scholarly journals Experimental Studies of Front-of-Package Nutrient Warning Labels on Sugar-Sweetened Beverages and Ultra-Processed Foods: A Scoping Review

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 569 ◽  
Author(s):  
Lindsey Smith Taillie ◽  
Marissa G. Hall ◽  
Barry M. Popkin ◽  
Shu Wen Ng ◽  
Nandita Murukutla

Policies that require front-of-package (FoP) nutrient warnings are becoming increasingly common across the globe as a strategy to discourage excess consumption of sugary drinks and ultra-processed food. However, a better understanding of the pathway through which FoP nutrient warnings work, as well as a review of how outcomes being measured in recent studies map onto this pathway, are needed in order to inform policy on the most effective FoP label design for reducing purchases of ultra-processed foods. This scoping review describes a conceptual model for how FoP nutrient warnings affect consumer behavior, examines which of these outcomes are currently being measured, and summarizes evidence from randomized controlled experiments. Twenty-two studies which experimentally tested nutrient warnings against a control label or other labeling systems were included for full-text review. Our conceptual model includes attention; comprehension, cognitive elaboration, and message acceptance; negative affect and risk perception; behavioral intentions, and behavioral response, along with other elements such as external factors and interpersonal communications. We found that many studies focused on outcomes such as attention, comprehension, and behavioral intentions, but considerable gaps in the evidence remain, particularly for intermediary steps on the pathway to behavioral change, such as negative affect and social interactions. FoP nutrient warnings were visually attended to by consumers, easy to understand, helped consumers identify products high in nutrients of concern, and discouraged them from purchasing these products, although other labeling systems were perceived as containing more information and performed better at helping consumers rank the healthfulness of products. More research is needed to understand whether and how nutrient warnings work in the real world to discourage consumer purchases of sugary drinks and ultra-processed food.

Author(s):  
Matheus Lopes Cortes ◽  
José Andrade Louzado ◽  
Marcio Galvão Oliveira ◽  
Vanessa Moraes Bezerra ◽  
Sóstenes Mistro ◽  
...  

Background: Ultra-processed foods are industrial formulations made from food extracts or constituents with little or no intact food and often containing additives that confer hyper-palatability. The consumption of these products increases the risk of chronic non-communicable diseases. Stressed people may engage in unhealthy eating as a way to cope. This study aimed to verify whether ultra-processed food consumption was associated with perceived stress levels in industrial and retail workers from Vitoria da Conquista, Brazil. Methods: This was a cross-sectional study carried out between July 2017 and August 2018. During the study period, 1270 participants completed a survey administered by an interviewer. Stress levels were assessed using the Perceived Stress Scale. Information regarding weekly ultra-processed food consumption was collected. Ultra-processed foods were classified into four groups: sugary drinks; sugary foods; fast foods; and canned foods, frozen foods, or processed meat. The Student’s t-test or one-way analysis of variance was used to assess the differences in stress levels and ultra-processed food consumption. Ordinal regression was used to determine the association between the degrees of stress and ultra-processed food consumption levels. Results: Factors such as a young age, being unmarried, smoking, high-risk alcohol consumption, negative health perception, and high perceived stress level indicated higher rates of ultra-processed food consumption. Ordinal regression analysis showed that high stress levels were associated with increased odds of higher ultra-processed food consumption (odds ratio: 1.94; 95% CI: 1.54–2.45). Conclusions: These findings could help identify appropriate target areas for interventions aimed at mental health promotion and healthier food consumption.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
B Srour ◽  
L K Fezeu ◽  
E Kesse-Guyot ◽  
B Allès ◽  
E Chazelas ◽  
...  

Abstract Objective The consumption of ultra-processed foods has been increasing during the last decades, and has been previously associated with increased risks of mortality and several chronic diseases. The objective of this study is to assess for the first time the prospective associations between consumption of ultra-processed foods and the risk of type 2 diabetes (T2D). Methods 104707 participants aged at least 18 years (median age 41.5 years) from the French NutriNet-Santé cohort (2009-2019). Dietary intakes were collected using repeated 24 hour dietary records, designed to register participants’ usual consumption for 3300 different food items, categorized according to their degree of processing by the NOVA classification. Associations between ultra-processed food intake and risk of T2D were assessed using multi-adjusted Cox proportional hazard models. Results Ultra-processed sugary products, fruits and vegetables, and beverages were the highest contributors of the ultra-processed category (respectively 27.9, 18.5 and 15.6%). Ultra-processed food intake was associated with a higher risk of T2D (n = 821 incident cases; hazard ratio for an absolute increment of 10 in the percentage of ultra-processed foods in the diet = 1.15 (1.06-1.25); P = 0.0009, 582252 person-years). These results remained statistically significant after adjustment for other metabolic comorbidities, for several markers of the nutritional quality of the diet (red meat and sugary drinks consumption, intakes of saturated fatty acids, sodium, sugar, dietary fiber or Healthy/Western patterns derived by principal component analysis) and after a large range of sensitivity analyses. Conclusions In this large observational prospective study, higher consumption of ultra-processed foods in the diet was associated with a higher risk of T2D. Public health authorities in several countries recently started to recommend privileging unprocessed/minimally processed foods and limiting ultra-processed food consumption. Key messages The consumption of ultra-processed food is associated with an increased risk of type 2 diabetes. As the French Public Helath agency recommends, their consumption should be limited. Nutritional composition, food additives, contact materials, or neoformed contaminants might play a role in these associations and further studies are needed to understand their relative contribution.


