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Open Access 01-12-2019 | Obesity | Research article

Systematic review of the impact of nutrition claims related to fat, sugar and energy content on food choices and energy intake

Authors: Laura H. Oostenbach, Esther Slits, Ella Robinson, Gary Sacks

Published in: BMC Public Health | Issue 1/2019

Abstract

Background

As part of efforts to address high levels of overweight and obesity, the provision of nutrition information (e.g., through nutrition labels and nutrition claims) on food packages has increasingly become an important policy option. This study aimed to assess the influence of nutrition claims relating to fat, sugar, and energy content on product packaging on several aspects of food choices to understand how they contribute to the prevention of overweight and obesity.

Methods

A systematic literature review was conducted using the online databases EBSCOhost Global Health, EBSCOhost Medline, ScienceDirect, Scopus, PsycINFO and Embase. Studies were included if they measured the influence of nutrition claims relating to fat, sugar, and energy content on outcomes related to body weight, and were published between January 2003 and April 2018.

Results

Eleven studies were included in the review. Results showed that nutrition claims can influence the knowledge of consumers with respect to perceived healthfulness of products, as well as expected and experienced tastiness of food products – making food products with nutrition claims seem healthier and less tasty. Nutrition claims can make the appropriate portion size appear to be larger and lead to an underestimation of the energy content of food products. Nutrition claims can also influence food purchase intentions, moderated by the perceived healthfulness of the relevant food products and the health consciousness of individuals. Nutrition claims were also found to have an impact on food purchases, to influence ‘consumption guilt’ (i.e., feeling of guilt associated with eating), and to increase consumption, moderated by the weight status of individuals. These influences were shown to vary depending on the type of claim and food carrying the claim.

Conclusions

There is evidence that, while nutrition claims may lead some consumers to improve their nutrition knowledge and select healthier options, it may also lead consumers to increase food consumption and overall energy intake. This may run counter to efforts to address overweight and obesity.

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World Health Organization. Obesity and overweight. https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight. Accessed 1 Mar 2018.

Talley NJ. National Health Summit on Obesity calls for Australia to take action to stem the pandemic. Med J Aust. 2017;206:106–7. https://doi.org/10.5694/mja16.01345.CrossRefPubMed

Güngör NK. Overweight and obesity in children and adolescents. J Clin Res Pediatr Endocrinol. 2014;6:129–43. https://doi.org/10.4274/Jcrpe.1471.CrossRefPubMed

Swinburn BA, Sacks G, Hall KD, McPherson K, Finegood DT, Moodie ML, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011;378:804–14. https://doi.org/10.1016/s0140-6736(11)60813-1.CrossRefPubMed

Cowburn G, Stockley L. Consumer understanding and use of nutrition labelling: a systematic review. Public Health Nutr. 2005;8:21–8. https://doi.org/10.1079/PHN2004666.CrossRefPubMed

Liberato SC, Bailie R, Brimblecombe J. Nutrition interventions at point-of-sale to encourage healthier food purchasing: a systematic review. BMC Public Health. 2014;14:919. https://doi.org/10.1186/1471-2458-14-919.CrossRefPubMedPubMedCentral

Freedman MR, Connors R. Point-of-purchase nutrition information influences food-purchasing behaviors of college students: a pilot study. J Am Diet Assoc. 2011;111(Suppl 5):S42–6. https://doi.org/10.1016/j.jada.2011.03.008.CrossRefPubMed

Becker MW, Bello NM, Sundar RP, Peltier C, Bix L. Front of pack labels enhance attention to nutrition information in novel and commercial brands. Food Policy. 2015;56:76–86. https://doi.org/10.1016/j.foodpol.2015.08.001.CrossRefPubMedPubMedCentral

Hieke S, Taylor CR. Critical review of the literature on nutritional labeling. J Consum Aff. 2011;46:120–56. https://doi.org/10.1111/j.1745-6606.2011.01219.x.CrossRef

10.

Provencher V, Jacob R. Impact of perceived healthiness of food on food choices and intake. Curr Obes Rep. 2016;5:65–71. https://doi.org/10.1007/s13679-016-0192-0.CrossRefPubMed

11.

