How Much Can Product Reformulation Improve Diet Quality in Households with Children and Adolescents?
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.1.1. Conceptual Model
2.1.2. Data Sources and Preparation
2.1.3. Statistical Analysis
- Household income: low (less than 185% of poverty line) versus high (equal to or greater than 185% of the poverty line);
- Race and ethnicity: non-Hispanic white, non-Hispanic black, Hispanic, Asian, and other;
- Locality: urban, part urban/rural, and rural.
3. Results
3.1. Changes in Nutrient Levels for Selected Products over Time
3.2. Results of Simulations of Effects of Reformulation
3.3. Results of Average Price Calculations for Healthier versus Less Healthy Products
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Product 1 | Nutrient | Brand Type | No. of Barcodes (2012) | Average Per Standardized Serving Values | |||
---|---|---|---|---|---|---|---|
2012 | 2014 | Difference | p-Value | ||||
Cereal bars | Saturated fat (grams) | Branded | 2086 | 2.14 | 1.95 | −0.19 | <0.01 |
Private label | 539 | 1.63 | 1.28 | −0.35 | <0.01 | ||
Cookies and brownies | Saturated fat (grams) | Branded | 3530 | 2.55 | 2.38 | −0.17 | <0.01 |
Private label | 1741 | 2.44 | 2.26 | −0.18 | <0.01 | ||
Crackers | Saturated fat (grams) | Branded | 1934 | 1.10 | 0.95 | −0.15 | <0.01 |
Private label | 866 | 0.94 | 0.76 | −0.18 | <0.01 | ||
Lunch combinations 2 | Calories | Branded | 95 | 320.06 | 346.88 | 26.82 | 0.02 |
Private label | 0 | -- | -- | -- | -- | ||
Sugar (grams) | Branded | 95 | 17.35 | 19.17 | 1.82 | 0.05 | |
Private label | 0 | -- | -- | -- | -- | ||
Dietary fiber (grams) | Branded | 95 | 1.33 | 1.44 | 0.11 | 0.03 | |
Private label | 0 | -- | -- | -- | -- | ||
Macaroni and cheese mix | Saturated fat (grams) | Branded | 181 | 2.10 | 1.91 | −0.19 | <0.01 |
Private label | 310 | 1.82 | 1.67 | −0.15 | <0.01 | ||
Nut butters | Saturated fat (grams) | Branded | 344 | 2.62 | 2.42 | −0.2 | <0.01 |
Private label | 394 | 3.17 | 2.92 | −0.25 | <0.01 | ||
Potato chips | Saturated fat (grams) | Branded | 1,745 | 2.02 | 1.82 | −0.20 | <0.01 |
Private label | 381 | 2.10 | 1.93 | −0.17 | <0.01 | ||
RTE cereal | Saturated fat (grams) | Branded | 1403 | 0.33 | 0.24 | −0.09 | <0.01 |
Private label | 1718 | 0.13 | 0.09 | −0.04 | <0.01 | ||
Tortilla chips and other chips | Saturated fat (grams) | Branded | 1681 | 1.80 | 1.56 | −0.24 | <0.01 |
Private label | 375 | 1.33 | 1.15 | −0.18 | <0.01 | ||
Yeast breads | Saturated fat (grams) | Branded | 1939 | 0.18 | 0.14 | −0.04 | <0.01 |
Private label | 1290 | 0.16 | 0.13 | −0.03 | <0.01 | ||
Yogurt | Saturated fat (grams) | Branded | 1030 | 1.46 | 1.38 | −0.08 | <0.01 |
Private label | 998 | 0.54 | 0.49 | −0.05 | <0.01 | ||
Dietary fiber (grams) | Branded | 1030 | 0.30 | 0.32 | 0.02 | <0.01 |
Nutrient | Product 1 | Average Per Standardized Serving Values | |||
---|---|---|---|---|---|
Branded | Private Label | Difference (Private Label − Branded) | p-Value | ||
Branded Better than Private Label | |||||
