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ObjectivesSnacks contribute to overconsumption of energy-dense foods and thence obesity. Previous studies in this area are limited by self-reported data and small samples. In a large population-based cohort of parent–child dyads, we investigated how modification of pre-packaged snack food, i.e. (a) item quantity and variety, and (b) dishware (boxed container) size affected intake.MethodsDesign: Randomized trial nested within the cross-sectional Child Health CheckPoint of the Longitudinal Study of Australian Children, clustered by day of visit. Sample: 1299 11–12 year olds, 1274 parents. Exposure: 2 × 2 manipulation of snack box container size and item quantity/variety: (1) small box, few items, (2) large box, few items, (3) small box, more items, (4) large box, more items. Procedure: Participants received a snack box during a 15 min break within their 3.5 h visit; any snacks remaining were weighed. Outcomes: Consumed quantity (grams) and energy intake (kilojoules). Analyses: Unadjusted linear regression.ResultsChildren who were offered a greater quantity and variety of snack items consumed considerably more energy and a slightly higher food mass (main effect for energy intake: 349 kJ, 95% CI 282–416, standardized mean difference (effect size) 0.66; main effect for mass: 10 g, 95% CI 3–17, effect size 0.17). In contrast, manipulating box size had little effect on child consumption, and neither box size nor quantity/variety of items consistently affected adults’ consumption.ConclusionIn children, reducing the number and variety of snack food items available may be a more fruitful intervention than focusing on container or dishware size. Effects observed among adults were small, although we could not exclude social desirability bias in adults aware of observation.

The paper aims to identify selected predictors of food label use to extend our knowledge about consumer behavior related to food purchases. Two types of information were examined: front-of-package (FOP) and back-of-package (BOP), and two contexts of reading labels were distinguished: during shopping and at home. Various types of potential predictors were tested, including demographic (e.g., age, gender, household size, place of living), socioeconomic (e.g., education, professional activity, income), behavioral (e.g., purchasing certain types of products), and psychographic (e.g., importance attached to various types of information) criteria. The survey was conducted with the use of the CAWI (Computer-Assisted Web Interviews) methodology in a sample of 1051 Polish consumers. Quota sampling was applied based on sex, age, education, place of living (urban vs. rural), and region. Descriptive statistics, t-tests, ANOVAs, Pearson correlation coefficients, and multiple and retrograde step regressions were applied. In retrograde step regression models, only one predictor (self-rated knowledge about nutrition healthiness) turned out to be significant for all four measures of label reading. The remaining predictors were specific to selected measures of reading labels. The importance of the information about the content of fat and that about the health effects of consuming a food product were significant predictors of three types of food label use. This study confirms the necessity to investigate reading labels in fine-grained models, adapted to different types of labels and different contexts of reading. Our results show that demographic or socioeconomic variables are not significant predictors of reading food labels for a large group of Polish consumers.

To characterise children's lunchbox contents for food, waste and packaging. A cross-sectional study was conducted. Lunchboxes were photographed at two time points on the same day: before first morning break to capture food and packaging and post-lunch break to capture food waste. Contents were coded using an audit tool developed using REDCap. Twenty-three sites across metropolitan Adelaide, South Australia including fourteen preschools and nine primary schools in low ( 8), medium ( 7) and high ( 8) socioeconomic areas. Preschool (ages 3-5 years) to Grade 7 primary school (ages 6-13 years) students. 673 lunchboxes were analysed. Grain foods dominated (with at least half of them being discretionary varieties), with 92 % of lunchboxes having at least one item from that category, followed by fruits (78 %), snacks (62 %), dairy (32 %) and vegetables (26 %). Lunchboxes of preschool children contained more fruits (92 % . 65 %; χ2(1) = 73·3, < 0·01), vegetables (36 % . 16 %; χ2(1) = 34·0, < 0·01) and dairy items (45 % . 19 %; χ2(1) = 53·6, < 0·01), compared to lunchboxes of primary school children. Snack foods were more prevalent in primary school (68 %) than preschool (55 %; χ2(1) = 11·2, < 0·01). Discretionary foods appeared more frequently, and single-use packaging accounted for half (53 %) of all packaging in lunchboxes, primarily from snacks and grain foods. Preschool children had less single-use packaging but more food waste. Vegetables were the most wasted food group. Sandwiches, fruits and various snacks are typical lunchbox foods, often accompanied by single-use packaging. Considering both health and environmental factors in lunchbox choices could benefit children and sustainability efforts in schools.

ObjectivesRural residents face unique challenges that contribute to poor diet quality and health. The objective of this study was to assess diet quality using the Alternative Healthy Eating Index (aHEI) among residents of a rural New York county with poor health outcomes, and identify geographic and individual-level factors associated with lower diet quality.DesignWe performed a cross-sectional study using survey data and multivariable linear regression analyses, supplemented by geographic distribution assessment of aHEI scores.SettingSullivan County, New York, a rural county with poor health outcomes.ParticipantsHouseholds in Sullivan County who responded to a dietary and sociodemographic health survey in 2021–2022.Outcome measuresThe primary outcome was the aHEI score and its dietary subscores. Secondary measures included sociodemographic characteristics, receipt of income assistance, financial hardship, food and housing insecurity, primary food store type, distance to food store and frequency of canned or plastic-wrapped food consumption.ResultsThe overall survey response rate was 42.5%. The mean aHEI score was 56.5 (SD: 11.9), normally distributed across respondents. Lower aHEI scores were associated with not completing high school (10.0 points lower vs college graduates, p<0.01), reporting a disability (3.5 points lower, p<0.01), experiencing food insecurity (3.0 points lower, p<0.01) and frequent consumption of canned foods (6.2 points lower compared with those who never consumed canned foods, p<0.01). Geographic analysis revealed clustering of predictors but no substantial geographic clustering of aHEI scores.ConclusionsPoor diet quality in rural areas is associated with education level, disability, food insecurity and canned food consumption. These findings highlight potentially modifiable risk factors and support the need for targeted interventions to improve diet quality and reduce health disparities in rural populations.

Background Nigeria is experiencing a growing burden of diet-related non-communicable diseases, particularly hypertension and cardiovascular disease, largely driven by high sodium intake and poor diet quality. Unhealthy dietary patterns characterized by excessive sodium, sugars, and unhealthy fats, and low intake of essential nutrients contribute to approximately 31% of global deaths annually. However, there is limited data on the sodium content and nutritional quality of foods in Nigerian markets. This study assessed and compared the availability, healthiness, and sodium content of packaged and unpackaged foods in Nigerian markets. Methods From August 2022 to December 2022, we collected and compared nutrition data on packaged and unpackaged foods from 35 outlets across three states in Nigeria. Data collection utilized the Food Switch Data Collector App. Healthiness was assessed using the Health Star Rating (HSR) system, which rates products from 0.5 (least healthy) to 5 stars (most healthy) based on their nutritional profile. Statistical analysis included descriptive statistics for packaged/unpackaged foods, calculating mean health star rating values and comparing them using Welch’s t-test, and analyzing sodium content using descriptive statistics and Mann-Whitney U tests. Results Packaged foods and beverages ( n  = 6636) were more available than unpackaged foods ( n  = 507). Overall, unpackaged foods had a higher mean HSR than packaged foods (4.6 vs. 3.4, p  < 0.001). Packaged meat and meat alternatives had significantly higher sodium (760.0 mg/100 g, IQR 560.0) compared to unpackaged (74.0 mg/100 g, IQR 45.0) ( p  < 0.001). Conclusions Packaged foods and beverages in Nigeria were less healthy and contained higher sodium levels than unpackaged foods. To encourage healthier diets, the Nigerian government should implement policies such as reformulation and front-of-pack nutrition labeling to improve the healthiness of packaged foods.

Optimal nutrition in early childhood fosters growth and development whilst preventing morbidity and mortality in later life. There is little research in New Zealand on commercially available complementary foods (CACFs). This cross-sectional study of the nutritional aspects and packaging of CACFs used data collected in four major supermarket chains in New Zealand in 2019 (Nutritrack). Of the 197 CACFs analysed, 43 (21.8%) were inappropriately recommended for consumption by children four months of age or older, 10 (5.1%) had added salt, and 67 (34.0%) contained free sugars. The majority (n = 136, 69.0%) contained ingredients with a sweet flavour. Relatively sweet vegetables like carrot and sweetcorn were used more often than bitter vegetables such as broccoli and spinach. The described texture of most (n = 145, 62.1%) wet ‘spoonable’ products was of the lowest complexity (smooth, puréed, custard). CACFs would adequately expose children to cow’s milk and wheat but not to other common food allergens (cooked hen’s egg, soy, fish, crustacean shellfish, peanut, and tree-nuts). If children’s diets include CACFs, non-commercial meals must be offered as well in order to meet nutritional guidelines related to the introduction of common food allergens, diversity of flavours, and complex textures for infants and toddlers.

Little is known about the healthfulness and cost of gluten-free (GF) foods, relative to non-GF alternatives, in Canada. This study compared the extent of processing, nutritional composition and prices of Canadian products with and without GF claims. Data were sourced from the University of Toronto Food Label Information Program (FLIP) 2013 (n = 15,285) and 2017 (n = 17,337) databases. Logistic regression models examined the association of NOVA processing category with GF claims. Calorie/nutrient contents per 100 g (or mL) were compared between GF and non-GF products. Generalized linear models compared adjusted mean prices per 100 g (or mL) of products with and without GF claims. The prevalence of GF claims increased from 7.1% in 2013 to 15.0% in 2017. GF claims appeared on 17.0% of ultra-processed foods, which were more likely to bear GF claims products than less-processed categories. Median calories and sodium were significantly higher in GF products; no significant differences were observed for saturated fat or sugars. Compared to non-GF products, adjusted mean prices of GF products were higher for 10 food categories, lower for six categories and not significantly different for six categories. Overall, GF claims are becoming increasingly prevalent in Canada; however, they are often less healthful and more expensive than non-GF alternatives, disadvantaging consumers following GF diets.

Packaging materials can be a source of chemical contaminants in food. Process-based migration models (PMM) predict the chemical fraction transferred from packaging materials to food (FC) for application in prioritisation tools for human exposure. These models, however, have a relatively limited applicability domain and their predictive performance is typically low. To overcome these limitations, we developed a linear mixed-effects model (LMM) to statistically relate measured FC to properties of chemicals, food, packaging, and experimental conditions. We found a negative relationship between the molecular weight (MW) and FC, and a positive relationship with the fat content of the food depending on the octanol-water partitioning coefficient of the migrant. We also showed that large chemicals (MW > 400 g/mol) have a higher migration potential in packaging with low crystallinity compared with high crystallinity. The predictive performance of the LMM for chemicals not included in the database in contact with untested food items but known packaging material was higher (Coefficient of Efficiency (CoE) = 0.21) compared with a recently developed PMM (CoE = −5.24). We conclude that our empirical model is useful to predict chemical migration from packaging to food and prioritise chemicals in the absence of measurements.

Background Extensive work has focused on the effects of nutrition label information on consumer behavior on the one hand, and on the effects of packaging graphics on the other hand. However, little work has examined how serving suggestion depictions - graphics relating to serving size - influence the quantity consumers serve themselves. The current work examines the prevalence of exaggerated serving size depictions on product packaging (study 1) and its effects on food serving in the context of cereal (study 2). Methods Study 1 was an observational field survey of cereal packaging. Study 2 was a mixed experimental cross-sectional design conducted at a U.S. university, with 51 student participants. Study 1 coded 158 US breakfast cereals and compared the serving sizes depicted on the front of the box with the suggested serving size stated on the nutrition facts panel. Study 2 measured the amount of cereal poured from exaggerated or accurate serving size depictions. Study 1 compared average servings via t-tests. Study 2 used a mixed model with cereal type as the repeated measure and a compound symmetry covariance matrix. Results Study 1 demonstrated that portion size depictions on the front of 158 cereal boxes were 64.7% larger (221 vs. 134 calories) than the recommended portions on nutrition facts panels of those cereals. Study 2 showed that boxes that depicted exaggerated serving sizes led people to pour 17.8% more cereal compared to pouring from modified boxes that depicted a single-size portion of cereal matching suggested serving size. This was 42% over the suggested serving size. Conclusions Biases in depicted serving size depicted on cereal packaging are prevalent in the marketplace. Such biases may lead to overserving, which may consequently lead to overeating. Companies should depict the recommended serving sizes, or otherwise indicate that the depicted portion represents an exaggerated serving size.

Canadians’ food purchases consist largely of packaged processed and ultra-processed products, which typically fall outside the “core” foods recommended by Canada’s Food Guide (CFG). Almost half of packaged products in Canada carry nutrition marketing (i.e., nutrient content and health claims). This study assessed whether packaged foods carrying nutrition marketing align with recommendations outlined in the 2007 CFG. Label data (n = 9376) were extracted from the 2013 Food Label Information Program (FLIP). Label components (including nutrition marketing) were classified using the International Network for Food and Obesity/NCDs Research, Monitoring and Action Support (INFORMAS) labelling taxonomy. The Health Canada Surveillance Tool (HCST) was used to assess the alignment of products to CFG. Each food or beverage was classified into one of five groups (i.e., Tier 1, Tier 2, Tier 3, Tier 4, “Others”). Products in Tier 1, 2 or water were considered “in line with CFG”. Most products in the analyzed sample were classified as Tier 2 (35%) and Tier 3 (27%). Although foods with nutrition marketing were significantly more likely to align to CFG recommendations (p < 0.001), many products not “in line with CFG” still carried nutrition marketing. This study provides important baseline data that could be used upon the implementation of the new CFG.