Delvina Gorton

Nutrition labels and claims in New Zealand and Australia: a review of use and understanding

Objective: To determine how well consumers use and understand nutrition labels and claims in New Zealand and Australia.

Nutrition labels: a survey of use, understanding and preferences among ethnically diverse shoppers in New Zealand.

OBJECTIVE Effective nutrition labels are part of a supportive environment that encourages healthier food choices. The present study examined the use, understanding and preferences regarding nutrition labels among ethnically diverse shoppers in New Zealand. DESIGN AND SETTING A survey was carried out at twenty-five supermarkets in Auckland, New Zealand, between February and April 2007. Recruitment was stratified by ethnicity. Questions assessed nutrition label use, understanding of the mandatory Nutrition Information Panel (NIP), and preference for and understanding of four nutrition label formats: multiple traffic light (MTL), simple traffic light (STL), NIP and percentage of daily intake (%DI). SUBJECTS In total 1525 shoppers completed the survey: 401 Maori, 347 Pacific, 372 Asian and 395 New Zealand European and Other ethnicities (ten did not state ethnicity). RESULTS Reported use of nutrition labels (always, regularly, sometimes) ranged from 66% to 87% by ethnicity. There was little difference in ability to obtain information from the NIP according to ethnicity or income. However, there were marked ethnic differences in ability to use the NIP to determine if a food was healthy, with lesser differences by income. Of the four label formats tested, STL and MTL labels were best understood across all ethnic and income groups, and MTL labels were most frequently preferred. CONCLUSIONS There are clear ethnic and income disparities in ability to use the current mandatory food labels in New Zealand (NIP) to determine if foods are healthy. Conversely, MTL and STL label formats demonstrated high levels of understanding and acceptance across ethnic and income groups.

Environmental influences on food security in high-income countries

Food security is a fundamental human right yet many people are food insecure, even in high-income countries. Reviewed here is the evidence for the physical, economic, sociocultural, and political environmental influences on household food security in high-income countries. The literature was evaluated using the ANGELO framework, which is a lens developed for understanding the environmental factors underpinning the obesity pandemic. A review of the literature identified 78 articles, which mostly reported on cross-sectional or qualitative studies. These studies identified a wide range of factors associated with food security. Foremost among them was household financial resources, but many other factors were identified and the complexity of the issue was highlighted. Few studies were prospective and even fewer tested the use of interventions other than the supplemental nutrition assistance program to address food security. This indicates a solution-oriented research paradigm is required to identify effective interventions and policies to enhance food security. In addition, comprehensive top-down and bottom-up interventions at the community and national levels are urgently needed.

What are the determinants of food insecurity in New Zealand and does this differ for males and females

Aims: Food insecurity is a lack of assured access to sufficient nutritious food. We aimed to investigate the demographic and socio‐economic determinants of food insecurity in New Zealand and whether these determinants vary between males and females.

Effects of a free school breakfast programme on children's attendance, academic achievement and short-term hunger: results from a stepped-wedge, cluster randomised controlled trial

Background Free school breakfast programmes (SBPs) exist in a number of high-income countries, but their effects on educational outcomes have rarely been evaluated in randomised controlled trials. Methods A 1-year stepped-wedge, cluster randomised controlled trial was undertaken in 14 New Zealand schools in low socioeconomic resource areas. Participants were 424 children, mean age 9±2 years, 53% female. The intervention was a free daily SBP. The primary outcome was childrens school attendance. Secondary outcomes were academic achievement, self-reported grades, sense of belonging at school, behaviour, short-term hunger, breakfast habits and food security. Results There was no statistically significant effect of the breakfast programme on childrens school attendance. The odds of children achieving an attendance rate <95% was 0.76 (95% CI 0.56 to 1.02) during the intervention phase and 0.93 (95% CI 0.67 to 1.31) during the control phase, giving an OR of 0.81 (95% CI 0.59 to 1.11), p=0.19. There was a significant decrease in childrens self-reported short-term hunger during the intervention phase compared with the control phase, demonstrated by an increase of 8.6 units on the Freddy satiety scale (95% CI 3.4 to 13.7, p=0.001). There were no effects of the intervention on any other outcome. Conclusions A free SBP did not have a significant effect on childrens school attendance or academic achievement but had significant positive effects on childrens short-term satiety ratings. More frequent programme attendance may be required to influence school attendance and academic achievement. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR)—ACTRN12609000854235.

