Professor Richard Shepherd

Introduction: Nutrition labelling is recognized as a key tool for combating this problem by providing consumers with information which promotes healthy eating. Objectives: To investigate the extent to which food labelling systems (FLS) encourage healthier choices. Method/Design: Laddering interviews with three groups (parents; 55+; teenagers) of 20 participants were carried out in the United Kingdom. The eight FLS studied varied in complexity (e.g. numerical, graphical and colour-based information), directiveness and benchmarking (nutrient- and product-level). Results: The relationship between gross amount of information presented and actual label use is mediated by the type of benchmarking used and by what participants think its level of directiveness implies about them. Participants suggested they could decrease the cognitive workload of an ostensibly complex FLS by initially engaging only with the traffic light colours. Participants were unlikely to engage with non-directive FLS without benchmarking because these were slow to use and difficult to understand, offering objective information but no tools for use; thus suggesting an erosion self-efficacy and decreased likelihood of use in future, particularly less experienced shoppers. Semi-directive FLS with nutrient-level benchmarking gave both information and tools for meaningful engagement, increasing self-efficacy and ability to use labels effectively. A product-level logo FLS sacrificed all else for speed and ease of use, reducing decisionmaking rather than empowering the making of informed choices. Conclusions: Future FLS designs need to consider the psychological as well as practical reasons why consumers choose to engage with some FLS and ignore others. In removing any obvious link between dietary recommendations and hard facts, overly simplified labels sacrifice flexibility, utility and persuasiveness on the assumption that ease and speed are all. By contextualising real information with colourful nutrient-level benchmarking an optimal FLS may encourage shoppers to make their own informed decisions, restoring that link and empowering them to take more interest in nutrition in the future.

Background Lower birth weight, often found in infants from minority ethnic groups, may be partly because of the disproportionate representation of ethnic minority groups in low-income areas. To develop an intervention, to improve the nutritional intake of young women from populations at risk of low-birth-weight babies, which would be culturally sensitive and well received by the intended recipients, a community development approach was used to investigate factors that might influence food choice and the nutritional intake of girls and young women from ethnic minority groups. Methods Focus group discussions were conducted across the UK, to explore factors that might affect the food choices of girls and young women of African and South Asian decent. The data was analysed using deductive content analysis (Qual. Soc. Res., 1, 2000, 1). Discussions were around the broad themes of buying and preparing food, eating food and dietary changes, and ideas for an intervention to improve diet. Results The focus group discussions indicated that all the communities took time, price, health and availability into consideration when making food purchases. The groups were also quite similar in their use of `Western' foods which tended to be of the fast food variety. These foods were used when there was not enough time to prepare a 'traditional' meal. Conclusion Many issues that affect the food choice of people who move to the UK are common within different ethnic groups. The idea of a practical intervention based on improving cooking skills was popular with all the groups.

This is the most comprehensive and robust evaluation of FOP nutrition signpost labelling published to date. It provides information on how FOP labels are used by shoppers in a retail environment; the extent to which they are accurately interpreted and the impact of the co-existence of the current range of FOP labels on comprehension. This aim of this research was to establish which FOP labelling scheme(s), or which combination of elements of schemes, best facilitate the accurate interpretation of key nutritional information by consumers such that they are enabled to make informed choices about the foods they purchase. The research addressed three key questions: (1) How well do individual signpost schemes (or elements of the schemes) enable consumers to correctly interpret levels of key nutrients?; (2) How do consumers use FOP labels in real life contexts in the retail environment and at home?; (3) How does the coexistence of a range of FOP label formats affect accurate interpretation of FOP labels?

Although the theory of planned behaviour (TPB) has been applied successfully in the area of food choice, it has been criticized for its pure utilitarian approach to the factors determining behaviour. Despite the increase in predictive power of the model with added components such as affective attitude and moral and ethical concerns, in most studies the elicitation process still only addresses people's utilitarian beliefs about the behaviour with little attention paid to other aspects. This study compares the traditional method of elicitation of advantages and disadvantages with two other methods (word association and open-ended) in the elicitations of beliefs, attitudes and moral concerns in relation to the consumption of organic foods. Results show the traditional method to be best for eliciting cognitive beliefs, open-ended emotion task for eliciting emotional beliefs and open-ended beliefs task best for moral concerns. The advantages and disadvantages of each method are discussed. (c) 2006 Elsevier Ltd. All rights reserved.

This study examined the impact of moral norms, self-identity, and past behavior on intention to buy organic tomatoes and organic tomato sauce, using the theory of planned behavior (TPB). The questionnaire, which included measures of attitudes, subjective norm, perceived behavioral control, moral norms, past behavior, and self-identity was completed by approximately 500 people for each food. Multiple regressions showed that for both foods, moral norms and self-identity added significantly to the prediction of intention over and above the other variables, even when the effect of past behavior was included. There was some evidence of past behavior moderating the self-identity/intention relationship for processed organic tomato sauce, but not for fresh organic tomatoes. Implications of the findings are discussed.

Different front-of-pack (FOP) labelling systems have been developed in Europe by industry and organisations concerned with health promotion. A study (n 2068) was performed to establish the extent to which inclusion of the most prevalent FOP systems--guideline daily amounts (GDA), traffic lights (TL), GDA+TL hybrid (HYB) and health logos (HL)--impact consumer perceptions of healthiness over and above the provision of a FOP basic label (BL) containing numerical nutritional information alone. The design included within- and between-subjects factors. The within-subjects factors were: food (pizzas, yogurts and biscuits), healthiness of the food (high health, medium health and low health) and the repeated measurements under BL and test FOP label conditions. The between-subjects factors were: the system (GDA, TL, GDA+TL hybrid, HL), portion size (typical portion size and a 50% reduction of a typical portion) and country (the UK, Germany, Poland and Turkey). Although the FOP systems tested did result in small improvements for objective understanding under some conditions, there was little difference between the provision of an FOP label containing basic numerical nutritional information alone or between the various systems. Thus, any structured and legible presentation of key nutrient and energy information on the FOP label is sufficient to enable consumers to detect a healthier alternative within a food category when provided with foods that have distinctly different levels of healthiness. Future research should focus on developing greater understanding of the psychological and contextual factors that impact motivation and the opportunity to use the various FOP systems in real-world shopping settings.

