Food choice,nutrition education and parental influence on British and Korean primary school children

The nutritional status of children can influence their health and the risk factors for developing chronic diseases later in life. Korea is unique in that it is relatively westernized and yet maintains much of the traditional foods and cooking methods. Effective nutrition education should help children to choose a healthy diet through the establishment of positive dietary practices and habits. The main purpose of this research is to compare awareness towards nutrition education between primary schools in the UK and Korea and nutritional knowledge that children and parents have in these countries. Dietary and healthy eating knowledge data were collected by a questionnaire as part of a case study comparison using one primary school in Manchester, UK, and one in Seoul, Korea. A total of 171 primary school children and 124 parents of the children were recruited. The results indicated that children and parents appeared to be aware of the importance of limiting fat, sodium and sugar intakes, and requiring non‐starch polysaccharide (NSP). However, in the case of some foods they did not have satisfactory nutritional knowledge of which foods were high in fat, salt, sugar and NSP. British children had a better understanding of the health implication of fat than Korean children, whereas more Korean children considered excessive salt intake harmful than British children. There seemed to be differences in dietary pattern and familiarity with food between the two countries. Children identified parents as the main source of nutritional information. Therefore, parents as well as children need to learn about nutrition in order to give appropriate information or advice to improve the diets of their children. Children preferred exciting, fun, positive and a practical approach to learning about nutrition, such as computer packages and cookery classes. Parents wanted schools to give their children more information about nutrition. This research has shown that nutrition education in schools should be concerned not only to provide nutritional knowledge but also to encourage children to choose healthy food by redesigning nutrition education and school meals.     

The influence of socio‐economic status on salt consumption in Northern Ireland

The long‐established association between high salt consumption and hypertension has led to calls for a reduction in salt intake. There is particular concern for the health status of Northern Irish consumers, who already have among the highest rates of coronary heart disease and stroke in the United Kingdom. With these concerns in mind, it is essential to establish the sources and patterns of salt consumption from discretionary and processed food sources before a reduction can be achieved. This study investigated differences in salt consumption patterns among consumers of varying socio‐economic status. Research consisted of a consumer questionnaire (n = 360) distributed within Northern Ireland. The results of the study revealed high discretionary salt usage and frequent consumption of processed foods among consumers of lower socio‐economic status. General observations from the questionnaire would suggest a need for improved health education for consumers in this group. The objective of health promotion should be to encourage a reduction in table and cooking salt usage and, in particular, in the consumption of highly salted processed foods. Enhanced product labelling is also encouraged to increase consumer awareness of current salt levels in food and of the availability of low‐salt foods. In addition, the results of this study advocate further development activity in the production of product formulations with low‐salt status.     

Food Advertising and Obesity Prevention: What Role for the European Union?

When the Television Without Frontiers Directive (TVWF Directive) was first adopted in 1989, there was very little discussion on how food advertising should be regulated at Community level. However, things have changed as a result of rising levels of obesity in all EU Member States. Consequently, several stakeholders have suggested that the advertising of unhealthy food to children should be restricted. This article analyses whether and how, bearing the obesity epidemic in mind, the European Union could regulate the marketing of food high in fat, sugar and salt to children (HFSS food). It starts by presenting the evidence supporting such regulation. It then focuses on the contribution which the TVWF Directive and the Audiovisual Media Services Directive (AVMS Directive) could make to the debate. It finally looks at the broader regulatory framework by discussing their relationship with other instruments of Community law relating to food advertising, and in particular the Unfair Commercial Practices Directive (UCP Directive) and the recently adopted Regulation on nutrition and health claims made on foods.

Eating fast food: attitudes of high‐school students

Alarmingly consistent recent research shows that industrially produced foods such as fast food contain compounds that add to obesity and high cholesterol among young people. Less physical activity and a higher propensity to eat ready‐made food (in Sweden and internationally) have aggravated the health situation for the young generation. They also have become ‘addicted’ to sugar by the consumption of lemonade and other sweet drinks that are often served in conjunction with fast food. Food consumption patterns are highly cultural, and, once formed in early years, they become difficult to change. The findings of this study, which was based on a small sample of written accounts and transcribed interviews, indicate that high‐school students in Sweden are well aware of the good and bad attributes of fast food, such as: speed, convenience, fat and sugar. Clear differences in attitude were found between male and female students: female students view fast food in a broad food chain context, whereas male students concentrate on fast eating and satiety.     