2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Bernard Srour ◽  
Léopold K. Fezeu ◽  
Emmanuelle Kesse-Guyot ◽  
Benjamin Allès ◽  
Caroline Méjean ◽  
...  

AbstractIntroduction:The consumption of ultra-processed foods has been increasing during the last decades, and has been previously associated with increased risks of mortality and several chronic diseases such as cancer, cardiovascular diseases, hypertension, and dyslipidemia. The objective of this study is to assess the prospective associations between consumption of ultra-processed foods and the risk of type 2 diabetes (T2D).Methods:Overall, 104707 participants aged at least 18 years (median age 41.5 years) from the French NutriNet-Santé cohort (2009–2019) were included. Dietary intakes were collected using repeated 24 hour dietary records (5.7/subject in average), designed to register participants' usual consumption for 3300 different food items. These were categorized according to their degree of processing by the NOVA classification. Associations between ultra-processed food intake and risk of type 2 diabetes were assessed using multivariable Cox proportional hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history and nutritional factors).Results:Ultra-processed sugary products, fruits and vegetables, and beverages were the highest contributors of the ultra-processed category (respectively 27.9, 18.5 and 15.6%). Ultra-processed food intake was associated with a higher risk of T2D (n = 821 incident cases; hazard ratio for an absolute increment of 10 in the percentage of ultra-processed foods in the diet = 1.15 (95% confidence interval 1.06 to 1.25); P = 0.0009, median follow-up: 6.0y, 582252 person-years). These results remained statistically significant after adjustment for other metabolic comorbidities, for several markers of the nutritional quality of the diet (red meat and sugary drinks consumption, intakes of saturated fatty acids, sodium, sugar, dietary fiber or Healthy/Western patterns derived by principal component analysis) and after a large range of sensitivity analyses.Conclusions:In this large observational prospective study, higher consumption of ultra-processed foods in the diet was associated with a higher risk of type 2 diabetes. These results need to be confirmed in other populations and settings, and causality remains to be established. Various dimensions of processing such as nutritional composition of the final product, food additives, contact materials, and neoformed contaminants might play a role in these associations and further studies are needed to better understand their relative contribution. Meanwhile, public health authorities in several countries recently started to recommend privileging unprocessed/minimally processed foods and limiting ultra-processed food consumption.Study Registration: Clinicaltrials.gov NCT03335644.


1998 ◽  
Vol 62 (2) ◽  
pp. 46-59 ◽  
Author(s):  
Dhruv Grewal ◽  
Kent B. Monroe ◽  
R. Krishnan

The authors expand and integrate prior price-perceived value models within the context of price comparison advertising. More specifically, the conceptual model explicates the effects of advertised selling and reference prices on buyers’ internal reference prices, perceptions of quality, acquisition value, transaction value, and purchase and search intentions. Two experimental studies test the conceptual model. The results across these two studies, both individually and combined, support the hypothesis that buyers’ internal reference prices are influenced by both advertised selling and reference prices as well as the buyers’ perception of the product's quality. The authors also find that the effect of advertised selling price on buyers’ acquisition value was mediated by their perceptions of transaction value. In addition, the effects of perceived transaction value on buyers’ behavioral intentions were mediated by their acquisition value perceptions. The authors suggest directions for further research and implications for managers.


2009 ◽  
Vol 2 (2) ◽  
pp. 115-126 ◽  
Author(s):  
Elisabeth Wells-Parker ◽  
Robert Mann ◽  
Patricia Dill ◽  
Gina Stoduto ◽  
Rania Shuggi ◽  
...  

