February: Nutrition Facts Label
Happy February
everyone! Nutrition facts panels are an integral tool for public health. This
month’s article dives into what factors are associated with frequent Nutrition
Facts label use, which nutrients are most frequently viewed, and how label use
is associated with actual dietary habits in young adults.
Background
Nutrition labels are a
low-cost tool with the potential to encourage healthy eating habits.
Objective
To investigate
correlates of frequent Nutrition Facts label use, describe the types of label
information most often used, and measure how label use relates to dietary
intake in young adults.
Design
Cross-sectional
population-based study of young adults participating in Project Eating and
Activity in Teens and Young Adults-IV.
Participants/setting
Surveys and food
frequency questionnaires were completed during 2015-2016 by young adults
(N=1,817; weighted sample=49% women) aged 25 to 36 years.
Main outcome measures
Nutrition Facts label
use, frequency of using specific information on labels, and dietary intake.
Statistical analyses performed
Relative risks and
adjusted means were used to examine how demographic, behavior, and
weight-related factors were associated with Nutrition Facts panel use, and how
label use related to dietary outcomes. Associations with P values
<0.05 were considered statistically significant.
Results
Approximately
one-third (31.4%) of participants used Nutrition Facts labels “frequently.” Use
was significantly higher for women; for participants with high education and
income; among those who prepared food regularly; among those who were
physically active; among those with a weight status classified as overweight;
and among those who were trying to lose, gain, or maintain weight. Label
components used most often included sugars (74.1%), total calories (72.9%),
serving size (67.9%), and the ingredient list (65.8%). Nutrition Facts label
users consumed significantly more fruits, vegetables, and whole grains and
fewer sugar-sweetened beverages, compared with nonusers. Nutrition Facts label
users ate significantly more frequently at sit-down restaurants but less
frequently at fast-food restaurants compared with nonusers.
Conclusions
Although Nutrition
Facts label use was associated with markers of better dietary quality in a
population-based sample of young adults, only one-third of participants used
labels frequently. Methods to improve label use should be studied, particularly
through leveraging weight- or health-related goals (eg, interest in making
healthier food choices), and meeting consumer preferences concerning label
content.
Questions:
Please provide your thoughts and impressions on the
article as a whole. Below are some questions of interest raised by the article.
1: Were you surprised by the rankings of the most frequently
used label components? As nutrition educators, should we collectively try to
emphasize other parts of the label that were viewed less frequently?
2: In the article, the authors note that the FDA’s
2016 changes to the Nutrition Facts label was in-line with consumer preferences
reflected in their own findings of label component use. What do these label
components indicate about consumer knowledge regarding these nutrients?
3: The study lists several factors that were related
to Nutrition Facts label use; however, the study participants’ age ranged from
25-36 years. In light of the final sample’s age range, do you think the listed
factors related to Nutrition Label use provide a complete picture of factors
influencing label use? What may be factors related to Nutrition label use in
older populations?
4: The article states that men generally have lower
label use and higher physical activity than women. The authors argue that physical
activity can be used to promote Nutrition Facts label use among physically
active men. In what manner do you think this can be achieved?
5: Only about one-third of the participants in the
study were described as using Nutrition Facts labels “frequently.” ‘Frequently’
was defined as scoring a 4 or 5 on a 5-point Likert scale, which corresponded
with “most of the time” and “always” respectively. Do you believe this is an
adequate and/or accurate measure of label use? If not, what are some possible
alternatives?
Link
to full text: http://jandonline.org/article/S2212-2672(17)31706-9/fulltext
posted by Michael O'Halloran @ 6:34 AM
56 comments
56 Comments:
1: Were you surprised by the rankings of the most frequently used label components? As nutrition educators, should we collectively try to emphasize other parts of the label that were viewed less frequently?
I wasn't surprised by the ranking of the frequently used label components. The article stated that there are many reasons that individuals read nutrition labels. It could be due to a disease state, a fad diet, or other dietary concerns. I was happy to see that serving size was amongst the top components.
2: In the article, the authors note that the FDA’s 2016 changes to the Nutrition Facts label was in-line with consumer preferences reflected in their own findings of label component use. What do these label components indicate about consumer knowledge regarding these nutrients?
As we know, the serving size increased on the food label and added sugars is now included. I think that these changes coincide with the wishes of the consumer, as well as, the wishes of nutrition experts. As nutrition experts, we understand that added sugars are different from naturally occurring sugars when it comes to product quality. The more patrons are exposed to this concept, the better they will understand that not all products that have sugars are bad. For instance, compare a fruit with the same amount of sugar as a juice box. We know that the fruit has a multitude of other health benefits along with those sugars in comparison to a juice box with added sugar.
3: The study lists several factors that were related to Nutrition Facts label use; however, the study participants’ age ranged from 25-36 years. In light of the final sample’s age range, do you think the listed factors related to Nutrition Label use provide a complete picture of factors influencing label use? What may be factors related to Nutrition label use in older populations?
I do not think that the final sample range reflects the total population use of label reading. An older population, let's say in their late 60's-70's, may be looking at things such as sodium or saturated fat over the total calories.
4: The article states that men generally have lower label use and higher physical activity than women. The authors argue that physical activity can be used to promote Nutrition Facts label use among physically active men. In what manner do you think this can be achieved?
I think if we can get RDs in gyms and in more sports magazines, we may be able to increase the use of label reading by men.
5: Only about one-third of the participants in the study were described as using Nutrition Facts labels “frequently.” ‘Frequently’ was defined as scoring a 4 or 5 on a 5-point Likert scale, which corresponded with “most of the time” and “always” respectively. Do you believe this is an adequate and/or accurate measure of label use? If not, what are some possible alternatives?
I do not believe that this is an adequate measure of label use as discussed earlier. I find that the survey did not reach a broad demographic in relation to age and I'm sure other factors. Therefore, I find that a more detailed and extensive study to coincide with the results of this study would provide a more accurate picture of label use. We need to speak to our supermarkets and look there to gather data.
I was surprised that serving size was on the list of most frequently used label components; we see such inflated serving sizes on most plates that it surprised me to find label users specifically looking for this portion of the label. I think different parts of the label are more important depending on the population we are working with. If we’re trying to help CHF pts, of course we will emphasize the sodium section of the label. I don’t think every person needs to look at every part of the label all of the time. That’s a very time-consuming task to ask of people who may not be nearly as interested in reading the nutrition facts label as us future dietitians are!
The changes in the nutrition facts label came about due to nutrients determined to be important to prevalent chronic disease states. Vitamin D and potassium will be required on the label and iron and Ca will continue to be required. Added sugar is also a new requirement. These new components directly relate to many chronic diseases in America-having these items on the label will help consumers with chronic disease make better food choices.
The majority of participants were 31-36 years old. In populations older than 36 years of age, factors related to label use may range from not knowing how to read a label to not being able to see the label.
With the current label (or current new label requirements) I think protein is probably the largest factor in persuading people with high levels of physical activity to read labels (whether or not they should actually concentrate so much on protein is another matter). The distribution of macronutrients may be another factor for the physically active to jump on the label-reading wagon.
I think Likert scales are relatively effective when used for data collection; however, all of the data in the study was self-reported. I think that aspect is more worrisome than whether the Likert scale was the best choice of measurement.
When I read that this was a study done in young adults, I assumed a population more similar to that of our age group. I think it would have been fascinating to understand how individuals who may just be starting off on their own and forming their own eating, grocery shopping, and food preparation habits, use nutrition labels, especially since food and health seem to be trending topics among those of our age. Also, as both Elyse and Erin eluded to, different populations, whether they be defined by age, gender, disease state, etc. are going to use labels for different reasons, therefore I think it is a difficult to truly identify the “most valuable” or “most-used” pieces of information contained on the panel . And as the data were in fact self-reported using a Likert scale, I think we have to take these results with some caution. What one person defines as being “most of the time” may be different than what the next person considers it to be. I also think there may be a good chance social desirability bias might exist in the reported data, and individuals may over-report “good behavior”, in this case, label use. I think it would be fascinating to do an observational study and see how individuals grocery shop and use the panel when selecting food items. I already like to peek into others’ carts at the grocery store and am very intrigued by and interested in understanding the motives behind individuals’ food purchases.
