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Food and Public Health: Food Supply, Marketing and Consumers
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Food and Public Health: Food Supply, Marketing and Consumers

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (28 February 2022) | Viewed by 50176

Special Issue Editors

Prof. Dr. Igor Pravst

E-Mail Website
Guest Editor
Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
Interests: nutrition and public health; dietary intake; macronutrients; vitamin D; free sugar; trans fatty acids
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Mary R. L'Abbé

E-Mail Website
Assistant Guest Editor
Faculty of Medicine, University of Toronto, ON M5S 1A8, Canada
Interests: food quality; health economics; nutrient profiling; nutrition and health claims; public health
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Sophie Hieke

E-Mail Website
Assistant Guest Editor
Munich Business School, D-80687 Munich, Germany
Interests: consumer behavior; consumer trust; food choice; food labelling; health claims
Prof. Dr. Bridget Kelly

E-Mail Website
Assistant Guest Editor
Early Start, School of Health and Society, Faculty of Social Sciences, University of Wollongong, Australia
Interests: food policy; food marketing; food labelling
Dr. Katja Žmitek

E-Mail Website
Assistant Guest Editor
Nutrition and Public Health Research Group, Nutrition Institute, 1000- Ljubljana, Slovenia
Interests: food fortification; food supplementation; vitamin D; iodine; public health
Dr. Anita Kušar

E-Mail Website
Assistant Guest Editor
Nutrition and Public Health Research Group, Nutrition Institute, 1000- Ljubljana, Slovenia
Interests: food labelling; functional foods; botanicals; public health

Special Issue Information

Dear Colleagues,

This Special Issue focuses on food and public health, addressing the challenges in the food supply and its availability, promotion, and issues of consumer literacy and perceptions, including consumer trust in the food value chain.

It is well established that nutrition is one of the major modifiable risk factors for chronic disease. However, the dietary decisions of individuals are extremely complex and are affected by different parameters, including those at the macro-level, such as the food supply and food policy. For example, people mostly depend on the foods that are available in the food supply, and it is crucial to consider not only their nutritional content, but also the presence of ingredients, which could present either a health risk or a protective factor. Food choices are affected by the way food is labelled and marketed. Countries are testing various approaches to restrict attractive marketing techniques, such as marketing to children, and nutrition and health claims on less healthy foods, based on different nutrient profiling models. Nutrient profiling can also be used in labelling to highlight healthier food choices or conversely, to identify less healthy foods, or can be used to rank or rate foods. Both at individual and population levels, such public health approaches are dependent on consumer health and nutrition literacy and trust issues. Consumer trust and values also affect confidence in food and the technologies/ingredients used in food production and processing.

The aim of this Special Issue is to contribute to the dissemination of knowledge about the factors affecting the food supply as well as policies to influence these, providing ideas for new research and more efficient public health interventions.

To further understand these effects, more evidence-based research is needed, with a focus on well-planned monitoring, modelling, and intervention studies. Thus, we have the privilege of inviting you to submit your unpublished work to this Special Issue. Researchers in nutrition, epidemiology, public health, health economics, consumer research, and other sciences are invited to submit high quality papers with the results of their studies, conducted with sound scientific methods. Research papers dealing with changes due to the COVID-19 pandemic in these areas are also welcome. Also, submissions of systematic reviews and meta-analyses related to the issues in this research area are also encouraged.

Prof. Dr. Igor Pravst
Prof. Dr. Mary R. L'Abbé
Prof. Dr. Sophie Hieke
Prof. Dr. Bridget Kelly
Dr. Katja Žmitek
Dr. Anita Kušar
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Food labelling
  • Food reformulation
  • Food composition and fortification
  • Nutrient profiling
  • Food marketing
  • Consumer trust
  • Health and nutrition literacy
  • Health economics
  • COVID-19 effects

Published Papers (14 papers)