Forty five subjects rated soup samples varying in salt concentration on three types of ratings, intensity, hedonic and relative-to-ideal. Estimates of the most preferred concentration for individual subjects from the hedonic and relative-to-ideal ratings correlated at r = 0.76 (P < 0.001). The estimates were not found to differ by t-test. The slope of the relative-to-ideal function correlated with the intensity slope at r = 0.31 (P < 0.05) but was more closely associated with the slope of a function derived from unfolding the hedonic ratings about the break point for individual subjects. These relationships were confirmed comparing the Weber ratios derived from the intensity ratings and tolerance discrimination ratios derived from the relative-to-ideal and unfolded hedonic ratings. Group data showed good agreement between intensity and relative-to-ideal ratings, since both are linearly related to the logarithm of concentration. These results suggest that relative-to-ideal ratings provide a more informative measure of most preferred concentration similar to that derived from hedonic ratings. The slope of the relative-to-ideal function reflects, in part, how concerned the subject is about deviations from ideal rather than being simply ratings of intensity in relation to the person's ideal. © 1989 Longman Group UK Limited.

Despite efforts, attempts to induce successful long term weight loss remain a problem in obesity research, with the majority of those who lose weight unable to control or sustain the loss. It is accepted that in order to bring about more successful approaches to weight management, it is vital to determine the psychosocial factors that underpin weight control capability. Previous research has demonstrated that successful weight maintainers and less successful overweight individuals display different patterns of weight control behaviours (1). The present study aims to explore weight control practices and help-seeking behaviours in an overweight sample from 8 European countries. Data were collected as part of the EU project DiOGenes – a pan-European project which aims to refine understanding of the individual genetic, dietary and behavioural factors influencing weight control, and how these factors interact. Participants of a pan-European dietary intervention trial (n ~ 700) completed a set of online questionnaires relating to their weight control practices and help-seeking behaviours before entering the trial such as use of antiobesity medication, commercial products and help from health professionals. Objective weight measurements were recorded at baseline as well as self-reported weight control history. The results of this investigation will be presented, focussing on inter country differences in weight control behaviours. Differences in weight control behaviours and baseline weight status and previous weight history will be explored.

Detailed angle and energy resolved measurements of positrons ejected from the back of a gold target that was irradiated with an intense picosecond duration laser pulse reveal that the positrons are ejected in a collimated relativistic jet. The laser-positron energy conversion efficiency is ∼2×10{-4}. The jets have ∼20 degree angular divergence and the energy distributions are quasimonoenergetic with energy of 4 to 20 MeV and a beam temperature of ∼1  MeV. The sheath electric field on the surface of the target is shown to determine the positron energy. The positron angular and energy distribution is controlled by varying the sheath field, through the laser conditions and target geometry.

The use of dietary supplements is increasing globally and this includes the use of plant food supplements (PFS). A variety of factors may be influencing this increased consumption including the increasing number of older people in society, mistrust in conventional medicine and the perception that natural is healthy. Consumer studies in this area are limited, with a focus on dietary supplements in general, and complicated by the use of certain plant food supplements as herbal medicines. Research indicates that higher use of dietary supplements has been associated with being female, being more educated, having a higher income, being white and being older, however the drivers for consumption of supplements are complex, being influenced by both demographic and health-related factors. The aim of this paper is to provide an overview of current knowledge about the users and the determinants of usage of plant food supplements. With growing consumption of these products, the need for effective risk-benefit assessment becomes ever more important and an insight into who uses these types of products and why is an important starting point for any future science-based decisions made by policy makers, PFS manufacturers and ultimately by consumers themselves.

The National Food Survey provides a valuable supply of information on the intake of food and nutrients in the British diet (Derry and Buss, 1984), but is confined to food brought into the home. The present study examined nutrient contribution from foods eaten outside the home to the overall diet. Seventy subjects (35 males and 35 females), were selected from a local health centre register, using age and sex as criteria, and asked to keep a written record of everything consumed for three days. There was a very high percentage of all subjects eating out over the three days, but most of this food could be classed as 'casual', or of the 'non-meal' category i.e. snacks. Employment was a significant determinant of frequency of eating out. The food groups contributing more highly to nutrient intake away from home were meats, sugars and preserves, alcoholic beverages, fish and chips. Energy from sugar, measured as sugar density, was significantly higher in 'away' foods, but fibre density and protein as a percentage of energy was higher in foods eaten at home. The percentage energy from nutrients to total energy did not differ greatly when alcoholic beverages were excluded from the data, apart from redistribution of the energy from alcohol between the other nutrients. The results show that foods eaten outside the home are potentially significant contributors to total nutrient intake, and future research on 'out of home' eating habits would benefit from inclusion of nutritional analysis.

RATIONALE: Recent legislation in USA and Europe aimed to improve information on packaged foods to assist food allergic consumers identify allergens. Legislation does not cover ‘may contain’ labels. There is little information on how information is used by allergic consumers when purchasing food. METHODS: We studied how peanut and nut allergic individuals use allergy advice boxes, ingredients lists, and other packaging information, excluding ‘may contain’. Thirty-two peanut and/ or nut allergic participants were observed during their normal food shop. Their spoken thoughts were audio-recorded. This was followed by a semi-structured interview. They were also given 13 potentially problematic packaged foods, and asked to explain whether they would purchase the food and their reasoning for the decision. Transcribed data from the shop, interview and 13-product task were analysed to explore use of label information. RESULTS: Most participants used the allergy advice box rather than the ingredients list for their primary check. Package-based information was generally considered reliable, but some brands were trusted more than others. Participants suggested a number of improvements, particularly more ‘nut free’ labelling. CONCLUSIONS: Participants used a combination of non-package based strategies (e.g. previous experience), in conjunction with label information to make purchase decisions. Trust of the food producer or supermarket informed interpretation of and confidence in labels. Images and product names, not intended by manufacturers as an allergen risk assessment aid were also used to inform choices.