Secondly, like Erin, I did not expect to see serving size as being a popular part of the label. We hear so much buzz about how people don’t pay attention to serving size, but this study suggests that they actually might. I personally think however, that sure, a person may know one serving of pasta is 2 oz, but how much does that look like once it is boiled, covered in sauce, and put on a plate? I think, as RDs, we need to focus more on a real-life, practical approach to nutrition education, especially when it comes to portion sizes and label reading. As Erin mentioned, people aren’t going to want to take the time (or even have the time) to read the entire label, and I don’t think that is always necessary. That is where we, as RDs, can come in and help clients and patients understand their individual nutrition needs and highlight some of the information they may specifically want to consider on nutrition labels.
After all this discussion about labels…
I wanted to mention at the same time however, I think it is important to not get too bent out of shape about nutrition facts and ingredients and to encourage more of an intuitive approach to eating in. While yes, I certainly understand that this may not be appropriate for everyone, I do think it is one option for the generally healthy, average individual to help encourage a healthier approach to eating that some may find more manageable and sustainable than reading labels.
Elyse, I like that you bring up the thought of how RDs can reach individuals for label education, specifically men. I do know some gyms have RDs on staff and agree that that may be a good avenue for outreach. It is challenging though to think of other options, especially if we are talking about the general population - people that aren't in the hospital or going to outpatient counseling or seeing a private practice RD or that don't belong to a health club/gym. I'd love for everyone to have the opportunity to work with an RD, but it is expensive. I think that HyVee and other supermarket RDs would be a great resource for individuals in terms of label education - what better place to help people understand how to use labels to select products than at the grocery store. From what I have read in your logs though, the RD has a lot going on and often times is interrupted by mundane tasks, and not to-mention, people aren't always eagerly inquiring about labels or asking for help. Maybe more free classes or easy-to-understand signage and brochures could help with this? Curious to hear how much time you spend on education with customers?
Another thought I had regarding the reported low men's use of labels, is maybe this portion of the population is not as involved in grocery shopping and food decisions as women?
Jenni,
I love that you brought up the social desirability bias-I hadn't thought about that! I always think people will be honest because all of their answers are relatively anonymous-but I think you're correct in that it is ingrained in us to take actions that are socially acceptable and desirable.
I also agree with you that the 2oz pasta serving is a bit abstract. That's why I like it so much that many RDs have begun using the "deck of cards" example for 3 oz of meat. Many also have rubber food models in their office ready to be used in demonstrations with clients.
Elyse,
I like how you mentioned that even consumers who didn't know of or want the nutrition facts label change will start to see the difference between natural and added sugars. I, too, think this will be an important change in consumerism and I'm excited to watch it happen!
Erin,
Great point about the focus for physically active individuals to understand protein when reading labels. For the most part as a society, we get all the protein and then some from the foods that we need. Additional protein supplements really aren't that necessary unless you're training hard or have a medical condition that requires increased needs. I know someone who is into physical fitness and reported consuming nearly 300 g of protein a day!!!!!! I tried to educate him that he doesn't need all those extra protein drinks and additives. Here's to hoping he listens before he has bigger problems on his hand.
Jenni,
I like your observation that everyone interprets phrasing differently. It's all relative. A more descriptive definition of the terms used would be beneficial. I also agree that individuals may skew some of their responses due to concerns about perception. So, then, how accurate are the findings?
Another point you made what how realistic the serving sizes are on the labels. I find myself struggling with some serving sizes on labels and I'm educated in FNS! The pasta example is spot on. We all know those individuals that will cook the entire box. How do they know a proper portion once it's cooked?
I am slightly surprised by the rankings of the most frequently used label components. Mainly, I was alarmed that sugars were viewed more frequently than calories. Through my experience with educating, I have noticed that people tend to only focus on how many calories are in a product to determine if it is “good for you,” not realizing that all components are equally as important. Recently, I have noticed myself looking straight to the serving sizes, amount of sodium, and ingredients list. I believe that these are three components that should be emphasized most during a basic nutrition education consult. Serving sizes because it is one component that can be easily overlooked and someone who does not realize how to use the serving size listed on a label will end up eating an entire container of something when the serving could only be for ¼ of the container. I was surprised that sodium did not even make the ranking list considering the prevalence of HTN and heart disease. Sodium is in nearly every product, so having clients be more aware of how much they are in taking could be the first step in reducing the risk of heart-related comorbidities. Finally, the ingredients list is important because products are listed in descending order of quantity, along with providing a ton of information about what you are actually consuming. Obviously, depending on different disease states, other components should be emphasized more than others. (Example: carbohydrates with diabetes).
The new Nutrition Facts label definitely reflects the outcomes of this study as it relates to consumer preference. The most used component was sugars, where on the new label a whole “added sugar” component will be added. Also, people use the total calories section which will now be enlarged. Also, serving sizes are going to be increased, which strongly highlights consumer’s preference. I think the fact that total Calories is going to be the very first thing a consumer will notice on the new label is undermining the importance of all other nutrient components.
In the older population, I think the use of nutrition facts labels come directly from different disease states and the role of the health care system emphasizing the importance of diet. In my opinion, I feel that many people do not worry about their health until they have to. Therefore, unless someone experiences a heart attack, they are not going to feel obligated to make lifestyle changes until it actually happens (as if it is a wake-up call).
I do not believe that the Likert scale was the best way to determine label use frequency in this study. I think it is challenging to determine how often someone uses a Nutrition Label. I also feel that either you use them all the time or you don’t look at them at all, so having middle options is confusing.
As Erin and Jenni both mentioned, I agree that many people will not take the time to sit and read an entire label at a grocery store. So as RD's it is our duty to educate people on their own individualized needs and components to look for on a Nutrition Facts label so that it only takes a quick glance to determine if the item is worth purchasing. Jenni, I appreciate your comment about encouraging a more intuitive approach to eating, and I completely agree with that statement.
Elyse, I agree with your statement about still struggling with portion sizes on nutrition labels even after years of education in the field. I run into this as well! Also, while I was interning at Unit 5, you may remember this as well, everything must be measured out for the student's lunches. We always ran into the question of how many celery sticks are actually in a serving of vegetables. It can definitely be tricky when foods are not easily measured by measuring cups or if someone does not have access to a food scale.
One point of this article that I found really interesting was the correlation between nutrition facts label usage and healthy behaviors. "Nutrition Facts label users consumed significantly more fruits, vegetables, and whole grains and fewer sugar-sweetened beverages, compared with nonusers. Nutrition Facts label users ate significantly more frequently at sit-down restaurants but less frequently at fast-food restaurants compared with nonusers." It is important to remember that correlation does not equate to causation, and in fact it could be the reverse. Rather than nutrition facts affecting food choices, perhaps people who are already trying to consume a healthier diet and have some nutrition knowledge are then more likely to read a nutrition fact label. This idea could be used in reference to question 4 (regarding how we can encourage men to use labels more). Perhaps men are more likely to believe that if they exercise more, they can eat "whatever they want." So if an en education program was designed to teach men specifically about how nutrition affects their health and can enhance performance and overall quality of life, then they would probably be more likely to read a nutrition fact label as a result of a greater desire to consume healthy foods.
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One of the most interesting parts of this study to me was the chosen characteristics measured in relation to food label use in young adults. This helps to expand what is known about the health attitudes and behaviors of those who commonly read labels. While there was statistically significant differences between behaviors typically perceived as healthful in frequent label users, I wonder how these indicators would change if a different definition of “frequent” was used. Initially, when reading the article, it jumped out to me that only those who answered a four or a five on the Likert scale regarding use of labels were identified as frequent. I think it was a really good choice to modify the question as they did to include “for the first time,” however, I think there are other confounding variables in regards to this question that weren’t addressed. For example, fresh fruits and vegetables rarely have nutrition labels, some “staple” food items may be bought out of habit and never considered based on the nutrition label, and lastly the question is worded to determine influence on purchasing or consuming the item, and as consumers sometimes I think there is an attitude of “I’m going to eat this regardless because I want it.” That being said, I don’t think we should be overly concerned that only one third of young adults use nutrition labels frequently because there are other factors contributing to their dietary choices and reading the labels may not be the cause of better health behaviors.
In regards to how this information could be used to promote nutrition label use among populations reporting lowering percentages, I think there are various education and marketing changes that could be researched. The paper briefly mentions exercise equivalents on packaging as a potential technique. I haven’t previously heard of this method but would be really interested to see how it would impact consumer food choices, assuming that it is actually looked at.
In addition to looking at how different marketing and informational techniques can be used to promote a more healthful diet, I think it will be really interesting to see how the FDA changes to the nutrition label will contribute to the frequency and influence labels have on food choices. I know one of the major concerns with the changes are the more realistic serving sizes. If consumers aren’t well informed that these are not recommendations, but common consumption amounts, I think it may actually increase the amounts of foods eaten. The results from this study conclude that serving size is the third most commonly looked at component of the label, after sugar and calories. Hopefully the FDA modifications in this area will have a greater influence on consumers’ decisions to eat a more healthful amount over the larger serving size.
