Effect of health warning labels on motivation towards energy-dense snack foods: Two experimental studies.
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ABSTRACT:
SUBMITTER: Ventsel M
PROVIDER: S-EPMC9194909 | biostudies-literature | 2022 Aug
REPOSITORIES: biostudies-literature
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Effect of health warning labels on motivation towards energy-dense snack foods: Two experimental studies.
Ventsel Minna M Pechey Emily E De-Loyde Katie K Pilling Mark A MA Morris Richard W RW Maistrello Giulia G Ziauddeen Hisham H Marteau Theresa M TM Hollands Gareth J GJ Fletcher Paul C PC
Appetite 20220514
Health warning labels (HWLs) show promise in reducing motivation towards energy-dense snack foods. Understanding the underlying mechanisms could optimise their effectiveness. In two experimental studies in general population samples (Study 1 n = 90; Study 2 n = 1382), we compared the effects of HWLs and irrelevant aversive labels (IALs) on implicit (approach) motivation towards unhealthy snacks, using an approach-avoidance task (Study 1), and a manikin task (Study 2). We also assessed explicit m ...[more]
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Project description:BackgroundThere is limited evidence concerning the potential effectiveness of health warning labels (HWLs) using images and text to depict possible negative health consequences of consumption, for reducing selection of energy-dense snack foods. Furthermore, the underlying mechanisms have received little attention; particularly effects on implicit attitudes, which previous work has shown may mediate the effect of aversive images on food choice.AimTo assess the impact of pairing image- and text-based HWLs with energy-dense snack foods on a) the selection of, and b) implicit and explicit attitudes towards, those foods.MethodsOnline experimental study with a representative UK sample (n = 1185), using a 2(Image/No Image) x 2(Text/No Text) factorial between-subjects design. Participants were randomised to one of four study arms, viewing snack food images paired with either: image-only HWLs, text-only HWLs, image-and-text HWLs, or no HWLs (control). HWLs concerned various negative health consequences of excess energy intake, such as heart disease and type 2 diabetes. The primary outcome was hypothetical food choice (energy-dense snack foods versus fruit), assessed post-intervention. Secondary outcomes were implicit and explicit attitudes.ResultsNeither food choice nor explicit attitudes were changed significantly by any type of HWL. Implicit attitudes towards energy-dense snack foods were more negative after exposure to text-only or image-and-text HWLs. Both implicit and explicit attitudes predicted unique variance in food choice.ConclusionsThis study suggests that short-term repeated exposure to HWLs paired with energy-dense snack foods may not consistently alter food choices, but can change implicit attitudes associated with food choices. Further laboratory and field studies are needed to more definitively assess the impact of HWLs on food selection and consumption in applied contexts and over time, as well as delineate underlying mechanisms.
| S-EPMC7895764 | biostudies-literature
Project description:Excessive 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. In a between-subjects, 3 (HWL: image-and-text, text-only, no label) x 2 (calorie information: present, absent), factorial experimental design, participants (N = 4134) 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. The proportion of participants selecting an energy-dense snack was reduced in all label groups, relative to the no label group (no label: 59%; calories only: 54%; text-only HWL: 48%; text-only HWL with calories: 44%; image-and-text HWL: 37%; image-and-text HWL with calories: 38%). Compared to the no label group, participants were least likely to select an energy-dense snack in the image-and-text HWL group (OR = 0.46, 95%CI = 0.40, 0.54, p < 0.001). 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.
| S-EPMC7450271 | biostudies-literature
Project description: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.