Scientific Advisory Bodies (SABs) are seen as “boundary organisations” working at the interface between science, policy and society. Although their narrowly defined remit of risk assessment is anchored in notions of rationality, objectivity, and reason, in reality, their sources for developing recommendations are not limited to scientific evidence. There is a growing expectation to involve non-scientific sources of information in the formation of knowledge, including the expectation of stakeholder consultation in forming recommendations. Such a move towards “democratisation” of scientific processes of decision making within SABs has been described and often studied as “post-normal science” (PNS) (Funtowicz and Ravetz, 1993). In the current paper we examine the application of PNS in practice through a study of stakeholder consultations within the workings of the UK Scientific Advisory Committee for Nutrition (SACN). We use the theoretical insights from PNS-related studies to structure the analysis and examine the way in which PNS tenets resonate with the practices of SACN. We have selected a particular case of the SACN UK recommendations for salt as it is characterized by scientific controversy, uncertainty, vested interests and value conflict. We apply the tenets of PNS through documentary analysis of the SACN Salt Subgroup (SSG) consultation documents published in 2002/2003: the minutes of the 5 SACN SSG’s meetings which included summary of the SACN SSG’s stakeholder consultation and the SSG’s responses to the consultation. The analysis suggests that the SACN consultation can be construed as a process of managing sources of risk to its organisation. Thus, rather than being an evidence of post normal scientific practice, engagement became a mechanism for confirming the specific framing of science that is resonant with technocratic models of science holding authority over the facts. The implications for PNS theory are discussed. The work herein has been carried out within the EURRECA Network of Excellence (http://www.eurreca.org), financially supported by the Commission of the European Communities, Specific Research Technology and Development (RTD) Programme Quality of Life and Management of Living Resources within the sixth framework programme, contract no. 0136196. This does not necessarily reflect the Commission’s views or its future policy in this area. We would like to acknowledge the contribution made to editing of the article from Israel Berger, University of Surrey. No conflicts of interest have been declared by authors.

On page 425, Richard Shepherd outlines The Eating, Food and Health LINK Programme that aims to bring high quality science and its commercial application together. The programme is sponsored by the Biotechnology and Biological Sciences Research Council, the Economic and Social Research Council, the government departments, and DEFRA and the DoH. Academic and industrial partners can come together to prepare proposals and bid for funding. Money from industry or certain charities is matched by public funds and the projects must aim improve diet and health in the UK. The research is centered on six inter-related themes; protective and beneficial components of the diet: physiological and psycho logical factors regulating appetite and energy balance; health, innovation and risk, understanding the factors determining food choice, changing demographics, labour markets and consumer demand; food chain 'shaping' of consumer decisions. The first eight projects, some of which relate to more than one theme, funded by the programme so far are described. Topics covered range from the iron status of vegetarians to the use of smart card technology to gather data on food choices. proposals are invited until 2003 and details of how to get more information about the programme are given.

This study used the theory of planned behavior (TPB) to examine the impact of moral concerns on intention to buy organic apples and organic pizza. Initially, beliefs were elicited from a group of 30 people using a combination of the traditional TPB elicitation technique supplemented by direct questioning about emotions associated with the behavior. The questionnaire-which included measures of behavioral beliefs, attitudes, subjective norm, perceived behavioral control, and measures of moral norms (worded both positively and negatively)-was completed by 281 people. Multiple regressions showed that for both foods, the positive moral component added significantly to the prediction of intention, while negative ones did not. Also, affective attitude was a strong predictor of intention for both foods.

Background: Most food in the UK is purchased in supermarkets and many of these purchases are routinely tracked through supermarket loyalty card data. Using such data may be an effective way to develop remote public health interventions and to measure objectively their effectiveness at changing food purchasing behaviour. Objectives: The FLICC study is a pilot randomised controlled trial of a digital behaviour change intervention. This pilot trial aimed to collect data on recruitment and retention rates and to provide estimates of effect sizes for the primary outcome (healthiness of ready meals and pizzas purchased) to inform a larger trial. Methods: The intervention consisted of a website where participants could access tailored feedback on previous purchases of ready meals and pizzas, set goals, model behaviour and practice using traffic light labels. The control consisted of web-based information on traffic light labelling. Participants were recruited via email from a list of loyalty card holders held by the participating supermarket. All food and drink purchases for the participants for the six months prior to recruitment, during the six week intervention period and during a twelve week wash out period were transferred to the research team by the participating supermarket. Healthiness of ready meal and pizzas was measured using a pre-developed scale based solely on the traffic light colours on the foods. Questionnaires were completed at recruitment, end of intervention and end of wash out to estimate the effect of the intervention on variables that mediate behaviour change (e.g. belief and intention formation). Results: We recruited 496 participants from an initial email to 50,000 people. Only three people withdrew from the study and purchase data were received for all other participants. 208 participants completed all three questionnaires. There was no difference in the healthiness of purchased ready meals and pizzas between the intervention and control arms either during the intervention period (P = 0.315) or at wash-out (P = 0.594). Conclusions: Whilst the FLICC study did not find evidence of an impact of the intervention on food purchasing behaviour, the unique methods used in this pilot trial are informative for future studies that plan to use supermarket loyalty card data in collaboration with supermarket partners. The experience of the trial showcases the possibilities and challenges associated with the use of loyalty card data in public health research.

Recent legislation has sought to improve the information printed on packaged foods relevant to the safety of food allergic consumers. We aimed to understand the complex risk assessment decisions made by peanut and nut-allergic adults when purchasing food, with particular reference to use of printed package information.

For individuals with a nut allergy, the avoidance of allergens is particularly challenging in situations where they are not preparing their own food. Many allergic reactions occur when eating outside the home.

