Dietary Decisions Research Articles

How Do Consumers Use Nutrition Labels on Food Products in the United States?

This study examined how consumers use food labels in the United States. Based on the results from the cluster analysis, eight nutrition label questions from the Health and Diet Survey fell into 2 categories of label usage: for shopping or for dietary decisions. Survey respondents reported equal or more consideration of nutrition-label information for dietary choices than for shopping decisions in 2008 compared with prior survey years. Female consumers, frequent label users, well-educated, consumers aged 50 to 59, or consumers with any health issues were significantly more likely to use food labels for all kinds of purposes than their corresponding counterparts.

Identifying the mechanisms through which behavioral weight-loss treatment improves food decision-making in obesity

ObjectivesBehavioral weight loss (BWL) programs are the recommended treatment for obesity, yet it is unknown whether these programs change one's ability to use self-control in food choices and what specific mechanisms support such change. Using experimental economics methods, we investigated whether changes in dietary behavior in individuals with obesity following BWL are driven by one or more of the following potential mechanisms: changes in the perception of the 1) health or 2) taste of food items, and/or 3) shifting decision weights for health versus taste attributes. Therefore, we compared these mechanisms between obese participants and lifetime normal weight controls (NW) both before and after BWL. MethodsFemales with obesity (N = 37, mean BMI = 33.2) completed a food choice task involving health ratings, taste ratings, and decision-making pre- and post-standard BWL intervention. NW controls (N = 30, BMI = 22.4) completed the same task. ResultsIndividuals with obesity exhibited increased self-control (selecting healthier, less tasty food choices) post-treatment. However, their rates of self-control remained significantly lower than NW. We found no differences in initial health perceptions across groups, and no changes with treatment. In contrast, taste ratings and the relative value of taste versus health decreased following treatment. Although, post-treatment participants continued to perceive unhealthy foods as tastier and used less self-control than NW controls, they showed significant improvements in these domains following a BWL intervention. ConclusionsTo help individuals improve dietary decisions, additional research is needed to determine how to make greater changes in taste preferences and/or the assignment of value to taste versus health attributes in food choices.

Vitamin-Fortified Snack Food May Lead Consumers to Make Poor Dietary Decisions

BackgroundThe US Food and Drug Administration’s (FDA’s) fortification policy discourages the fortification of certain foods, including sugars and snack foods such as cookies, candies, cakes, chips, and carbonated beverages, yet manufacturers sometimes add vitamins and minerals to snack foods. ObjectiveTo assess whether vitamin-fortified snack foods affect consumers’ information-seeking, purchase decisions, and product-related health perceptions. DesignFor this experimental study, participants were randomly assigned to study conditions to compare products that varied in product type, nutrition profile, and fortification and nutrient claim status. Data were collected via an online consumer panel. Participants/settingUS adults aged 18 years and older were randomly selected from Research Now’s e-panel online household panel. Data were collected during fall 2014 (N=5,076). InterventionParticipants were randomly assigned to one of 24 conditions: two products (vegetable chip/potato chip), two nutrition profiles (healthier/less healthy), two fortification scenarios (not fortified/fortified), and three nutrient claim conditions (two no claim/one with claim). The design was not balanced; claims were not shown on products that were not vitamin fortified. Main outcome measuresOutcome measures were information-seeking (viewed the Nutrition Facts label), purchase decisions, perception of product healthfulness, and correct selection of product with the healthier nutrient profile. Statistical analysis performedLogistic regression was used to test all models. Analyses was adjusted for general label use, consumes product, health status, age, sex, level of education, presence of children in the household, and race/ethnicity. ResultsWhen the snack food carried a nutrient claim for vitamin fortification, participants were 1) less likely to look for nutrition information on the Nutrition Facts label, 2) more likely to select the product for purchase, 3) more likely to perceive the product as healthier, and 4) less likely to correctly choose the healthier product. ConclusionsSnack foods that have been vitamin-fortified may cause consumers to make poor dietary decisions.