Van Kleef E, Van Trijp H, Paeps F, Ferná N-CL. Consumer preferences for front-of-pack calories labelling. Public Health Nutr. 2007;11:203–13. https://doi.org/10.1017/S1368980007000304.CrossRefPubMed

12.

Viola GCV, Bianchi F, Croce E, Ceretti E. Are food labels effective as a means of health prevention? J Public Health Res. 2016;5:768. https://doi.org/10.4081/jphr.2016.768.CrossRefPubMedPubMedCentral

13.

Grunert KG, Wills JM. A review of European research on consumer response to nutrition information on food labels. J Public Health. 2007;15:385–99. https://doi.org/10.1007/s10389-007-0101-9.CrossRef

14.

Drichoutis AC, Lazaridis P, Nayga RM. Consumers’ use of nutritional labels: a review of research studies and issues. Acad Mark Sci Rev. 2006;10:93–118 http://www.amsreview.org/articles/drichoutis09-2006.pdf.

15.

Ni Mhurchu C, Gorton D. Nutrition labels and claims in New Zealand and Australia: a review of use and understanding. Aust New Zeal J Public Heal. 2007;31:105–12. https://doi.org/10.1111/j.1753-6405.2007.00026.x.CrossRef

16.

Food Standards Australia New Zealand. Australia New Zealand Food Standards Code – Standard 1.2.7 – Nutrition, health and related claims. Commonw Aust Gaz. 2017. https://www.legislation.gov.au/Details/F2017C01048. Accessed 8 Apr 2018.

17.

The European Parliament and the Council of the European Union. Regulation (EC) no 1924/2006 of the European Parliament and of the council of 20 December 2006 on nutrition and health claims made on foods. Off J Eur Union. 2006;404:9–25 https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32006R1924&from=en.

18.

Canada. Food and Drug Regulations C.R.C., c. 870 - B.01.401- Nutrition Labelling. https://laws-lois.justice.gc.ca/PDF/C.R.C.,_c._870.pdf. Accessed 18 Jan 2019.

19.

Food and Drug Administration. A Food Labeling Guide. College Park; 2013. www.fda.gov/FoodLabelingGuide. Accessed 18 Jan 2019.

20.

Cecchini M, Warin L. Impact of food labelling systems on food choices and eating behaviours: a systematic review and meta-analysis of randomized studies. Obes Rev. 2016;17:201–10. https://doi.org/10.1111/obr.12364.CrossRefPubMed

21.

Shangguan S, Afshin A, Shulkin M, Ma W, Marsden D, Smith J, et al. A meta-analysis of food labeling effects on consumer diet behaviors and industry practices. Am J Prev Med. 2019;56:300–14. https://doi.org/10.1016/j.amepre.2018.09.024.CrossRefPubMed

22.

Brown HM, Rollo ME, De Vlieger NM, Collins CE, Bucher T. Influence of the nutrition and health information presented on food labels on portion size consumed: a systematic review. Nutr Rev. 2018;76:655–77. https://doi.org/10.1093/nutrit/nuy019.CrossRefPubMed

23.

Williams P. Nutrition science and policy consumer understanding and use of health claims for foods. Nutr Rev. 2005;63:256–64. https://doi.org/10.1301/nr.2005.jul.256.CrossRefPubMed

24.

Chandon P. How package design and packaged-based marketing claims Lead to overeating. Appl Econ Perspect Policy. 2013;35:7–31. https://doi.org/10.1093/aepp/pps028.CrossRef

25.

Shemilt I, Hendry V, Marteau TM. What do we know about the effects of exposure to “low alcohol” and equivalent product labelling on the amounts of alcohol, food and tobacco people select and consume? A systematic review BMC Public Health. 2017;17:29. https://doi.org/10.1186/s12889-016-3956-2.CrossRefPubMed

26.

Kaur A, Scarborough P, Rayner M. A systematic review, and meta-analyses, of the impact of health-related claims on dietary choices. Int J Behav Nutr Phys Act. 2017;14:93. https://doi.org/10.1186/s12966-017-0548-1.CrossRefPubMedPubMedCentral

27.

World Health Organization. Diet, nutrition and the prevention of chronic diseases: report of a joint WHO/FAO expert consultation, Geneva, 28 January - 1 February 2002. Geneva; 2003. http://apps.who.int/iris/bitstream/10665/42665/1/WHO_TRS_916.pdf?ua=1. Accessed 18 Jan 2019.

