Designing a new physical activity calorie equivalent food label and comparing its effect on caloric choices to that of the traffic light label among mothers: a mixed-method study

Shirin Seyedhamzeh; Saharnaz Nedjat; Elham Shakibazadeh; Azam Doustmohammadian; Hedayat Hosseini; Asma Kazemi; Nafiseh Azizolahi; Maryam Chamary; Cain C T Clark; Ahmadreza Dorosty Motlagh

doi:10.3389/fpubh.2023.1280532

Designing a new physical activity calorie equivalent food label and comparing its effect on caloric choices to that of the traffic light label among mothers: a mixed-method study

Shirin Seyedhamzeh, Saharnaz Nedjat, Elham Shakibazadeh, Azam Doustmohammadian, Hedayat Hosseini, Asma Kazemi, Nafiseh Azizolahi, Maryam Chamary, Cain C T Clark, Ahmadreza Dorosty Motlagh

Centre for Intelligent Healthcare

Research output: Contribution to journal › Article › peer-review

26 Downloads (Pure)

Abstract

We designed a new type of 'physical activity calorie equivalent' (PACE) food label in Iran to compare its effect with that of the traffic light food label (TLL) on caloric choices. Mixed-method study. Mothers of school children between the ages of 6-12 years. In the qualitative phase, 10 focus group discussions (FGDs) were conducted with various groups of mothers, and two FGDs were conducted with food science and nutrition experts to design a new PACE label. In the quantitative phase, 496 mothers were randomly assigned to five groups: (1) no nutrition label, (2) current TLL, (3) current TLL + educational brochure, (4) PACE label, and (5) PACE label + brochure. Samples of dairy products, beverages, cakes, and biscuits were presented. ANOVA and multiple linear regressions were applied to examine the association between label types and calories of the selected products as our main outcome. The mothers' perspectives were classified into two sub-themes, the PACE label's facilitators and barriers. The new PACE label's characteristics were divided into two subcategories: (a) appearance, and (b) nutritional information, including 14 codes. In the quantitative section, mean calories of the selected foods were lowest in the TLL + brochure group (831.77 kcal; 95% CI: 794.23-869.32), and highest in the PACE label group (971.61; 95% CI: 926.37-1016.84). The new PACE label was a combination of PACE, TLL, and warning labels. It did not significantly affect lower caloric choice, however, the TLL + brochure option was effective in choosing foods with fewer calories. : The study was registered in the Iranian Registry of Clinical Trials 23 (IRCT20181002041201N1). [Abstract copyright: Copyright © 2023 Seyedhamzeh, Nedjat, Shakibazadeh, Doustmohammadian, Hosseini, Kazemi, Azizolahi, Chamary, Clark and Motlagh.]

Original language	English
Article number	1280532
Number of pages	12
Journal	Frontiers in Public Health
Volume	11
Early online date	14 Nov 2023
DOIs	https://doi.org/10.3389/fpubh.2023.1280532
Publication status	E-pub ahead of print - 14 Nov 2023

Bibliographical note

© 2023 Seyedhamzeh, Nedjat, Shakibazadeh, Doustmohammadian, Hosseini, Kazemi, Azizolahi, Chamary, Clark and Motlagh. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Funder

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was approved by Tehran University of Medical Sciences under the registry code of 96-03-161-37037 and registered at the Iranian Registry of Clinical Trials [https://irct.ir/]. At the beginning of the study the consent form was signed by the participants.

Keywords

nutrition label
physical activity
TLL
obesity
PACE

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.3389/fpubh.2023.1280532Licence: CC BY

Pure-Clark-2023-VoR (1)Final published version, 1.34 MBLicence: CC BY

Cite this

Seyedhamzeh, S., Nedjat, S., Shakibazadeh, E., Doustmohammadian, A., Hosseini, H., Kazemi, A., Azizolahi, N., Chamary, M., Clark, C. C. T., & Motlagh, A. D. (2023). Designing a new physical activity calorie equivalent food label and comparing its effect on caloric choices to that of the traffic light label among mothers: a mixed-method study. Frontiers in Public Health , 11, Article 1280532. Advance online publication. https://doi.org/10.3389/fpubh.2023.1280532

Designing a new physical activity calorie equivalent food label and comparing its effect on caloric choices to that of the traffic light label among mothers: a mixed-method study. / Seyedhamzeh, Shirin; Nedjat, Saharnaz; Shakibazadeh, Elham et al.
In: Frontiers in Public Health , Vol. 11, 1280532, 14.11.2023.

