Food Label Use and Associated Factors: A Cross Sectional Study from Occupied Palestinian Territories

Research Article

Austin J Nutri Food Sci. 2021; 9(2): 1155.

Food Label Use and Associated Factors: A Cross Sectional Study from Occupied Palestinian Territories

Natour N*, Al-Tell M and Al-Ayedi M

Department of Public Health, School of Medicine, An-Najah National University, Palestine

*Corresponding author: Nihal Natour, Department of Public Health, School of Medicine, An-Najah National University, Nablus, West Bank, Palestine

Received: June 09, 2021; Accepted: June 29, 2021; Published: July 06, 2021

Abstract

Background: Use of food labels can help consumers to make informed choices on foods they purchase which could have beneficial role in protection from obesity and diet related chronic diseases. The aim of this study was to investigate food label use in the Palestinian society along with related factors.

Methods: Electronic survey was distributed on social media platforms to Palestinian society in West Bank, Gaza, and other places of Palestinian communities’ presence. The survey collected data on demographic variable, obesity, chronic disease history and nutritional deficiencies. In addition to food label use information. Data was analyzed using IBM SPSS 21 software.

Results: We included 271 participants in our study, mean age of our study group was 25.6±10 y, mainly females. Obesity was present in 24.4% of the study group, whereas 42.8% reported they were not satisfied with their current weight and 49.4% reported they attempted to lose weight. The prevalence of label use in our study group was 61.6%. Majority of label users obtained information on amount of calories, serving size, fat, sugar, vitamins and minerals content. Very few obtained information on sodium, saturated fat and transfat in food product. Food label use was significantly related to age (p<0.05) and healthy dietary patterns (p<0.05), but was not related to obesity and chronic disease.

Conclusion: Our study indicate high rate of label use among Palestinians with some gaps in nutrition information obtained.

Keywords: Food label; Diet; Obesity; Calories

Introduction

Food labels are considered part of healthy informed choice to purchase food products as they provide information on food ingredients such as calories, proteins, fat (saturated, transfat), cholesterol and sodium [1]. Studies indicated an association between nutrition label use and decrease in risk of chronic diseases such as Diabetes mellitus [2]. In year 1990, the nutrition and labeling education act allowed the creation of food label with aim of combating obesity and diet related chronic diseases in USA. Current regulation requires the food manufacturer to provide information on important nutrients according to their significance to population health [3]. In Occupied Palestinian territories currently there is no clear declared regulations on food labels, given that, up to author knowledge, most food products contain food labels, but the information provided on label are not adequately informative for example lacking information on total ingredients or important items such saturated and transfat.

Consumers around the world are becoming more interested in obtaining nutrition information about the food they consume given that interpretation of nutrition information may be different across the public [4]. Although, according to author knowledge, most products in Palestinian Territories is labeled, currently there is no published policy on food label and no specification for type of food label to be used although, in neighbor Arab countries such as Lebanon, Nutrition label on food product is mandatory, and manufacturer should provide information on ingredient list, allergen declaration alongside with other information such as date of making [5].

In previous work, attitudes towards healthy eating and value of food, vulnerability to diet related diseases, nutrition knowledge and numeracy and gender were associated with food label use [6]. Mostly, in Occupied Palestinian territories the Guideline Daily Amount (GDA) labels which show the amount of fat, saturated fat, sugar and sodium is used mainly. However, some products are marketed with lower information in terms of clarity and magnitude of information presented [7].

Label use is associated with changes in dietary behavior in segment of the population, most importantly decrease in energy intake, decreasing unhealthy dietary behavior and increase vegetables intake. At the same time, label use may improve manufacturer standards in food production such as decrease sodium and transfat content of manufactured food products [8]. Among study group from USA, frequent label user had lower intake of sodium and salty snacks [9]. However, impact of label use on Palestinian population was not studied before.

Some studies showed that females were more likely to use food labels, in addition to adults who have nutrition awareness and positive attitudes towards food selection [10]. Barriers towards nutrition label use included; lack of interest, lack for food purchasing and lacking time [11]. Knowing the factors associated with not using food labels and improving food label content in Palestinian Occupied territories is imperative.

Cardiovascular diseases and cancer are the leading causes of death in Palestinian occupied territories [12]. In the year 2017, globally 11 million deaths were attributable to poor dietary factors including; high intake of sodium, low intake of whole grains and low intake of fruits [13]. Hence the goals of this study were: 1) to evaluate trends of food label use among Palestinians 2) to evaluate demographic and lifestyle factors related to label use in Palestinian society 3) to study the association between dietary habits and food label use

Methodology

A cross-sectional design was used to evaluate the trends of food labels among Palestinians through an electronic data collection tool which was distributed through different social methods that included facebook and professional, social and student facebook groups. The population consisted of all Palestinians living in the West Bank, Gaza, and in Israel. A convenient sampling method was adopted to reach the determined sample size of n=271.

The data collection tool was adopted based on a Literature review. In the study by Ollberding, information on age, diet, use of food label, item of food label used, gender, education, income and smoking were obtained, whereas in the study by Samuel et al, data on chronic disease (Diabetes mellitus) was obtained, we extended data on diseases to include any chronic disease or nutrition related disease [2,6]. It consisted of 3 parts the first one was about the demographic data; the second part was about the medical history that included questions about nutritional problems as deficiency of vitamins and minerals. The last part assessed the participants regarding their use of food labels in term of checking and reading them before using the food item and the reason for reading it. Information on weight, height, obesity, upper part obesity were self reported.

A self- administered food frequency survey to capture dietary habits in the last three days was adapted and translated from previous work [14]. The answer for each question was based on categorical response that was based on Likert scale. The frequency of consumption of dietary items in the last 3 days were was converted to ranked number. The paricipants were asked on the degree they consumed various types of fruits of vegetables, meats, cereals that are available to the Palestinian society. Then, major food groups’ categories (vegetables, fruits, proteins, fat and grains) were created and calculated from taking the sum of food items that represent each group group.

Ethical consideration

The research was conducted in accordance with Declaration of Helsinki and approval from the IRB at An Najah National University was obtained before conducting the study. Agreement of participant was ensured through acceptance of the invitation and answering the questionnaire.

Statistical analysis

Data was summarized using percentages and means ± SD. Differences of study variables between food label users and non-users was calculated using Chi-square tests if variables were categorical and t-test if variables were continuous. Age was categorized into 4 groups, and variables were compared across 4 different age groups using chisquare or exact test according to number of participants available. Gender was not included because it was tested and was not found significant predictor and including it would decrease our sample size. Data was analyzed by IBM SPSS 21.

Results

The study included 271 participants to whom data on food label use was available. For some variables, there were some missing values and hence they were excluded from final analysis, but they were included in unadjusted analysis to identify the factors that were significantly associated with Food Label use. In general (Table 1), using food label was more common than not using it in the study group. Majority of the study participants were females and younger age participants with mean age for group (25.6 ± 10.0 y). Almost one fourth of the study group reported being obese and slightly higher value reported having upper body obesity. More than half of the study reported not being satisfied by their current weight status and slightly less than half tried to lose weight. Small proportion of the study participants reported being diagnosed with nutrition problems such as malnutrition, vitamin D deficiency, vitamin B12 deficiency, food allergy and anemia. Almost, 40% of the study participants reported using nutrition supplementation. Table 2 provides description of study continuous variables including diet score variables.