Skip to main content
Top
Published in: Nutrition Journal 1/2013

Open Access 01-12-2013 | Research

Simplifying healthful choices: a qualitative study of a physical activity based nutrition label format

Authors: Jonas J Swartz, Sunaina Dowray, Danielle Braxton, Paul Mihas, Anthony J Viera

Published in: Nutrition Journal | Issue 1/2013

Login to get access

Abstract

Background

This study used focus groups to pilot and evaluate a new nutrition label format and refine the label design. Physical activity equivalent labels present calorie information in terms of the amount of physical activity that would be required to expend the calories in a specified food item.

Methods

Three focus groups with a total of twenty participants discussed food choices and nutrition labeling. They provided information on comprehension, usability and acceptability of the label. A systematic coding process was used to apply descriptive codes to the data and to identify emerging themes and attitudes.

Results

Participants in all three groups were able to comprehend the label format. Discussion about label format focused on issues including gender of the depicted figure, physical fitness of the figure, preference for walking or running labels, and preference for information in miles or minutes. Feedback from earlier focus groups was used to refine the labels in an iterative process.

Conclusions

In contrast to calorie labels, participants shown physical activity labels asked and answered, “How does this label apply to me?” This shift toward personalized understanding may indicate that physical activity labels offer an advantage over currently available nutrition labels.
Appendix
Available only for authorised users
Literature
1.
go back to reference Mokdad AH, Serdula MK, Dietz WH, Bowman BA, Marks JS, Koplan JP: The spread of the obesity epidemic in the United States, 1991–1998. JAMA. 1999, 282: 1519-1522. 10.1001/jama.282.16.1519.CrossRefPubMed Mokdad AH, Serdula MK, Dietz WH, Bowman BA, Marks JS, Koplan JP: The spread of the obesity epidemic in the United States, 1991–1998. JAMA. 1999, 282: 1519-1522. 10.1001/jama.282.16.1519.CrossRefPubMed
2.
go back to reference Mokdad AH, Serdula MK, Dietz WH, Bowman BA, Marks JS, Koplan JP: The continuing epidemic of obesity in the United States. JAMA. 2000, 284: 1650-1651. 10.1001/jama.284.13.1650.CrossRefPubMed Mokdad AH, Serdula MK, Dietz WH, Bowman BA, Marks JS, Koplan JP: The continuing epidemic of obesity in the United States. JAMA. 2000, 284: 1650-1651. 10.1001/jama.284.13.1650.CrossRefPubMed
3.
go back to reference Ogden CL, Carroll MD, Kit BK, Flegal KM: Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA. 2012, 307: 483-490. 10.1001/jama.2012.40.CrossRefPubMed Ogden CL, Carroll MD, Kit BK, Flegal KM: Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA. 2012, 307: 483-490. 10.1001/jama.2012.40.CrossRefPubMed
4.
go back to reference Nestle M: Health care reform in action–calorie labeling goes national. N Engl J Med. 2010, 362: 2343-2345. 10.1056/NEJMp1003814.CrossRefPubMed Nestle M: Health care reform in action–calorie labeling goes national. N Engl J Med. 2010, 362: 2343-2345. 10.1056/NEJMp1003814.CrossRefPubMed
5.
go back to reference Harnack LJ, French SA: Effect of point-of-purchase calorie labeling on restaurant and cafeteria food choices: A review of the literature. Int J Behav Nutr Phys Act. 2008, 5: 51-10.1186/1479-5868-5-51.CrossRefPubMedPubMedCentral Harnack LJ, French SA: Effect of point-of-purchase calorie labeling on restaurant and cafeteria food choices: A review of the literature. Int J Behav Nutr Phys Act. 2008, 5: 51-10.1186/1479-5868-5-51.CrossRefPubMedPubMedCentral
6.
go back to reference Swartz JJ, Braxton D, Viera AJ: Calorie menu labeling on quick-service restaurant menus: an updated systematic review of the literature. Int J Behav Nutr Phys Act. 2011, 8: 135-10.1186/1479-5868-8-135.CrossRefPubMedPubMedCentral Swartz JJ, Braxton D, Viera AJ: Calorie menu labeling on quick-service restaurant menus: an updated systematic review of the literature. Int J Behav Nutr Phys Act. 2011, 8: 135-10.1186/1479-5868-8-135.CrossRefPubMedPubMedCentral
