thesis

Evaluating and improving understanding and use of current UK nutrition labels among older adults

Abstract

Background: New formats of UK nutrition labels were mandatorily introduced on-pack and for products sold online, from 2014. However, there is a lack of evidence concerning older adults’ understanding and use of this information and the extent to which these may be improved with nutrition label education. With respect to older adults, this research aimed to (1) explore use of this information and potentially related consumer characteristics and (2) evaluate objective understanding of the current UK nutrition labels, before developing and evaluating a pilot education intervention targeting label understanding. Methods: An online survey was developed to evaluate understanding of current UK nutrition labels and their use among older adults aged 50 years or older. Exploration of these adults’ engagement with online nutrition information was also undertaken using “Think aloud sessions”. Following a systematic review of the effect of nutrition label education on consumers’ use and understanding of this information, a single-arm pre post-intervention study design was used to evaluate a pilot educational intervention among community service-users. Results: Frequent use of nutrition labels during purchases was reported by 51% of all survey respondents (n=181) and predicted by increasing levels of personal motivation (OR 1.1, 95% CI 1.1, 1.2), nutrition knowledge (OR 1.3, 95% CI: 1.1, 1.5) as well as self-rated (OR 1.2 95% CI: 1.0, 1.5), but not objective (OR 1.1, 95% CI: 0.9, 1.3), understanding of this information. Respondents had difficulties understanding the meaning of specific elements of the current UK nutrition labels, including “Reference Intakes (RI)” terminology. Infrequent use of online nutrition information could be explained by a variety of factors related to supermarket website use and information presentation. Finally, the developed educational intervention increased levels of participants’ (n = 30) objective understanding of current UK nutrition labels (quiz score out of 5 MD=1.4, 95% CI: -2.1, -0.8), as well as participants’ confidence in their use of this information to make healthier food choices (using a 7-point scale, MD = 1.0, 95% CI: 0.5 to 1.6). Conclusion: Older adults’ understanding of current UK nutrition labels may be improved with nutrition label education. Implications for policy and practice are given. Further research into the impact of education on older adults’ nutrition label understanding, use and dietary intakes is now warranted

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