Label Reading Research Articles

Anaphylactic Reaction With The Measles-Mumps-Rubella Vaccine In A Patient With Cow's Milk Allergy

The most common food allergy in children worldwide is cow's milk allergy. The most known allergens from cow's milk proteins are casein, alpha-lactalbumin, and beta-lactoglobulin. Lactalbumin hydrolysate is used as a stabilizer in the measles mumps rubella (MMR) vaccine originating in India. Different commercial forms of the MMR vaccine are available. While neomycin stabilizes, lactalbumin hydrolysate is used in the other form. We present a patient who was followed up for cow's milk allergy and developed anaphylaxis after the MMR vaccine originating from India. A 4-year-old girl with a history of anaphylaxis with cow's milk whose vaccinations were applied by the routine vaccination schedule in the family health center. Sneezing and urticaria started 1 minute after immunization. The patient presented to the emergency department (within 10 minutes after vaccination) with severe respiratory distress and intercostal retractions. The patient was administered three doses of intramuscular adrenaline, 5 minutes apart, intravenous pheniramine and methylprednisolone, and a nebulizer short-acting beta agonist. Symptoms regressed approximately 40 minutes after hospitalization. In our patient with a history of cow's milk anaphylaxis and lactalbumin-specific immunoglobulin E value of 61.3 kU/L, anaphylactic reaction with MMR vaccine seems to be related to the lactalbumin contained in the vaccine. Families and physicians should be meticulous about reading labels in the follow-up of patients with known food allergies.

Focus on food instead of nutrients improves consumers’ understanding of meals’ nutrition quality

Abstract Background Nowadays, most of the information directed to consumers focuses on nutrients, ignoring the impact of the interactions between different foods, origin or degree of processing. The methodologies currently applied have led consumers to confuse foods with nutrients, meat and fish are often referred to as “proteins”, grains and potatoes are referred to as “carbohydrates, forgetting that these foods are source of other nutrients, such as fat, proteins or fibre. Furthermore, its efficacy is compromised by the difficulties of reading labels among consumers. Objectives This study aimed to evaluate the understanding about food and nutritional information presented in menus to consumers, comparing the nutrient-focused approach (Nutrition Declaration) and the new food-focused approach (infographic - based on the Portuguese food Guide, from previous research). Methods 4 different meals were created, 2 balanced and complete in terms of food and nutrient content and 2 unbalanced and uncomplete. A questionnaire was applied, evaluating the understanding of the balance and healthiness of the meals, using the two approaches (nutrient-focused and food-focused). The order of presentation of the approaches and the meals was randomized for all participants. The questionnaire was distributed online through snowball sampling. Results 221 individuals participated, mostly female (67%), aged 25 to 54 years old. Evaluation of meals (“how balanced” and “how complete” the meal is) using the Nutrition Declaration did not allow to distinguish the quality of meals (Mb = 3,8;Mc=4,0), in opposite the Infographic returned significant differences between M1/M2 (Mb = 4,3;Mc=4,4) and M3/M4 (Mb = 2,5;Mc=2,6) (p < 0.01) allowing consumers to perceive differences between meals. The percentage of consumers that respond “I don’t know” to these questions decreased using the food-focused tool (13% vs 2%). Conclusions The food-focused approach allows for better understanding of meals’ nutritional balance. Key messages • The infographic provides more information about the daily food portions and how different meals and types of food contribute for complying food and nutritional recommendations. • The use of the infographic in menus, recipes, cookbooks and clinical advice may improve better food choices and a healthier lifestyle.