Background Traffic light labelling of foods—a system that incorporates a colour-coded assessment of the level of total fat, saturated fat, sugar and salt on the front of packaged foods—has been recommended by the UK Government and is currently in use or being phased in by many UK manufacturers and retailers. This paper describes a protocol for a pilot randomised controlled trial of an intervention designed to increase the use of traffic light labelling during real-life food purchase decisions. Methods/design The objectives of this two-arm randomised controlled pilot trial are to assess recruitment, retention and data completion rates, to generate potential effect size estimates to inform sample size calculations for the main trial and to assess the feasibility of conducting such a trial. Participants will be recruited by email from a loyalty card database of a UK supermarket chain. Eligible participants will be over 18 and regular shoppers who frequently purchase ready meals or pizzas. The intervention is informed by a review of previous interventions encouraging the use of nutrition labelling and the broader behaviour change literature. It is designed to impact on mechanisms affecting belief and behavioural intention formation as well as those associated with planning and goal setting and the adoption and maintenance of the behaviour of interest, namely traffic light label use during purchases of ready meals and pizzas. Data will be collected using electronic sales data via supermarket loyalty cards and web-based questionnaires and will be used to estimate the effect of the intervention on the nutrition profile of purchased ready meals and pizzas and the behavioural mechanisms associated with label use. Data collection will take place over 48 weeks. A process evaluation including semi-structured interviews and web analytics will be conducted to assess feasibility of a full trial. Discussion The design of the pilot trial allows for efficient recruitment and data collection. The intervention could be generalised to a wider population if shown to be feasible in the main trial. Trial registration ISRCTN: ISRCTN19316955 webcite

Food-based dietary guidelines (FBDG) have primarily been designed for the consumer to encourage healthy, habitual food choices, decrease chronic disease risk and improve public health. However, minimal research has been conducted to evaluate whether FBDG are utilised by the public. The present review used a framework of three concepts, awareness, understanding and use, to summarise consumer evidence related to national FBDG and food guides. Searches of nine electronic databases, reference lists and Internet grey literature elicited 939 articles. Predetermined exclusion criteria selected twenty-eight studies for review. These consisted of qualitative, quantitative and mixed study designs, non-clinical participants, related to official FBDG for the general public, and involved measures of consumer awareness, understanding or use of FBDG. The three concepts of awareness, understanding and use were often discussed interchangeably. Nevertheless, a greater amount of evidence for consumer awareness and understanding was reported than consumer use of FBDG. The twenty-eight studies varied in terms of aim, design and method. Study quality also varied with raw qualitative data, and quantitative method details were often omitted. Thus, the reliability and validity of these review findings may be limited. Further research is required to evaluate the efficacy of FBDG as a public health promotion tool. If the purpose of FBDG is to evoke consumer behaviour change, then the framework of consumer awareness, understanding and use of FBDG may be useful to categorise consumer behaviour studies and complement the dietary survey and health outcome data in the process of FBDG evaluation and revision.

Weight management is a dynamic process, with a pre-treatment phase, a treatment (including process) phase and post-treatment maintenance, and where relapse is possible during both the treatment and maintenance. Variability in the statistical power of the studies concerned, heterogeneity in the definitions, the complexity of obesity and treatment success, the constructs and measures used to predict weight loss and maintenance, and an appreciation of who and how many people achieve it, make prediction difficult. In models of weight loss or maintenance: (i) predictors explain up to 20–30% of the variance; (ii) many predictors are the sum of several small constituent variables, each accounting for a smaller proportion of the variance; (iii) correlational or predictive relationships differ across study populations; (iv) inter-individual variability in predictors and correlates of outcomes is high and (v) most of the variance remains unexplained. Greater standardization of predictive constructs and outcome measures, in more clearly defined study populations, tracked longitudinally, is needed to better predict who sustains weight loss. Treatments need to develop a more individualized approach that is sensitive to patients' needs and individual differences, which requires measuring and predicting patterns of intra-individual behaviour variations associated weight loss and its maintenance. This information will help people shape behaviour change solutions to their own lifestyle needs.

There have been many studies of what influences consumers in their decisions to purchase or consume organic foods, mainly concerned with fresh organic foods. These show a discrepancy between attitudes and behavior with people being positive about organic foods but often not purchasing them. This discrepancy seems to be explained by the fact that consumers do not consider "organically produced" to be an important purchase criterion, that organic foods are not perceived to surpass conventional foods regarding taste and shelf life (two qualities rated to be of great importance), and because of the perceived premium prices of organic foods. In two Swedish studies, health benefits were demonstrated to be more strongly related to attitudes and behavior toward organic foods than were perceived environmental benefits. A new European Union (EU) project will investigate the influences on both fresh and processed organic foods and investigate the role of moral, ethical, and affective influences on choice across eight EU countries.

There are a number of possible reasons for the lack of effectiveness of attempts at changing dietary behaviors. While lack of information and knowledge about foods and nutrient contents might play a part, motivation to change is likely to be much more important. Food choice, like any complex human behavior, is influenced by many interrelating factors, including various physiological, social and cultural factors, and these need to be taken into account when considering dietary interventions. In many cases people lack motivation to change. This can be related to optimistic bias, where people underestimate the risk to themselves relative to others from a variety of hazards. People feel less at risk personally for many dietary risks and this is related both to the control they feel they have over dietary behaviors and also to their considering themselves to have better diets than the average. The ' stages of change ' model is a possible means for trying to address these motivational issues. While this model has been applied to various forms of behavior such as smoking, there are a number of problems transferring such a model from smoking to dietary behaviors, including the lack of clear cut specific behaviors and behavior change targets in the dietary field.

There have been a number of recommendations for reducing fat in the diet, of which consuming milk of a lower fat content is one of the most popular. In the reported study, the Theory of Planned Behavior (TPB) was applied to attitudes towards the consumption of milks of differing fat contents. Subjects (N = 257) completed a mail questionnaire in which the basic components of the model were assessed. A measure of perceived moral obligation for family's health was also included since it was predicted that this would constitute an influence not only on intentions, but also on attitudes. The findings largely support the predictive effect of the inclusion of the measure of perceived moral obligation Differential attitudes and the use of alternative outcome evaluation scales are also examined. The findings are discussed in relation to possible extensions to the model.

The present study examined the moderating role of attitudinal ambivalence within the theory of planned behaviour (TPB). Attitude, subjective norm, perceived behavioural control (PBC), behavioural intentions and self-reported behaviour were assessed in relation to 20 healthy eating behaviours in a prospective questionnaire design in 232 members of the general public in the UK. Between-participants univariate and multivariate analyses indicated attitude-behaviour and PBC-behaviour relationships to be weaker in higher ambivalence compared to lower ambivalence respondents. These effects were confirmed in within-participants analyses. The findings are discussed in terms of the role of ambivalence in furthering our understanding of relationships in the TPB.