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Research

16 pages, 2270 KiB  
Article
Comparison of Nutri-Score and Health Star Rating Nutrient Profiling Models Using Large Branded Foods Composition Database and Sales Data
by Edvina Hafner and Igor Pravst
Int. J. Environ. Res. Public Health 2023, 20(5), 3980; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20053980 - 23 Feb 2023
Cited by 6 | Viewed by 2511
Abstract
Front-of-package nutrition labelling (FOPNL) is known as an effective tool that can encourage healthier food choices and food reformulation. A very interesting type of FOPNL is grading schemes. Our objective was to compare two market-implemented grading schemes—European Nutri-Score (NS) and Australian Health Star [...] Read more.
Front-of-package nutrition labelling (FOPNL) is known as an effective tool that can encourage healthier food choices and food reformulation. A very interesting type of FOPNL is grading schemes. Our objective was to compare two market-implemented grading schemes—European Nutri-Score (NS) and Australian Health Star Rating (HSR), using large Slovenian branded foods database. NS and HSR were used for profiling 17,226 pre-packed foods and drinks, available in Slovenian food supply dataset (2020). Alignment between models was evaluated with agreement (% of agreement and Cohen’s Kappa) and correlation (Spearman rho). The 12-month nationwide sales-data were used for sale-weighing, to address market-share differences. Study results indicated that both models have good discriminatory ability between products based on their nutritional composition. NS and HSR ranked 22% and 33% of Slovenian food supply as healthy, respectively. Agreement between NS and HSR was strong (70%, κ = 0.62) with a very strong correlation (rho = 0.87). Observed profiling models were most aligned within food categories Beverages and Bread and bakery products, while less aligned for Dairy and imitates and Edible oils and emulsions. Notable disagreements were particularly observed in subcategories of Cheese and processed cheeses (8%, κ = 0.01, rho = 0.38) and Cooking oils (27%, κ = 0.11, rho = 0.40). Further analysis showed that the main differences in Cooking oils were due to olive oil and walnut oil, which are favoured by NS and grapeseed, flaxseed and sunflower oil that are favoured by HSR. For Cheeses and cheese products, we observed that HSR graded products across the whole scale, with majority (63%) being classified as healthy (≥3.5 *), while NS mostly graded lower scores. Sale-weighting analyses showed that offer in the food supply does not always reflect the sales. Sale-weighting increased overall agreement between profiles from 70% to 81%, with notable differences between food categories. In conclusion, NS and HSR were shown as highly compliant FOPNLs with few divergences in some subcategories. Even these models do not always grade products equally high, very similar ranking trends were observed. However, the observed differences highlight the challenges of FOPNL ranking schemes, which are tailored to address somewhat different public health priorities in different countries. International harmonization can support further development of grading type nutrient profiling models for the use in FOPNL, and make those acceptable for more stake-holders, which will be crucial for their successful regulatory implementation. Full article
(This article belongs to the Special Issue Food and Public Health: Food Supply, Marketing and Consumers)
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13 pages, 544 KiB  
Article
Exposure to Food Marketing via Social Media and Obesity among University Students in Saudi Arabia
by Najlaa M. Aljefree and Ghada Talat Alhothali
Int. J. Environ. Res. Public Health 2022, 19(10), 5851; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19105851 - 11 May 2022
Cited by 7 | Viewed by 4042
Abstract
This study investigated the associations between obesity and unhealthy food/drink intake with both the frequency of social media platform usage and food/drink marketing exposure on social media. Data were obtained from 316 university students aged 18–29 years at two universities in Jeddah, Saudi [...] Read more.
This study investigated the associations between obesity and unhealthy food/drink intake with both the frequency of social media platform usage and food/drink marketing exposure on social media. Data were obtained from 316 university students aged 18–29 years at two universities in Jeddah, Saudi Arabia. These participants completed online questionnaires with sections on demographics, anthropometric measurements, social media platform usage, food marketing exposure via social media, and unhealthy food consumption. All of the participants, 20.3% and 13.6% were overweight and obese, respectively. Snapchat was the most popular application (85.8%), followed by Instagram (75%), YouTube (61%), Twitter (51%), and TikTok (50%). The obese participants were more likely to purchase foods/drinks after watching relevant social media advertisements than their non-obese counterparts (p < 0.04). Moreover, those who purchased foods/drinks more frequently after watching such advertisements consumed higher amounts of potato chips (p < 0.01) and fast foods (p < 0.03). Finally, those who used Snapchat, TikTok, and Instagram tended to have higher consumption rates for potato chips (p < 0.02), fast foods (p < 0.01), sweets (p < 0.02), and sugary drinks (p < 0.04). Public health policymakers in Saudi Arabia should consider regulating unhealthy food and drink advertisements on social media platforms, especially those targeted at younger generations. Full article