| S-EPMC7071470 | biostudies-literature
Project description:BACKGROUND/OBJECTIVE:Although reducing energy density (ED) enhances weight loss, it is unclear whether all dietary strategies that reduce ED are comparable, hindering effective ED guidelines for obesity treatment. This study examined how changes in number of low-energy-dense (LED) (<4.186 kJ/1.0 kcal g-1) and high-energy-dense (HED) (>12.56 kJ/3.0 kcal g-1) foods consumed affected dietary ED and weight loss within an 18-month weight loss trial. METHODS:This secondary analysis examined data from participants randomized to an energy-restricted lifestyle intervention or lifestyle intervention plus limited non-nutrient dense, energy-dense food variety (n=183). Number of daily LED and HED foods consumed was calculated from three, 24-h dietary recalls and anthropometrics were measured at 0, 6 and 18 months. Multivariable-adjusted generalized linear models and repeated-measures mixed linear models examined associations between 6-month changes in number of LED and HED foods and changes in ED, body mass index (BMI), and percent weight loss at 6 and 18 months. RESULTS:Among mostly female (58%), White (92%) participants aged 51.9 years following an energy-restricted diet, increasing number of LED foods or decreasing number of HED foods consumed was associated with 6- and 18-month reductions in ED (β=-0.25 to -0.38 kJ g-1 (-0.06 to -0.09 kcal g-1), P<0.001). Only increasing number of LED foods consumed was associated with 6- and 18-month reductions in BMI (β=-0.16 to -0.2 kg m-2, P<0.05) and 6-month reductions in percent weight loss (β=-0.5%, P<0.05). Participants consuming ⩽2 HED foods per day and ⩾6.6 LED foods per day experienced better weight loss outcomes at 6- and 18-month than participants only consuming ⩽2 HED foods per day. CONCLUSION:Despite similar reductions in ED from reducing number of HED foods or increasing number of LED foods consumed, only increasing number of LED foods related to weight loss. This provides preliminary evidence that methods used to reduce dietary ED may differentially influence weight loss trajectories. Randomized controlled trials are needed to inform ED recommendations for weight loss.
| S-EPMC5902316 | biostudies-literature
Project description:Front-of-package labeling (FOPL) is a policy tool that helps consumers to make informed food choices. South Africa has not yet implemented this labeling system. The aim of this study was therefore to explore adult South African consumers' perceptions of front-of-package warning labels on foods and non-alcoholic beverages (referred to as drinks in this paper) and their insights into features that could influence the effectiveness of the warning label. Using a qualitative approach, the study purposively selected consumers diversified by urbanization, gender, socioeconomic status, and literacy. We collected data from a total of 113 participants through 12 focus group discussions. Data were systematically coded and divided into five themes namely, positive attitudes toward warning labels, perceived benefits of warning labels, perceived behavior modification, perceived beneficiaries of warning labels, and effective attributes of warning labels. Almost all participants from all socio-economic backgrounds were positive about warning labels, reporting that warning labels concisely and understandably educated them about the nutritional composition of foods. Other perceived advantages were that warning labels warn of health implications, are easily understandable and could benefit child health. Some participants anticipated that warning labels would reduce their purchases of unhealthy foods, while others thought the labels would have no effect on their purchasing habits. Participants found the warning labels attention grabbing and stated that they preferred a black triangle placed on a white background (referred to as a holding strap henceforth), the words "high in" and "warning" in bold and uppercase text, an exclamation mark, and an icon depicting the excessive nutrient. In South Africa warning labels may improve consumer understanding of nutrition information and assist consumers in determining the nutritional quality of packaged foods and drinks.