Part 1: Models of food choice A Conceptual Model of the Food Choice Process over the Life Course, J Sobal, C A Bisogni, C M Devine and M Jastran, Cornell University, USA The Integration of Biological, Social, Cultural, and Psychological Influences on Food Choice, P Rozin, University of Pennsylvania, USA Social Psychological Models of Food Choice, M Conner, University of Leeds, UK and C J Armitage, University of Sheffield, UK Part 2: Biological and learning influences on food choice Biological Influences on Energy Intake, K Westerterp, Maastricht University, The Netherlands Food Neophobia in Humans, P Pliner and S-J Salvy, University of Toronto at Mississauga, Canada The Role of Learning in Development of Food Preference, M R Yeomans, University of Sussex, UK Mood, emotions and food choice, E L Gibson, Roehampton University, UK Food Cravings and Addictions, S Higgs, University of Birmingham, UK Part 3: Societal influences on food choice Marketing Parameters and their Influence on Consumer Food Choice, K G Grunert, Aarhus School of Business, Denmark The Role of Context in Food Choice, Food Acceptance and Food Consumption, H L Meiselman, Natick Soldier Center, USA The Impact of the Media on Food Choice, J Reilly, University of Glasgow, UK The Impact of Advertising on Food Choice: the Social Context of Advertising, M Caraher, City University, UK and J Landon, National Heart Forum, UK Part 4: Food choices across the lifespan Adolescents, Food Choice and Vegetarianism, K Trew, C Clark, G McCartney, Queens University Belfast, Ireland, J Barnett, University of Surrey, UK and O Muldoon, Queens University Belfast, Ireland Intra-family Influences on Food Choice at Mid-life , J L Brown, Pennsylvania State University, USA Food Choices in Later Life, M Lumbers and M Raats, University of Surrey, UK Part 5: Changing dietary behaviour The Impact of Optimistic Bias on Dietary Behaviour, V Scaife, S Miles, University of East Anglia, UK and P Harris, University of Sheffield, UK Implementation Intentions: Strategic Automatisation of Food Choice, T L Webb, P Sheeran and C J Armitage, University of Sheffield, UK The Use of the Stages of Change Model with Dietary Behaviours, R Shepherd, What is a Healthy Diet Community? D Bowen, Fred Hutchinson Cancer Research Center, USA and T Hilliard Eating Behaviour in Obesity, J Wardle, University College London, UK

Background: Research has suggested that patients and treatment providers hold different beliefs and models of obesity. This could impact consistency and quality of interventions for weight management. This study investigated the attitudes and beliefs of health professionals, commercial weight management advisors (expert patients) and overweight and obese dieters, towards obesity. Methods: Data were collected using a self-administered questionnaire from 287 health professionals, 85 expert patients and 116 dieters. Respondents gave their views on obesity causation and consequences, and the most efficacious means to manage obesity. Demographic data and self-reported height and weight were also collected. Factor analysis, ANOVA and t-tests were used to analyse the data. Results: Health professionals, expert patients and dieters held similar models of obesity, identifying the same causes (lifestyle causes), consequences (medical consequences) and treatments (currentrecommended options) of obesity/overweight. Conclusion: This study indicated broad similarity between beliefs and attitudes of those involved in obesity treatment and those they aim to treat than previously suggested. The concordance of beliefs between patients and treatment providers is an encouraging finding and may have important implications for public health strategies in this area.

Health professionals have a major role to play in addressing obesity and overweight in the general population1. Differences in beliefs and attitudes to obesity between healthcare providers and individuals attempting weight control are likely to act as a barrier in successful weight management. The aim of the present research was to investigate differences in attitudes and perceptions of obesity between healthcare providers and overweight and obese individuals. A web-based questionnaire designed to measure attitudes, perceptions, beliefs and barriers to successful weight control was developed. Healthcare participants were recruited through mailing lists of professional organisations for health professionals and students with an interest in obesity. Dieters were recruited via email advertisement sent out to companies in the Surrey Research Park, Guildford, UK. A five-point scale from 1 (not at all) to 5 (totally) was used, mean scores were produced. The questionnaire was completed by 283 health professionals and 116 dieters. The majority of the sample was female (82%) and married or living with a partner (70%). The data on beliefs about the causes of obesity were factor analysed and four factors were produced (see Table). Both groups believe that ‘lifestyle factors’ have the greatest role to play in causing obesity. These factors include unhealthy food choices, lack of exercise, food portion size and lack of self control. Significant differences were revealed between the groups for ‘medical factors’ and ‘psychological factors’, with health professionals more likely than dieters to view psychological factors as important and dieters more likely to view ‘medical factors’ as an important cause of obesity. There was a significant difference (P £ 0.001) in beliefs about the effects of obesity, with health professionals reporting factors such as driving, going to the toilet, dressing, basic interpersonal interaction, family relationships, educational attainment and fertility, affect obesity more than dieters think they do. Differences in attitudes to a range of methods for dealing with obesity were revealed between the two samples. Health professionals were significantly more positive about surgery (mean score; health professionals 3.19, dieters 2.68; P

The objective of this study was to relate behaviour change mechanisms to nutritionally relevant behaviour and demonstrate how the different mechanisms can affect attempts to change these behaviours. Folate was used as an example to illuminate the possibilities and challenges in inducing behaviour change. The behaviours affecting folate intake were recognised and categorised. Behaviour change mechanisms from "rational model of man", behavioural economics, health psychology and social psychology were identified and aligned against folate-related behaviours. The folate example demonstrated the complexity of mechanisms influencing possible behavioural changes, even though this only targets the intake of a single micronutrient. When considering possible options to promote folate intake, the feasibility of producing the desired outcome should be related to the mechanisms of required changes in behaviour and the possible alternatives that require no or only minor changes in behaviour. Dissecting the theories provides new approaches to food-related behaviour that will aid the development of batteries of policy options when targeting nutritional problems.