Calories | Frankfurters | 156.42 | 168.09 | 11.67 | <0.01 |
Fruit drinks | 92.89 | 101.68 | 8.79 | <0.01 | |
Saturated fat (grams) | Frankfurters | 4.83 | 5.20 | 0.37 | 0.02 |
Macaroni and cheese (RTE) | 7.06 | 9.50 | 2.44 | 0.04 | |
Nut butters | 2.47 | 2.89 | 0.42 | <0.01 | |
Sugar (grams) | Cereal bars | 9.17 | 10.52 | 1.35 | <0.01 |
Crackers | 2.01 | 2.66 | 0.65 | <0.01 | |
Frankfurters | 1.03 | 1.49 | 0.46 | <0.01 | |
Fruit drinks | 21.82 | 25.07 | 3.25 | <0.01 | |
Sodium (milligrams) | Cookies and brownies | 88.61 | 99.66 | 11.05 | <0.01 |
Frankfurters | 532.70 | 570.98 | 38.28 | <0.01 | |
Fruit drinks | 32.59 | 39.71 | 7.12 | <0.01 | |
Macaroni and cheese mix | 572.18 | 604.93 | 32.75 | <0.01 | |
Nut butters | 88.58 | 116.08 | 27.50 | <0.01 | |
RTE cereal | 119.20 | 150.33 | 31.13 | <0.01 | |
Yeast breads | 270.90 | 290.83 | 19.93 | <0.01 | |
Yogurt | 89.25 | 96.1 | 6.85 | <0.01 | |
Dietary fiber (grams) | Cereal bars | 2.64 | 2.36 | −0.28 | <0.01 |
Cookies and brownies | 0.78 | 0.58 | −0.20 | <0.01 | |
Crackers | 1.37 | 1.00 | −0.37 | <0.01 | |
Ice cream | 0.63 | 0.32 | −0.31 | <0.01 | |
Nut butters | 2.25 | 2.00 | −0.25 | <0.01 | |
Pizza | 2.38 | 2.05 | −0.33 | <0.01 | |
Potato chips | 1.04 | 0.98 | −0.06 | <0.01 | |
RTE cereal | 2.17 | 1.89 | −0.28 | <0.01 | |
Yeast breads | 2.64 | 2.01 | −0.63 | <0.01 | |
Private Label Better than Branded | |||||
Calories | Yogurt | 146.7 | 127.18 | −19.52 | <0.01 |
Saturated fat (grams) | Cereal bars | 1.96 | 1.41 | −0.55 | <0.01 |
Crackers | 0.99 | 0.78 | −0.21 | <0.01 | |
Macaroni and cheese (mix) | 1.88 | 1.64 | −0.24 | 0.04 | |
Pizza | 6.11 | 5.52 | −0.59 | <0.01 | |
RTE cereal | 0.28 | 0.08 | −0.20 | <0.01 | |
Tortilla and other chips | 1.52 | 1.13 | −0.39 | <0.01 | |
Yogurt | 1.39 | 0.44 | −0.95 | <0.01 | |
Sugar (grams) | Macaroni and cheese (mix) | 5.04 | 4.39 | −0.65 | <0.01 |
Pizza | 4.46 | 3.69 | −0.77 | <0.01 | |
Potato chips | 0.89 | 0.71 | −0.18 | <0.01 | |
Yogurt | 19.05 | 17.82 | −1.23 | <0.01 | |
Sodium (milligrams) | Cereal bars | 105.22 | 97.88 | −7.34 | <0.01 |
Soft drinks | 29.62 | 21.09 | −8.53 | <0.01 | |
Tortilla and other chips | 220.86 | 171.92 | −48.94 | <0.01 |
Calories | Saturated Fat (g) | Sugar (g) | Sodium (mg) | Dietary Fiber (g) | |
---|---|---|---|---|---|
NHANES total daily intake 1 | 2079 | 26.3 | 112 | 3409 | 16.3 |
Baseline amount in purchases (2014) | 220.23 | 2.25 | 12.76 | 265.24 | 2.20 |
Average amount in 1-star products | 202.35 | 1.09 | 7.47 | 227.89 | 4.00 |
Change to average 1-star target | −17.88 | −1.16 | −5.29 | −37.35 | 1.80 |
% change relative to baseline purchases | −8.1% | −51.6% | −41.5% | −14.1% | 81.8% |
% change relative to NHANES daily intake | −0.9% | −4.4% | −4.7% | −1.1% | 11.0% |
Average amount in maximum-star products | 137.41 | 0.62 | 3.26 | 143.01 | 4.41 |
Change to average maximum-star target | −82.83 | −1.63 | −9.49 | −122.23 | 2.21 |
% change relative to baseline purchases | −37.6% | −72.4% | −74.4% | −46.1% | 100.5% |
% change relative to NHANES daily intake | −4.0% | −6.2% | −8.5% | −3.6% | 13.6% |