Adolescents’ attitudes towards organic food: a survey of 15‐ to 16‐year old school children

Adolescents are the consumers of tomorrow; therefore policies aimed at increasing organic food consumption should address the needs of this group. To discover their attitudes towards organic food and their knowledge of the subject, a survey among almost 700 school children aged 15–16 years was conducted. Four main groups of questions were used: adolescents’ knowledge of organic food, attitudes, whether they bought organic food and the perceived influences they exerted on the buying patterns of their parents. From the survey it can be concluded that adolescents’ attitudes towards organic food are positive, but their knowledge of and their willingness to buy it are low. Campaigns aimed at encouraging the purchasing of organic food targeted at adolescents should particularly emphasize those characteristics of organic foods that they can relate to their interests and ethical preferences, for example, animal welfare and environmental considerations.     

Consumers’ Opinions and Use of Food Labels,Nutrition, and Health Claims: Results from Turkey

This study was conducted to reveal Turkish consumers’ (18–65 years residing 10 cities, n = 1200) opinions and use of food labels, nutrition, and health claims. The majority of both females and males (64.7%, 68.2%) seldom read food labels. Risk for not paying attention to food labels was increased 1.287-fold when the gender was male. The percentage of reading food labels increases as education and income levels of individuals increase (p < 0.05). Expiry dates of foods were the most frequent read item on labels (58.0%). Males mostly read information on label to learn the price of the food (71.0%) while females read it to learn the energy value of food (79.0%). Females had more knowledge on nutrition claims compared to males (p < 0.05). The nutrition claims, which were most frequently read by females and males, were trans fat free (23.5%, 21.0%) and low fat/fat free (23.3%, 20.5%). The claim organic was paid most attention on fruit and vegetables (52.0%). The claim “low cholesterol contributes to maintenance of cardiovascular-health” was the most common health claim read. In summary, Turkish consumer’s behaviour of reading labels and nutrition-health claims could change according to some sociodemographic factors and food products.     

An experimental investigation of the effect of TV cooking show consumption on children's food choice behaviour

For several decades, television consumption has been crucial in the complex web of factors underlying the obesity epidemic. It has been suggested that if television cooking shows would endorse healthy eating styles, they may have positive effects on consumers’ eating habits. This study empirically investigated the consequences of exposing children (N = 85, aged 9–12 years) to an existing television cooking show episode endorsing the consumption of fruits and vegetables compared with exposure to a non‐food‐related science show. The measures included pre‐test and post‐test attitudes toward health/nutrition and fruits/vegetables, as well as state preferences for a list of healthy and unhealthy foods. At the end of the study, children were separately given the choice between a popular cookie and a piece of fruit as a reward; this was used as a behavioural measure. The results of a logistic regression on the behavioural choice measure showed that the mere exposure to one episode of the television cooking show significantly increased the odds that the children would choose a piece of fruit over a cookie. Repeated‐measures analyses showed that watching this single episode also decreased children's state appetite for unhealthy foods. State appetites for healthy foods and attitudes toward health/nutrition or fruits/vegetables did not change after watching the television cooking show episode. In sum, existing television cooking shows that endorse healthy eating positively influence children's food consumption in the short term and may have the potential to be used as platforms for nutrition education.     

Consumer Perceptions of “Functional Food” in the United States

There is a strong trend to market products that promise improved health in the United States. Functional food is a rather new concept promoting the healthfulness of foods. Functional food manufacturers should provide motivating and trustful marketing messages. However, since the term “functional foods” lacks definition, communication to consumers is challenging and can be confusing. This study investigates how U.S. consumers understand the concept of functional foods. An online survey containing 64 questions was structured to measure awareness, consumption, and trust toward functional foods. Based on a definition provided in the survey, a clear minority (15%) of the respondents (n = 1027) stated they had heard of functional foods before the survey. Compared to the respondents who had not heard of functional foods, they more often used whole wheat cereals, vegetable juice, carrots, toast with high fibre and green tea (Chi-square –test, p < 0.001). Food and drug administration (FDA), health associations, and dieticians were the most trusted sources of information for functional food decisions with 28%, 24%, and 20% shares of the respondents, respectively. Food producers, food retailers and media together were chosen as the most trustworthy source by less than 1.5%. We concluded U.S. consumers find functional foods confusing and even unreliable. To strengthen their confidence, we suggest clear and transparent collaboration with nutrition and health specialist and product- specific marketing messages based on solid scientific documentation.     

