- Email: [email protected]
Perceived relevance and foods with health-related claims
Food Quality and Preference 24 (2012) 129–135
Contents lists available at SciVerse ScienceDirect
Food Quality and Preference journal homepage: www.elsevier.com/locate/foodqual
Perceived relevance and foods with health-related claims M. Dean a,⇑, P. Lampila c, R. Shepherd b, A. Arvola c, A. Saba d, M. Vassallo d, E. Claupein e, M. Winkelmann e, L. Lähteenmäki f a
School of Biological Sciences, Queen’s University Belfast, NI, UK Department of Psychology, University of Surrey, UK c VTT Technical Research Centre of Finland, Finland d Istituto Nazionale di Ricerca per gli Alimenti e la Nutrizione, Italy e Max Rubner-Institut, Karlsruhe, Germany f MAPP, Business and Social Sciences, Aarhus University, Denmark b
a r t i c l e
i n f o
Article history: Received 16 June 2011 Received in revised form 12 October 2011 Accepted 13 October 2011 Available online 28 October 2011 Keywords: Health claims Relevance Perceived healthiness Perceived benefit Willingness to buy
a b s t r a c t Although consumer perception of the health claims and nutrition information has been studied widely there is relatively little understanding about the motivational factors underpinning claim perception. The objective of this study is to investigate how levels of perceived relevance influence consumers’ responses to health claims that either promise to reduce a targeted disease risk or improve well-being in comparison to other types of health-related messages, and how attitudes towards nutritionally healthy eating, functional food and previous experience relating to products with health claims affect the consumers’ perceptions of nutrition and health claims. The data (N = 2385) were collected by paper and pencil surveys in Finland, the UK, Germany and Italy on a target group of consumers over 35 year old, solely or jointly responsible for the family’s food shopping. The results showed that relevance has a strong influence on perceptions of personal benefit and willingness to buy products with health claims. However the impact of relevance is much stronger when the health risks are relevant to self than when it is relevant to those close to oneself, especially when the claim promises a targeted risk reduction with detailed information about function and health outcome. Previous experience with products with health claims and interest in nutritionally healthy eating promoted the utility of all claims, regardless of whether they were health or nutrition claims. However, to be influenced by health claims consumers also need to have a positive attitude towards functional food products. Ó 2011 Elsevier Ltd. All rights reserved.
1. Introduction The new EU legislation (Regulation (EC) No 1924/2006) controls the use of nutrition and health claims in products by necessitating that claims should be based on sound scientific findings and approved by the EU Commission before use. Consumer perception of health claims and nutrition information has been widely studied lately (e.g. Grunert, Wills, & Fernández-Celemín, 2010; Grunert et al., 2009; van Trijp & van der Lans, 2007), but we still know relatively little about how motivational factors affect claim perception, and how relevance and attitudes to healthy eating influence perceptions of health and nutrition claims. Health claims promise a health-related benefit, whereas nutrition claims state the presence of a nutritionally beneficial compo⇑ Corresponding author. Address: School of Biological Sciences, Queen’s University Belfast, David Keir Building, Stranmillis Road, Belfast BT9 5AG, UK. Tel.: +44 2890 976561. E-mail address: [email protected] (M. Dean). 0950-3293/$ - see front matter Ó 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.foodqual.2011.10.006
nent or composition leaving the consumer to make the connection between the component and health. Risk reduction claims are a specific category of health claims that link the product with a specific disease which are assessed and approved on a case-by-case basis (Regulation (EC) No. 1924/2006). Recently studies on health claims show that the type of base product, the type of claim and the functional ingredient used all affect benefit perceptions and willingness to buy products with health claims (Ares & Gámbaro, 2007; Grunert et al., 2009; Urala, Arvola, & Lähteenmäki, 2003; van Kleef, van Trijp, & Luning, 2005; van Trijp & van der Lans, 2007). Several studies suggest that perceived relevance is one of the key motivating factors influencing the acceptability of functional foods (Verbeke, 2005) and specific product application (Urala et al., 2003). According to legislation, a health claim should be formulated in a way that allows consumers to understand the beneficial effects of the product (Regulation (EC) No. 1924/2006). Although health claims have been shown to increase perceived healthiness of products (Dean et al., 2007; Urala et al., 2003; van Kleef et al., 2005; van Trijp & van der
130
M. Dean et al. / Food Quality and Preference 24 (2012) 129–135
Lans, 2007; Wansink, Sonka, & Hasler, 2004), the increase has been moderate at best. In addition it is not clear whether respondents’ ratings of healthiness are based on their assessment of the product’s overall healthfulness or relate to the benefit the product specifically promises to deliver to their own health. Since the beneficial effects of the product with a specific health claim may only be relevant to some people, the aim of this study is to investigate the importance of relevance in relation to claims that are either clearly targeted at a risk group or targeted at a wider audience promising general health benefits. It is hypothesised that consumers with higher self-rated relevance (whether personal relevance to self or in relation to one’s close family or friends) will increase their perception of healthiness of the product, perceived benefit to self and the likelihood to buy the product compared to consumers with low relevance. In addition relevance to self is expected to increase perceptions of benefit to self of products with health claims. Nutrition claims typically promise general benefit to everyone, thereby targeting consumers in general rather than specific groups of buyers. Therefore the relevance of risk of disease is not expected to play an important role in influencing the utility value of products with nutrition claims. Instead, interest in these products is expected to be higher for those who have interest in nutritionally healthy eating when compared to those who do not have such an interest. Nutritional healthiness typically refers to choosing products (e.g. low-fat, high-fibre, fruit and vegetables) with high nutrient density contributing to a diet that lowers the risk of noncontagious diseases in the long-term, but does not promise any specific health benefits. In contrast foods with health claims, especially with risk reduction claims, resemble medicines with the idea being that by eating these products one can influence a specific and relatively well-defined physiological function or related health factors. The strongest attitudinal factor that predicts willingness to use functional foods has been the reward one gets by taking care of oneself with the consumption of these products (Urala & Lahteenmaki, 2007). The association is shown to be highly product and claim dependant with a suggestion that products with health claims that have been on the market a while have become part of a nutritionally healthy diet. Weiner (2010) discusses the biomedical discourse around cholesterol lowering foods to point out that these products are partly viewed by the public as alternatives to medicines, facilitating health promoting results without requiring a change in their diet. This is seen partly as an easier option that allows people to ignore living a healthy lifestyle and the efforts required to do so. However, although the effects of products with risk reduction claims can be compared to medicines, they are still seen mostly as foods, whereas supplements are more often categorised as drugs (de Jong, Ocké, Branderhorst, & Friele, 2003). Therefore it is theorised that interest in nutritionally healthy eating is associated with the appeal of nutritionally relevant health messages such as nutrition claims (e.g. contains whole grain vs. no info). However, consumers need to have positive attitudes towards foods with health claims (so-called functional foods) in order for them to perceive health claims positively. The objective of this research is to investigate how perceived relevance influences consumers’ responses to specific disease risk reduction health claims, general health claims and nutrition claims. The second objective is to see whether attitudes towards nutritionally healthy eating and attitudes towards functional foods have an impact on perceptions relating to products with health claims. The study used conjoint analysis to examine the relative impact (measured as part-worth utilities) of various factors (base product, health claim, nutrition claim and pictorial cue) on ratings of perceived healthiness, benefit to me and likelihood of buying.
