Repeated exposure and conditioning strategies for increasing vegetable liking and intake: Systematic review and meta-analyses of the published literature

Background Vegetable intakes are typically lower than recommended for health. Although repeated exposure has been advocated to increase vegetable liking and consumption, no combination of the evidence yet provides a measure of benefit from repeated exposure or alternative conditioning strategies. Objective This work aimed to identify and synthesize the current evidence for the use of repeated exposure and conditioning strategies for increasing vegetable liking and consumption. Design Three academic databases were searched over all years of records using prespecified search terms. Published data from all suitable articles were tabulated in relation to 3 research questions and combined via meta-analyses. Results Forty-three articles detailing 117 comparisons investigating the use of repeated exposure and conditioning strategies for increasing liking and intakes of vegetables were found. Our analyses demonstrate: 1) increased liking and intakes of the exposed vegetable after repeated exposure compared with no exposure; 2) increased liking for the exposed vegetable after conditioning compared with repeated exposure, increased intakes after the use of rewards, and some suggestion of decreased intakes after flavor-nutrient conditioning; and 3) increased liking and intakes of a novel vegetable after repeated exposure to a variety of other vegetables compared with no exposure or repeated exposure to one other vegetable. Effect sizes, however, are small, and limited evidence suggests long-term benefits. Our analyses, furthermore, are limited by limitations in study design, compliance, and/or reporting. Conclusions Based on our findings, we recommend the use of repeated exposure to one and a variety of vegetables, and the use of rewards, for increasing vegetable liking and consumption. Confirmation from further large, well-conducted studies that use realistic scenarios, however, is also required

Nutrition information and its influence on menu choice within higher education establishments

©Emerald Group Publishing Limited. Purpose - The purpose of this paper is to evaluate the influence of nutritional information on menu choices in a higher educational setting using a menu designed by the students themselves. Design/methodology/approach - Based on USDA healthy eating standards, a menu comprising seven healthy and seven unhealthy meal options were presented, once unlabeled as control (n = 214) and once labeled with healthy and non-healthy nutrient icons as an intervention test menu (n = 212). Findings - Findings demonstrate that despite a positive observed trend, there were no significant differences between healthy selection of labeled and unlabeled dishes (p = 0.16).Practical implications - Providing nutritional information in student cafeterias may be challenging but helpful. However, more strategies need to be developed with student input to provide nutrition data on menus in an informative, comprehensive, yet friendly way that encourages healthy eating in campus foodservices. The authors would like to thank Sodexho at Montclair State University for their full cooperation with this project. Competing interests: the author(s) declare that they have no competing interests. Authors’ contributions: authorship is based on substantive contributions to each of the following: conception and design of the study; generation and collection of data, analysis and/or interpretation; and drafting or revision of the manuscript and approval of the final version. Ethical approval: the Independent Ethical Review Board of Montclair State University gave full approval for this study. An information sheet and consent form was distributed to all respondents and signed and where informed consent implied through participation and completion of the questionnaire. Respondents were informed of their right to withdraw from the survey and that their identity would be protected. Data were stored safely for the duration of the study, for administrative purposes, after which handling of data sets will adhere to guidelines of the Data Protection Act 1998.Social implications – No labeling system or legislation can control choices made by individuals, so the responsibility for a healthy selection must always remain personal. However, consumers should have input on menus as they have a stake in the outcome of the products. Originality/value – This novel study tested a student-designed menu to assess whether user input can influence food choice

Plate versus bulk trolley food service in a hospital: comparison of patients’ satisfaction

Objective The aim of this research was to compare plate with bulk trolley food service in hospitals in terms of patient satisfaction. Key factors distinguishing satisfaction with each system would also be identified. Methods A consumer opinion card (n = 180), concentrating on the quality indicators of core foods, was used to measure patient satisfaction and compare two systems of delivery, plate and trolley. Binary logistic regression analysis was used to build a model that would predict food service style on the basis of the food attributes measured. Further investigation used multinomial logistic regression to predict opinion for the assessment of each food attribute within food service style. Results Results showed that the bulk trolley method of food distribution enables all foods to have a more acceptable texture, and for some foods (potato, P = 0.007; poached fish, P = 0.001; and minced beef, P ≤ 0.0005) temperature, and for other foods (broccoli, P ≤ 0.0005; carrots, P ≤ 0.0005; and poached fish, P = 0.001) flavor, than the plate system of delivery, where flavor is associated with bad opinion or dissatisfaction. A model was built indicating patient satisfaction with the two service systems. Conclusion This research confirms that patient satisfaction is enhanced by choice at the point of consumption (trolley system); however, portion size was not the controlling dimension. Temperature and texture were the most important attributes that measure patient satisfaction with food, thus defining the focus for hospital food service managers. To date, a model predicting patient satisfaction with the quality of food as served has not been proposed, and as such this work adds to the body of knowledge in this field. This report brings new information about the service style of dishes for improving the quality of food and thus enhancing patient satisfaction

What Do Patients Value in the Hospital Meal Experience?

