Types of fruits and vegetables used in commercial baby foods and their contribution to sugar content

Fruits and vegetables (F&V) are often featured in names of commercial baby foods (CBFs). We aimed to survey all available CBFs in the UK market with F&V included in the food name in order to describe the amount and types of F&V used in CBF and their contribution to total sugar content. Food labels were used to identify F&V and total sugar content. Fruits were more common than vegetables in names of the 329 CBFs identified. The six most common F&V in the names were all relatively sweet: apple, banana, tomato, mango, carrot and sweet potato. The percentage of F&V in the foods ranged from a median of 94% for sweet-spoonable to 13% for dry-savoury products. Fruit content of sweet foods (n = 177) was higher than vegetable content of savoury foods (n = 152) with a median (IQR) of 64.0 g/100 g (33.0–100.0) vs. 46.0 g/100 g (33–56.7). Fruit juice was added to 18% of products. The proportion of F&V in CBF correlated significantly with sugar content for all the food types except dry-savoury food (sweet-spoonable r = 0.24, P = 0.006; savoury-spoonable r = 0.65, P < 0.001; sweet-dry r = 0.81, P < 0.001; savoury-dry r = 0.51, P = 0.06) and explained up to two-thirds of the variation in sugar content. The F&V content of CBFs mainly consists of fruits and relatively sweet vegetables which are unlikely to encourage preferences for bitter-tasting vegetables or other non-sweet foods. F&V contribute significantly to the total sugar content, particularly of savoury foods

A community-based cooking programme "Eat Better Feel Better" can improve child and family eating behaviours in low socioeconomic groups

Background: The immediate and sustained impacts of the Eat Better Feel Better cooking programme (EBFBCP) on food choices and eating behaviours in families and children were evaluated. Methods: The EBFBCP (6 weeks, 2 hours/week) was delivered by community-based organisations in Greater Glasgow and Clyde, Scotland. Before, after and at follow-up, parents/caregivers completed short pictorial questionnaires to report family/child eating behaviours and food literacy. Results: In total, 83 EBFBCPs were delivered and 516 participants enrolled, of which 432 were parents and caregivers. Questionnaire completion rates were 57% (n=250) for before and after and 13% (n=58) for follow-up. Most participants (80%) were female, 25–44 years old (51%) and considered socioeconomically deprived (80%). The immediate effects of the EBFBCP on eating behaviours and food literacy were families ate less takeaway/fast foods (10% reduction, p=0.019) and ready meals (15% reduction, p=0.003) and cooked more from scratch (20% increase, p<0.001). Children’s consumption of discretionary food/drinks was significantly reduced after the EBFBCP for sugary drinks (10% reduction, p=0.012), savoury snacks (18%, p=0.012), biscuits (17%, p=0.007), sweets/chocolates (23%, p=0.002), fried/roasted potatoes (17%, p<0.001) and savoury pastries (11%, p<0.001). The number of fruit (15%, p=0.008) and vegetable portions (10%, p<0.001) increased, while the number of biscuit portions decreased (13%, p=0.005). Parental food label reading increased (calories, 22%; fat, 23%; sugar, 22%; ingredients, 19%; and portion size, 19%). Most changes were sustained at a median of 10 months’ follow-up. Conclusion: The EBFBCP improved children’s and families’ food choices and behaviours. The EBFBCP can be recommended to support families to make better food choices

Survey of emotional themes used in marketing of commercial baby foods in the UK—implications for nutrition promotion in early childhood

Claims used in the marketing of commercial baby foods are often misleading, and there are concerns that they exploit parental anxieties. We adapted a hierarchical consumer emotions model to explore the emotional themes used in the marketing of commercial baby foods sold in the UK market. A survey administered in three large UK supermarkets collected in-store data on commercial baby food characteristics and the marketing claims used on commercial baby food packaging. The keywords found in these claims were entered in N-Vivo and allocated to four preexisting emotional themes: contentment, happiness, love, and pride. The prevalence of each theme was compared by age suitability (4+, 6+, 9+, and 12+ months) and taste (sweet/savoury) profile. A total of 1666 marketing claims (median 5, IQR 3) and 1003 emotional keywords (median 3, IQR 3) were identified on the packaging of 341 commercial baby foods. Foods suitable for infants aged 6+ months displayed more claims (50%, p < 0.05) and emotional keywords (56%, p = 0.07). Savoury foods displayed more emotional keywords (63%, p < 0.001). The keywords “little”, “encourage”, “love(ly)”, and “tiny” were the most frequently used words under the theme of love (36% total contribution). The emotional connotations of the keywords under the theme “love” are extensively used in the marketing claims on commercial baby food packaging. These might exploit parental vulnerabilities and influence their purchasing of commercial baby foods