1.1. Hypotheses (1) Perceived relevance will increase perceived healthiness, perceived benefit to self and likelihood to buy of products with health claims, especially in the presence of a risk reduction claim. (2) Perceived personal relevance will have a stronger impact on perceived healthiness, perceived benefit to self and likelihood to buy than relevance to others. (3) Perceived personal relevance will have a stronger impact on the perceived personal benefit than on the perceived general healthiness. (4) Perceived relevance will have no effect on perceived healthiness, perceived benefit to self and likelihood to buy when nutrition claims are targeted at the general public. (5) General health interest will be positively related to perceived healthiness, perceived benefit to self and likelihood buy of products with nutrition claims, but the relationship between general health interest and health claims will depend on the type of health claim. (6) Those who view products with health claims as tools to repair flaws in diet (foods as medicines or functional foods) will perceive higher healthiness, more benefit to self and greater likelihood to buy of products with health claims. 2. Method The study was a part of the European HealthGrain project which researched possibilities of developing products that contain protective compounds from wholegrain or their fractions (Poutanen et al., 2008). The regular consumption of wholegrain cereals has been associated with reduced risk of various types of diseases, including type 2 diabetes (Chatenoud et al., 1998; Liu et al., 2000; Meyer et al., 2009). Therefore the health-related messages in this study where associated with products that contain cereals. This report concentrates on motivational factors underlying perceptions of health claims and nutrition claims. Overall results and country specific differences from the same data have been reported in Saba et al. (2010). 2.1. Subjects The data (N = 2385) were collected by paper and pencil surveys in Finland (n = 682), the UK (n = 547), Germany (n = 504) and Italy (n = 652). The target group of this study was over 35 year old consumers, since the lack of personal relevance for young consumers has been identified as a barrier for the acceptance of functional foods (Wilkinson, Pidgeon, Lee, Pattison, & Lambert, 2004). The participants were solely or jointly responsible for the family’s food shopping. In the total sample the share of females was 50.8%. The respondents were from 35 to 95 years old the mean age being 52.1 years (SD = 11.80). Table 1 describes the country wise characteristics of the participants by gender and age group. There were no significant differences between countries in gender distribution. However, the share of respondents in the older age group was higher in the Finnish sample than in other countries. 2.2. Questionnaire The first section of the questionnaire measured perceived relevance of type 2 diabetes, the second section measured perceptions relating to products described with different health-related messages and the third part measured health-related attitude,
131
M. Dean et al. / Food Quality and Preference 24 (2012) 129–135
Table 1 Description of the sample: socio-demographic characteristics, the share of weekly users of the studied product types, the share of functional food (FF) consumers and the means of health related food attitudes. The significance of the difference between the countries. Total (N = 2385)
Finland (n = 682)
UK (n = 547)
Germany (n = 504)
Italy (n = 652)
Gender (%) Male Female
49 51
47 53
50 50
50 50
50 50
Age group (%) 35–50 years 51–95 years
48 51
42 58
51 49
50 50
51 49
FF use Sum of frequencies
17.3
19.1
17.6
16.8
15.6
Subjective knowledge Mean
3.9
4.6
3.4
3.7
3.7
Relevance To self To other
16.3 31.1
19.4 30.4
15.5 30.3
15.1 26.0
14.6 36.4
Means of attitudes GHI AFM
4.7 4.3
5.0 4.5
4.7 4.0
4.6 4.0
4.6 4.4
Sig. Ns
p = 0.001
p < 0.001 p < 0.001 P < 0.001
subjective knowledge and use of functional foods. The socio-demographic questions were included at the end. 2.2.1. Relevance of type 2 diabetes Diabetes was selected as the target disease because consumers are not as aware of the link between diabetes and wholegrain consumption as they are of the link between fibre and CVD, and there are fewer products marketed with risk reduction of type 2 diabetes. Choosing a relatively little known health association encouraged participants to process the information in the claims rather than responding automatically based on their existing beliefs. To activate participants’ involvement in the issue, relevance of diabetes risk was measured on two items at the beginning of the questionnaire. In order to be able to differentiate between the ‘relevance to self’ and ‘relevance to others’, participants were asked about the perceived risk of diabetes to self and to those close to them. The question relating to personal relevance (‘Do you suffer from diabetes or do you consider yourself as having a high risk for developing diabetes?’) was answered ‘‘yes’’ by 16.4% (n = 391) of the respondents. These respondents were classified as the ‘relevant to self’ group. The question relating to knowing someone with diabetic related issues (‘Do you have a relative or close acquaintance who has diabetes or difficulties in balancing their blood glucose levels?’) was answered ‘‘yes’’ by 43.5% (n = 1032) of the respondents. This categorisation was used in the regression analyses to predict utilities. Some respondents answered yes to both relevance questions. For the investigation of the differences in utility means, only those who answered no to relevance to self-question (31.1%; n = 737) were classified as the ‘relevant to others’ group. Those respondents who answered ‘no’ or ‘do not know’ to both the above questions (52.6%; n = 1248) were classified as the ‘not relevant’ group. All others were classified as missing data. 2.2.2. Conjoint analysis Conjoint analysis (Green & Srinivasan, 1978, 1990) enables the examination of the roles of different product characteristics independently with a limited number of product descriptions. In this paper we are interested in the factors that influence consumer perception of health claims and whole grain information, since they present verbal claims that can be classified either as health or nutrition claims. The overall design is described below to illustrate the context in which the claims were presented. In this
p < 0.001 p < 0.001
study four product characteristics that varied in three or two levels were used: these were the base product (three levels: bread, cake and cereal-containing yoghurt), health claim (three levels: no claim, general claim and risk reduction claim), visual cue (three levels: no cue, natural cue and medical cue) and the presence of wholegrain (two levels: no information and information). The three product types were selected as they were considered to be different in their healthiness image: ‘bread’ as example of a staple grain food (with a positive health image); ‘cake’ as occasional/hedonistic grain food (with neutral/negative health image); and ‘yoghurt with cereals’ as a non-cereal carrier (with a neutral/positive health image). The product types were illustrated as simple drawings. Symbols associated with different kind of healthiness (medical vs. natural) were selected from a pilot study carried out in all four countries. As the objective of this paper is to look at how levels of perceived relevance influence consumers’ responses to different health claims, product related analysis is not reported here. In addition the health-related cue information is excluded from these analyses as the impact of this on the responses was relatively small (see Saba et al., 2010). The health claim related to diabetes was presented either as an unspecific benefit claim addressing blood sugar balance or as a targeted claim promising risk reduction of type 2 diabetes. The benefit claim (BC): ‘Promotes regulation of blood sugar balance’ is a functional health claim (according to the EC regulation), which gave information about health-related effects. The risk reduction claim (RRC): ‘Contains cereal-based compounds which balance the blood glucose levels and therefore lower the risk of type 2 diabetes’ is a disease risk reduction claim (according to the EC regulation), which gave information about the functional ingredient, the function and the long term risk reduction of disease as a health outcome. The wordings were tested for comprehension and ease of understanding in pre-tests in four countries (N = 181). The nutrition claim (NC): ‘contains wholegrain’ related to wholegrain with two levels: no label and a label. A full factorial design with four attributes and eleven levels would have generated 54 hypothetical combinations of profiles that needed to be shown to the respondents. In order to reduce participant fatigue, a fractional orthogonal design procedure (SPSS, 2007) generated nine standard cards describing hypothetical products (for detailed descriptions see Saba et al., 2010). Each card represented a simple base-product picture with the description of the