Changes in the Sodium Content of New Zealand Processed Foods: 2003–2013

Decreasing population sodium intake has been identified as a “best buy” for reducing non-communicable disease. The aim of this study was to explore 10-year changes in the sodium content of New Zealand processed foods. Nutrient data for nine key food groups were collected in supermarkets in 2003 (n = 323) and 2013 (n = 885). Mean (SD) and median (min, max) sodium content were calculated by food group, year and label type (private/branded). Paired t-tests explored changes in sodium content for all products available for sale in both years (matched; n = 182). The mean (SD) sodium content of all foods was 436 (263) mg (100 g)−1 in 2003 and 433 (304) mg (100 g)−1 in 2013, with no significant difference in matched products over time (mean (SD) difference, −56 (122) mg (100 g)−1, 12%; p = 0.22). The largest percentage reductions in sodium (for matched products) were observed for Breakfast Cereals (28%; −123 (125) mg (100 g)−1), Canned Spaghetti (15%; −76 (111) mg (100 g)−1) and Bread (14%; −68 (69) mg (100 g)−1). The reduction in sodium was greater for matched private vs. branded foods (−69 vs. −50 mg (100 g)−1, both p < 0.001). There has been modest progress with sodium reduction in some New Zealand food categories over the past 10 years. A renewed focus across the whole food supply is needed if New Zealand is to meet its global commitment to reducing population sodium intake.

Interpretation of two nutrition content claims: a New Zealand survey

Objective: To determine how various population groups in New Zealand interpret the nutrition content claims ‘97% fat free’ and ‘no added sugar’ on food labels.

Consumer views on the potential use of mobile phones for the delivery of weight-loss interventions

BACKGROUND The surge in the incidence of obesity and being overweight demands new options to extend the reach of weight-loss interventions. Mobile phones provide a medium for reaching large numbers of people in a cost-effective manner. The present study aimed to explore the potential for weight-loss interventions to be delivered via mobile phone. METHODS A mixed methods approach was employed. A telephone survey was conducted with 306 randomly selected participants, and 10 focus groups were undertaken with 54 purposively selected participants. The telephone survey comprised questions exploring the nature and acceptability of any potential weight-loss programme that might be delivered via mobile phones. The focus groups were conducted to explore issues of acceptability in more depth than was possible in the survey. RESULTS Two-thirds of participants reported support for a mobile phone weight-loss intervention, with greater levels of support amongst younger age groups and rural Māori (the indigenous population in New Zealand). Participants liked the idea of ready access to weight-loss information, and associated feedback and encouragement. The results suggest that interventions would need to include aspects of social support, use tailored and personalised content, and be practical and relevant so that they appeal to consumers. Appropriate methods of providing social support using a mobile phone require further exploration. CONCLUSIONS Mobile phones may provide a novel but acceptable way to deliver a weight-loss intervention. They have the potential to be automatically personalised and tailored to the needs of the individual, at the same time as being delivered at a population level.

Clinical guidelines for weight management in New Zealand adults, children and young people.

This paper summarises the treatment algorithms (Figures 1 and 2) and key messages from the Clinical Guidelines for Weight Management in New Zealand Adults, Children and Young People prepared for the Ministry of Health. The guidelines aim to provide support to weight management providers in primary care and the community. The full guidelines and methods can be downloaded from the Ministry website (http://www.moh.govt.nz).

Response to a Letter to the Editor from Katherine Rich.

A letter to Nutrients from the Chief Executive of the New Zealand Food and Grocery Council [1] questioned the validity of methods and findings reported in our recent paper, “Changes in the Sodium Content of New Zealand Processed Foods: 2003–2013” [2]. [...]