Impact of explained v. unexplained front-of-package nutrition labels on parent and child food choices: a randomized trial.

The present study investigated whether parent/child pairs would select more healthful foods when: (i) products were labelled with front-of-package (FOP) nutrition labels relative to packages without labels; (ii) products were labelled with colour-coded Multiple Traffic Light (MTL) FOP labels relative to monochromatic Facts up Front (FuF) FOP labels; and (iii) FOP labels were explained via in-aisle signage v. unexplained. Participants were randomly assigned to one of five conditions: (i) FuF labels with in-aisle signs explaining the labels; (ii) FuF labels, no signage; (iii) MTL labels with in-aisle signage; (iv) MTL labels, no signage; (v) control group, no labels/signage. Saturated fat, sodium, sugar and energy (calorie) content were compared across conditions. The study took place in a laboratory grocery aisle. Parent/child pairs (n 153) completed the study. Results did not support the hypothesis that MTL labels would lead to more healthful choices than FuF labels. The presence of FOP labels did little to improve the healthfulness of selected foods, with few exceptions (participants with v. without access to FOP labels selected lower-calorie cereals, participants with access to both FOP labels and in-aisle explanatory signage selected products with less saturated fat v. participants without explanatory signage). Neither MTL nor FuF FOP labels led to food choices with significantly lower saturated fat, sodium or sugar. In-aisle signs explaining the FOP labels were somewhat helpful to consumers in making more healthful dietary decisions. New FOP labelling programmes could benefit from campaigns to increase consumer awareness and understanding of the labels.

An Examination of Factors Associated With Self-Efficacy for Food Choice and Healthy Eating among Low-Income Adolescents in Three U.S. States

Background: Self-efficacy is a crucial component in effective health communication and health promotion interventions and serves as a moderator for behavior change. Although awareness and risk perception are important in the behavior change process, self-efficacy gives people the necessary confidence in their ability to engage in advocated health behaviors. In addressing childhood obesity, self-efficacy plays a crucial role in dietary decisions. Informed by the social cognitive theory, this study examines the behavioral and environmental factors that determine self-efficacy for healthy food choices and healthy eating among adolescents in low income communities. Method: A survey was administered among adolescents in 6th to 8th grades from three U.S. States -- Kansas, Ohio and South Dakota (N=410). Results: Results show a correlation between efficacy for healthy food choice and the adolescent’s perceptions of behavioral control or sense of empowerment. Attitudes towards overall health predict efficacy for healthy eating and for healthy food choice. Other predictors for healthy eating include perceptions of peers’ health concerns and perceptions on healthy food availability whereas perceived control influences efficacy for healthy food choice. Gender played a significant role in adolescents’ perceptions of peers’ health concerns whereas geographical location (state played a role in their in adolescents’ attitudes toward health. Ethnicity was a more significant factor in their perceived barriers for healthy eating, perceptions for healthy food availability and in attitudes towards health. Conclusion: The study suggests ethnic-specific nutrition education that focuses on attitudes towards health as well as community partnerships that would support a healthy food environment to enhance self-efficacy and healthy dietary behaviors among adolescents.

Factors Determining Dietary Decisions for South Asians Living in the U.S.

South Asians are at an increased risk of diabetes and heart disease.Lifestyle factors play a role in the development of these conditions.The objective is to understand factors that aid in making healthy food decisions specifically for South Asians living in the U.S.This can help guide the development of culturally appropriate nutrition education programs for South Asians which focus on increasing the knowledge,awareness and improved dietary behavior in this population.

