Willingness to pay for personalised nutrition across Europe

yesPersonalised nutrition (PN) may promote public health. PN involves dietary advice based on individual characteristics of end users and can for example be based on lifestyle, blood and/or DNA profiling. Currently, PN is not refunded by most health insurance or health care plans. Improved public health is contingent on individual consumers being willing to pay for the service. Methods: A survey with a representative sample from the general population was conducted in eight European countries (N = 8233). Participants reported their will- 25 ingness to pay (WTP) for PN based on lifestyle information, lifestyle and blood information, and lifestyle and DNA information. WTP was elicited by contingent valuation with the price of a standard, non-PN advice used as reference. Results: About 30% of participants reported being willing to pay more for PN than for non-PN advice. They were on average prepared to pay about 150% of the reference price of a standard, non-personalised advice, with some differences related to socio-demographic factors. Conclusion: There is a potential market for PN 30 compared to non-PN advice, particularly among men on higher incomes. These findings raise questions to what extent personalized nutrition can be left to the market or should be incorporated into public health programsEC (FW7) funded Food4me projectThe full text will be available 12 months after publicatio

Percepção do consumidor frente aos riscos associados aos alimentos, sua segurança e rastreabilidade.

An increase in consumer interest in food safety has been observed in the last few decades. Governments have been pressed to adopt measures that assure the safety of foods and, as a consequence, legislation related to the contamination of food by physical, chemical and microbiological contaminants is being implemented. Within this context it is relevant to investigate the perception of Brazilian consumers on such issues. The present work evaluated the criteria used by consumers from Rio de Janeiro and Campinas to buy foods, and their vision of the risks of food contamination. The perception of consumers on traceability and its importance in contributing to the safety of foods was also evaluated using the Focus Group methodology. Three sessions were carried out (two in Campinas and the third in Rio de Janeiro). Differences were found between the consumers from the two cities. The Campinas consumers were more concerned and interested in the matter than those from Rio de Janeiro, since they reported looking for more information on the food labels. Mention was made of the risks of food poisoning, botulism, and pesticides by respondents in both cities. The main products considered as showing health risks were meats and seafood, the latter particularly in Rio. Products considered safe by consumers included fruits (without pesticides), vegetables and dried products. All the consumer groups were concerned about food contamination by pesticides and heavy metals. In relation to microbiological contamination, the three groups highlighted the risks of bacteria, especially Salmonella. Traceability was considered relevant by the three groups, since it should contribute to a more efficient product recall if necessary. However, from the consumer perspective, it will also lead to a price increase, although increasing consumer confidence in the safety of the foods. Many of the consumer concerns reflected information published in magazines and newspapers, such as the use of hormones in chicken. Industries and retailers should communicate scientific information about safety topics, thus contributing to consumer education.Nas últimas décadas, tem-se observado um crescente interesse dos consumidores pelas questões relacionadas à segurança dos alimentos. Os governos têm sido pressionados a adotar medidas que assegurem a inocuidade dos alimentos e, consequentemente, legislações rigorosas quanto à contaminação dos alimentos por agentes físicos, químicos e microbiológicos estão sendo implantadas. Dentro desse panorama, conhecer a percepção do consumidor brasileiro sobre o tema é extremamente relevante. No presente estudo, avaliaram-se, em duas grandes cidades brasileiras (Campinas-SP e Rio de Janeiro-RJ), os critérios utilizados por consumidores para a compra de produtos alimentícios e suas visões sobre os riscos potenciais de contaminação dos alimentos. Avaliou-se também a percepção dos consumidores sobre a rastreabilidade e seu papel na melhoria da segurança dos alimentos, utilizando-se a metodologia focus group. Três sessões de discussão foram conduzidas (duas em Campinas e uma no Rio de Janeiro), tendo sido observadas diferenças entre os consumidores das distintas praças. Os consumidores de Campinas mostraram-se mais preocupados e interessados no assunto do que os do Rio de Janeiro, pois relataram buscar mais informações nos rótulos de alimentos. Menções relacionadas a riscos, como intoxicação alimentar, botulismo e agrotóxicos foram comuns para os entrevistados das duas cidades e, entre os principais produtos considerados com risco à saúde, ficaram as carnes e os frutos do mar, sendo estes últimos com maior ênfase no Rio de Janeiro. Dentre os produtos reconhecidos como seguros, destacaram-se as frutas (produzidas sem agrotóxicos), os legumes e os produtos secos/desidratados. Em todos os grupos, observou-se grande preocupação com a contaminação por agrotóxicos e metais pesados. Em termos microbiológicos, ambas as praças destacaram os riscos com bactérias, especialmente a Salmonella. O tema rastreabilidade se mostrou relevante nos três grupos, pois esta deve contribuir para o recolhimento mais eficiente de produtos, caso seja necessário. No entanto, sob a ótica do consumidor, a rastreabilidade leva ao aumento dos preços, embora aumente a confiança em relação à segurança dos alimentos. Muitas das preocupações dos consumidores refletem as informações publicadas em revistas e jornais, como o caso da crença de que hormônios são utilizados na cadeia da carne de frango. Indústria e varejistas devem incrementar a comunicação de informações científicas sobre a segurança dos alimentos, contribuindo, assim, na educação do consumidor