Food consumption,lifestyle patterns,and body mass index of a group of white South African students

There is worldwide concern that higher education students are increasingly engaging in unhealthy eating and lifestyle practices. A total of 488 white students participated in a study aimed at investigating the current food consumption and related lifestyle patterns of students at a South African residential university. The respondents’ self‐reported weight and height was used to calculate their body mass index (BMI). Closed and open‐ended questions measured aspects of the respondents’ usual eating patterns and lifestyles. The meal patterns and composition confirmed Western‐orientated food practices, as the majority consumed three meals a day, with in‐between meal snacking, and a different meal pattern over weekends. Respondents’ food intake was further characterized by a low intake of fruit, vegetables, and dairy products and frequent consumption of foods high in fat, sugar, and sodium. Although the majority (66.8%) of the study group were classified as normal weight according to their BMI, when comparing males and females, more males than females were overweight and obese. Only 54% of the males had a normal weight compared to 82% of the females. There was, however, no statistically significant difference (p = 0.149) between how males and females in the different BMI groups felt about their weight. The study also explored the relationships between the respondents’ BMI, gender, food consumption patterns, and type of residence. The features of the food consumption patterns were depicted according to whether breakfast was eaten or not; snacking activity between meals; the consumption of ready‐prepared convenience meals, fast foods; home‐cooked meals; and eating out. There were no statistical significant differences between the BMI categories of males and females regarding their habit to eat breakfast or not; and to snack between meals either during the morning, in the afternoon or after supper. Similarly, no statistical significant differences were noted when relating the BMI categories of the gender groups to the frequency of consumption of ready‐prepared, convenience type meals, fast foods, and home‐cooked meals. However, a statistical significant difference (p‐value 0.006) was found between BMI categories per gender and general frequency of eating out. No statistical differences was noted between BMI categories, gender and place of residence irrespective of the type, whether the student lived with parents, independently in a flat or apartment, or a house with friends or a room, or in a university residence.     

Sodium content in foods: Brazilian consumers’ opinions,subjective knowledge and purchase intent

This study attempted to gain insights on Brazilian consumers’ subjective knowledge of sodium content in processed and homemade foods and their purchase intent for products with reduced‐sodium content. A questionnaire was distributed to 409 consumers selected by convenience quota sampling. We found that Brazilian consumers were concerned about the amount of salt (sodium chloride) in the products they consumed, regardless of educational levels, income, age, lifestyles, or health conditions. However, they still considered their consumption to be above WHO‐recommended limits and had little subjective knowledge about the term ‘sodium’. While processed products were considered the main contributors of high‐sodium intake, participants were not concerned about addition of salt at the table and salt in homemade food. The majority of respondents rarely read the sodium content on food labels; however, men and older individuals were more likely to read label information on sodium content. Products with reduced sodium were found to have market appeal, which justifies investments in research to develop these products. Therefore, in addition to the efforts to reduce sodium in the processed‐food industry, it is necessary to promote awareness about the importance of food labelling, especially sodium content, and the need to reduce salt in homemade food and additions during meals.     

Cultural resistance to fast‐food consumption? A study of youth in North Eastern Thailand

Increased intake of saturated fat and refined sugars underlies much of the problem of emerging obesity all over the world. This includes middle-income countries like Thailand, which are subject to successful marketing of Western fast foods especially targeted at adolescents. In this study we explore the socio-cultural influences on fast-food intake for non-metropolitan (rural and urban) adolescents in North East Thailand (Isan). Our questionnaire sample included 634 persons aged 15-19 years who are in and out of formal schooling and who are randomly representing upper, central and lower Isan. All were asked about their knowledge of fast-food health risks and their attitudes towards, and consumption of, fast food and traditional food. As well, we used several focus groups to obtain qualitative data to complement the information derived from the questionnaire. Some three quarters of sampled youth were aware that fast food causes obesity and half knew of the link to heart disease. About half consumed fast food regularly, induced by the appeal of 'modern' lifestyles, social events and marketing, as well as by the convenience, speed and taste. Nearly two-thirds thought that local foods should be more popular and these beliefs were more likely to be found among children from educated and urban families. Local foods already constitute a cultural resistance to fast-food uptake. We propose several methods to boost this resistance and protect the youth of Thailand against fast food and its many adverse health consequences.     

