Impact of health warning labels on snack selection: an online experimental study

BackgroundExcessive consumption of energy-dense food increases the risk of obesity, which in turn increases the risk of non-communicable diseases, including heart disease, type 2 diabetes and most non-smoking-related cancers. Health warning labels (HWLs) that communicate the adverse health consequences of excess energy consumption could reduce intake of energy-dense foods. The aim of the current study was to estimate the impact on selection of energy-dense snacks of (a) image-and-text HWLs (b) text-only HWLs and (c) calorie information. Methods A between-subjects, 3 (HWL: image-and-text, text-only, no label) x 2 (calorie information: present, absent), factorial experimental design. Participants (N=4,134) were randomised to view a selection of energy-dense and non-energy-dense snacks with one of five label types or no label. The primary outcome was the proportion of participants selecting an energy-dense snack in a hypothetical vending machine task.ResultsThe proportion of participants selecting an energy-dense snack was reduced in all label groups, relative to the no label group (image-and-text HWL: 37%; image-and-text HWL with calories: 38%; text-only HWL: 48%; text-only HWL with calories: 44%; calories only: 54%; no label: 59%). Participants were least likely to select an energy-dense snack in the image-and-text HWL group and most likely in the no label group (OR = 0.46, 95%CI = 0.40, 0.54, p < 0.001).Conclusions Health warning labels – particularly those including an image and text - have the potential to reduce selection of energy-dense snacks in an online setting. Their impact on selection and consumption in real-world settings awaits testing.Trial registration: The study protocol (https://osf.io/6n7h9, registered: April 1st 2019) and data analysis plan (https://osf.io/zvrs5) were pre-registered on the Open Science Framework. KeywordsHealth warning labels, pictorial labels, graphic warnings, snacks, food, choice architecture, energy-dense

Download Full-text

Impact of Image-and-text and Text-only Health Warning Labels on Selection and Consumption of Food and Alcohol Products: Systematic Review with Meta-analysis

10.31234/osf.io/jt52m ◽

2019 ◽

Cited By ~ 3

Author(s):

Natasha Clarke ◽

Emily Pechey ◽

Daina Kosīte ◽

Laura M König ◽

Eleni Mantzari ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Experimental Studies ◽

Control Group ◽

Warning Labels ◽

Health Warning ◽

Alcoholic Drinks ◽

Randomised Controlled ◽

The Impact ◽

Selection Of

Reducing harmful consumption of food (including non-alcoholic drinks) and alcoholic drinks would prevent much disease. Evidence from tobacco control shows that placing health warning labels (HWLs) on these products reduces their selection and consumption. A systematic review with meta-analysis was conducted using Cochrane methods to assess the impact on selection (including hypothetical selection) or consumption of food or alcoholic drinks with image-and-text (sometimes termed ‘pictorial’) and text-only HWLs placed on these products. Studies were required to be randomised or quasi-randomised controlled trials. Fourteen studies were included, three on alcohol, eleven on food. For our primary outcomes, eleven studies measured selection and one measured consumption (two measured only other secondary outcomes). Meta-analysis of twelve comparisons from nine studies (n=12,635) found HWLs reduced selection of the targeted product compared to a control group with no HWL (RR=0.74 (95% CI 0.68 to 0.80)), with participants 26% less likely to choose a product displaying a HWL. A planned subgroup analysis suggested a larger effect on selection of image-and-text HWLs (RR=0.65 (95% CI 0.54 to 0.80)) than text-only HWLs (RR=0.79 (95% CI 0.74 to 0.85)), but this difference was not statistically significant. These findings suggest significant potential for HWLs to reduce selection of food and alcohol, but all experimental studies to date were conducted in laboratory or online settings with outcomes assessed immediately after a single exposure. Studies in field and more naturalistic laboratory settings are urgently needed to estimate the potential effects of HWLs on food and alcohol.

