USING PACE LABELLING Flashcards
Energy balance
Energy intake through food:
- Carbohydrate
- Protein
- Fat
Energy expenditure through: (burning)
- Basal metabolism (60-75%) – internal organs
- Thermogenesis (10%) – regulating body heat (keeping warm/cold)
- Physical activity (15-30%)
World Health Organization reported principal reason for excess weight problem is sustained energy imbalance between calories consumed and calories expended.
Foods with higher energy density tend to have high fat or sugars and low water content, for example:
- Biscuits
- Fried chips
- Fried chicken
- Pies and cakes
in contrast things with lots of water/fibre are lower in denisty- pasta, rice, veg, fruit, soups
The way we store, take in and burn energy varies from person to person.
64%- UK overweight/obese
16%- UK eating disorders (including children, adolescence, adults)
28%- aged 11-16 overweight/ obese
eating behaviour inn young people
Eating behaviour in young people:
Average young person (approx. aged 11-17) consumes an excess of calories from:
- Soft drinks
- Cakes
- Biscuits
Can account for 40% of total energy
Lai, Hutchinson and Evans (2019)
Toumpakari, Haase and Johnson (2016)
- Discretionary foods (sweet treats) widely available outside of home such as shops, corner shops, restaurants, cafes and schools - Lai, Hutchinson and Evans (2019)
- Linked with unhealthy food choices in young people and consumption of larger portions of energy dense food.
- About a fifth eat home cooked meals at least once per week, due to poverty (this gap is growing)
- E.g., Adams et al, 2015; Ziauddeen et al., 2018
impact of these eating beh in young people
Impact:
Lifestyles Team, NHS Digital, 2022
- In England, childhood obesity is increasing.
- Around 40% children living with overweight or obesity by the time they leave primary school.
Sport England, 2022- NHS digital 2022
- About 50% young people not meeting ng national guideline amount of at least one hour of physical activity per day.- sport England, 2022
- average young person (11-17) consumes an excess of calories from soft drinks, cakes and biscuits (can account for 40% of total energy)- Lai, Hutchinson and evans 2019
Health risks associated with: Being underactive and living with obesity: (varies from person to person- the way we take in calories varies)
- Mood and wellbeing- social and physical, self esteem,
- High cholesterol
- Heart attacks
- Sleep problems
- Diabetes
- Cancers
- PCOS- polycystic ovarian syndrome- uncontrollable, metabolism is slower
- bit of a cycle
key drivers in adolescence
focus on adolescence because-
Adolescence marks a time where individuals make their own decisions on:
- What they eat
- Where they eat
Thus, eating habits are established and may track into adulthood
key drivers:
.Neurocognitive
- Prefrontal cortex (decision making) still developing
o Parts of working memory, understanding complex information, controlling of emotions etc.
- This then means: may not yet understand context (eg: high energy) or effects of un healthy food or drink
.Self-regulation:
- Focus on taste, hunger, immediate sugar hit
.Influence:
- Availability, parental, peer and marketing
o Eg: biscuits and sweet treats last much longer whereas fruit and vegetables can look less appealing on shelves
o High sugar content food tends to last longer
really hard to break these habits
fatty and sugary foods are also addictive
schools in England
- It wasn’t until 2015 where most recent school food standards introduced to provide children with healthy and balanced food
- BUT schools still permitted to sell discretionary foods such as cakes and biscuits which contribute to poor health
- WHY? Several reasons one of which is source of revenue in school, profit, food waste, cost for children, some sporty children need these energy dense foods
changing behaviour through nudging
- Try to give people a choice instead of taking the choice away from them
o Eg: calories on menu, smoking
Smoking; an example of nudging by making it more expensive, images on them of people with bad lungs, hide cigarette packages behind doors, smoke outside, indoor smoking was banned – so they gradually made access to smoking harder but didn’t ban it – it has become unsocial to smoke - “A nudge… is any aspect of the choice architecture that alters people’s behaviour 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.
- Called choice architecture as you change the product and environment
nudging
- Nudge approaches may target promotion of healthier food/drink choices, by for example:
o Changing the position of foods in displays
o Making healthier options more available
o Adding food labels - Using nudges means that less healthy choices can still be available allowing individuals freedom to choose what they eat
Nudging and labels:
- Nutrition labelling on food and drinks is used as a nudging strategy to help promote or nudge healthier eating/drinking in the public
- You will have seen these in shops and some restaurants
- Studies on nudging interventions show they hold promise in increasing healthier food choices
Issues with nudging labels
- not accessible- e.g. the elderly, blind
- eating disorders
nudging labels-
Nudging and labels interventions:
Underlying mechanism of nutrition labelling interventions is to:
- Increase purchase or consumption of healthy food/drink
- Decrease purchase or consumption of less healthy food/drink
Label interventions aimed at young people typically involve school canteens. Interventions include:
- Placing labels/stickers on foods to show they are healthy or unhealthy
- Re-positioning foods with labels
- Use of colourful pictures of promoted food
- Digital advertisement
nudging does:
- increase purchase of healthy food
- decrease calories intake per day
- decrease purchase of unhealthy food
nudging however
- only small changes in behaviour
- concepts difficult to understand
- leading to underestimating the amount of energy in items
understanding labelling
- Hammond et al., 2023-UK survey of 10- to 17-year-olds:
- 53% reported that 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, however
- Only 15% reported to using them (often or all the time) to make food choices
so USE of them is quite LOW
PACE Labelling-
Trialled with adults – trialled with adolescents in US but not adolescents in UK
PACE Labelling is very controversial. It is an easy to read label but it doesn’t just tell you the calories – it also tells you how to burn it. No mention to fat or sugar amounts.
PACE labels won’t be on all foods – only on high energy density foods which we don’t need but want to eat, eg: biscuits, chocolate.
PACE Vs TLLs:
- PACE labelling has a simple design
- PACEs information can be targeted to different populations (i.e., with different weights) relatively 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)
more on PACE
PACE Labels:
- 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
- PACE food labelling may also prompt or nudge people to be physically activity
Studies in UK adults show more participants report PACE labels:
- Easier to understand than TLLs (41% (PACE) vs 27% (TLLs))
- Catch their attention compared to TLLs (49% vs 31%)
- More likely to help them avoid high calorie foods compared to TLLs (44% vs 28%)
- Daley et al., 2019
Intervention studies show:
- PACE labelling decreases number of calories chosen from menus/consumed by public when compared to comparator labelling or no labelling.
- Daley et al., 2019
iris et al., 2023-
Examining young people’s views and understanding of traffic light and physical activity calorie equivalent (PACE) food labels | BMC Public Health (springer.com)
Survey study with 808 young people recruited from different secondary schools:
- Survey showed TLL and pace labels
- 71% correctly understood what calories are
- 96% reported that they had previously seen TLLs on food and drinks
- PACE label were easier to understand compared to TLL (69% vs 31%)
Participants who had seen TLLs on food and drinks before:
- 19% looked at TLLs often/always.
- 42% said they would look at PACE labels often/always if implemented.
- 43% of participants who looked at TLLs rarely/sometimes said that they would look at PACE labels 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 the TLL despite being controversial.