28.

Effective Public Health Practice Project. Dictionary for Quality Assessment Tool for Quantitative Studies. 2009. https://merst.ca/wp-content/uploads/2018/02/qualilty-assessment-dictionary_2017.pdf. Accessed 23 Aug 2018.

29.

Effective Public Health Practice Project. Quality Assessment Tool for Quantitative Studies Method. 2009;:1–4. https://merst.ca/wp-content/uploads/2018/02/quality-assessment-tool_2010.pdf.

30.

Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339:b2700. https://doi.org/10.1136/bmj.b2700.CrossRefPubMedPubMedCentral

31.

Chan C, Patch C, Williams P. Australian consumers are sceptical about but influenced by claims about fat on food labels. Eur J Clin Nutr. 2005;59:148–51. https://doi.org/10.1038/sj.ejcn.1602038.CrossRefPubMed

32.

Bialkova S, Sasse L, Fenko A. The role of nutrition labels and advertising claims in altering consumers’ evaluation and choice. Appetite. 2016;96:38–46. https://doi.org/10.1016/j.appet.2015.08.030.CrossRefPubMed

33.

Mai R, Hoffmann S. How to combat the unhealthy = tasty intuition: the influencing role of health consciousness study 3. J Public Policy Mark. 2015;34:63–83. https://doi.org/10.1509/jppm.14.006.CrossRef

34.

Roefs A, Jansen A. The effect of information about fat content on food consumption in overweight/obese and lean people. Appetite. 2004;43:319–22. https://doi.org/10.1016/j.appet.2004.05.002.CrossRefPubMed

35.

Faulkner GP, Pourshahidi LK, Wallace JMW, Kerr MA, McCaffrey TA, Livingstone MBE. Perceived “healthiness” of foods can influence consumers’ estimations of energy density and appropriate portion size. Int J Obes. 2014;38:106–12.CrossRef

36.

Norton JE, Fryer PJ, Parkinson JA. The effect of reduced-fat labelling on chocolate expectations. Food Qual Prefer. 2013;28:101–5. https://doi.org/10.1016/j.foodqual.2012.08.004.CrossRef

37.

Andrews JC, Netemeyer RG, Burton S. The nutrition elite: do only the highest levels of caloric knowledge, Obesity knowledge, and motivation matter in processing nutrition ad claims and disclosures? J Public Policy Mark. 2009;28:41–55. https://doi.org/10.1509/jppm.28.1.41.CrossRef

38.

Belei N, Geyskens K, Goukens C, Ramanathan S, Lemmink J. The best of both worlds? Effects of attribute-induced goal conflict on consumption of healthful indulgences study 1. J Mark Res. 2012;49:900–9. https://doi.org/10.1509/jmr.10.0155.CrossRef

39.

Ebneter DS, Latner JD, Nigg CR. Is less always more? The effects of low-fat labeling and caloric information on food intake, calorie estimates, taste preference, and health attributions. Appetite. 2013;68:92–7. https://doi.org/10.1016/j.appet.2013.04.023.CrossRefPubMed

40.

Wansink B, Chandon P. Can “low-fat” nutrition labels Lead to Obesity? J Mark Res. 2006;43:605–17 https://www.jstor.org/stable/pdf/30162434.pdf?refreqid=excelsior%3A221b5b123a164e91b8b819cd83f6b78b.CrossRef

41.

Brug J. Determinants of healthy eating: motivation, abilities and environmental opportunities. Fam Pract. 2008;25(Supplement 1):i50–5. https://doi.org/10.1093/fampra/cmn063.CrossRefPubMed

42.

Dolan RJ. Emotion, Cognition, and Behavior. Science. 2002;298:1191–4. https://doi.org/10.1126/science.1076358.CrossRefPubMed

43.

Weber EU, Johnson EJ. Mindful judgment and decision making. Annu Rev Psychol. 2009;60:53–85. https://doi.org/10.1146/annurev.psych.60.110707.163633.CrossRefPubMed

44.