After reading through this article, I was not surprised by the various ratings of most frequently used label components. For many of us educating on labels, I think we stress the importance of looking at serving size when viewing the label. In addition to that, the other components include aspects that are often associated with distinct diets or buzz words that I think we often see in media. Thinking about “cutting calories” or “low/no sugar diets” as well as certain ingredients that are either praised as a “superfood” or demonized, these seemed to correlate with many of the common trends in media. For older age ranges, I think there may be more frequent use of categories like total carbohydrates and sodium. I believe these categories may be more frequented for this population due to the high prevalence of diabetes and hypertension within older age groups. It would definitely be interesting to see the outcomes for various age groups to find out what they look at and how they apply them to their eating habits!
Jenni,
I appreciate your thoughts on moving towards intuitive eating and steering away from label reading for healthy patients. Although there can be some benefits to using the labels, they seem to create unnecessary stress for those who can do fine by just eating a balanced plate and eating when they are hungry. Something about having additional numbers to look at just makes people want to critically evaluate things, and when they aren’t knowledgeable about what that means for them, it can be detrimental.
Bonnie,
I think you’re spot on in terms of how we could have some reverse correlations between individuals eating healthier looking at nutrition facts on purpose versus those reading labels and having that influence their intake. As we cannot know what motivates these patients and their decision making based on this kind of study, there may be further room for investigation to better pin point those correlations and their directions.
Like many, I was not very surprised by the rankings of the most frequently used label components. I think there has been an increase interest in added sugars, and the results are indicative of that. As nutrition educators, we should dig deeper and investigate the areas that people are not reading and why. I think dietary fat is a questionable area for a common consumer. Many do not know the difference or the numbers to aim for or limit themselves to. Sugars and calories are easier, fat is a bit more complicated. I think finding ways to educate our clients and make it easier to grasp is important.
As briefly discussed already, I think the most frequently used label components are indicative of current popular nutrition topics for young and middle-aged adults. For older populations, components like sodium and fiber content may be more popular, as they are more related to the types of diet restrictions and concerns of that age range.
I’m sure we’ve all seen the labels that include the amount of time of a specific activity it would take to burn off the calories of the item. I’m not sure if these truly promote physical activity, but it’s a try. I do feel as though there is a correlation between a healthy lifestyle and using nutrition labels. It tends to be a snowball effect where someone becomes more active, begins to eat healthier, and then begins to want a deeper understanding of nutrition. I think as nutrition educators, we should know where to promote our services and know what to educate.
I’m not sure there is another method other than a Likert Scale to find the frequency of label use. As many discussed, any research method is not perfect nor are self-reported responses always accurate, but that’s what research is. I would be interested to see this study replicated on a wider population or multiple times on different age groups.
Mike, You raise some good questions to this article.
I was not overly surprised by the rankings of most frequently used label components. The only one I thought may be more common than the ingredients list would be %fat. There are so many low fat items on the shelf these days so I thought that may be more of a priority. However, it may be the population age range. Fat used to be considered a bad thing, which we now know, is not completely true. This may had more of an effect on older generations. This may be one explanation as to why %fat was not a higher importance in this particular population. I believe that this list of top items would be slightly different if 55-70 year olds had participated. I am sure (or at least hope) that sodium would be on the top list because so many older people have to (or should) monitor sodium intake for various health reasons.
I do think that as nutrition educators why should point out some other important areas of the nutrition label. However, I think this will be on an individual basis. The majority of people do not have time to look at the whole label and compare point by point to another label on a similar product. I would find what is most important for the person to focus on first. Once they have grown accustomed to looking at that I would add something else for them to consider. I think many people get overwhelmed by the nutrition facts and just need to be introduced slowly on the most important topics that affect their health (sodium, fiber, carbs, etc).
I do think that this study brought light to an important discovery. People who regularly read label tend to make healthier choices in life. However, only 1/3 of people are regularly reading them. This gives us as RDs the opportunity/responsibility to reach the other 2/3 and teach them how to read labels and why doing so is even important. I think this could be a way to simply make a lasting change in many peoples lives that is simple and easy to do.
Elyse, I agree that I was glad that serving size made the top list though I was not necessarily expecting it to be there. When I teach pts on label reading I always stress the importance of looking at the serving size. If they eat twice as much they need to double the numbers the see. It is a relieve to know that at least 1/3 of people know this is important
Erin, I would agree that protein is the most important part of a label for people who are physically active. I think this alone would help draw them towards reading labels. I would be concerned though that if this item was stressed too much, some may not eat other healthy items that are naturally low in protein (vegetables, grains, etc.). Clear education would be very important.
Jamey, I like how you phrased how becoming healthy is like a snowball. I could not agree more that it is our responsibility as nutrition educators to know what is most important to educate on to each separate individual to allow this health snowball to continue growing.
1: Were you surprised by the rankings of the most frequently used label components? As nutrition educators, should we collectively try to emphasize other parts of the label that were viewed less frequently?
Like Rachel, I was surprised to see that sugars drew more attention than total calories from consumers. I also found interest in how total calories was followed by serving size considering how at the moment, they are not the most user-friendly for the general public. Although consumers may be reading this information on a food label, it does not necessarily mean they are interpreting the information correctly to apply to their portions at meal time. This is where education from an RD becomes imperative for the success of clients or out-patients. For portions of the food label that often go overlooked (calories from fat, saturated fat and cholesterol), I think it is incredibly important for us to emphasize them and the impact they can have on health in the long run. It is also important to consider how emphasis on certain factors of a food label may differ with age, disease state, medical history, etc.
2: In the article, the authors note that the FDA's 2016 changes to the Nutrition Facts label was in-line with consumer preferences reflected in their own findings of label component use. What do these label components indicate about consumer knowledge regarding these nutrients?
I think the current changes are reflective of what is needed and what emerging research is showing to be exceedingly important in the United States. It will be interesting to see how nutrition education continues to evolve as improvements, such as with the food label are made.
3: The study lists several factors that were related to Nutrition Facts label use; however, the study participants' age ranged from 25-36 years. In light of the final sample's age range, do you think the listed factors related to Nutrition Label use provide a complete picture of factors influencing label use? What may be factors related to Nutrition label use in older populations?
I would say this was not an appropriate age range to be used for a generalization of information pertaining to food label use. Not only does this age range not account for the age range of college students (which would greatly contribute to this study), this age also negates the inclusion of the geriatric population. What is deemed significant for a 25 year old to look at on a nutrition label will likely not be the same for a 60 year old individual. Inclusion of these younger and older populations would allow us to better understand differed age groups and how they perceive and interpret food labels. In turn, this information could be utilized in consults to better assist and understand our clients.
4: The article states that men generally have lower label use and higher physical activity than women. The authors argue that physical activity can be used to promote Nutrition Facts label use among physically active men. In what manner do you think this can be achieved?
Personally, I think this would assist a male the best if his motivation for physical activity participation was intrinsic versus extrinsic. We would need to consider why these men were participating in physical activity before we could determine whether there could be a correlation between the two variables. Generally speaking, I think it is safe to say those who participate in physical activity for the feel good factors (intrinsic) would be more inclined to engage in other healthy behaviors such as reading food labels. For those who participate for extrinsic reasons (to look good, for example) I think it may be more difficult to achieve this kind of behavior due to it being shown that these individuals typically engage I healthy behaviors short term versus long-term.
Reilly, I appreciate how you mentioned everyone will have a unique understanding and need for food labels depending on age, disease, medical history and other factors. As future RD's this will be a large component of our job that will be individualized for each client or patient. I also found it surprising how percent fat did not make it into the top three! As you said, this could certainly have to do with the range of ages that were considered for this study. I would have found this data and study more intriguing if a larger age group was considered. Your mention of time and being effective in our nutrition recommendations also stood out to me. The process you outlined is streamlined and timely and I think many patients and clients appreciate when RD's can be practical in their suggestions and account for their client's own lifestyles. Lastly, I like your takeaway of food label education being a huge opportunity for us in our careers to improve lives in a simple yet meaningful way.
