Ellis L. Vyth

Front-of-pack Nutrition label stimulates healthier product development: A quantitative analysis.

BackgroundIn addition to helping consumers make healthier food choices, front-of-pack nutrition labels could encourage companies to reformulate existing products and develop new ones with a healthier product composition. This is the largest study to date to investigate the effect of a nutrition logo on the development of healthier products by food manufacturers.MethodsA total of 47 food manufacturers joining the Choices Foundation in the Netherlands (response: 39.5%) indicated whether their Choices products were newly developed, reformulated or already complied with the Choices criteria and provided nutrient composition data for their products (n = 821; 23.5% of the available Choices products in August 2009).ResultsMost products carrying the logo as a result of reformulation and new product development were soups and snacks. Sodium reduction was the most common change found in processed meats, sandwiches, soups and sandwich fillings. Dietary fiber was significantly increased in most newly developed Choices product groups; for example, in fruit juices, processed meats, dairy products, sandwiches and soups. Saturated fatty acids (SAFA) and added sugar were significantly decreased both in reformulated and newly developed dairy products. Caloric content was significantly decreased only in reformulated dairy products, sandwich fillings and in some newly developed snacks.ConclusionsThe results indicate that the Choices logo has motivated food manufacturers to reformulate existing products and develop new products with a healthier product composition, especially where sodium and dietary fiber are concerned.

A Front-of-Pack Nutrition Logo: A Quantitative and Qualitative Process Evaluation in the Netherlands

This study aimed to perform a quantitative and qualitative process evaluation of the introduction of the Choices logo, a front-of-pack nutrition logo on products with a favorable product composition, adopted by many food producers, retail and food service organizations, conditionally endorsed by the Dutch government, validated by scientists, and in the process of international dissemination. An online questionnaire was sent to adult consumers 4 months after the introduction of the logo (n = 1,032) and 1 year later (n = 1,127). Additionally, seven consumer focus groups (n = 41) were conducted to provide more insight into the questionnaire responses. Quantitative analyses showed that exposure to the logo had significantly increased. Elderly and obese respondents reported to be more in need of a logo than younger and normal-weight individuals. Women perceived the logo more attractive and credible than men did. Further qualitative analyses indicated that the logos credibility would improve if it became known that governmental and scientific authorities support it. Elderly respondents indicated that they needed a logo due to health concerns. Consumers interested in health reported that they used the logo. Further research focusing on specific target groups, forming healthful diets, and health outcomes is needed to investigate the effectiveness of the Choices logo.

The effects of using a nutrition logo on consumption and product evaluation of a sweet pastry

Nutrition logos have received a great deal of attention to stimulate people to eat a healthier diet. However, very little is known neither about actual consumption behavior related to nutrition logos nor about potential compensatory eating behaviors due to nutrition logos. The aim of this study was to assess the effects of using an existing nutrition logo on consumption and product evaluation of a chocolate mousse cake. A cross-over design was applied with two conditions: a condition with a logo and a condition without a logo. Participants were females recruited in the university community (n = 36, mean age 22.6 ± 6.3). Data on consumption, tastefulness, perceived healthiness, dietary restraint and Body Mass Index were collected. No significant differences between conditions were found on consumption and tastefulness. The cake was rated as significantly less unhealthy in the logo condition. In conclusion, results cannot be extrapolated to other products, especially not to products that are perceived as healthy. In this study, the use of a nutrition logo did not result in an increased consumption and had no effect on the rating of taste of a sweet pastry among females from the university community.

Methodological quality of front‐of‐pack labeling studies: a review plus identification of research challenges

This review evaluates the methodological quality of current front-of-pack labeling research and discusses future research challenges. Peer-reviewed articles were identified using a computerized search of the databases PubMed and Web of Science (ISI) from 1990 to February 2011; reference lists from key published articles were used as well. The quality of the 31 included studies was assessed. The results showed that the methodological quality of published front-of-pack labeling research is generally low to mediocre; objective observational data-based consumer studies were of higher quality than consumer studies relying on self-reports. Experimental studies that included a control group were lacking. The review further revealed a lack of a validated methodology to measure the use of front-of-pack labels and the effects of these labels in real-life settings. In conclusion, few methodologically sound front-of-pack labeling studies are presently available. The highest methodological quality and the greatest public health relevance are achieved by measuring the health effects of front-of-pack labels using biomarkers in a longitudinal, randomized, controlled design in a real-life setting.

Consuming a diet complying with front-of-pack label criteria may reduce cholesterol levels: a modeling study.