Research output: Contribution to journal › Article › peer-review

Seyedhamzeh, S, Nedjat, S, Shakibazadeh, E, Doustmohammadian, A, Hosseini, H, Kazemi, A, Azizolahi, N, Chamary, M, Clark, CCT & Motlagh, AD 2023, 'Designing a new physical activity calorie equivalent food label and comparing its effect on caloric choices to that of the traffic light label among mothers: a mixed-method study', Frontiers in Public Health , vol. 11, 1280532. https://doi.org/10.3389/fpubh.2023.1280532

Seyedhamzeh S, Nedjat S, Shakibazadeh E, Doustmohammadian A, Hosseini H, Kazemi A et al. Designing a new physical activity calorie equivalent food label and comparing its effect on caloric choices to that of the traffic light label among mothers: a mixed-method study. Frontiers in Public Health . 2023 Nov 14;11:1280532. Epub 2023 Nov 14. doi: 10.3389/fpubh.2023.1280532

@article{aae867b7e92e452788c3c733cf01a2ce,

title = "Designing a new physical activity calorie equivalent food label and comparing its effect on caloric choices to that of the traffic light label among mothers: a mixed-method study",

abstract = "We designed a new type of 'physical activity calorie equivalent' (PACE) food label in Iran to compare its effect with that of the traffic light food label (TLL) on caloric choices. Mixed-method study. Mothers of school children between the ages of 6-12 years. In the qualitative phase, 10 focus group discussions (FGDs) were conducted with various groups of mothers, and two FGDs were conducted with food science and nutrition experts to design a new PACE label. In the quantitative phase, 496 mothers were randomly assigned to five groups: (1) no nutrition label, (2) current TLL, (3) current TLL + educational brochure, (4) PACE label, and (5) PACE label + brochure. Samples of dairy products, beverages, cakes, and biscuits were presented. ANOVA and multiple linear regressions were applied to examine the association between label types and calories of the selected products as our main outcome. The mothers' perspectives were classified into two sub-themes, the PACE label's facilitators and barriers. The new PACE label's characteristics were divided into two subcategories: (a) appearance, and (b) nutritional information, including 14 codes. In the quantitative section, mean calories of the selected foods were lowest in the TLL + brochure group (831.77 kcal; 95% CI: 794.23-869.32), and highest in the PACE label group (971.61; 95% CI: 926.37-1016.84). The new PACE label was a combination of PACE, TLL, and warning labels. It did not significantly affect lower caloric choice, however, the TLL + brochure option was effective in choosing foods with fewer calories. : The study was registered in the Iranian Registry of Clinical Trials 23 (IRCT20181002041201N1). [Abstract copyright: Copyright {\textcopyright} 2023 Seyedhamzeh, Nedjat, Shakibazadeh, Doustmohammadian, Hosseini, Kazemi, Azizolahi, Chamary, Clark and Motlagh.]",

keywords = "nutrition label, physical activity, TLL, obesity, PACE",

author = "Shirin Seyedhamzeh and Saharnaz Nedjat and Elham Shakibazadeh and Azam Doustmohammadian and Hedayat Hosseini and Asma Kazemi and Nafiseh Azizolahi and Maryam Chamary and Clark, {Cain C T} and Motlagh, {Ahmadreza Dorosty}",

note = "{\textcopyright} 2023 Seyedhamzeh, Nedjat, Shakibazadeh, Doustmohammadian, Hosseini, Kazemi, Azizolahi, Chamary, Clark and Motlagh. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.",

year = "2023",

month = nov,

day = "14",

doi = "10.3389/fpubh.2023.1280532",

language = "English",

volume = "11",

journal = "Frontiers in Public Health ",

issn = "2296-2565",

publisher = "Frontiers Media",

}

TY - JOUR

T1 - Designing a new physical activity calorie equivalent food label and comparing its effect on caloric choices to that of the traffic light label among mothers: a mixed-method study

AU - Seyedhamzeh, Shirin

AU - Nedjat, Saharnaz

AU - Shakibazadeh, Elham

AU - Doustmohammadian, Azam

AU - Hosseini, Hedayat

AU - Kazemi, Asma

AU - Azizolahi, Nafiseh

AU - Chamary, Maryam

AU - Clark, Cain C T

AU - Motlagh, Ahmadreza Dorosty

N1 - © 2023 Seyedhamzeh, Nedjat, Shakibazadeh, Doustmohammadian, Hosseini, Kazemi, Azizolahi, Chamary, Clark and Motlagh. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