Supporting Healthier Food Choices in Remote Indigenous Communities: Developing a Food Choice App

This article posits the development of a healthier food choice app as a means of contributing to facilitating nutritionally superior food selection among indigenous Australians living in remote communities. A significant health gap exists between indigenous and non-indigenous people in Australia. Further, indigenous Australians living in remote communities carry a significant and disproportionate share of this gap. One contributor to poor health is poor nutrition: current food consumption in remote communities is a diet dominated by highly processed foods and characterized by high levels of sugar, refined cereals, and low intake of fruit and vegetables coupled with excessive sodium intake and deficiency in a number of micronutrients. Employing two marketing-based concepts, the dual processing model of nutritional labeling and habit, as the basis for the development of a healthier food app, we contend that a food choice app has the potential to disrupt habitual behavior and generate new learning about healthier food choices in remote indigenous communities. The app would be based on the George Institute’s FoodSwitch app, which enables users to scan barcodes of food products at the point of purchase and determines if the food item is a healthy choice and otherwise suggests healthier alternatives. The proposed app would utilize existing imagery used by the Jimmy Little Foundation, a not-for-profit organization working in remote indigenous communities promoting healthier food and lifestyle practices, and would provide information in a culturally appropriate and clearly communicated form.     

Parents’ knowledge,behaviour and concerns of food chemical hazards: Korean mothers sending their preschool‐aged children to child care centres

Although incidences of foodborne illness caused by chemical hazards are increasing, the studies on public awareness of food chemical hazards are limited. This study was conducted to assess mothers’ knowledge, behaviour and concerns on diverse food chemical hazards. A total of 960 mothers sending their preschool‐aged children to child care centres in Gwanak‐Gu, Seoul, Korea were surveyed, and 633 (65.9%) returned the questionnaires. After excluding inappropriate questionnaires, 364 (37.9%) were analysed. The majority of the mothers were able to identify food categories containing acrylamide (83.2%) and trans fat (80.2%), while slightly over half of the mothers named food categories containing allergen (56.3%) or pesticide residues (57.1%). Less than two thirds of mothers were knowledgeable of human exposure pathway to environmental contaminants (59.3%), acrylamide (55.2%) or heavy metals (65.9%). A significant number of mothers showed familiarity on health risk from dietary exposure to environmental contaminants (82.4%), trans fat (91.5%) or heavy metals (96.7%) (P < 0.05). The data on safe food behaviour towards environmental contaminants (81.8%), acrylamide (98.0%), heavy metals (96.7%) and trans fat (90.6%) showed high levels of right behaviours. About 47.2% and 22.8% of mothers read label of food additives and ingredient statement on allergen when purchasing processed foods, respectively. Mothers seemed to be concerned about food chemical hazards. Among the sociodemographic characteristics, only age significantly differentiated mothers’ concerns on chemical hazards in foods (P < 0.05). This study suggests that mothers needed to be educated on food chemical hazards regardless of their education levels, occupation status or the number of child.     

Changes in family food habits: the role of migration

The food habits of people generally dictate their nutritional well‐being, which subsequently affects their physical and mental health. A change in environment is one of the major factors that could bring about positive or negative changes in food consumption patterns. The food habits of 50 migrant families living in a suburb of Accra were studied to find out what changes have taken place as a result of a change in living environment. The homemaker in each family was interviewed to obtain information on socioeconomic characteristics, past and present food procurement and consumption patterns, food avoidances and factors that influence food selection and consumption. The findings revealed that, although the majority stuck to foods they were accustomed to, there were striking changes in sources of food procurement, the number of meals prepared at home and the relative frequency of consumption of some staple foods. One‐third of the study group felt that their diets had become poorer as a result of the change in environment. Two factors, time and money, were associated with the changes that had taken place. The study provides some evidence for the existence of inadequate diets among migrant families. This might even reflect a more serious situation facing the numerous migrant youth, who have no families to cater for them and, hence, put their health at risk. Home economists and other related professionals could be instrumental in drawing up intervention programmes to ensure adequate selection and consumption of food to promote good health among migrants to the city.     