Evaluating text, icon, and graphic nutrition labels: An eye tracking experiment with Latino adults in the US

The US Food and Drug Administration (FDA) is developing front-of-package nutrition labels for packaged foods. Identifying the most promising type of label among Latino adults could inform federal regulation, given high rates of diet-related disease in Latino populations. Additionally, exploring English-language label effects among populations with limited English proficiency could inform equitable label design. We examined whether text, icon, or graphic nutrition labels attract attention among Latino populations and whether label effects differed by English proficiency. In 2023, we recruited 63 adults in North Carolina identifying as Latino/a/é (hereinafter “Latino”); 48% had limited English proficiency. Participants viewed four labels on a can of soup in random order: a barcode label (control) and text, icon, and graphic labels reading, “WARNING: High in sodium.” Eye trackers measured time spent viewing the label (dwell time), number of times viewing the label (fixation count), and time to first fixation on the label. A survey assessed secondary outcomes. Dwell time was highest for the graphic label (mean=2.58 seconds (s)), followed by icon (mean=2.34s), text (mean=1.94s), and control labels (mean=.96s; p for each label vs. control <.001). The impact of label type on dwell time did not differ by English proficiency (p=.669). Fixation count was highest for the graphic label, followed by the icon, text, and control labels (p for each label vs. control <.001). Participants viewed the graphic and text labels more quickly than control (ps=.01). Self-reported attention, perceived message effectiveness, and understandability were higher for text, icon, and graphic labels than control (all p<.001 vs. control). This study suggests that front-of-package labels signaling that foods are high in nutrients of concern can attract consumers’ attention, especially when the labels include images or icons.

Development of a sports nutrition knowledge questionnaire for elite track and field athletes

Background: Satisfactory nutrition knowledge among athletes is important to encourage proper dietary habits to overcome deficiencies and enhance sports performance. Identifying knowledge gaps in sports nutrition is essential for improving athletes' understanding through a tool that evaluates both general nutrition knowledge (GNK) and sports nutrition knowledge (SNK). This study aims to develop the Athletic Sports Nutrition Knowledge Questionnaire (A-SNKQ) specifically for Sri Lankan track and field athletes. Methods: The development of the A-SNKQ followed an extensive step-wise approach. Firstly, a systematic literature review was conducted on existing SNK questionnaires for athletes. Secondly, sports nutrition guidelines were incorporated into the questionnaire. Thirdly, information from local literature was gathered to ensure contextual relevance. Lastly, a qualitative study involving key athletic stakeholders was conducted to gain cultural insights. Results: The final version of the questionnaire consists of 32 questions in 12 sub-sections under two main sections: GNK section covers macronutrients, micronutrients, energy balance, hydration, and weight management, SNK section addresses carbohydrate loading, pre-training, training and post-training meals, sports supplements, supplement label reading, isotonic drinks, doping, and relative energy deficiency syndrome in sports. Conclusions: The GNK section addresses the fundamental nutritional concepts, while SNK focuses on the knowledge associated with the sporting performance of athletes.

Racial and Ethnic Differences in Sodium Sources and Sodium Reduction Behaviors among US Adults: NHANES 2017-2020 pre pandemic.

Background Nearly all US adults exceed sodium recommendations, which increases cardiovascular risk. Understanding racial and ethnic differences in sodium sources and behaviors could lead to nuanced public health messaging, dietary interventions, and clinical guidance to more equitably achieve population-level sodium reduction. Methods Using National Health and Nutrition Examination Survey 2017-2020 pre-pandemic data, racial and ethnic differences in sodium sources and sodium-related behaviors (e.g., salt use at the table and in food preparation, doctor advice to reduce sodium, attempts to reduce sodium, and label reading) were assessed using weighted chi-square. Given the nutrient database?s assumption that rice is salted may be inappropriate for some ethnic groups, we conducted a secondary analysis altering this assumption. Results Pizza, soup, and chicken were top sources of sodium across racial and ethnic groups. For Asian Americans, 4 top sources were unique (e.g., soy-based condiments). Black adults reported the highest rates of reducing sodium (67% vs. 44% among White adults) and receiving physician sodium reduction advice (35% vs.18% among Asian Americans). Asian Americans were the most likely to frequently use salt during food preparation (66% vs. Other Race adults 32%) but reported not using salt at the table (43% vs. 23% among Other Race adults). Assuming rice is unsalted reduces Asian American sodium intake estimates by ~325 mg/day. Conclusions While product reformulation targets and front-of-pack nutrition labeling may help reduce sodium intake across groups, to equitably address sodium intake, culturally appropriate advice on sources of sodium and salt usage may be needed, particularly for Asian Americans.