PY - 2023/11/14

Y1 - 2023/11/14

N2 - We designed a new type of 'physical activity calorie equivalent' (PACE) food label in Iran to compare its effect with that of the traffic light food label (TLL) on caloric choices. Mixed-method study. Mothers of school children between the ages of 6-12 years. In the qualitative phase, 10 focus group discussions (FGDs) were conducted with various groups of mothers, and two FGDs were conducted with food science and nutrition experts to design a new PACE label. In the quantitative phase, 496 mothers were randomly assigned to five groups: (1) no nutrition label, (2) current TLL, (3) current TLL + educational brochure, (4) PACE label, and (5) PACE label + brochure. Samples of dairy products, beverages, cakes, and biscuits were presented. ANOVA and multiple linear regressions were applied to examine the association between label types and calories of the selected products as our main outcome. The mothers' perspectives were classified into two sub-themes, the PACE label's facilitators and barriers. The new PACE label's characteristics were divided into two subcategories: (a) appearance, and (b) nutritional information, including 14 codes. In the quantitative section, mean calories of the selected foods were lowest in the TLL + brochure group (831.77 kcal; 95% CI: 794.23-869.32), and highest in the PACE label group (971.61; 95% CI: 926.37-1016.84). The new PACE label was a combination of PACE, TLL, and warning labels. It did not significantly affect lower caloric choice, however, the TLL + brochure option was effective in choosing foods with fewer calories. : The study was registered in the Iranian Registry of Clinical Trials 23 (IRCT20181002041201N1). [Abstract copyright: Copyright © 2023 Seyedhamzeh, Nedjat, Shakibazadeh, Doustmohammadian, Hosseini, Kazemi, Azizolahi, Chamary, Clark and Motlagh.]

AB - We designed a new type of 'physical activity calorie equivalent' (PACE) food label in Iran to compare its effect with that of the traffic light food label (TLL) on caloric choices. Mixed-method study. Mothers of school children between the ages of 6-12 years. In the qualitative phase, 10 focus group discussions (FGDs) were conducted with various groups of mothers, and two FGDs were conducted with food science and nutrition experts to design a new PACE label. In the quantitative phase, 496 mothers were randomly assigned to five groups: (1) no nutrition label, (2) current TLL, (3) current TLL + educational brochure, (4) PACE label, and (5) PACE label + brochure. Samples of dairy products, beverages, cakes, and biscuits were presented. ANOVA and multiple linear regressions were applied to examine the association between label types and calories of the selected products as our main outcome. The mothers' perspectives were classified into two sub-themes, the PACE label's facilitators and barriers. The new PACE label's characteristics were divided into two subcategories: (a) appearance, and (b) nutritional information, including 14 codes. In the quantitative section, mean calories of the selected foods were lowest in the TLL + brochure group (831.77 kcal; 95% CI: 794.23-869.32), and highest in the PACE label group (971.61; 95% CI: 926.37-1016.84). The new PACE label was a combination of PACE, TLL, and warning labels. It did not significantly affect lower caloric choice, however, the TLL + brochure option was effective in choosing foods with fewer calories. : The study was registered in the Iranian Registry of Clinical Trials 23 (IRCT20181002041201N1). [Abstract copyright: Copyright © 2023 Seyedhamzeh, Nedjat, Shakibazadeh, Doustmohammadian, Hosseini, Kazemi, Azizolahi, Chamary, Clark and Motlagh.]

KW - nutrition label

KW - physical activity

KW - TLL

KW - obesity

KW - PACE

UR - http://www.scopus.com/inward/record.url?scp=85178009531&partnerID=8YFLogxK

U2 - 10.3389/fpubh.2023.1280532

DO - 10.3389/fpubh.2023.1280532

M3 - Article

C2 - 38035293

SN - 2296-2565

VL - 11

JO - Frontiers in Public Health

JF - Frontiers in Public Health

M1 - 1280532

ER -

Designing a new physical activity calorie equivalent food label and comparing its effect on caloric choices to that of the traffic light label among mothers: a mixed-method study

Abstract

Bibliographical note

Funder

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this