(This article belongs to the Special Issue Food and Public Health: Food Supply, Marketing and Consumers)
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16 pages, 2294 KiB  
Article
Categorizing Foods by Relative Healthfulness: A Scoping Review of Front of Pack Labelling
by Shivneta Singh, Ashika Naicker and Sinenhlanhla Ntokozo Memela
Int. J. Environ. Res. Public Health 2021, 18(22), 11980; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182211980 - 15 Nov 2021
Cited by 1 | Viewed by 2592
Abstract
Worksites are a suitable platform for employees to engage in behavioral change towards a healthy lifestyle by the modification of the food environment. Grading canteen foods at worksites into categories of relative healthfulness is an important indicator in the planning of food environmental [...] Read more.
Worksites are a suitable platform for employees to engage in behavioral change towards a healthy lifestyle by the modification of the food environment. Grading canteen foods at worksites into categories of relative healthfulness is an important indicator in the planning of food environmental interventions. However, in the absence of mandatory front of pack (FOP) labelling in South Africa, categorizing packaged and cooked food at worksite canteens is challenging. A scoping review was conducted on FOP labelling schemes to inform the selection of a FOP labelling scheme best suited for canteen foods at worksites in South Africa. The results of the scoping study, tabulated into a narrative summary, showed that there are several well-developed approaches to classifying foods by relative healthfulness through nutrient profiling and different forms of expression. It is recommended that because worksite canteen food sales in South Africa include both packaged and cooked food, and that a general test of various labelling schemes should be conducted to determine if a directional change is made towards purchasing healthier foods. Grading foods using interpretational aides such as an adapted FOP nutrition label to the South African context into categories of relative healthfulness can be a practical tool to inform food environmental interventions at worksite canteens and beyond. Full article
(This article belongs to the Special Issue Food and Public Health: Food Supply, Marketing and Consumers)
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17 pages, 774 KiB  
Article
Development of the University Food Environment Assessment (Uni-Food) Tool and Process to Benchmark the Healthiness, Equity, and Environmental Sustainability of University Food Environments
by Davina Mann, Janelle Kwon, Shaan Naughton, Sinead Boylan, Jasmine Chan, Karen Charlton, Jane Dancey, Carolyn Dent, Amanda Grech, Victoria Hobbs, Sophie Lamond, Sandra Murray, Melissa Yong and Gary Sacks
Int. J. Environ. Res. Public Health 2021, 18(22), 11895; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182211895 - 12 Nov 2021
Cited by 5 | Viewed by 4953
Abstract
Globally, there is increasing interest in monitoring actions to create healthy, equitable and environmentally sustainable food environments. Currently, there is a lack of detailed tools for monitoring and benchmarking university food environments. This study aimed to develop the University Food Environment Assessment (Uni-Food) [...] Read more.
Globally, there is increasing interest in monitoring actions to create healthy, equitable and environmentally sustainable food environments. Currently, there is a lack of detailed tools for monitoring and benchmarking university food environments. This study aimed to develop the University Food Environment Assessment (Uni-Food) tool and process to benchmark the healthiness, equity, and environmental sustainability of food environments in tertiary education settings, and pilot test its implementation in three Australian universities in 2021. The Uni-Food tool development was informed by a review of the literature and input from an expert advisory panel. It comprises three components: (1) university systems and governance, (2) campus facilities and environments, and (3) food retail outlets. The process for implementing the tool is designed for universities to self-assess the extent to which they have implemented recommended practice in 68 indicators, across 16 domains, weighted based on their relative importance. The pilot implementation of the tool identified moderate diversity in food environments across universities and highlighted several opportunities for improvements at each institution. The assessment process was found to be reliable, with assessors rating the tool as easy to use, requiring minimal resources. Broad application of the tool has the potential to increase accountability and guide best practice in tertiary education and other complex institutional settings. Full article