Psychological Determinants of Consumer Acceptance of Personalised Nutrition in 9 European Countries

YesObjective: To develop a model of the psychological factors which predict people’s intention to adopt personalised nutrition. Potential determinants of adoption included perceived risk and benefit, perceived self-efficacy, internal locus of control and health commitment. Methods: A questionnaire, developed from exploratory study data and the existing theoretical literature, and including validated psychological scales was administered to N = 9381 participants from 9 European countries (Germany, Greece, Ireland, Poland, Portugal, Spain, the Netherlands, the UK, and Norway). Results: Structural equation modelling indicated that the greater participants’ perceived benefits to be associated with personalised nutrition, the more positive their attitudes were towards personalised nutrition, and the greater their intention to adopt it. Higher levels of nutrition self-efficacy were related to more positive attitudes towards, and a greater expressed intention to adopt, personalised nutrition. Other constructs positively impacting attitudes towards personalised nutrition included more positive perceptions of the efficacy of regulatory control to protect consumers (e.g. in relation to personal data protection), higher self-reported internal health locus of control, and health commitment. Although higher perceived risk had a negative relationship with attitude and an inverse relationship with perceived benefit, its effects on attitude and intention to adopt personalised nutrition was less influential than perceived benefit. The model was stable across the different European countries, suggesting that psychological factors determining adoption of personalised nutrition have generic applicability across different European countries. Conclusion: The results suggest that transparent provision of information about potential benefits, and protection of consumers’ personal data is important for adoption, delivery of public health benefits, and commercialisation of personalised nutrition.This project has received funding from the European Union’s Seventh Framework Programme for research, technological development and demonstration under grant agreement n u 265494 (http://cordis.europa.eu/fp7/home_en.html). Food4Me is the acronym of the project ‘‘Personalised nutrition: an integrated analysis of opportunities and challenges’’ (http://www.food4me.org/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Making personalised nutrition the easy choice: creating policies to break down the barriers and reap the benefits

Personalised diets based on people\u27s existing food choices,and/or phenotypic, and/or genetic information hold potential to improve public dietary-related health. The aim of this analysis, therefore, has been to examine the degree to which factors which determine uptake of personalised nutrition vary between EU countries to better target of policies to encourage uptake, and optimise the health benefits of personalised nutrition technology. A questionnaire developed from previous qualitative research was used to survey nationally representative samples from 9 EU countries (N=9381). Perceived barriersto the uptake of personalised nutrition comprised three factors (data protection; the eating context; and societal acceptance). Trust insources of information comprised 4 factors (commerce and media;practitioners; government; family and friends). Benefits comprised single factor. Analysis of Variance (ANOVA) was employed to comparedifferences in responses between the United Kingdom; Ireland; Portugal;Poland; Norway; the Netherlands; Germany; and Spain. The resultsindicated that those in Greece, Poland, Ireland, Portugal and Spain,rated the benefits of personalised nutrition highest, suggesting aparticular readiness in these countries to adopt personalised nutritioninterventions. Greek participants were more likely to perceive the socialcontext of eating as a barrier to adoption of personalised nutrition,implying a need for support in negotiating social situations whilst on aprescribed diet. Those in Spain, Germany, Portugal and Poland scoredhighest on perceived barriers related to data protection. Government wasmore trusted than commerce to deliver and provide information onpersonalised nutrition overall. This was particularly the case inIreland, Portugal and Greece, indicating an imperative to build trust,particularly in the ability of commercial service providers to deliverpersonalised dietary regimes effectively in these countries. These findings, obtained from a nationally representative sample of EU citizensimply that a parallel, integrated, public-private delivery system would capture the needs of most potential consumer

Capturing health and eating status through a nutritional perception screening questionnaire (NPSQ9) in a randomised internet-based personalised nutrition intervention : the Food4Me study

