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      Assessment of the knowledge, attitudes and practices of Lebanese shoppers towards food labeling: The first steps in the Nutri-score roadmap

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          Abstract

          Background: Food labeling is a fundamental educational tool for advocating for public awareness. It emphasizes knowledge of the nutrient content of food and thus directs the choice towards the healthiest food products.

          This cross-sectional survey aimed to assess the knowledge, attitudes, and practices (KAP) regarding nutrition label use in Lebanon through a valid questionnaire.

          Methods: Overall, 768 participants (mean age: 30.8 ±12, males: 60.2%) were recruited randomly between February and May 2020. We used word of mouth and social media to recruit our sample population.

          Results: Social media was the most accessed tool to attain nutrition information by responders (39.8%). More than half the participants expressed positive attitudes to check information related to sugars (66.4%), vitamins (64.9%), total fats (61.7%), proteins (59.1%), and calories (58.7%) on the food label. Expiry date, price, and brand name were the top three considerations while reading food labels. About half (46.5%) reported to “always” look at the food label. Responders reported reading labels related primarily to sugars (44.3%), calories (38.8%), and total fats (36.8%). The optimal total KAP score was 46; our findings revealed a mean KAP score of 14.46 ±7 (31.4%). When categorizing the KAP scores, 15% had high scores, and 85% scored low. Spearman’s coefficients showed positive correlations between knowledge-attitude, knowledge-practice, and attitude-practice scores, with p<0.001. The regression analysis revealed that gender, age, BMI, residency area, educational level, university degree, health and diet statuses, and activity level were significant predictors of the KAP score. Being on a diet had the highest odds (OR=3.107, CI=1.904-5.072, p<0.001).

          Conclusion: The low awareness of food labels leads Lebanese people to choose unhealthy food options. A planned educational program is recommended to ease the interpretation of these labels.

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          Most cited references45

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          Nutrition knowledge, and use and understanding of nutrition information on food labels among consumers in the UK.

          Based on in-store observations in three major UK retailers, in-store interviews (2019) and questionnaires filled out at home and returned (921), use of nutrition information on food labels and its understanding were investigated. Respondents' nutrition knowledge was also measured, using a comprehensive instrument covering knowledge of expert recommendations, nutrient content in different food products, and calorie content in different food products. Across six product categories, 27% of shoppers were found to have looked at nutrition information on the label, with guideline daily amount (GDA) labels and the nutrition grid/table as the main sources consulted. Respondents' understanding of major front-of-pack nutrition labels was measured using a variety of tasks dealing with conceptual understanding, substantial understanding and health inferences. Understanding was high, with up to 87.5% of respondents being able to identify the healthiest product in a set of three. Differences between level of understanding and level of usage are explained by different causal mechanisms. Regression analysis showed that usage is mainly related to interest in healthy eating, whereas understanding of nutrition information on food labels is mainly related to nutrition knowledge. Both are in turn affected by demographic variables, but in different ways.
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            Transforming the food system to fight non-communicable diseases

            Malnutrition and unhealthy diets are important risk factors for non-communicable diseases. Francesco Branca and colleagues call for changes in both what and how food is produced, marketed, and consumed
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              The effects of nutrition knowledge on food label use. A review of the literature.

              Nutrition information on food labels is an important source of nutrition information but is typically underutilized by consumers. This review examined whether consumer nutrition knowledge is important for communication of nutrition information through labels on packaged foods. A cognitive processing model posits that consumers with prior knowledge are more likely to use label information effectively, that is, focus on salient information, understand information, and make healthful decisions based on this information. Consistent with this model, the review found that nutrition knowledge provides support for food label use. However, nutrition knowledge measures varied widely in terms of the dimensions they included and the extensiveness of the assessment. Relatively few studies investigated knowledge effects on the use of ingredient lists and claims, compared to nutrition facts labels. We also found an overreliance on convenience samples relying on younger adults, limiting our understanding of how knowledge supports food label use in later life. Future research should 1) investigate which dimensions, or forms, of nutrition knowledge are most critical to food label use and dietary decision making and 2) determine whether increases in nutrition knowledge can promote great use of nutrition information on food labels.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: InvestigationRole: MethodologyRole: Project AdministrationRole: SupervisionRole: ValidationRole: Writing – Original Draft Preparation
                Role: Data CurationRole: Formal AnalysisRole: Writing – Original Draft Preparation
                Role: InvestigationRole: MethodologyRole: SupervisionRole: Writing – Review & Editing
                Role: Data CurationRole: Formal AnalysisRole: Writing – Review & Editing
                Role: ConceptualizationRole: Data CurationRole: MethodologyRole: Writing – Review & Editing
                Role: Data CurationRole: Formal AnalysisRole: Writing – Review & Editing
                Role: Data CurationRole: Formal AnalysisRole: Writing – Review & Editing
                Journal
                F1000Res
                F1000Res
                F1000Research
                F1000 Research Limited (London, UK )
                2046-1402
                5 May 2022
                2022
                : 11
                : 84
                Affiliations
                [1 ]Faculty of Public Health, Lebanese University, Beirut, 961, Lebanon
                [2 ]PHENOL research group (Public HEalth Nutrition prOgram-Lebanon), Faculty of Public Health, Lebanese University, Beirut, 961, Lebanon
                [3 ]Lebanese University Nutrition Surveillance Center (LUNSC), Lebanese Food Drugs and Chemical Administrations, Lebanese University, Beirut, Lebanon
                [4 ]World Health Organization Regional Office for the Eastern Mediterranean, World Health Organization, Cairo, 11371, Egypt
                [5 ]Faculty of Nursing and Health Sciences, Notre Dame University, Zouk Mosbeh, Lebanon
                [1 ]Food Security Research Center AND Department of Food Science and Technology, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
                [1 ]Department of Nutritional Sciences, Faculty of Health Sciences, University of Balamand, Tripoli, Lebanon
                [1 ]Department of Nutritional Sciences, Faculty of Health Sciences, University of Balamand, Tripoli, Lebanon
                [1 ]Food Security Research Center AND Department of Food Science and Technology, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
                Lebanese University, Lebanon
                Author notes

                No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Competing interests: No competing interests

                Author information
                https://orcid.org/0000-0001-7392-4835
                https://orcid.org/0000-0001-7387-8277
                https://orcid.org/0000-0003-0028-494X
                Article
                10.12688/f1000research.75703.2
                9194517
                35721597
                b81dc9e8-34ee-4aaa-a3b3-bfffbd2c5e7c
                Copyright: © 2022 Hoteit M et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 21 April 2022
                Funding
                The author(s) declared that no grants were involved in supporting this work.
                Categories
                Research Article
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                food labels,knowledge,attitude,practices,lebanon
                food labels, knowledge, attitude, practices, lebanon

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