Socioeconomic position, energy labelling and portion size selection: An online study comparing calorie and physical activity calorie equivalent (PACE) labelling in UK adults.
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ABSTRACT:
SUBMITTER: Marty L
PROVIDER: S-EPMC8385415 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundNutritional labels aim to support people to make informed healthy food choices, but many people do not understand the meaning of calories on food labels. Another approach is to provide calorie information with an interpretation of what the calorie content of food means for energy expenditure, known as physical activity calorie equivalent (PACE) labelling. PACE aims to illustrate how many minutes of physical activity are equivalent to the calories contained in food/drinks. This study investigated the views of the public about the possible implementation of PACE labelling.MethodsData was obtained from a nationally representative sample of adults in the United Kingdom and collected by UK Ipsos KnowledgePanel. Panellists are recruited via a random probability unclustered address-based sampling method. 4,000 panellists were randomly invited to participate and asked to compare their views about traffic light and PACE labelling preferences and behaviour parameters.ResultsData were analysed descriptively and using logistic and multinomial regression analyses. 2,668/4,000 (67%) of those invited participated. More participants preferred traffic light (43%vs33%) than PACE labelling, but more reported PACE was easier to understand (41%vs27%) and more likely to catch their attention (49%vs31%). More participants thought PACE was more likely to help them avoid high calorie food than traffic light labelling (44%vs28%). Physically active (3-4 or 5+ days/week) respondents were more likely to report PACE would catch their attention than traffic light labelling, compared with less active participants (weighted adjusted relative risk ratio = 1.42 (1.00-2.00) and 1.45 (1.03-2.05 respectively)). Perceived overweight was the most predictive factor (weighted adjusted OR = 2.24 (1.19 to 4.20)) in whether PACE was considered useful in helping people decide what to eat/buy.ConclusionThe public identified value to their health in labelling food with PACE information. PACE labelling may be a useful approach to complement current approaches to food labelling.
| S-EPMC10501579 | biostudies-literature
Project description:BackgroundChildhood obesity is a public health challenge in many countries. Food labelling may help children make healthier food choices. Food is typically labelled using the traffic light label system but this is complex to understand. Physical activity calorie equivalent (PACE) labelling may be easier for children to understand and more appealing because it contextualises the energy content of food/drinks.MethodsA cross-sectional online questionnaire was completed by 808 adolescents aged 12-18 years in England. The questionnaire investigated participants' views and understanding of traffic light and PACE labels. Participants were also asked about their understanding of the meaning of calories. The questionnaire explored participants' views about the potential frequency of use of PACE labels and their perceived usefulness in influencing purchasing and consumption decisions. Questions that explored participants' views about the possible implementation of PACE labelling, preferences for food settings and types of food/drinks they may like such labelling implemented, and whether PACE labels would encourage physical activity were included. Descriptive statistics were explored. Analyses assessed associations between variables and tested differences in the proportions of views about the labels.ResultsMore participants reported PACE labels as easier to understand than traffic light labels (69% vs 31%). Of participants who had seen traffic light labels, 19% looked at them often/always. Forty-two percent of participants would look at PACE labels often/always. The most common reason why participants never/would never look at food labels is because they are not interested in making healthy choices. Fifty-two percent of participants said PACE labels would make it easier for them to choose healthy food and drinks. Fifty percent of participants reported PACE labels would encourage them to be physically active. It was perceived that PACE labels could be useful in a range of food settings and on a range of food/drinks.ConclusionsPACE labelling may be easier for young people to understand and more appealing/useful to them than traffic light labelling. PACE labelling may help young people choose healthier food/drinks and reduce excess energy consumption. Research is now needed to understand the impact of PACE labelling on food choice among adolescents in real eating settings.
