UNASSIGNED: Nutritional literacy (NL) has a critical influence on food choices. The objective of the present study was to examine the association of NL with nutrition label use.
UNASSIGNED: A cross-sectional study was conducted in Bengbu, China. In total, 955 adults were interviewed using a questionnaire designed for the present study to collect information on demographics, lifestyle, nutrition label use, and NL. Binary logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (CI) for nutrition label use and its predictive variables.
UNASSIGNED: In total, 40.4% of the participants reported looking at nutrition label when purchasing prepackaged foods. NL was significantly positively associated with nutrition label use and specifically with checking nutrition facts table, purported nutrition benefits and purported health benefits. In terms of specific facets of NL, nutrition knowledge, applying skills, and critical skills were associated with nutrition label use. After stratification by monthly income and education, the association between NL and nutrition label use was discovered only in individuals with low monthly income. Additionally, nutrition knowledge was associated with nutrition label use only in adults with high education level, whereas applying skills were associated with nutrition label use only in those with low education level.
UNASSIGNED: The use of nutrition label remains low among Chinese community residents, especially the purported nutritional benefits and purported health benefits. NL is positively associated with nutrition label use, especially with respect to functional and critical NL, with differences based on socioeconomic status. The findings highlight the need for NL interventions targeting individuals with different levels of education and income to encourage use of nutrition label in China.

OBJECTIVE: To determine the contribution of ultra-processed foods (UPFs) to overall macronutrient intake and their association with anthropometric measurements, and to explore the perceptions regarding UPF consumption among young adults in Puducherry, India.
METHODS: This study included 630 participants from three colleges selected using multistage cluster sampling. Following the demonstration of portion estimation, dietary data from previous day were collected using a Google Form-based tool. The participant\'s anthropometric measures were taken. Food items were classified into NOVA groups and intake analysis was performed using DietSoft software. The participants with low and high consumption were identified and focus group discussions were conducted in each group using criterion sampling.
RESULTS: Of all the participants, 178 (28.3%) were overweight or obese. UPF contributed 9.3% of total energy intake and 2.8% protein, 9.9% fat, and 9.9% carbohydrates. The most consumed UPFs were biscuits, wafers (25%), and potato chips(16.2%). No significant association was found between anthropometric measures and UPF consumption. Qualitative findings revealed four major themes, further explained using the socio-ecological framework.
CONCLUSIONS: UPF consumption in the region was lower than that reported in other global and Indian studies. While our study did not find a significant association between UPF consumption and anthropometric measures, there is a concerning shift from traditional diets to increased UPF reliance, driven by convenience and commercial factors. Addressing this is crucial for healthier choices and combating non-communicable diseases during this pivotal life stage.

Food composition data in the Eastern Mediterranean Region countries are often lacking, obsolete, or unreliable. The study aims to provide reliable nutrient data on food products consumed in Oman in order to evaluate their nutritional quality, the consistency of the nutrition labeling and claims, and, ultimately, the use for food consumption surveys and update the current food composition database. Contents of fat, fatty acids, carbohydrates, protein, sugars, and sodium were chemically analyzed in 221 foods and beverages. Products were classified according to their nutritional composition and the extent of processing and coded according to the FoodEx2 system. Labels and laboratory values were compared using the tolerance levels of the European Union. Results indicate that the nutrition labeling aligns with the values obtained in the laboratory, with the exception of 6.3% discrepancies in TFA content, where the reported values are higher than the appropriate reference values. The most frequent category (71.5%) was ultra-processed foods. In terms of inconsistencies in the nutritional claims, 5.1% of food products with claims did not comply with the statement \"sugar-free\" or \"low salt\". Our study provides evidence to support the necessity of comprehensive recommendations for consumers and food industries, which are aimed at enhancing the nutritional quality of products and augmenting consumer awareness.

