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      Is the effect of menu energy labelling on consumer behaviour equitable? A pooled analysis of twelve randomized control experiments

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          Abstract

          Menu energy labelling has been implemented as a public health policy to promote healthier dietary choices and reduce obesity. However, it is unclear whether the influence energy labelling has on consumer behaviour differs based on individuals’ demographics or characteristics and may therefore produce inequalities in diet. Data were analysed from 12 randomized control trials (N = 8508) evaluating the effect of food and drink energy labelling (vs. labelling absent) on total energy content of food and drink selections (predominantly hypothetical) in European and US adults. Analyses examined the moderating effects of participant age, sex, ethnicity/race, education, household income, body mass index, dieting status, food choice motives and current hunger on total energy content of selections.

          Energy labelling was associated with a small reduction (f 2 = 0.004, −50 kcal, p < 0.001) in total energy selected compared to the absence of energy labelling. Participants who were female, younger, white, university educated, of a higher income status, dieting, motivated by health and weight control when making food choices, and less hungry, tended to select menu items of lower energy content. However, there was no evidence that the effect of energy labelling on the amount of energy selected was moderated by any of the participants’ demographics or characteristics. Energy labelling was associated with a small reduction in energy content of food selections and this effect was similar across a range of participants’ demographics and characteristics. These preliminary findings suggest that energy labelling policies may not widen existing inequalities in diet.

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          Global nutrition transition and the pandemic of obesity in developing countries.

          Decades ago, discussion of an impending global pandemic of obesity was thought of as heresy. But in the 1970s, diets began to shift towards increased reliance upon processed foods, increased away-from-home food intake, and increased use of edible oils and sugar-sweetened beverages. Reductions in physical activity and increases in sedentary behavior began to be seen as well. The negative effects of these changes began to be recognized in the early 1990s, primarily in low- and middle-income populations, but they did not become clearly acknowledged until diabetes, hypertension, and obesity began to dominate the globe. Now, rapid increases in the rates of obesity and overweight are widely documented, from urban and rural areas in the poorest countries of sub-Saharan Africa and South Asia to populations in countries with higher income levels. Concurrent rapid shifts in diet and activity are well documented as well. An array of large-scale programmatic and policy measures are being explored in a few countries; however, few countries are engaged in serious efforts to prevent the serious dietary challenges being faced. © 2012 International Life Sciences Institute.
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            Obesity, eating behavior and physical activity during COVID-19 lockdown: A study of UK adults

            Eating, physical activity and other weight-related lifestyle behaviors may have been impacted by the COVID-19 crisis and people with obesity may be disproportionately affected. We examined weight-related behaviors and weight management barriers among UK adults during the COVID-19 social lockdown. During April–May of the 2020 COVID-19 social lockdown, UK adults (N = 2002) completed an online survey including measures relating to physical activity, diet quality, overeating and how mental/physical health had been affected by lockdown. Participants also reported on perceived changes in weight-related behaviors and whether they had experienced barriers to weight management, compared to before the lockdown. A large number of participants reported negative changes in eating and physical activity behavior (e.g. 56% reported snacking more frequently) and experiencing barriers to weight management (e.g. problems with motivation and control around food) compared to before lockdown. These trends were particularly pronounced among participants with higher BMI. During lockdown, higher BMI was associated with lower levels of physical activity and diet quality, and a greater reported frequency of overeating. Reporting a decline in mental health because of the COVID-19 crisis was not associated with higher BMI, but was predictive of greater overeating and lower physical activity in lockdown. The COVID-19 crisis may have had a disproportionately large and negative influence on weight-related behaviors among adults with higher BMI.
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              Does social class predict diet quality?

              A large body of epidemiologic data show that diet quality follows a socioeconomic gradient. Whereas higher-quality diets are associated with greater affluence, energy-dense diets that are nutrient-poor are preferentially consumed by persons of lower socioeconomic status (SES) and of more limited economic means. As this review demonstrates, whole grains, lean meats, fish, low-fat dairy products, and fresh vegetables and fruit are more likely to be consumed by groups of higher SES. In contrast, the consumption of refined grains and added fats has been associated with lower SES. Although micronutrient intake and, hence, diet quality are affected by SES, little evidence indicates that SES affects either total energy intakes or the macronutrient composition of the diet. The observed associations between SES variables and diet-quality measures can be explained by a variety of potentially causal mechanisms. The disparity in energy costs ($/MJ) between energy-dense and nutrient-dense foods is one such mechanism; easy physical access to low-cost energy-dense foods is another. If higher SES is a causal determinant of diet quality, then the reported associations between diet quality and better health, found in so many epidemiologic studies, may have been confounded by unobserved indexes of social class. Conversely, if limited economic resources are causally linked to low-quality diets, some current strategies for health promotion, based on recommending high-cost foods to low-income people, may prove to be wholly ineffective. Exploring the possible causal relations between SES and diet quality is the purpose of this review.
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                Author and article information

                Journal
                8006808
                696
                Appetite
                Appetite
                Appetite
                0195-6663
                1095-8304
                3 April 2023
                01 March 2023
                05 January 2023
                01 March 2024
                : 182
                : 106451
                Affiliations
                [a ] Department of Psychology, University of Liverpool, Liverpool, UK
                [b ] Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
                [c ] Gender Identity Development Service, Tavistock and Portman NHS Trust, London, UK
                [d ] Behavioural Research Unit, Economic and Social Research Institute, Ireland & School of Psychology, Trinity College Dublin, Dublin, Ireland
                [e ] Department of Psychology, City, University of London, UK
                [f ] Centre des Sciences Du Goût et de l’Alimentation, CNRS, INRAE, Institut Agro, Université Bourgogne Franche-Comté, F-21000, Dijon, France
                Author notes

                Author contributions

                All authors contributed to designing the research. ER and LM analysed the data and drafted the manuscript. All authors contributed to the manuscript and approved the final manuscript.

                [* ] Corresponding author. Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK. eric.robinson@ 123456liv.ac.uk (E. Robinson).
                Article
                NIHMS1884265
                10.1016/j.appet.2023.106451
                10082393
                36610541
                551e5e2a-dc72-4f6d-8ea1-c18bd5fc3a6a

                This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/).

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                energy labeling,calorie labels,individual differences,obesity policy

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