BACKGROUND: National guidelines emphasize healthy eating to promote wellbeing and prevention of non-communicable diseases. The perceived healthiness of food is determined by many factors affecting food intake. A positive perception of healthy eating has been shown to be associated with greater diet quality. Internet-based methodologies allow contact with large populations. Our present study aims to design and evaluate a short nutritional perception questionnaire, to be used as a screening tool for assessing nutritional status, and to predict an optimal level of personalisation in nutritional advice delivered via the Internet. METHODS: Data from all participants who were screened and then enrolled into the Food4Me proof-of-principle study (n = 2369) were used to determine the optimal items for inclusion in a novel screening tool, the Nutritional Perception Screening Questionnaire-9 (NPSQ9). Exploratory and confirmatory factor analyses were performed on anthropometric and biochemical data and on dietary indices acquired from participants who had completed the Food4Me dietary intervention (n = 1153). Baseline and intervention data were analysed using linear regression and linear mixed regression, respectively. RESULTS: A final model with 9 NPSQ items was validated against the dietary intervention data. NPSQ9 scores were inversely associated with BMI (β = -0.181, p < 0.001) and waist circumference (Β = -0.155, p < 0.001), and positively associated with total carotenoids (β = 0.198, p < 0.001), omega-3 fatty acid index (β = 0.155, p < 0.001), Healthy Eating Index (HEI) (β = 0.299, p < 0.001) and Mediterranean Diet Score (MDS) (β = 0. 279, p < 0.001). Findings from the longitudinal intervention study showed a greater reduction in BMI and improved dietary indices among participants with lower NPSQ9 scores. CONCLUSIONS: Healthy eating perceptions and dietary habits captured by the NPSQ9 score, based on nine questionnaire items, were associated with reduced body weight and improved diet quality. Likewise, participants with a lower score achieved greater health improvements than those with higher scores, in response to personalised advice, suggesting that NPSQ9 may be used for early evaluation of nutritional status and to tailor nutritional advice. TRIAL REGISTRATION: NCT01530139 .Peer reviewedFinal Published versio

Application of behavior change techniques in a personalized nutrition Electronic Health intervention study: protocol for the web-based Food4Me randomized controlled trial

Background: In order to determine the efficacy of behavior change techniques (BCT) applied in dietary and physical activity intervention studies, it is first necessary to record and describe techniques which have been used during such interventions. Published frameworks used in dietary and smoking cessation interventions undergo continuous development and most are not adapted for online delivery. The Food4Me study (N=1607) provided the opportunity to use existing frameworks to describe standardized online techniques employed in a large-scale internet-based intervention to change dietary behaviour and physical activity. Objectives: To describe techniques embedded in the Food4Me study design and explain the selection rationale. To demonstrate the use of behaviour change technique taxonomies, develop standard operating procedures for training, and identify strengths and limitations of the Food4Me framework that will inform its use in future studies. Methods: The 6-month randomized controlled trial took place simultaneously in 7 European countries, with participants receiving one of 4 levels of personalized advice (generalized, intake-based, intake+phenotype-based and intake+phenotype+gene-based). A 3-phase approach was taken: (I), existing taxonomies were reviewed and techniques were identified a priori for possible inclusion in the Food4Me study; (II) a standard operating procedure was developed to maintain consistency in the use of methods and techniques across research centers; (III) the Food4Me BCT framework was reviewed and updated post intervention. An analysis of excluded techniques was also conducted. Results: Of 46 techniques identified a priori as being applicable to Food4Me, 17 were embedded in the intervention design. Eleven were from a dietary taxonomy and 6 from a smoking cessation taxonomy. In addition, the 4-category smoking cessation framework structure was adopted for clarity of communication. Smoking cessation texts were adapted for dietary use where necessary. A posteriori, a further 9 techniques were included. Examination of excluded items highlighted the distinction between techniques considered appropriate for face-to-face vs internet-based delivery. Conclusions: The use of existing taxonomies facilitated the description and standardization of techniques used in Food4Me. We recommend that for complex studies of this nature, technique analysis should be conducted a priori to develop standardized procedures and training, and reviewed a posteriori to audit the techniques actually adopted. The present framework description makes a valuable contribution to future systematic reviews and meta-analyses which explore technique efficacy and underlying psychological constructs. This was a novel application of the behavior change taxonomies, and was the first internet-based personalized nutrition intervention to use such a framework remotely

The perceived impact of the National Health Service on personalised nutrition service delivery among the UK public