(This article belongs to the Special Issue Food and Public Health: Food Supply, Marketing and Consumers)
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17 pages, 1242 KiB  
Article
An Assessment of Government Capacity Building to Restrict the Marketing of Unhealthy Food and Non-Alcoholic Beverage Products to Children in the Region of the Americas
by Sofía Rincón-Gallardo Patiño, Fabio Da Silva Gomes, Steven Constantinou, Robin Lemaire, Valisa E. Hedrick, Elena L. Serrano and Vivica I. Kraak
Int. J. Environ. Res. Public Health 2021, 18(16), 8324; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168324 - 06 Aug 2021
Cited by 1 | Viewed by 2892
Abstract
The Pan American Health Organization (PAHO) Strategic Plan 2020–2025 committed to reduce children’s consumption of energy-dense nutrient-poor food and beverage products high in fat, sugar and salt (HFSS) and promote healthy eating patterns to reduce malnutrition in all forms. This paper describes the [...] Read more.
The Pan American Health Organization (PAHO) Strategic Plan 2020–2025 committed to reduce children’s consumption of energy-dense nutrient-poor food and beverage products high in fat, sugar and salt (HFSS) and promote healthy eating patterns to reduce malnutrition in all forms. This paper describes the capacity-building needs in PAHO’s Member States to restrict the marketing of HFSS food and beverages to children. We asked Ministries of Health officials or national institutes/departmental representatives (n = 35) to complete a 28-item web-based survey (January to July 2020). Capacity-building needs were assessed using an adapted version of the World Health Organization’s government capacity-building framework with three modules: public health infrastructure, policies and information systems. Notable achievements for the PAHO’s Plan of Action were identified. State representatives reported strong infrastructure and information systems; however, policy improvements are needed to increase comprehensive national responses. These include using a constitutional health and human rights approach within the policies, policies that document conflict of interest from non-state actors, and strengthening regulatory oversight for digital media platforms. These findings provide baseline data and we suggest priorities for further action to strengthen national governments’ capacity-building and to accelerate the development, implementation, and monitoring systems to restrict the marketing of HFSS food and non-alcoholic beverages to children in the region of the Americas. Full article
(This article belongs to the Special Issue Food and Public Health: Food Supply, Marketing and Consumers)
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16 pages, 402 KiB  
Article
Availability, Nutritional Profile and Processing Level of Food Products Sold in Vending Machines in a Spanish Public University
by Naiara Martinez-Perez and Marta Arroyo-Izaga
Int. J. Environ. Res. Public Health 2021, 18(13), 6842; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18136842 - 25 Jun 2021
Cited by 8 | Viewed by 2953
Abstract
Background. Given the lack of data about the nutritional value and other determinants of the consumption of foods and drinks sold in vending machines in European universities and the relevance of this sector in Spain, it is necessary to obtain scientific data on [...] Read more.
Background. Given the lack of data about the nutritional value and other determinants of the consumption of foods and drinks sold in vending machines in European universities and the relevance of this sector in Spain, it is necessary to obtain scientific data on this topic. The present study aimed to assess the availability, nutritional profile and processing level of food products from vending machines at a Spanish public university and to investigate differences in nutritional profile according to the cost and promotion. Methods. Cross-sectional descriptive study. Data from all products available (3894) were collected and analysed using the criteria of the Spanish Agency for Consumption, Food Safety and Nutrition and the United Kingdom nutrient profiling model. The items were also classified according to the degree of industrial processing through the NOVA system. Promotion was assessed, taking into account where products were displayed in vending machines. Results. The most common products were sweets (23.4% of the total options), coffee (20.3%) and salty snacks (11.7%). According to the combination of the two criteria used to assess nutritional profile, 48.6% of the products were classified as with low nutritional quality (LNQ). In addition, 73.8% of the items were categorised as “ultra-processed”. Foods (β = 0.31, 95% CI 0.24, 0.39, p < 0.001) and hot drinks (β = 0.46, 95% CI 0.39, 0.52, p < 0.001) with high nutritional quality (HNQ) were more likely to have higher prices than alternatives with LNQ. Both foods and cold drinks that support healthy dietary recommendations were promoted to a lesser extent than those with LNQ (p < 0.001). Conclusion. Almost half of the products were of LNQ and three-quarters had a high level of processing. Moreover, foods and cold drinks with LNQ were less expensive and more often promoted than alternatives with HNQ. Full article