A number of previous studies have reported on the aspects of hospital food service that patients value, but usually as a secondary finding, and not generally based upon patient-centred approaches. This study employed a questionnaire produced ab initio from interviews with patients and hospital staff, the data from which were subjected to factor and cluster analysis, in order to identify and prioritise the factors that contribute to the meal experience empirically. The most important factors, food and service were as identified by other authors. In decreasing order of importance were social, personal and situational factors. The results confirm that improving the quality of the food and the efficiency with which it reaches the patients remain the most important objectives of hospital food service

A Mobile Phone App for the Provision of Personalized Food-Based Information in an Eating-Out Situation: Development and Initial Evaluation.

BACKGROUND: Increasing pressure from governments, public health bodies, and consumers is driving a need for increased food-based information provision in eating-out situations. Meals eaten outside the home are known to be less healthy than meals eaten at home, and consumers can complain of poor information on the health impact and allergen content of meals eaten out. OBJECTIVE: This paper aimed to describe the development and early assessment of a mobile phone app that allows the provision of accurate personalized food-based information while considering individual characteristics (allergies, diet type, and preferences) to enable informed consumer choice when eating out. METHODS: An app was designed and developed to address these requirements using an agile approach. The developed app was then evaluated at 8 public engagement events using the System Usability Scale (SUS) questionnaire and qualitative feedback. RESULTS: Consideration of the literature and consultation with consumers revealed a need for information provision for consumers in the eating-out situation, including the ability to limit the information provided to that which was personally relevant or interesting. The app was designed to provide information to consumers on the dishes available in a workplace canteen and to allow consumers the freedom to personalize the app and choose the information that they received. Evaluation using the SUS questionnaire revealed positive responses to the app from a range of potential users, and qualitative comments demonstrated broad interest in its use. CONCLUSIONS: This paper details the successful development and early assessment of a novel mobile phone app designed to provide food-based information in an eating-out situation in a personalized manner

Identifying key factors that encourage vegetable intake by young adults: using the health belief model

Purpose: Adequate vegetable consumption is fundamental to a healthy balanced diet; however, global compliance with recommendations is poor which is particularly important for young adults as they form food consumption habits. There is a growing interest in the circular economy of hospitality and sustainability of current dietary patterns in light of climate change and an expanding global population. The food value chain needs to be considered both vertically and horizontally where the research and development (R&D) investment is optimised by being “joined up” and not fragmentary; in addition, consumer trade-offs of health vs for example sensory appeal are taken into consideration. The purpose of this study was to identify factors predicting acceptance of vegetable dishes by young adults and present a roadmap that can be used for dish development and healthful marketing. Design/methodology/approach: This study used the health belief model (HBM) as framework to investigate key factors that encourage vegetable intake by young adults using an online questionnaire sample of 444 enrolled in undergraduate programs at universities in Brazil. Findings: Structural modelling showed that vegetable consumption frequency was positively influenced by Health concerns, Naturalness and Self-efficacy (including cooking skills), whereas Sensory factors and Familiarity demonstrated a negative loading that might be related to unpleasantness. Originality/value: Globally, there is a strong need to promote the consumption of vegetables as a public health policy priority but also to ameliorate barriers to action that could be facilitated by availability, dish development and healthful marketing in hospitality operations

Case Study: Wellness, tourism and small business development in a UK coastal resort: Public engagement in practice

This article examines the scope of well-being as a focus for tourism and its potential as a tool for small business development, particularly the opportunities for tourism entrepreneurs in coastal resorts. The study reports an example of public engagement by a research team and the co-creation of research knowledge with businesses to assist in business development by adapting many existing features of tourist resorts and extending their offer to wider markets. The synergy between well-being and public health interests also brings potential benefits for the tourism workforce and the host community. The Case Study outlines how these ideas were tested in Bournemouth, a southern coastal resort in the UK, in a study ultimately intended to be adopted nationally and with more wide reaching implications for global development of the visitor economy. Local changes ascribed to the study are assessed and its wider potential is evaluated

Comparison of three nudge interventions (priming, default option, and perceived variety) to promote vegetable consumption in a self-service buffet setting.