Jenni, there are a couple of points in your post that really stood out to me. First off, I completely agree that if this study were to be altered to observational, the results may be more accurate and without bias. I too am also intrigued when I take a look at others carts in grocery stores. I'm glad I am not the only one who does this. And it is never with intent to judge, but I think we all have that innate interest in understanding WHY people do what they do. Or in this case, purchase what they purchase. And for me, this curiosity stems from just wanting to better understand the thought processes that go through the heads of the general public so that I can alter my counseling to strike a chord with them. I was also surprised about the serving size being in the top three items looked at on food labels. But as I said in my initial post, although they may be reading this, it does not necessarily mean they understand how it looks on a plate. This is why I really enjoy utilizing food models with patients or clients. Lastly, I really appreciate your comment on intuitive eating. I am looking forward to learning more about this approach throughout my career.
Bonnie, your thought that perhaps men who are physically active think they can eat whatever they want made me laugh! I think many people have this mentality. I like your thoughts on education on how nutrition affects health and can enhance performance and overall quality of life. I'm wondering how this can be achieved or simply how getting more men to read labels can be done without education. Placement on product? Ads and commercials? Even then, I think the root of it is that there is a lack of people's understanding of their nutrition needs. It all goes back to what I always push for: more nutrition education in schools beginning from a young age. It's hard to teach a old dog new tricks, but starting nutrition education from a young age can avoid that and create lifelong healthy habits.
Samantha, I love how you discussed intrinsic versus extrinsic motivational factors. I agree that this would affect if a person is more inclined to engage in other healthy behaviors. I also think of all of the attempts to attract those who are motivated by extrinsic factors. These are usually tactics like "abs are made in the kitchen" and those Pinterest/Instagram accounts whose message is healthy eating, but image is someone's body.
Regarding the most frequently used label components, I was not too surprised at the items listed. I was, however, surprised that total carbohydrates and the breakdown of fats were not mentioned. To me, these are also important components of the nutrition facts label. I guess if the young adults are not diabetic and not worrying about heart-health, they are not aware of the implications behind total carbohydrates or the different fats found in their foods as they are not preached on in the media as other components. I am happy that they are looking at sugars- and that is especially great now that they will able to see the grams of added sugars in additional to total sugars (as others mentioned)! Education may be needed to explain grams you should aim for of these certain items. The young adults likely just think lowest is best when it comes to calories and grams in a serving, but do they truly know how to decipher their findings from the labels? Additionally, I am a little surprised that protein did not make the list, as increased protein foods (example could be Greek yogurt) are much more popular these days and at my internship rotation I hear clients all of the time discuss their protein intake. Sodium is also important to look at, so yes, I believe that RDN’s should promote more comprehensive label reading!
On the other hand, Erin makes a great point that not all parts of the label are necessary for an individual of the general population- and if it is too time-consuming, they may not want to look at every label of every product they are interested in!
As I touched on above, certain factors that may heavily influence an older population to read different parts of the label could be diabetes and heart disease. Obviously a person’s goals and interest in what they are consuming is a very individual thing- and even people that have certain factors do choose to skip label reading or only look at certain portions of it, such as glancing at the amount of calories. I do not feel that the list from the article provides a complete picture, as that truly cannot be obtained, only an educated guess.
I like Jenni’s suggestion of an observational study. She is right that there is likely some sort of bias, such as social desirability to report what they think they should. Additionally, the age range is an interesting one. Perhaps another study should be done for a little younger age range, though I can understand to some degree why they chose 25- this way they are including less college students, as we know that would include a whole different set of factors. Finally, I appreciate some of our colleagues’ ideas to promote label reading in the physically active male population. Right away I thought of the TVs at the rec center. Some of them are set on the local ad channel- what if subtle nutrition messages, including label reading, could be brought into gyms this way? The other tactic that comes to mind is some sort of demonstration, poster, or model that represents certain aspects of the nutrition facts label. For example, at my rotation, one of the dietitians has a set of vials that represent the amount of sugar in certain items, such as Mountain Dew (92 grams of sugar in 24 fluid ounces). Visuals are powerful- I remember Rachel did a bulletin board like this and it was eye-opening at her site! I echo that Sam made a great point that we have to tailor this to their motivation, and try to tap into those intrinsic factors!
I wasn’t too surprised that sugar drew a lot of attention over other nutrients & calories. A lot of emphasis has been put on sugar in recent years which is why consumers look at it first. I think it’s important to emphasize to consumers to get the “whole picture” when looking at the nutrition label. For example, if a person with optimal health only looks at total fat when reading the nutrition label, they may never eat peanut butter because they may interpret it as a “bad” food for having a lot of fat. However, we know that peanut butter isn’t “bad” and that it’s important to emphasize balance within the diet. This is where I think the importance of nutrition education comes into play so consumers can understand what each element of the label means and how to interpret it correctly.
The piece of the article that I found most interesting was the suggestion of including exercise equivalents on the label to get men more interested in the label. While in some ways, I think adding exercise equivalents would be a neat idea, I would worried how it might impact those with eating disorders or disordered eating habits related to dieting in general (especially considering those trying to lose weight used the labels more frequently). I also don’t really know how effective it would be to put exercise equivalents on nutrition labels; not all men are interested in physical activity so it may not encourage that many to look at the label. Perhaps there is a better way to get a larger variety of men more interested in the label. As Elyse stated, I think getting more RD’s in gyms would be a good start so we can provided evidence-based nutrition education to gym-goers. I’ve worked at a gym for nearly 10 years and I have definitely heard some conversations from the men about nutrition that are pretty far off from the truth.
Lastly, I tend to agree with Jenni. I think that when appropriate, it’s best to adapt an intuitive approach to eating rather than putting tons of emphasis on specific nutrients. Of course, it is still important to educate and encourage nutrient dense food choices but I also think it’s more effective and manageable for most people to look at their diet as a “whole picture” versus just focusing on specific elements or nutrients.
1: Were you surprised by the rankings of the most frequently used label components? As nutrition educators, should we collectively try to emphasize other parts of the label that were viewed less frequently?
I was not surprised by the ratings of the most frequently used label components. When I overhear people talking about food labels, I often hear people commenting on the sugar content in the food and complaining that one serving is only 3 cookies and about how it’s ridiculous that 3 cookies is however many calories. The only one that I am a little surprised at is that “calories from fat” was viewed less frequently. This surprises me because I feel the lay person has a misconception about fat in our diet leading me to believe this would be viewed much more than 51.7% of the time.
I think it is important for us as nutrition educators to focus on the nutrition facts label as a whole. The more people know about the nutrition facts label, the better they can adjust their dietary habits if they happen to become diabetic, have a CVA, or be diagnosed with any number of things that may require a nutrition intervention.
3: The study lists several factors that were related to Nutrition Facts label use; however, the study participants’ age ranged from 25-36 years. In light of the final sample’s age range, do you think the listed factors related to Nutrition Label use provide a complete picture of factors influencing label use? What may be factors related to Nutrition label use in older populations?
I don’t believe that a complete picture was painted when you take into consideration the reason why the older population may not read labels. For one, the older population is at risk for many complications involving their eye sight. Even though we have made certain things on the label larger for better visibility, the majority of the nutrition facts label is still in smaller print. This would cause the visually impaired older population to defer looking at the label all together. Also, the older population may not know how to read a food label in the first place.
4: The article states that men generally have lower label use and higher physical activity than women. The authors argue that physical activity can be used to promote Nutrition Facts label use among physically active men. In what manner do you think this can be achieved?
In my experience, many physically active men like to follow an IIFYM routine. In this case, I think making the macronutrients stand out a little more may increase the likelihood of physically active men to read nutrition labels.
5: Only about one-third of the participants in the study were described as using Nutrition Facts labels “frequently.” ‘Frequently’ was defined as scoring a 4 or 5 on a 5-point Likert scale, which corresponded with “most of the time” and “always” respectively. Do you believe this is an adequate and/or accurate measure of label use? If not, what are some possible alternatives?
I do not think that this is a good representation of label use. I’m not sure how accurate I am with this statement but I think when people grocery shop, they usually tend to pick up the same items at each trip. This would cause someone to look at a label one time and then not refer to the label again. Every once in a while a person may compare two products but I think the price may have a larger say in which item the consumer decides to buy rather than the nutrient content of the two foods. So to say that someone looks at labels all the time may not be accurate. I think that a better way to represent the question would be to ask the consumer how often they refer to the label when purchasing a new food item or when comparing two or more food items.
Stephanie,
I think you make a great observation when talking about the changes in portion sizes and how the public will respond to this. This is one thing I hadn’t thought much about in a while. I thought changing the portion size would be a good idea to better inform the population of what they are typically eating. It didn’t cross my mind that people may look at this as recommended portion sizes. I think it would be interesting to see how this change in particular affects consumer eating habits and whether or not this becomes a beneficial change.