Mapping ultra-processed foods (UPFs) in India: a formative research study

BackgroundIncreased consumption of ultra-processed foods (UPFs) which have additives such as artificial colours, flavours and are usually high in salt, sugar, fats and specific preservatives, are associated with diet-related non-communicable diseases (NCDs). In India, there are no standard criteria for identifying UPFs using a classification system based on extent and purpose of industrial processing. Scientific literature on dietary intake of foods among Indian consumers classifies foods as unhealthy based on presence of excessive amounts of specific nutrients which makes it difficult to distinguish UPFs from other commercially available processed foods.MethodsA literature review followed by an online grocery retailer scan for food label reading was conducted to map the types of UPFs in Indian food market and scrutinize their ingredient list for the presence of ultra-processed ingredients. All UPFs identified were randomly listed and then grouped into categories, followed by saliency analysis to understand preferred UPFs by consumers. Indian UPF categories were then finalized to inform a UPF screener.ResultsA lack of application of a uniform definition for UPFs in India was observed; hence descriptors such as junk-foods, fast-foods, ready-to-eat foods, instant-foods, processed-foods, packaged-foods, high-fat-sugar-and-salt foods were used for denoting UPFs. After initial scanning of such foods reported in literature based on standard definition of UPFs, an online grocery retailer scan of food labels for 375 brands (atleast 3 brands for each food item) confirmed 81 food items as UPFs. A range of packaged traditional recipes were also found to have UPF ingredients. Twenty three categories of UPFs were then developed and subjected to saliency analysis. Breads, chips and sugar-sweetened beverages (e.g. sodas and cold-drinks) were the most preferred UPFs while frozen ready-to-eat/cook foods (e.g. chicken nuggets and frozen kebabs) were least preferred.ConclusionIndia needs to systematically apply a food classification system and define Indian food categories based on the level of industrial processing. Mapping of UPFs is the first step towards development of a quick screener that would generate UPF consumption data to inform clear policy guidelines and regulations around UPFs and address their impact on NCDs.

World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guidelines update – XVI - Nutritional management of cow's milk allergy

Cow's milk allergy (CMA) is one of the most common presentations of food allergy in early childhood. Management of CMA involves individualized avoidance of cow's milk and other mammalian milk and foods containing these. Optimal elimination of cow's milk avoidance includes: label reading; information about safe and nutritious substitute foods; appropriate choice of infant formula or a plant-based food; establishing tolerance to baked milk and monitoring nutritional intake and growth. Substitute formulas are divided into soy formula (not hydrolyzed), milk-based extensively hydrolyzed formulas, rice based extensive, and partially hydrolyzed formulas and amino acid-based formulas. The use of other mammalian milks is not recommended for the management of cow's milk allergy due to a high level of cross-reactivity and nutritional concerns. For toddlers who are eating well, children, and adults, a suitable plant-based beverage may be a suitable alternative to a specialized formula, following careful nutritional considerations. Families need to be instructed on finding suitable nutritious foods and how to prepare suitable meals at home. Individuals with CMA also need to know how to identify and treat acute severe reactions.

Self-reported attention and responses to cigarette package labels at the end of a two-week randomized trial of cigarette package labeling configurations.