2021 ◽  
pp. 019459982110137
Author(s):  
Joseph N. Gonzalez ◽  
Lucas G. Axiotakis ◽  
Victoria X. Yu ◽  
David A. Gudis ◽  
Jonathan B. Overdevest

Objective The COVID-19 pandemic has spurred widespread adoption and advancement in telehealth activities, representing a marked change in otolaryngology practice patterns. The present study undertakes a scoping review of research focused on telehealth in otolaryngology (teleotolaryngology) to identify key themes and commonly utilized outcome measures that will assist future development in this growing field. Data Sources PubMed, Embase, and Cochrane databases and reference review. Review Methods Per guidelines of the PRISMA Extension for Scoping Reviews, we performed database queries using a comprehensive search strategy developed in collaboration with research librarians at the Columbia University Irving Medical Center. We identified 596 unique references to undergo title and abstract review by 2 independent reviewers, leaving 439 studies for full-text review. Results We included 285 studies for extraction of notable findings, leaving 262 unique studies after accounting for content overlap. We identified core outcome measures, including patient and provider satisfaction, costs and benefits, quality of care, feasibility, and access to care. Publication volume increased markedly over time, though only 4% of studies incorporated randomized study group assignment. Using an iterative approach to thematic development, we organized article content across 5 main themes: (1) exploration of teleotolaryngology evolution, (2) role in virtual clinical encounters, (3) applications in interdisciplinary care and educational initiatives, (4) emerging and innovative technologies, and (5) barriers to implementation. Conclusion This scoping review of teleotolaryngology documents its evolution and identifies current use cases, limitations, and emerging applications, providing a foundation from which to build future studies, inform policy decision making, and facilitate implementation where appropriate.


2021 ◽  
pp. 003329412110126
Author(s):  
Eric D. Wesselmann ◽  
Shane W. Boyd ◽  
Jordan A. Arellanes ◽  
Alexander Driskell ◽  
Matthew S. Hesson-McInnis

Environmental commitment, the subjective experience of dependence on the natural environment, is marked by a long-term orientation and psychological attachment towards the natural environment. The current research replicates and extends previous research on temporarily increasing environmental commitment ( Davis et al., 2009 ). We employed Davis et al.’s manipulation in two experimental studies (one laboratory, one online): we asked participants to spend time writing either about ways in which they are interdependent with the natural environment (high commitment manipulation) or unconnected with the environment (low commitment manipulation). In both studies we replicated the key finding that reflecting on one’s interdependence with the environment increases commitment. We extended the previous research by finding evidence that this commitment effect was mediated by satisfaction with one’s relationship to the environment. We did not replicate the original findings that the interdependence manipulation influences environmental behavioral intentions.


Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2289 ◽  
Author(s):  
María Belén Ruíz-Roso ◽  
Patricia de Carvalho Padilha ◽  
Diana C. Matilla-Escalante ◽  
Paola Brun ◽  
Natalia Ulloa ◽  
...  

Aim: to describe physical activity and ultra-processed foods consumption, their changes and sociodemographic predictors among adolescents from countries in Europe (Italy and Spain) and Latin America (Brazil, Chile, and Colombia) during the SARS-CoV-2-pandemic period. Methods: Cross-sectional study via web survey. International Physical Activity Questionnaire (IPAQ) and weekly ultra-processed food consumption data were used. To compare the frequencies of physical activity status with sociodemographic variables, a multinomial logistic and a multiple logistic regression for habitual ultra-processed foods was performed. In final models, p < 0.05 was considered significant. Results: Sample of 726 adolescents, mostly females (59.6%) aged 16–19 years old (54.3%). Adolescents from Latin America presented odds ratio (OR) 2.98 (CI 95% 1.80–4.94) of being inactive and those whose mothers had higher level of education were less active during lockdown [OR 0.40 (CI 95% 0.20–0.84)]. The habitual ultra-processed consumption was also high during this period in all countries, and more prevalent in Latin America. Conclusion: A higher prevalence of inactivity was observed in this population, but reductions of physical activity and habitual ultra-processed consumption during the pandemic were more pronounced in Latin America. Our findings reinforce the importance of promoting a healthy lifestyle, i.e., exercise and diet, during periods of social isolation.


Author(s):  
Mary J. Sandage ◽  
Elizabeth S. Ostwalt ◽  
Lauren H. Allison ◽  
Grace M. Cutchin ◽  
Mariah E. Morton ◽  
...  

Purpose The primary aim of this review was to identify environmental irritants known to trigger chronic cough through the life span and develop a comprehensive clinically useful irritant checklist. Method A scoping review was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews, checklist, and explanation. English-language, full-text resources were identified through Medline, PsycINFO, SPORTDiscus, Web of Science, and ProQuest Dissertations and Theses Global. Results A total of 1,072 sources were retrieved; of these, 109 were duplicates. Titles of abstracts of 963 articles were screened, with 295 selected for full-text review. Using the exclusion and inclusion criteria listed, 236 articles were considered eligible and 214 different triggers were identified. Triggers were identified from North America, Europe, Africa, Asia, and Australia. Occupational exposures were also delineated. Conclusions A clinically useful checklist of both frequently encountered triggers and idiosyncratic or rare triggers was developed. The clinical checklist provides a unique contribution to streamline and standardize clinical assessment of irritant-induced chronic cough. The international scope of this review extends the usefulness of the clinical checklist to clinicians on most continents.


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