1: Were you surprised by the rankings of the most frequently used label components? As nutrition educators, should we collectively try to emphasize other parts of the label that were viewed less frequently?
No, I was not surprised by most frequently used label components. I often hear people talk about watching their sugar, carbohydrate, and fat intake. I think with the increase in diabetes and obesity, it would make sense that most people have to watch their sugar and carbohydrate intake.
As nutrition educators, I think we should educate our clients on the importance of the Daily Values, especially with sodium. Many Americans, are unaware of the high sodium content in many of our processed foods. High sodium diets are linked to Heart Disease, the number on killer in America. Also, I think we need to address the difference between natural sugars and added sugars.
2: In the article, the authors note that the FDA’s 2016 changes to the Nutrition Facts label were in-line with consumer preferences reflected in their own findings of label component use. What do these label components indicate about consumer knowledge regarding these nutrients?
I think the current changes, show that the public in more concerned with their health than in the past. The current wave of nutrition, is becoming more popular and the FDA is taking steps to stay inline with what is important to the American people.
3: The study lists several factors that were related to Nutrition Facts label use; however, the study participants’ age ranged from 25-36 years. In light of the final sample’s age range, do you think the listed factors related to Nutrition Label use provide a complete picture of factors influencing label use? What may be factors related to Nutrition label use in older populations?
No, depending on the health status of the individual, some people may be concerned with other parts of the nutrition label. Younger males, may be more concern with protein content for muscles building or the teenage girl may be concerned with iron. Older adults, are more likely to look at the sodium, potassium, and vitamin K, content of foods, especially since many elderly Americans take multiple prescriptions.
4: The article states that men generally have lower label use and higher physical activity than women. The authors argue that physical activity can be used to promote Nutrition Facts label use among physically active men. In what manner do you think this can be achieved?
I think if we need to focus more research on the common foods choices of physically active men. What types of foods to the tend to eat and why? If we could find a correlation between their two topics, it may help RD's find new ways to educate men on the nutrition label.
5: Only about one-third of the participants in the study were described as using Nutrition Facts labels “frequently.” ‘Frequently’ was defined as scoring a 4 or 5 on a 5-point Likert scale, which corresponded with “most of the time” and “always” respectively. Do you believe this is an adequate and/or accurate measure of label use? If not, what are some possible alternatives?
I do not think the is an accurate measure of label reading. Many consumers only look at one of two components of the foods label and do not read the rest. In addition, parents may not read the labels of the foods their children place into the grocery chart, especially in the child is causing a scene in the supermarket. I think the question should be rewritten to ask how often does someone read the entire food label. I think we also need to ask if the general public understands the nutrition facts label.
Bonnie,
I really liked your comment about people may be trying to eat healthier and are more likely to use the nutrition facts label. The studied noted that a high percentage of the participants were white, well-educated, with a high income. If this study had been done with mainly lower income individuals and families the results may have been different. In addition, I like you suggestions for promoting the nutrition facts labels among men. If we can show them a relationship between physical performance and exercise, they many be more concerned with their eating choices.
Erin,
I like that you brought up the fact that participants self-reported using the Likert scale. Many individuals may have over/under estimated their use of the nutrition facts label. In addition, I think you made a good point that older adults may have trouble reading a nutrition label or have a lack of understanding about it.
1: Were you surprised by the rankings of the most frequently used label components? As nutrition educators, should we collectively try to emphasize other parts of the label that were viewed less frequently?
I was not surprised by the rankings that were found to be most frequently used label components. In fact, these happened to be the parts of nutrition labels that I personally look at the most. Similar to the people in the study, sugar is the very first aspect of nutrition labels that I evaluate. Total kcals and serving size closely follow. I do not find myself looking at the ingredient list as frequently, but still fairly often. Therefore, based on the similarities between the study results and my personal tendencies, I am not at all surprised by the rankings of the most frequently used label components. As nutrition educators, I think there are not only other parts of the label that were not viewed as frequently that we need to emphasize, but also further education on the top ranked components need facilitated. If these are the most frequently evaluated aspects of nutrition labels, then it is our responsibility to make sure consumers can fully interpret and understand the information they are reading. Sadly, this study determined that only about one third of this population is reading nutrition labels. Therefore, maybe as nutrition educators our beginning teaching point is the importance of reading nutrition labels.
3: The study lists several factors that were related to Nutrition Facts label use; however, the study participants’ age ranged from 25-36 years. In light of the final sample’s age range, do you think the listed factors related to Nutrition Label use provide a complete picture of factors influencing label use? What may be factors related to Nutrition label use in older populations?
Because the participants in this study were between the ages of 25-36, the results cannot be generalized to the population of people all ages. Nonetheless, I understand that researchers probably chose to study this population as they seem to be the ones who read nutrition labels the most. Nonetheless, the small age range is an unfortunate study implication. Those of older age are more likely to have nutrition-related diseases or nutrient deficiencies that would make their results of this same study different from the actual study results. I would guess older consumers would most likely be looking for amounts of sodium, fiber, and vitamins and/or minerals that they may be lacking. Additionally, this study does not include the high school-aged or college-aged population. Re-doing this study with both a younger and older population would greatly strengthen this study and contribute interesting data.
5: Only about one-third of the participants in the study were described as using Nutrition Facts labels “frequently.” ‘Frequently’ was defined as scoring a 4 or 5 on a 5-point Likert scale, which corresponded with “most of the time” and “always” respectively. Do you believe this is an adequate and/or accurate measure of label use? If not, what are some possible alternatives?
In all honesty, I am not entirely sure how one could quantify this measure of how often study participants viewed nutrition labels. Therefore, I feel as though the Likert scale was appropriate for this study. Nevertheless, there are other aspects that need to be taken into consideration. For example, is this study referring to reading nutrition labels before buy food at the grocery store? Before ordering food at a restaurant? Both? Additionally, does this refer to buying new foods? Or every single time a consumer purchases food? Personally, I usually look at a nutrition label once, and if I like it, continue to purchase that product without re-checking the label every time.
1: Were you surprised by the rankings of the most frequently used label components? As nutrition educators, should we collectively try to emphasize other parts of the label that were viewed less frequently?
I was not surprised by the total calories or serving size. However, with this population I was surprised that sugars and the ingredients list were a part of the most frequently used label components. Since the questionnaires were completed more recently, it is possible that the trends of "easy to read" or the "only buy what you know" ingredient lists were popular like they are today. A similar line of thought with the higher use of the label for sugars, which is the sugar/added sugar trend was popular or beginning to be popular for the general population during 2015-2016 and that is why this population was using it more. As nutrition educators, when teaching a more diverse population at once, it may be important to put emphasis on looking at foods as a whole. Meaning that though the participants were looking at sugars, they were not looking as much at cholesterol, fiber, and saturated fats. However, just because a packaged food is lower in sugar/added sugar, does not mean that company wouldn't make up flavor change in the product by adding fats and sodium. Thus as educators we need to focus on teaching how to look at the nutrition facts label as a whole.
2: In the article, the authors note that the FDA’s 2016 changes to the Nutrition Facts label was in-line with consumer preferences reflected in their own findings of label component use. What do these label components indicate about consumer knowledge regarding these nutrients?
Consumers wanting to see the total calories reflect the more "realistic" serving size of foods makes sense with what the study found was most frequently observed by the participants. Once there are more products using reasonable serving sizes to reflect what most people are actually consuming, it would be interesting to conduct a study like this again and see if the amount of label users increases to more than 1/3 of participants.
3: The study lists several factors that were related to Nutrition Facts label use; however, the study participants’ age ranged from 25-36 years. In light of the final sample’s age range, do you think the listed factors related to Nutrition Label use provide a complete picture of factors influencing label use? What may be factors related to Nutrition label use in older populations?
This age range's results definitely cannot be used for generalizing everyone's possible use of nutrition facts labels. I think the use could change for different older age ranges depending on several factors. One factor could be trends that were more prominent during that age ranges younger adulthood; those trends may still be in their mind while looking at nutrition labels. Also, different health issues with an older population would impact what and why they are looking at certain parts of the nutrition label. It would be interesting to see a study with younger populations to see when youth start looking at labels and for what reasons. As well as a study with a healthy older population to see their use of a nutrition label.