| S-EPMC8475997 | biostudies-literature
Project description:BackgroundDietary variety is a factor that influences consumption but has received little attention in obesity treatment.ObjectiveThis study examined the effect of limiting the variety of different non-nutrient-dense, energy-dense foods (NND-EDFs) (i.e., chips, ice cream, cookies) on dietary intake and weight loss during an 18-mo lifestyle intervention.DesignTwo hundred two adults aged 51.3 ± 9.5 y with a BMI (in kg/m2) of 34.9 ± 4.3 (57.8% women, 92.2% white) were randomly assigned to 1 of 2 interventions: Lifestyle (1200-1500 kcal/d, ≤30% of energy as fat; n = 101) or Lifestyle + limited variety (LV) (limit variety of NND-EDFs, i.e., 2 choices; n = 101). Both interventions involved 48 group sessions. Dietary intake, NND-EDF hedonics, NND-EDF variety in the home, and weight were assessed at 0, 6, 12, and 18 mo.ResultsIntent-to-treat analyses showed that the Lifestyle+LV group consumed less variety (P < 0.01) and energy daily (P < 0.05) from NND-EDFs than did the Lifestyle group at 6, 12, and 18 mo. The Lifestyle+LV group consumed less total energy daily (P < 0.05) at 6 mo than did the Lifestyle group. The Lifestyle+LV group reported less (P < 0.05) NND-EDF variety in the home at 6 and 18 mo than did the Lifestyle group. The hedonics of one chosen NND-EDF decreased more (P < 0.05) in the Lifestyle+LV group. Despite these effects, no difference in percentage weight loss occurred at 18 mo (Lifestyle+LV: -9.9 ± 7.6%; Lifestyle: -9.6 ± 9.2%).ConclusionsLimitations in dietary variety decreased intakes in the targeted area but did not affect weight loss. Limiting variety in more areas may be needed to improve weight loss and weight-loss maintenance. This trial was registered at clinicaltrials.gov as NCT01096719.
| S-EPMC3349452 | biostudies-literature
Project description:Issue addressedEffective interventions to reduce energy drink (ED) consumption are needed. This study explored the effect of warning labels on intentions to reduce ED consumption, perceived label effectiveness and protection motivation theory (PMT) constructs.MethodsAustralian ED consumers aged 18 to 39 years (N = 343) participated in an experimental online survey, randomly assigned to view one of three ED warning label conditions (weight gain, cardiac effects, no label-control). Intentions to reduce ED consumption, perceived effectiveness of labels and selected PMT constructs were assessed.ResultsParticipants reported moderate-high awareness of the health effects of consumption (62.68%) and advisory statements on EDs (69.39%), including daily consumption limits (48.40%). EDs were consumed frequently, with 56.26% regular (at least weekly) consumers and most commonly for functional benefits (e.g., alertness). ED warning labels did not have a statistically significant effect on intentions to reduce consumption. The cardiac label performed better than the weight gain label in 'grabbed attention' (72.97% vs. 55.66%, p = 0.008), with non-significant trends (p > 0.05, absolute differences ≥ 10%) suggesting it was stronger on some other perceived effectiveness measures. Supplementary analyses indicated females in the cardiac condition reported greater intentions to reduce ED consumption than females in the control condition (p = 0.042).ConclusionsGraphic warning labels and labels warning of cardiac effects are worthy of further exploration as a potential intervention to reduce ED consumption. SO WHAT?: Future research should explore the motivations underlying ED consumption and further explore messages that will resonate with consumers.
| S-EPMC11843077 | biostudies-literature
Project description:Despite growing evidence that warning labels reduce purchases of sugary drinks, less is known about warnings' impact on purchases of sugary snacks. This paper aimed to experimentally test whether a front-of-package label warning about high sugar content ("sugar warning label") would reduce parents' likelihood of selecting a labeled snack versus a non-labeled snack for their child in a food store setting. Participants (n = 2,219 parents of at least one child aged 1-5y) were recruited via an online panel and asked to complete a shopping task in a virtual convenience store. Participants were randomized to one of three labeling conditions: barcode control, text-only sugar warning label, or pictorial sugar warning label. Participants viewed two granola snacks, one labeled and one unlabeled, and selected one for purchase. A post-shopping survey measured secondary outcomes. Predictions and analyses were preregistered on www.clinicaltrials.gov (NCT04381481). Participants exposed to the text or pictorial sugar warning labels were less likely to select the labeled snack than those in the barcode control group (21%, 18%, and 34% respectively; p < 0.001 for both comparisons of warning to control). Relative to the barcode control label, the text and pictorial sugar warning labels resulted in greater attention, anticipated social interactions, negative affect, cognitive elaboration, and perceived message effectiveness, as well as lower perceptions of healthfulness, appeal, and intentions to purchase or consume the product (p < 0.001 for all comparisons of warnings to control). There were no differences in outcomes between text and pictorial sugar warning labels. In conclusion, text and pictorial sugar warning labels reduced parents' likelihood of selecting a labeled granola snack for their children. These results contribute to a growing body of evidence showing that warning labels influence food purchasing behaviors.