Cigarette package inserts that describe quitting benefits and tips may promote cessation; however, research is needed to understand better their effects, including potentially enhancing the effects of pictorial health warning labels (PHWLs). A randomized trial with a 2×2 factorial design was conducted with adult smokers (n=356) assigned to either small text-only health warning labels (HWLs; control); inserts with cessation messages, and the small text-only HWLs (inserts-only); large PHWLs (PHWLs-only); both inserts and PHWLs (inserts + PHWLs). Participants received a 14-day supply of their preferred cigarettes with packs labeled to reflect their group. Upon finishing the trial, participants reported their past 14-day frequency of noticing, reading, thinking about smoking harms and cessation benefits, talking about labels, and forgoing cigarettes because of the labels. Ordered logistic models regressed these outcomes on labeling groups, and mediation analyses assessed whether attention (i.e. noticing, reading) to labels mediated effects of labeling exposure on other outcomes (i.e. thinking about harms/benefits, talking, forgoing). The inserts + PHWLs group reported higher frequencies than the control group for all outcomes. Compared to the control group, both the inserts-only and PHWLs-only groups reported higher frequency of noticing (AOR=3.53 and 2.46, respectively) and reading labels (AOR=2.89 and 1.71), thinking about smoking risks because of the labels (AOR=1.93 and 1.82), and talking about labels (AOR=2.30 and 2.70). Participants in the inserts-only group also reported more frequent thinking about quitting benefits (AOR=1.98). Attention mediated all labeling effects except for the contrast between PHWLs only and control. Compared to text-only HWLS, cigarette labeling that involves inserts, PHWLs, or both appears more effective at drawing attention to warnings, which mediated the effects on cessation-related psychosocial and behavioral outcomes.

Front labeling, dietary patterns and body Mass index in older adults in Chile

OBJETIVE: To determine the association between the frequency of warning labels reading (WLR) in foods, with dietary patterns and Body Mass Index in older adults (OA). METHODOS: Secondary analysis study, carried out using the National Health Survey 2016–2017 database. Information about older adults’ dietary patterns, front-of-package food labeling, anthropometric and demographic data were analyzed. Chi-square test was used for the statistical analysis and logistic regression. RESULTS: The number of participants was 1,510 (≥60 years old). It was noted that WLR in OA is associated with greater compliance with dietary guidelines with respect to fish consumption (p &lt; 0.01), dairy products (p &lt; 0.001), type of dairy (p &lt; 0.001), whole grain cereals (p &lt; 0.001), pulses (p &lt; 0.05), fruits (p &lt; 0.01), sugary drinks (p &lt; 0.001) and water (p &lt; 0.001), without significant differences in the consumption of vegetables (p = 0.167) and sugar-sweetened juices (p = 0.382), also without differences between WLR and Body Mass Index (p = 0.678). CONCLUSIONS: This study presents innovative data on older adults since it evaluates the behavior, the frequency of reading warning labels (WLR) in foods with dietary patterns, Chile, which is the first country in the world to have a warning labels mandatory.

A Case Report and Pediatric Literature Review: Povidone as a Rare Cause of Anaphylaxis in Children.

Background: Povidone, a synthetic polymer commonly used in various products such as antiseptics, cosmetics, and medications, has been associated with allergic reactions, including anaphylaxis. Despite its widespread use, cases of povidone-induced anaphylaxis, especially in children, are under-recognized. This case report aims to highlight the importance of considering povidone allergy in pediatric patients presenting with anaphylaxis. Case Presentation: We describe a 3-year-old boy who experienced anaphylaxis following the application of povidone-iodine antiseptic solution to a leg wound. He presented with generalized urticaria, angioedema, dyspnea, and cough. Prompt diagnosis and management were initiated in the emergency department. He experienced the second anaphylaxis with povidone-containing eye drops prescribed during an ophthalmology visit. Conclusions: Povidone allergy should be considered in pediatric patients presenting with anaphylaxis, especially those with idiopathic reactions or multiple drug allergies. Clinicians should emphasize patient education on label reading and the provision of adrenaline autoinjectors to prevent life-threatening reactions associated with povidone exposure.

