Abstracts / Journal of Nutrition & Intermediary Metabolism 1 (2014) 1e55 3 challenges. The tendency in health promotion to promote only the positive people’s diets. This new system includes both interpretive elements (the ‘eat more’ messages is based on the false notion of diet as a fixed pipe number of stars, ranging between one-half to five stars, and the level of whereby pushing more vegetables in one end results in more confec- specific nutrients, reported as low, medium, or high) and informational tionary and unhealthy snacks falling out the other end. Public health elements (e.g. grams per 100 g of specific nutrients). A cost-benefit should ideally have as detailed and nuanced appreciation of consumer analysis of the system concluded that “the aggregate benefits of the HSR choice as commercial marketing currently has but the most pressing task is system in the context of multiple public health initiatives, will likely pay to persuade politicians that to achieve healthy population diets requires back (i.e. meet or exceed) aggregate costs over an indicative five year multiple strategies, some of which are readily branded by the food in- implementation period” (4). The system is voluntary for the first five dustry as ‘nanny state’.Influencing consumers to choose healthy foods will years, during which time it will be reviewed to assess take-up levels first require influencing policy-makers to choose effective food policies among food producers. and actions. Dietary improvements resulting from interpretive front-of-pack labelling The practical questions thus shift from being problem-oriented (under- can be expected to occur via several mechanisms. In the first instance, standing what factors currently influence consumer choices) to solution- consumers motivated to utilise food labelling (e.g. those watching their oriented (understanding what interventions are achievable and what weight or with specific health problems such as diabetes or hypertension) impacts they are likely to have on creating healthier diets). Thus, from the will have additional information at their disposal. This will enhance the myriad of influences arise a handful of potential interventions to focus on cognitive processing aspect of food purchase decisions. Second, consumers and the usual proposals include: restricting unhealthy food marketing to who lack the motivation or ability to use existing forms of food labelling children; taxes and subsidies; provision of information and interpretive will be exposed to an alternative form of information that is assimilated signals (like Health Star Rating system); food polices on provision, service either subconsciously or with much less cognitive effort. This will enhance and procurement, and; placement strategies like confectionary-free decision-making that is undertaken with the use of heuristics. Third, much checkouts or ‘green food zones’ around schools. food purchasing is undertaken out of habit. Exposure to highly visible, While the likely effectiveness of these strategies is highly varied and easily understood nutrition information has the potential to act as a dis- segmented, it is the factors beyond the size of the impact on diet which ruptor to normal purchase habits and trigger re-evaluation of the available will determine whether these strategies are implemented or not. These alternatives at the point of purchase. This increases the likelihood that broader factors include: protecting children from being targeted by new, healthier options will be selected. predatory marketing of products which damage their health; consumers’ Finally, and perhaps most importantly, clear, accessible nutrition infor- right to know the healthiness of the food products being purchased; mation will constitute a powerful motivator for product reformulation. reducing pester power and supporting parents; policy coherence aligning Within product categories there are wide disparities in star ratings, e.g. non-health policies with health outcomes; public demand for action to cheese and peanut butter (5). Those products with a higher rating will improve the healthiness of food environments, and; alignment of strate- possess a distinct competitive advantage relative to low-scoring products. gies with political ideologies. This will provide a strong incentive for food producers to ‘even the playing Research, evaluation and monitoring of these strategies and the broader field’ by improving the nutritional profile of their offerings. factors which influence their implementation is a priority and will provide Perhaps the clearest indication of the potential for the new Health Star us with the solution-oriented evidence needed to support healthy food Rating system to produce these positive effects is the extent to which choices by consumers. certain members of the food industry have resisted and attempted to Funding source(s): N/A. thwart the new system. We now wait in eager anticipation for the wide- spread adoption of the Health Star Rating system and the resulting im- THE EFFECTS OF FOOD LABELLING ON CONSUMER CHOICE AND provements in consumers’ awareness of the nutritional value of foods and INDUSTRY PRACTICES changes in their subsequent purchase decisions. Funding source(s): N/A. S. Pettigrew 1. 