Paige,
I agree with your comment regarding the exercise equivalents on food labels being potentially detrimental. I also think it gives the wrong overall message as well. I have heard the saying so many times, "calories in, calories out." But it is so much more than that. Not all calories are created equal. As we know saturated fats can have a very different long term physiological effect than poly unsaturated fatty acids. So, although you would technically have to run the same distance to burn a certain amount of each, that is really missing the mark. We want food labels to encourage a better understanding of the nutrition components of the foods we eat. Plus, exercise is a really good thing, and framing it in that light makes it seem like a punishment for eating.
1: Were you surprised by the rankings of the most frequently used label components? As nutrition educators, should we collectively try to emphasize other parts of the label that were viewed less frequently?
I agree with almost everyone when they said that it was a surprise that total calories was below sugars in the components often used. However, I feel that the talk of sugar and how to read it on a label is being talked about more. People who are becoming more health conscious are starting to look at labels and find out how much sugar is in an item from natural or artificial sweeteners. One thing that I feel needs to have more attention on a food label is sodium. Anything that is processed or prepackaged can contain a lot of sodium and even things that are marked as health foods. Americans tend to consume more sodium than the recommended and I think there just needs to be proper education on foods that contain a lower amount of sodium and how much is recommended.
3: The study lists several factors that were related to Nutrition Facts label use; however, the study participants’ age ranged from 25-36 years. In light of the final sample’s age range, do you think the listed factors related to Nutrition Label use provide a complete picture of factors influencing label use? What may be factors related to Nutrition label use in older populations?
I think it is a good reference since this age group is starting to become more health conscious because of social media, celebrities and other outlets. From talking to my parents and grandparent’s generation, what they look at nutritionally is a little different then my generation. For example, I remember my parents stressing about how much cholesterol was in eggs and how we need to avoid them where are not research has come out say it is not as bad as we used to think. My parents generation also would not measure anything out or focus on the serving sizes because it was not something that was stressed in school. These are just things that I have personally noticed but nutrition trends are changing all the time just like anything in the medical or health field so we cannot generalize it to the entire population.
4: The article states that men generally have lower label use and higher physical activity than women. The authors argue that physical activity can be used to promote Nutrition Facts label use among physically active men. In what manner do you think this can be achieved?
I think that men do focus on their nutrition but in the aspect of macronutrients. I always hear men who are into fitness that talk about protein and carbohydrate consumption but never sugars or serving sizes. Maybe education on how looking at these other factors can help their athletic performance. Education on how nutrition can help them with their recovery can also be a good incentive to get them to look more into what they are eating and how to read a nutrition label.
Elyse,
I could not agree more with your answers especially on the age of individuals who are in the research. My grandparents and parents focused a lot on saturated fat and cholesterol whereas I feel that this population is looking at how much we are eating. I think you make an interesting point on the health magazines for men to look into their nutrition. My only concern would be how to get them to look at smaller nutrients over the macros. I also wonder if the gender of the RD will make a difference. It may be something that I overthink but I know a lot of my friends who are really into fitness look at more RDs who are a male figure. Just a thought!
Lauren,
I agree with the fact that this generation looks more into the diets that social media puts on like low carb or sugar. I do not think the older generation focused on that too much but it would be interesting to see if they had any "fads". I know looking at cholesterol was a big thing but did it make as much media as it does now?
1: I was surprised, like many others, that calories were looked at less than sugars. I think that nutrition labels, especially the new requirements for those labels, highlight calories much clearer than sugars. I think this is a good sign that people are actually educated enough to know what to look for and where to find it on the label. This may be due to the higher prevalence in this age group for blood sugar related illness. However, with this being said, carbohydrates are significantly lower in this category than sugars are. I think there is room for education about carbohydrates and their connection to sugar.
2: I think its important that consumers are making a push for their own health concerns. The new label shows that people are most interested in the total calories and their macro-nutrients. I also think it is interesting that consumers are more interested in serving size. It is a nice change for a country of excess. I think this is due to increased basic knowledge about nutrition and food sustainability in the general public.
3: I was very surprised that the sample population's age skewed to the higher side because the study made it seem like the population age would be more similar to college or high school aged students. The issue with using an older population is that they are more likely to have had professional nutrition education due to an illness or a referral from a M.D. These people are also more educated than younger populations might be. Some of the population had a master's degree. This significantly affects their nutrition knowledge and priorities.
4: I think that by educating men who are physically active about the connection between diet and exercise you would easily be able to convince them to use nutrition labels more. By educating on the best nutrients for recovery or muscle building, men would be able to use nutrition to enhance their physical activity.
5: I do not think this is accurate. While I would say that I care a large amount about food label, there are many foods in my own life that I simply do not look at the food label because I either have used a similar product before.There are also products that I will not look at the food label simply because I do not care at the time. There are also foods that do not have food labels. All of these are reasons that this number may not be the most accurate way to describe this behavior.
1. Like Erin and Jenni, I did not expect serving size to be a highly used label component, especially not the highest one. I think this is because usually, the serving size is either in terms that aren't normally referred to (such as grams or ounces, like Jenni mentioned) or because one eats however much they want regardless of the serving size (for items such as chips or pasta). I am also surprised that fat was not a component that was normally looked for, because it seems like fat has such a bad connotation and people try to avoid it, hence the popularity of low-fat marketed items. I'm not totally surprised that the ingredient list was a top component, but I am curious as to exactly why. I wonder what specifically is being looked for and if it is for health reasons, like sugar, or for disease-specific reasons, like gluten-containing ingredients or dairy.
As educators, I think it would be vital to educate individuals on every aspect of the food label, but paying specific attention to the daily values. Many people don't understand what the daily value percentages mean and that they are specific to a 2,000 calorie diet. Since most people do not know what the recommendation is for each macronutrient, it would be simpler to help them understand the daily values, especially for components such as saturated fat, total fat and sodium.
2. Since this study found that sugar is a largely observed component, I think the new food label is directly in line with this by including the breakdown of sugar into natural and added sugars. I think the difference between natural and added sugar has been a large area of confusion for consumers and that clearly showing the added sugars will help people not only understand the difference but also be more aware of high-sugar foods.
3. Although I appreciate the purpose of this study, I think it definitely had limitations. Like many others pointed out, the age range was very narrow and excludes many individuals that buy food and may read food labels. Although older populations may be reading food labels for different reasons based on disease states, I think it would be informative to know what they are looking at and what they are overlooking. Moreover, similar to what Jenn said, it is possible that younger individuals are more health-conscious and informed. Therefore, it would be interesting to see if they actually do read food labels.
Bonnie,
I think you made a really valid point that the result of this paper are not causation for these better health behaviors, but rather a correlation with nutrition fact label use. I think it would be very difficult to design a randomized controlled study that with variables that would give more conviction of causation. Elyse mentioned conducting future research regarding nutrition label use in supermarkets and at the point of decision making by consumers and I think this is a really good context to get a better idea of how labels are being used by consumers. However, this would limit the population to those who perform grocery shopping for their household. It also may not be very representative of those who frequently eat out. It shocked me that the article had one participant say they eat out 90 times in a month. Essentially, that is every meal and so this population would purchase very different items when shopping compared to someone who mostly cooks at home.
1: I was not surprised by the rankings of the most frequently used label components because sugar content, total calories, serving size, and the ingredient list are the components I personally look for first. Additionally, these were emphasized more frequently when I took a mandatory health class in junior high school. We should collectively try to emphasize other parts of the label that were used less frequently, but I believe that the most frequently used label components (in addition to the fifth most frequently used component, total fat) are the most relevant to personal concerns of individuals, especially those in the age range group of of 25-36 years. While other parts of the label may not necessarily be a personal concern to many individuals, knowledge about other components could help individuals eat a more balanced diet (which may also prevent some diet-related health issues such as type 2 diabetes or obesity).
2: Consumers know about how added sugars are “bad for you.” Sugar-free foods and beverages are marketed in a manner to convey that they are healthier. Additionally, most consumers know that excess calories will cause weight gain, and knowing serving sizes is important in knowing exactly how many calories are being consumed. There also seems to be an aversion to things that sound like “chemicals,” such as high-fructose corn syrup, partially hydrogenated oils, aspartame, and so on. By reading ingredient lists, consumers can avoid ingredients they worry about.
3: No, diet-related health goals of older populations often differ from younger populations. For example, older individuals tend to get more hypertensive than their younger counterparts and are told to be careful of sodium intake. Another example is that there tends to be a larger concern for heart conditions in older populations, so they may concentrate more on fat and saturated fat content as well.
4: I believe drawing connections between physical activity and the importance of food content would promote using the food labels. Many people think of just protein intake for physical activity, but more motivation to use labels may be triggered if men are educated on how food content may improve their bodies, positively impact physical activity and the effects of physical activity, and so on.