Digital native students using nutritional apps: are they more adherent to a mediterranean diet model? Results from the good APPetite survey

Reading and understanding food labels are crucial steps in healthy dietary choices. Nutrition-related applications (n-apps) have increased in the recent years and the aim of this study was to assess the use and the perception of n-apps among a population of university students, also investigating the attitude and relationship with reading food labels and adherence to the Mediterranean diet (Medi-Lite score).In 2023, 316 students, mainly attending the courses of Medicine, Pharmacy and Dietetics at the University of Brescia, Italy, completed an anonymous and specifically designed survey. 33.9% of the students stated that they use or have used n-apps. The most used apps were Yuka, MyFitnessPal, Fat Secret and Yazio, especially for the ease of use, speed, nutritional values estimation and barcode reading. 53.2% and 53.5% of the students declared to be food information and nutrition label readers respectively and the Medi-Lite mean value was 9.98 ± 2.46. N-app-users were significantly more attentive to food information and nutrition label than app not-users (both p < 0.0001) and recorded a Medi-Lite score significantly higher (p = 0.0131).The present study found for the first time an extensive correlation between the use of n-apps, the food labels awareness and healthy eating habits in a digitally native population.

Validation of a Community-Based Approach Toward Personalized Dementia Risk Reduction: The Kimel Family Centre for Brain Health and Wellness

Background/ObjectivesThe Kimel Family Centre for Brain Health and Wellness is a research-driven community centre testing the efficacy of personalized dementia risk reduction programming on dementia risk and cognition. The objective of this protocol is to validate this approach by following people for two years.Design/SettingParticipants will receive a comprehensive dementia risk assessment, including nonmodifiable and modifiable risk factors, from which they will receive a Personalized Dementia Risk Report and Program Strategy, indicating their health conditions increasing and their risk level in five modifiable risk domains: physical activity, brain-healthy eating, cognitive engagement, social connections, and mental wellbeing. Equipped with this information, participants will enroll in programs within the Centre to address their risk factors. Changes to their dementia risk, cognition, and Personalized Program Strategy will be communicated through re-assessments of risk factors every six months (risk and cognition) and every year (comprehensive assessment).ParticipantsParticipants (n = 450) will be 50 years of age or older, without a diagnosis of dementia, and sufficiently fluent in English to complete the assessments and understand program instructors. One goal is that our participant sample will include people of low income (with fundraising providing free community centre membership), and from various ethnoracial backgrounds.InterventionParticipants will select programs to meet their Personalized Program Strategy. For physical activity, they will gradually work toward the Canadian Society for Exercise Physiology guidelines. For brain-healthy eating, they will learn about the Brain Health Food Guide and food label reading, and then take additional programs. For cognitive engagement and mental wellbeing, they will take at least one hour of relevant programming per week. Social connections will be reinforced throughout all programs. All participants will also have access to the Canadian Consortium on Neurodegeneration’s CAN-THUMBS Up online, educational program on modifiable dementia risk factors, called Brain Health PRO.MeasurementsThe comprehensive assessment includes numerous dementia risk factors, but the primary measures are risk in the five domains, health conditions proximal to those five risk domains, and cognition, and how these are affected by adherence and quality of goal-directed future simulation. We hypothesize a reduced risk in the five domains within six months, improvements in health biomarkers within a year, and maintenance of cognition within two years, with these benefits accruing with greater adherence, but only up to a point, at which benefits will plateau, and greater benefits among participants whose goal-directed simulations are more vivid, personally-relevant, achievable, and positive.ConclusionsThis innovative approach overcomes a number of limitations present in prior multidomain dementia prevention trials. Adapting a preference clinical trial that is embedded in a community centre, where participants have autonomy to choose programs to address their modifiable dementia risk factors, has real-world applicability in the global effort to reduce dementia risk.