7.
go back to reference Balfour D, Moody R, Wise A, Brown K: Food choice in response to computer generated nutrition information provided about meal selections in workplace restaurants. J Hum Nutr Diet. 1996, 9: 231-237. 10.1046/j.1365-277X.1996.00452.x.CrossRef Balfour D, Moody R, Wise A, Brown K: Food choice in response to computer generated nutrition information provided about meal selections in workplace restaurants. J Hum Nutr Diet. 1996, 9: 231-237. 10.1046/j.1365-277X.1996.00452.x.CrossRef
8.
go back to reference Yamamoto JA, Yamamoto JB, Yamamoto BE, Yamamoto LG: Adolescent fast food and restaurant ordering behavior with and without calorie and fat content menu information. J Adolescent Health. 2005, 37: 397-402. 10.1016/j.jadohealth.2004.10.002.CrossRef Yamamoto JA, Yamamoto JB, Yamamoto BE, Yamamoto LG: Adolescent fast food and restaurant ordering behavior with and without calorie and fat content menu information. J Adolescent Health. 2005, 37: 397-402. 10.1016/j.jadohealth.2004.10.002.CrossRef
9.
go back to reference Cinciripini PM: Changing food selections in a public cafeteria an applied behavior analysis. Behav Modif. 1984, 8: 520-539. 10.1177/01454455840084004.CrossRef Cinciripini PM: Changing food selections in a public cafeteria an applied behavior analysis. Behav Modif. 1984, 8: 520-539. 10.1177/01454455840084004.CrossRef
10.
go back to reference Milich R, Anderson J, Mills M: Effects of visual presentation of caloric values on food buying by normal and obese persons. Percept Mot Skills. 1976, 42: 155-162. 10.2466/pms.1976.42.1.155.CrossRefPubMed Milich R, Anderson J, Mills M: Effects of visual presentation of caloric values on food buying by normal and obese persons. Percept Mot Skills. 1976, 42: 155-162. 10.2466/pms.1976.42.1.155.CrossRefPubMed
11.
go back to reference Elbel B, Gyamfi J, Kersh R: Child and adolescent fast-food choice and the influence of calorie labeling: a natural experiment. Int J Obes. 2011, 35: 493-500. 10.1038/ijo.2011.4.CrossRef Elbel B, Gyamfi J, Kersh R: Child and adolescent fast-food choice and the influence of calorie labeling: a natural experiment. Int J Obes. 2011, 35: 493-500. 10.1038/ijo.2011.4.CrossRef
12.
go back to reference Elbel B, Kersh R, Brescoll VL, Dixon LB: Calorie labeling and food choices: a first look at the effects on low-income people in New York City. Health Aff. 2009, 28: 1110-1121. 10.1377/hlthaff.28.6.w1110.CrossRef Elbel B, Kersh R, Brescoll VL, Dixon LB: Calorie labeling and food choices: a first look at the effects on low-income people in New York City. Health Aff. 2009, 28: 1110-1121. 10.1377/hlthaff.28.6.w1110.CrossRef
13.
go back to reference Finkelstein EA, Strombotne KL, Chan NL, Krieger J: Mandatory menu labeling in one fast-food chain in King County, Washington. Am J Prev Med. 2011, 40: 122-127. 10.1016/j.amepre.2010.10.019.CrossRefPubMed Finkelstein EA, Strombotne KL, Chan NL, Krieger J: Mandatory menu labeling in one fast-food chain in King County, Washington. Am J Prev Med. 2011, 40: 122-127. 10.1016/j.amepre.2010.10.019.CrossRefPubMed
14.
go back to reference Harnack LJ, French SA, Oakes JM, Story MT, Jeffery RW, Rydell SA: Effects of calorie labeling and value size pricing on fast food meal choices: results from an experimental trial. Int J Behav Nutr Phys Act. 2008, 5: 63-10.1186/1479-5868-5-63.CrossRefPubMedPubMedCentral Harnack LJ, French SA, Oakes JM, Story MT, Jeffery RW, Rydell SA: Effects of calorie labeling and value size pricing on fast food meal choices: results from an experimental trial. Int J Behav Nutr Phys Act. 2008, 5: 63-10.1186/1479-5868-5-63.CrossRefPubMedPubMedCentral
15.
go back to reference Chu YH, Frongillo EA, Jones SJ, Kaye GL: Improving patrons’ meal selections through the use of point-of-selection nutrition labels. Am J Public Health. 2009, 99: 2001-2005. 10.2105/AJPH.2008.153205.CrossRefPubMedPubMedCentral Chu YH, Frongillo EA, Jones SJ, Kaye GL: Improving patrons’ meal selections through the use of point-of-selection nutrition labels. Am J Public Health. 2009, 99: 2001-2005. 10.2105/AJPH.2008.153205.CrossRefPubMedPubMedCentral