BACKGROUND: The method of displaying nutrition information labels on the front of food packaging (FOP: Front of Pack) has been implemented worldwide to prevent lifestyle-related diseases. This study aimed to investigate whether the use of the UK\'s Traffic Light Food (TLF) label, known as the FOP label, influences the dietary choices of Japanese youth and promotes healthy dietary choices.
METHODS: Diet selection was performed for one week each during the baseline and intervention periods. During the intervention period, TLF labels were displayed on meal images of the intervention group. Participants chose what they would like to have for dinner of the day from 15 images. Each meal was scored based on the color of the nutrition label, and a comparison between groups was made to determine whether TLF labeling influenced meal selection for dinner. The psychological stress caused by the presence or absence of nutrition labels and nutritional components when choosing meals was also evaluated.
RESULTS: A total of 69 participants were randomly assigned to two groups. Dietary choice scores indicated that the TLF-labeled group made significantly healthier dietary choices than the unlabeled group. Additionally, the TLF-labeled group showed a significant increase in the percentage of people conscious of nutritional components when choosing meals. Furthermore, a significant increase in the number of people conscious of protein, a nutritional ingredient not indicated on the TLF label, was observed. During the test period, no difference in psychological stress caused by the presence and absence of the TLF labels was observed.
CONCLUSIONS: The use of TLF labels also encouraged healthy dietary choices among Japanese university students. The use of FOP nutrition labels should be considered in Japan to prevent lifestyle-related diseases through healthy dietary choices.
BACKGROUND: UMIN Clinical Trials Registry Number: UMIN000047268. Registered March 23, 2022.

One novel strategy to shift food choices in digital shopping environments is to automatically recommend healthier alternatives when an unhealthy choice is made. However, this raises the question which alternative products to recommend. This study assesses 1) whether healthier food swap recommendations are effective, even though the unhealthy choice was made in the presence of visible FOP nutrition labels, and 2) how the similarity of the alternatives influences the acceptance of food swap recommendations. Based on a pre-test, similarity of the recommendation was operationalized in terms of animal-based versus plant-based options. A randomized controlled trial (healthy food swap recommendation conditions: none, similar animal-based, dissimilar plant-based, or mixed animal- and plant-based) with 428 Dutch participants was conducted in a simulated online supermarket. Additional healthier food swap recommendations improved the nutritional quality of the final basket compared to only providing Nutri-Score nutrition labels (-1.7 mean FSA score, p < .001, medium Cohen\'s d = -0.48). Compared to the dissimilar condition, acceptance of an alternative was more likely in the mixed (odds-ratio = 2.78, p = .015) and in the similar condition (odds-ratio = 2.24, p = .048), but the nutritional quality of the final basket did not differ between treatment conditions. Individuals in treatment conditions who did not receive any recommendation (i.e. only made healthy choices) had higher Nutri-Score familiarity and general health interest than individuals who received recommendations. This suggests that for individuals with higher knowledge and motivation FOP nutrition labels were sufficient, whereas for individuals with lower knowledge and motivation additional food swap recommendations can improve dietary choices. Food swap recommendations may act as meaningful reminders by disrupting the automatic choice process and triggering individuals to rethink their (unhealthy) choice.

Food labels are low-cost, informational tools that can help curb the spread of diet-related non-communicable diseases. This study described consumers\' knowledge, attitudes, and practices related to food labels in Jordan and explored the relationship between knowledge and attitude with comprehensive use of food labels. A cross-sectional, online survey assessed Jordanian adult consumers\' ability to comprehend the nutritional contents of food labels (knowledge score), their attitudes towards food labels (attitude scale), and how frequently they used different parts of food labels (practice scale). Multivariate logistic regression models assessed predictors of comprehensive use of food labels. A total of 939 adults participated in the study. Total mean scores for the practice scale (14 questions), attitude scale (8 questions), and knowledge score (4 questions) were 49.50 (SD, 11.36; min, 5; max, 70), 29.70 (SD, 5.23; min, 5; max, 40), and 1.39 (SD, 1.33; min, 0; max, 4), respectively. Comprehensive users of food labels (26.4%) were more likely female, responsible for grocery shopping, and had higher mean knowledge and attitude scores. Jordanian consumers seem to have good practices and attitudes related to food label use but suboptimal knowledge regarding content. Future interventions should focus more on enhancing knowledge and awareness related to food labels.

We designed a new type of \'physical activity calorie equivalent\' (PACE) food label in Iran to compare its effect with that of the traffic light food label (TLL) on caloric choices.
Mixed-method study.
Mothers of school children between the ages of 6-12 years.
In the qualitative phase, 10 focus group discussions (FGDs) were conducted with various groups of mothers, and two FGDs were conducted with food science and nutrition experts to design a new PACE label. In the quantitative phase, 496 mothers were randomly assigned to five groups: (1) no nutrition label, (2) current TLL, (3) current TLL + educational brochure, (4) PACE label, and (5) PACE label + brochure. Samples of dairy products, beverages, cakes, and biscuits were presented. ANOVA and multiple linear regressions were applied to examine the association between label types and calories of the selected products as our main outcome.
The mothers\' perspectives were classified into two sub-themes, the PACE label\'s facilitators and barriers. The new PACE label\'s characteristics were divided into two subcategories: (a) appearance, and (b) nutritional information, including 14 codes. In the quantitative section, mean calories of the selected foods were lowest in the TLL + brochure group (831.77 kcal; 95% CI: 794.23-869.32), and highest in the PACE label group (971.61; 95% CI: 926.37-1016.84).
The new PACE label was a combination of PACE, TLL, and warning labels. It did not significantly affect lower caloric choice, however, the TLL + brochure option was effective in choosing foods with fewer calories.Clinical trial registration: The study was registered in the Iranian Registry of Clinical Trials 23 (IRCT20181002041201N1).

