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Food and nutrition labelling as a nutrition education tool: understanding, perspectives and practices of South African dietitians – reading without comprehension (understanding)
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Introduction
Food and nutrition labelling is an effective tool to address diet-related non-communicable diseases (NCDs), in which nutrition education plays an integral role.
Objectives
To investigate South African dietitians’ understanding, perspectives and practices of food and nutrition labelling as a nutrition education tool.
Design
A quantitative descriptive cross-sectional study was conducted.
Setting
A nationwide survey was undertaken of dietitians from all sectors of practice.
Subjects
Dietitians registered with the Health Professions Council of South Africa (HPCSA) (n = 137).
Outcome measures
A self-administered electronic survey was used for data collection.
Results
Awareness of labelling regulations was high (86.9%); however, confidence in knowledge of regulations was lacking (53.3%), as well as knowledge regarding food-labelling regulations (R146) (52.6%). More than half (57.7%) regarded labels as relevant to their daily work and 51.8% used labels frequently, varying use depending on client needs. For education purposes, the nutrition information table (75.2%), client-specific nutrients (70.0%) and health endorsement logos (HELs) (59.2%) were most frequently used. Product healthiness was mainly evaluated using the cooking method (86.1%), level of processing (67.9%) and product category (63.5%). Least used aspects were origin/certification claims (39.4%) and animal husbandry (34.3%). Highly rated aspects included belief in label efficacy (88.3%), accuracy (81.8%), a positive attitude (87.6%) and relevance (80.2%).
Conclusion
To promote optimal use of labelling as a nutrition education tool, standardisation, trustworthiness and continuing education should be addressed. Furthermore, the urgent promulgation of the draft food labelling regulations will address existing barriers to label use.
This paper aims to summarise current evidence and highlight best practices, in order to propose a paediatric food-based dietary guideline (FBDG) on exclusive breastfeeding for South Africa. A literature search was conducted to profile the current nutritional status of children and breastfeeding practices in South Africa, reflect on the commitment and capacity that has been pledged and built for exclusive and continued breastfeeding over the past five years, and highlight the action needed to improve infant and young child feeding practices in the country. From the review, it was clear that the nutritional status of children and breastfeeding practices in South Africa remain unsatisfactory. The evidence base supporting the importance of exclusive and continued breastfeeding on a global and local level has been broadened. There are comprehensive and practical international guidelines to guide the protection, promotion of, and support for breastfeeding. Comprehensive and sound national and provincial policies and guidelines have also been developed in South Africa. The political will to address infant and young child feeding has been advanced and demonstrated, and a supportive environment created through commitment and capacity building. There is a need for focused action addressing adequate monitoring and evaluation of processes during all stages of the implementation of evidence-based and theoretical planning. These actions should drastically improve exclusive and continued breastfeeding and advance the health and survival of children in South Africa. The recent momentum gained in support of improving infant
and young child feeding could further be enhanced by the process of reviewing the preliminary South African paediatric FBDG and field testing the following proposed message: “Give only breast milk, and no other foods or liquids, to your baby for the first six months of life”.
Background:
Suboptimal diet is an important preventable risk factor for non-communicable diseases (NCDs); however, its impact on the burden of NCDs has not been systematically evaluated. This study aimed to evaluate the consumption of major foods and nutrients across 195 countries and to quantify the impact of their suboptimal intake on NCD mortality and morbidity.
Methods:
By use of a comparative risk assessment approach, we estimated the proportion of disease-specific burden attributable to each dietary risk factor (also referred to as population attributable fraction) among adults aged 25 years or older. The main inputs to this analysis included the intake of each dietary factor, the effect size of the dietary factor on disease endpoint, and the level of intake associated with the lowest risk of mortality. Then, by use of disease-specific population attributable fractions, mortality, and disability-adjusted life-years (DALYs), we calculated the number of deaths and DALYs attributable to diet for each disease outcome.
Findings:
In 2017, 11 million (95% uncertainty interval [UI] 10-12) deaths and 255 million (234-274) DALYs were attributable to dietary risk factors. High intake of sodium (3 million [1-5] deaths and 70 million [34-118] DALYs), low intake of whole grains (3 million [2-4] deaths and 82 million [59-109] DALYs), and low intake of fruits (2 million [1-4] deaths and 65 million [41-92] DALYs) were the leading dietary risk factors for deaths and DALYs globally and in many countries. Dietary data were from mixed sources and were not available for all countries, increasing the statistical uncertainty of our estimates.
Interpretation:
This study provides a comprehensive picture of the potential impact of suboptimal diet on NCD mortality and morbidity, highlighting the need for improving diet across nations. Our findings will inform implementation of evidence-based dietary interventions and provide a platform for evaluation of their impact on human health annually.
Funding:
Bill & Melinda Gates Foundation.
Background
The already many and further increasing number of label elements make food labels progressively “busy”. The question is whether all these label elements are useful, and impactful, in conveying information to consumers, to help them making easier, safer, and healthier food choices.
Scope and approach
The scope of this review is food safety and nutrition labelling information. Diverse perspectives are considered on the importance of the label on food and on what type of information finds its mandatory or voluntary way onto the food label. How the information on the food label is read and understood by consumers and how this impacts their purchasing decisions and – eventually – their health, is discussed.
Key findings and conclusions
It is recommended to do further research on the inferences that consumers make from the use of allergen symbols on food labels; Increase the understanding of the health impact of nutrition-related label elements on the key targets obesity prevalence and NCD (risk factors); Closely monitor the consumer understanding and true health impact of mandatory front-of-pack nutrition labelling schemes; The food industry to enable “healthier” food choices and (to continue) to reduce levels of added sugars, salt and saturated fats in foods, and discontinue the use of partially hydrogenated oils and fats; Increase the nutrition knowledge of consumers (of all ages), preferably by using e-learning for skill development; and increase the global harmonisation in the use of label elements on foods.
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