Extensive use of on-pack promotional claims on commercial baby foods in the UK

Objective: To explore and categorise the nature of promotional claims on packaging of commercial baby foods (CBFs). Setting: UK Methodology: An online survey of CBFs (for infants up to 12+ months) in 7 UK supermarkets and Amazon in 2020. On-pack promotions were classified as marketing, composition, health, and nutrient claims using the WHO Nutrient Profile Model draft for infants and young children, and European Union regulation on health and nutrition claims. Main outcome measure: Distribution and proportion of claim types, and association between product characteristics and claim types. Results: A total of 6265 promotional claims were identified on 724 products. Marketing (99%, n=720), composition (97%, n=705) and nutrient claims (85%, n=616) were found on the majority of CBFs, compared with health claims (6%, n=41). The median (Q1, Q3) number of total claims per product was 9 (7, 10), marketing 5 (3, 6), composition 2 (1, 2), nutrient 2 (1, 2), and 0 (0, 0) health. Marketing claims were mainly texture (84%, n=609, eg, super smooth) and taste related (70%, n=511, eg, first tastes). The main composition claim was organic (63%, n=457) while nutrient claims were mainly around ‘no added’ or ‘less’ sugar (58%, n=422) and salt (57%, n=417). Baby led weaning claims (BLW) (eg, encourages self-feeding) were found on 72% of snacks, with a significantly higher (p<0.01) number of BLW claims on snacks (99%, n=209) compared with other product types. Conclusion: Promotional claims on CBF packaging are extensively used and, for the most part, unregulated. CBFs are promoted using ‘healthy halo’ connotations that might confuse parents. Regulations on their use should be implemented to avoid inappropriate marketing

How Effective is the “Eat Better Feel Better” Community‐based Cooking Intervention at Tackling Barriers of Time, Cost, Waste and Knowledge of Healthy Eating in Glasgow, Scotland?

Barriers of time, cost, waste and knowledge hinder cooking practice which is linked to poor diets. We aimed to evaluate the short and mid‐term effectiveness of a community‐based cooking intervention developed by the National Health Service (NHS) in Greater Glasgow and Clyde (GGC), Scotland in tackling the barriers of time, cost, waste and knowledge of healthy eating. We used a single‐group repeated measures design. A 6‐week, 2 hour per week cooking intervention was delivered in community‐based facilities in four health and social care partnership localities in NHS GGC. All participants who enrolled in this intervention were asked to complete questionnaires at baseline and post‐intervention, a follow‐up evaluation was conducted after 3–4 months via postal questionnaires. Of the 117 participants who enrolled, 62 completed baseline and post‐intervention questionnaires and 17 completed questionnaires at all three time‐points. The majority (65%) were female, over 45 years old, of Scottish descent, and were considered socioeconomically deprived. Confidence constructs related to cooking skills were assessed with a scale between 1 (not confident) and 7 (very confident), and are reported as medians for baseline, post‐intervention and follow‐up (p for changes from baseline to follow‐up). For the participants who completed all three questionnaires, a positive and significant change in 10 out of 12 confidence constructs was seen. These were as follows: “following a simple recipe (5, 6, 7; p=0.038), “planning meals before shopping” (4, 6, 5; p=0.030), “shopping on a budget (4, 5, 6; p=0.037), “shopping for healthier food” (4, 5, 5; p=0.008), “cooking new foods” (2, 5, 4; p=0.002, “cooking healthier foods” (4, 6, 5; p=0,006), “storing foods safely” (4, 6, 7; p=0.011); “using leftovers for other meals” (3.5, 5, 5; p=0.040), “reading food labels” (3, 5, 6; p=0.001) and “food hygiene” ( 5, 6, 7; p=0.034). Baseline and follow‐up results for cooking practices such as eating ready‐meals changed from 59% to 24% of those who responded “yes” (p=0.034) and throwing away leftovers from a median of 3 (once a week) to 2 (< once a week) (p=0.017). Similarly, frequency in eating healthier choices (e.g. oily fish) increased from 2 (< once a week) to 4 (2–4 times a week) (p=0.039) while knowledge for correct portion sizes increased from 35% to 88% (p=0.004). The median values for self‐reported spending on food per week were identical between the three time points (£40.00, p=0.653). However, the median values for the amount of money spent on takeaway/fast food per week at baseline, post‐intervention and follow‐up was £8.00, £5.00, and £2.00, respectively. In conclusion, despite the limited number of respondents, the results clearly show that the intervention was effective in increasing confidence and reducing the barriers of time, waste and knowledge in the short and mid‐term and has the potential to be embedded as part of public health improvement strategies to improve diet in Scotland

Childhood stunting and micronutrient status unaffected by RCT of micronutrient fortified drink

Micronutrient supplementation is widely used to prevent stunting in children under 5 years in low- and middle-income countries (LMIC), but the impact of treatment has been disappointing, possibly due to non-compliance. Our aim was to deliver long-term micronutrient supplementation via a novel, culturally acceptable liquid food to improve linear growth in a high stunting prevalence region. In a randomised control trial, 971 children aged 6–72 months received either ‘Chispuditos®’ (n = 681), a hot drink (atole) fortified with micronutrients (atole + MN) (9 mg/zinc, 12.5 mg/iron), or lactose-free milk (n = 290) for 18 months. Primary outcomes were changes in length/height-for-age (HAZ) score and the prevalence of stunting at 18-month follow-up. Adherence was monitored monthly, and 73% children in atole + MN group consumed at least half their daily zinc and iron requirement. At 18 months, there was no difference between the treatments in growth [mean change in HAZ −0.02 (95% CI −0.12, 0.08)] or stunting [atole + MN 41%, milk 41%; RR 0.99 (95% CI 0.84, 1.19)]. There were no differences in haemoglobin (HB), ferritin or zinc. No children had iron deficiency anaemia (IDA) at outcome, but zinc deficiency remained equally prevalent in both groups: atole + MN 35%, milk 35% [RR 1.02 (95% CI 0.83, 1.24)]. There was no difference in morbidity between the groups, and micronutrient status was unrelated to HAZ. Long-term micronutrient supplementation via a culturally acceptable food had no impact on stunting or morbidity, raising the question of whether large-scale micronutrient supplementation is worthwhile