132
M. Dean et al. / Food Quality and Preference 24 (2012) 129–135
level of attribute ‘health claim’, ‘whole grain’ and ‘a symbol’. Respondents were asked to assume that the product would be available in shops they normally go to. The respondents were asked to rate each card on a seven-point scale of dependent variables ‘How healthy is this product’ (healthiness)? ‘How beneficial is this product to you’ (benefit to me)? ‘How likely is it that you would buy this product’ (likelihood to buy)? Responses ranged from ‘not at all – 1’ to ‘extremely – 7’. 2.2.3. Attitudes Consumers’ motivation in relation to nutritionally healthy eating was measured using the General health interest questionnaire (GHI) (Roininen, Lähteenmäki, & Tuorila, 1999; Roininen et al., 2001), whereas attitude towards using foods as tools to repair flaws in healthiness of the diet was measured with four items. Of the four selected items, three came from the Reward factor in Urala and Lahteenmaki (2007) and the fourth was added to emphasise the disease connection. The attitude measure was named ‘attitude towards using food as a medicine’ (AFM). The four items were chosen after testing 20 items in pre-tests (N = 114) on the ability to discriminate between individuals in all four participating countries. The items used were ‘I can prevent diseases by regularly eating foods with health claims’, ‘Foods with health claims can repair the damage caused by an unhealthy diet’, ‘Foods with health claims make it easier to follow a healthy lifestyle’ and ‘Eating foods with health claims will help me not to get some diseases’. These multi-item scales contain verbal statements that were rated on a seven-point scale (1 = ‘strongly disagree’; 7 = ‘strongly agree’). Reliabilities for the attitude scales were high (Cronbach’s alpha for GHI 0.84 and AFM 0.84). The scores between GHI and AFM were moderately correlated r = 0.43 (p < 0.001). 2.2.4. Familiarity and subjective knowledge Participants’ familiarity with functional foods was asked in relation to five product types: vitamin enriched, fibre enriched, cholesterol lowering, probiotic bacteria containing and omega-3 fatty acids containing food products, with examples of each given. To get an overall score of familiarity the responses to the five products were simply summed together and used as an indicator of familiarity with these products in the regression analyses. The means of the sum was 17.3 (SD = 3.19) with a range of 5–25. Most of the participants reported consuming functional foods at least occasionally. The reported use was highest in Finland and lowest in Italy (Table 1). As higher relevance may be related to higher perceived knowledge of diabetes-related issues subjective knowledge was measured with five items (Flynn & Goldsmith, 1999). Three items were negatively worded and these ratings were reversed before calculated the mean of the five items. The subjective knowledge items were highly correlated with Cronbach’s alpha of 0.88. 2.3. Data analysis The respondent’s task was to rate nine product profiles. The conjoint analysis procedure produces estimated partworth utilities which indicate how influential each attribute level is in the formation of consumer preferences for a particular combination (Wang & Sun, 2003). In this study we use these part-worth utilities to indicate the importance of attribute levels on perceived healthiness and benefit to me in addition to likelihood to buy, which can be regarded as an estimate of preference. Conjoint part-worth utilities were estimated using ordinary least squares regression (OLS). Mean differences between partworth utilities for perceived healthiness, benefit to me and likelihood to buy by relevance (relevance to self, relevance to others and not relevant) were investigated using repeated measure ANO-
VAs with Scheffe’s tests. These were conducted for health claims (benefit claim and risk reduction claim) and the nutrition claim (no label, contains wholegrain label). Statistical analysis was undertaken using SPSS v.17 (SPSS, 2007). Multiple regression was used to study the role of relevance in predicting the part-worth utilities for perceived healthiness, benefit to me and likelihood to buy as dependent variables by a model that consisted of socio-demographics factors (gender and age), subjective knowledge, familiarity with functional foods, general health interest and attitude towards foods as medicine as independent variables in addition to relevance. Relevance in the regression was entered separately as relevance to self and relevance to others. 3. Results The three dependant variables perceived healthiness, benefit to me and willingness to buy are highly correlated (Table 2). However, they are treated as separate variables since they portray different aspects of consumer responses to health-related claims in relation to relevance. 3.1. Relevance The more relevant diabetes was to participants (relevant to self compared to relevant to others) the more they saw the product with a claim, especially with a risk-reduction claim as healthy (F (4, 4566) = 23.1; p < 0.001), of benefit to them (F (4, 4552) = 69.1; p < 0.001) and were more likely to buy the product (F (4, 4568) = 51.3; p < 0.001) (Fig. 1). Hypotheses 1 and 2 were supported. Also (hypothesis 3) the magnitude of support for perceived benefit to me was higher than for perceived general healthiness (see Fig. 1). Interestingly, although increase in relevance (to both self and others) increased perception of benefit to me for the risk reduction claim, only those who said that diabetes was relevant to self were more willing to buy products with the risk reduction claim when compared to products with the benefit claim and no claim. The results indicate that while people may perceive products with risk reduction claims to be healthy, personal relevance is required to perceive these foods as being of benefit to them and for them to be willing to buy them. Results showed that contrary to prediction relevance did marginally affect people’s perceptions of healthiness of the product when a nutrition claim such as ‘contains wholegrain’ label is added (F (2, 2283) = 3.2; p < 0.05), and also affected perceptions of benefit to me (F (2, 2276) = 11.6; p < 0.001) and their likelihood of buying the product (F (2, 2084) = 5.7; p < 0.01). Thus people perceived the product with a nutrition claim such as a wholegrain label to be healthy and their perception of healthiness increase with level of relevance (see Fig. 2). Further when personally relevant, participants perceived the product to be of greater benefit to them and were willing to buy it. Thus hypothesis 4 was not supported. The relative magnitudes of support showed that while participants perceived the product with a nutrition claim such as ‘contains wholegrain’ to be healthy, and of benefit to them, this was not fully reflected in their likelihood of buying (healthiness = 0.25, benefit to me = 0.24, likelihood of buying = 0.13).