16.
go back to reference Roberto CA, Larsen PD, Agnew H, Baik J, Brownell KD: Evaluating the impact of menu labeling on food choices and intake. Am J Public Health. 2010, 100: 312-318. 10.2105/AJPH.2009.160226.CrossRefPubMedPubMedCentral Roberto CA, Larsen PD, Agnew H, Baik J, Brownell KD: Evaluating the impact of menu labeling on food choices and intake. Am J Public Health. 2010, 100: 312-318. 10.2105/AJPH.2009.160226.CrossRefPubMedPubMedCentral
17.
go back to reference Variyam JN: Nutrition labeling in the food-away-from-home sector: an economic assessment. 2005, Washington, DC: US Department of Agriculture, Report number ERR4 Variyam JN: Nutrition labeling in the food-away-from-home sector: an economic assessment. 2005, Washington, DC: US Department of Agriculture, Report number ERR4
18.
go back to reference Bleich SN, Herring BJ, Flagg DD, Gary-Webb TL: Reduction in purchases of sugar-sweetened beverages among Low-income black adolescents after exposure to caloric information. Am J Public Health. 2012, 102: 329-335. 10.2105/AJPH.2011.300350.CrossRefPubMedPubMedCentral Bleich SN, Herring BJ, Flagg DD, Gary-Webb TL: Reduction in purchases of sugar-sweetened beverages among Low-income black adolescents after exposure to caloric information. Am J Public Health. 2012, 102: 329-335. 10.2105/AJPH.2011.300350.CrossRefPubMedPubMedCentral
19.
go back to reference Fitch RC, Harnack LJ, Neumark-Sztainer DR, Story MT, French SA, Oakes JM, Rydell SA: Providing calorie information on fast-food restaurant menu boards: consumer views. Am J Health Promot. 2009, 24: 119-132.CrossRef Fitch RC, Harnack LJ, Neumark-Sztainer DR, Story MT, French SA, Oakes JM, Rydell SA: Providing calorie information on fast-food restaurant menu boards: consumer views. Am J Health Promot. 2009, 24: 119-132.CrossRef
20.
go back to reference Campos S, Doxey J, Hammond D: Nutrition labels on pre-packaged foods: a systematic review. Public Health Nutr. 2011, 1-11. Campos S, Doxey J, Hammond D: Nutrition labels on pre-packaged foods: a systematic review. Public Health Nutr. 2011, 1-11.
21.
go back to reference Blumenthal K, Volpp KG: Enhancing the effectiveness of food labeling in restaurants. JAMA. 2010, 303: 553-554. 10.1001/jama.2010.85.CrossRefPubMed Blumenthal K, Volpp KG: Enhancing the effectiveness of food labeling in restaurants. JAMA. 2010, 303: 553-554. 10.1001/jama.2010.85.CrossRefPubMed
22.
go back to reference Cowburn G, Stockley L: Consumer understanding and use of nutrition labeling: a systematic review. Public Health Nutr. 2005, 8: 21-28. 10.1079/PHN2005666.CrossRefPubMed Cowburn G, Stockley L: Consumer understanding and use of nutrition labeling: a systematic review. Public Health Nutr. 2005, 8: 21-28. 10.1079/PHN2005666.CrossRefPubMed
23.
go back to reference Grunert KG, Wills JM, Fernández-Celemín L: Nutrition knowledge, and use and understanding of nutrition information on food labels among consumers in the UK. Appetite. 2010, 55: 177-189.CrossRefPubMed Grunert KG, Wills JM, Fernández-Celemín L: Nutrition knowledge, and use and understanding of nutrition information on food labels among consumers in the UK. Appetite. 2010, 55: 177-189.CrossRefPubMed
24.
go back to reference Grunert KG, Wills JM: A review of European research on consumer response to nutrition information on food labels. J Public Health. 2007, 15: 385-399. 10.1007/s10389-007-0101-9.CrossRef Grunert KG, Wills JM: A review of European research on consumer response to nutrition information on food labels. J Public Health. 2007, 15: 385-399. 10.1007/s10389-007-0101-9.CrossRef
25.
go back to reference Bleich SN, Pollack KM: The publics’ understanding of daily caloric recommendations and their perceptions of calorie posting in chain restaurants. BMC Publ Health. 2010, 10: 121-10.1186/1471-2458-10-121.CrossRef Bleich SN, Pollack KM: The publics’ understanding of daily caloric recommendations and their perceptions of calorie posting in chain restaurants. BMC Publ Health. 2010, 10: 121-10.1186/1471-2458-10-121.CrossRef