Download Full-text

Reclaiming the value of pictorial health warning labels in Jordan

Tobacco Control ◽

10.1136/tobaccocontrol-2017-053679 ◽

2017 ◽

Vol 27 (5) ◽

pp. 589-591

Author(s):

Nour A Obeidat ◽

Mai Al-Hadid ◽

Asma A Hatoqai ◽

Rawan A Shihab ◽

Feras I Hawari

Keyword(s):

Focus Groups ◽

The Novel ◽

Warning Labels ◽

Health Warning ◽

Inductive Approach ◽

Graphic Images ◽

Vicarious Experiences ◽

The Impact ◽

Selection Of

BackgroundIn Jordan, four non-graphic pictorial health warning labels (PHWLs) concerning a limited selection of tobacco-caused harms have been used since 2011; however, research suggests that they may be ineffective.ObjectivesTo explore Jordanian smokers’ reactions to novel PHWLs featuring various health themes and/or graphic and symbolic imagery and to discuss existing PHWLs in light of the novel PHWLs.MethodsWe conducted 14 focus groups (FGs) with smokers who assessed 12 novel PHWLs and commented on four existing PHWLs. Data were analysed using an inductive approach.ResultsSix themes emerged from the FG discussions: understanding the overall meaning of PHWLs, the impact of graphic images, magnitude and controllability of harm, personal or vicarious experiences, the futility of quitting and fatalism. PHWLs depicting graphic respiratory and oral tobacco-caused harms resonated with most smokers. Smokers also sought direct, harm-specific taglines when trying to understand the overall PHWL. Some smokers viewed the PHWLs as exaggerated, and while the majority acknowledged that smoking was harmful, they felt that PHWLs would not accomplish their goal of inducing quitting.ConclusionsOur findings support the use of graphic imagery to communicate tobacco-caused harms (particularly respiratory ones) and the use of specific taglines explaining the mechanism of harm depicted.

Download Full-text

Health Warning Labels for Smokeless Tobacco: The Impact of Graphic Images on Attention, Recall, and Craving

Nicotine & Tobacco Research ◽

10.1093/ntr/ntx021 ◽

2017 ◽

Vol 19 (10) ◽

pp. 1172-1177 ◽

Cited By ~ 11

Author(s):

Elizabeth G Klein ◽

Amanda J Quisenberry ◽

Abigail B Shoben ◽

Sarah Cooper ◽

Amy K Ferketich ◽

...

Keyword(s):

Smokeless Tobacco ◽

Warning Labels ◽

Health Warning ◽

Graphic Images ◽

The Impact

Download Full-text

Health warning labels and alcohol selection: an experiment in a naturalistic shopping laboratory

10.31234/osf.io/kr578 ◽

2020 ◽

Cited By ~ 1

Author(s):

Natasha Clarke ◽

Anna Katherine Mary Blackwell ◽

Katie De-loyde ◽

Emily Pechey ◽

Alice Hobson ◽

...

Keyword(s):

Bayes Factor ◽

Emotional Arousal ◽

Warning Labels ◽

Health Consequences ◽

Excessive Alcohol Consumption ◽

Health Warning ◽

Adverse Health ◽

Alcoholic Drinks ◽

Excessive Alcohol ◽

The Impact

Background and aims Health warning labels (HWLs) on tobacco products reduce smoking. There is an absence of evidence concerning the impact of alcohol HWLs on selection or purchasing in naturalistic settings. Using a commercial-standard naturalistic shopping laboratory, this study aimed to estimate the impact on selection of alcoholic drinks of HWLs describing adverse health consequences of excessive alcohol consumption.DesignA between-subjects randomised experiment with three groups: Group 1: image-and-text HWL; Group 2: text-only HWL; Group 3: no HWL.SettingA commercial-standard naturalistic shopping laboratory. Participants Adults (n=399) over the age of 18, who purchased beer or wine weekly to drink at home. InterventionsParticipants were randomised to one of three groups varying in the HWL displayed on the packaging of the alcoholic drinks: i. image-and-text HWL; ii. text-only HWL; iii. no HWL. Participants completed a shopping task, selecting items from a range of alcoholic and non-alcoholic drinks, and snacks. MeasurementThe primary outcome was the proportion of alcoholic drinks selected. Secondary outcomes included HWL ratings on negative emotional arousal and label acceptability.FindingsThere was no clear evidence of a difference in the HWL groups for the percentage of drinks selected that were alcoholic compared to no HWL (44%): image-and-text HWL: 46% (OR=1.08, 95%CI=0.82,1.42); text-only HWL: 41% (OR=0.87, 95%CI=0.67,1.14). Concordant with there being no difference between groups, there was extreme evidence in favour of the null hypothesis (Bayes factor [BF] < 0.01). Negative emotional arousal was higher (p< 0.001) and acceptability lower (p< 0.001) in the image-and-text HWL group, compared to the text-only HWL group. ConclusionsIn a naturalistic shopping laboratory, health warning labels describing the adverse health consequences of excessive alcohol consumption did not change selection behaviour.