Rational choice models are characterized by the image of the self-interested Homo economicus. The role of moral concerns, which may involve a concern for others' welfare in people's judgments and choices, questions the descriptive validity of such models. Increasing evidence of a role for perceived moral obligation within the expectancy-value-based theory of reasoned action and the theory of planned behavior indicates the importance of moral-normative influences in social behavior. In 2 studies, the influence of moral judgments on attitudes toward food produced with the use of genetic engineering techniques and toward meat consumption is addressed. The reasons participants provide for their moral judgments indicate some foci of their moral concerns. The results of both studies corroborate earlier findings that perceived moral obligation (moral norm) has independent effects on behavioral intentions; they also provide evidence that such judgments may affect attitudes themselves. The results are discussed in relation to the need for attitude-behavior models to reflect the role of moral evaluations in judgment and choice.

Background: Precautionary ‘may contain’ warnings are used to indicate possible allergen contamination. Neither food safety nor foods labelling legislation address this issue. The aim of this study is to understand how peanut and nut allergic adults interpret ‘may contain’ labelling and how they use this information when purchasing food. Methods: Qualitative methods were used to explore both behaviour and attitudes. The behaviour and ‘thinking aloud’ of 32 participants were recorded during their normal food shop. A semi-structured interview also explored participants’ views about 13 potentially problematic packaged foods. Transcribed data from these tasks were analysed to explore the interpretation of ‘may contain’ labelling and how this influenced food choice decisions. Results: Peanut and nut allergic individuals adopt a complex range of responses and strategies to interpret ‘may contain’ labelling. Many claimed such labelling was not credible or desirable; many ignored it whilst some found it helpful and avoided products with all such labelling. Interpretation and consequent decisions were not only based on the detail of the labelling but also on external factors such as the nature of the product, the perceived trustworthiness of the producer and on the previous experience of the nut allergic individual. Conclusions: ’May contain’ labelling was interpreted in the light of judgements about the product, producer and previous personal experience. It is vital that these interpretation strategies are taken into account by those responsible for labelling itself and for the provision of advice to nut allergic individuals. Suggestions to improve labelling and advice to the allergic individual are considered.

Behavioural reactions to potential hazards are likely to be determined by psychologically derived factors (risk perceptions) as well as rational estimates of risk. Research has shown that risk perception is a complex psychological construct, where different potential hazards are associated with different hazard characteristics. One of the most important determinants of risk perception is knowledge about a given hazard. It is probable that reactions will be determined not only by what is conveyed in the content of risk information but also by other characteristics of the information source. A predominant source of risk information for the public is the media, although there are at present no adequate models available to describe how such risk information is conveyed. If communication with the public on issues of risk is to be effective, then it must take due account of the role and effect of the media. Given that the public is suddenly exposed to a problem by the media in the context of a 'crisis', it is possible that polarization of views among the public and scientific community (and other interested parties, such as pressure groups) will take place, often on the basis of inadequate data. This research examines how the British press communicate risk information. The focus is food-related hazards: food biotechnology, microbiological hazards, food irradiation, chemicals and pesticide residues, and food additives. The development of a content-analysis schedule, and its subsequent application to 182 newspaper reports refemng to food-related hazards, is presented. Correspondence analysis of the resulting data indicated that substantial differences in risk reporting occurs for hazards with different perceptual characteristics. Methods of testing derived models of media transmission of risk information against formation of attitudes are discussed.

One hundred and three subjects completed a questionnaire on consumption of low-fat milks, along with attitudes and beliefs about consumption. Females showed a generally more favourable disposition towards consuming low-fat milks, whereas age and social class had little effect. The belief-evaluation scores showed good prediction of behavioural intention and self-reported behaviour. A principal components analysis of the belief-evaluation scores showed the nutritional beliefs to be separable from the sensory and functional beliefs, with the price items not clearly related to either. The nutritional beliefs were more closely related to the person's attitude towards consuming low-fat milk.

A key step towards developing appropriate evidence-based public health nutrition policies is determining exactly how that evidence should be collected and assessed. Despite this the extent to which different evidence bases influence policy selection is rarely explored. This paper presents an epistemological framework which offers a range of considerations effecting this process generally and with particular implications for both micronutrient requirements and the role of behaviour in the policy-making process. Qualitative case study data covering six European countries/regions (Czech Republic, Italy, Netherlands, Nordic countries, Poland and Spain), and three micronutrients (folate, iodine and vitamin D), have been presented to illustrate the relevance of the Framework.

Objective To examine the workings of the nutrition-related scientific advisory bodies in Europe, paying particular attention to the internal and external contexts within which they operate. Design Desk research based on two data collection strategies: a questionnaire completed by key informants in the field of micronutrient recommendations and a case study that focused on mandatory folic acid (FA) fortification. Setting Questionnaire-based data were collected across thirty-five European countries. The FA fortification case study was conducted in the UK, Norway, Denmark, Germany, Spain, Czech Republic and Hungary. Results Varied bodies are responsible for setting micronutrient recommendations, each with different statutory and legal models of operation. Transparency is highest where there are standing scientific advisory committees (SAC). Where the standing SAC is created, the range of expertise and the terms of reference for the SAC are determined by the government. Where there is no dedicated SAC, the impetus for the development of micronutrient recommendations and the associated policies comes from interested specialists in the area. This is typically linked with an ad hoc selection of a problem area to consider, lack of openness and transparency in the decisions and over-reliance on international recommendations. Conclusions Even when there is consensus about the science behind micronutrient recommendations, there is a range of other influences that will affect decisions about the policy approaches to nutrition-related public health. This indicates the need to document the evidence that is drawn upon in the decisions about nutrition policy related to micronutrient intake.