5: No, definitions of these descriptors may vary per individual, so results may not accurately reflect the frequencies. Clear definitions of each option on the scale would help make the information more detailed. For example, defining “most of the time” as being something like, “more than half the time” or giving a percentage range of label usage may help. However, I can see that accurate recall on specific amounts may be difficult for participants, and creating adequate descriptors for the study could be challenging. Additionally, using the current Likert scoring in the study may be less burdensome to analyze.
1: To be honest, I was surprised on what items were at the rank of most frequently used label components. I have a different background on perspectives of American lifestyle, especially the one passed through media overseas, therefore my previous idea, before coming to the U.S. was that nobody used Nutrition label information and did not care about what was their food. This has rapidly changed with what I experienced in the supermarket, through classes and/or lectures about this topic. Also, with this article. As a result, my previous idea was crushed into a different one with people concerned about their health and aligned to the most frequently used label components. If general population had a class like Nutrition 101 as a guideline to check their health through nutrition label, sugar, fat, and macronutrients would be the top rank of this label information sought.
The Nutrition label is only one of many tools that could be used by the nutrition educators. Being able to fully understand all the information on it is extremely important in order to achieve goals such as improving nutrition knowledge. Also, the less frequently viewed information could provide a better understanding of the most viewed ones. An example is food rich in fat soluble vitamins and poor on fat, which can lead to a poor absorption of the vitamin no matter the concentration of it; other common examples are carbohydrates, that could be composed by fibers and sugar and depending on the balance of it the outcome can be more beneficial to health or not. As a conclusion, we have to emphasize other parts of the nutrition label in order to promote a greater understanding of the items frequently viewed at until then.
3: Talking about the complete picture of factors that influence label usage is almost impossible. Due to the fact that the same food is present in most of an individual's life and may be appropriate for one period (e.g.: childhood) but not necessarily to the next phase. It is not possible to generalize to the entire lifespan. The easiest way to visualize is using a group of people with a certain disease, for example hypertension. The first item viewed on the label will be sodium and not sugar, highlighting the difference between not only age but also affect of welfare on influence.
Specifically, on elderly population some factors that could lead to a different rank could be certain diseases, higher or lower intake necessity according to the nutritional status, comprehension on the names - most of the elderly do not know what some words mean, since did not exist back on the days, and so on. The importance here is to overpass those barriers, emphasize the knowledge, and encourage the continuity of the usage of information to improve their health.
4: This specific population is a challenge for Dietitians, much has to do with myths around this population and environment, such as higher intake of protein is always needed, or diet consisting only of sweet potato and chicken are the best to promote and improve muscle growth. In my personal opinion promote the use of nutrition label information among those men could be attach to their goals in physical activity level. For example, if the pursuing goal is to grow muscle, the information on the label could be used to help this pursuit; if the goal pursued is to lose weight the information could be used to emphasize this. The important is draw attention to whatever the person is seeking and adapting the information to match those needs, leading to a nutritional education "disguised" as design personal information.
Once you have a loyal person for these types of information and thinks it is time to the next step, go on and deepen their knowledge. You can evolve and drag more information from the label that previously was not important or necessary by the judgment of the client. Nutritional education is not a sudden process, instead is made up of steps, especially with population that shows resistance to nutritional knowledge and changing that differs from what they already know and practice.
1. I was initially surprised to see ingredient list as one of the most frequently used components. This is based on my own experiences obtaining feedback from individuals about their use of the label or their surprise when educating about it. However, after some consideration I expect this may have something to do with an increase in fads to avoid certain ingredients or due to allergies/intolerances. Someone that has an allergy, intolerance, or stigma related to a certain ingredient would most likely be very cognizant of nutrition labels and pay close attention to the ingredients. I would be interested to find out what specifically consumers were looking for when looking at the ingredient list. I believe that as nutrition educators we should try and emphasize parts of the label that may be more meaningful when making selections. However, this also involves the need to then communicate why these various parts are meaningful. If something is in bold or larger font it may not be of much use if the individual doesn't know what to do with that information or why it is important.
2. This indicates that consumers are aware that these components of the label are meaningful. This may also reflect what consumers are seeing in media regarding nutrition - calories, sugar, and serving size. However, it may also indicate that consumers are only focusing on these more base-layer components but may need more education about how to use other parts of the label that would also be beneficial to better understand the full picture of the product. Additionally, consumers may be looking at these components, but I wonder how they are using this information and if they are reading labels and focusing on these components out of fear (for example, so that they don't consume something with too many calories or too much fat/sugar) rather than looking for nutrient value? This is especially true since there were more participants that reported trying to lose weight.
3. I would speculate that older populations may look at the label to help abide by dietary restrictions related to a diagnosis - such as carbohydrates for someone with diabetes or sodium for those with high blood pressure.
4. I would say sending messages about the need for carbohydrates and protein related to physical activity could be one strategy. Men are typically considered more likely to be trying to put on muscle mass, so there could be an education component about fueling workouts and promoting muscle growth. There could be a focus on different types of carbohydrates and timing -
what to look for at a meal compared to a pre/post-workout snack. Additionally, looking at sodium, calcium, potassium, magnesium, phosphate, chloride could be a focus to educate about electrolytes and the need to replenish fluid and electrolytes lost through sweat after a hard training session. Overall, targeting performance, body composition, and other PA related goals may be a strategy to encourage this group to pay more attention to labels.
5. I question this approach. Some individuals in this group may not buy a lot of products that require looking at the label - for example more fresh fruits, vegetables, protein, grains, etc. They could answer one of the lower numbers and this would indicate a negative result since we want consumers to pay attention to labels. Therefore, one approach may be to ask about specific products and ask when purchasing that product for the first time how likely they are to look at the label.
1. I was surprised that the label was referenced more often for sugar over both calories and serving size. Especially noting that calories are at the top of the list, bolded, and sometimes have a bigger size. With more awareness to food sensitivities/allergies, ingredient controversies and a rise in ingredient promotion, I am also surprised that the ingredient list was last. I think that consumers are starting to become more interested and aware of purchased foods and it is evident that there is some sort of influence promoting sugar to be the most often looked at. That being said, yes, other parts of the label should be emphasized.
2. Well, as I stated for number one, I was surprised that calories and servings were not top priority when looking at food labels, but I do not think that the sample for this study was appropriate. I do believe that the changes for the food labels are favorable when it comes to consumer preferences. I think the changes are reflective of consumer’s attempts to make healthier choices.
3. I think this age range was very small which excluded many others who purchase foods and read food labels. It was not broad enough to include those who may really be able to contribute to the study. Different age groups are motivated by different health factors and possible financial burdens, prompting different motivations for label seeking. The study would have completely different results with inclusion of younger individuals who are recently grocery shopping for themselves and the elderly generation with different nutrient needs.
Stephanie,
I have since been trying to think about how to show causation rather than correlation and wondering what that study might look like. Perhaps a large sample of people who were separated into 2 groups. One group would be instructed to look at food labels of at least 5 items each time they shop. One given no instruction. Then compare if the group who looked at the food labels changed their shopping/eating behaviors. Of course there may be errors in self-report, but it still might provide evidence that simply looking at a food label caused a difference in behavior, or not. Also, a similar study might work for eating out. They might be asked to read the nutrition facts before ordering and then determine if there was altered food choices. I know seeing the calories on the Portillos menu was surprising to me.
Stephanie,
Like you, I also was wondering how the results of the study would differ had the researchers defined “frequent” differently. Additionally, in my post, I also mentioned the fact that many people read the nutrition label when they buy a product for the first time, but no longer evaluate the label when they go to purchase the item subsequently. Identifying this occurrence, and then better defining “frequent” could have provided more accurate results in the case of this study. I also wish this study would have included a broader age range, as they excluded the college-age and elderly populations. Further studies need to be conducted with these two key populations.
I was interested in your paragraph on how the information could be used to promote use of nutrition labels to those who currently are not using them. I have not heard of mentioning exercise equivalents on nutrition labels before. This is an interesting concept, and I wish to research it further.
Finally, you make a great point on the topic of nutrition label changes, when you state, “If consumers aren’t well informed that these are not recommendations, but common consumption amounts, I think it may actually increase the amounts of foods eaten.” I honestly had never considered this, but your hypothesis makes sense.
