PACE Labelling week/lecture 2 Flashcards
what do we get our energy intake through?
carbs fat and protein
what is our energy expenditure through?
basal metabolism (60-75%)
thermogenesis (10%)
physical activity (15-30%)
what do foods with higher energy density usually have?
high fat or sugars and low water content
examples of high energy density foods
biscuits
fried chips and chicken
pies and cakes
what do foods that are lower in energy density have?
a lot of water or fibre
examples of low energy dense foods
fruit and veg
pasta and rice
potatoes with skins that absorb water during cooking
veg-based dishes with added water e.g. soups and stews
11-17 year olds consume an excess of calories from what?
soft drinks cakes and biscuits
how much extra energy do young people consume from fizzy drinks, cakes and biscuits (cite)
40% of total energy
Lai, Hutchinson and Evans (2019) Toumpakari, Haase and Johnson (2016)
big factor linked to excessive calories in young adults?
- Discretionary foods widely available outside of home (shops, restaurant, cafes and schools)
about how many people eat meals out of the home at least once per week? cite
○ About 1/5 eat meals of the home at least once per week
○ E.g., Adams et al, 2015; Ziauddeen et al., 2018
how many children are obese by the time they leave school? cite
- Around 40% of children are living with overweight or obesity by the time they leave primary school
○ Lifestyles Team, NHS Digital, 2022
about how many young people don’t meet the national guidelines for 1 hour of physical activity per day? cite
- About 50% of young people don’t meet national guideline amount at least one hour physical activity per day
○ Sport England, 2022
key drivers in adolescents
- Adolescents start to make own decisions on what and where they eat
- Eating habits are established and may track into adulthood
- Neurocognitive
○ PFC still developing (until abt 18-21yrs) - decision making
○ May not understand context (e.g. high energy) or effects of unhealthy food or drink - Self-regulation
○ Focus on taste, hunger, immediate sugar hit - Influence
○ Availability, parental, peer and marketing
food standards in schools
- 2015: most recent school food standards introduced to provide children with healthy and balanced food
- Still permitted to sell discretionary foods such as cakes and biscuits which contribute to poor health
- Big reason is a source of revenue in school
what is nudging?
- “A nudge… is any aspect of the choice architecture that alters people’s behavior in a predictable way without forbidding any options or significantly changing their economic incentives… the intervention must be easy and cheap to avoid”
○ Thaler and Sunstein, 2008 p6.
ways in which nudging may target promotion of healthier food and drink
- May target promotion of healthier food and drink choices by:
○ Changing position of foods in displays
○ Making healthier options more available
○ Adding food labels- Using nudging means less healthy choices can still be available allowing freedom to choose what to eat
underlying mechanism to nudging
○ Increase purchase or consumption of healthy food and drink
○ Decrease purchase or consumption of less healthy food and drink
nudging in school canteens
○ Placing labels and stickers on foods to show they are healthy or unhealthy
○ Re-positioning foods with labels
○ Use of colourful pictures of promoted food
○ Digital ads
positives of nudging
○ Increases purchase of healthy food (measured by transaction data)
○ Decreases calories intake per day (measured by food weight and calorie conversion)
○ Decreases purchase of unhealthy food (transaction data)
negatives of nudging
○ Small changes in behaviour
○ Concepts difficult to understand
○ Leading to underestimating the amount of energy in items
percentages of young people understanding food labelling (cite)
○ 53% reported they had noticed traffic light labels (TLLs) either often or all the time
○ 40% reported that the TLLs were easy or very easy to understand to understand
○ 15% reported to using them (often or all the time) to make food choices
Hammond et al., 2023
reasoning for PACE labelling
- May contribute to small change approach to weight management
- Steering public to make small decisions about what they eat may be easier for them to achieve compared to large lifestyle changes
- May also prompt or nudge people to be physically active
why are PACE labels better than TLLs?
- Pace labelling has a simple design
- PACEs info can be targeted to different populations easily and quickly using online calculators
- Reference intake values on TLLs based on adult female which may not be meaningful for other populations (i.e. children, adolescents)
Daley et al 2019 study on PACE vs TLLs
- UK adult study show more ppts report PACE labels: (Daley et al., 2019)
○ Easier to understand than TLLs (41% vs 27%)
○ Catch their attention compared to TLLs (49% vs 31%)
○ More likely to help them avoid high calorie foods compared to TLLs (44% vs 28%)
○ Decreases number of calorie chosen from menus/consumed by public when compared to comparator labelling or no labelling
Iris et al., (2021) exploratory study
- undertsanding calories
- PACE vs TLLs
○ Survey study with 808 young people recruited from different secondary schools
○ TLL and pace labels
○ 71% correctly understood what calories are
○ 96% reported they had previously seen TLLs on food and drinks
○ PACE labels easier to understand compared to TLL (69% vs 31%)
○ Ppts who had seen TLLs before:
§ 19% looked often/always
§ 42% said they would look at PACE often/always if implemented
§ 43% who looked rarely/sometimes said they would look at PACE more often
§ 68% who never looked at TLLs said they would look at PACE labels more often
○ 52% felt PACE label was easier to help choose healthy food and drinks on their own compared to TLL
Iris et al., intervention study
○ PACE labelling on cakes and biscuits in secondary schools
○ Schools randomised into control or intervention
○ Primary outcome measure: number of weekly purchases sold of cakes and biscuits
○ Anonymised purchasing used as a proxy outcome for consumption as most individuals would consume their purchase
○ Intervention schools displayed PACE labelling for a minimum of 4 weeks and for up to 6 weeks
○ Control schools continued with usual practice
○ Anonymised purchase data from schools on number cakes/sweets biscuits sold, before, during and after the study period collected
○ Schools
§ Ranged in size from 709-1781 students
§ Located in urban and rural areas
§ From the East and West Midlands and the North-east regions of England
§ Based in affluent and deprived areas as defined by % pupils eligible for free school meals within schools (ranged from 10% to 42%)
○ Decrease in purchases of cakes and biscuits in intervention schools by a small but statistically significant amount
○ Per 100 students, a reduction of roughly 11 cakes/biscuits bought per week in the intervention schools compared to controls
○ Found labels helpful
○ Most sometimes used labels
○ Nested Qualitative Interviews
§ Findings from interviews shows PACE labelling appears to:
□ Increase capability in young people’s food decision making
□ influence them to avoid/reduce purchases of cakes and biscuits as they associated eating them with ‘high energy cost’.
□ Be a useful approach to help young people choose healthier food in the school environment
qualitative interview findings for effect of PACE labelling
○ Mixed findings
○ Depends on individual’s own attitude, viewpoints and motivation
○ Depends on emotional experience
○ Interaction with Schools: Some concerns for potential negative impact of PACE labelling in students, which was a barrier to implementation. But qualitative findings show students have lesser concerns
- knowledge