Household Demographic | Calories | Saturated Fat (g) | Sugar (g) | Sodium (mg) | Dietary Fiber (g) |
---|---|---|---|---|---|
Change Using Average 1-Star Targets | |||||
All | −17.9 | −1.2 | −5.3 | −37.4 | 1.8 |
Income level: | |||||
Low income | −18.3 | −1.2 | −5.4 | −36.7 | 1.8 |
High income | −17.6 | −1.2 | −5.2 | −37.7 | 1.8 |
Race and ethnicity: | |||||
Non-Hispanic white | −18.1 | −1.3 | −5.4 | −41.0 | 2.0 |
Non-Hispanic black | −21.4 | −1.0 | −6.1 | −32.2 | 1.5 |
Hispanic | −16.4 | −0.9 | −4.9 | −31.1 | 1.5 |
Asian and other | −14.6 | −1.0 | −4.3 | −28.3 | 1.5 |
Urban vs. rural: | |||||
Urban | −18.1 | −1.1 | −5.3 | −36.0 | 1.8 |
Part urban/rural | −17.6 | −1.2 | −5.2 | −40.0 | 1.9 |
Rural | −17.2 | −1.3 | −5.2 | −40.5 | 1.9 |
Change Using Maximum-Star Targets | |||||
All | −82.8 | −1.6 | −9.5 | −122.2 | 2.2 |
Income level: | |||||
Low income | −81.1 | −1.6 | −9.5 | −120.4 | 2.2 |
High income | −83.9 | −1.7 | −9.5 | −123.4 | 2.2 |
Race and ethnicity: | |||||
Non-Hispanic white | −88.6 | −1.8 | −10.0 | −133.4 | 2.4 |
Non-Hispanic black | −78.8 | −1.4 | −9.7 | −106.1 | 1.8 |
Hispanic | −71.1 | −1.3 | −8.5 | −102.3 | 1.8 |
Asian and other | −67.1 | −1.3 | −7.6 | −95.7 | 1.8 |
Urban vs. rural: | |||||
Urban | −81.5 | −1.6 | −9.5 | −119.0 | 2.2 |
Part urban/rural | −85.2 | −1.7 | −9.5 | −128.4 | 2.3 |
Rural | −87.8 | −1.8 | −9.5 | −131.5 | 2.3 |
Meets CFBAI Criteria | Does Not Meet CFBAI Criteria | p-Value | ||||||
---|---|---|---|---|---|---|---|---|
N | % of Servings for Products with Nutritional Information | $/Serving | N | % of Servings for Products with Nutritional Information | $/Serving | Difference (Meets − Does Not Meet) | ||
Cereal bars | 166 | 4.3 | $0.62 | 2292 | 95.7 | $0.96 | −$0.34 | <0.0001 |
Private label | 35 | 10.6 | $0.44 | 311 | 89.4 | $0.37 | $0.07 | 0.0007 |
Crackers | 202 | 8.6 | $0.43 | 2281 | 91.4 | $0.36 | $0.07 | 0.0002 |
Tortilla and other chips | 125 | 1.5 | $0.47 | 1783 | 98.5 | $0.35 | $0.12 | <0.0001 |
RTE cereal | 342 | 13.3 | $0.28 | 2401 | 86.7 | $0.29 | −$0.01 | 0.8199 |
Private label | 122 | 14.2 | $0.18 | 1121 | 85.8 | $0.21 | −$0.03 | <0.0001 |
Yeast bread | 558 | 15.7 | $0.28 | 2521 | 84.3 | $0.25 | $0.03 | 0.0594 |
Yogurt | 1126 | 60.6 | $0.82 | 797 | 39.4 | $0.76 | $0.06 | <0.0001 |
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Muth, M.K.; Karns, S.A.; Mancino, L.; Todd, J.E. How Much Can Product Reformulation Improve Diet Quality in Households with Children and Adolescents? Nutrients 2019, 11, 618. https://doi.org/10.3390/nu11030618
Muth MK, Karns SA, Mancino L, Todd JE. How Much Can Product Reformulation Improve Diet Quality in Households with Children and Adolescents? Nutrients. 2019; 11(3):618. https://doi.org/10.3390/nu11030618
Chicago/Turabian StyleMuth, Mary K., Shawn A. Karns, Lisa Mancino, and Jessica E. Todd. 2019. "How Much Can Product Reformulation Improve Diet Quality in Households with Children and Adolescents?" Nutrients 11, no. 3: 618. https://doi.org/10.3390/nu11030618