The first question asks, “As nutrition educators, should we collectively try to emphasize other parts of the label that were viewed less frequently?” I think that at this point, we should simply be worried about increasing the number of people who read nutrition labels, in general, rather than emphasizing parts of the label that are viewed less frequently. It worries me that this study found that only one third of the population are even looking at nutrition labels. I feel like increasing this percentage is what we need to be focusing on before altering nutrition labels.
Paige and Bonnie - I am 100% in agreement with you both that putting exercise equivalents on nutrition labels would likely be detrimental to individuals' relationships with food. And I think it would affect even those without a history of disordered eating patterns. Yes, food is fuel for movement and function, but it is so much more than that. I follow a few anti-diet and Health at Every Size (HAES) RDs and we often chat about how to balance intuitive eating with nutrition/wellness and how, for some, labels really do play a big role in what they choose to eat...but perhaps not necessarily for the right reasons. I think as RDs we need to encourage people to reflect on the motivations behind their eating and exercise patterns more - similar to the MI approach we have all learned in MNT.
Abby,
I also think it would be interesting to see how different age categories prioritized the items on the nutrition facts label. I wonder what would change for each decade of age. It makes me wonder if older generations would still focus on things like cholesterol and carbohydrates because there was such hype around these things years ago (similarly to what Jen said about her parents). It would also be interesting, like you said, to see when youth starts paying attention to nutrition labels as well as what caused them to pay attention to the label—because of parental use/influence, a nutrition class at school, a visit to a RD, media, etc.
Austin,
I thought you brought up a great point when talking about how people may only refer to the label of a particular item once or be more opt to compares prices of items over nutrition labels. Personally, the only time I really look at the label is when a new product catches my eye. There is little reason to continually look at the nutrition label of regularly purchased items. This also makes me wonder how the results of the study would change if the participants were of various socioeconomic statuses.
Abby,
I had the same thought as you when it came to ingredient lists being on the top of the list of frequently used nutrition label components. As you mentioned, the trend of "easy to read" or the "only buy what you know" when it comes to ingredients probably plays a huge role in this outcome. Additionally, the prevalence of food allergies may also have impacted this figure, as those with allergies must view the ingredient list to determine if a product contains allergens. Also like you, I would love to see this study done again after the number of people who use food labels increases above a third of participants. I also wish the study were done with a larger population. I think it is unfortunate that the study did not include both the college-age and elderly populations.
Rachel,
I agree with you that where client attention should be focused when reading a label needs to be customizable to disease state and nutrition goals. Aspects of the label will have greater importance for some more than others. I think current trends in labeling are reflecting this with the use of symbols indicating “gluten free,” “reduced sodium,” “kosher” and “heart healthy” with a simple small icon that can be quickly recognizable by those who have specific dietary choices or restrictions. Educating clients on what the symbols and claims actually mean, in addition to key factors to consider when making food choices will be an important part of counseling. Along with this I think it is important to remember to take into account what a client is willing and able to do and look for when making choices. It may not be reasonable to ask a client to look at four or five things on the label at first. Instead asking them to focus on one thing to make more conscience choices may be an important starting point.
Ally,
I think it is interesting as well that the group observed sugars more than carbohydrates. It would have been nice if the participants were also asked why they looked at those certain parts of the nutrition fact label. I agree that your guess of maybe some of them have had some diabetes/prevention education and maybe did not fully grasp that it is not just the added sugar part, which has influenced them to look at that area of the label. This study definitely needs to be completed with a wider age range and maybe even one with participants who either have diabetes or pre-diabetes. If this group also looks at just sugar the most, maybe the nutrition fact label needs to be made even clearer when it comes to carbohydrates.
Helena,
You brought up an interesting point with your observations of Americans and use of the nutrition facts label before you came to America and after you have been here (and read this study and others like it). Though places out of America are probably only seeing stereotypes via social media or movies, it still gives the idea that Americans do not care about their health. So yes, even though with studies like this one we can see that people are using the nutrition facts label, it would be a great study to see how the participants apply the information from the label. Finding out does the stereotype match how people actually use the information from the nutrition facts label would be beneficial for dietitians for how to continue working on educating use of the label in an individual and community setting.
Kirsten,
I like the point you made on the possibility of these three components of the food label being the most viewed by consumers because they are often the components most talked about in the media. I had not thought about the possibility that the other components are viewed less because they are the components that consumers are least educated on or least familiar with. I think this could be a possible explanation.
Jennifer,
I think you made a good point in saying that men, especially men who exercise, do often look at labels but that they look for different components. I agree with you and I think it would be interesting to complete another study like this comparing what men and women look for on labels. This would not have to be restricted to individuals that exercise, but that could be another avenue for research as well. Maybe then it would be easier to better answer this question of how we can improve label usage among men.
Katie,
I also wanted to know how this study would have differed had it included a broader age range. I know elderly people generally have more health problems and may look for key words like "sodium," but I do not think they were taught how to read a food label while in school like many of us were. As you mentioned, I also think that we should concentrate on teaching people how to read and comprehend nutrition labels first before recommendations. If someone does not know how to read a food label, it will be hard to even follow recommendations.
Bonnie,
I think that was a great point you made that correlation does not equate to causation, as you mentioned in relation to correlations like people who eating healthier tend to go to sit-down restaurants more frequently than the people who eat less healthy options. These can be interesting correlations to note, but we must be careful about how we interpret information.
Additionally, from some anecdotal interactions, I see where you're coming from in your speculation that "perhaps men are more likely to believe that if they exercise more, they can eat 'whatever they want.'" It would be interesting to find research about food and exercise attitudes and beliefs among different demographics (age, sex/gender, etc.) to see if there is any truth to that speculation. I think further qualitative research using thematic analysis has potential to provide some insight into common themes and differences among men and women and their nutrition beliefs and attitudes.
Jenn,
I too was surprised that calories were looked at less than sugars. With sodium’s presence in so many foods, I agree that there should be more education on sodium content. I think so many people over look this or are not aware of the potential hazards. it is difficult to avoid sodium due to the nature of consuming processed and prepackaged foods and the busy lifestyle that so many live today and education and awareness should be more prevalent. I personally noticed that when I tried to avoid the sodium in a can of cream of chicken for a recipe that the calorie content spiked up to make up for the flavor and when we are talking the new format of the labels, calories are most often looked at. I think it is a hard balance between sugars and sodium and looking at labels is so individualized based on personal needs, personal preference, dietary, or medically. I was surprised that the sample in the study was a little higher, causing me to wonder the education and/or priorities of this population.
Ally,
I also was surprised that calories were looked at less than sugars. I would agree with the new label’s update in thinking the general population has the most interest in total calories and serving sizes but I also wonder if we have been conditioned to do so with the push of society to lose weight and intake vs output. If we were taught mindful eating would serving size even be necessary? I agree that there has been somewhat of an increase in basic nutritional knowledge in the general public. With all of the diets out there and new ones appearing every day, I wonder how much of the label seeking is a push to be healthy or how much is a trend.
I agree that a scale based on frequency is a good representation of label use. You made a good point about not looking at food labels due to using the same or a similar product in the past and some foods not having labels, such as produce. When I think of my personal label use I mainly look at the label when it is a new product I am trying. You made some great points in your post!
Amy,
I did not think about why those components on the label would be the most frequently used, and I completely agree with your point of view; I would say that this is a world common characteristic on Nutritional Education. Looking back on my undergraduate curriculum, and the classes that were mandatory to take along with the syllabus contents of it, I can clearly see a pattern carried on for over 50 years (since the major of Nutrition in Brazil is fairly new) of analyze those components only. Definitely the effort of making a change on the relevance of other components present on the label is necessary and must be done in a community sense to improve the general population knowledge about nutrition aspect of what they are eating, encouraging a better nutritional choice and hopefully, like you mentioned, prevent some diet-related issues.
Paige,
I could not describe in a better way my concern of comparison between the food and exercises being on the label. Especially if you consider the general population knowledge about nutrition is not extensive to the biological need of for example calories to keep important organs functioning even in a rest state, usually their concern is connected to the number seen on the scale and how to reduce. One possible alternative of your suggestion of having someone at the gym that understand nutrition explaining to this population the importance of the label, and usage of exercises equivalents could be a tool on this program. The results on those interventions usually are beneficial, I used to work with a dietitian in Brazil going to the gym on rush hours and talking about nutrition with users; very often people who cannot afford an appointment with the dietitian were the most interested ones, and results of those educations were great to the dietitian - private appointment number increase -, to the users - on the next on duty time they would approach talking about results in short period of time with simple changes -, and to the general population - those people used to spread the knowledge among their social cycles increasing the number on private appointments indirectly too.
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