Search

TikTok influencer videos are becoming increasingly popular for promotional purposes and are appealing to adolescents. Yet, the products' level of integration into the storyline of such videos influences their recognizability as advertisements, which is concerning as they expose adolescents to unhealthy social media food marketing, leading to unhealthy consumption. This study investigated whether a sponsorship disclosure in a TikTok influencer video with different levels of product-plot integration increases adolescents' persuasion knowledge and impacts their brand outcomes. This between-subjects 2 × 2 experiment included 245 Dutch adolescents with a mean age of 13.6 (SD = 1.42). Participants watched a TikTok video in which the brand Doritos was shown passively or integrated into the storyline, with or without a disclosure. The sponsorship disclosure significantly increased recognition of advertising (F(241) = 4.48, p = .035) and understanding of persuasive intent (F(241) = 13.28, p =

PurposeSnacks at work are often of poor dietary quality. The main objective of the current study is to examine the effect of making vegetable snacks available at workplace meetings on consumption.Design/methodology/approachIn three between-subjects field experiments conducted at a hospital and three ministries in the Netherlands, with meeting as the unit of condition assignment, attendees were exposed to an assortment of vegetables, varying in vegetable variety and presence of promotional leaflet in study 1 (N = 136 meetings), serving container in study 2 (N = 88 meetings) and additional presence of cookies in study 3 (N = 88 meetings). Consumption of vegetables and cookies was measured at meeting level to assess grams consumed per person.FindingsAcross the three studies, average consumption per meeting attendee was 74 g (SD = 43) for study 1; 78 g (SD = 43) for study 2 and 87 g (SD = 35) for study 3. In the first study, manipulation of perceived variety and information leaflets did not affect intake. In the second study, significantly more vegetables were eaten when they were offered in single sized portions (M = 97 g, SD = 45) versus in a shared multiple portions bowl (63 g, SD = 38) (p Practical implicationsThe present studies show how availability of vegetables at unconventional occasions makes meeting attendants consume considerable portions of vegetables on average. As such, offering healthy snacks at the workplace may be a valuable part of workplace health promotion programs and positively change the “office cake culture”.Originality/valueVegetable intake is less than recommended in many countries worldwide. Many snacking occasions are at work, which makes office meetings a potential consumption occasion to encourage vegetable intake. Hence, the aim of this study is to examine whether free availability of vegetable snacks during meetings contributes to their consumption among meeting attendees and under what conditions consumption is optimal.

Traditional food marketing stimulates adolescents' consumption of energy-dense, nutrient-poor foods. These dietary behaviours may track into adulthood and lead to weight gain, obesity and related non-communicable diseases. While social media use in adolescents has proliferated, little is known about the content of food marketing within these platforms, and how this impacts adolescents' dietary behaviours. This paper aimed to obtain expert insights on factors involved in the association between social media food marketing (SMFM) and adolescent dietary behaviours, and to explore their views on key priorities, challenges and strategies for future SMFM research and policies. One-on-one semi-structured interviews (n = 17) were conducted with experts from Western Europe, Australia and North America, in the fields of public health (policy), nutrition science, social media marketing, adolescent medicine, clinical psychology, behavioural sciences, communication, food industry, social influencing, and social marketing. The experts' collective responses identified that the line between food content posted by social media users and food companies is blurred. Adolescents' processing of SMFM may be mostly implicit, involving social comparison, emotional engagement, and attaching symbolic meanings to foods. Mediating factors and adolescent-specific and SMFM-specific moderating factors potentially influencing adolescents' response to SMFM were summarized in a Social Ecological model. Experts agreed that there is limited scientific evidence on adolescent-targeted SMFM and there are no strict regulations in place to protect adolescents from unhealthy SMFM, while adolescents are active social media users who are cognitively vulnerable to implicit marketing tactics. Adolescent-targeted SMFM should be controlled by encouraging healthy food marketing or limiting junk food marketing. Also, prioritizing both quantitative research on SMFM exposure and its impact, and qualitative research to obtain adolescents’ perspectives, is crucial to advocate for regulatory changes regarding adolescent-targeted SMFM content.

Purpose In many countries, schools move toward healthier canteen assortments by limiting the supply of unhealthy foods. The question arises whether this gives any undesirable side effects with students (e.g. compensation in purchases from school to outside retailers, reactance) and how to handle these so that operating school canteens remains financially viable. The purpose of this paper is to identify perspectives toward healthy school food assortments held by vocational education students and professionals within secondary and vocational schools with responsibility for school food policy (e.g. school canteen workers, teachers, school directors) in the Netherlands. Design/methodology/approach Four focus groups were conducted with students at a vocational school (n=25 in total). A semi-structured interview guide was used to conduct discussions. The interview guide also included three school canteen scenario’s (A: 100 percent healthy food, B: 50 percent healthy/50 percent unhealthy foods and C: 100 percent unhealthy food) and a set of nine intervention strategies. A brief survey included questions on the same three scenario’s and nine intervention strategies. A web-based survey was conducted among 68 professionals responsible for school food policy and included their evaluation of the same canteen scenarios and interventions. Survey data were analyzed using descriptive statistics and content analysis. Content analysis was done on the qualitative data. Findings School food professionals were highly supportive of Scenario A (100 percent healthy food), as this formed a better fit with their policies and was believed to stronger encourage healthy eating. They did worry about financial feasibility given lower affordability and student reluctance to accept the assortment. Students were less in favor of Scenario A. Students discussed getting value for money and remaining freedom to make unhealthy choices. The authors discuss implications for policy makers who aim to implement measures to improve young people’s eating habits. Originality/value This study contributes to the literature on creating healthier school food environments. This study uniquely examines a healthier school canteen from a viability perspective, including the views of students as primary customers. Given the need to progressively increase the number of foods complying to dietary guidelines in canteen assortments, this study provides insights into how and why assortment changes best can be implemented.

