic signatures.

When humans age, changes in body composition arise along with lifestyle-associated disorders influencing fitness and physical decline. Here we provide a comprehensive view of dietary intake, physical activity, gut microbiota (GM), and host metabolome in relation to physical fitness of 207 community-dwelling subjects aged +65 years. Stratification on anthropometric/body composition/physical performance measurements (ABPm) variables identified two phenotypes (high/low-fitness) clearly linked to dietary intake, physical activity, GM, and host metabolome patterns. Strikingly, despite a higher energy intake high-fitness subjects were characterized by leaner bodies and lower fasting proinsulin-C-peptide/blood glucose levels in a mechanism likely driven by higher dietary fiber intake, physical activity and increased abundance of Bifidobacteriales and Clostridiales species in GM and associated metabolites (i.e., enterolactone). These factors explained 50.1% of the individual variation in physical fitness. We propose that targeting dietary strategies for modulation of GM and host metabolome interactions may allow establishing therapeutic approaches to delay and possibly revert comorbidities of aging.

Impact of a nudging intervention and factors associated with vegetable dish choice among European adolescents.

PURPOSE: To test the impact of a nudge strategy (dish of the day strategy) and the factors associated with vegetable dish choice, upon food selection by European adolescents in a real foodservice setting. METHODS: A cross-sectional quasi-experimental study was implemented in restaurants in four European countries: Denmark, France, Italy and United Kingdom. In total, 360 individuals aged 12-19 years were allocated into control or intervention groups, and asked to select from meat-based, fish-based, or vegetable-based meals. All three dishes were identically presented in appearance (balls with similar size and weight) and with the same sauce (tomato sauce) and side dishes (pasta and salad). In the intervention condition, the vegetable-based option was presented as the "dish of the day" and numbers of dishes chosen by each group were compared using the Pearson chi-square test. Multivariate logistic regression analysis was run to assess associations between choice of vegetable-based dish and its potential associated factors (adherence to Mediterranean diet, food neophobia, attitudes towards nudging for vegetables, food choice questionnaire, human values scale, social norms and self-estimated health, country, gender and belonging to control or intervention groups). All analyses were run in SPSS 22.0. RESULTS: The nudging strategy (dish of the day) did not show a difference on the choice of the vegetable-based option among adolescents tested (p = 0.80 for Denmark and France and p = 0.69 and p = 0.53 for Italy and UK, respectively). However, natural dimension of food choice questionnaire, social norms and attitudes towards vegetable nudging were all positively associated with the choice of the vegetable-based dish. Being male was negatively associated with choosing the vegetable-based dish. CONCLUSIONS: The "dish of the day" strategy did not work under the study conditions. Choice of the vegetable-based dish was predicted by natural dimension, social norms, gender and attitudes towards vegetable nudging. An understanding of factors related to choosing vegetable based dishes is necessary for the development and implementation of public policy interventions aiming to increase the consumption of vegetables among adolescents.

Attitudes and knowledge towards plant-based diets of young adults across four European countries. Exploratory survey.

This study explored consumer awareness, knowledge and attitudes towards a plant-based diet (PBD) in Belgium, Denmark, the Netherlands and Spain. Furthermore, it assessed knowledge and attitudinal determinants of whether consumers consider the term PBD more appealing than VTD (vegetarian) or VND (vegan). An online survey was conducted among young adults (age 18-30 years) (n = 438) in October 2018. It showed that awareness of the term PBD differed significantly among the countries and was lowest in Spain. Nearly all respondents reported awareness of the terms VTD and VND. Overall, respondents had limited knowledge of a PBD composition and many respondents considered the term PBD equivalent to VND. A neutral to slightly positive attitude towards a PBD was found, and specifically positive regarding health, environment and animal welfare. Many Belgian and Dutch respondents perceived the term PBD as more appealing than VND, while many Danish and Spanish respondents were more indifferent. Knowledge about PBDs and perceiving such diets as tasty and enjoyable contributed significantly to the likelihood of perceiving the term PBD as more appealing than VTD and VND. The concept 'plant-based diet' is promising for future health promotion initiatives in Europe, with special focus on provision of adequate information.

A Mobile Phone App for the Provision of Personalized Food-Based Information in an Eating-Out Situation: Development and Initial Evaluation.

BACKGROUND: Increasing pressure from governments, public health bodies, and consumers is driving a need for increased food-based information provision in eating-out situations. Meals eaten outside the home are known to be less healthy than meals eaten at home, and consumers can complain of poor information on the health impact and allergen content of meals eaten out. OBJECTIVE: This paper aimed to describe the development and early assessment of a mobile phone app that allows the provision of accurate personalized food-based information while considering individual characteristics (allergies, diet type, and preferences) to enable informed consumer choice when eating out. METHODS: An app was designed and developed to address these requirements using an agile approach. The developed app was then evaluated at 8 public engagement events using the System Usability Scale (SUS) questionnaire and qualitative feedback. RESULTS: Consideration of the literature and consultation with consumers revealed a need for information provision for consumers in the eating-out situation, including the ability to limit the information provided to that which was personally relevant or interesting. The app was designed to provide information to consumers on the dishes available in a workplace canteen and to allow consumers the freedom to personalize the app and choose the information that they received. Evaluation using the SUS questionnaire revealed positive responses to the app from a range of potential users, and qualitative comments demonstrated broad interest in its use. CONCLUSIONS: This paper details the successful development and early assessment of a novel mobile phone app designed to provide food-based information in an eating-out situation in a personalized manner.