Personalised nutrition (PN) has the potential to reduce disease risk and optimise health and performance. Although previous research has shown good acceptance of the concept of PN in the UK, preferences regarding the delivery of a PN service (e.g. online v. face-to-face) are not fully understood. It is anticipated that the presence of a free at point of delivery healthcare system, the National Health Service (NHS), in the UK may have an impact on end-user preferences for deliverances. To determine this, supplementary analysis of qualitative data obtained from focus group discussions on PN service delivery, collected as part of the Food4Me project in the UK and Ireland, was undertaken. Irish data provided comparative analysis of a healthcare system that is not provided free of charge at the point of delivery to the entire population. Analyses were conducted using the 'framework approach' described by Rabiee (Focus-group interview and data analysis. Proc Nutr Soc 63, 655-660). There was a preference for services to be led by the government and delivered face-to-face, which was perceived to increase trust and transparency, and add value. Both countries associated paying for nutritional advice with increased commitment and motivation to follow guidelines. Contrary to Ireland, however, and despite the perceived benefit of paying, UK discussants still expected PN services to be delivered free of charge by the NHS. Consideration of this unique challenge of free healthcare that is embedded in the NHS culture will be crucial when introducing PN to the UK

Research for food and health in Europe: themes, needs and proposals

Background Diet, in addition to tobacco, alcohol and physical exercise, is a major factor contributing to chronic diseases in Europe. There is a pressing need for multidisciplinary research to promote healthier food choices and better diets. Food and Health Research in Europe (FAHRE) is a collaborative project commissioned by the European Union. Among its tasks is the description of national research systems for food and health and, in work reported here, the identification of strengths and gaps in the European research base. Methods A typology of nine research themes was developed, spanning food, society, health and research structures. Experts were selected through the FAHRE partners, with balance for individual characteristics, and reported using a standardised template. Results Countries usually commission research on food, and on health, separately: few countries have combined research strategies or programmes. Food and health are also strongly independent fields within the European Commission's research programmes. Research programmes have supported food and bio-technology, food safety, epidemiological research, and nutritional surveillance; but there has been less research into personal behaviour and very little on environmental influences on food choices - in the retail and marketing industries, policy, and regulation. The research is mainly sited within universities and research institutes: there is relatively little published research contribution from industry. Discussion National food policies, based on epidemiological evidence and endorsed by the World Health Organisation, recommend major changes in food intake to meet the challenge of chronic diseases. Biomedical and biotechnology research, in areas such as 'nutrio-genomics', 'individualised' diets, 'functional' foods and 'nutri-pharmaceuticals' appear likely to yield less health benefit, and less return on public investment, than research on population-level interventions to influence dietary patterns: for example policies to reduce population consumption of trans fats, saturated fats, salt and energy density. Research should now address how macro-diets, rather than micro-nutritional content, can be improved for beneficial impacts on health, and should evaluate the impact of market changes and policy interventions, including regulation, to improve public health. Conclusions European and national research on food and health should have social as well as commercial benefits. Strategies and policies should be developed between ministries of health and national research funding agencies. Collaboration between member states in the European Union can yield better innovation and greater competitive advantage

Food Risk/Benefit Communication: A Systematic Review

A systematic review relevant to the following research questions was conducted (1) the extent to which different theoretical frameworks have been applied to food risk/benefit communication and (2) the impact such food risk/benefit communication interventions have had on related risk/benefit attitudes and behaviors. Fifty four papers were identified. The analysis revealed that (primarily European or US) research interest has been relatively recent. Certain food issues were of greater interest to researchers than others, perhaps reflecting the occurrence of a crisis, or policy concern. Three broad themes relevant to the development of best practice in risk (benefit) communication were identified: the characteristics of the target population; the contents of the information; and the characteristics of the information sources. Within these themes, independent and dependent variables differed considerably. Overall, acute risk (benefit) communication will require advances in communication process whereas chronic communication needs to identify audience requirements. Both citizen's risk/benefit perceptions and (if relevant) related behaviors need to be taken into account, and recommendations for behavioral change need to be concrete and actionable. The application of theoretical frameworks to the study of risk (benefit) communication was infrequent, and developing predictive models of effective risk (benefit) communication may be contingent on improved theoretical perspectives

Self-efficacy, habit strength, health locus of control and response to the personalised nutrition Food4Me intervention study

YesPurpose – Randomised controlled trials identify causal links between variables but not why an outcome has occurred. This analysis sought to determine how psychological factors assessed at baseline influenced response to personalised nutrition. Design/methodology/approach – Web-based, randomised, controlled trial (RCT) was conducted across seven European countries. Volunteers, both male and female, aged over 18 years were randomised to either a non-personalised (control) or a personalised (treatment) dietary advice condition. Linear mixed model analysis with fixed effects was used to compare associations between internal and external health locus of control (HLoC), nutrition self-efficacy (NS-E) and self-report habit index (S-RHI) at baseline (N 5 1444), with healthy eating index (HEI) and Mediterranean diet index (MDI) scores between conditions post-intervention (N 5 763). Findings – An increase in MDI scores was observed between baseline and six months in the treatment group which was associated with higher NS-E (pEU FP7 Project “Personalised nutrition: an integrated analysis of opportunities and challenges” (Contract No. KBBE. 2010.2.3–02, Project No. 265494