Lyndal Wellard

The effect of energy and traffic light labelling on parent and child fast food selection: a randomised controlled trial

OBJECTIVES Labelling of food from fast food restaurants at point-of-purchase has been suggested as one strategy to reduce population energy consumption and contribute to reductions in obesity prevalence. The aim of this study was to examine the effects of energy and single traffic light labelling systems on the energy content of child and adult intended food purchases. PARTICIPANTS AND METHODS The study employed a randomised controlled trial design. English speaking parents of children aged between three and 12 years were recruited from an existing research cohort. Participants were mailed one of three hypothetical fast food menus. Menus differed in their labelling technique- either energy labels, single traffic light labels, or a no-label control. Participants then completed a telephone survey which assessed intended food purchases for both adult and child. The primary trial outcome was total energy of intended food purchase. RESULTS A total of 329 participants completed the follow-up telephone interview. Eighty-two percent of the energy labelling group and 96% of the single traffic light labelling group reported noticing labelling information on their menu. There were no significant differences in total energy of intended purchases of parents, or intended purchases made by parents for children, between the menu labelling groups, or between menu labelling groups by socio-demographic subgroups. CONCLUSIONS This study provided no evidence to suggest that energy labelling or single traffic light labelling alone were effective in reducing the energy of fast food items selected from hypothetical fast food menus for purchase. Additional complementary public health initiatives promoting the consumption of healthier foods identified by labelling, and which target other key drivers of menu item selection in this setting may be required.OBJECTIVES Labelling of food from fast food restaurants at point-of-purchase has been suggested as one strategy to reduce population energy consumption and contribute to reductions in obesity prevalence. The aim of this study was to examine the effects of energy and single traffic light labelling systems on the energy content of child and adult intended food purchases. PARTICIPANTS AND METHODS The study employed a randomised controlled trial design. English speaking parents of children aged between three and 12 years were recruited from an existing research cohort. Participants were mailed one of three hypothetical fast food menus. Menus differed in their labelling technique – either energy labels, single traffic light labels, or a no-label control. Participants then completed a telephone survey which assessed intended food purchases for both adult and child. The primary trial outcome was total energy of intended food purchase. RESULTS A total of 329 participants completed the follow-up telephone interview. Eighty-two percent of the energy labelling group and 96% of the single traffic light labelling group reported noticing labelling information on their menu. There were no significant differences in total energy of intended purchases of parents, or intended purchases made by parents for children, between the menu labelling groups, or between menu labelling groups by socio-demographic subgroups. CONCLUSIONS This study provided no evidence to suggest that energy labelling or single traffic light labelling alone were effective in reducing the energy of fast food items selected from hypothetical fast food menus for purchase. Additional complementary public health initiatives promoting the consumption of healthier foods identified by labelling, and which target other key drivers of menu item selection in this setting may be required.

Regulating health claims on food labels using nutrient profiling: what will the proposed standard mean in the Australian supermarket?

OBJECTIVE Proposed Australian regulation of claims on food labels includes requirements for products carrying a health claim to meet nutrient profiling criteria. This would not apply to nutrition content claims. The present study investigated the number and healthiness of products carrying claims and the impact of the proposed regulation. DESIGN Observational survey of claims on food packages across three categories: non-alcoholic beverages, breakfast cereals and cereal bars. Nutrient profiling was applied to products carrying claims to determine their eligibility to carry health claims under the proposed regulation. SETTING Three large metropolitan stores from the three major supermarket chains in Sydney, Australia were surveyed in August 2011. SUBJECTS All claims on 1028 products were recorded. Nutrition composition and ingredients were collected from the packaging, enabling nutrient profiling. The proportion of products in each category carrying claims and the proportion of these that did not meet the nutrient profiling criteria were calculated. RESULTS Two-thirds of products in the three categories (ranging from 18 to 78 %) carried at least one claim. Of those carrying health claims, 31 % did not meet the nutrient profiling criteria. These would be ineligible to carry these claims under the proposed regulation. Additionally, 29 % of products carrying nutrition content claims did not meet the nutrient profiling criteria. CONCLUSIONS The number of products carrying nutrition content claims that did not meet the nutrient profiling criteria suggests that comprehensive regulation is warranted. Promotion of unhealthy foods using claims is potentially misleading for consumers and hinders their ability to select healthier foods. Implementation of the proposed regulation represents an improvement to current practice.