Download Full-text

Impact of PET-imaging during treatment planning on outcome in meningioma patients.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e13542 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e13542-e13542

Author(s):

Stephanie E Combs ◽

Hanna Fischer ◽

Theresa Voglhuber ◽

Christian Diehl ◽

Chistoph Straube ◽

...

Keyword(s):

Treatment Planning ◽

Pet Imaging ◽

Residual Tumor ◽

Target Volume ◽

Open Science ◽

Low Grade ◽

High Grade ◽

Prognostic Assessment ◽

Science Framework ◽

The Impact

e13542 Background: Modern radiotherapy (RT) techniques such as IMRT combined with IGRT increased safety and precision over the years. However, during treatment planning, the definition of the planning target volume (PTV) remains challenging, and differentiation between healthy tissue, i.e., meninges, post-operative changes, and residual tumor can be difficult using MR and CT imaging alone. In this study, we evaluated the impact of additional PET-imaging on local control (LCR) and overall survival (OS). Methods: We analyzed 351 patients with primary RT of meningiomas treated between 1996 and 2018 and divided the cohort into low-grade (n = 283) and high-grade (n = 68) cases. All patients were treated with fractionated stereotactic radiotherapy (FSRT) with a median dose of 54.0 Gy and a median single dose of 1.8 Gy. A radiation oncologist delineated PTV based on diagnostic CT and MRI and, if available, additional PET-imaging. We used only PET-images acquired within 50 days before RT. In our clinic, PET-planned meningioma treatment started in 2000 with Methionine (2001-2010), between 2004 and 2011 F-18 FET tracer was used, and since 2011 only 68Ga-Dotanoc/Dotatoc PETs are acquired. This study is registered under the open science framework: DOI 10.17605/OSF.IO/RYX9D. Results: Median follow-up was 6.9 years (95%-KI: 6.3-7.4). For low-grade meningiomas, mean OS was 15.5 years (95%-KI: 14.7-16.2) and mean PFS was 15.7 years (95%-KI: 14.9-16.6); for high-grade cases, median OS was 13.8 years (95%-KI: 10.4-17.1), and median PFS was 8.9 years (95%-KI: 6.4-11.4). PET imaging had a significant impact on OS (p = 0.030) and PFS (p = 0.023) for low-grade meningiomas; however, in the multivariate analysis (with the prognostic factors age, gender, PTV, Karnofsky index, and time from resection to RT), it remained only significant for LCR. For high-grade cases, PET-imaging had no influence. Conclusions: PET-imaging improves the detection of tumor cells, especially during treatment planning. It showed a significant influence on OS and LCR. Further analyses will investigate the influence of PET regarding, e.g., residual tumor tissue, tumor size, and establish cut-off values for which tumors additional PET-imaging might be beneficial. With the further prognostic a weighted scoring system will be developed for prognostic assessment. [Table: see text]

Download Full-text

Alcohol pictorial health warning labels: the impact of self-affirmation and health warning severity

BMC Public Health ◽

10.1186/s12889-018-6243-6 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 6

Author(s):

Carlos Sillero-Rejon ◽

Angela S. Attwood ◽

Anna K. M. Blackwell ◽

José-Angel Ibáñez-Zapata ◽

Marcus R. Munafò ◽

...

Keyword(s):

Warning Labels ◽

Health Warning ◽

The Impact

Download Full-text

Impact of Successive Exertional Heat Injuries on Thermoregulatory and Systemic Inflammatory Responses in Mice

Journal of Applied Physiology ◽

10.1152/japplphysiol.00160.2021 ◽

2021 ◽

Author(s):

Aaron R. Caldwell ◽

Kentaro Oki ◽

Shauna M. Ward ◽

Jermaine A. Ward ◽

Thomas A. Mayer ◽

...