26.
go back to reference Goldsworthy RC, Schwartz NC, Mayhorn CB: Interpretation of pharmaceutical warnings among adolescents. J Adolescent Health. 2008, 42: 617-625. 10.1016/j.jadohealth.2007.11.141.CrossRef Goldsworthy RC, Schwartz NC, Mayhorn CB: Interpretation of pharmaceutical warnings among adolescents. J Adolescent Health. 2008, 42: 617-625. 10.1016/j.jadohealth.2007.11.141.CrossRef
27.
go back to reference Daniel KL, Goldman KD, Lachenmayr S, Erickson JD, Moore C: Interpretations of a teratogen warning symbol. Teratology. 2001, 64: 148-153. 10.1002/tera.1058.CrossRefPubMed Daniel KL, Goldman KD, Lachenmayr S, Erickson JD, Moore C: Interpretations of a teratogen warning symbol. Teratology. 2001, 64: 148-153. 10.1002/tera.1058.CrossRefPubMed
28.
go back to reference van Kleef E, van Trijp H, Paeps F, Fernández-Celemín L: Consumer preferences for front-of-pack calories labelling. Public Health Nutr. 2008, 11: 203-213.CrossRefPubMedPubMedCentral van Kleef E, van Trijp H, Paeps F, Fernández-Celemín L: Consumer preferences for front-of-pack calories labelling. Public Health Nutr. 2008, 11: 203-213.CrossRefPubMedPubMedCentral
29.
go back to reference Weiss BD, Mays MZ, Martz W, Castro KM, DeWalt DA, Pignone MP, Mockbee J, Hale FA: Quick assessment of literacy in primary care: the newest vital sign. Ann Fam Med. 2005, 3: 514-522. 10.1370/afm.405.CrossRefPubMedPubMedCentral Weiss BD, Mays MZ, Martz W, Castro KM, DeWalt DA, Pignone MP, Mockbee J, Hale FA: Quick assessment of literacy in primary care: the newest vital sign. Ann Fam Med. 2005, 3: 514-522. 10.1370/afm.405.CrossRefPubMedPubMedCentral
30.
go back to reference Blair S, Dunn A, Marcus B, Carpenter R, Jaret P: Active living every day. 2001, Champaign, IL: Human Kinetics Blair S, Dunn A, Marcus B, Carpenter R, Jaret P: Active living every day. 2001, Champaign, IL: Human Kinetics
33.
go back to reference Paasche Orlow MK, Parker RM, Gazmararian JA, Nielsen Bohlman LT, Rudd RR: The prevalence of limited health literacy. J Gen Intern Med. 2005, 20: 175-184. 10.1111/j.1525-1497.2005.40245.x.CrossRefPubMedPubMedCentral Paasche Orlow MK, Parker RM, Gazmararian JA, Nielsen Bohlman LT, Rudd RR: The prevalence of limited health literacy. J Gen Intern Med. 2005, 20: 175-184. 10.1111/j.1525-1497.2005.40245.x.CrossRefPubMedPubMedCentral
34.
go back to reference Krueger RA: Focus groups: a practical guide for applied research. 2009, Los Angeles: SAGE Krueger RA: Focus groups: a practical guide for applied research. 2009, Los Angeles: SAGE
35.
go back to reference Dowray S, Swartz JJ, Braxton D, Viera AJ: Potential effect of physical activity based menu labels on the calorie content of selected fast food meals. Appetite. 2012, 62: 173-181.CrossRefPubMed Dowray S, Swartz JJ, Braxton D, Viera AJ: Potential effect of physical activity based menu labels on the calorie content of selected fast food meals. Appetite. 2012, 62: 173-181.CrossRefPubMed
36.
go back to reference Larson N, Story M: Menu Labeling: Does Providing Nutrition Information at the Point of Purchase Affect Consumer Behavior. A research synthesis. 2009, : Healthy Eating Research national program. Robert Wood Johnson Foundation Larson N, Story M: Menu Labeling: Does Providing Nutrition Information at the Point of Purchase Affect Consumer Behavior. A research synthesis. 2009, : Healthy Eating Research national program. Robert Wood Johnson Foundation
Metadata
Title
Simplifying healthful choices: a qualitative study of a physical activity based nutrition label format
Authors
Jonas J Swartz
Sunaina Dowray
Danielle Braxton
Paul Mihas
Anthony J Viera
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Nutrition Journal / Issue 1/2013
Electronic ISSN: 1475-2891
DOI
https://doi.org/10.1186/1475-2891-12-72

Other articles of this Issue 1/2013

Nutrition Journal 1/2013 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine