CARDIFF METROPOLITAN UNIVERSITY CARDIFF SCHOOL OF ..., Study Guides, Projects, Research of Nutrition

Download CARDIFF METROPOLITAN UNIVERSITY CARDIFF SCHOOL OF ... and more Study Guides, Projects, Research Nutrition in PDF only on Docsity! Student Number:20074266 1 CARDIFF METROPOLITAN UNIVERSITY CARDIFF SCHOOL OF HEALTH SCIENCES DEPARTMENT OF HEALTHCARE SCIENCES AND FOOD BSc (Hons) Public Health Nutrition Dissertation Academic Paper Title: Do consumers use Front of Pack labelling to make healthier food choices? Chloe Knorz Student Number: 20074266 2017 Supervisor: Shirley Hinde Word Count: 5155 Student Declaration In Respect of Individual Work I declare that the whole of this work is the result of my individual effort and that all quotations from other authors have been acknowledged. Dissertation submitted in partial fulfillment of the requirements of Cardiff Metropolitan University for the Degree of Bachelor of Science with Honours. Signed : Chloe Knorz Date: May 2017 Student Number:20074266 2 Table 1: Most frequent circumstances participants claim to use FOP labels in. Circumstance No. of participants Choosing readily prepared lunch options 28 Shopping for myself 26 Shopping for my family 14 Shopping for my children 4 *24% of participants (n=12) selected two answers for this question Table 2: Participants perception of the meaning behind the coloured sectors used in TLL. Colour Sector Theme Quote Amber Average or medium n=33 “Salt level is medium against daily allowance…” (ID15). “...medium amount of salt in the product….” (ID19). Green Healthy n=47 “...a healthier percentage of your daily intake of something” (ID27). “Healthy levels of a substance” (ID4). Do consumers use Front of Pack labelling to make healthier food choices? Knorz, C and Hinde, S. Centre of Nutrition and Dietetics, Cardiff, Metropolitan University Cardiff, CF5 2YB Contact: Hinde, S. E-mail: [email protected] Background Strong evidence exists which links dietary intake and health. The 2015 Health Survey for England revealed 62.9% of adults were obese or overweight. This increases the need for strategies to support consumers making healthier choices. Watson et al (2014) claim easily accessible and consistent nutritional information on front of pack (FOP) labels can encourage consumers to make healthier food choices when shopping. Two key FOP formats used are Traffic Light Labelling (TLL) and Reference Intake (RI). RI’s are a current, adapted format of the discontinued Guideline Daily Amount (GDA) format. This study aimed to gain an understanding of consumers perception and use of FOP labelling. Methods An online, cross sectional questionnaire was designed using Qualtric's survey software. The questionnaire link was distributed via the researcher's social media page. The questionnaire explored;  Consumers understanding of TL colours  Consumers understanding of RI  Circumstances when FOP are used  Consumers opinions on clarity of FOP formats Results The response rate was 49. Participants were predominately female (84%). The most frequent age group was 18-25 years old (n=22). Results showed 33% of participants (n=16) claim to “Always” use FOP labels. Ninety two percent (n=45) indicated that they knew what RI meant. The theme “Average recommendation” was cited by n=42. e.g “The amount of a substance that is suggested for an average healthy adult in a day” (ID19). A total of 84% of participants (n=41) revealed they felt more information on how to use FOP labelling needs to be provided to the general public. Participants overlapped when asked to express the aspects of FOP labelling which are clear and the aspects that lack clarity. For example, 26% of participants (n=12) reported the “Percentages” as being unclear, whilst 9% (n=4) claimed that percentages were a clear aspect. Discussion and Conclusion This study found that the majority of the participants demonstrated a basic understanding of how to use the TLL. Kelly and colleagues (2009) state the TLL format was the most effective format for assisting participants in making healthier food choices. Participants expressed less confidence with RI's, partly because of the use of percentages. GDA’s were reported as being misunderstood by consumers, which corresponds with previous research stating 47% of adults find simple percentages difficult to grasp (Lobstein et al. 2007). Findings supported the need to change from GDA's to RI's. In conclusion, this study reinforces the need for further information to be provided to the general public, on how to use FOP labels to assist with healthier food purchases. Providing the public with further information could increase the frequency of FOP label use and in turn benefit the health of the the general public. References Kelly. B., Hughes. C., Chapman. K., Chun-Yu J., Dixon. H., Crawford. J., King. l ., Daube. M. and Slevin. T. (2009). “Consumer Testing of the Acceptability and Effectiveness of Front-of-Pack Food Labelling Systems for the Australian Grocery Market.” Health Promotion International 24:120-129. Available at: https://www.ncbi.nlm.nih.gov/pubmed/19336501 (Accessed: 2nd March 2017). Lobstein. T, Landon. J, Lincoln. P, Ash. R and Press. V. 2007. “Misconceptions and misinformation: The problems with Guideline Daily Amounts (GDAs)”. Available at: http://nhfshare.heartforum.org.uk/rmassets/reports/nhfgdareport.pdf (Accessed: 27th February 2017). Public Health England. 2017. “UK and Ireland prevalence and trends”. Available at: https://www.noo.org.uk/NOO_about_obesity/adult_obesity/UK_prevalence_and_t rends (Accessed: 1st March 2017). Watson. L, Kelly. B, Hector. D, Hughes. C, King. L, Crawford. J, Sergeant. J and Chapman. K. 2014. “Can front of pack labelling schemes guide healthier food choices? Australian shoppers’ responses to seven labelling formats”. Science Direct. Available at: http://www.sciencedirect.com/science/article/pii/S0195666313004091 (Accessed: 13th February 2017). Student Number:20074266 5 (Feunekes et al. 2008). However, the most commonly recognized formats which are used within the UK are the Traffic Light (TL) format and Reference Intake (RI). Figure 1: Example of a Traffic Light Labelling Format. According to The Faculty of Public Health (2008), the TL allow consumers to compare two products quickly and encourages them to select healthier food choices. Consumers are encouraged to choose products which contain more green and amber sectors than red traffic sectors (The Faculty of Public Health. 2008). Scarborough et al (2015) conducted an online food choice study which revealed that consumers focused more on avoiding foods containing the red traffic light than choosing foods which were represented by green traffic lights. Thus, this implies the participants had a basic understanding of what the colour coding represented. Figure 2: Example of the Reference Intake Format combined with Traffic Light Format. RI’s refer to quantitative estimates of nutrient intakes which are used for structuring and assessing the diets of average sized, healthy adults (National Academy of Sciences. 1998). The RI’s on FOP labels are displayed using percentages. RI’s replaced the discontinued Guideline Daily Amount (GDA) format, however the rationale behind how the values are determined remains the same (Food Label.org. 2016). GDA’s have been criticized by Lobstein et al (2007) due to GDA’s being based on the Student Number:20074266 6 portion size of the individual food product. Portion sizes vary between manufacturers and therefore GDA’s are eligible for causing consumer confusion when attempting to compare two similar products to assess which is healthier. In addition to this, the Faculty of Public Health (2008) state GDA labelling as being misleading due to consumers misinterpreting GDA’s as daily targets instead of a limit which should not be exceeded. Therefore GDA’s were discontinued and RI’s became the current, adapted version with the hope of consumers interpreting RI’s as a reference to assist with dietary choices and not as a target. Demographics. Research conducted by the International Food Information Council (IFIC) Foundation discovered that only 4% of their participants claimed to “never” use food labels to assess the nutritional content of the product (Borra. 2006). Therefore this suggests that consumers do use the FOP labelling information to seek out the information that they require. One of the characteristics which has been linked to being more likely to use food labels to aid healthier food choices is being female (Guthrie et al. 1995). Campos, Doxey and Hammond (2011) state that multiple studies have shown that the age range covering young adults to middle aged adults are more likely to use food labels than older adults. Drichoutis, Lazaridis and Nayga (2006. cited in Arslanagic, Pestek and Kadic-Maglajlic. 2013) further these findings by claiming that food label use varies by gender, age and educational background. Conclusion. Significant evidence states that consuming a healthier dietary intake can reduce an individuals risk of suffering from obesity or nutrition related diseases. FOP labelling provides the relevant information a consumer requires, to aid the comparison of food products and allow for healthier options to be purchased. The two most common FOP labelling formats, the TL and RI, have the ability to help consumers achieve a healthier dietary intake when used correctly. The aim of this study will be to; 1. Gain an understanding of whether consumers understand and use FOP labelling to make healthier food choices. It is hoped that the aim of this study will be achieved through devising an online questionnaire, which specifically focuses on the use of the two FOP formats previously discussed. Student Number:20074266 7 Methodology. A cross sectional study was conducted using an online questionnaire focusing on consumers use of FOP labels. Participants. The link for the questionnaire was posted on the researcher’s social media page. This gave members of the general public the choice of anonymously completing the questionnaire. Those who did complete the questionnaire formed the study’s participants. The participants were required to be eighteen years old or above in order to meet with ethical standards due to parental consent being required for children under the age of eighteen (European Union Agency for Fundamental Rights. 2014). This requirement was approved by the Ethics Panel for School of Health Sciences, Cardiff Metropolitan University preparatory to the commencement of data collection (See Appendix 1). Materials. Data collection took place in the form of an online questionnaire (See Appendix 3). The questionnaire was developed using a survey programme known as Qualtric’s (Qualtric’s Survey Software) which is supported by Cardiff Metropolitan University. The development of an online questionnaire allowed for there to be minimal financial implications for the researcher, in comparison to the cost of developing and distributing a postal questionnaire (Ilieva, Baron and Healey. 2002). Subsequent to the formation of the questionnaire, the survey software enabled the researcher to activate and post the link for the questionnaire on the researcher’s social media page. All responses the software received came through anonymously. It was important to guarantee the participants anonymity as this optimizes the chance of respondents (Kings and Miles. 1995. cited in Ilieva, Baron and Healey. 2002). Reasoning for this could be anonymity relieves the respondent from the pressure of providing the “correct” answer, instead of sharing the true level of understanding they have. Therefore, ensuring the questionnaire was anonymous and that this was stated within the Participant Information Sheet (See Appendix 2) would benefit both the response rate and the validity of the results obtained. The first section of the questionnaire was designed to capture the demographic of the participants, using basic questions referring to the gender and age of each participant. Following this, the second section of the questionnaire focused on the TL labelling on FOP labels. Images of food labels were given and participants were required to answer true or false questions regarding the healthiness of the given product. In order to gain a more in depth incite of participants understanding of TL labelling, participants were also asked qualitative questions. These required Student Number:20074266 10 However, there was an element of misunderstanding with both of these questions. Respondents explained what nutrient categories the colours were referring to on the given labels, instead of explaining what each colour represents as a general concept for FOP labels. For example, one quote received for the colour green was; “2 types of fats: saturated and unsaturated”(ID5). To confirm participants understanding of FOP, they were asked to identify whether the images in Table 1 below relate to the statement given to each of them. Participants were required to answer using true or false. The results for Image A showed 63% (n=31) of participants, claim that the statement given was false. Results for Image B showed the majority of participants decided that the given statement was false (92%) (n=45). Table 1: Image A and Image B. Images. Image Given Statement Given A Unhealthy food choice. B Healthy food choice. When given a scale to select their level of understanding of the FOP images previously provided (Table 1 above), the categories most frequently selected were 4 and 5. Indicating that participants felt they had a clear understanding of the FOP labels provided (See Figure 2 below). Student Number:20074266 11 Figure 2: Scale to show participants understanding of previous images used in questionnaire. Participants were required to explain their reasoning for the answer they provided on the scale above. The themes identified from the answers can be seen in Table 2 below. Table 2: Reason for answer provided on scale in previous question. Theme Quote ID number General Understanding n=11 “I think I have a moderate knowledge by am not 100%”. ID21 Contents of food n=12 “There are a lot of people with health issues or special dietary requirements and thus information is very important”. ID27 Recommended Intake n=4 “... it helps them give an indication of a recommended serving and nutritional information”. ID33 Colour Coding n=7 “The traffic light system makes it easier for consumers to make healthier options” ID47 Difficult to understand n=7 “I think the images on food/drinks packaging are recognised, but not always fully understood…” ID18 Student Number:20074266 12 Understanding of the term Reference Intake (RI) was explored, with 92% (n=45), indicating that they knew what RI meant. Table 3 shows the general categories found within the answers. Table 3: Categories formed from participants perception of RI. Category Quote ID number. Average Recommendation n=42 “The amount of a substance that is suggested for an average healthy adult in a day”. “What the average adult should eat a day” “Your daily allowance recommendation” ID19 ID10 ID22 Healthy n=1 “To have a healthy diet”. ID20 Portion Size n=1 “How big the portion should be”. ID3 Participants were asked to select from the options provided to reveal their use of FOP labels. Results showed 33% participants (n=16) claimed to always use food labelling formats to aid their product choices (See Figure 3 below). Figure 3: Use of food labels. When asked to specify the circumstances in which they use food labels, results revealed the majority of participants 58% (n=28) use FOP when selecting readily prepared lunch options (See Figure 4 below). Student Number:20074266 15 Table 7: Negative aspects of FOP labels. Theme Quote ID Portion Size n=8 “Portion sizes don’t tend to be representative of what people will actually consume and so can be quite misleading” ID35 Percentages n=12 “The %...i feel would be tricky for some people to understand”. ID20 Student Number:20074266 16 Discussion. The aim of this study was to gain an understanding of whether consumers understand and use FOP labelling to make healthier food choices. The questionnaire devised focused on the participants understanding of TLL aspect and RI’s.The study had limitations which were not realised before the data collection process commenced. The researcher was unaware of an option within the Qualtric’s survey software which ensured participants could only select one answer per question. Therefore the results received for one question showed many participants chose multiple answers which may of limited accuracy of the results received. Additionally, the option to make all questions mandatory was not selected and therefore it was possible for participants to choose to refrain from answering a question. This had to be taken into consideration when analysing the results received. As the questionnaire was released via the researcher’s social media, the majority of the responses received were from participants within a similar age category and demographic to the researcher. This limit’s the diversity of the results received. The gender response rate was significantly disproportionate, with only 16% of participants being male (n=8). Previous research carried out by Freire et al (2016) stated that females admitted to using food labelling formats to make healthier food choices more consistently than males. The results showed a similar pattern, with 24% (n=12) females declaring that they “Always” use FOP labels to help make healthier food purchases. Only 8% (n=4) males selected the “Always” option. Furthering this, 31% (n=15) females selected the option “Half the time”, in comparison to 0% of males (n=0). However an independent unpaired t-test showed no significant relationship between FOP label use and gender (p0.810, t-0.241 and df 46). Full SPSS independent t-test ouput can be seen in Appendix 4. Interestingly, the most frequently chosen circumstances in which participants claimed to use food labels was when choosing a readily prepared lunch product (n=28) and when shopping for themselves (n=26). Which suggests members of the public are interested in finding out the contents within their food choices. FOP labelling was designed to allow consumers to examine the components of readily prepared food. This is consistent with the survey results as it is the most frequent circumstance participants use FOP labels. However, 24% (n=12) of participants selected two answers for this question,which could reduce the viability of the findings. Participants reasons for using FOP labels compare to research conducted by Malam et al (2009). Participants use FOP labels when shopping for their children, comparing multiple products and when trying to reduce specific nutrients e.g salt (Malam et al. 2009). Research also implies that the most important factors to consumers when purchasing food products are taste and cost, with nutritional considerations following after these (Glanz et al. 1998). Student Number:20074266 17 Therefore participants may withhold from using FOP labelling due to using alternatives motivations to make decisions such as cost. This is an area which could be focused on within future research. Scarborough et al (2015) concluded that participants within their study were more focused on avoiding food products with red sectors, than choosing food products because of their green sectors. This could be due to a misunderstanding of what the TLL represents and how it should be used within the general public. This compares to the qualitative result achieved when asking participants to explain what the amber colour represents within TL FOP label. The qualitative question revealed the theme of “High” being cited by 17% of participants (n=8). For example, “Negative effects” (ID3). “Dangerously high” (ID4). This suggests participants may have a misunderstanding of the general concept of amber colour coding. To compare, when asked about what the green colour coding meant on the food label, 96% of participants (n=47) provided answers which formulated the theme “Healthy”. For example, “There is a healthier percentage of your daily intake of something” (ID27). This demonstrates a clear recognition of the positive meaning behind green TL coding. This could be due to the participants association with the traffic light system in other aspects of their life, specifically driving; where the colour green represents it being safe to proceed (Department for Transport. 2007). When given an example of the TL on a food label, 98% of participants claimed to recognise the format. However due to the result previously discussed, there may be limitations within the general public’s level of understanding of the representation of the amber traffic light. Temple and Fraser (2014) suggest an additional traffic light should be added to display the overall healthiness of the food product.Therefore this study has highlighted the requirement for future research, to focus on the understanding of each of the three colour coded sectors individually to gain clearer evidence of understanding of the entire TLL format. When deciding if the statement given claiming Image A was an unhealthy food choice was true or false, 63% (n=31)of participants selected “False”. The TL sectors for Image A showed four green sectors and one amber sector for Sugar. Therefore, the majority of the participants were able to recognise that this food choice would be an acceptable, healthy choice to make. Comparatively, Roberto et al (2012. cited Student Number:20074266 20 In conclusion, the majority of the results that were obtained within this study coincide with previous research conducted on FOP labelling. This study reinforced the need for further provision of information which demonstrates how the FOP labelling formats have been designed to assist the public’s food choices. It is essential that this information is delivered to the public more specifically, through health promotion campaigns and is readily available on reliable websites. Allowing the general public to achieve a better understanding or demolish any confusion that previously existed. Participants were familiar with and able to use basic parts of the FOP formats to distinguish between healthier food choices, however they revealed the desire for further information to be provided to them in the future. Student Number:20074266 21 References. Arslanagic. M, Pestek. A. and Kadic-Maglaklic. S. 2013. “Perceptions of Healthy Food Packaging Information: Do men and women perceive differently?” Available at: http://www.sciencedirect.com/science/article/pii/S1877042813050556 (Accessed: 12th February 2017). Balcombe. K, Fraser. I and Salvatore. D.F. 2010. “Traffic lights and food choice: A choice experiment examining the relationship between nutritional food labels and price”. Available at: http://www.sciencedirect.com/science/article/pii/S0306919210000126 (Accessed: 27th February 2017). Borra. S. 2006. “Consumer perspectives on food labels”. Available at: http://ajcn.nutrition.org/content/83/5/1235S.full (Accessed: 3rd March 2017). Boztug.Y, Juhl. HJ, Elshiewy. O, et al. 2012. “Are consumers influenced in their food choice by health labels?” In Proceedings of the 41st EMAC Conference: 22 – 25 May 2012, Lisbon, Portugal.Available at: http://www.emac2012.org/userfiles/emac2012_conferenceproceedings_final%20m ay%2017.pdf (Accessed: 2nd March 2017). Brimelow. A. 2007. “Public want food “traffic lights”. BBC News. Available at: http://news.bbc.co.uk/1/hi/health/6397187.stm (Accessed: 8TH April 2017). Campos. S, Doxey. J and Hammond. D. 2011. “Nutrition labels on pre-packaged foods: a systematic review”. Available at: https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S1368 980010003290 (Accessed: 3rd March 2017). Department for Transport, 2007, “Know your traffic signs”. Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/51 9129/know-your-traffic-signs.pdf Page 119. (Accessed: 8th February 2017) Ducrot. P, Julia. C, Mejean. C, Touvier. M, Fezeu. K.L, Hercberg. S and Peneau. S. 2016. “Impact of Different Front-of-Pack Nutrition Labels on Consumer Purchasing Intentions: A Randomized Controlled Trial”. American Journal of Preventative Medicine, Volume 50, Issue 5, Pages 627-636. Available at: http://www.sciencedirect.com.ezproxy.cardiffmet.ac.uk/science/article/pii/S074937 9715007242 (Accessed: 6th February 2017). European Union Agency for Fundamental Rights. 2014. “Child participation in research”. Available at: Student Number:20074266 22 http://fra.europa.eu/en/theme/rights-child/child-participation-in-research (Accessed: 14th February 2017). Feunekes.I.G, Gortemaker.A.I, Willems. A.A, Lion. R and van den Kommer. M. 2008. “Front-of-pack nutrition labelling: testing effectiveness of different nutrition labelling formats front-of-pack in four European countries.” Available at: https://www.ncbi.nlm.nih.gov/pubmed/17629351 (Accessed: 1st March 2017). Freire. W, B, Waters. W. F, Rivas-Marino.G, Ngyuyen. T and Rivas. P. 2016. “A qualitative study of consumer perceptions and use of traffic light food labelling in Ecuador.” Available at: https://www.ncbi.nlm.nih.gov/pubmed/27618994 (Accessed: 12th February 2017) Food Label. Org. 2016. “Reference Intakes (Previously Guideline Daily Amounts)”. Available at: http://www.foodlabel.org.uk/label/reference-intakes.aspx (Accessed: 23rd March 2017). Gregori. D, Ballali. S, Vögele. C, Gafare. CE, Stefanini. G and Widhalm, K. 2013. “Evaluating food front-of-pack labelling: a pan-European survey on consumers' attitudes toward food labelling.” Available at: https://www.ncbi.nlm.nih.gov/pubmed/24224854 (Accessed: 29th February 2017). Glanz. K., Basil. M., Maibach. E., Goldberg .J. and Snyder. D. 1998. “Why Americans Eat What They Do: Taste, Nutrition, Cost, Convenience, and Weight-control Concerns as Influences on Food Consumption.” Journal of the American Dietetic Association 98: 1118-1126. Available at: https://www.ncbi.nlm.nih.gov/pubmed/9787717 (Accessed: 3rd March 2017). Guthrie.F. J, Fox.J. J, Cleveland.E. L and Welsh. S. 1995. “Who uses nutrition labeling, and what effects does label use have on diet quality?”. Available at: http://www.sciencedirect.com/science/article/pii/S0022318212804225 (Accessed: 3rd March 2017). IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp. (Accessed: 15th March 2017). Ilieva. J, Baron. S and Healey. M. N. 2002. “Online surveys in marketing research: pros and cons”. Available at: http://www.academia.edu/605579/Online_surveys_in_marketing_research_pros_an d_cons (Accessed: 15th February 2017). Kelly. B., Hughes. C., Chapman. K., Chun-Yu J., Dixon. H., Crawford. J., King. l ., Daube. M. and Slevin. T. (2009). “Consumer Testing of the Acceptability and Effectiveness of Front-of-Pack Food Labelling Systems for the Australian Grocery Market.” Health Student Number:20074266 25 Appendices. 1. Ethical Approval Letter 2. Participant Information Sheet 3. Hard Copy of Research Tool - Questionnaire 4. Raw Data Appendix. 26 Student_Number:20074266 Candi? ther tout Carripal Wednesday, 30 November 2016 cahs/ethics /appioved special cords! Kitare, Chae Anghered BSc Public Health Nutrition Cardiff School of Health Sciences Dear Applicant Re: Application for Ethical Approval: Do consumers use the front of pack labelling to make healthier food choices? Project Reference Number : 8513 Your ethics application, asshown above was considered by the Health Care and Food Ethics Panel on 30/14/2016. | am pleased ta inform you that your apolication for ethical approval was APPROVED, subject to the conditions fisted belaw — please red carefully. 3 Conditions of royal L Clarify data destruction after exam board Pizase confirm by email to HCFETHICS @eardifimet.ac.uk thet you understand the “special conditions of approvel® and that where changes to the information sheet, consent form and/or procedures are deemed necessary, these Nave teen carried out as requested. If you sre. a student — your supervisor must do this Standard Con: ns of Approval: 1. Your Ethics Application naz been given 2 Project Reference number ss =bove This MUST be quoted on sil documentation relating te the aroject (Eg. consent forms, information sheets), together with the full project title " All documents cust also have the approved University Logo and the Version number in addition to the reference and project title as above 3. A full Risk Assessment must be undertaken for tnis proposal, as appropriate, and be made svailableta the Committee if requested 4. Any changes in connection to the proposal as approved, muzt be referred ta the 27 Student_Number:20074266 aS = Calelaeeiaiaeiataiehianay Panel/Committee for consideration without delay quoting your Project Reference Number. Changes to the proposed project may have ethical implicstions so must be approved 5. Any Untoward incident which occurs in conection with this proposal must be reperted back to the Panel without delay. 6. HFyour project involves the use of humen samples, your approval is gwen on the condition that you or your supervisor notify the HTA Designated Individual of your intention te work with such material by completing the form entitled “Notification of Intention to Work with Human Semples". Theform must be submitted to the PD (Sean Duggan}, BEFORE any ‘activity on this project is undertsken This approval expires on30/11/2017 . Please set a reminder on your Qutlock calendar or equivalent if you need to continue beyond this appravel date. ft is your responsibility ta reapply / request extension ifnecessary. Yours sincerely i tl, ue (ala. Prof. Arthur Tatham (Ohair of Department of Healthcare and Food Ethics Panel Cerdiif Schaal of Health Sciences Uandef Campus Westem Avenue, Cardiff CFS 2¥B Tel : 029 20417125 E-mail : [email protected] Student Number:20074266 30 Please circle: True / False 7. Decide whether the next statement relating to the image below is true or false. This would be a healthy food choice. Please circle: True / False 8. Do you know what is meant by the “recommended intake”? Please circle: Yes / No 9. If the answer was yes to question 6, please explain what you think is meant by the “recommended intake”? 10. On a scale of 1 to 5, with 1 referring to not understanding the image in question 3, 3 referring to having seen the image on food labels but not understanding the image and 5 being the image is recognised and clearly understood, how useful do you think having this information is on a food label? Please circle: 1 / 2 / 3 / 4 / 5 11. Please explain your reason for circling the chosen answer in the previous question. Student Number:20074266 31 12. Do you use this food labeling system to help choose which food products are healthier for you? Please circle: Always / Half of the time / Occasionally / Never 13. How often do you use this food labeling system to aid your food product decisions? Please circle: Every day / 1-3 days a week / Purchasing the weekly food shop / Not often once every few weeks / Never 14. In what circumstances do you use this food labeling system to aid your decisions, please tick next to appropriate options: When choosing readily prepared lunch options e.g. sandwiches or pasta When shopping for myself When shopping for my family When shopping for my children Never Other 15. Please explain further if you have chosen “Other” below. 16. Please explain why you would use the food labeling system to aid your decision under these circumstances? 17. Do you feel more information needs to be provided to the public on how to use these parts of the food labels in order to support healthier food choices? Please circle: Yes / No 18. What part of the food label do you think is clear to understand and why? Student Number:20074266 32 19. What part of the food label do you think is unclear and why? 20. Do you feel the font size on food labels is clear? Please tick appropriate option. Yes the font size is clear No the font size is too small No the font size is too big 21. Please include any additional feedback you have regarding food labeling here. Completed and returned questionnaires implies consent has been given by the participant. Student Number:20074266 35 ID Number Gender Age Recognise food label Image A Image B Perceptio n of RI Scale of understan ding Use FOP for healthier choices Frequenc y of FOP use Circumstanc es for FOP use No. of answers chosen previous question More informatio n Font size 1 2 2 1 1 2 1 3 3 4 1 1 1 1 2 2 1 1 2 2 1 5 1 1 1, 2 2 2 1 3 2 3 1 1 2 1 4 2 4 6 1 1 1 4 2 2 1 2 2 1 2 3 4 1 1 1 1 5 2 3 1 1 2 2 4 2 2 1,2,3,4 4 1 2 6 1 2 1 1 2 1 5 1 1 1,2 2 1 2 7 2 1 1 2 2 1 5 2 3 2 1 1 1 8 2 2 1 2 2 1 5 4 5 5 1 1 1 9 2 3 1 2 2 1 5 3 4 6 1 2 1 10 2 5 1 2 2 1 4 3 4 3 1 1 2 11 2 1 1 2 2 1 4 3 4 1 1 1 2 12 2 1 1 1 2 1 4 2 4 1 1 1 1 13 2 3 1 1 2 1 4 4 5 5 1 1 1 14 2 5 1 2 2 1 3 3 3 1,3 2 1 1 15 2 6 1 2 2 1 3 3 4 1,6 2 1 1 16 2 0 1 2 2 1 5 2 2 1 1 2 1 17 2 7 1 1 1 1 5 1 3 3 1 2 2 18 1 2 1 2 2 1 4 3 4 1,3 2 1 2 19 2 1 1 2 2 1 5 2 4 2 1 1 1 20 2 6 1 1 2 1 5 1 2 1 1 1 2 21 2 1 1 1 1 2 3 2 2 1,2 2 1 2 22 2 4 1 1 2 1 4 1 1 1,2,3,4 4 1 1 23 2 7 1 1 1 1 4 4 5 5 1 2 1 24 2 1 1 2 2 1 4 4 5 5 1 1 2 25 2 1 1 2 2 1 5 1 1 2 1 1 1 Student Number:20074266 36 26 2 7 1 1 2 1 5 2 3 1,2,3 3 1 2 27 2 3 1 1 2 1 5 3 4 1,4 2 1 2 28 2 1 1 2 2 1 5 1 1 2 1 2 1 29 1 1 1 2 2 1 4 1 3 1,2 2 1 1 30 2 6 2 2 2 1 2 4 5 5 1 1 1 31 2 2 1 2 2 1 4 1 3 1,2,3 3 2 1 32 2 1 1 1 2 1 4 2 2 1,2 2 1 1 33 2 2 1 2 2 1 5 1 4 1 1 1 1 34 2 1 1 2 2 1 4 2 3 1,2,3 3 1 1 35 1 2 1 2 2 1 4 2 2 1,2,3 3 1 1 36 2 1 1 1 2 1 4 1 2 1,2,3,4 4 1 1 37 2 5 1 2 2 1 5 1 2 1,3 2 2 1 38 1 1 1 1 2 1 3 1 1 2 1 1 1 39 2 6 1 2 2 1 3 4 5 5 1 1 2 40 1 1 1 1 2 2 3 4 5 5 1 1 1 41 2 1 1 2 1 1 4 3 3 2 1 1 1 42 2 2 1 2 2 1 4 2 2 2 1 1 2 43 1 1 1 2 2 1 5 1 1 1,2,3 3 1 1 44 2 3 1 2 2 1 4 1 3 1,2,3 3 1 2 45 2 1 1 1 2 2 5 3 3 1 1 1 2 46 2 1 1 2 2 1 4 1 3 2 1 1 1 47 2 1 1 2 2 1 5 2 2 1,2 2 1 1 49 2 1 1 2 2 1 5 2 2 1,2 2 1 1 Student Number:20074266 37 ID Amber Colour Theme 1 To be aware of the content but not a warning Medium/Average 2 Medium levels Medium/Average 3 Negative effects High 4 Dabgerousely high High 5 Sodium level Sodium level/ RDA% 6 That the amount of salt per 30g is ok for you Medium/Average 7 The food contains a moderate amount of salt per portion Medium/Average 8 The level of salt being medium Medium/Average 9 High High 10 In the middle Medium/Average 11 That it's not exactly bad but it's not exactly good either. Medium/Average 12 That there is an average amount of salt in 30g of cereal Medium/Average 13 Mid range of RDA Medium/Average 14 Med alert Medium/Average 15 Salt level is medium against daily allowance based on daily consumption Medium/Average 16 Medium level of an adult's daily intake Medium/Average 17 Low salt Low 18 It suggests that the level of Salt content per 30g of cereal is classified as being at a medium percentage of an adults reference intake Medium/Average 19 That there is a medium amount of salt in the product in comparison to other foods Medium/Average 20 Salt content is near to daily recommend Medium/Average 21 Medium salt levels Medium/Average 22 That it is has a slightly higher salt content than i would like but not too high Medium/Average 23 Tells the % of the recommended daily intake Sodium level / RDA % 24 Over the recommended amount but not dangerously effective to bad health Medium/Average 25 Its not too bad, average sort of food Medium/Average 26 Take care Medium/Average 27 There is a sligtly higher percentage of something in food than would normally be recommended. Medium/Average 28 Not great High Student Number:20074266 40 ID Quotes - What is meant by RI Theme 1 What is advised for an 'average' adult female/male based on what nutrients etc are required for basic bodily functions Average recommendation 2 The average allowance of a particular thing that a person should have in a day Average recommendation 3 How big or small the portion should be. Portion size 4 Average daily intake for a grown man or woman Average recommendation 5 6 How much the average person should be eating each day Average recommendation 7 The amount of a certain type of nutrient that the government suggests people should eat every day Average recommendation 8 Based on daily intake of food Average recommendation 9 You should have that amount recommended in a day and not more if possible Average recommendation 10 What the average adult should eat a day Average recommendation 11 The amount of each category that you are supposed to have a day. Average recommendation 12 The suggested amount to have Average recommendation 13 Average daily intake sufficient to meet nutritional requirements Average recommendation 14 How much your sposed to have Average recommendation 15 The typical allowance an adult should have in a day for a heathy diet Average recommendation 16 The suggested daily intake of fat/saturates/sugars/salt for an adult Average recommendation 17 daily allowance recommed Average recommendation 18 I think this refers to the amount of food/drink recommended as part of a daily intake, without exceeding a 'High' level, for the average sized male/female. Average recommendation 19 The amount of a substance that is suggested for an average healthy adult in a day Average recommendation 20 To have a healthy diet Healthy 21 22 Your daily allowance recommendation Average recommendation 23 Daily dose Average recommendation 24 below or within the guided daily amount Average recommendation 25 What you should eat for example women should intake 2000 cals Average recommendation 26 guidelines which recommend how much salt, fat and sugar we should have each day Average recommendation 27 The propsed amount of something that should be ingested. Average recommendation 28 How much of each you should ear Average recommendation 29 The amount of a certain product that someone should be eating in a balanced diet Average recommendation Student Number:20074266 41 30 Your daily dosage. Average recommendation 31 32 The recommended intake is how much should be consumed daily to be of a healthy level Average recommendation 33 The recommended daily consumption of various nutrients for an adult that consumes 2200 calories on a daily basis Average recommendation 34 it is the safe amount of the nutrient to intake Average recommendation 35 The amount of each food group you are meant to comsume each day Average recommendation 36 The suggest amount of something that you should consume a day Average recommendation 37 The recommended amount of fats etc you should have in a day Average recommendation 38 r How much to should eat of that food Average recommendation 39 Guideline of what should be eaten per day Average recommendation 40 41 The amount an adult should have in one day Average recommendation 42 The guideline amount someone should have each day Average recommendation 43 The recommended amount of calories, fat, sugar, etc that an adult should consume Average recommendation 44 Recommended intake is a generalised calculation for the recommended amount of the major food groups an adult would need in any one day (plus extras like salt and sugar content specifically isolated). It's meant as a guide to allow people to balance their diet more efficiently, rather than just 'calorie counting' and assuming they are sufficient in all the groups. Average recommendation 45 46 What we should eat in a day to be healthy Average recommendation 47 The amount of a nutrient that you are meant to be consuming a day based on guidelines Average recommendation 48 The recommended amount of something you should eat Average recommendation 49 Recommended consumption amount Average recommendation Student Number:20074266 42 ID Quotes - Reason for the number they selected on the scale of understanding. Theme 1 The colours give a rough indicator of how healthy/unhealthy the food is. However with little knowledge around diet etc people can misinterpret foods as being healthy as they are low in fat, however are usually high in sugars to compensate for this. It doesn't provide enough information and depending on how the food is used ie post workout will depend on how that energy/fat is used in the body Colour Coding 2 I think it's a quick and easy way to reference the amounts of things in good and to know whether they contain a high or low level of particular things Understand 3 It'/ very important to know what's in ur food Contents of food 4 5 Somtimes its confusing Difficult to understand 6 So people can make clear better food choices depending on their dietary needs Contents of food 7 8 It gives enough details to decide on food choice Contents of food 9 It's easy to understand food labels Understand 10 People need to know what is in their food Contents of food 11 I've seen a lot of the images before and i have a basic knowledge on them. Understand 12 The colours on food packaging helps to identify the foods that are healthy and un healthy Colour coding 13 Let's you know what's in the food you are eating Contents of food 14 15 It's not that relevant a lot of products may have 1. High that doesn't make them unhealthy in a balanced diet Understand 16 You don't have to calculate yourself whether it is a good or bad choice of food/drink, the colours clearly indicate whether it is. Much quicker. Colour Coding 17 I usually look at this label wen selecting food Understand 18 I think the images on food/drinks packaging are recognised, but not always fully understood, partly as there are so many variables for each person to apply when making a decision e.g. Their own height/weight and what this product would mean to their own health. Also from an education perspective, the majority of people don't understand what salts, sugars, fats etc specifically do to the body, and therefore don't make this link when choosing products. Difficult to understand 19 Clearer to identify, saves looking on back of product Understand 20 Traffic lights a good visual Colour coding 21 I think I have a moderate knowledge but am not 100% Understand 22 Because it helps you to choose whether yyour food is good for you or bad Contents of food 23 Simply because I don't pay attention to them but if I did I would understand them Difficult to understand 24 I feel they are relevant however they can be confusing, if present in a pie chart compared to the daily amount, customers can visually see the representative amount better Difficult to understand Student Number:20074266 45 21 The colours as this is universally recognised Colour coding 22 The traffic light system colours as everyone knows what they are Colour coding 23 All is understandable if you are interested All of it 24 The colours are easy to understand but can be misleading Colour coding 25 The calories Contents 26 Colours red meaning danger Colour coding 27 The colours help highlight the good and bad parts. Colour coding 28 The % Numbers 29 The colours and percentages Colour coding 30 Date Need more education 31 All pretty good easy to follow. Colours a good indication Colour coding 32 The numbers are clear. Numbers 33 It is also clear however I think because people don't understand them, they overlook them Need more education 34 the basic colours of green, amber and red along with low, medium and high Colour coding 35 Colour system is easy to visualise Colour coding 36 The colours, outlines bad, ok and good well enough for people to understand Colour coding 37 It tells you exactly what's in the product Contents 38 The colour system Colour coding 39 Colour coding is easy to check at a glance Colour coding 40 41 The colour coding make it quick to skim to the get the general idea. Colour coding 42 The colour indicators Colour coding 43 The majority of the label is clear to understand, however the colour coding is the easiest to understand Colour coding 44 The percentages are fairly clear-but this is to me. 'General public' may disagree and be uncomfortable with numbers Numbers 45 The colour codes Colour coding 46 RAG system as it is a visual resource to show what is healthy and what is unhealthy Colour coding 47 The colours because people usually know that green is good and red is bad Colour coding 48 Colours Colour coding 49 Colour code Colour coding Student Number:20074266 46 ID Quotes - Unclear aspect of FOP formats Theme 1 the energy /calorie section is not always understood by consumers they want to relate it to how quick the calories would be burned in doing an exercise etc Energy 2 None, if anything I think more things should be added (e.g. Protein etc) N/A 3 It'/ only not clear if u never ask or try Need more understanding 4 5 Saturated fat Need more understanding 6 Sizing and amount guide, example per 40g etc Portion size 7 None N/A 8 None N/A 9 N/a N/A 10 Energy Energy 11 It's not detailed enough for people to understand if they've not seen one before. Need more understanding 12 The 'energy' part becuase to me it just looks like lots of numbers and it takes a while to figure out the percentages. Pecentages 13 Percentages Percentages 14 none of it N/A 15 Recommended allowance Percentages 16 The calories per pack, sometimes they will only do them for 100g when the product is 25g Portion size 17 shld show content for whole content not portion Portion size 18 The percentages are unclear as they don't represent enough people (below or above average size) and also Percentages 19 none N/A 20 The %...i feel would be tricky for some people to understand Percentages 21 N/A N/A 22 23 24 The percentages are unclear because they do not specify out of what the percentage is taken, it's not clear if it's representation 2.0% could be a lot in some cases Percentages 25 The energy part Energy 26 your daily allowances should be printed for people to see Percentages Student Number:20074266 47 27 Although the labe is self explanatory younger people may have a difficulty u derstanding the percentages and some of the wording. It should be taught from an early age. percentages 28 The colours Colour coding 29 How much of the product it refers to Portion size 30 Most Need more understanding 31 None N/A 32 The colour system is a good idea but it can be unclear whether amber levels are good or bad Colour coding 33 - N/A 34 the percentages of the nutrients and the different colours used Percentages 35 Portion sizes dont tend to be representative of what people will actually consume and so can be quite misleading Portion sizes 36 The percentage, not clear what the percentage represents-m percentages 37 None N/A 38 None of it N/A 39 Numerical values are confusing Percentages 40 41 It can take a while to properly understand all the information because there can be a lot of it. Need more understanding 42 Not sure N/A 43 None of it N/A 44 The fact these amounts are given 'per serving', the size of which can sometimes be unclear does not help. People are quite unlikely to read the small information on the label and calculate compared to how many people are actually eating the food inside. Portion size 45 Unsure N/A 46 None N/A 47 It's per 100g which can be confusing for consumers as they might assume that it's per portion or per pack Portion size 48 ,% and grams Percentages 49 Portion size Portion size Student Number:20074266 50 48 49 Shows at a quick glance which is healthier Healthy ID Quotes - Additional Feedback Theme 2 As above, could include more things, but as it is is good Clearer 3 Thanks N/A 8 N/a N/A 9 They should make it more clear if unhealthy ingredients are in the product Clearer 10 weeks It is very important that people understand what these labels mean Clearer 12 I think that the clearer and easier food labelling is, the more beneficial it is when I am shopping because I can quickly look at as a guide. Clearer 18 I think food labelling could provide a little detail on how a particular food/drink might effect different sized people. For example a taller person may require more calories as part of their daily diet, so if reliant only upon food packaging would regularly be on a low net calorie intake, especially if exercising. More specific 22 The food labelling idea is a brilliant idea however to make use of it for customers they need to rethink the visual aspect to make it easier and clearer to read and understand Clearer 24 I like the traffic light system easy to recognise 32 They need to all follow the same system and be used on all products in order to aid understanding and unity Clearer 37 More advice needs to be given on how to relate the numerical values Clearer Student Number:20074266 51 SPSS Output. T-TEST GROUPS=YesNo('1' '2') /MISSING=ANALYSIS /VARIABLES=Gender FopUse /CRITERIA=CI(.95). Independent Samples Test Levene's Test for Equality of Variances t-test for Equality of Means F Sig. t df Sig. (2-tailed) Mean Differenc e Std. Error Differenc e 95% Confidence Interval of the Difference Lower Upper 3 Equal variances assumed 4.283 .044 -.241 46 .810 -.100 .414 -.934 .734 Equal variances not assumed -.194 8.515 .851 -.100 .516 -1.277 1.077