Regulatory Compliance of Cosmetic Products in Kenya: A Narrative Review on Quality and Safety

This study reviews the regulatory compliance of cosmetic products in Kenya, with a focus on consumer risks and potential public health impact. A narrative review study design was employed and a literature search was conducted using government reports, publications, academic databases, and other relevant sources. Keywords such as cosmetic industry challenges and cosmetic regulation in Kenya were employed to search the literature for papers. Data focusing on regulatory frameworks, enforcement mechanisms, adverse reactions, and industry challenges was then extracted and discussed in the form of a narration. The growth of the cosmetic industry, fueled by urbanization, a rising middle class, and increased grooming awareness, has attracted both local and international investors, presenting challenges in maintaining product quality and safety standards. Seven cases of adverse reactions related to cosmetics were reported by Pharmacy and Poisons Board between 2018-2023. The current study identifies noteworthy challenges by examining Kenya’s regulatory framework, led by the Pharmacy and Poisons Board and the Kenya Bureau of Standards. Enforcement disparities within international standards, variance in regulations on prohibited ingredients, inconsistent labeling requirements, industry dynamics, and counterfeiting, compounded with the complex nature of safety assessments raise concerns for cosmetic regulators, distributors, and manufacturers. The study highlights existing gaps in regulatory oversight emphasizing the necessity of robust enforcement mechanisms. Compliance assessments by KEBS and PPB encompass the evaluation of ingredients, formulations, microbial contamination, packaging, and labeling. Factors contributing to regulatory noncompliance include poor product quality aggravated by supply chain complexities in the vast and diverse sector. The cosmetic cottage industry inadvertently presents a quality risk to consumers due to limited process and testing capacity. Reported adverse reactions, particularly to mercury-containing skin-lightening products, raise concerns about public health implications. This study advocates for continuous product monitoring and heightened vigilance. The review proposes improvement strategies, emphasizing a dynamic regulatory approach, periodic ingredient reviews, a centralized product approval system, and alignment with global manufacturing standards. Targeted consumer education initiatives focusing on product quality attributes, adverse reaction reporting, label reading, and counterfeit awareness are recommended.

Psychometric Analyses of a Food Literacy Behaviors Questionnaire for Adults With Type 2 Diabetes Mellitus.

The purpose of the study was to develop and validate a food literacy instrument specific to individuals with type 2 diabetes mellitus (T2DM). Twelve T2DM-specific, food literacy-related statements underwent content validity and face validity testing, and exploratory factor analysis (EFA) was conducted (phase 1). The 6 statements remaining after EFA testing were added to an existing food literacy questionnaire called the Eating and Food Literacy Behaviors Questionnaire (EFLBQ). Confirmatory factor analysis (CFA) examined the EFLBQ plus the T2DM-specific statements, and the instrument was called the Eating and Food Literacy Questionnaire for Diabetics (EFLBQ-D; phase 2). Both EFA and CFA were administered by third-party provider Centiment via Qualtrics to adults with T2DM residing in the 13 United States Department of Agriculture Southern region states. Reliability was assessed via point estimate reliability testing. The EFA items clustered into 2 factors each with 3 statements: (1) carbohydrate counting and nutrition label reading and (2) healthy food preparation methods. The CFA indicated that the EFLBQ-D had good fit and that the factors had good reliability. The EFLBQ's integrity was maintained with its items loading on the respective constructs. The EFLBQ-D appears to be a valid, reliable instrument for use by researchers and professionals to better understand food behaviors and food literacy skills of those with T2DM. This is an important tool to help individualize medical nutrition therapy, improving patient care in this population.

Real-World Performance Benchmarks in the Reading Ability of Prescription Drug Labels by Community-Dwelling Older Adults

