Revisões sistemáticas related to this topic

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Systematic review

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The effect of energy and fat content labeling on food consumption pattern: a systematic review and meta-analysis.

Autores Agarwal D , Ravi P , Purohit B , Priya H
Revista Nutrition reviews
Year 2022
Links Pubmed DOI

Este artigo inclui 10 Primary studies 10 Primary studies (10 references)

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CONTEXT: Consumption of high-energy food has increased globally, thereby leading to an increase in many diseases. One strategy for addressing this is to make people aware of their energy intake through energy and fat labels. However, the effectiveness of this remains debatable. OBJECTIVE: This review aims to pool the mixed outcomes of recent studies assessing the effect of energy and fat content labeling on food consumption pattern. DATA SOURCES: Google Scholar, MEDLINE, and Cochrane Library databases were searched. Randomized controlled and quasi-experimental controlled trials published from 2014 to 2019 were included. DATA EXTRACTION: Two reviewers screened 413 abstracts independently. Qualitative and quantitative data was extracted from 10 articles; meta-analysis was carried out on 6 of those studies. RESULTS: The majority of the included papers were conducted in the regions of America, the Western Pacific, and Europe. Overall, the 6 studies claimed that labeling did not reduce the consumption of energy or fat. However, meta-analysis showed that fat and energy content labeling of food had a statistically significant effect on consumption. Subgroup analysis showed no difference with respect to types of labels, ie, context labeling vs traffic-light labeling, but energy content labels seemed to be more effective than fat content labels in influencing healthy food choices. CONCLUSION: Energy and fat content labeling were shown to reduce the consumption of each significantly. However, the outcome was influenced by the study setting and the population concerned. There is a need for research in other regions in order to assess the global effectiveness of nutrition labels on food consumption. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42020172675.

Systematic review

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Impact of health warning labels on selection and consumption of food and alcohol products: Systematic review with meta-analysis.

Revista Health psychology review
Year 2021
Links Pubmed DOI PubMed Central

Este artigo inclui 15 Primary studies 15 Primary studies (15 references)

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Health warning labels (HWLs) could reduce harmful consumption of food (including non-alcoholic drinks) and alcoholic drinks. A systematic review with meta-analysis using Cochrane methods was conducted to assess the impact on selection (including hypothetical selection) or consumption of food or alcoholic drink products displaying image-and-text (sometimes termed ‘pictorial’) and text-only HWLs. Fourteen randomised controlled trials were included, three for alcohol, eleven for food. For the primary outcomes, eleven studies measured selection and one measured consumption (two measured only other secondary outcomes). Meta-analysis of twelve comparisons from nine studies (n=12,635) found HWLs reduced selection of the targeted product compared with no HWL (RR=0.74 (95%CI 0.68–0.80)), with participants 26% less likely to choose a product displaying a HWL. A planned subgroup analysis suggested a larger (although not statistically significant) effect on selection of image-and-text HWLs (RR=0.65 (95%CI 0.54–0.80)) than text-only HWLs (RR=0.79 (95%CI 0.74–0.85)). These findings suggest significant potential for HWLs to reduce selection of food and alcoholic drinks, but all experimental studies to date were conducted in laboratory or online settings with outcomes assessed immediately after a single exposure. Studies in field and naturalistic laboratory settings are needed to estimate the potential effects of food and alcohol HWLs. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Systematic review

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Nudging in Public Health Lifestyle Interventions: A Systematic Literature Review and Metasynthesis.

Revista Health education & behavior : the official publication of the Society for Public Health Education
Year 2020
Links Pubmed DOI

Este artigo inclui 66 Primary studies 66 Primary studies (66 references)

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Nudging is increasingly used in public health interventions in Western societies to produced health-promoting behavior changes; however, there is lack of clarity as to what constitutes a nudge, scant knowledge of the effectiveness of nudging techniques in public health lifestyle interventions and a number of ethical and value-based concerns. The aim of this review is to address these research lacunae and identify the characteristics of nudges in empirical research on public health interventions intended to induce healthy lifestyle changes, including whether they are effective. We conducted systematic searches for relevant articles published between January 2008 and April 2019 in three databases, PubMed, CINAHL and PsycINFO, and combined this with a metasynthesis to construct interpretative explanations. A total of 66 original studies met the inclusion criteria. The findings of the systematic review showed that most nudging interventions involved diet/nutrition, most were carried out as single experiments, and the majority had the intended effects. Specific nudging techniques were identified with respect to the broader nudging categories of accessibility, presentation, using messages and pictures, technology-supported information, financial incentives, affecting the senses, and cognitive loading; several studies included more than one nudging technique. Although many nudging techniques had the intended effects, it is unclear whether they would work outside the study setting. The synthesis revealed that the studies lacked critical reflection on the assumptions about health that were implicit in nudging interventions, the cultural acceptability of nudges, the context-free assumptions of nudging theory, and the implications of these aspects for the public health context.