(This article belongs to the Special Issue Food and Public Health: Food Supply, Marketing and Consumers)
20 pages, 1672 KiB  
Article
Using Social Media to Preserve Consumers’ Awareness on Food Identity in Times of Crisis: The Case of Bakeries
by Francesc Fusté-Forné and Nela Filimon
Int. J. Environ. Res. Public Health 2021, 18(12), 6251; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18126251 - 09 Jun 2021
Cited by 9 | Viewed by 6262
Abstract
Departing from the understanding of food tourism in urban environments, this research analyses the brand engagement of bakeries during the COVID-19 lockdown period, and the first stages of the de-escalation process. A mixed-methods study is designed to analyze the case of six selected [...] Read more.
Departing from the understanding of food tourism in urban environments, this research analyses the brand engagement of bakeries during the COVID-19 lockdown period, and the first stages of the de-escalation process. A mixed-methods study is designed to analyze the case of six selected bakeries in Catalonia (Spain). Drawing on data obtained from semi-structured interviews (N = 6) and a visual content analysis of the businesses’ social media promotion in Instagram (N = 638), results show the performance of bakeries during pandemic times, where a change in production and consumption behaviors is observed and takeaway and delivery helped them to survive. In particular, their social media promotion in Instagram also revealed how bakeries have managed this difficult situation and kept a close relationship with customers, standing up as a symbol of resilience against the odds and contributing to preserve customers’ awareness on food and health, and the city’s identity, through digital branding strategies that communicate messages around bread and pastry foods (the product), the shop and the workshop (the place), and both the employees and the customers (the people). Full article
(This article belongs to the Special Issue Food and Public Health: Food Supply, Marketing and Consumers)
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23 pages, 1099 KiB  
Article
Quantifying Child-Appeal: The Development and Mixed-Methods Validation of a Methodology for Evaluating Child-Appealing Marketing on Product Packaging
by Christine Mulligan, Monique Potvin Kent, Laura Vergeer, Anthea K. Christoforou and Mary R. L’Abbé
Int. J. Environ. Res. Public Health 2021, 18(9), 4769; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18094769 - 29 Apr 2021
Cited by 11 | Viewed by 3527
Abstract
There is no standardized or validated definition or measure of “child-appeal” used in food and beverage marketing policy or research, which can result in heterogeneous outcomes. Therefore, this pilot study aimed to develop and validate the child-appealing packaging (CAP) coding tool, which measures [...] Read more.
There is no standardized or validated definition or measure of “child-appeal” used in food and beverage marketing policy or research, which can result in heterogeneous outcomes. Therefore, this pilot study aimed to develop and validate the child-appealing packaging (CAP) coding tool, which measures the presence, type, and power of child-appealing marketing on food packaging based on the marketing techniques displayed. Children (n = 15) participated in a mixed-methods validation study comprising a binary classification (child-appealing packaging? Yes/No) and ranking (order of preference/marketing power) activity using mock breakfast cereal packages (quantitative) and focus group discussions (qualitative). The percent agreement, Cohen’s Kappa statistic, Spearman’s Rank correlation, and cross-classification analyses tested the agreement between children’s and the CAP tool’s evaluation of packages’ child-appeal and marketing power (criterion validity) and the content analysis tested the relevance of the CAP marketing techniques (content validity). There was an 80% agreement, and “moderate” pairwise agreement (κ [95% CI]: 0.54 [0.35, 0.73]) between children/CAP binary classifications and “strong” correlation (rs [95% CI]: 0.78 [0.63, 0.89]) between children/CAP rankings of packages, with 71.1% of packages ranked in the exact agreement. The marketing techniques included in the CAP tool corresponded to those children found pertinent. Pilot results suggest the criterion/content validity of the CAP tool for measuring child-appealing marketing on packaging in accordance with children’s preferences. Full article
(This article belongs to the Special Issue Food and Public Health: Food Supply, Marketing and Consumers)
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12 pages, 333 KiB  
Article
Impact of Employment, Essential Work, and Risk Factors on Food Access during the COVID-19 Pandemic in New York State
by Lauren A. Clay and Stephanie Rogus
Int. J. Environ. Res. Public Health 2021, 18(4), 1451; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18041451 - 04 Feb 2021
Cited by 16 | Viewed by 4205
Abstract
The COVID-19 pandemic disrupted food systems and the economy in the U.S. and abroad. This cross-sectional study examined the direct and indirect impacts of COVID-19 on food access among low-income and Black, Indigenous, and people of color (BIPOC) in New York State. New [...] Read more.
The COVID-19 pandemic disrupted food systems and the economy in the U.S. and abroad. This cross-sectional study examined the direct and indirect impacts of COVID-19 on food access among low-income and Black, Indigenous, and people of color (BIPOC) in New York State. New York residents were recruited to complete a web-based survey through Qualtrics. The survey took place in May and June 2020 and asked participants about COVID-19 health impacts, risk factors, and food access. Chi-square analysis examined issues with food access experienced by demographic characteristics, work disruptions, health impacts, and household risk for contracting the virus and experiencing severe illness, and significant results were analyzed in a series of logistic regression models. After accounting for covariates, Hispanic respondents, those with likely Major Depressive Disorder, and essential workers were more likely to experience worse food access during COVID-19. Improved policies and services to address impacts on vulnerable populations such as BIPOC, those suffering from mental health disorders, and workers in lower-paying essential jobs can reduce the risk of food access issues at this time. Future research can identify how food access issues during the pandemic influenced diet quality, chronic disease risk and infection, and persistence of food access issues. Full article
(This article belongs to the Special Issue Food and Public Health: Food Supply, Marketing and Consumers)
14 pages, 1164 KiB  
Article
Can Healthy Checkout Counters Improve Food Purchases? Two Real-Life Experiments in Dutch Supermarkets
by Marlijn Huitink, Maartje P. Poelman, Jacob C. Seidell, Lothar D. J. Kuijper, Trynke Hoekstsra and Coosje Dijkstra
Int. J. Environ. Res. Public Health 2020, 17(22), 8611; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17228611 - 19 Nov 2020
Cited by 9 | Viewed by 2418
Abstract
Most snacks displayed at supermarket checkouts do not contribute to a healthy diet. We investigated the effects of introducing healthier snack alternatives at checkouts in supermarkets on purchasing behavior. In Study 1, we investigated the effect of completely substituting less healthy with healthier [...] Read more.
Most snacks displayed at supermarket checkouts do not contribute to a healthy diet. We investigated the effects of introducing healthier snack alternatives at checkouts in supermarkets on purchasing behavior. In Study 1, we investigated the effect of completely substituting less healthy with healthier snacks (one supermarket). In Study 2, we investigated the effect of placing and discounting healthier snacks while the less healthy snacks remain in place (two supermarkets). In both studies, the number of purchased snacks (per 1000 customers) was used as the outcome variable. Results for Study 1 showed that the absolute number of purchased checkout snacks was 2.4 times lower (95% confidence interval (CI): 1.9–2.7) when healthier snacks instead of less healthy snacks were placed at the supermarket checkouts. Results for Study 2 showed that when additional healthier snacks were placed near the checkouts, the absolute number of healthier purchased snacks increased by a factor of 2.1 (95% CI: 1.3–3.3). When additional healthier snacks were placed near the checkouts and discounted, the absolute number of healthier purchased snacks increased by a factor of 2.7 (95% CI: 2.0–3.6), although this was not statistically significant higher than placement only (ratio: 1.1, 95% CI: 0.7–1.9). Purchases of less healthy snacks did not decline, and even slightly increased, during the intervention period (ratio: 1.3, 95% CI: 1.1–1.5). If supermarkets want to promote healthier snack purchases, additional healthier products can be positioned near the checkouts. However, this does not discourages the purchase of less healthy snacks. Therefore, to discourage unhealthy snack purchases at supermarket checkouts, a total substitution of less healthy snacks with healthier alternatives is most effective. Full article
