No 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 2218 parents of children ages 1–5. Parents were randomly assigned to view fruit drinks displaying one of three claims (“No artificial sweeteners,” “100% Vitamin C,” and “100% All Natural”) or no claim (i.e., control group). Parents selected among each of two 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 = 0.14, 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 = 0.059). All claims made parents more likely to incorrectly believe that the fruit drinks contained no added sugar and were 100% juice compared to the control (d ranged from 0.26–0.84, all P < 0.001), as assessed in a post-test survey. The impact of claims on selection of the fruit drink (versus 100% juice) did not vary by any of the moderators examined (e.g., race/ethnicity, income; all moderation P > 0.057). 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. Clinical Trial Registry: This trial was registered with ClinicalTrials.gov as NCT04381481.

During the COVID-19 pandemic, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Cash Value Benefit (CVB) for fruits and vegetables increased by roughly USD 25/month/person. We sought to understand WIC participant perceptions of this change and barriers and facilitators to using the CVB. We conducted 10 virtual focus groups (5 rural, 5 urban/suburban) with WIC participants (n = 55) in North Carolina in March 2022. Focus groups were recorded and transcribed. We open-coded the content and used thematic analysis to uncover consistencies within and between sampled groups. Participants expressed favorable perceptions of the CVB increase and stated the pre-pandemic CVB amount was insufficient. Barriers to using the increased CVB were identifying WIC-approved fruits and vegetables in stores and insufficient supply of fruits and vegetables. Barriers were more pronounced in rural groups. Facilitators of CVB use were existing household preferences for fruits and vegetables and the variety of products that can be purchased with CVB relative to other components of the WIC food package. Participants felt the CVB increase allowed their families to eat a wider variety of fruits and vegetables. The CVB increase may improve fruit and vegetable intake, particularly if made permanent, but barriers to CVB and WIC benefit use may limit the potential impact.

Objectives COVID-19 has created a new normal, affecting food purchasing behaviors, moving a portion of them online. It is unknown how these behavioral shifts may differ by sociodemographic characteristics and whether shifts may widen or diminish existing diet-related disparities. To fill these gaps, we use nationally-representative Consumer Panel survey data to examine shifts in online grocery shopping by sociodemographic characteristics. Methods The Nielsen COVID-19 Shopper Behavior Survey was administered to a subset of Nielsen Homescan panel participants in March-April 2020 (n = 17,262 households (HH)). We describe survey-weighted HH sociodemographic characteristics and reasons for online shopping. Survey weighted-multivariable logistic regression was used to examine sociodemographic correlates of reported increases in online food shopping. Results One third (34%) of our survey-weighted sample said they shopped for groceries online more since COVID-19, and 60% of these HH reported planning to continue shopping online after COVID-19. In adjusted analyses, all age groups (40–54 y, 55–64y, 65 + y) had lower odds of online shopping than heads of HH 39 years or younger (all OR = 0.7, P < 0.001). Lower educated (high school or less) HH had lower odds of online shopping compared to higher educated (college or more) HH (OR = 0.7, P < 0.001). HH in the South had higher odds of online shopping than those in the Northeast (OR = 1.2, P = 0.006). Compared to Non-Hispanic (NH) white HH, Hispanic HH had higher odds of online shopping (OR = 1.2, P = 0.02), and NH Asian HH had lower odds of online shopping (OR = 0.8, P = 0.02). HH with children had higher odds of online shopping compared to households without children (OR = 1.4, P < 0.001). Of those who said they would increase the amount of online shopping they did for everyday items including food (37%), the top reasons were to avoid public germs and COVID-19 (81%), to take advantage of the convenience (44%) and to access a better selection (17%). Conclusions There are disparities in shifts in online shopping behaviors due to COVID-19. Understanding these disparities can inform public health nutrition interventions related to online food shopping. We will assess the August 2020 survey as the pandemic may further change food shopping habits. Funding Sources Arnold Ventures & National Institutes of Health

Objective: To estimate the prevalence of online grocery shopping in a nationally representative sample and describe demographic correlates with online grocery shopping. Design: The Nielsen COVID-19 Shopper Behavior Survey was administered to a subset of Nielsen National Consumer Panel participants in July 2020. We used survey weighted-multivariable logistic regression to examine demographic correlates of having ever online grocery shopped. Setting: Online survey. Participants: 18,598 Nielsen National Consumer Panel participants in the United States. Results: Thirty-nine percent of respondents had purchased groceries online, and among prior purchasers, 89% indicated that they would continue to online grocery shop in the next month. Canned/packaged foods was the most shopped for grocery category online, followed by beverages, fresh foods, and lastly, frozen foods. In adjusted analyses, younger respondents (39y or less) were more likely (47%) to have ever shopped for groceries online than older age groups (40-54y, 55-64y, 65+y) (29%, 22%, and 23%, respectively, all p<0.001). Those with greater than a college degree were more likely to have ever grocery shopped online (45%) than respondents with some college education (39%), and with a high school education or less (32%) (both p<0.001). Having children, having a higher income, and experiencing food insecurity, particularly among higher income food insecure households, were also associated with higher probability of prior online grocery shopping. Conclusions: The COVID-19 pandemic accelerated the transition to online grocery shopping. Future research should explore the nutrition implications of online grocery shopping.