Table 2 The range of correlation (Pearson’s r) between perceived healthiness, perceived benefit to me and willingness to buy (n = 2381–2391; P < 0.001) in the nine sample descriptions presented to respondents.
Healthiness Benefit to me
Benefit to me
Likelihood to buy
0.68–0.79
0.53–0.70 0.77–0.82
133
M. Dean et al. / Food Quality and Preference 24 (2012) 129–135
Fig. 1. Effect of relevance and types of claim (no claim (none), benefit claim (BC) and risk reduction claim (RRC)) on perception of healthiness, benefit to me and likelihood to buy.
When it was relevant to self while perceived healthiness, benefit to me and likelihood to buy all increased for the risk reduction claim, only benefit for me increased for the nutrition claim. Also, relevance to others was a significant but weaker predictor for benefit for me and likelihood to buy for the risk reduction claim and subjective knowledge a significant predictor for the likelihood to buy variable for the nutrition claim. In addition, familiarity with functional foods was a significant and relatively strong predictor for both types of claims, and surprisingly the coefficients were higher for the dependent variables of the nutrition claim (Table 2). General health interest was positively linked to all three dependent variables, but had stronger coefficients for benefit to me and likelihood to buy ratings for the nutrition claim, as expected, supporting hypothesis 5. Attitude towards using foods as medicine was positively associated a risk reduction claim (with the exception of perceived healthiness), but negatively with the nutrition claim. Hypothesis 6 was partially supported. In relation to the socio-demographic variables age predicted higher support for nutrition claim in healthiness, benefit to me and likelihood to buy, whereas for the risk reduction claim only likelihood to buy was linked to age. The analyses were also run for the benefit claim, but the regression analyses only explain up to 3% of the variance in utilities with relevance to self on its own or in combination with familiarity with functional foods and attitude to foods as medicine as significant, but weak predictors. Due to the low explanatory value these analyses are not shown in the table. 4. Discussion 4.1. Relevance
Fig. 2. Effect of relevance and nutrition claim (no label, wholegrain label) on perception of healthiness, benefit to me and likelihood to buy.
3.2. Role of relevance linked to other predictors The relative role of relevance in relation to other variables was investigated by predicting perceived healthiness, benefit for me and likelihood to buy by gender, age, familiarity with functional foods, subjective knowledge, general health interest, attitude towards food as medicine and relevance. Overall, these independent variables explained less of variance in perceived healthiness (4%) than the benefit to me (8–9%) and likelihood to buy (11–12%) (see Table 3).
In this study two types of health claims were presented, namely a benefit claim and a risk reduction claim, with different messages and different levels of information. The benefit claim promoted overall general well-being, while the risk reduction claim made a strong promise to mitigate negative consequences by reducing a specific disease risk. Relevance was shown to increase the influence of both types of claims in terms of perceived healthiness, benefit to me and likelihood to buy, which supports our first hypothesis. However, when people were sub-divided depending on the level of relevance, those with relevance to self, gave higher ratings for the benefit to self and likelihood to buy compared to those with relevance to others. This indicates that respondents in this study recognised the benefit of the product to themselves. However for the healthiness utility the difference between
Table 3 Standardised regression coefficients predicting utilities of perceived healthiness, benefit to me and likelihood to buy for risk reduction and nutrition claims. Healthiness Risk reduction claim Beta Gender Age Subj. knowledge FF use Relevance to self Relevance to others GHI AFM R square (adj.)
.03 .03 .02 .09*** .07*** .04 .12*** .02 .042
Level of significance is marked with asterisks. p 6 .05). ** p < 0.01. *** p < 0.001. *
Benefit to me Nutrition claim Beta .02 .08*** .02 .13*** .00 .03 .13*** .07** .043
Risk reduction claim Beta .06** .02 .03 .05* .19*** .04* .12*** .07*** .094
Likelihood to buy Nutrition claim Beta .01 .11*** .01 .12*** .06** .00 .18*** .06* .075
Risk reduction claim Beta .04 .06** .04 .11*** .13*** .05** .12*** .09*** .108
Nutrition claim Beta .00 .12*** .05* .17*** .00 .00 .24*** .10*** .123
134
M. Dean et al. / Food Quality and Preference 24 (2012) 129–135
relevance groups was much smaller. Thus the healthiness attribute seems to represent a general healthiness of the product with all respondents agreeing on the order of claims regardless of relevance. However the difference in perceived healthiness between claims varied according to relevance. This implies that the rating of overall healthiness is not the most effective way to measure perceived personal benefit. In the more personal oriented benefit to me and likelihood to buy measures, the relevance to self group made a clear distinction between the benefit claim and the risk reduction claim, whereas the relevance to other group did not see any differences between the benefit claim and risk reduction claim. This supports the hypothesis that when people are motivated (high relevance) they are more likely to be influenced by the risk reduction claims that promise to deliver specifically targeted benefits. The results fit well with previous research (Urala et al., 2003; Van Kleef et al., 2005; Verbeke, 2005) which showed that people tend to prefer risk reduction claims, when claims relate to wellknown risk factors of common lifestyle-related diseases, as opposed to more general claims promoting nutritional well-being. However, our results go one step further to show that the effect of relevance on claim preference is rather small unless it is personally relevant and that people with high self relevance are the group that is most influenced by risk reduction claims. When not personally relevant risk reduction claims have very small utility values and the products are not likely to be purchased. However, it is important to note that, although consumers who consider themselves to be at risk recognise the healthiness and beneficial effects of products with health claims, they are not necessarily willing to buy the product which explains the low likelihood of buying utility. This suggests that even when personally relevant and the benefit perceptions of products with health claims are enhanced, people still have other preconceptions and barriers that stop them from buying these products (Lappalainen, Kearney, & Gibney, 1998). Therefore to understand and market products with health claims, manufacturers need to investigate not only how beneficial people see these products to be, but also how appealing the products are to consumers. In addition the study showed that subjective knowledge of participants does not necessarily increase the likelihood of buying of these products or mediate the impact of relevance. In addition the study showed that relevance had a very minor impact on perceptions relating to the nutrition claim and then only for the benefit for me utility. Nutrition claims, such as contains wholegrain, do not target specific risk groups or disease, although there is scientific evidence to support the beneficial effects of wholegrain products in lowering the risk of type 2 diabetes (Chatenoud et al., 1998; Liu et al., 2000; Meyer et al., 2009). This implies that consumers are either not aware of the link between whole grain intake and type 2 diabetes or the level of information given in the nutrition claim is not sufficient to activate this link. 4.2. Attitudes and perceptions of health related messages As expected the utilities of the nutrition claim was strongly linked to interest in nutritionally healthy eating (measured by GHI), and surprisingly nutritionally healthy eating interest was also positively related to the utilities of the risk reduction claim. It appears that risk of diabetes is associated in people’s minds with nutritional interests and the link between general health interest and perceived healthiness for the risk reduction claim was as strong as the link for the nutrition claim. However when the behavioural likelihood to buy was assessed the general health interest had a stronger predictive value for the nutrition claim than for the risk reduction claim. This indicates that consumers need to find the messages relevant to themselves and be positive about