An Umbrella Review of Systematic Reviews on Food Choice and Nutrition Published between 2017 and-2019.

The objective of this umbrella review was to provide an update on the latest knowledge in the field of food choice and nutrition. Databases Scopus and ISI-Web of Science were searched for "food choice" AND nutrition. Papers were included if they were systematic reviews published between January 2017 and August 2019 on any subpopulation group. In total, 26 systematic reviews were kept. Data were extracted with a predetermined grid including first author, publication year, country, population group, explanatory constructs (intervention focus) and reported outcomes. Common indicators for outcome measures on food choice and nutrition studies are nutrition knowledge, healthy food choices, food purchases and food and nutrient intake. The most common strategy implemented to alter food choice with a nutritional aim is nutrition education, followed by provision of information through labels. Among children, parent modelling is key to achieving healthy food choices. In general, combining strategies seems to be the most effective way to achieve healthier food consumption and to maintain good nutrition in all age groups.

A Provegetarian Food Pattern Emphasizing Preference for Healthy Plant-Derived Foods Reduces the Risk of Overweight/Obesity in the SUN Cohort.

Provegetarian diets (i.e., preference for plant-derived foods but not exclusion of animal foods) have been associated with a reduced risk of long-term weight gain and could be more easily embraced than strict vegetarian diets. However, not all plant-derived foods are equally healthy. In the "Seguimiento Universidad de Navarra" (SUN) cohort, we prospectively evaluated the association between different provegetarian food patterns and the incidence of overweight/obesity in 11,554 participants with initial body mass index <25 kg/m2. A provegetarian food pattern (FP) was built by assigning positive scores to plant foods and reverse scores to animal foods. A healthful and an unhealthful provegetarian FP, which distinguished between healthy (fruits/vegetables/whole grains/nuts/legumes/olive oil/coffee) and less-healthy plant foods (fruit juices/potatoes/refined grains/pastries/sugary beverages), were also built. A total of 2320 new cases of overweight or obesity were identified after a median follow-up of 10.3 years. Higher baseline conformity with the overall provegetarian FP was inversely associated with overweight/obesity (HR comparing extreme quintiles: 0.85; 95% CI: 0.75 to 0.96; p-trend: 0.014). This association was stronger for the healthful FP (HR: 0.78; 95% CI: 0.67 to 0.90; p-trend: <0.001) and was not apparent for the unhealthful FP (HR: 1.07; 95% CI: 0.92 to 1.23; p-trend: 0.551). In a large prospective cohort of relatively young adults, better conformity with a healthy provegetarian diet was associated with a reduced long-term risk of overweight/obesity, whereas no consistent trend was found for a FP that emphasized less-healthy plant foods.

Older consumers' attitudes towards food carriers for protein-enrichment.

Understanding the demands of older consumers is of importance for successful development of functional foods targeted at this segment of the population. This study aimed to examine older adults' attitudes towards food carriers for protein enrichment. In total 182 consumers (mean age: 66.6 ±â€¯6.9) participated in a survey designed to evaluate their willingness to try and purchase 16 target food carriers for protein enrichment. Food carriers were chosen to vary systematically on three fundamental dimensions: healthiness (healthy vs. unhealthy), novelty (traditional vs. novel), and types of meal (meal-component vs. snack). Results showed that among the carrier formats, older consumers were most willing to purchase and try healthy, traditional meal component foods enriched with protein. By segmenting older consumers using a latent class approach, an increase in purchase willingness of protein-enriched foods was found when protein-enriched foods were tailored to particular segments, suggesting that a segmentation-based approach to product development would be beneficial. Future studies may need to explore older consumers' actual purchase intention through the tasting of appealing protein-enriched foods in real life, which might help reduce older consumers' skepticism towards protein-enriched foods.

Sensory-Driven Development of Protein-Enriched Rye Bread and Cream Cheese for the Nutritional Demands of Older Adults.

To promote healthy aging and minimize age-related loss of muscle mass and strength, adequate protein intake throughout the day is needed. Developing and commercializing protein-enriched foods holds great potential to help fulfill the nutritional demands of older consumers. However, innovation of appealing protein-enriched products is a challenging task since protein-enrichment often leads to reduced food palatability. In this study, rye bread and cream cheese prototypes fortified by whey protein hydrolysate (WPH), whey protein isolate (WPI), and/or soy protein isolate (SPI) were developed. Both sensory properties and consumer liking of prototypes were evaluated. Results showed that different proteins had various effects on the sensory characters of rye bread and cream cheese. The taste and texture modification strategies had positive effects in counteracting negative sensory changes caused by protein-enrichment. Consumers preferred 7% WPH and 4% WPH + 4% SPI-enriched breads with taste and texture modified. Sour taste and dry texture had considerable effects on consumer liking of rye bread. Addition of WPI and butter enhanced the flavor of cream cheese and increased consumer acceptance. Protein-enrichment doubled the protein content in the most liked prototypes, which have the potential to be incorporated into older consumers' diets and improve their protein intake substantially.