Background: European consumers are faced with a myriad of food related risk and benefit information and it is regularly left up to the consumer to interpret these, often conflicting, pieces of information as a coherent message. This conflict is especially apparent in times of food crises and can have major public health implications. Scientific results and risk assessments cannot always be easily communicated into simple guidelines and advice that nonscientists like the public or the media can easily understand especially when there is conflicting, uncertain or complex information about a particular food or aspects thereof. The need for improved strategies and tools for communication about food risks and benefits is therefore paramount. The FoodRisC project ("Food Risk Communication - Perceptions and communication of food risks/benefits across Europe: development of effective communication strategies”) aims to address this issue. The FoodRisC project will examine consumer perceptions and investigate how people acquire and use information in food domains in order to develop targeted strategies for food communication across Europe. Methods/Design: This project consists of 6 research work packages which, using qualitative and quantitative methodologies, are focused on development of a framework for investigating food risk/benefit issues across Europe, exploration of the role of new and traditional media in food communication and testing of the framework in order to develop evidence based communication strategies and tools. The main outcome of the FoodRisC project will be a toolkit to enable coherent communication of food risk/benefit messages in Europe. The toolkit will integrate theoretical models and new measurement paradigms as well as building on social marketing approaches around consumer segmentation. Use of the toolkit and guides will assist policy makers, food authorities and other end users in developing common approaches to communicating coherent messages to consumers in Europe. Discussion: The FoodRisC project offers a unique approach to the investigation of food risk/benefit communication. The effective spread of food risk/benefit information will assist initiatives aimed at reducing the burden of food-related illness and disease, reducing the economic impact of food crises and ensuring that confidence in safe and nutritious food is fostered and maintained in Europe.

The aim of the present abstract is to report on obese individuals’ weight-loss goals and factors influencing these goals. Current guidelines recommend a target weight loss of 5–10% of original weight for successful weight control(1). However, research has shown that this level is a great underestimation of what obese individuals consider as successful or acceptable weight loss(2). Unmet goals or expectations in weight control can lead to negative behaviours and psychological profiles, and ultimately abandonment of weight-control efforts. Data reported here were collected as part of the EU 6th Framework project DiOGenes, a dietary intervention trial investigating the effectiveness of high- and low-GI and -protein diets on weight maintenance, following a rapid weight-loss period, in an obese cohort. Participants were asked to indicate their target weight in kilograms in a questionnaire completed at the screening phase. A target weightloss score was then calculated by subtracting self-reported target weight from baseline weight. Target weight-loss scores ranged from + 11 kg to - 88.6 kg and were highly correlated with baseline weight (r - 0.73, P

Using a survey, this study investigated public perceptions relating to different healthy grain foods (bread, pasta and biscuits) and how these perceptions are influenced by gender, nationality, base product (staple vs. fun food), type of health claim (general vs. specific) and people's perceptions associated with different production methods. Two thousand and ninety-four (50.4% women, 49.5% men) members of the public from the UK, Italy, Finland and Germany completed the survey questionnaire. The participants were over 18 years of age and were solely or jointly responsible for the family's grocery shopping. Results confirmed that similar to other functional foods, there were gender and country differences in people's perceptions of benefits relating to functional grain products. Men perceived more benefit in products with specific health claims and women in products with general health claims. However, when it was personally relevant, men's levels of perceived benefit in products with general health claims were equally high as women's. Further, modification of staple foods was perceived as more beneficial than fun foods and people preferred processes such as fortification and traditional cross-breeding to others such as genetic modification. In addition, the differences in perceived benefits between foods with general and specific health claims were largest for staple foods than for hedonistic foods. (c) 2007 Elsevier Ltd. All rights reserved.

Objectives. Interest in attitudes and ambivalence has highlighted problems with the adequacy of conceptualizing attitudes as unitary, unidimensional, evaluations. In this paper, we report an application of the Theory of Planned Behaviour (Ajzen, 1991) in the domain of dietary choice which investigates the hypothesis that ambivalence will attenuate observed attitude-intention relationships (since the evaluations influencing the expression of attitudes are more Likely to differ from the evaluations influencing the expression of intentions for people who are more ambivalent. Design. Participants complete a postal questionnaire which contained, inter alia, measures assessing the components cf the Theory of Planned Behaviour and a measure of ambivalence. Methods. Participants (N = 296) were recruited via advertisements placed in local newspapers, asking for volunteers to assist in a research project. Participants were randomly assigned to complete a questionnaire about either their chocolate consumption or their meat consumption. Participants were paid pound4. Results. The findings show considerable support for the hypothesis: there was a tendency for attitude-intention relationships to be attenuated among participants with higher levels of ambivalence, compared to participants with lower levels of ambivalence. Conclusions. The research supports the widespread view that ambivalence is an important issue, both for those involved in basic attitude research and for those who seek to use attitude theories in applied research. In particular, the findings indicate that ambivalence may often have implications for the predictive ability of attitude-intention-behaviour models, especially when applied to health-related behaviours that are characterized by motivational conflicts.

Dietary changes can be difficult to effect both at an individual and at a population level, and even when changes do occur they are often far slower and less pronounced than might be expected. Three possible reasons for this situation will be considered: the complexity of food choice and competing influences, attitudinal ambivalence and optimistic bias. Food choice is influenced by a large number of factors, not only health considerations, and therefore it is not surprising that interventions based primarily on health concerns have been ineffective. Another concern is that people do not always have clear-cut attitudes, but rather can be ambivalent about foods and about healthy eating, and this factor might impact on the translation of beliefs and attitudes into behaviour. A third possible reason is optimistic bias, where individuals believe themselves to be at less risk from various hazards than is the average person. This effect has been demonstrated for nutritional risks, and this factor might lead people to take less note of health education messages. The stages-of-change model from health psychology has been proposed as a method for improving the effectiveness of behaviour change interventions. However, there are a number of problems in transferring such a model from smoking, where it was originally developed, to dietary behaviours, including the lack of clear-cut specific behaviours and behaviour change targets in the dietary field.

It was hypothesised that consumers' expectations of liking for a food would be affected by its appearance both when raw and when cooked and that the impact of these expectations on actual liking for the product after eating would vary with consumer awareness of internal body states (private body consciousness). We found that consumers' expectations of liking for the food generated by the appearance of the cooked product was related to expectation of liking from viewing the raw product. Under some conditions, consumers liked a food less after consumption if a raw product that generated low expectation of liking had been presented beforehand. There was no evidence that private body consciousness modified the consumers' susceptibility to expectation effects. It was concluded that expectations of liking for a food generated by appearance both when raw and cooked influenced final evaluation of the product during consumption. (C) 2003 Elsevier Ltd. All rights reserved.