Systematic review

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Influence of Intrinsic and Extrinsic Food Attributes on Consumers' Acceptance of Reformulated Food Products: a Systematic Review.

Autores Bolha A , Blaznik U , Korošec M
Revista Zdravstveno varstvo
Year 2020
Links Pubmed DOI PubMed Central

Este artigo inclui 38 Primary studies 38 Primary studies (38 references)

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INTRODUCTION: Reducing the salt, sugar and fat content of food is recognised worldwide as one of the strategies available for reducing the incidence of obesity and non-communicable diseases. The food industry has a major influence on achieving these goals by preserving intrinsic (chemical and sensory properties) and modifying extrinsic (food packaging and other external information) food attributes that can influence purchasing decisions. This article is a literature review of studies that analyse the influence of intrinsic and/or extrinsic attributes on consumer product preference and purchasing decisions. METHODS: A keyword search for relevant studies was conducted using Web of Science, an interdisciplinary electronic resource. Articles from other sources were also included and systematically reviewed. RESULTS: The search string identified 266 results. Thirty-eight articles were included in the final analysis and coded according to intrinsic and extrinsic food attributes, reformulated nutrient, food category, condition, research methods, consumer response, study location and sample size. There are several authors investigating the effect of intrinsic rather than extrinsic product attributes. Most research deals with processed foods in the category of milk and dairy products, followed by sweetened fruit juices, meat products, sweets and bread. Salt content is the attribute most often reduced, followed by sugar and fat. CONCLUSIONS: Consumers find it hard to swap potential health benefits for hedonic attributes. When evaluating products in expected conditions, they usually rate the reformulated product more highly than the conventional one, while in informed conditions they usually choose the regular product. When products are labelled with a traffic light or nutritional warnings, consumers opt for a reformulated product, even in informed conditions. This review highlights the heterogeneity between food groups, and the fact that many factors influence consumers' product preferences and purchasing decisions. The product should be analysed as a whole and tested in blind, expected and informed conditions, as each individual factor represents a phase of the consumer purchasing decision. The extent of nutrient reduction should be determined by calculating the difference threshold, and the industry should reformulate products gradually based on how consumers detect the reduction.

Systematic review

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That's My Cue to Eat: A Systematic Review of the Persuasiveness of Front-of-Pack Cues on Food Packages for Children vs. Adults.

Revista Nutrients
Year 2020
Links Pubmed DOI

Este artigo inclui 43 Primary studies 43 Primary studies (43 references)

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Packaging is increasingly recognized as an essential component of any marketing strategy. Visual and informational front-of-pack cues constitute salient elements of the environment that may influence what and how much someone eats. Considering their overwhelming presence on packaging of non-core foods, front-of-pack cues may contribute to the growing rates of overweight and obesity in children and adults. We conducted a systematic review to summarize the evidence concerning the impact of front-of-pack cues on choices and eating behaviors. Four electronic databases were searched for experimental studies (2009-present). This resulted in the inclusion of 57 studies (in 43 articles). We identified studies on children (3-12 years) and adults (≥ 18 years), but no studies on adolescents (12-18 years). The results suggest that children and adults are susceptible to packaging cues, with most evidence supporting the impact of visual cues. More specifically, children more often choose products with a licensed endorser and eat more from packages portraying the product with an exaggerated portion size. Adults' eating behaviors are influenced by a range of other visual cues, mainly, package size and shape, and less so by informational cues such as labels.

Systematic review

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Effects of physical activity calorie equivalent food labelling to reduce food selection and consumption: systematic review and meta-analysis of randomised controlled studies.