| S-EPMC10264867 | biostudies-literature
Project description:BackgroundA recent meta-analysis suggested that using physical activity calorie equivalent (PACE) labels results in people selecting and consuming less energy. However, the meta-analysis included only 1 study in a naturalistic setting, conducted in 4 convenience stores. We therefore aimed to estimate the effect of PACE labels on energy purchased in worksite cafeterias in the context of a randomised study design.Methods and findingsA stepped-wedge randomised controlled trial (RCT) was conducted to investigate the effect of PACE labels (which include kcal content and minutes of walking required to expend the energy content of the labelled food) on energy purchased. The setting was 10 worksite cafeterias in England, which were randomised to the order in which they introduced PACE labels on selected food and drinks following a baseline period. There were approximately 19,000 workers employed at the sites, 72% male, with an average age of 40. The study ran for 12 weeks (06 April 2021 to 28 June 2021) with over 250,000 transactions recorded on electronic tills. The primary outcome was total energy (kcal) purchased from intervention items per day. The secondary outcomes were: energy purchased from non-intervention items per day, total energy purchased per day, and revenue. Regression models showed no evidence of an overall effect on energy purchased from intervention items, -1,934 kcals per site per day (95% CI -5,131 to 1,262), p = 0.236, during the intervention relative to baseline, equivalent to -5 kcals per transaction (95% CI -14 to 4). There was also no evidence for an effect on energy purchased from non-intervention items, -5 kcals per site per day (95% CI -513 to 504), p = 0.986, equivalent to 0 kcals per transaction (95% CI -1 to 1), and no clear evidence for total energy purchased -2,899 kcals per site (95% CI -5,810 to 11), p = 0.051, equivalent to -8 kcals per transaction (95% CI -16 to 0). Study limitations include using energy purchased and not energy consumed as the primary outcome and access only to transaction-level sales, rather than individual-level data.ConclusionOverall, the evidence was consistent with PACE labels not changing energy purchased in worksite cafeterias. There was considerable variation in effects between cafeterias, suggesting important unmeasured moderators.Trial registrationThe study was prospectively registered on ISRCTN (date: 30.03.21; ISRCTN31315776).
| S-EPMC9642872 | biostudies-literature
Project description:Reducing the energy density (ED) of product selections made during online supermarket food shopping has potential to decrease energy intake. Yet it is unclear which types of intervention are likely to be most effective and equitable. We recruited 899 UK adults of lower and higher socioeconomic position (SEP) who completed a shopping task in an online experimental supermarket. Participants were randomised in a 2 × 2 between-subjects design to test the effects of two interventions on the ED of shopping basket selections: labelling lower-ED products as healthier choices and increasing the relative availability of lower-ED products within a range (referred to as proportion). Labelling of lower-ED products resulted in a small but significant decrease (-4.2 kcal/100 g, 95% CIs -7.8 to -0.6) in the ED of the shopping basket. Increasing the proportion of lower-ED products significantly decreased the ED of the shopping basket (-17 kcal/100 g, 95% CIs -21 to -14). There was no evidence that the effect of either intervention was moderated by SEP. Thus, both types of intervention decreased the ED of foods selected in an online experimental supermarket. There was no evidence that the effectiveness of either intervention differed in people of lower vs. higher SEP.
| S-EPMC7760499 | biostudies-literature
Project description:Acute colon cancer surgery has a poor 90-day mortality of 21.0% compared with only 3% after elective colorectal cancer surgery in Denmark. The high mortality after acute colon cancer surgery compared with elective surgery emphasizes the importance of identifying factors associated with acute onset and poor short-term survival after acute surgery. Socioeconomic position has previously showed to be a risk factor for acute versus elective onset of colorectal cancer. Furthermore, if patients with low socioeconomic position have higher postoperative mortality this could reflect differences in the treatment of patients according to their socioeconomic position.
The aim of the clinical study is:
1. To examine if patients with short education, low income, living alone, or living in rural areas are more likely to undergo acute colorectal cancer surgery than elective surgery compared with patients with longer educations, higher income, living with a partner, or living in urban areas.