Fries or a fruit bag? Investigating the nutritional composition of fast food children’s meals

The impact of childrens fast food meals on their daily nutritional requirements has not been assessed in Australia. Analysis of the nutritional composition of childrens meals from six fast food chains was conducted. The energy, saturated fat, sugar and sodium content of all childrens meals from the chains were assessed against the fast food industry-defined nutrient criteria for healthy meals and childrens recommended daily nutritional requirements, as defined by the Nutrient Reference Values and the Dietary Guidelines for Children and Adolescents in Australia. Overall childrens fast food meals are high in saturated fat, sugar and sodium. Only 16% and 22% of meals met the industrys nutrient criteria for children aged 4-8 and 9-13 years, respectively. Seventy-two percent of fast food meals exceeded 30% of the daily energy recommendations for 4 year old children, and 90% of meals exceeded 30% of the upper limit for sodium for children aged 4-8. Some meals also exceeded the upper limit for sodium and daily saturated fat recommendations for children aged 4-8 years. Reformulation of childrens meals to improve their nutritional composition and revision of the industrys nutrient criteria to align with childrens dietary requirements are urgently needed.

Investigating fruit and vegetable claims on Australian food packages

OBJECTIVES Fruit and vegetable claims on food packages are not regulated under Australian food standards. The present study aimed to: (i) investigate the number and healthiness of products carrying fruit and vegetable claims in Australia; and (ii) compare the nutrition composition of these products with fresh fruit and/or vegetables. DESIGN Content analysis of fruit and vegetable claims on food packages. The Australian food standards nutrient profiling model was used to determine the proportion of products not meeting nutrient profiling criteria. The nutrient composition of products carrying claims referencing the servings of fruit and vegetables in the product were compared with that of the dominant fruit and/or vegetables in each product. SETTING The five largest supermarket chains in Australia. SUBJECTS All available products in the fruit snacks, soups and fruit and vegetable juices/fruit drinks categories (n 762) were surveyed. Nutrition composition, ingredients and claims were recorded for each product. RESULTS Of the products surveyed, 48 % (n 366) carried at least one claim, of which 34 % (n 124) did not meet nutrient profiling. Products carrying claims referencing the number of servings of fruit and vegetables had more energy, sodium, saturated fat and sugar, and less fibre, than fresh fruit and/or vegetables (all P<0·001). CONCLUSIONS Many products carried fruit and vegetable claims and were significantly higher in energy, saturated fat, sugars and sodium than fresh fruit and vegetables. Marketing these products as a way of meeting fruit and vegetable intake is inaccurate and potentially misleading. Fruit and vegetable claims should be regulated using nutrient profiling.

Who is responsible for selecting children's fast food meals, and what impact does this have on energy content of the selected meals?

Aim The present study aimed to: (i) document the role of parents in childrens fast food meal selection; (ii) determine whether parental demographics, weight status or fast food consumption frequency were associated with who selects childrens fast food meals; and (iii) determine whether the total energy content of childrens meals selected from a hypothetical fast food menu was associated with selection responsibility. Methods A cross-sectional survey of 477 parents of children aged 3–12 years in New South Wales, Australia, was conducted. Participants completed two computer-assisted telephone interviews. The first collected demographic and anthropometric data including height and weight. Participants were subsequently mailed a hypothetical fast food menu. The second interview asked who was responsible for selecting their childrens fast food meals, and what items would be chosen. Energy content of the selections was examined. Results Most parents (60%) stated that they shared meal selection responsibility with their children. Parents with higher education levels (P < 0.01) or younger children (P < 0.01) were more likely to take responsibility for meal selection. When parents stated that children were responsible, they chose fast food meals with significantly higher energy content than when responsibility was shared (P < 0.01). Conclusions The present study shows that parents are influential in childrens fast food intake. Parents should be encouraged to play an active role in assisting children to make healthier fast food choices, to reduce the impact of high-energy meals on their overall diets.