The reasoned/reactive model: A new approach to examining eating decisions among female college dieters and nondieters

Female college students are prone to unhealthy eating patterns that can impact long-term health. This study examined female students' healthy and unhealthy eating behaviors with three decision-making models. Specifically, the theory of reasoned action, prototype/willingness model, and new reasoned/reactive model were compared to determine how reasoned (logical) and reactive (impulsive) factors relate to dietary decisions. Females (N=583, Mage=20.89years) completed measures on reasoned cognitions about foods (attitudes, subjective norms, nutrition knowledge, intentions to eat foods), reactive cognitions about foods (prototypes, affect, willingness to eat foods), dieting, and food consumption. Structural equation modeling (SEM) revealed the new reasoned/reactive model to be the preeminent model for examining eating behaviors. This model showed that attitudes were related to intentions and willingness to eat healthy and unhealthy foods. Affect was related to willingness to eat healthy and unhealthy foods, whereas nutrition knowledge was related to intentions and willingness to eat healthy foods only. Intentions and willingness were related to healthy and unhealthy food consumption. Dieting status played a moderating role in the model and revealed mean-level differences between dieters and nondieters. This study highlights the importance of specific factors in relation to female students' eating decisions and unveils a comprehensive model for examining health behaviors.

Validation of the Food-Linked Virtual Response task.

This research validates a computerized dietary selection task (Food-Linked Virtual Response or FLVR) for use in studies of food consumption. In two studies, FLVR task responses were compared with measures of health consciousness, mood, body mass index, personality, cognitive restraint toward food, and actual food selections from a buffet table. The FLVR task was associated with variables which typically predict healthy decision-making and was unrelated to mood or body mass index. Furthermore, the FLVR task predicted participants' unhealthy selections from the buffet, but not overall amount of food. The FLVR task is an inexpensive, valid, and easily administered option for assessing momentary dietary decisions.

The Impact of Content-Based Network Technologies on Perceptions of Nutrition Literacy

Background: Consumers are exposed to obesogenic environments on a regular basis. Building nutrition literacy is critical for sustaining healthy dietary habits for a lifetime and reducing the prevalence of chronic disease. Purpose: There is a need to investigate the impact of content-based network (CBN) technologies on perceptions of nutrition literacy because use of content-based networks has increased indefinitely. Methods: A quantitative survey analyzed by structural equation modeling was used to examine 3 CBN characteristics: serendipitous nutrition discovery, nutrition information management, and social modeling in relation to nutrition self-efficacy and perceptions of nutrition literacy among a sample of undergraduate students (N = 349). Results: Users of the website Pinterest, the most popular CBN, provide support that perception of the CBN's ability to provide access to new and interesting nutrition content impacts feelings of self-efficacy when making dietary decisions. Translation to Health Education Practice: Content-based networks such as Pinterest may serve as a viable tool for increasing nutrition literacy by enhancing self-efficacy around nutrition.

Intra-Household Nutritional Dynamics: A Cross-Sectional Study of Maasai Communities in Kenya.

To date, research on dietary consumption and nutritional outcomes of the Maasai in Kenya have failed to explore how gender dynamics and intra-household bargaining power affect dietary decisions. This exploratory qualitative study investigates the decision-making processes regarding eating habits and health-seeking behavior within Maasai families in Kenya, and how such roles currently support or conflict with maternal and child health (MCH) program activities in the field of nutritional education and practices. The data were collected from the three group ranches in Laikipia County in Kenya and draws on six focus group discussions with a total of 24 Maasai men and 24 Maasai women. Our research has documented that the dietary and health-seeking decisions of Maasai families are influenced by complex intra- and extra-household factors. Programmatic interventions need to examine decision-making processes within the context of multi-generational family dynamics and gender hierarchies to scale up community-driven interventions to ensure sustained behavior change.

Correlates of nutrition label use among college students and young adults: a review.