general nutritional healthiness in order for them to be interested in products with health claims. The results demonstrate that health claims are unlikely to be perceived as magic bullets to health by those who are not interested in nutritional healthiness. It also highlights the challenge of marketing food products with health-related messages to all consumers as products with health claims are mostly appealing to those consumers who are already highly motivated about healthy eating. The positive attitude towards using food as medicine to repair flaws in diets to prevent disease added to the utility of risk reduction health claims, but decreased the utility of the nutrition claim. This suggests that health claims are perceived differently from nutrition claims. However the study showed that having a general nutrition interest supports the likelihood of buying products with health claims and the prediction of choices is better when attitude towards functional food products is included in the equation. These results are in accordance with earlier findings from Finland where, in addition to attitudes towards functional foods, general health interest was a significant predictor of willingness to use products for some functional foods (Urala & Lahteenmaki, 2007). The results confirm that some products with health claims are viewed as fitting into nutritionally healthy eating, but not by all respondents. This suggests that there are consumers who wish to find new solutions to healthy eating and the foods with health claims fulfil that role. In previous studies users of functional foods have been seen as more innovative consumers compared to those choosing nutritionally recommended foods (Saher, Arvola, Landeman, & Lahteenmaki, 2004). It could be argued that those with a negative attitude towards functional food products perceive higher utilities for nutrition claims, and are likely to seek more conventional solutions for healthy eating without including products with health claims. 4.3. Familiarity and subjective knowledge As seen in earlier studies (Grunert et al., 2009; Lähteenmäki et al., 2010; van Trijp & van der Lans, 2007), previous exposure to functional foods seems to facilitate their acceptance, especially when claims have more detailed information such as the risk reduction claim in this study. However, reported use of functional foods also increases the utility of nutrition claims. Exposure to foods with health-related claims may increase both the familiarity of different functional ingredients, but also the associative links related to them regardless of the legislative status of the claim, such as nutrition or health claim. Also previous exposure to claims may facilitate the processing of information in new claims as consumers use their exposure as reference material to draw upon to evaluate the new claims. Thus in markets where claims have existed new claims may become one more product attribute among many others, and consumers are likely to pay a varying amount of attention to these pieces of information based on their personal need when making choices. Further consumers may not necessarily categorise claims as health or nutrition claims, but assess them based on the benefits they promise. In this study the socio-demographics factors were weak predictors of the utilities, although age was positively linked to the utilities relating to the nutrition claim. Age has been linked in other studies to higher appeal of foods with health-related claims (Ares, Gimenez, & Gámbaro, 2009; Siegrist, Stampfli, & Kastenholz, 2008) although the effect has not been very strong and so is in line with our findings. 4.4. Limitations of the study The level of relevance in this study was measured by two questions and is a measure of perceived relevance, and is not an objective measure (e.g. BMI, waist circumference, blood pressure etc.).
M. Dean et al. / Food Quality and Preference 24 (2012) 129–135
From a consumer study perspective this approach has both strengths and weaknesses. The main weakness is that when a positive link between perceived relevance and claim perception is found, we cannot be sure if the people who perceive themselves at risk are the right target group for the product when viewed from a health status point. However, having an elevated level of risk but not being aware of it is not likely to affect purchase behaviour. As perceived self-relevance was shown to have an impact on product choices the first task should focus on making people more aware of their risk factors in order to achieve the desired impact. This can be attained by informing consumers about the risk factors (e.g. BMI) or by providing opportunities to have physiological risk factors monitored e.g. blood pressure or blood cholesterol levels. The strength of the perceived relevance approach is that self-reported relevance measures the consumer’s motivation directly and therefore is an important predictor. Another limitation of this study was the use of a single example to represent each of the claims. However, our results demonstrate the importance of self-relevance on a targeted claim. The results suggest that the role of perceived relevance should be taken into account when investigating health claims. The carryover effect of self-relevance on one type of disease risk onto other risk reduction claims needs to be tested in future studies. 5. Conclusions The study showed that relevance has a strong influence on perceptions of personal benefit and willingness to buy products with health claims. However the impact of relevance is much stronger when the health risks are relevant to self than when it is relevant to those close to oneself, especially when claims promise a targeted risk reduction with detailed information given about the function and health outcome. Previous experience with products with health claims and interest in nutritionally healthy eating promoted the utilities of all claims, regardless of whether they were health or nutrition claims. However, for increase in utilities for health claims in addition to previous experience and nutritionally healthy eating consumers also needed to be positive about functional foods in general. Acknowledgements This study was financially supported by the European Commission in the Communities Sixth Framework Program, Project HEALTHGRAIN (PF6-514008). This publication reflects only authors’ views and the Community is not liable for any use that may be made of the information contained in this publication. References Ares, G., & Gámbaro, A. (2007). Influence of gender, age and motives underlying food choice on perceived healthiness and willingness to try functional foods. Appetite, 49, 148–158. Ares, G., Gimenez, A., & Gámbaro, A. (2009). Consumers perceived healthiness and willingness to try functional milk desserts. Influence of ingredient, ingredient name and health claim. Food Quality and Preference, 20, 50–56. Chatenoud, L., Tavani, A., La-Vecchia, C., Jacobs, D. R. J., Negri, E., Levi, F., et al. (1998). Wholegrain food intake and cancer risk. International Journal of Cancer, 77, 24–28.
135
de Jong, N., Ocké, M. C., Branderhorst, H. A. C., & Friele, R. (2003). Demographic and lifestyle characteristics of functional food consumers and dietary supplement users. British Journal of Nutrition, 89, 273–281. Dean, M., Shepherd, R., Arvola, A., Vassallo, M., Winkelmann, M., Claupein, E., et al. (2007). Consumer perceptions of healthy cereal products and production methods. Journal of Cereal Science, 46, 188–196. Flynn, L. R., & Goldsmith, R. E. (1999). A short, reliable measure of subjective knowledge. Journal of Business Research, 46(1), 5 7–66. Green, P. E., & Srinivasan, V. (1978). Conjoint analysis in consumer research: Issues and outlook. Journal of Consumer Research, 5, 103–123. Green, P. E., & Srinivasan, V. (1990). New developments with implications for research and practice. Conjoint Analysis in Marketing, 54, 3–19. Grunert, K. G., Lähteenmäki, L., Boztug, Y., Martinsdottir, E., Ueland, Ø., & Åström, A. L. (2009). Perception of health claims among Nordic consumers. Journal of Consumer Policy, 32, 269–287. Grunert, K. G., Wills, J. M., & Fernández-Celemín, L. (2010). Nutrition knowledge, and use and understanding of nutrition information on food labels among consumers in the UK. Appetite, 55(2), 177–189. Lähteenmäki, L., Lampila, P., Grunert, K., Boztug, Y., Ueland, Ø., Åström, A., et al. (2010). Impact of health-related claims on the perception of other product attributes. Food Policy, 35, 230–239. Lappalainen, R., Kearney, J., & Gibney, M. (1998). A pan EU survey of consumer attitudes to food, nutrition and health: An overview. Food Quality and Preference, 9, 467–478. Liu, S., Manson, J. E., Stampfer, M. J., Hu, F. B., Giovannucci, E., Colditz, G. A., et al. (2000). A prospective study of wholegrain intake and risk of type 2 diabetes mellitus in US women. American Journal Public Health, 90, 1409–1415. Meyer, K. A., Kushi, L. H., Jacob, D. R. J., Slavin, J., Sellers, T. A., & Folsom, A. R. (2009). Carbohydrates, dietary fiber, incident type 2 diabetes mellitus in older women. American Journal Clinical Nutrition, 71, 921–930. Poutanen, K., Shepherd, R., Shewry, P. R., Delcour, J. A., Björck, I., & Van Der Kamp, J.W. (2008). Beyond wholegrain: The European HEALTHGRAIN project aims at healthier cereal foods. Cereal Foods World, 53, 32–35. Regulation (EC) No 1924/2006 of the European Parliament and of the Council of 20 December 2006 on nutrition and health claims made on foods. Official Journal of the European Union L 404, 9–25. Roininen, K., Lähteenmäki, L., & Tuorila, H. (1999). Quantification of consumer attitudes to health and hedonic characteristics of foods. Appetite, 33, 71–88. Roininen, K., Tuorila, H., Zandstra, E. H., Vehkalahti, K., Strubenitsky, K., & Mela, D. J. (2001). Differences in health and taste attitudes and reported behaviour among Finnish, Dutch and British consumers: A cross-national validation of the Health and Taste Attitude Scales (HTAS). Appetite, 37, 22–45. Saba, A., Vassallo, M., Shepherd, R., Lampila, P., Arvola, A., Dean, M., et al. (2010). Country-wise differences in perception of health-related messages in cerealbased food products. Food Quality and Preference, 21, 385–393. Saher, M., Arvola, A., Landeman, M., & Lahteenmaki, L. (2004). Impressions of functional food consumers. Appetite, 42, 79–89. Siegrist, M., Stampfli, N., & Kastenholz, H. (2008). Consumers’ willingness to buy functional foods: The influence of carrier, benefit and trust. Appetite, 51, 526–529. SPSS (2007). SPSS statistics 17.0 for WindowsTM. Chicago, IL: SPSS Inc.. Urala, N., Arvola, A., & Lähteenmäki, L. (2003). Strength of health-related claims and their perceived advantage. International Journal of Food Science and Technology, 38, 815–826. Urala, N., & Lahteenmaki, L. (2007). Consumers’ changing attitudes towards functional foods. Food Quality and Preference, 18, 1–12. van Kleef, W., van Trijp, H. C. M., & Luning, P. (2005). Functional foods: Health claimfood product compatibility and the impact of health claim framing on consumer evaluation. Appetite, 44, 299–308. van Trijp, H. C. M., & van der Lans, I. A. (2007). Consumer perceptions of nutrition and health claims. Appetite, 48, 305–324. Verbeke, W. (2005). Consumer acceptance of functional foods: Socio-demographic, cognitive and attitudinal determinants. Food Quality and Preference, 16, 45–57. Wang, Q., & Sun, J. (2003). Consumer’s preference and demand for organic food: Evidence from a Vermont survey. In American agricultural economics association annual meeting, Montreal, Canada, July 27–30 (p. 12). Montreal, Canada: American Agricultural Economics Association. Wansink, B., Sonka, S. T., & Hasler, C. M. (2004). Front-label health claims: When less is more. Food Policy, 29, 659–667. Weiner, K. (2010). Configuring users of cholesterol lowering foods: A review of biomedical discourse. Social Science and Medicine, 71, 1541–1547. Wilkinson, S. B. T., Pidgeon, N., Lee, J., Pattison, C., & Lambert, N. (2004). Exploring consumer attitudes towards functional foods: A qualitative study. Journal of Nutraceutical, 4(3/4), 5–28.
Contents lists available at SciVerse ScienceDirect
Food Quality and Preference journal homepage: www.elsevier.com/locate/foodqual
Perceived relevance and foods with health-related claims M. Dean a,⇑, P. Lampila c, R. Shepherd b, A. Arvola c, A. Saba d, M. Vassallo d, E. Claupein e, M. Winkelmann e, L. Lähteenmäki f a
School of Biological Sciences, Queen’s University Belfast, NI, UK Department of Psychology, University of Surrey, UK c VTT Technical Research Centre of Finland, Finland d Istituto Nazionale di Ricerca per gli Alimenti e la Nutrizione, Italy e Max Rubner-Institut, Karlsruhe, Germany f MAPP, Business and Social Sciences, Aarhus University, Denmark b
a r t i c l e
i n f o
Article history: Received 16 June 2011 Received in revised form 12 October 2011 Accepted 13 October 2011 Available online 28 October 2011 Keywords: Health claims Relevance Perceived healthiness Perceived benefit Willingness to buy
a b s t r a c t Although consumer perception of the health claims and nutrition information has been studied widely there is relatively little understanding about the motivational factors underpinning claim perception. The objective of this study is to investigate how levels of perceived relevance influence consumers’ responses to health claims that either promise to reduce a targeted disease risk or improve well-being in comparison to other types of health-related messages, and how attitudes towards nutritionally healthy eating, functional food and previous experience relating to products with health claims affect the consumers’ perceptions of nutrition and health claims. The data (N = 2385) were collected by paper and pencil surveys in Finland, the UK, Germany and Italy on a target group of consumers over 35 year old, solely or jointly responsible for the family’s food shopping. The results showed that relevance has a strong influence on perceptions of personal benefit and willingness to buy products with health claims. However the impact of relevance is much stronger when the health risks are relevant to self than when it is relevant to those close to oneself, especially when the claim promises a targeted risk reduction with detailed information about function and health outcome. Previous experience with products with health claims and interest in nutritionally healthy eating promoted the utility of all claims, regardless of whether they were health or nutrition claims. However, to be influenced by health claims consumers also need to have a positive attitude towards functional food products. Ó 2011 Elsevier Ltd. All rights reserved.
1. Introduction The new EU legislation (Regulation (EC) No 1924/2006) controls the use of nutrition and health claims in products by necessitating that claims should be based on sound scientific findings and approved by the EU Commission before use. Consumer perception of health claims and nutrition information has been widely studied lately (e.g. Grunert, Wills, & Fernández-Celemín, 2010; Grunert et al., 2009; van Trijp & van der Lans, 2007), but we still know relatively little about how motivational factors affect claim perception, and how relevance and attitudes to healthy eating influence perceptions of health and nutrition claims. Health claims promise a health-related benefit, whereas nutrition claims state the presence of a nutritionally beneficial compo⇑ Corresponding author. Address: School of Biological Sciences, Queen’s University Belfast, David Keir Building, Stranmillis Road, Belfast BT9 5AG, UK. Tel.: +44 2890 976561. E-mail address: [email protected] (M. Dean). 0950-3293/$ - see front matter Ó 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.foodqual.2011.10.006
nent or composition leaving the consumer to make the connection between the component and health. Risk reduction claims are a specific category of health claims that link the product with a specific disease which are assessed and approved on a case-by-case basis (Regulation (EC) No. 1924/2006). Recently studies on health claims show that the type of base product, the type of claim and the functional ingredient used all affect benefit perceptions and willingness to buy products with health claims (Ares & Gámbaro, 2007; Grunert et al., 2009; Urala, Arvola, & Lähteenmäki, 2003; van Kleef, van Trijp, & Luning, 2005; van Trijp & van der Lans, 2007). Several studies suggest that perceived relevance is one of the key motivating factors influencing the acceptability of functional foods (Verbeke, 2005) and specific product application (Urala et al., 2003). According to legislation, a health claim should be formulated in a way that allows consumers to understand the beneficial effects of the product (Regulation (EC) No. 1924/2006). Although health claims have been shown to increase perceived healthiness of products (Dean et al., 2007; Urala et al., 2003; van Kleef et al., 2005; van Trijp & van der
130
M. Dean et al. / Food Quality and Preference 24 (2012) 129–135
Lans, 2007; Wansink, Sonka, & Hasler, 2004), the increase has been moderate at best. In addition it is not clear whether respondents’ ratings of healthiness are based on their assessment of the product’s overall healthfulness or relate to the benefit the product specifically promises to deliver to their own health. Since the beneficial effects of the product with a specific health claim may only be relevant to some people, the aim of this study is to investigate the importance of relevance in relation to claims that are either clearly targeted at a risk group or targeted at a wider audience promising general health benefits. It is hypothesised that consumers with higher self-rated relevance (whether personal relevance to self or in relation to one’s close family or friends) will increase their perception of healthiness of the product, perceived benefit to self and the likelihood to buy the product compared to consumers with low relevance. In addition relevance to self is expected to increase perceptions of benefit to self of products with health claims. Nutrition claims typically promise general benefit to everyone, thereby targeting consumers in general rather than specific groups of buyers. Therefore the relevance of risk of disease is not expected to play an important role in influencing the utility value of products with nutrition claims. Instead, interest in these products is expected to be higher for those who have interest in nutritionally healthy eating when compared to those who do not have such an interest. Nutritional healthiness typically refers to choosing products (e.g. low-fat, high-fibre, fruit and vegetables) with high nutrient density contributing to a diet that lowers the risk of noncontagious diseases in the long-term, but does not promise any specific health benefits. In contrast foods with health claims, especially with risk reduction claims, resemble medicines with the idea being that by eating these products one can influence a specific and relatively well-defined physiological function or related health factors. The strongest attitudinal factor that predicts willingness to use functional foods has been the reward one gets by taking care of oneself with the consumption of these products (Urala & Lahteenmaki, 2007). The association is shown to be highly product and claim dependant with a suggestion that products with health claims that have been on the market a while have become part of a nutritionally healthy diet. Weiner (2010) discusses the biomedical discourse around cholesterol lowering foods to point out that these products are partly viewed by the public as alternatives to medicines, facilitating health promoting results without requiring a change in their diet. This is seen partly as an easier option that allows people to ignore living a healthy lifestyle and the efforts required to do so. However, although the effects of products with risk reduction claims can be compared to medicines, they are still seen mostly as foods, whereas supplements are more often categorised as drugs (de Jong, Ocké, Branderhorst, & Friele, 2003). Therefore it is theorised that interest in nutritionally healthy eating is associated with the appeal of nutritionally relevant health messages such as nutrition claims (e.g. contains whole grain vs. no info). However, consumers need to have positive attitudes towards foods with health claims (so-called functional foods) in order for them to perceive health claims positively. The objective of this research is to investigate how perceived relevance influences consumers’ responses to specific disease risk reduction health claims, general health claims and nutrition claims. The second objective is to see whether attitudes towards nutritionally healthy eating and attitudes towards functional foods have an impact on perceptions relating to products with health claims. The study used conjoint analysis to examine the relative impact (measured as part-worth utilities) of various factors (base product, health claim, nutrition claim and pictorial cue) on ratings of perceived healthiness, benefit to me and likelihood of buying.