2. To examine if there is an association between education, income, cohabitation, or urbanicity and 1-year mortality after acute colorectal cancer surgery.
| 2277284 | ecrin-mdr-crc
Project description:There are well documented socioeconomic disparities in diet quality and obesity. Menu energy labelling is a public health policy designed to improve diet and reduce obesity. However, it is unclear whether the impact energy labelling has on consumer behaviour is socially equitable or differs based on socioeconomic position (SEP). Systematic review and meta-analysis of experimental (between-subjects) and pre-post implementation field studies examining the impact of menu energy labelling on energy content of food and/or drink selections in higher vs. lower SEP groups. Seventeen studies were eligible for inclusion. Meta-analyses of 13 experimental studies that predominantly examined hypothetical food and drink choices showed that energy labelling tended to be associated with a small reduction in energy content of selections that did not differ based on participant SEP (X2(1) = 0.26, p = .610). Effect estimates for higher SEP SMD = 0.067 [95% CI: -0.092 to 0.226] and lower SEP SMD = 0.115 [95% CI: -0.006 to 0.237] were similar. A meta-analysis of 3 pre-post implementation studies of energy labelling in the real world showed that the effect energy labelling had on consumer behaviour did not significantly differ based on SEP (X2(1) = 0.22, p = .636). In higher SEP the effect was SMD = 0.032 [95% CI: -0.053 to 0.117] and in lower SEP the effect was SMD = -0.005 [95% CI: -0.051 to 0.041]. Overall there was no convincing evidence that the effect energy labelling has on consumer behaviour significantly differs based on SEP. Further research examining multiple indicators of SEP and quantifying the long-term effects of energy labelling on consumer behaviour in real-world settings is now required. Registered on PROSPERO (CRD42022312532) and OSF ( https://doi.org/10.17605/OSF.IO/W7RDB ).
| S-EPMC9903416 | biostudies-literature
Project description:Somatosensation greatly increases the ability to control our natural body. This suggests that supplementing vision with haptic sensory feedback would also be helpful when a user aims at controlling a robotic arm proficiently. However, whether the position of the robot and its continuous update should be coded in a extrinsic or intrinsic reference frame is not known. Here we compared two different supplementary feedback contents concerning the status of a robotic limb in 2-DoFs configuration: one encoding the Cartesian coordinates of the end-effector of the robotic arm (i.e., Task-space feedback) and another and encoding the robot joints angles (i.e., Joint-space feedback). Feedback was delivered to blindfolded participants through vibrotactile stimulation applied on participants' leg. After a 1.5-hour training with both feedbacks, participants were significantly more accurate with Task compared to Joint-space feedback, as shown by lower position and aiming errors, albeit not faster (i.e., similar onset delay). However, learning index during training was significantly higher in Joint space feedback compared to Task-space feedback. These results suggest that Task-space feedback is probably more intuitive and more suited for activities which require short training sessions, while Joint space feedback showed potential for long-term improvement. We speculate that the latter, despite performing worse in the present work, might be ultimately more suited for applications requiring long training, such as the control of supernumerary robotic limbs for surgical robotics, heavy industrial manufacturing, or more generally, in the context of human movement augmentation.
| S-EPMC10249844 | biostudies-literature
Project description:Men with more advantaged socioeconomic position (SEP) have been observed to have higher levels of testosterone. It is unclear whether these associations arise because testosterone has a causal impact on SEP. In 306,248 participants of UK Biobank, we performed sex-stratified genome-wide association analysis to identify genetic variants associated with testosterone. Using the identified variants, we performed Mendelian randomization analysis of the influence of testosterone on socioeconomic position, including income, employment status, neighborhood-level deprivation, and educational qualifications; on health, including self-rated health and body mass index; and on risk-taking behavior. We found little evidence that testosterone affected socioeconomic position, health, or risk-taking. Our results therefore suggest that it is unlikely that testosterone meaningfully affects these outcomes in men or women. Differences between Mendelian randomization and multivariable-adjusted estimates suggest that previously reported associations with socioeconomic position and health may be due to residual confounding or reverse causation.