Nutrition labels are an essential source for consumers to obtain nutrition-related information on food products and serve as a population-level intervention with unparalleled reach. The present study systematically reviewed existing evidence on the correlates of nutrition label use among college students and young adults. Keyword and reference searches were conducted in PubMed, EBSCO, PsycInfo, Cochrane Library and Web of Science. Inclusion criteria included: study design (randomized controlled trial, cohort study, pre-post study or cross-sectional study); population (college students and young adults 18-30 years old); main outcome (nutrition label use); article type (peer-reviewed publication); and language (English). College/university. College students and young adults. Sixteen studies based on data from college surveys in four countries (USA, UK, Canada, South Korea) were identified from keyword and reference search. Reported prevalence of nutrition label use varied substantially across studies; a weighted average calculation showed 36·5 % of college students and young adults reported using labels always or often. Females were more likely to use nutrition labels than males. Nutrition label use was found to be associated with attitudes towards healthy diet, beliefs on the importance of nutrition labels in guiding food selection, self-efficacy, and nutrition knowledge and education. The impact of nutrition labelling on food purchase and intake could differ by population subgroups. Nutrition awareness campaigns and education programmes may be important mechanisms for promoting nutrition label use among college students and young adults. Future research is warranted to assess the role of label use on improved dietary decisions.

Standardized food images: A photographing protocol and image database

The regulation of food intake has gained much research interest because of the current obesity epidemic. For research purposes, food images are a good and convenient alternative for real food because many dietary decisions are made based on the sight of foods. Food pictures are assumed to elicit anticipatory responses similar to real foods because of learned associations between visual food characteristics and post-ingestive consequences. In contemporary food science, a wide variety of images are used which introduces between-study variability and hampers comparison and meta-analysis of results. Therefore, we created an easy-to-use photographing protocol which enables researchers to generate high resolution food images appropriate for their study objective and population. In addition, we provide a high quality standardized picture set which was characterized in seven European countries. With the use of this photographing protocol a large number of food images were created. Of these images, 80 were selected based on their recognizability in Scotland, Greece and The Netherlands. We collected image characteristics such as liking, perceived calories and/or perceived healthiness ratings from 449 adults and 191 children. The majority of the foods were recognized and liked at all sites. The differences in liking ratings, perceived calories and perceived healthiness between sites were minimal. Furthermore, perceived caloric content and healthiness ratings correlated strongly (r ≥ 0.8) with actual caloric content in both adults and children. The photographing protocol as well as the images and the data are freely available for research use on http://nutritionalneuroscience.eu/. By providing the research community with standardized images and the tools to create their own, comparability between studies will be improved and a head-start is made for a world-wide standardized food image database.

Vending Assessment and Program Implementation in Four Iowa Worksites.

The worksite food environment, including vending options, has been explored as an important contributor to dietary decisions made every day. The current study describes the vending environment, and efforts to change it, in four Iowa worksites using a series of case studies. Data were gathered by local coordinators as part of the Iowa Community Transformation Grant project. Data were collected from three sources. First, the Nutrition Environment Measures Survey-Vending was used to assess healthy vending options in worksite machines before and after the intervention. Second, employee vending behavior was evaluated with a pre-, post-intervention survey. Items assessed attitudes and behaviors regarding vending, plus awareness and reaction to intervention activities. Third, program coordinators documented vending machine intervention strategies used, such as social marketing materials and product labels. The Nutrition Environment Measures Survey-Vending documented that the majority of vending options did not meet criteria for healthfulness. The vending survey found that employees were generally satisfied with the healthier items offered. Some differences were noted over time at the four worksites related to employee behavior and attitudes concerning healthy options. There were also differences in intervention implementation and the extent of changes made by vending companies. Overall, findings demonstrate that a large percentage of employees are constrained in their ability to access healthy foods due to limited worksite vending options. There also remain challenges to making changes in this environment. Findings have implications for public health practitioners to consider when designing healthy vending interventions in worksites.

How Do Consumers Use Nutrition Labels on Food Products?