Keyword(s):

Core Temperature ◽

Injury Severity ◽

Inflammatory Responses ◽

Recovery Period ◽

Organ Damage ◽

Open Science ◽

Tissue Samples ◽

Adaptive Processes ◽

Science Framework ◽

The Impact

The purpose of the study was to determine if repeated exertional heat injuries (EHIs) worsen the inflammatory response and subsequent organ damage. We assessed the impact of a single EHI bout (EHI0) or 2 separate EHI episodes separated by 1 (EHI1), 3 (EHI3), and 7 (EHI7) days in male C57BL/6J mice (N = 236). To induce EHI, mice underwent a forced running protocol until loss of consciousness or core temperature reached ≥ 42.7°C. Blood and tissue samples were obtained 30 minutes, 3 hours, 1 day or 7 days after the EHI. We observed that mice undergoing repeated EHI events (EHI1, EHI3, and EHI7) had longer running distances prior to collapse (~ 528 meters), tolerated higher core temperatures (~0.18°C) prior to collapse, and had higher minimum core temperature (indicative of injury severity) during recovery relative to EHI0 group (~2.18°C; all P < .05). Heat resilience was most pronounced when latency was shortest between EHI episodes (i.e., thermal load and running duration highest in EHI1), suggesting the response diminishes with longer recoveries between EHI events. Furthermore, mice experiencing a second EHI exhibited increased serum & liver HSP70, and lower corticosterone, FABP2, MIP-1β, MIP-2, and IP-10 relative to mice experiencing a single EHI at specific points during the recovery period (typically 30-min to 3-hr after the EHI). Our findings indicate that an EHI event may initiate some adaptive processes that provide acute heat resilience to subsequent EHI conditions. Data and code are available at Open Science Framework repository: https://osf.io/n5ahf/?view_only=bca7ccb1b1554e1192ae776e6a7584d3

Download Full-text

INFLUENCE OF EXERCISE PROGRAM CONTENT ON ELDERLY PERSONS WITH DIABETES MELITUS TIP 2

sportlogia ◽

10.5550/sgia.211701.en.mmdm ◽

2021 ◽

Vol 17 (1) ◽

pp. 25-33

Author(s):

Raid Mekić ◽

◽

Merisa Mekić ◽

Zana Dolićanin ◽

Adem Mavrić ◽

...

Keyword(s):

Exercise Program ◽

The Elderly ◽

Elderly Persons ◽

Exercise Frequency ◽

Scientific Papers ◽

Program Content ◽

The Impact ◽

Selection Of ◽

Diabetes Melitus

The research included seven original scientific papers. All of them addressed the main problem and could give an adequate answer. The aim of this study was to determine the impact of exercise content on people with type 2 diabetes mellitus (DM) and the importance of this activity on the health of people with this problem. The selection of works from 2002 to 2019 was taken as a method. We conclude that the physical activity of people with DM is partially limited due to the specificity of the disease. Special attention should be paid to side effects, especially hypoglycemia. Exercise frequency should be at least three days a week for aerobic activities and two days a week for resistance activities. The risk of hypoglycemia is increased, glycemic control in this population is more difficult to achieve. The goals of DM management in the elderly should be set differently for each patient.

Download Full-text

Value orientations of the doctor as predictor of efficiency of activity of the medical organization

10.37690/1811-0185-2020-9-63-70 ◽

2020 ◽

pp. 63-70

Author(s):

K. N. Tsaranov ◽

◽

E. M. Klimova ◽

T. V. Akimov ◽

A. B. Zvansky ◽

...

Keyword(s):

Medical Information ◽

Value Orientations ◽

Medical Information System ◽

Medical Organization ◽

Professional Activities ◽

Medical Institutions ◽

The Individual ◽

The Impact ◽

Selection Of

The article presents the results of an empirical study of the value orientations of dental clinic employees. It is suggested that gaps in human values are factors that influence professional activities in terms of communication (in the production team) and ultimately the profitability of the individual in the teams. The initial data is obtained from the reports of the clinic’s medical information system and the Schwartz’s Value Survey (SVS) and Portrait Values Questionnaire (PVQ). In addition, we used a retrospective analysis and a questionnaire survey. Doctors were divided into two groups based on the impact of value gaps on the share of revenue plan fulfillment (type one and type two groups). Attention is drawn to the direction of relationships in the group of the first type, all correlations of average strength are direct, in the group of type 2 – reverse. In the structure of the profile of value orientations, there are differences between the groups on the second place in importance for the respondents in the group of the first type are the value orientation (VO) “Achievement” and secondly, “Self-Direction”, third place in the group of the first type is “Benevolence”, whereas in the group of the second type of “Benevolence” in 4th place. To increase economic efficiency, managers of medical institutions need to organize activities to create cultural artifacts about the normative ideals of those values that affect the workflow, take into account the data of the employee’s value profile for optimal selection of the team composition (work shift).

Download Full-text