BACKGROUND: Dietary choices in out-of-home eating are key for individual as well as for public health. These dietary choices are caused by a wide array of determinants, one of which is automatic decision-making. Nudging is attracting considerable interest due to its understanding and application of heuristic biases among consumers. The aim of this study is to test and compare three nudges in promoting vegetable consumption among test persons in a food lab-based experiment. METHODS: The initial sample consisted of 88 participants recruited in Copenhagen, Denmark. Each study participant was randomly assigned to one of the three experiments: priming, default and perceived variety. The priming arm of the experiment consisted of creating a leafy environment with green plants and an odour of herbs. In the default arm of the experiment, the salad was pre-portioned into a bowl containing 200g of vegetables. The third experiment divided the pre-mixed salad into each of its components, to increase the visual variety of vegetables, yet not providing an actual increase in items. Each individual was partaking twice thus serving as her/his own control, randomly assigned to start with control or experimental setting. RESULTS: The default experiment successfully increased the energy intake from vegetables among the study participants (124 kcal vs. 90 kcal in control, p<0.01). Both the priming condition and perceived variety reduced the total energy intake among the study participants (169 kcal, p<0.01 and 124 kcal, p<0.01, respectively), mainly through a decrease in the meat-based meal component. CONCLUSIONS: Considerable progress has been made with regard to understanding the use of nudging in promoting a healthier meal composition, including increasing vegetable intake. This study suggests that the nature of a nudge-based intervention can have different effects, whether it is increasing intake of healthy components, or limiting intake of unhealthy meal components. This work has demonstrated that consumer behaviour can be influenced without restricting or providing incentives for behaviour change. The present findings have promising application to the foodservice sector

Construction and analysis of a modular model of caspase activation in apoptosis

<p>Abstract</p> <p>Background</p> <p>A key physiological mechanism employed by multicellular organisms is apoptosis, or programmed cell death. Apoptosis is triggered by the activation of caspases in response to both extracellular (extrinsic) and intracellular (intrinsic) signals. The extrinsic and intrinsic pathways are characterized by the formation of the death-inducing signaling complex (DISC) and the apoptosome, respectively; both the DISC and the apoptosome are oligomers with complex formation dynamics. Additionally, the extrinsic and intrinsic pathways are coupled through the mitochondrial apoptosis-induced channel via the Bcl-2 family of proteins.</p> <p>Results</p> <p>A model of caspase activation is constructed and analyzed. The apoptosis signaling network is simplified through modularization methodologies and equilibrium abstractions for three functional modules. The mathematical model is composed of a system of ordinary differential equations which is numerically solved. Multiple linear regression analysis investigates the role of each module and reduced models are constructed to identify key contributions of the extrinsic and intrinsic pathways in triggering apoptosis for different cell lines.</p> <p>Conclusion</p> <p>Through linear regression techniques, we identified the feedbacks, dissociation of complexes, and negative regulators as the key components in apoptosis. The analysis and reduced models for our model formulation reveal that the chosen cell lines predominately exhibit strong extrinsic caspase, typical of type I cell, behavior. Furthermore, under the simplified model framework, the selected cells lines exhibit different modes by which caspase activation may occur. Finally the proposed modularized model of apoptosis may generalize behavior for additional cells and tissues, specifically identifying and predicting components responsible for the transition from type I to type II cell behavior.</p

Increasing vegetable intakes: rationale and systematic review of published interventions

Purpose While the health benefits of a high fruit and vegetable consumption are well known and considerable work has attempted to improve intakes, increasing evidence also recognises a distinction between fruit and vegetables, both in their impacts on health and in consumption patterns. Increasing work suggests health benefits from a high consumption specifically of vegetables, yet intakes remain low, and barriers to increasing intakes are prevalent making intervention difficult. A systematic review was undertaken to identify from the published literature all studies reporting an intervention to increase intakes of vegetables as a distinct food group. Methods Databases—PubMed, PsychInfo and Medline—were searched over all years of records until April 2015 using pre-specified terms. Results Our searches identified 77 studies, detailing 140 interventions, of which 133 (81 %) interventions were conducted in children. Interventions aimed to use or change hedonic factors, such as taste, liking and familiarity (n = 72), use or change environmental factors (n = 39), use or change cognitive factors (n = 19), or a combination of strategies (n = 10). Increased vegetable acceptance, selection and/or consumption were reported to some degree in 116 (83 %) interventions, but the majority of effects seem small and inconsistent. Conclusions Greater percent success is currently found from environmental, educational and multi-component interventions, but publication bias is likely, and long-term effects and cost-effectiveness are rarely considered. A focus on long-term benefits and sustained behaviour change is required. Certain population groups are also noticeably absent from the current list of tried interventions