ObjectiveTo understand how consumers use food labels and the trends of changes in consumer food label usage styles. To our knowledge, the present study was the first that examines food label usage styles with four compatible nationally representative surveys.Design, Setting and ParticipantsWe compared four cross-sectional Health & Diet Surveys (HDS) — HDS 1994 (n=1,945), 1995 (n=1,001), 2002 (2,743) and 2008 (n=2,584). United States Adults (18+).Outcome Measures and AnalysisEight food label usage questions and an index summing up these eight questions. We used cluster analysis, multinomial logistic, ordinary least squares regression modeling and nonparametric statistics.ResultsAs speculated, the eight label questions were grouped into two categories, which were generally in line with our label usage for shopping decisions or dietary decisions (e.g., meal planning) classifications. Regarding label usage styles, consumers paid either equal or more attention to label information for dietary decisions rather than for shopping decisions in 2008 as compared to previous years 1995 and 2002. More people used labels for all purposes around the implementation of NLEA in 1994 and 1995 as compared to 2008 (P < .001). Females, highly educated (some college or above), young old (aged 50-59), consumers with any health issue, and frequent label users were significantly more likely to use food labels for all kinds of purposes.Conclusions and ImplicationsEnhanced efforts in teaching consumers to use food labels for dietary purposes are needed.FundingNone. ObjectiveTo understand how consumers use food labels and the trends of changes in consumer food label usage styles. To our knowledge, the present study was the first that examines food label usage styles with four compatible nationally representative surveys. To understand how consumers use food labels and the trends of changes in consumer food label usage styles. To our knowledge, the present study was the first that examines food label usage styles with four compatible nationally representative surveys. Design, Setting and ParticipantsWe compared four cross-sectional Health & Diet Surveys (HDS) — HDS 1994 (n=1,945), 1995 (n=1,001), 2002 (2,743) and 2008 (n=2,584). United States Adults (18+). We compared four cross-sectional Health & Diet Surveys (HDS) — HDS 1994 (n=1,945), 1995 (n=1,001), 2002 (2,743) and 2008 (n=2,584). United States Adults (18+). Outcome Measures and AnalysisEight food label usage questions and an index summing up these eight questions. We used cluster analysis, multinomial logistic, ordinary least squares regression modeling and nonparametric statistics. Eight food label usage questions and an index summing up these eight questions. We used cluster analysis, multinomial logistic, ordinary least squares regression modeling and nonparametric statistics. ResultsAs speculated, the eight label questions were grouped into two categories, which were generally in line with our label usage for shopping decisions or dietary decisions (e.g., meal planning) classifications. Regarding label usage styles, consumers paid either equal or more attention to label information for dietary decisions rather than for shopping decisions in 2008 as compared to previous years 1995 and 2002. More people used labels for all purposes around the implementation of NLEA in 1994 and 1995 as compared to 2008 (P < .001). Females, highly educated (some college or above), young old (aged 50-59), consumers with any health issue, and frequent label users were significantly more likely to use food labels for all kinds of purposes. As speculated, the eight label questions were grouped into two categories, which were generally in line with our label usage for shopping decisions or dietary decisions (e.g., meal planning) classifications. Regarding label usage styles, consumers paid either equal or more attention to label information for dietary decisions rather than for shopping decisions in 2008 as compared to previous years 1995 and 2002. More people used labels for all purposes around the implementation of NLEA in 1994 and 1995 as compared to 2008 (P < .001). Females, highly educated (some college or above), young old (aged 50-59), consumers with any health issue, and frequent label users were significantly more likely to use food labels for all kinds of purposes. Conclusions and ImplicationsEnhanced efforts in teaching consumers to use food labels for dietary purposes are needed. Enhanced efforts in teaching consumers to use food labels for dietary purposes are needed.