Background: Despite known recommendations regarding standards for print size and the intuitive importance of vision in reading prescription labels, the predictive nature of vision and prescription label readability remains largely undefined. Furthermore, while the importance of vision is recognized, various demographic factors associated with the ability to read prescription labels have not been fully elucidated. Objective: Describe relationships between visual acuity, point size, and readability of prescription labels and provide insight into demographic factors associated with prescription label readability. Methods: Cross-sectional examination of prescription label readability by older, community-dwelling adults. Subjects were evaluated as to demographics, visual acuity, and ability to read test instruments consisting of unaltered prescription label features of five medications dispensed by community pharmacies and two drug samples. Descriptive statistics in conjunction with a logit predictive model were employed for data analysis. Results: Instructions for medication use were most recognizable, identified and correctly read by 95.60% of the study cohort while directions for the use of drug samples were lowest (34.91%). Among prescription label features, auxiliary labels consistently demonstrated poor readability. Level of visual acuity was statistically related to the ability to read prescription labels while identifying prescription label components increased proportionally with point size. Race, gender, and history of a recent eye examination were statistically significant predictors of prescription label reading ability. Visual acuity alone was found to explain approximately 26% of the variablity in ability to read Rx labels. Conclusion: Visual acuity is predictive of the ability to access Rx label information and should be considered a modifiable variable for improving prescription label reading ability amenable by appropriate eye care and spectacle correction.

Mixed methods evaluation of nutrition education for limited resource audiences

This paper presents an exploratory evaluation of pilot nutrition education programs, Plan Shop Save Cook (PSSC). Behavior change between two nutrition education programs, Buy Eat Live Healthy (BELH; n=92 and PSSC; n=42), was examined using pre- and post-program questionnaire responses. Both programs resulted in significant improvement in food resource management (FRM) behaviors; however, there was no significant difference in the amount of change between the programs. Qualitative data suggests participants perceived label reading as the most useful information provided in the PSSC programs. The current findings suggest short-term behavior change can be achieved with a limited dose program.

The Effects of an Educational Intervention About Front-of-Package Labeling on Food and Beverage Selection Among Children and Their Caregivers: Protocol for a Randomized Controlled Trial.

Overweight and obesity pose a global public health challenge and have a multifactorial origin. One of these factors includes obesogenic environments, which promote ultraprocessed foods characterized by being high in calories, saturated fats, added sugars, and sodium. In Mexico, it has been estimated that 30% of the total energy consumed comes from processed foods. The Modification to the Official Mexican Standards introduces nutritional information through black octagonal seals that alert consumers about products with excessive amounts of some components for a better food selection in the population. However, the effects of warning labels on processed food selection and purchases among children remain unknown. We aimed to evaluate the impact of a digital educational intervention focusing on front-of-package warning labels on the food selection and purchasing behavior of elementary schoolchildren and their caregivers. Children from 4 elementary schools in Mexico City, 2 public and 2 private schools, will participate in a randomized controlled trial. The schools will be chosen by simple random sampling. Schools will be randomized into 2 groups: intervention and control. In the control group, the dyads (caregiver-schoolchildren) will receive general nutritional education, and in the intervention group, they will receive guidance on reading labels and raising awareness about the impact of consuming ultraprocessed products on health. The educational intervention will be conducted via a website. Baseline measurements will be taken for both groups at 3 and 6 months. All participants will have access to an online store through the website, allowing them to engage in exercises for selecting and purchasing food and beverages. In addition, other measures will include a brief 5-question exam to evaluate theoretical understanding, a 24-hour reminder, a survey on food habits and consumption, application of a food preference scale, anthropometric measurements, and recording of school lunch choices. Registration and funding were authorized in 2022, and we will begin data collection in September 2024. Recruitment has not yet taken place, but the status of data analysis and expected results will be published in April 2025. The study is expected to contribute to evaluating whether reinforcing front-of-package warning labels with education enhances its effects and makes them more sustainable. Conducting this study will allow us to propose whether or not it is necessary to develop new intervention strategies related to front-of-package labeling for a better understanding of the population, improved food choices, and better health outcomes. ClinicalTrials.gov NCT06102473; https://clinicaltrials.gov/study/NCT06102473. PRR1-10.2196/54783.

