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Nutrition-related claims lead parents to choose less healthy drinks for young children: a randomized trial in a virtual convenience store.
Am J Clin Nutr. 2022 Apr 01; 115(4):1144-1154.AJ

Abstract

BACKGROUND

Consumption of sugar-sweetened beverages, including fruit drinks (i.e., fruit-flavored drinks containing added sugar), contributes to childhood obesity.

OBJECTIVES

We aimed to examine whether nutrition-related claims on fruit drinks influence purchasing among parents and lead to misperceptions of healthfulness.

METHODS

We conducted an experiment in a virtual convenience store with 2219 parents of children ages 1-5 y. Parents were randomly assigned to view fruit drinks displaying 1 of 3 claims ("No artificial sweeteners," "100% Vitamin C," and "100% All Natural") or no claim (i.e., control group). Parents selected among each of 2 drinks for their young child: 1) a fruit drink or 100% juice (primary outcome), and 2) a fruit drink or water.

RESULTS

When choosing between a fruit drink and 100% juice, 45% of parents who viewed the fruit drink with the "No artificial sweeteners" claim, 51% who viewed the "100% Vitamin C" claim, and 54% who viewed the "100% All Natural" claim selected the fruit drink, compared with 32% in the no-claim control group (all P < 0.001). "No artificial sweeteners" (Cohen's d = 0.13, P < 0.05) and "100% All Natural" (d = 0.15, P < 0.05) claims increased the likelihood of parents choosing the fruit drink instead of water but "100% Vitamin C" did not (P = 0.06). All claims made parents more likely to incorrectly believe that the fruit drinks contained no added sugar and were 100% juice than the control (d ranged from 0.26 to 0.84, all P < 0.001), as assessed in a posttest survey. The impact of claims on selection of the fruit drink (compared with 100% juice) did not vary by any of the moderators examined (e.g., race/ethnicity, income; all moderation P > 0.05).

CONCLUSIONS

Nutrition-related claims led parents to choose less healthy beverages for their children and misled them about the healthfulness of fruit drinks. Labeling regulations could mitigate misleading marketing of fruit drinks.This trial was registered at clinicaltrials.gov as NCT04381481.

Authors+Show Affiliations

Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA. Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA. Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA.Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA. Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, USA.Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA. Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA.Insight Policy Research, Arlington, VA, USA.Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA. Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.Center for Science in the Public Interest, Washington, DC, USA.Center for Science in the Public Interest, Washington, DC, USA.Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA. Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

35040866

Citation

Hall, Marissa G., et al. "Nutrition-related Claims Lead Parents to Choose Less Healthy Drinks for Young Children: a Randomized Trial in a Virtual Convenience Store." The American Journal of Clinical Nutrition, vol. 115, no. 4, 2022, pp. 1144-1154.
Hall MG, Lazard AJ, Higgins ICA, et al. Nutrition-related claims lead parents to choose less healthy drinks for young children: a randomized trial in a virtual convenience store. Am J Clin Nutr. 2022;115(4):1144-1154.
Hall, M. G., Lazard, A. J., Higgins, I. C. A., Blitstein, J. L., Duffy, E. W., Greenthal, E., Sorscher, S., & Taillie, L. S. (2022). Nutrition-related claims lead parents to choose less healthy drinks for young children: a randomized trial in a virtual convenience store. The American Journal of Clinical Nutrition, 115(4), 1144-1154. https://doi.org/10.1093/ajcn/nqac008
Hall MG, et al. Nutrition-related Claims Lead Parents to Choose Less Healthy Drinks for Young Children: a Randomized Trial in a Virtual Convenience Store. Am J Clin Nutr. 2022 Apr 1;115(4):1144-1154. PubMed PMID: 35040866.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nutrition-related claims lead parents to choose less healthy drinks for young children: a randomized trial in a virtual convenience store. AU - Hall,Marissa G, AU - Lazard,Allison J, AU - Higgins,Isabella C A, AU - Blitstein,Jonathan L, AU - Duffy,Emily W, AU - Greenthal,Eva, AU - Sorscher,Sarah, AU - Taillie,Lindsey Smith, PY - 2021/07/29/received PY - 2022/01/13/accepted PY - 2023/01/18/pmc-release PY - 2022/1/19/pubmed PY - 2022/4/5/medline PY - 2022/1/18/entrez KW - childhood obesity KW - front-of-package labels KW - marketing KW - nutrition-related claims KW - randomized controlled trial KW - sugar-sweetened beverages SP - 1144 EP - 1154 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 115 IS - 4 N2 - BACKGROUND: Consumption of sugar-sweetened beverages, including fruit drinks (i.e., fruit-flavored drinks containing added sugar), contributes to childhood obesity. OBJECTIVES: We aimed to examine whether nutrition-related claims on fruit drinks influence purchasing among parents and lead to misperceptions of healthfulness. METHODS: We conducted an experiment in a virtual convenience store with 2219 parents of children ages 1-5 y. Parents were randomly assigned to view fruit drinks displaying 1 of 3 claims ("No artificial sweeteners," "100% Vitamin C," and "100% All Natural") or no claim (i.e., control group). Parents selected among each of 2 drinks for their young child: 1) a fruit drink or 100% juice (primary outcome), and 2) a fruit drink or water. RESULTS: When choosing between a fruit drink and 100% juice, 45% of parents who viewed the fruit drink with the "No artificial sweeteners" claim, 51% who viewed the "100% Vitamin C" claim, and 54% who viewed the "100% All Natural" claim selected the fruit drink, compared with 32% in the no-claim control group (all P < 0.001). "No artificial sweeteners" (Cohen's d = 0.13, P < 0.05) and "100% All Natural" (d = 0.15, P < 0.05) claims increased the likelihood of parents choosing the fruit drink instead of water but "100% Vitamin C" did not (P = 0.06). All claims made parents more likely to incorrectly believe that the fruit drinks contained no added sugar and were 100% juice than the control (d ranged from 0.26 to 0.84, all P < 0.001), as assessed in a posttest survey. The impact of claims on selection of the fruit drink (compared with 100% juice) did not vary by any of the moderators examined (e.g., race/ethnicity, income; all moderation P > 0.05). CONCLUSIONS: Nutrition-related claims led parents to choose less healthy beverages for their children and misled them about the healthfulness of fruit drinks. Labeling regulations could mitigate misleading marketing of fruit drinks.This trial was registered at clinicaltrials.gov as NCT04381481. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/35040866/Nutrition_related_claims_lead_parents_to_choose_less_healthy_drinks_for_young_children:_a_randomized_trial_in_a_virtual_convenience_store_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/nqac008 DB - PRIME DP - Unbound Medicine ER -