The ability to perceive bodily signals of satiation and hunger is key for the self-regulation of food intake. Measuring this competence in large populations and/or in ecologically valid conditions requires valid self-reports. In this research, we tested the construct validity of two self-report measures of the Multidimensional Internally Regulated Eating Scale (MIRES); Sensitivity to physiological signals of satiation (SS) and Sensitivity to physiological signals of hunger (SH). In two pre-registered studies, we examined associations of SS and SH with behavioural indicators of the incidental ability to perceive the onset of satiation and hunger, respectively, but also with a generic self-report of interoceptive awareness (Multidimensional Assessment of Interoceptive Awareness - MAIA). The associations of MAIA with the behavioural indicators were also examined. In a healthy sample of 113 males/females (19–68 years), SS was not associated with satiation threshold as measured with the water load test in the laboratory (Study 1). Likewise, in a healthy sample of 107 females (18–27 years), SH was not associated with hunger threshold as measured with the preload test in a semi-controlled setting (Study 2). Neither MAIA was associated with the thresholds, but was positively associated with SS and SH, providing preliminary evidence for their construct validity.

Binnen het project de Gezonde Schoollunch is gedurende een half jaar op drie basisscholen in Nederland een gezonde schoollunch aangeboden. Het doel van de procesevaluatie, beschreven in dit rapport, is om op systematische manier te achterhalen wat goed is gegaan en wat minder goed is gegaan gedurende dit halve jaar schoollunch. De evaluatie betreft het hele proces rondom de schoollunch, dat wil zeggen van de logistiek rondom het bestellen en de levering van de lunch tot en met de waardering van de schoollunch door kinderen, personeel en ouders. Zaken die centraal staan zijn (1) de voorbereiding (deelnemende scholen, menusamenstelling, logistieke inrichting), (2) de waardering van de lunch, de logistieke processen en (3) de kosten van de schoollunch.

An increasing number of studies investigate the effects of mindfulness on food intake and weight outcomes, while the underlying mechanisms by which mindfulness exerts its effects have received less attention. We conducted two pre-registered studies to shed light on the frequently proposed yet largely understudied hypothesis that mindfulness improves awareness of bodily signals of satiation and hunger. We assessed the ability to perceive the onset of bodily signals of satiation with the two-step water load test (Study 1) and the ability to perceive the onset of bodily signals of hunger with the preload test (Study 2). A brief mindfulness exercise (body scan) did not impact the perception of satiation but improved the ability to perceive bodily signals of hunger. After the consumption of a standardized preload, participants in the two experimental conditions felt equally satiated; nevertheless, those in the mindfulness condition perceived the onset of hunger 18min earlier than those in the control condition and this effect persisted also in the presence of control variables. These findings together suggest that even a single and short mindfulness exercise can improve perception of hunger signals substantially, while more intensive mindfulness training may be needed to impact perception of satiation signals.

Internally regulated eating style, the eating style that is driven by internal bodily sensations of hunger and satiation, is a concept that has received increasing attention in the literature and health practice over the last decades. The various attempts that have been made so far to conceptualize internally regulated eating have taken place independently of one another and each sheds light on only parts of the total picture of what defines internally regulated eating. This has resulted in a literature that is rather fragmented. More importantly, it is not yet clear which are the characteristics that comprise this eating style. In this paper, we identify and describe the full spectrum of these characteristics, namely, sensitivity to internal hunger and satiation signals, self-efficacy in using internal hunger and satiation signals, self-trusting attitude for the regulation of eating, relaxed relationship with food, and tendency to savor the food while eating. With this research, we introduce a common language to the field and we present a new theoretical framework that does justice not just to the full breadth of characteristics that are necessary for the internally regulated eating style but also to the associations between them and the potential mechanisms by which they contribute to this eating style.

Many adolescents have poor eating habits. As a major part of their caloric intake takes place at school, the present study aims to examine the effect of increasing the availability of healthier foods in school canteens on sales, student attitude and self-reported behaviour. A quasi-experimental study was carried out at two vocational schools in the Netherlands over a 10-month period, where the visible share of healthier products was gradually or abruptly increased from 60% to 80%. Outcome measures were sales data for healthier and less healthy foods and drinks in the canteens, as well as surveys. The proportion of healthier products sold increased from 31.1% during the baseline period to 35.9% in the final period. A gradual increase led to higher relative sales of healthier products (40%) than an abrupt change (34.5%). Survey data showed that students&rsquo, moderate satisfaction remained insensitive to the changes over time. Overall, results suggest that increasing the availability of healthier products in school canteens leads to small positive changes in sales of products, particularly in the product groups beverages and sandwiches. A gradual introduction may ensure that students slowly get used to assortment changes.