| S-EPMC8318368 | biostudies-literature
Project description:Reducing portion sizes of commercially available foods could be an effective public health strategy to reduce population energy intake, but recent research suggests that the effect portion size has on energy intake may differ based on socioeconomic position (SEP). We tested whether the effect of reducing food portion sizes on daily energy intake differed based on SEP. Participants were served either smaller or larger portions of food at lunch and evening meals (N = 50; Study 1) and breakfast, lunch and evening meals (N = 46; Study 2) in the laboratory on two separate days, in repeated-measures designs. The primary outcome was total daily energy intake (kcal). Participant recruitment was stratified by primary indicators of SEP; highest educational qualification (Study 1) and subjective social status (Study 2), and randomisation to the order portion sizes were served was stratified by SEP. Secondary indicators of SEP in both studies included household income, self-reported childhood financial hardship and a measure accounting for total years in education. In both studies, smaller (vs larger) meal portions led to a reduction in daily energy intake (ps < .02). Smaller portions resulted in a reduction of 235 kcal per day (95% CI: 134, 336) in Study 1 and 143 kcal per day (95% CI: 24, 263) in Study 2. There was no evidence in either study that effects of portion size on energy intake differed by SEP. Results were consistent when examining effects on portion-manipulated meal (as opposed to daily) energy intake. Reducing meal portion sizes could be an effective way to reduce overall daily energy intake and contrary to other suggestions it may be a socioeconomically equitable approach to improving diet. These trials were registered at www. gov as NCT05173376 and NCT05399836.
| S-EPMC10134633 | biostudies-literature
Project description:ObjectivesThis study aimed to explore the independent association between socioeconomic position, defined by occupation, and severe maternal morbidity among women in the UK.DesignCase-control study.SettingThe analysis was conducted as a case-control analysis, using data from a series of studies of direct causes of severe maternal morbidity undertaken through the UK Obstetric Surveillance System (UKOSS), with data collected throughout all consultant-let obstetric units in the UK.ParticipantsThe analysis included 1144 cases and 2256 comparison women (controls). UKOSS studies from which data on case women were obtained included amniotic fluid embolism, acute fatty liver of pregnancy, eclampsia, peripartum hysterectomy, therapies for peripartum haemorrhage and uterine rupture.Primary outcome measureOdds of severe maternal morbidity by socioeconomic group, independent of ethnicity, maternal age, smoking, pre-existing medical condition, body mass index (BMI), multiple pregnancy and past pregnancy complications. Occupation was used to classify different socioeconomic groups.Secondary outcome measureOdds of morbidity related to ethnic group, maternal age, smoking, pre-existing medical condition, BMI, multiple pregnancy and past pregnancy complications.ResultsAcross the socioeconomic groups, compared with the 'managerial/professional' group, adjusted ORs were 1.17 (95% CI 0.94 to 1.45) for the 'intermediate group', 1.16 (95% CI 0.93 to 1.45) for 'routine/manual', 1.22 (95% CI 0.92 to 1.61) for 'unemployed' women and 1.51 (95% CI 1.18 to 1.94) for women with missing socioeconomic information. Women of non-white ethnicity, older maternal age (?35 years), BMI ?25 kg/m(2) and those with pre-existing medical condition/s, multiple pregnancy or past pregnancy complications were shown to have a significantly increased odds of severe maternal morbidity.ConclusionsThis study suggests that socioeconomic position may be independently associated with an increased risk of severe maternal morbidity, although the observed association was not statistically significant. Further research is warranted to confirm this and investigate why this association might exist in a country where healthcare is universal and free at the point of access.
| S-EPMC3686175 | biostudies-literature