1 School of Psychology and Speech Pathology, Curtin University, References Perth, WA, Australia 1. Blewett N, Goddard N, Pettigrew S, Reynolds C, Yeatman H. Labelling E-mail: [email protected] Logic. Report prepared for the Australia and New Zealand Food Regulation Ministerial Council, 2011. The rapid escalation of obesity worldwide has been attributed to macro- 2. Pettigrew S, Pescud M. The salience of food labeling among low-income environmental factors that have increased the availability and visibility of families with overweight children. J Nutr Educ Behav. 2013;45(4):332e339. high-energy foods while reducing opportunities for physical activity. 3. Vyth EL, Steenhuis IHM, Brandt HE, Roodenburg AJC, Brug J, Seidell JC. Although most responses to the obesity epidemic have focused on Methodological quality of front-of-pack labeling studies: a review plus encouraging individuals to change their food choices, it is recognised that identification of research challenges. Nutr Rev. 2012;70(12):709e720. ‘upstream’ responses that change the food environment will be critical in 4. PricewaterhouseCoopers 2014. Health Star Rating System Cost Benefit addressing this complex and intractable problem. Effective food labelling Analysis. Report prepared for the Department of Health, Australia. Avail- is one such upstream strategy (1). able at http://www.health.gov.au/internet/main/publishing.nsf/Content/ Consumers have a right to information about their food. The mandatory foodsecretariat-front-of-pack-labelling-1 Nutrition Information Panel (NIP) and ingredients lists located on the back 5. CHOICE. What krafty companies don’t want you to know. Media release, of most packaged food products in Australia achieve this to some extent. 26/2/14. Available at http://www.choice.com.au/media-and-news/media- However, these forms of nutrition information cannot meet the needs of all releases/2014-media-releases/what-krafty-companies-dont-want-you- consumers due to their reliance on high levels of motivation and literacy to-know.aspx for access and interpretation (2). Interpretive food labelling located on the front of packs can overcome these limitations by providing ‘at a glance’ information about products’ healthiness, both in isolation and relative to other foods. The use of symbols that give an overall indication of the Lecture in honour of dr trevor beard nutritional status of the food provides an interpretive function that assists Dr Trevor Beard (1920e2010) e INDEFATIGABLE ANTI-SODIUM consumers by synthesising the more complex information provided else- CRUSADER where on the pack. In an interpretive labelling system, the symbol(s) may be accompanied by text that provides more detailed information. Various D.R. Woodward 1. 1 Retired, formerly at University of Tasmania, Hobart, TAS, interpretive front-of-pack labelling systems have been proposed and Australia tested, including those that feature symbols such as traffic lights, ticks, and E-mail: [email protected] stars (3). The recent introduction of the Health Star Rating (HSR) system for front- Trevor Beard completed a medical degree at Cambridge University. In 1951, of-pack food labelling in Australia reflects a growing body of evidence he migrated with his family to Tasmania, where he spent 21 years as a relating to the potential of interpretive food labelling to improve hard-working rural general practitioner. 4 Abstracts / Journal of Nutrition & Intermediary Metabolism 1 (2014) 1e55

His career trajectory was dramatically affected in 1960 by three cases of hydatid disease - one fatal e in his practice. This led him to spearhead a state-wide campaign to eliminate this disease. Trevor’s relentless com- munity campaigning led to human hydatids incidence falling to zero in Tasmania by the early 1970s. From 1972 to 1987, he worked in public and community health in the Canberra public service. In the late 1970s self-diagnosis with hypertension further affected Trevor’s career trajectory. He adopted a diet that was very low in sodium, with very satisfactory results. In the early 1980s he took up formal research, with two major trials of low- salt diets between 1981 and 1984 (1, 2). In parallel, he set up a community group NoSal (later Salt Skip) to encourage Canberra to support people seeking to minimise sodium intake. After retirement from the public service, Trevor moved to Hobart, and was promptly recruited onto the research staff of the newly-created Menzies Centre (later the Menzies Research Institute of Tasmania.). He actively Ă continued in this role for over 20 years, publishing a range of original research, including the first community-representative survey of sodium intakes in Australia (3) and a trial of calcium diglutamate for enhancing the The concern over calcium and cardiovascular disease lacks dose response palatability of low-salt soups (4). and mechanistic proof. Our study in a pig model of metabolic syndrome fi He frequently advocated for low sodium intakes, particularly in sub- showed no increases in coronary artery calci cation or plaque formation missions to various official committees, including the revision of the with elevated calcium intakes from dairy or supplement. Nutrient Reference Values. Trevor also continued to spearhead the At present, current dietary recommended for calcium still appear to be a increasingly-national activities of Salt Skip, with enthusiastic use of com- good target with potential risks for chronic disease if intakes fall too short puter technology. He never really “retired”. or greatly exceed these recommendations. He died in 2010, at the age of 90, of complications that followed a suc- Funding source(s): N/A. cessful total knee replacement. References Trevor’s legacy? An island freed from the scourge of hydatids, and greatly- 1. Reid IR. Ch. 36 Cardiovascular safety of calcium supplements. In: enhanced consciousness of salt/sodium in both lay and professional circles Nutritional Influences on Bone Health. Eds P. Burckhardt et al. Springer- e ninety years well spent! Verlag, London UK, pgs 365-372, 2013. Funding source(s): N/A. 2. Weaver CM. Calcium is not only safe but important for health. Ch. 35. In: fl References Nutritional In uences of Bone Health. International Congress Series Pro- 1. Beard TC, Cooke HM, Gray WR, Barge R. Randomised controlled trial of a ceedings of the 8th International Symposium on Nutrition Aspects of no-added-sodium diet for mild hypertension. Lancet. 1982;28(2): 455-8. Osteoporosis, Lausanne, Switzerland. Burckhardt P, Dawson-Hughes B, 2. Beard TC, Cooke HM, Gray WR, Ellem DP. Spontaneous remission and its Weaver CM, eds, Springer, 359-364, 2013. significance for trials in primary prevention of hypertension. Ann Clin Res. 3. Prentice RL, Pettinger MB, Jackson RD, Wactawaski-Wende J, LaCroix 1984;16(Suppl 43): 132-5. AZ, Anderson GL, Chlebowski RT, Manson JE, Van Horn L, Vitolins MZ, fi 3. Beard TC, Woodward DR, Ball PJ, Hornsby H, von Witt RJ, Dwyer T. The Datta M, LeBlanc ES, Cauley JA, Rossouw JE. Health risks and bene ts from ’ Hobart Salt Study 1995: few meet national sodium intake target. Med J calcium and vitamin D supplementation: Women s Health Initiative Aust. 1997;166: 404-7. clinical trial and cohort study. Osteoporosis Int. 2013;24: 567-80. This fi 4. Ball PJ, Woodward DR, Beard TC, Shoobridge A, Ferrier M. Calcium paper analyses the bene ts and risks to bone, CVD and mortality from the diglutamate improves taste characteristics of lower-salt soup. Eur J Clin largest and longest RCT of calcium and vitamin D supplementation from the Nutr. 2002;56: 519-23. WHI with subanalysis for adherent participants and those not taking their own calcium and vitamin D supplements at baseline. It also includes analysis Dairy Australia lecture of a large prospective observational cohort from the same catchment as the IS THERE A CALCIUM CONTROVERSY? DO CALCIUM RCT. RECOMMENDATIONS AIMED AT PROTECTING AGAINST OSTEOPOROSIS 4. Weaver CM. Calcium supplementation: Is protecting against osteopo- PROMOTE CARDIOVASCULAR DISEASE? rosis counter to protecting against cardiovascular disease? Curr Osteoporos Rep. 2014;12: 211-8. C. Weaver 1. 1 Department of Nutrition Science, Purdue University, USA E-mail: [email protected] Plenary 3: “new” foods for/from animals WILL INSECTS SOLVE WORLD HUNGER? Calcium is the dominant mineral in bone and is a shortfall nutrient in the diet. For those consuming inadequate dietary calcium, calcium supple- A.L. Yen 1. 1 Department of Environment and Primary Industries Victoria & ments have been a standard strategy for prevention of osteoporosis. School of Applied Systems Biology, La Trobe University, Bundoora, Victoria, Recently, calcium supplementation has been linked to both increased and Australia decreased cardiovascular disease risk creating considerable uncertainty E-mail: [email protected] and debate (1, 2). Moreover, recent reports have shed uncertainty over the effectiveness of calcium supplements to reduce risk of fracture. Background: A recent report prepared by Wageningen University on Although the importance of good calcium nutrition is well known, deter- behalf of the Food and Agriculture Organization of the United Nations (1) mining the advantage of calcium supplementation to either bone or heart advocated greater use of insects as both human food and animal feed as a health has been hampered by poor subject compliance and study design means of feeding the exponentially-growing global population. This flaws. report generated much media attention concentrating on the negative The best randomized, controlled trial to date that takes into account attitudes of people towards eating insects rather than how insects can adherence to supplementation is from the Women’s Health Initiative contribute to food security. On the other hand, there were a few exag- (WHI) (3). Figure 1 shows the risk as Hazard Ratios of calcium and vitamin gerated claims that using insects as a food source would solve world D supplements for hip fracture, heart diseases, breast cancer, and overall hunger. mortality (4). Hip fracture is greatly reduced, breast fracture significantly There are several cultural and health barriers to the acceptance of insects reduced, and no significant effects on diseases of the heart or overall as food. The main obstacle is the western attitude towards insects, and mortality were observed. with increasing globalization of western food cultures, this attitude is