The ‘Healthy School Lunch’ project (PPS Een gezonde schoollunch - TKI AF-16098) aimed to study the feasibility and impact of offering a healthy school lunch in Dutch primary schools. In the first phase of the project we studied the support for a healthy school lunch among a wide range of stakeholders and we explored what they thought a healthy school lunch should look like. The next phase aimed to study the effects of a healthy school lunch on dietary intake and cognitive performance. In order to investigate the effects of providing a healthy school lunch on the dietary intake of children during lunch, a longitudinal intervention study with three schools was designed, where a healthy school lunch was offered for six months. Due to various financial and methodological reasons that were not fully considered when starting this project, it was not possible to combine the dietary intake and cognition study in the school lunch intervention. Instead, we explored the possibilities and requirements to perform a solid experimental cross-over study on the effects of a healthy school lunch on cognitive performance within the Healthy School Lunch Project. This process is described in the current report. We started with a review of the literature on the effects of a healthy school lunch on cognitive performance of children. Studies on the immediate and transient effects of a healthy school lunch versus skipping lunch showed, on a variety of cognitive measures, small and inconsistent effects on alertness and working memory of children. Studies on the long-term effects of a healthy school lunch versus habitual lunch showed small improvements in concentration and language processing ability of children. Given the restriction that long term effects of a school lunch on cognitive performance could not be examined within the scope of this project, the focus shifted to understanding immediate effects. A well-designed study to capture immediate effects of a healthy school lunch on cognitive performance of children within our project would require a strictly controlled cross-over design in a school setting. The intervention should consist of an ad libitum buffet-style healthy school lunch, compared with a control condition in which children eat ad libitum from a provided lunch comparable to the common relatively unhealthy packed school lunch of Dutch children. Finding an adequate measure for cognitive performance is hampered by the great variation of previously used measures across studies. These ranged from relatively indirect measures of concentration and disengagement to standardized computerized tests assessing specific cognitive domains such as alertness and higher-level executive functions. Hence, a comprehensive battery of tests would be advisable to explore various potential effects. Power calculations would be needed to determine the sample size of such a study, but it is clear that large numbers of children would be needed, given the small expected effects and methodological challenges. As more than one participating school would be needed, multilevel statistical models would be required to handle grouped and individual children’s data. More research on the effects of a healthy school lunch on cognition in primary school children would be very useful. However, a well-designed study that would provide convincing evidence of the effects of a healthy school lunch on cognitive performance in primary school children, would require a high cost set-up that places a very high burden on both the children and the schools. Therefore, we decided that it is not realistic to perform this study within the Healthy School Lunch project. In this report we would like to share our findings, considerations and recommendations to researchers of future studies on the effect of healthy school lunches on cognitive performance in children. Het project de 'Gezonde Schoollunch' (TKI AF-16098) onderzoekt de haalbaarheid en het effect van een verzorgde gezonde schoollunch op de basisschool in Nederland. In de eerste fase van het onderzoek hebben we onderzocht wat het draagvlak is van verschillende stakeholders voor een gezonde schoollunch en hoe een gezonde schoollunch er volgens hen uit moet zien. De tweede fase van het onderzoek had als doel om het effect van een gezonde schoollunch op de voedingsinname en cognitieve prestaties bij kinderen te onderzoeken. Om het effect van de gezonde schoollunch op de voedingsinname te onderzoeken hebben we een interventiestudie van een half jaar uitgevoerd op drie Nederlandse basisscholen. Door verscheidene financiële en methodologische uitdagingen die we bij de start van dit project niet voorzien hadden, bleek het niet mogelijk om de voedingsinnamestudie en de cognitieve studie te combineren. In plaats daarvan hebben we onderzocht wat de mogelijkheden en voorwaarden zijn voor het uitvoeren van een cross-sectioneel onderzoek naar de effecten van een gezonde schoollunch op cognitieve prestaties van basisschoolleerlingen binnen het project de Gezonde Schoollunch. Dit proces wordt beschreven in dit rapport. Als eerste is een literatuurstudie uitgevoerd naar het effect van een gezonde schoollunch op een verscheidenheid aan cognitieve uitkomstmaten. Deze literatuurstudie liet zien dat een gezonde schoollunch (in vergelijking met geen lunch) op de korte termijn (i.e. kort na inname van de schoollunch), kleine maar inconsistente effecten kan hebben op de alertheid en het werkgeheugen van kinderen. Langetermijneffecten van een gezonde schoollunch (in vergelijking met een gewone lunch) lieten kleine verbeteringen zien in concentratie en taalverwerking van kinderen. Aangezien het bestuderen van de lange termijn effecten van een gezonde schoollunch op cognitieve vaardigheden van kinderen niet kon worden onderzocht binnen de scope van dit project, is de focus verlegd naar effecten die kort na de lunch optreden (immediate effects). Een optimaal ontworpen studie naar de korte termijneffecten van een gezonde schoollunch op de cognitieve prestaties van de kinderen zou een strikt gecontroleerde cross-over studie inhouden met drie meetmomenten, die uitgevoerd wordt in de schoolomgeving. De interventie zou kunnen bestaan uit een gezond ad libitum lunchbuffet dat wordt vergeleken met een controleconditie waarin kinderen een lunch krijgen die lijkt op de standaardlunch van Nederlandse kinderen. Aangeraden wordt om een batterij aan cognitieve tests te gebruiken om zo verschillende effecten op cognitie te kunnen verkennen. Een powerberekening is nodig, maar het is duidelijk dat een groot aantal kinderen nodig zal zijn vanwege de eerder gevonden kleine effecten zijn en de vele methodologische uitdagingen. Hierbij moet methodologisch rekening gehouden worden met de geclusterde resultaten per school en klas en daarom zal een multi-level design en analyses nodig zijn. Hoewel meer onderzoek naar de effecten van een gezonde schoollunch op de cognitie bij kinderen op de basisschool is gerechtvaardigd, vraagt een goed ontworpen studie die overtuigend bewijs zou kunnen leveren om een aanpak, inzet en financiële belasting die aanzienlijk is. De belasting van scholen en kinderen bij een dergelijke studie is enorm hoog. Daarom hebben we besloten dat het niet realistisch is om dit onderzoek binnen het lopende project uit te voeren. We raden onderzoekers die dit willen gaan onderzoeken aan om de uitdagingen en aanbevelingen beschreven in dit rapport zorgvuldig te lezen en te overwegen.