There is no legal definition of a smoothie, so the European legislation applicable to its labeling is that of fruit juice. The smoothie market has grown in recent years, as it can include a wide variety of ingredients: fruits, fruit purees, honey, milk and vegetable milks, vegetables, herbs, cereals, cereal flours, seaweed, and crushed ice. In this study, 57 smoothies were reviewed. All of them were purchased in supermarkets and classified into eight types according to the main ingredients. Fifteen legal statements/items were reviewed on the pack labels: eleven mandatory and three optional. Moreover, nutrition labels, nutritional claims, images, marks, and other symbols were also reviewed. Only 22.8% of the samples complied with EU and Spanish labeling legislation. More incorrectness was related to the name of the food and the fruits included as main ingredients; other errors related to the allergy/intolerance statements, and some nutritional claims concerning vitamin C were also detected to a lesser extent. General advice is provided for consumers to interpret smoothie labels correctly. Lawmakers should amend legislation to accept the term \"smoothie\" as a legal name.

UNASSIGNED: A proper evaluation on the intention of using nutrition label in patients with coronary heart disease (CHD) is crucial to design and formulate of behavior-based interventions. A valid and reliable instrument based on theoretical basis is needed to measure individual intention toward nutrition label use and identify underlying socio-cognitive factors.
UNASSIGNED: To develop and test validity and reliability of the theoretically based nutrition label use (NLU) scale and to promote the use of nutrition labels in CHD patients.
UNASSIGNED: A questionnaire was developed based on the theory of planned behavior (TPB), empirical literatures, expert review and pilot tested. A total of 460 CHD patients in a hospital in Changsha were investigated using this questionnaire from April 2021 to August 2021. The items and dimensions in the scale were explored and confirmed using item-analysis, content validity, exploratory factor analytical (EFA), confirmatory factor analytical (CFA), internal consistency and split-half reliability tests.
UNASSIGNED: A total of 33 items with 4 structural factors were identified, including 10 items of attitude, 6 items of subjective norm, 12 items of perceived behavior control, and 5 items of intention. The total variance explained by the EFA model was 68.563%. The model was further tested with CFA. The measurement model fitted the data well (Ratio of chi-square minimum and degree of freedom (CMIN/DF) =1.743, goodness of fit index (GFI) =0.814, incremental fit index (IFI) =0.946, Tuker-Lewis index (TLI) =0.940, the comparative fit index (CFI) =0.945, the root mean square error of approximation (RMSEA) =0.057). The content validation index (CVI) of the scale was 0.82, and the CVI of the items ranged from 0.8 to 1.00. The reliability of the scale was 0.976 (p < 0 0.001) using Cronbach\'s alpha and 0.937 (p < 0.001) using the split-half coefficient.
UNASSIGNED: The newly developed Nutrition Label Use Scale can serve as a valid and reliable tool to evaluate the nutrition label use of CHD patients.

Students from nutritionally-vulnerable neighborhoods face dietary challenges through built environment of college vending machines. In this cross-sectional study, snacks and beverages sold in vending machines for a 4-week period in a Bronx-based Hispanic-serving college were recorded. Nutritional information was recorded from nutrition labels. Proportion of low- and high-sodium foods, \"smart snacks\" with a limit of 200 kcal and 200 mg of sodium, and foods with added sugar were recorded. Snacks had significantly higher calories and sodium per serving (227 kcal, 208 mg) than beverages (132 kcal, 90 mg) (t-test, p < 0.001). Almost a third of the snacks (32%) qualified as \"smart snacks\" for calories and 62% qualified as \"smart snacks\" for sodium. Beverages contained less than half the number of ingredients as snacks. About 53% of beverages and almost 60% of snacks listed sugar among the first five ingredients. Results underscore the need for colleges to promote less-processed entities with less added sugar.