Advertising to children initiatives have not reduced unhealthy food advertising on Australian television.

Background In response to rising childhood obesity rates, the Australian food industry implemented two initiatives in 2009 to reduce the marketing of unhealthy food to children. This study evaluated the efficacy of these initiatives on the rate of unhealthy food advertising to children on Australian television. Methods The rates of food advertisements on three free‐to‐air commercial television channels and a youth‐oriented digital channel in Sydney, Australia were analysed over 2 weekdays (16 h) and two weekend days (22 h). Advertisements were categorized according to the healthiness of foods advertised (non‐core, core, miscellaneous) and signatory status to the food industry advertising initiatives. Results Total food advertising rates for the three channels increased from 5.5/h in 2011 to 7.3/h in 2015, due to an increase of 0.8/h for both core and miscellaneous foods. The rate of non‐core food advertisements in 2015 (3.1/h) was similar to 2011 (3.0/h). The youth‐oriented channel had fewer total food advertisements (3.7/h versus 7.3/h) but similar fast‐food advertisement rates (1.3/h versus 1.3/h). Conclusions There was no change in the rate of unhealthy food advertising since 2011, suggesting minimal impact of the current food industry initiatives on reducing childrens exposure to unhealthy food advertising.

Energy-dense fast food products cost less: an observational study of the energy density and energy cost of Australian fast foods.

Objective: To examine the association between energy cost and energy density of fast food products.

Energy and nutrient composition of menu items at Australian coffee chains

Aim Worldwide, there are concerns about the link between fast food and overall poor dietary quality and weight gain. Beverages and snack foods purchased from coffee chains may contribute excess energy and nutrients to the diet if they are consumed in addition to usual meals. The present study investigated the energy, saturated fat and sugar content of beverages and sweet snacks from major coffee chains and compared the nutrient content to daily intake (DI) reference values for adults. Methods Nutrition information per serve was sourced from the Australian websites of five coffee chains with the largest number of outlets in New South Wales and compared to DI reference values for adults for energy, saturated fat and sugars. Energy per serve was compared to 600 kJ, the Australian Dietary Guidelines recommendation for one serve of a discretionary food. Results Eighty-four per cent (n = 238) of sweet snacks and 65% (n = 79) of cold beverages provided more than two equivalent serves (1200 kJ) of a discretionary food. Sixteen (13%) cold beverages and 47 (16%) sweet snacks provided over 50% DI of saturated fat. Sixty-six (54%) cold beverages and 47 (16%) sweet snacks had more than half the DI of sugars. Conclusions Food and beverage items from coffee chains may contribute to excess intake of energy and other nutrients of public health concern if consumed in addition to meals. To assist consumers to make informed and healthier fast food choices, accessible detailed nutrition information should be available along with reductions in portion sizes and reformulation to more nutritious menu items.

Sponsorship of junior sport development programs in Australia

Objective: This study investigated the nature and extent of unhealthy food, beverage, alcohol and gambling sponsors of childrens sport development programs.

The availability and accessibility of nutrition information in fast food outlets in five states post-menu labelling legislation in New South Wales.

Objectives: 1) Explore the availability and accessibility of fast food energy and nutrient information post‐NSW menu labelling legislation in states with and without menu labelling legislation. 2) Determine whether availability and accessibility differed compared with pre‐menu labelling legislation in NSW.