Investigating key beliefs guiding mothers' dietary decisions for their 2–3 year old

Currently, there is no research in Australia that systematically investigates the underlying beliefs for mothers' decisions regarding their young child's nutritional needs based on current guidelines. We aimed to determine, using a Theory of Planned Behaviour (TPB) belief-based approach, key beliefs that guide mothers' decisions with regards to: (a) providing their child with a wide range of foods from the five food groups (‘healthy eating’); and (b) limiting their child's intake of ‘discretionary choices’ (e.g. lollies). Mothers (N = 197, M age = 34.39, SD = 5.65) completed a main questionnaire either online or on hard copy (paper-based), with a 1-week phone follow-up of the target behaviours (N = 161). Correlations and multiple regression analyses were conducted, and a number of key behavioural, normative, and control beliefs emerged for both healthy eating and discretionary choice behaviours. For healthy eating, mothers identified behavioural beliefs ‘improving my child's health’ and ‘resistance from my child’; normative beliefs ‘other family members’ and ‘spouse/partner’; and control beliefs ‘child's food preferences’. For discretionary choices, behavioural beliefs ‘maintain consistent energy levels in my child’ for intentions, and ‘give my child their required nutritional intake’; normative beliefs ‘spouse/partner’, ‘healthcare professionals’ and ‘friends’; and control beliefs ‘child's food preferences’ were identified. These findings can inform the development of future intervention programmes aimed at modifying mothers' child feeding practices to encourage healthy eating and limit discretionary choice intake and, ultimately, increase the life expectancy of the current generation of children.

Modern Diet and its Impact on Human Health

The general public’s view of modern diet and human health has undergone drastic changes in recent years. There is general harmony that many chronic health problems, first noted in Western countries but progressively flourished worldwide, relate mainly to diet. There is far less consensus, however, about the dietary factors implicated in such health problems. This lack of understanding has opened the door to a propagation of different recommendations as to the best diet for modern humans. Let me note that all human alive today are member of the same species, Homo sapiens, and as such, all are fully “modern” humans. Dietary fats are a key example. Since the anti-fat health education initiatives of the 1980’s and early 1990’s, certain dietary fats have been increasingly recognized as actually beneficial to health. Diet conscious like the mainstream populace, are now getting the message that wise dietary fat choices offer essential fatty acids, blood lipid management, maintained endocrine and immune function, inflammation control, metabolic effects and even potential body composition and performance benefits. Toward this end, many companies now sell specialty dietary fat supplements and recognized health authorities have begun recommending them to certain population. Increasingly, the average consumer has come to regard the supermarket as obstacle of conflicting and potentially dangerous dietary decisions: low fat, high fat, no fat; no meat, less fatty meat; no eggs, one egg a week, unlimited eggs; less carbohydrate, more whole grains, no cereal products; more fruit, less sugar; and so on. Too much confusing information is available, much attention is paid by the popular press and public to fad diets and preliminary dietary findings, and too little attention is paid to serious dietary recommendation. The present review of studies aims to strengthen our knowledge regarding the dietary requirements, food sources, and potential benefits, Modern food and its impact on human health. Practical suggestions for incorporating healthy fats will be made. Both food-source and supplemental intakes will be addressed with interrelationships to health throughout.

Sociodemographic and cultural factors of adult obesity in El Salvador: an exploratory cross-sectional study

Background/objectives: The purpose of this study was to explore the sociodemographic and cultural factors associated with adult obesity in El Salvador, a country that has rapidly shifted from food insecurity to obesity as a primary health risk. Subjects/methods: Using face-to-face interviews and a food frequency questionnaire, we interviewed a convenience sample of 180 Salvadorans who identified their dietary habits, perceived nutritional value of food items, and other factors influencing consumption. Results: Obesity (BMI ≥30) was exhibited by 27.3% of participants, and another 41.1% were overweight (BMI 25-30). These results spanned all levels of socioeconomic status. Obesity prevalence, however, was only 18.5% in the most rural area. Obesity increased with age and was almost twice as prevalent in women as in men. Within the occupational subgroup of traditional market vendors, we observed an obesity prevalence of 39.8% as compared with 17.6% prevalence in non-vendors, indicating that in addition to these merchants’ relative inactivity, the traditional market has actually become an obesogenic food environment. When asked to describe their dietary decisions, participants overwhelmingly pointed to personal preference and nutritional value as being very influential, while downplaying the effect of cost, convenience, tradition and advertising. Conclusions: With the growing trends of globalization, urbanization, and industrialization, population-based approaches will be necessary to stem the rise in obesity. When setting priorities for such policy measures, precautions must be taken to not exacerbate preexisting health disparities.