Kinderen in de basisschoolleeftijd eten te weinig groente, fruit en volkorenproducten. Melk en yoghurt worden steeds vaker vervangen door alternatieven met veel suiker [1]. Dit zien we ook terug in de lunchtrommels op basisscholen: er zijn grote verschillen in de samenstelling en kwaliteit van broodtrommels tussen kinderen op school en tussen scholen onderling [2, 3, 4]. De invoering van het continurooster op steeds meer basisscholen maakt de introductie van een verzorgde schoollunch mogelijk. Er zijn echter nog veel vragen over een verzorgde schoollunch in Nederland. Een daarvan is: wat is de voorkeur van ouders? En daaraan gekoppeld de vragen: wat kost dat en wat zijn ouders bereid ervoor te betalen? Dit artikel geeft een beeld van de voorkeuren van ouders met betrekking tot een verzorgde schoollunch en de kosten ervan, en van de betalingsbereidheid van ouders.

Physical cues surrounding foods are known to influence consumption, but research into the underlying mechanisms is limited. This research aims to disentangle these underlying mechanisms, testing one specific physical aspect: the presence or absence of a cover on snack bowls. We hypothesized that the presence (versus the absence) of a cover would decrease the likelihood of consumption and that the effect would be explained through a) norm perceptions discouraging eating, b) heightened effort to take the foods, and c) lowered salience of attractive foods. In two field contexts (Study 1, 40 observation periods; Study 2, N = 711) and a lab experiment (Study 3, N = 151), the cover’s presence was manipulated and the number of snacks taken was observed. In Studies 2 and 3, perceptions of social norms, effort, and salience were reported. The likelihood of taking snacks indeed decreased when the cover was present versus absent (Studies 1–3). In Study 2, the presence (versus the absence) of the cover seemed to decrease perceived social norms (p = 0.05) and increased perceived effort, whereas in Study 3 a significant decrease in perceived social norms and salience and an increase in perceived effort were observed. Moreover, the effect of the cover on likelihood of consumption was mediated by perceptions of salience. The organization of physical aspects in food environments influences consumption and may change perceptions of social norms, effort, and salience. Particularly, perceptions of salience might explain the effect of the cover on likelihood of consumption.

Purpose The purpose of this paper is to test whether the IKEA-effect (Norton et al., 2012) – better liking for self-crafted products than for identical products crafted by others – can be exploited to increase liking and consumption of vegetable snacks in children. Design/methodology/approach A between-subjects experiment was conducted at an after school care facility. In total, 86 children aged four to six either crafted a peacock with vegetables or with non-food objects following an example. After the task, children ate snack vegetables ad libitum, and rated their liking for the vegetables and pride in crafting the peacock. Findings No significant main effect of the vegetable snack creation on consumption and liking was observed. Also, perceived pride did not mediate the effect of self-crafting vegetable snacks on consumption of and liking for vegetables. Research limitations/implications Vegetable consumption did not differ between children who were either simply exposed to vegetable snacks while crafting or those who were crafting the vegetable snacks themselves. The equal consumption might suggest that this is caused by simple exposure, but more research is needed comparing self-crafting and exposure to a condition where there is no initial exposure to vegetables. Originality/value Although the IKEA-effect has been demonstrated in adults, this is one of the first studies evaluating the IKEA-effect in children and as a means to increase liking for a generally disliked product in this target group, i.e. vegetables. The IKEA-effect could not be replicated under these more stringent conditions, where the experimental set-up enabled disentangling exposure and crafting effects.

Portion sizes of commercially available foods have increased, and there is evidence that exposure to portion sizes recalibrates what is perceived as &lsquo, normal&rsquo, and subsequently, how much food is selected and consumed. The present study aims to explore the role of social (descriptive and injunctive) and personal portion size norms in this effect. Across two experiments, participants were either visually exposed to (Study 1, N = 329) or actually served (Study 2, N = 132) a smaller or larger than normal food portion. After 24 h, participants reported their intended consumption (Study 1) or served themselves and consumed (Study 2) a portion of that food and reported perceived portion size norms. In Study 1, visual exposure to portion size did not significantly affect intended consumption and perceived portion size norms. In Study 2, participants consumed a smaller portion of food when they were served a smaller rather than a larger portion the previous day, which was mediated by perceived descriptive and injunctive social (but not personal) portion size norms. Results suggest that being served (but not mere visual exposure to) smaller (relative to larger) portions changes perceived social norms about portion size and this may reduce future consumption of that food.