IJCM_282A: Knowledge, attitude and practices towards food labelling and its use among health care students of Mangalore

Background: Food labelling plays a crucial role in informing consumers about the nutritional content of prepackaged food items, aiding them in making informed choices for their diet and health. However, the level of knowledge, attitudes, and practices regarding food labelling among healthcare students, particularly medical and dental students, remain understudied. Understanding these aspects is essential given the increasing consumption of prepackaged foods, especially among the youth. Methodology: A cross-sectional study was conducted among medical and dental students at Kasturba Medical College (KMC) and Manipal College of Dental Sciences (MCODS), Manipal University, Mangalore. A total of 191 undergraduate students participated in the study. Data were collected using a semi-structured questionnaire covering aspects related to knowledge, attitudes, and practices regarding food labeling and nutritional content. The questionnaire was administered after obtaining informed consent, and data were analyzed using SPSS v17.0. Results: The study found that the majority of students had moderate knowledge about food labelling and its nutritional applications. While most students reported reading food labels before purchasing prepackaged items, the most sought-after products were snacks like chips and aerated drinks. However, time constraints were cited as a significant hindrance to reading labels. Despite favourable attitudes towards food labelling, a low proportion of students reported changing their food preferences based on label information. Conclusion: In conclusion, the study highlights the need for educational programs to enhance students’ knowledge about nutrition and food libelling. Additionally, there is a call for clearer and more informative libelling practices to empower consumers to make healthier food choices. Awareness programs targeting students can play a pivotal role in emphasizing the importance of food labels in promoting a balanced diet and overall well-being.

Utilizing a medical school outreach program to help high school students explore the impact of food security and ultraprocessed foods on health risks.

We offered an enrichment program for high school students with the theme, "The Environment, Health, and You" during the Summer of 2022 and the Spring of 2023. We developed several educational modules for high school students that provided them with an opportunity to learn and explore the foundations of physiological systems, nutrient needs to maintain health, and the impact that environmental factors can have on them. The modules included videos, discussion boards, games, readings, and labs. These modules were integrated into the first session: Your Body and Health. On day 1, the first module explored the basic physiology and anatomy of the body with respect to the organization of cells into organ systems. Additionally, the educational content included information on macro- and micronutrients and their impact on body development, nutrition, and metabolism. The nutrition module explored nutrition concepts and various factors that can impact healthy eating patterns, such as food insecurity issues and the consumption of ultraprocessed foods. A lab activity on label reading was included to help empower students to make healthy choices. A total of 43 high school students participated in the program. Overall, the quality of the educational content in the modules was rated highly by the students, and they indicated that the educational experience inspired them to learn more about the physiology and nutrition concepts associated with human metabolism, and the importance of healthy food choices to maintain health.NEW & NOTEWORTHY We describe how we integrated guided learning teaching modules in an enrichment program for high school students with the aim of enhancing their knowledge and skills to empower them to take charge of their own health risks and well-being.

Dietary management of IgE and non-IgE-mediated food allergies in pediatric patients.

Food allergies (FA) consist of both IgE and non-IgE-mediated entities, with varying phenotypes and overlapping and different considerations for each specific disease presentation. In general, all FAs place children at increased risk for inadequate nutritional intake and negative impacts on their nutritional status, as well as negative impacts on the quality of life for the entire family. To minimize these untoward effects, a multidisciplinary approach should be taken, including consultation and management with a dietitian trained in the varying presentations of FA. Families should be instructed on label reading as a first line of nutritional management. During a nutrition consultation, the age of the child, growth, and nutritional status should be considered. Food refusal should be assessed and addressed. Families should be educated on avoidance and appropriate substitutions. In the case of cow's milk allergy, a suitable specialized formula should be suggested if the infant is not breastfed or if breast milk supply is not sufficient. Other mammalian milk should be avoided and careful consideration should be given before plant-based milk is used in young children. Specific food allergies may differ in terms of advice provided on the level of avoidance required, whether precautionary advisory labels should be avoided, and if a maternal avoidance of the allergen during breastfeeding should be advised. The role of immunonutrition on overall health should be discussed.