Children’s Food Choice: Advertised Food Type,Health Knowledge and Entertainment

The purpose of this research is to examine how the moderating effects of health knowledge (inactive vs. active) and advertising’s entertainment level (high vs. low) affect children’s response to advertising’s food content (unhealthy vs. healthy). First, a primary study using the qualitative method was conducted with the purpose of identifying healthy and unhealthy food options based on culture, eating habits, nutritional value and the access of Iranian children to each option so that they could be displayed in TV advertising, advergames and questionnaires. Then, a 2 × 2 × 2 full-factorial, randomized, mixed-effects experimental design was used to test the research framework. 330 students (aged 6–11) participated in the study. The findings revealed that children tended to choose more unhealthy foods after exposure to unhealthy food advertising. This effect was greater for a higher level of entertainment, and was successfully moderated by the activation of health knowledge. It was concluded that embedding health messages in advertising (included TV advertising and advergames) help retrieving children’s health knowledge and therefore, choosing less unhealthy food by them.     

Food consumption patterns,dietary quality and health status of expectant mothers: case studies in suburban and rural communities in Ghana

The study was conducted to determine the food consumption patterns, dietary quality and health status of expectant women and also to assess their level of awareness of nutritional requirements during pregnancy. Food beliefs, taboos and superstitions held by the women were also investigated. Using the purposive sampling technique, 30 pregnant women attending the Maternal and Child Health Clinic at Dodowa (rural) and University Hospital, Legon (suburban), were selected for the study. A structured questionnaire was used to collect information on the respondents’ nutritional knowledge, beliefs, taboos and superstitions and health status. A food frequency questionnaire and the 24‐h dietary recall method were used to obtain information on food consumption patterns and dietary quality. The study revealed that, although the majority of the respondents (83.3%) had some knowledge of nutrition, not all were applying it in their feeding practices because of financial constraints. With regard to consumption patterns, most of the women (83.3%) were having three meals a day, while the rest either ate twice a day or anytime they were hungry. Seventy‐three per cent of the respondents also increased their food intake during pregnancy. Foods eaten were based mainly on starchy roots and tubers, cereals and vegetables. Legumes, oilseeds and fruits were often lacking in the main meals of respondents. Although animal products were consumed daily, the quantities taken were very small to provide for adequate protein, especially in the rural area. Various types of food were avoided by some of the expectant mothers for reasons such as nausea, loss of appetite, taboos and superstition. With regard to dietary quality, respondents from the rural area had diets of poorer quality in terms of nutrient intake compared with those from the suburban area. In both communities, iron contents of diets were quite low. Forty‐seven per cent of the women interviewed were anaemic, with a higher prevalence of anaemia being observed in the rural community. Common ailments reported by the women were dizziness, headache, waist pains and malaria. Based on the results of the study, it was recommended that nutrition education for pregnant women should be stepped up at antenatal clinics especially in rural areas.     

Playing With Food: Content Analysis of Food Advergames

This study examines how food marketers use advergames, custom‐built and branded online games, to promote food products to children and provides the nutritional content of the food products featured in the advergames. The results reveal that food marketers use advergames heavily, with candy and gum or food products high in sugar most frequently appearing in the analyzed games. Children are often invited to “play with” the foods integrated as active game components. Finally, despite the educational benefits of interactive games, fewer than 3% of the games analyzed in this study appear to educate children about nutritional and health issues.     

Healthy and tasty school snacks: suggestions from Brazilian children consumers

Children do not choose what to eat based on health issues alone, and the high availability of non‐nutritious food in the environment can be a barrier to the consumption of healthy foods. Brazilian children are consuming processed, savoury, rich in fat, sodium and refined carbohydrates rather than more nutrient‐dense foods. Foods offered in public school meals and those sold in private school canteens in Brazil are subject to regulation, but not the snacks brought from home. This study identified the suggestions of public and private school students about the characteristics that a snack should present in order to be considered both healthy and palatable. A qualitative exploratory study using focus groups was conducted with 128 primary school students aged 7–10 years old. Interviews were transcribed and content analysis was conducted, generating three categories: (1) foods actually consumed during snack breaks; (2) examples of foods considered healthy and/or tasty for consumption during snack breaks; and (3) desired characteristics of a healthy and tasty snack. Foods of high energy density and low nutritional value were mentioned as the most consumed snacks, usually brought from home or purchased within/near the schools. Consumption of meals offered by the National School Meal Program was reported by only one‐third of the public school students. Fruits, natural juices and vegetables were considered healthy foods; sweet‐tasting preparations containing fruits were considered tasty; while fruits and natural fruit juices were considered both healthy and tasty. Sweet‐tasting preparations containing fruits were mentioned as examples of snacks with the desired healthy/tasty characteristics. The disparity between what was actually consumed and what was reported as ideal leads us to question the availability in retail stores of healthy yet palatable foods that meet this population's desires.