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Attitudes, Motivation and Ability to read and understand Health Claims

Understanding Health-related Claims and Symbols

While the use of claims and their wording is regulated, it is not fully understood how consumers interpret these claims. CLYMBOL researchers, led by the University of Surrey, have carried out a set of qualitative studies in order to better understand how consumers make sense of claims and symbols. Although several features influence consumers’ acceptance of nutrition and health claims, the paramount factors are their familiarity with the nutrient/substance within the claim and their personal relevance. It is, therefore, very likely that consumers perceive the same claims differently, as familiarity and relevance are both factors depending on the individual.

Short and simple claims are perceived more favourably. It seems less important for consumers if the stated function or benefit is omitted from a claim when the nutrient/substance in the claim is familiar to them. Consumers are unlikely to read detailed information on the package while shopping and are also unlikely to regard information associated with an unfamiliar nutrient positively, no matter the level of detail. For many consumers more detailed claims using “scientific” language are problematic to understand. Additionally, results suggest consumers may not consciously differentiate between a nutrition and a health claim in the way regulatory experts do.


Interpreting Health Claims

Health claims can refer to an individual nutrient and its effect on one’s health benefit. However, it can happen that background knowledge is necessary for consumers to understand the claim. For example, knowing reduced salt consumption supports maintenance of normal blood pressure has little practical meaning, unless put into context. Connecting elevated blood pressure to heart health, enables the consumer to form a connection between reduced salt consumption and its influence on heart health. That is why CLYMBOL researchers evaluated how and to what extent consumers analyse health claims by using their individual health knowledge. To do this, the project evaluated responses of over 500 consumers in five EU countries (DE, SI, ES, NL, UK). Research revealed that consumers draw inferences beyond the information presented within the claim by using personal beliefs and additional causal knowledge. Results suggest that familiar or personally relevant nutrients/substances could lead to an “upgrade” of the statement, with the upgrade being merely based on the consumers’ opinion and beliefs and not based on what is actually stated in the claim. For example, participants reported that saturated fat had an influence on heart health, although this was not indicated in the claim. Overall, it could be shown that participants reach appropriate conclusions from health claims, but the strength of these conclusions is influenced by their prior knowledge. The interpretation of claims is not only affected by consumers’ subjective causal models, but also a second independent factor: the belief in the claim itself. A claim which was believed to be true led to stronger inferences.


The Effect of Images on Perception of Health Claims

There have been discussions whether an image can be as effective as a text to relay information. It could be shown that images can indeed represent health claims. The nearly 400 participants in five countries (DE, SI, ES, NL, UK) were presented with several pictures of fictional food products with various claims, some with and some without an image. Afterwards they were asked to recall and recognise those claims. When asked about what they had seen on the food product, study participants often falsely reported having read health claims. These recollection errors increased when images were displayed on the packaging which in turn could lead a person to falsely think a specific health benefit was mentioned. In conclusion, images on packages can affect people’s beliefs about the healthiness of products. However, it is important to note that the data suggests the participants’ inferences from the images were spontaneous and unconscious, not deliberate. Warning the participants that the images were meaningless did not prevent errors. Therefore, it is believed the participants were not aware or not able to avoid making inferences when viewing products.


Health Claims and their Relation to the European Disease Burden

The Regulation 1924/2006 does not demand that health-related claims must have public health relevance. Therefore, health-related claims might be misleading if they over-emphasise diseases or conditions which are not very common. In addition, nutrition claims could emphasise the presence of a nutrient which is not under-consumed, like proteins, or over-consumed, like dietary cholesterol. Consumers might come to the conclusion that they have a lack/surplus of these constituents and change their diet accordingly. Comparison of the claims found in our food and drink database to the nutrition and health status among European consumers revealed that the type of health claims currently available on products is not strongly related to public health needs. Illnesses like cardiovascular diseases and cancer contribute the most to the public disease burden, but relatively few health claims refer to these conditions. Many health claims refer to digestive functions such as “Rye fibre contributes to normal bowel function”, although the burden of disease of the digestive tract is relatively low. However, medicinal claims are not permitted in the EU, therefore producers are restricted in how they can mention specific diseases in claims. Referring to risk factors by using disease risk reduction claims (e.g. “Plant stanol esters have been shown to reduce blood cholesterol. Blood cholesterol is a risk factor in the development of coronary heart disease") could be an alternative, but establishing a link between specific nutrients or foods and a risk factor is very difficult. There is stronger evidence for different diets than for single foods, but the topic is very complex and therefore it is especially complicated to communicate this information in the limited space of a claim.


Motivation and Ability to process Health-related Claims and Symbols

People who were more concerned about their health were more motivated to read and to understand health claims such as “Calcium is needed for the maintenance of normal bones “and “Calcium and vitamin D are needed for normal growth and development of bone in children”. The same goes for participants who cared about healthy eating. This is what a representative online survey with over 5000 participants in ten European countries (UK, DE, NL, ES, SI, CZ, FR, DK, GR, LI) found. Generally, people were more inclined to mentally process specific health claims when they thought the mentioned health benefit is important for their personal health.

People who were more familiar with health claims tended to be more able to process specific health claims. The better someone was educated, the more they were motivated to mentally process and understand health claims. Additionally, people who have the main responsibility to purchase food in the household were more motivated and more able to understand health claims and symbols, followed by people who share the responsibility. The major driver for consumers’ motivation to deal with health claims and symbols was their need for information. Their most important factor for their ability to understand claims was their subjective knowledge about the healthiness of food. Objective nutrition and health knowledge did not show significant impact. Consumers’ motivation and ability were positively and significantly correlated. Meaning, the more motivated someone is to understand claims, the better their ability to actually understand claims is, and vice versa. Significant variations between the countries in the participants’ motivation and ability to process health claims and symbols were noticeable. In Southern Europe relatively higher levels of motivation and ability were observed, followed by the Eastern, the Northern and then the Western countries.


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