Background Lunch is an important part of a healthy diet, which is essential for the development, growth and academic performance of school-aged children. Currently there is an increasing number of Dutch primary schoolchildren who are transitioning from eating lunch at home to school. There is limited knowledge about the current quality of the lunches consumed by primary schoolchildren in the Netherlands and whether there are any differences between lunches consumed at home or at school. To investigate differences in content and quality of lunches consumed by Dutch primary schoolchildren at home and at school. Methods Cross-sectional study among 363 Dutch primary schoolchildren aged 4–12 years based on the first two years of the 2012–2016 Dutch National Food Consumption Survey. Demographic characteristics were obtained through a questionnaire. Diet was assessed with two non-consecutive 24-h dietary recalls. Quality of lunches was assessed on their nutritional quality whether they fitted the nutritional guidelines. ‘Nonparametric tests were used to examine the content and quality of the lunches between place of consumption and parental educational position. Results The most consumed lunch products among primary schoolchildren were bread, dairy products and sugar-sweetened beverages. Fruit and vegetable consumption was very low. Consumption of milk and other dairy products was higher among children who eat lunch at home than children who eat lunch at school (p Conclusions The current content of the lunches consumed by Dutch primary schoolchildren leaves room for improvement, especially regarding fruit and vegetables. The statistically significantly higher consumption of sugar-sweetened beverages and lower consumption of milk and dairy products at school vs. home is worrisome, as currently more children in the Netherlands are transitioning to having lunch at school.

Children's breakfast habits are suboptimal. A novel school-based education programme was developed and tested with the aim of improving children's attitude, knowledge and breakfast quality. A pre- and post-test design was used with four conditions: group-based education, role modelling, tailored feedback with goal setting, and a combination of these three delivery modes. Two hundred eighty children from disadvantaged communities (9.3 ± 0.8 years) participated in three lessons at school over a two-month period. Children's attitude, knowledge and breakfast behaviour were evaluated by a pre- and post-questionnaire completed by the children. A follow-up measure was executed at 24 weeks. The data were analysed by repeated measures ANOVA. At baseline, 90% of the children ate breakfast on the measurement day; 60–76% of the children ate breakfast daily. Between pre- and post-test, a significant time effect was found for children's attitude, self-efficacy, knowledge and behaviour (all p < 0.05). Children in the feedback condition improved most favourably: correct classification of breakfast products increased by 10 products (out of 44) and breakfast quality score improved by 25 points (on a 100-point scale). The feedback condition also resulted in positive changes in the home setting. The follow-up test showed a decline in children's knowledge and their breakfast quality across conditions. To conclude, this study showed that a three-lesson school programme based on individual feedback and goal setting is most effective for changing knowledge on breakfasting and self-reported breakfast quality among children aged 8–10 years living in disadvantaged neighbourhoods. To maintain effectiveness, longer-term programmes embedded in the school curriculum are needed to enhance breakfast quality. Future research should explore the optimal duration and intensity of such programmes and should incorporate the topic of suitable portion sizes.

Health-related claims and symbols are intended as aids to help consumers make informed and healthier food choices but they can also stimulate the food industry to develop food that goes hand in hand with a healthier lifestyle. In order to better understand the role that health claims and symbols currently have and in the future potentially can have, the objective of the CLYMBOL project (“Role of health-related claims and symbols in consumer behaviour”, Grant no 311963) is to investigate consumers’ understanding of health claims and symbols, and how they affect purchasing and consumption [1]. As part of this endeavour, it is important to understand the history of use of claims and symbols in Europe. What have consumers been exposed to and how were these health-related messages used and discussed among the public? In this study, we interviewed key stakeholders across Europe about how health claims have been regulated in their country, how health symbols have been and currently are being treated, what form of monitoring there is or should be and how both health claims and symbols have been debated in the public opinion. In 26 European Union (EU) Member States, opinions from 53 key informants from up to three different stakeholder groups were gathered: national food authorities, representatives of the food industry, and consumer organisations. While 14 Member States reported (at least partial) regulation of the use of health claims and/or symbols before the introduction of the EU Regulation (EC 1924/2006) on nutrition and health claims made on foods [2], mandatory reporting of use had only been in place in three EU Member States. A number of voluntary codes of practice for health claims and/or symbols (i.e. pre-approval or justification when challenged) was said to be in use in 15 Member States. There are only a few national databases on health claims and symbols available, the data for which is often incomplete. Only eight Member States reported having some form of database from which information about health claims and symbols could be extracted. The stakeholders interviewed expressed a strong interest in measuring the impact of health claims and symbols, particularly research into the effects on consumer behaviour (e.g. awareness and understanding, attitudes towards products carrying claims and symbols and purchase/consumption effects), public health (health outcomes and changes in national health status due to the introduction of claims and symbols on food products) and economic aspects including sales, return on investment and reputation measurements. Public debates were said to have evolved around the topics of consumer understanding of claims, acceptance as well as trust in the information presented but also the effects on vulnerable groups such as children and elderly consumers. Another field of debate was said to have been the question of the effectiveness of health claims and symbols. Lastly, stakeholders reported that public debates focussed mainly on the legislative aspects, i.e. how to apply the EU Regulation (No 1924/2006) with regards to wording issues, the evaluation process at the European Food Safety Authority (EFSA), the status of various claims and the nutrient profile modelling to be introduced in Europe.

In this paper, we describe the systematic development and validation of the Multidimensional Internally Regulated Eating Scale (MIRES), a new self-report instrument that quantifies the individual-difference characteristics that together shape the inclination towards eating in response to internal bodily sensations of hunger and satiation (i.e., internally regulated eating style). MIRES is a 21-item scale consisting of seven subscales, which have high internal consistency and adequate to high two-week temporal stability. The MIRES model, as tested in community samples from the UK and US, had a very good fit to the data both at the level of individual subscales, but also as a higher-order formative model. High and significant correlations with measures of intuitive eating and eating competence lent support to the convergent validity of MIRES, while its incremental validity in relation to these measures was also upheld. MIRES as a formative construct, as well as all individual subscales, correlated negatively with eating disorder symptomatology and weight-related measures (e.g., BMI, weight cycling) and positively with adaptive behavioral and psychological outcomes (e.g., proactive coping, body appreciation, life satisfaction), supporting the criterion validity of the scale. This endeavor has resulted in a reliable and valid instrument to be used for the thorough assessment of the features that synthesize the profile of those who tend to regulate their eating internally.

Vending machines often provide relatively energy-dense snack foods and beverages at a wide variety of points-of-purchase. Vending-machine interventions that stimulate low-calorie choices can therefore play a role in improving the healthfulness of the food environment landscape. The aim of this study is to examine the effects of four vending-machine interventions, varying in level of intrusiveness, on consumers’ choices, consumers’ acceptance of such interventions, and consumers’ evaluations of the choice they made. In a between-subjects design experiment (N = 206), respondents were asked to purchase a snack and a beverage from a vending machine. In addition to a no-intervention condition, four types of incrementally intrusive interventions were implemented: calorie labelling, increasing accessibility of low-calorie choices, increasing prices of high-calorie choices, and restricting availability of high-calorie choices. A post-choice questionnaire included items concerning intervention acceptance, and assortment and choice evaluations. Compared to the no-intervention condition, the most intrusive intervention (i.e. restricting availability of high-calorie choices) led to more low-calorie choices (39% vs. 78%), while less intrusive interventions (i.e. calorie labelling, increasing accessibility of low-calorie choices, and increasing prices of high-calorie choices) did not. Intervention acceptance and choice evaluations were equally high across the four intervention types. Overall, the results suggest that restricting high-calorie options is a promising route to stimulate healthier choices from vending machines. As such, the present study provides intervention opportunities in the combat against obesity for governments and their potential allies, such as food manufacturers and the food service industry.

This chapter assesses whether nudging techniques can be argued to be a less restrictive but equally effective way to regulate diets in EU law, when contrasted to classical information-related or content-related regulation. It has been argued that nudging techniques, due to their freedom-preserving nature, might influence the proportionality test in such a way that authorities need to give preference to nudging techniques over content-related or information regulation. We will illustrate on the example of EU food law how behavioural sciences have first altered the EU food law’s goal from the mere provision of safety to also steering behaviour towards healthier diets. In line with this development, the regulatory toolbox advanced beyond the traditional dichotomy of content-related vs. information-related regulation, eventually adding nudging as a third way to regulate. Drawing on previous works of legal scholars we will then present the hypothesis that nudging techniques, according to their choice preserving nature on the one hand and steering character on the other, may be less restrictive but equally effective when contrasted with information-related or content-related regulation. With reference to recent CJEU case law that such a claim would better be backed up by scientific evidence, we will evaluate several nudging studies in the area of food that test the effectiveness of this approach. We will illustrate that, while nudging indeed has a choice-preserving nature and therefore might be less restrictive, it may also be classified under certain circumstances equally effective to information-related regulation. The EU judiciary has introduced an interpretation of the proportionality principle which requires a general preference for information-related rules. The evidence presented, however, may call for a different interpretation of the proportionality principle in some cases to the end that it may require policy makers in the EU to primarily use nudges instead of information-related regulation.

Consumer choices are often influenced by the default option presented. This study examines the effect of whole wheat bread as a default option in a sandwich choice situation. Whole wheat bread consists of 100% whole grain and is healthier than other bread types that are commonly consumed, such as brown or white bread. A pilot survey (N = 291) examined the strength of combinations of toppings and bread type as carrier to select stimuli for the main study. In the main experimental study consisting of a two (bread type) by two (topping type) between-subjects design, participants (N = 226) were given a free sandwich at a university stand with either a relatively unhealthy deep-fried snack (croquette) or a healthy topping. About half of the participants were offered a whole wheat bun unless they asked for white bun, and the other half were offered a white bun unless they asked for a whole wheat bun. Regardless of the topping, the results show that when the whole wheat bun was the default option, 108 out of 115 participants (94%) decided to stick with this default option. When the default of bread offered was white, 89 out of 111 participants (80%) similarly chose to stick with this default. Across conditions, participants felt equally free to make a choice. The attractiveness of and willingness to pay for the sandwich were not affected by default type of bread. This study demonstrated a strong default effect of bread type. This clearly shows the benefit of steering consumers towards a healthier bread choice, by offering healthier default bread at various locations such as restaurants, schools and work place canteens.

ObjectivePeople eat more unhealthy foods when served more (portion size effect) and when the food is served in larger units (unit size effect). The present study aimed to examine whether these effects can be used for the good: to increase vegetable consumption among children.DesignA 2×2 between-subjects experiment was conducted at two schools. Pupils were presented in class with cucumber that varied both in unit size (one piece v. pre-sliced) and portion size (one-third v. two-thirds of a cucumber). Children ate ad libitum during the morning break and filled in a survey.SettingPrimary schools in the centre of the Netherlands.SubjectsPrimary-school pupils (n 255) aged 8–13 years.ResultsChildren ate 54 % more cucumber when served a large compared with a smaller portion (difference of 49 g; PP=0·58), but were considered as less convenient to eat than small units (P=0·001).ConclusionsFindings suggest that children’s vegetable intake can be improved by serving larger portions in smaller-sized pieces.

This study explores the role of dichotomous thinking on eating behavior and its association with restraint eating and weight regain in a wide range of people. In a web-based survey with 241 adults, dichotomous thinking and behavioral outcomes related to eating (restraint eating, weight regain, body mass index, dieting) were assessed. Results showed that eating-specific dichotomous thinking (dichotomous beliefs about food and eating) mediates the association between restraint eating and weight regain. We conclude that holding dichotomous beliefs about food and eating may be linked to a rigid dietary restraint, which in turn impedes people’s ability to maintain a healthy weight.

There is little agreement among governments, institutions, scientists and food activists as to how to best tackle the challenging issues of health and sustainability in the food sector. This essay discusses the potential of school meals as a platform to promote healthy and sustainable food behavior. School meal programs are of particular interest for improving public diet because they reach children at a population scale across socio-economic classes and for over a decade of their lives, and because food habits of children are more malleable than those of adults. Current research on the history and health implications of school meal programs is reviewed in a cross-national comparative framework, and arguments explored that speak for the need of a new developmental phase of school meals as an integrative learning platform for healthy and sustainable food behavior. Nutritional, social, practical, educational, economical, political, and cultural perspectives and challenges linked to the implementation of healthy and sustainable school meals are discussed. Finally, the need for long-term interventions and evaluations is highlighted and new research directions are proposed.

Promoting protein consumption in the elderly population may contribute to improving the quality of their later years in life. Our study aimed to explore knowledge, perceptions and preferences of elderly consumers regarding protein-enriched food. We conducted three focus groups with independently living (ID) elderly (N¿=¿24, Mage¿=¿67¿years) and three with elderly living in a residential home (RH) (N¿=¿18, Mage¿=¿83¿years). Both the ID and RH elderly were predominantly sceptical about functional food in general. Confusion, distrust and a perceived lack of personal relevance were main perceived barriers to purchasing and consuming these products, although a majority of the participants did report occasionally consuming at least one type of functional food. For the ID elderly, medical advice was an important facilitator that could overcome barriers to purchasing and consuming protein-enriched food, indicating the importance of personal relevance for this group. For the RH elderly, in contrast, sensory appeal of protein-enriched foods was a facilitator. Carrier preferences were similar for the two groups; the elderly preferred protein-enriched foods based on healthy products that they consumed frequently. Future studies should explore ways to deal with the confusion and distrust regarding functional food within the heterogeneous population of elderly. Keywords Focus group; Protein; Functional food; Senior; Distrust; Personal relevance

Objective: What predicts whether a child will be at risk for obesity? Whereas past research has focused on foods, eating habits, feeding styles, and family meal patterns, this study departs from a food-centric approach to examine how various dinner rituals might influence the BMIs of children and adults. Methods: In this study of 190 parents (BMI529.167.2) and 148 children (BMI520.364.4), the relationship between their BMIs and everyday family dinner rituals was examined using both correlation and regression analysis (controlled for educational level of parents). Results: Families who frequently ate dinner in the kitchen or dining room had significantly lower BMIs for both adults (r520.31) and children (r520.24) compared to families who ate elsewhere. Additionally, helping cook dinner was associated with higher BMI for girls (r50.26), and remaining at the table until everyone is finished with eating was associated with lower BMI for boys (r520.31). Conclusions: Dinner tables may be one place where social support and family involvement meet—both of which relate to the BMI of children as well as parents. Family meals and their rituals might be an underappreciated battleground to fight obesity.

Could smaller snack portions be similarly effective in decreasing cravings or feelings of hunger as larger portions? To answer this, three common snack foods – chocolate, apple pie, potato chips – were given to 104 participants as either a small portion (x) or a substantially larger portion (5–10x). Results indicate that smaller portions satisfied one’s ratings of hunger and craving similar to larger portions, but led to a mean intake that was significantly lower than in the large portion condition (with a difference of 103 calories). This suggests that 15 min after eating a considerably smaller snack, people will have eaten much less but will feel equally satisfied.

The objective of this study was to explore parents', children's, and experts' beliefs and experiences about breakfast motivation, opportunity, and ability and elicit their thoughts on effective interventions to encourage healthy breakfast consumption. The setting was a disadvantaged neighbourhood in Rotterdam, the Netherlands. Focus groups with mothers and children and semi-structured individual interviews with experts were conducted. Interview guides were developed based on the motivation, opportunity, and ability consumer psychology model. Thirty-two mothers of primary school children participated in five group discussions, eight focus groups were conducted with 44 children, and nine experts participated in interviews. Data from expert interviews and group discussions were coded and thematically analysed. The following themes emerged from the focus groups: (1) generally high motivation to have breakfast, (2) improved performance at school is key motivator, (3) limited time hinders breakfast, and (4) lack of nutritional knowledge about high quality breakfast. Experts mentioned lack of effort, knowledge, and time; financial constraints; and environmental issues (food availability) as barriers to breakfasting healthily. Several ways to encourage healthy breakfasting habits were identified: (1) involvement of both children and parents, (2) role models inspiring change, and (3) interactive educational approaches. Experts perceived more problems and challenges in achieving healthy breakfast habits than did mothers and children. Lack of opportunity (according to the children and experts) and ability (according to the experts) were identified, although the motivation to eat a healthy breakfast was present. Predominant barriers are lack of time and nutritional knowledge. Overall, findings suggest educational and social marketing approaches as interventions to encourage healthy breakfast consumption.

Even though whole grain foods have various health benefits, consumers have been found not to eat enough of them. Nudging interventions are built on the premise that food purchases and consumption are strongly influenced by the environment in which decisions are made. Little research has been conducted to examine the influence of a small and inexpensive nudging intervention on bread choices in a real-life supermarket context. An in-store experiment was conducted in two six-week periods in two supermarkets to investigate the effects of accessibility on consumers’ purchase of healthier whole grain and other types of bread. In the high accessibility condition, healthier bread was placed in a more convenient location for the shopper on the left side of the shelves where it was encountered first. In the low accessibility condition, it was placed on the right side. There were consistent significant differences in sales between supermarkets, types of bread, day of the week, but not between low and high accessibility. Additional research is needed to better understand the effects of convenience and accessibility on bread choices.

Regulators legislate businesses’ use of claims on product packaging by mostly focusing on textual claims and the extent to which they could potentially mislead consumers. Interpreting textual claims generally requires consumers to engage in extensive and deliberate processing (so-called type 2 processing in dual processing models in social psychology). In real life competitive choice settings, however, businesses preferably make use of colours and other visual elements to successfully attract consumers. In case this approach supports consumers in making healthier food decisions, it can be seen as a form of nudging, as this approach largely appeals to consumers’ reactive, intuitive modes of decision making (i.e., system 1 processing). Nevertheless, visuals may mislead consumers to a larger extent than textual claims in that they overpromise health benefits of consuming the product. In order to effectively regulate health claims in the EU, we claim that regulation has to devote attention to the regulation of pictorial claims. We will first illustrate such a mechanism and its potential for effective nudging on the example of health and nutrition claims in the EU. We will then investigate on the example of the differences between textual and pictorial claims whether the EU health claims regulation is effective in making sure that sales techniques of food companies are being regulated as effective nudging instead of misleading marketing tactics.

Research in developed countries showed that many citizens perceive that radio signals transmitted by mobile phones and base stations represent potential health risks. Less research has been conducted in developing countries focused on citizen perceptions of risks and benefits, despite the recent and rapid introduction of mobile communication technologies. This study aims to identify factors that are influential in determining the tradeoffs that Bangladeshi citizens make between risks and benefits in terms of mobile phone technology acceptance and health concerns associated with the technology. Bangladesh was selected as representative of many developing countries inasmuch as terrestrial telephone infrastructure is insubstantial, and mobile phone use has expanded rapidly over the last decade, even among the poor. Issues of importance were identified in a small-scale qualitative study among Bangladeshi citizens (n = 13), followed by a survey within a sample of Bangladeshi citizens (n = 500). The results demonstrate that, in general, the perceived benefits of mobile phone technology outweigh the risks. The perceived benefits are primarily related to the social and personal advantages of mobile phone use, including the ability to receive emergency news about floods, cyclones, and other natural disasters. Base stations were seen as a symbol of societal advance. The results furthermore suggest that overall risk perceptions are relatively low, in particular health risks, and are primarily driven by perceptions that related to crime and social inconvenience. Perceived health risks are relatively small. These findings show that risk communication and management may be particularly effective when contextual factors of the society where the system is implemented are taken into consideration.

In European countries, there has been growing consumer distrust regarding the motives of food safety regulators and other actors in the food chain, partly as a result of recent food safety incidents. If consumer confidence in food safety is to be improved, a systematic understanding of what consumers perceive to be best practice in risk management is crucial. Previous qualitative and quantitative research has revealed underlying factors determining consumer perceptions of food risk management quality. The aim of the current case studies is to provide `proof of principles¿ of these different factors against historic and emerging food safety incidents. Participants in four countries were questioned about country specific case studies, guided by the earlier findings regarding factors that determine perceived good practice in food risk management. In each country, two food safety incidents were selected. Semi-structured interviews with at least 25 participants per case study were conducted in Germany (BSE; nematode worms in fish), Greece (mould in Greek yogurt/carcinogenic honey crisis; avian influenza), Norway (E. coli in meat; contaminants in Norwegian salmon) and the UK (BSE; contaminants in Scottish salmon). The results generally confirm the importance of the previously identified factors, which help to explain relative perceptions of well and poorly managed incidents. Differences and similarities across countries and cases are detailed, and implications for future efforts to communicate about risk management are drawn. Keywords: food safety; consumer evaluations; food risk management; trust; food safety incidents

Recent emphasis within policy circles has been on transparent communication with consumers about food risk management decisions and practices. As a consequence, it is important to develop best practice regarding communication with the public about how food risks are managed. In the current study, the provision of information about regulatory enforcement, proactive risk management, scientific uncertainty and risk variability were manipulated in an experiment designed to examine their impact on consumer perceptions of food risk management quality. In order to compare consumer reactions across different cases, three food hazards were selected (mycotoxins on organically grown food, pesticide residues, and a genetically modified potato). Data were collected from representative samples of consumers in Germany, Greece, Norway and the UK. Scores on the "perceived food risk management quality" scale were subjected to a repeated-measures mixed linear model. Analysis points to a number of important findings, including the existence of cultural variation regarding the impact of risk communication strategies-something which has obvious implications for pan-European risk communication approaches. For example, while communication of uncertainty had a positive impact in Germany, it had a negative impact in the UK and Norway. Results also indicate that food risk managers should inform the public about enforcement of safety laws when communicating scientific uncertainty associated with risks. This has implications for the coordination of risk communication strategies between risk assessment and risk management organizations.