Revista Journal of epidemiology and community health
Year 2020
Links Pubmed DOI

Este artigo inclui 14 Primary studies 14 Primary studies (14 references)

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BACKGROUND: There is limited evidence that nutritional labelling on food/drinks is changing eating behaviours. Physical activity calorie equivalent (PACE) food labelling aims to provide the public with information about the amount of physical activity required to expend the number of kilocalories in food/drinks (eg, calories in this pizza requires 45 min of running to burn), to encourage healthier food choices and reduce disease. OBJECTIVE: We aimed to systematically search for randomised controlled trials and experimental studies of the effects of PACE food labelling on the selection, purchase or consumption of food/drinks. METHODS: PACE food labelling was compared with any other type of food labelling or no labelling (comparator). Reports were identified by searching electronic databases, websites and social media platforms. Inverse variance meta-analysis was used to summarise evidence. Weighted mean differences (WMD) and 95% CIs were used to describe between-group differences using a random effects model. RESULTS: 15 studies were eligible for inclusion. When PACE labelling was displayed on food/drinks and menus, significantly fewer calories were selected, relative to comparator labelling (WMD=-64.9 kcal, 95% CI -103.2 to -26.6, p=0.009, n=4606). Presenting participants with PACE food labelling results in the consumption of significantly fewer calories (WMD=-80.4 kcal, 95% CI-136.7 to -24.2, p=0.005, n=486) relative to comparator food labelling. CONCLUSION: Based on current evidence PACE food labelling may reduce the number of kilocalories selected from menus and decrease the number of kilocalories/grams of food consumed by the public, compared with other types of food labelling/no labelling. TRIAL REGISTRATION NUMBER: CRD42018088567.

Systematic review

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The effect of front-of-package labels or point-of-sale signage on consumer knowledge, attitudes and behavior regarding sugar-sweetened beverages: a systematic review.

Revista Nutrition reviews
Year 2020
Links Pubmed DOI

Este artigo inclui 21 Primary studies 21 Primary studies (21 references)

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CONTEXT: Globally, the use of labels or signage targeting SSBs remains in its infancy and there is limited evidence available regarding its ability to decrease purchase and consumption of SSBs. OBJECTIVE: This systematic review aimed to synthesize the evidence on the effect of sugar- or health-related sugar-sweetened beverage (SSB) warning labels or signage on knowledge, attitudes, and beliefs, and SSB purchase and consumption. DATA SOURCES: Nine databases - Ovid Medline, Emerald Insight, Scopus, Informit, Business Source Complete, CINAHL, Global Health, PsychINFO, and SocIndex - were searched along with grey literature from inception to December 2019. The PRISMA guidelines were applied for reporting this systematic review. STUDY SELECTION: Studies examining the impact of front of pack (FOP) labels and/or point of sale (POS) signage highlighting added sugar content or its health risks were included. DATA EXTRACTION: Two authors independently extracted data on items, including study details, study design, population characteristics, intervention label details (type, duration, and settings), and outcomes measures. The Effective Public Health Practice Project tool was used to assess the study quality. DATA ANALYSIS: Findings were synthesized narratively. RESULTS: Twenty-one studies published between 1992 and 2019 were included. Of these, 16 studies examined the impact of FOP labels and 5 studies examined the impact of POS signage. Both FOP labels and POS signage were associated with improved health knowledge, attitudes, and beliefs regarding SSBs and reduced SSB purchases. Warning labels with diet-related health consequences were found to be particularly effective. Overall quality of studies was assessed as mixed. CONCLUSION: Health- or sugar-related FOP labels and POS signage for SSBs are promising public health measures and may improve consumers' health behaviors toward reduced SSB purchase and consumption.

Systematic review

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A Meta-Analysis of Food Labeling Effects on Consumer Diet Behaviors and Industry Practices.

Revista American journal of preventive medicine
Year 2019
Links Pubmed DOI PubMed Central

Este artigo inclui 59 Primary studies 59 Primary studies (59 references)

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CONTEXT: The influence of food and beverage labeling (food labeling) on consumer behaviors, industry responses, and health outcomes is not well established. EVIDENCE ACQUISITION: PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Ten databases were searched in 2014 for studies published after 1990 evaluating food labeling and consumer purchases/orders, intakes, metabolic risk factors, and industry responses. Data extractions were performed independently and in duplicate. Studies were pooled using inverse-variance random effects meta-analysis. Heterogeneity was explored with I2, stratified analyses, and meta-regression; and publication bias was assessed with funnel plots, Begg's tests, and Egger's tests. Analyses were completed in 2017. EVIDENCE SYNTHESIS: From 6,232 articles, a total of 60 studies were identified, including 2 million observations across 111 intervention arms in 11 countries. Food labeling decreased consumer intakes of energy by 6.6% (95% CI= -8.8%, -4.4%, n=31), total fat by 10.6% (95% CI= -17.7%, -3.5%, n=13), and other unhealthy dietary options by 13.0% (95% CI= -25.7%, -0.2%, n=16), while increasing vegetable consumption by 13.5% (95% CI=2.4%, 24.6%, n=5). Evaluating industry responses, labeling decreased product contents of sodium by 8.9% (95% CI= -17.3%, -0.6%, n=4) and artificial trans fat by 64.3% (95% CI= -91.1%, -37.5%, n=3). No significant heterogeneity was identified by label placement or type, duration, labeled product, region, population, voluntary or legislative approaches, combined intervention components, study design, or quality. Evidence for publication bias was not identified. CONCLUSIONS: From reviewing 60 intervention studies, food labeling reduces consumer dietary intake of selected nutrients and influences industry practices to reduce product contents of sodium and artificial trans fat.

Systematic review

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Choice architecture interventions to improve diet and/or dietary behaviour by healthcare staff in high-income countries: A systematic review

Revista BMJ open
Year 2019
Links Pubmed DOI PubMed Central

Este artigo inclui 27 Primary studies 27 Primary studies (27 references)

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Objectives We were commissioned by the behavioural insights team at Public Health England to synthesise the evidence on choice architecture interventions to increase healthy purchasing and/or consumption of food and drink by National Health Service (NHS) staff. Data sources MEDLINE, EMBASE, CINAHL, Cochrane Central register of Controlled Trials, PsycINFO, Applied Social Sciences Index and Abstracts and Web of Science were searched from inception until May 2017 and references were screened independently by two reviewers. Design A systematic review that included randomised experimental or intervention studies, interrupted time series and controlled before and after studies. Participants Healthcare staff of high-income countries. Intervention Choice architecture interventions that aimed to improve dietary purchasing and/or consumption (outcomes) of staff. Appraisal and synthesis Eligibility assessment, quality appraisal, data abstraction and analysis were completed by two reviewers. Quality appraisal of randomised trials was informed by the Cochrane Handbook, and the Risk of Bias Assessment Tool for Nonrandomized Studies was used for the remainder. Findings were narratively synthesised. Results Eighteen studies met the inclusion criteria. Five studies included multiple workplaces (including healthcare settings), 13 were conducted in healthcare settings only. Interventions in 10 studies were choice architecture only and 8 studies involved a complex intervention with a choice architecture element. Interventions involving a proximity element (making behavioural options easier or harder to engage with) appear to be frequently effective at changing behaviour. One study presented an effective sizing intervention. Labelling alone was generally not effective at changing purchasing behaviour. Interventions including an availability element were generally reported to be successful at changing behaviour but no included study examined this element alone. There was no strong evidence for the effect of pricing on purchasing or dietary intake. Conclusion Proximity, availability and sizing are choice architecture elements that are likely to be effective for NHS organisations. Trial registration number CRD42017064872. © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.

Systematic review

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Physical activity equivalent labeling vs. calorie labeling: a systematic review and meta-analysis.

Revista The international journal of behavioral nutrition and physical activity
Year 2018
Links Pubmed DOI PubMed Central

Este artigo inclui 8 Primary studies 8 Primary studies (8 references)

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BACKGROUND: Many countries are trying to identify strategies to control obesity. Nutrition labeling is a policy that could lead to healthy food choices by providing information to consumers. Calorie labeling, for example, could lead to consumers choosing lower calorie foods. However, its effectiveness has been limited. Recently, physical activity equivalent labeling (i.e., displaying calories in terms of estimated amount of physical activity to burn calories) has been proposed as an alternative to the calorie-only label. The aim of this review was to identify and evaluate the published literature comparing effects on health behavior between physical activity equivalent labeling and calorie-only labeling. METHOD: We searched the following databases: Pubmed/medline, Scopus, Web of science, Agris, Cochrane library, Google Scholar. We also searched along with reference lists of included articles. Articles that were published between 1 January 2000 and 31 October 2016 were eligible for inclusion provided they reported on studies that examined the effects of both types of labeling and included at least one outcome of interest. Mean and standard deviations of the included results were combined using a fixed-effect model. The difference in calories purchased between people exposed to physical activity labeling and calorie-only labeling was calculated as weighted mean difference by using a fixed-effect model. RESULT: The difference of calories ordered between physical activity label and calorie label groups was not statistically significant (SMD: -0.03; 95% CI: -0.13, 0.07). The difference of calories ordered between physical activity label and calorie label according to real vs unreal (e.g. web-based) condition was 65 Kcal fewer in real-world settings. CONCLUSION: Physical activity calorie equivalent labeling in minutes does not significantly reduce calories ordered compared to calorie-only labeling.