(This article belongs to the Special Issue Food and Public Health: Food Supply, Marketing and Consumers)
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13 pages, 534 KiB  
Article
Nutritional Composition of Gluten-Free Labelled Foods in the Slovenian Food Supply
by Živa Lavriša, Maša Hribar, Anita Kušar, Katja Žmitek and Igor Pravst
Int. J. Environ. Res. Public Health 2020, 17(21), 8239; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17218239 - 07 Nov 2020
Cited by 8 | Viewed by 2862
Abstract
The market of gluten-free (GF) foods has been expanding in recent years. GF foods are consumed not only by those with medical predispositions for avoiding gluten, but also by a specific segment of consumers, searching for “healthier” food choices. For these, such practices [...] Read more.
The market of gluten-free (GF) foods has been expanding in recent years. GF foods are consumed not only by those with medical predispositions for avoiding gluten, but also by a specific segment of consumers, searching for “healthier” food choices. For these, such practices can present a serious limitation in the variability of food choices. Considering that GF foods are commonly perceived as healthier alternatives, there is a lack of knowledge on the nutritional profile and content of specific nutrients of GF-labelled foods compared to general food supply. A comparison of nutritional composition of GF/non-GF packed foods in the Slovenian food supply was conducted. The nutrient profiling scoring criterion (NPSC) and content of specific nutrients/energy was compared between GF-labelled and regular foods. The highest proportion of GF-labelled products were found in food categories, which typically do not contain gluten (Cheese imitates, Milk imitates, Yoghurt imitates, Canned fish and seafood and Processed meat). Significant differences in the nutrient profile between GF-labelled and regular products were found in Cakes, muffins and pastry, Crisps and snacks, Desserts and Milk imitates. GF-labelled foods often had lower protein and sugar content. Energy value was comparable in most categories and no significant differences in salt content were found, compared to non-GF products. In conclusion, GF-labelled foods will unlikely bring health benefits to those who are not medically required to follow GF diet. Public health initiatives should aim towards promotion of consuming non-processed foods and provision of reliable information about who is required to consume GF foods. Full article
(This article belongs to the Special Issue Food and Public Health: Food Supply, Marketing and Consumers)
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17 pages, 1683 KiB  
Article
Snacks and The City: Unexpected Low Sales of an Easy-Access, Tasty, and Healthy Snack at an Urban Snacking Hotspot
by Caroline Schlinkert, Marleen Gillebaart, Jeroen Benjamins, Maartje P. Poelman and Denise de Ridder
Int. J. Environ. Res. Public Health 2020, 17(20), 7538; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17207538 - 16 Oct 2020
Cited by 3 | Viewed by 3666
Abstract
While many people declare an intention to eat and snack more healthily, a large body of research has found that these intentions often do not translate into actual behavior. This failure to fulfil intentions is regularly attributed to the obesogenic environment, on which [...] Read more.
While many people declare an intention to eat and snack more healthily, a large body of research has found that these intentions often do not translate into actual behavior. This failure to fulfil intentions is regularly attributed to the obesogenic environment, on which basis it is assumed that changing the food environment may lead to more healthy snacking behavior. To test this premise in real life practice, the present research project investigated whether making a healthy snack easy-to-access in an urban environment characterized by unhealthy snacking would support people in their intentions of purchasing more healthy snacks. The urban snack project consisted of three phases. In Phase 1, a hotspot location for unhealthy snacking was determined by using a Global Positioning System to track people’s snacking locations and a survey to verify the location. In Phase 2, an attractive snack was developed that met consumers’ criteria of what constituted a healthy and tasty snack, together with corresponding branding that also included a small food truck from which to sell the newly developed snacks. In Phase 3, the snack was sold from the food truck located at the previously determined unhealthy snacking hotspot. We counted the number of snacks sold and canvassed people’s opinions about the snack and its branding, finding that in spite of people’s appreciation for the snack, the food truck, and the branding, actual sales of the snack were very low. In the Discussion, we name predominant eating and purchasing habits as possible reasons for these low sales. Future research could focus on placing the healthy snack directly beside people’s habitual snack purchase location to ensure that the new choice gets better recognized. Overall, the findings suggest that merely placing healthy snacks more prominently in people’s food environment is not sufficient to lead people to snack more healthily. Full article
(This article belongs to the Special Issue Food and Public Health: Food Supply, Marketing and Consumers)
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19 pages, 499 KiB  
Article
Prevalence and Credibility of Nutrition and Health Claims: Policy Implications from a Case Study of Mongolian Food Labels
by Nyamragchaa Chimedtseren, Bridget Kelly, Anne-Therese McMahon and Heather Yeatman
Int. J. Environ. Res. Public Health 2020, 17(20), 7456; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17207456 - 13 Oct 2020
Cited by 3 | Viewed by 2395
Abstract
Nutrition and health claims should be truthful and not misleading. We aimed to determine the use of nutrition and health claims in packaged foods sold in Mongolia and examine their credibility. A cross-sectional study examined the label information of 1723 products sold in [...] Read more.
Nutrition and health claims should be truthful and not misleading. We aimed to determine the use of nutrition and health claims in packaged foods sold in Mongolia and examine their credibility. A cross-sectional study examined the label information of 1723 products sold in marketplaces in Ulaanbaatar, Mongolia. The claim data were analysed descriptively. In the absence of national regulations, the credibility of the nutrition claims was examined by using the Codex Alimentarius guidelines, while the credibility of the health claims was assessed by using the European Union (EU) Regulations (EC) No 1924/2006. Nutritional quality of products bearing claims was determined by nutrient profiling. Approximately 10% (n = 175) of products carried at least one health claim and 9% (n = 149) carried nutrition claims. The credibility of nutrition and health claims was very low. One-third of nutrition claims (33.7%, n = 97) were deemed credible, by having complete and accurate information on the content of the claimed nutrient/s. Only a few claims would be permitted in the EU countries by complying with the EU regulations. Approximately half of the products with nutrition claims and 40% of products with health claims were classified as less healthy products. The majority of nutrition and health claims on food products sold in Mongolia were judged as non-credible, and many of these claims were on unhealthy products. Rigorous and clear regulations are needed to prevent negative impacts of claims on food choices and consumption, and nutrition transition in Mongolia. Full article
(This article belongs to the Special Issue Food and Public Health: Food Supply, Marketing and Consumers)
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12 pages, 749 KiB  
Article
Sweet, Fat and Salty: Snacks in Vending Machines in Health and Social Care Institutions in Slovenia
by Urška Rozman, Igor Pravst, Urška Pivk Kupirovič, Urška Blaznik, Primož Kocbek and Sonja Šostar Turk
Int. J. Environ. Res. Public Health 2020, 17(19), 7059; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17197059 - 27 Sep 2020
Cited by 5 | Viewed by 3139
Abstract
Vending machines in health and social care facilities are often the only possible choice for a quick snack for workers and visitors, in many cases providing unhealthy dietary choices. Our study aimed to analyse the variety and nutritional quality of foods available in [...] Read more.
Vending machines in health and social care facilities are often the only possible choice for a quick snack for workers and visitors, in many cases providing unhealthy dietary choices. Our study aimed to analyse the variety and nutritional quality of foods available in vending machines placed in social and health care institution in Slovenia. The available snacks were quantitatively assessed, using traffic light profiling. The model used for nutrient profiling was that of the Food Standards Australia New Zealand (FSANZ). Vending machines in 188 institutions were surveyed, resulting in 5625 food-items consisting of 267 unique product labels. Sweet products dominate in vending machines offers (about 70%), while nuts and seeds (8.4%), yoghurts (2.1%), fruits (1.4%) and milk (0.3%) are present in a very small proportion or are not available at all. According to FSANZ, 88.5% of all displayed food items in vending machines can be considered as lower nutritional quality or less healthy products. The authors’ future activities will be focused on ensuring wider availability of healthy dietary choices and on including official guidelines in tender conditions for vending machines in health and social care institutions in Slovenia. Full article
(This article belongs to the Special Issue Food and Public Health: Food Supply, Marketing and Consumers)
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