| S-EPMC10173438 | biostudies-literature
Project description:UnlabelledNutrition labels have raised awareness of the energetic value of foods, and represent for many a pivotal guideline to regulate food intake. However, recent data have created doubts on label accuracy.ObjectiveWe tested label accuracy for energy and macronutrient content of prepackaged energy-dense snack food products. We measured "true" caloric content of 24 popular snack food products in the U.S. and determined macronutrient content in 10 selected items.Design and methodsBomb calorimetry and food factors were used to estimate energy content. Macronutrient content was determined according to Official Methods of Analysis. Calorimetric measurements were performed in our metabolic laboratory between April 20th and May 18th and macronutrient content was measured between September 28th and October 7th of 2010.Results and conclusionServing size, by weight, exceeded label statements by 1.2% [median] (25th percentile -1.4, 75th percentile 4.3, P = 0.10). When differences in serving size were accounted for, metabolizable calories were 6.8 kcal (0.5, 23.5, P = 0.0003) or 4.3% (0.2, 13.7, P = 0.001) higher than the label statement. In a small convenience sample of the tested snack foods, carbohydrate content exceeded label statements by 7.7% (0.8, 16.7, P = 0.01); however fat and protein content were not significantly different from label statements (-12.8% [-38.6, 9.6], P = 0.23; 6.1% [-6.1, 17.5], P = 0.32). Carbohydrate content explained 40% and serving size an additional 55% of the excess calories. Among a convenience sample of energy-dense snack foods, caloric content is higher than stated on the nutrition labels, but overall well within FDA limits. This discrepancy may be explained by inaccurate carbohydrate content and serving size.
| S-EPMC3605747 | biostudies-literature
Project description:BACKGROUND:Sugar taxes and front-of-package (FOP) nutrition labelling systems are strategies to address diet-related non-communicable diseases. However, there is relatively little experimental data on how these strategies influence consumer behavior and how they may interact. This study examined the relative impact of different sugar taxes and FOP labelling systems on beverage and snack food purchases. METHODS:A total of 3584 Canadians 13 years and older participated in an experimental marketplace study using a 5 (FOP label condition) × 8 (tax condition) between-within group experiment. Participants received $5 and were presented with images of 20 beverages and 20 snack foods available for purchase. Participants were randomized to one of five FOP label conditions (no label; 'high in' warning; multiple traffic light; health star rating; nutrition grade) and completed eight within-subject purchasing tasks with different taxation conditions (beverages: no tax, 20% tax on sugar-sweetened beverages (SSBs), 20% tax on sugary drinks, tiered tax on SSBs, tiered tax on sugary drinks; snack foods: no tax, 20% tax on high-sugar foods, tiered tax on high-sugar foods). Upon conclusion, one of eight selections was randomly chosen for purchase, and participants received the product and any change. RESULTS:Compared to those who saw no FOP label, participants who viewed the 'high in' symbol purchased less sugar (- 2.5 g), saturated fat (- 0.09 g), and calories (- 12.6 kcal) in the beverage purchasing tasks, and less sodium (- 13.5 mg) and calories (- 8.9 kcal) in the food tasks. All taxes resulted in substantial reductions in mean sugars (- 1.4 to - 4.7 g) and calories (- 5.3 to - 19.8 kcal) purchased, and in some cases, reductions in sodium (- 2.5 to - 6.6 mg) and saturated fat (- 0.03 to - 0.08 g). Taxes that included 100% fruit juice ('sugary drink' taxes) produced greater reductions in sugars and calories than those that did not. CONCLUSIONS:This study expands the evidence indicating the effectiveness of sugar taxation and FOP labelling strategies in promoting healthy food and beverage choices. The results emphasize the importance of applying taxes to 100% fruit juice to maximize policy impact, and suggest that nutrient-specific FOP 'high in' labels may be more effective than other common labelling systems at reducing consumption of targeted nutrients.
| S-EPMC6528263 | biostudies-literature