This paper describes the development and validation of a nutritional knowledge questionnaire. The questionnaire included a forced choice nutrient density section and multiple choice exercise. Two groups of respondents (group 1, nutrition professionals, n = 27; group 2, engineering undergraduates, n = 55) completed the questionnaire. Significant differences were found between group scores for each of the four nutrients (protein, carbohydrate, fat and fibre) and for the multiple choice (P < 0.001). Cronbach's alpha for the complete questionnaire was 0.82. These results suggest a robust and valid test instrument for the measurement of nutritional knowledge, which will be used to examine relationships between nutritional knowledge and behaviour.

Attitudinal ambivalence is generally construed as existing when the same attitude object is evaluated simultaneously as both positive and negative. The present research examined the moderating role of attitudinal ambivalence (as assessed by split-semantic differential measure) on the relationship between bipolar semantic differential measures of attitude and subsequent behaviour using moderated regression analysis. In Study 1, higher levels of attitudinal ambivalence were shown to result in weaker attitude-behaviour relationships for eating a low-fat diet (N = 140) and eating 5 portions of fruit and vegetables per day (N = 142). Study 2 (N = 361) replicated this effect when also including a measure of past behaviour for eating a low-fat diet. Implications for understanding the relationship between attitudes and behaviour are discussed. Copyright (C) 2002 John Wiley Sons, Ltd.

Eighty subjects rated flavoured milk samples which varied in sweetener (sugar versus aspartame) and fat content (full-versus low-fat milk). Twenty of the subjects were in a control condition and received no information about the samples. The remaining sixty subjects initially rated the samples with no information and then rated them again when given information on the fat and sugar content of the samples. Ratings of sweetness, body, healthiness and calorie content were influenced by the information but liking and likelihood of buying were not affected in the overall group. Dividing subjects on the basis of attitudes towards low- and full-fat flavoured milks, however, showed different effects within the two subgroups. When information was given, both liking and rated likelihood of buying increased for the type of sample towards which subjects had a more generally positive attitude. Those subjects with more positive attitudes towards low-fat flavoured milks showed a clear differentiation in ratings of the healthiness of the samples when information was provided. However, those with more positive attitudes towards full-fat flavoured milks did not differentiate the samples in terms of rated healthiness. Similar effects were found when the subjects were divided on the basis of dietary restraint. Those subjects with higher scores for dietary restraint showed greater differentiation of the samples in terms of calorie content, healthiness and sweetness. © 1993.

A questionnaire on consumption of a high-fat food item (chips) was completed by 288 subjects. This questionnaire was based in part on the Fishbein and Ajzen theory of reasoned action, but also included measures of habit and perceived behavioural control. In line with the theory of reasoned action, both the person's attitude and the subjective norm were found to be important predictors of reported consumption. Habit, but not perceived control, was also found to be an important predictor of intention and of behaviour. © 1992.

Using the Theory of Planned Behaviour (TPB), this study investigates weight control in overweight and obese participants (27kg/m(2)⩽BMI

Attempts to use attitudes and beliefs held by people as a way of examining the influences on food choice have often failed to show clear relationships because of the lack of a clear theoretical framework. The attitudes model developed by Fishbein and Ajzen is presented as one approach for achieving this. Fat intake has been studied using this approach. It has shown good prediction of consumption of foods contributing highly to fat in the diet and demonstrated the importance of both sensory and nutritional beliefs. General nutritional knowledge has been shown to relate to consumption only to a very limited degree. Initial tests of extensions of this approach, incorporating measures of habit and perceived control, have demonstrated the importance of habit in this area. © 1991.

Daily use of table salt was measured for 10 weeks in a staff canteen serving approximately 2400 meals. During the study the size of the holes in the salt pots was manipulated, and the corresponding amount of table salt used was measured. Staff also completed a questionnaire on salt use, which was used to calculate the percentage of staff using the salt pots. Results indicate that, despite a 10 day exposure to each new hole size, individuals used significantly more table salt when the salt pots with the largest holes were supplied. However, when the 'shaking' time was estimated by relating the amount used to the flow rate, the salt pots with the largest holes were shaken for a shorter time. This finding suggests that the adding of table salt to food is subject to both sensory and habitual control. © 1990.

Two experiments are reported that examined consumers' perceptions of food package labels where health and nutrition claims were present and where they had been removed. Unlike previous studies examining the influence of information on perception, realistic materials were used. This was accomplished by presenting information on a computer as photo-realistic images of packages where claims had been removed by editing to give a without-claims condition. Automatic presentation of materials and data collection meant participants proceeded through the computer questionnaire without the presence of an experimenter. The experiment was conducted with both British and French consumers. No significant difference on purchase intention or attitude to purchase was found between conditions with either population sample. The British group showed a significant trend to rate products as likely to be approved by those whose opinion they regarded as important in the claims condition. French participants showed a similar effect whereby packages without claims were always perceived as significantly beneficial with a low subjective norm effect and a mixture of both factors with claims present. In both population samples, label information provision was evaluated more highly than a collection of single sensory and nutritional attributes. Multiple regressions against attitude to purchase showed that sensory attributes were given higher weighting than nutritional or direct label attitude measures with both groups. Argument that health and nutrition claims are likely to have very large effects on consumers' buying patterns thus may be treated with caution. These results suggest that from a marketing perspective where claims are relevant they should be given a subsidiary position to claims about sensory qualities.

The repertory grid method and the 'item by use' appropriateness method were used to study the place milk occupies within the diet, its perceived appropriateness and people's beliefs concerning different types of milk. The results of both methods suggest that consumers tend to find their most used type of milk suitable for all their uses of milk. In the repertory grid study the high-fat milk users separated the milks to a greater extent on 'taste/flavour', 'richness', and 'wateriness' whereas the low-fat milk users separated the milks to a greater extent on 'fat content', 'creaminess', 'richness', and 'healthiness'. In the 'item by use' appropriateness study high-fat milk users used no particular use-attribute to separate the milks, whereas the low-fat milk users separated the milks to a greater extent on 'when I want something low in calories', 'when I want something that contains little fat', and 'when on a diet'. © 1992.