Practicing Food Anxiety: Making Australian Mothers Responsible for Their Families’ Dietary Decisions

Concerns about the relationship between diet, weight, and health find widespread expression in the media and are accompanied by significant individual anxiety and responsibilization. However, these pertain especially to mothers, who undertake the bulk of domestic labor involved in managing their families’ health and wellbeing. This article employs the concept of anxiety as social practice to explore the process whereby mothers are made accountable for their families’ dietary decisions. Drawing on data from an Australian study that explored the impact of discourses of childhood obesity prevention on mothers, the article argues that mothers’ engagements with this value-laden discourse are complex and ambiguous, involving varying degrees of self-ascribed responsibility and blame for children's weight and diets. We conclude by drawing attention to the value of viewing food anxiety as social practice, in highlighting issues that are largely invisible in both official discourses and scholarly accounts of childhood obesity prevention.

Social marketing to improve healthy dietary decisions

Purpose– The purpose of this research is to improve the understanding of drivers and inhibitors of healthy diet behaviors in the context of an emerging economy, such as Mexico, with a severe problem of overweight and obesity. The theory of planned behavior (TPB) and protection motivation theory (PMT) provided the theoretical background for this study.Design/methodology/approach– A qualitative approach was used, given the limited amount of information available on consumers’ motivations to change behavior. In-depth interviews with experts in nutrition and four focus groups with consumers from two segments were performed to collect information. Thematic analysis was used to analyze information.Findings– PMT provided a better explanation of current dietary behavior; the positive attitudes that, according to TPB, are the immediate antecedent of behavior offered a poor explanation for autoreported behaviors. Results indicate that perceived low self-efficacy and high costs prevent change of behavior. Meanwhile, low vulnerability and severity among younger consumers adds to the low intention to adopt a healthier diet. In general, sensorial attributes of products, such as texture, flavor, color, smell and appearance, prevail over nutritional attributes.Practical implications– The outline of a social marketing program is suggested after the research findings. This program emphasizes prevention and is intended to complement governmental policies designed to modify the environment to facilitate access to healthy food.Originality value– Social marketing principles have been developed and applied mainly in the context of developed countries. This work contributes to the extension of such principles to an emerging economy with a public health problem related to overweight. Results of the research provide the basis to mold an appropriate intervention.

Impact of different policies on unhealthy dietary behaviors in an urban adult population: an agent-based simulation model.

Unhealthy eating is a complex-system problem. We used agent-based modeling to examine the effects of different policies on unhealthy eating behaviors. We developed an agent-based simulation model to represent a synthetic population of adults in Pasadena, CA, and how they make dietary decisions. Data from the 2007 Food Attitudes and Behaviors Survey and other empirical studies were used to calibrate the parameters of the model. Simulations were performed to contrast the potential effects of various policies on the evolution of dietary decisions. Our model showed that a 20% increase in taxes on fast foods would lower the probability of fast-food consumption by 3 percentage points, whereas improving the visibility of positive social norms by 10%, either through community-based or mass-media campaigns, could improve the consumption of fruits and vegetables by 7 percentage points and lower fast-food consumption by 6 percentage points. Zoning policies had no significant impact. Interventions emphasizing healthy eating norms may be more effective than directly targeting food prices or regulating local food outlets. Agent-based modeling may be a useful tool for testing the population-level effects of various policies within complex systems.