Background/Objectives:Front-of-pack nutrition labels can help consumers to make healthier choices and stimulate healthier product development. This is the first modeling study to investigate the potential impact on cholesterol levels of consuming a diet consisting of products that comply with the criteria for a ‘healthier choice logo’.Subjects/Methods:National food consumption and food composition data were used to estimate the nutrient intake of the Dutch adult population (18–70 years) before and after replacing foods that did not comply with the Choices front-of-pack label criteria. Different scenarios were established. The difference in cholesterol levels in the Dutch population was assessed before and after replacement by means of equations from meta-analyses that calculate how blood lipids change when diet composition changes.Results:After replacing non-complying products with products, which comply with the labels criteria (maximum scenario), saturated fatty acids median intake reduced from 14.5 to 9.8 en%. Trans-fatty acids reduced from 0.95 to 0.57 en%. The average predicted changes in low-density lipoprotein and total cholesterol levels were −0.25 and −0.31 mmol/l, respectively. Because high-density lipoprotein (HDL) cholesterol levels reduced as well (−0.05 mmol/l), overall, the result was a slightly positive change in the total cholesterol/HDL ratio (−0.03).Conclusions:Our findings suggest that the consumption of foods complying with the criteria for a front-of-pack label could contribute moderately to cardiovascular risk reduction via influencing blood lipids. These findings were independent of other potential effects on related health outcomes.

Using nudging and social marketing techniques to create healthy worksite cafeterias in the Netherlands: intervention development and study design

BackgroundThe worksite cafeteria is a suitable setting for interventions focusing on changing eating behavior, because a lot of employees visit the worksite cafeteria regularly and a variety of interventions could be implemented there.The aim of this paper is to describe the intervention development and design of the evaluation of an intervention to make the purchase behavior of employees in the worksite cafeteria healthier. The developed intervention called “the worksite cafeteria 2.0” consists of a set of 19 strategies based on theory of nudging and social marketing (marketing mix). The intervention will be evaluated in a real-life setting, that is Dutch worksite cafeterias of different companies and with a number of contract catering organizations.Methods/designThe study is a randomized controlled trial (RCT), with 34 Dutch worksite cafeterias randomly allocated to the 12-week intervention or to the control group. Primary outcomes are sales data of selected products groups like sandwiches, salads, snacks and bread topping. Secondary outcomes are satisfaction of employees with the cafeteria and vitality.DiscussionWhen executed, the described RCT will provide better knowledge in the effect of the intervention “the worksite cafeteria 2.0” on the purchasing behavior of Dutch employees in worksite cafeterias.Trial registrationDutch Trial register: NTR5372.

Development of the 'Canteen Scan' : an online tool to monitor implementation of healthy canteen guidelines

BackgroundTo improve the availability and accessibility of healthier food and drinks in schools, sports and worksites canteens, national Guidelines for Healthier Canteens were developed by the Netherlands Nutrition Centre. Until now, no tool was available to monitor implementation of these guidelines. This study developed and assessed the content validity and usability of an online tool (the ‘Canteen Scan’) that provides insight into and directions for improvement of healthier food products in canteens.MethodsThe Canteen Scan was developed using a three-step iterative process. First, preliminary measures and items to evaluate adherence to the guidelines were developed based on literature, and on discussions and pre-tests with end-users and experts from science, policy and practice. Second, content validity of a paper version of the Canteen Scan was assessed among five end-users. Third, the online Canteen Scan was pilot tested among end-users representing school canteens. Usability was measured by comprehensibility, user-friendliness, feasibility, time investment, and satisfaction.ResultsThe content validity of the Canteen Scan was ensured by reaching agreement between stakeholders representing science, policy and practice. The scan consists of five elements: 1) basic conditions (e.g. encouragement to drink water and availability of policy regarding the guidelines), 2) product availability offered on displays (counter, shelf) and 3) in vending machines, 4) product accessibility (e.g. promotion and placement of products), and 5) an overall score based on the former elements and tailored feedback for creating a healthier canteen. The scan automatically classifies products into healthier or less healthy products. Pilot tests indicated good usability of the tool, with mean scores of 4.0–4.6 (5-point Likert scale) on the concepts comprehensibility, user-friendliness and feasibility.ConclusionThe Canteen Scan provides insight into the extent to which canteens meet the Dutch Guidelines for Healthier Canteens. It also provides tailored feedback to support adjustments towards a healthier canteen and with the scan changes over time can be monitored. Pilot tests show this tool to be usable in practice.