Lerner JS, Li Y, Valdesolo P, Kassam KS. Emotion and decision making. Annu Rev Psychol. 2015;66:799–823. https://doi.org/10.1146/annurev-psych-010213-115043.CrossRefPubMed

45.

Burnett MS, Lunsford DA. Conceptualizing guilt in the consumer decision-making process. J Consum Mark. 1994;11:33–43. https://doi.org/10.1108/07363769410065454.CrossRef

46.

Loewenstein G, Lerner JS. The role of affect in decision making. In: Davidson R, Sherer K, Goldsmith H, editors. Handbook of affective sciences. 1st ed. New York: Oxford University Press; 2003. p. 619–42. https://www.andrew.cmu.edu/user/gl20/GeorgeLoewenstein/Papers_files/pdf/RoleofEffectEmotion.pdf.

47.

Balasubramanian SK, Cole C. Consumers’ search and use of nutrition information: the challenge and promise of the nutrition labeling and education act. 2002. https://www.jstor.org/stable/pdf/3203458.pdf?refreqid=excelsior%3A6aa5793059db259c6ff51a46d033d95c.

48.

Rolls BJ, Morris EL, Roe LS. Portion size of food affects energy intake in normal-weight and overweight men and women. Am J Clin Nutr. 2002;76:1207–13. https://doi.org/10.1093/ajcn/76.6.1207.CrossRefPubMed

49.

Meiselman HL. Methodology and theory in human eating research. Appetite. 1992;19:49–55. https://doi.org/10.1016/0195-6663(92)90235-X.CrossRefPubMed

50.

Counihan C, van Esterik P. Food and Culture. 3rd edition. New York: Routledge; 2013.

51.

Mattes R, Tan S. The influence of the food environment on Ingestive behaviors. In: Bray G, Bouchard C, editors. Handbook of Obesity – epidemiology, etiology, and physiopathology. 3rd ed. Florida: Taylor and Francis Group; 2014. p. 317–25.CrossRef

52.

de Ridder D, Kroese F, Evers C, Adriaanse M, Gillebaart M. Healthy diet: health impact, prevalence, correlates, and interventions. Psychol Health. 2017;32:907–41. https://doi.org/10.1080/08870446.2017.1316849.CrossRefPubMed

53.

European Commission. Nutrient profiles for foods bearing claims. 2017. https://ec.europa.eu/food/sites/food/files/safety/docs/ln_claims_refit_survey_health-claims-nutrient-profiles.pdf.

54.

Hodgkins C, Barnett J, Wasowicz-Kirylo G, Stysko-Kunkowska M, Gulcan Y, Kustepeli Y, et al. Understanding how consumers categorise nutritional labels: a consumer derived typology for front-of-pack nutrition labelling. Appet. 2012;59:806–17. https://doi.org/10.1016/j.appet.2012.08.014.

55.

Ministry of Health, Sub secretariat of Public Health. Law 20.606 On nutritional composition of food and its advertising. Off Gaz. 2012.

56.

World Health Organization. Report of the Commission on Ending Childhood Obesity. Geneva; 2016. http://apps.who.int/iris/bitstream/handle/10665/204176/9789241510066_eng.pdf?sequence=1. Accessed 18 Jan 2019.

57.

World Health Organization Europe. Action plan for the prevention and control of noncommunicable diseases in the WHO European region. Geneva; 2016. http://www.euro.who.int/pubrequest.

58.

World Health Organization, United Nations Development Programme. Guidance Note on the Integration of Noncommunicable Diseases into the United Nations Development Assistance Framework. Geneva; 2015. https://www.who.int/nmh/ncd-task-force/guidance-note.pdf. Accessed 18 Jan 2019.

59.

Obesity W. World Health Organization. Geneva: Taking Action on Childhood Obesity Report; 2018. http://apps.who.int/iris/bitstream/handle/10665/274792/WHO-NMH-PND-ECHO-18.1-eng.pdf?ua=1.

Title: Systematic review of the impact of nutrition claims related to fat, sugar and energy content on food choices and energy intake
Authors: Laura H. Oostenbach
Esther Slits
Ella Robinson
Gary Sacks
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Obesity
Obesity
Nutrition
Overweight
Published in: BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-019-7622-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Systematic review of the impact of nutrition claims related to fat, sugar and energy content on food choices and energy intake

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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