1.1. Hypotheses (1) Perceived relevance will increase perceived healthiness, perceived benefit to self and likelihood to buy of products with health claims, especially in the presence of a risk reduction claim. (2) Perceived personal relevance will have a stronger impact on perceived healthiness, perceived benefit to self and likelihood to buy than relevance to others. (3) Perceived personal relevance will have a stronger impact on the perceived personal benefit than on the perceived general healthiness. (4) Perceived relevance will have no effect on perceived healthiness, perceived benefit to self and likelihood to buy when nutrition claims are targeted at the general public. (5) General health interest will be positively related to perceived healthiness, perceived benefit to self and likelihood buy of products with nutrition claims, but the relationship between general health interest and health claims will depend on the type of health claim. (6) Those who view products with health claims as tools to repair flaws in diet (foods as medicines or functional foods) will perceive higher healthiness, more benefit to self and greater likelihood to buy of products with health claims. 2. Method The study was a part of the European HealthGrain project which researched possibilities of developing products that contain protective compounds from wholegrain or their fractions (Poutanen et al., 2008). The regular consumption of wholegrain cereals has been associated with reduced risk of various types of diseases, including type 2 diabetes (Chatenoud et al., 1998; Liu et al., 2000; Meyer et al., 2009). Therefore the health-related messages in this study where associated with products that contain cereals. This report concentrates on motivational factors underlying perceptions of health claims and nutrition claims. Overall results and country specific differences from the same data have been reported in Saba et al. (2010). 2.1. Subjects The data (N = 2385) were collected by paper and pencil surveys in Finland (n = 682), the UK (n = 547), Germany (n = 504) and Italy (n = 652). The target group of this study was over 35 year old consumers, since the lack of personal relevance for young consumers has been identified as a barrier for the acceptance of functional foods (Wilkinson, Pidgeon, Lee, Pattison, & Lambert, 2004). The participants were solely or jointly responsible for the family’s food shopping. In the total sample the share of females was 50.8%. The respondents were from 35 to 95 years old the mean age being 52.1 years (SD = 11.80). Table 1 describes the country wise characteristics of the participants by gender and age group. There were no significant differences between countries in gender distribution. However, the share of respondents in the older age group was higher in the Finnish sample than in other countries. 2.2. Questionnaire The first section of the questionnaire measured perceived relevance of type 2 diabetes, the second section measured perceptions relating to products described with different health-related messages and the third part measured health-related attitude,
131
M. Dean et al. / Food Quality and Preference 24 (2012) 129–135
Table 1 Description of the sample: socio-demographic characteristics, the share of weekly users of the studied product types, the share of functional food (FF) consumers and the means of health related food attitudes. The significance of the difference between the countries. Total (N = 2385)
Finland (n = 682)
UK (n = 547)
Germany (n = 504)
Italy (n = 652)
Gender (%) Male Female
49 51
47 53
50 50
50 50
50 50
Age group (%) 35–50 years 51–95 years
48 51
42 58
51 49
50 50
51 49
FF use Sum of frequencies
17.3
19.1
17.6
16.8
15.6
Subjective knowledge Mean
3.9
4.6
3.4
3.7
3.7
Relevance To self To other
16.3 31.1
19.4 30.4
15.5 30.3
15.1 26.0
14.6 36.4
Means of attitudes GHI AFM
4.7 4.3
5.0 4.5
4.7 4.0
4.6 4.0
4.6 4.4
Sig. Ns
p = 0.001
p < 0.001 p < 0.001 P < 0.001
subjective knowledge and use of functional foods. The socio-demographic questions were included at the end. 2.2.1. Relevance of type 2 diabetes Diabetes was selected as the target disease because consumers are not as aware of the link between diabetes and wholegrain consumption as they are of the link between fibre and CVD, and there are fewer products marketed with risk reduction of type 2 diabetes. Choosing a relatively little known health association encouraged participants to process the information in the claims rather than responding automatically based on their existing beliefs. To activate participants’ involvement in the issue, relevance of diabetes risk was measured on two items at the beginning of the questionnaire. In order to be able to differentiate between the ‘relevance to self’ and ‘relevance to others’, participants were asked about the perceived risk of diabetes to self and to those close to them. The question relating to personal relevance (‘Do you suffer from diabetes or do you consider yourself as having a high risk for developing diabetes?’) was answered ‘‘yes’’ by 16.4% (n = 391) of the respondents. These respondents were classified as the ‘relevant to self’ group. The question relating to knowing someone with diabetic related issues (‘Do you have a relative or close acquaintance who has diabetes or difficulties in balancing their blood glucose levels?’) was answered ‘‘yes’’ by 43.5% (n = 1032) of the respondents. This categorisation was used in the regression analyses to predict utilities. Some respondents answered yes to both relevance questions. For the investigation of the differences in utility means, only those who answered no to relevance to self-question (31.1%; n = 737) were classified as the ‘relevant to others’ group. Those respondents who answered ‘no’ or ‘do not know’ to both the above questions (52.6%; n = 1248) were classified as the ‘not relevant’ group. All others were classified as missing data. 2.2.2. Conjoint analysis Conjoint analysis (Green & Srinivasan, 1978, 1990) enables the examination of the roles of different product characteristics independently with a limited number of product descriptions. In this paper we are interested in the factors that influence consumer perception of health claims and whole grain information, since they present verbal claims that can be classified either as health or nutrition claims. The overall design is described below to illustrate the context in which the claims were presented. In this
p < 0.001 p < 0.001
study four product characteristics that varied in three or two levels were used: these were the base product (three levels: bread, cake and cereal-containing yoghurt), health claim (three levels: no claim, general claim and risk reduction claim), visual cue (three levels: no cue, natural cue and medical cue) and the presence of wholegrain (two levels: no information and information). The three product types were selected as they were considered to be different in their healthiness image: ‘bread’ as example of a staple grain food (with a positive health image); ‘cake’ as occasional/hedonistic grain food (with neutral/negative health image); and ‘yoghurt with cereals’ as a non-cereal carrier (with a neutral/positive health image). The product types were illustrated as simple drawings. Symbols associated with different kind of healthiness (medical vs. natural) were selected from a pilot study carried out in all four countries. As the objective of this paper is to look at how levels of perceived relevance influence consumers’ responses to different health claims, product related analysis is not reported here. In addition the health-related cue information is excluded from these analyses as the impact of this on the responses was relatively small (see Saba et al., 2010). The health claim related to diabetes was presented either as an unspecific benefit claim addressing blood sugar balance or as a targeted claim promising risk reduction of type 2 diabetes. The benefit claim (BC): ‘Promotes regulation of blood sugar balance’ is a functional health claim (according to the EC regulation), which gave information about health-related effects. The risk reduction claim (RRC): ‘Contains cereal-based compounds which balance the blood glucose levels and therefore lower the risk of type 2 diabetes’ is a disease risk reduction claim (according to the EC regulation), which gave information about the functional ingredient, the function and the long term risk reduction of disease as a health outcome. The wordings were tested for comprehension and ease of understanding in pre-tests in four countries (N = 181). The nutrition claim (NC): ‘contains wholegrain’ related to wholegrain with two levels: no label and a label. A full factorial design with four attributes and eleven levels would have generated 54 hypothetical combinations of profiles that needed to be shown to the respondents. In order to reduce participant fatigue, a fractional orthogonal design procedure (SPSS, 2007) generated nine standard cards describing hypothetical products (for detailed descriptions see Saba et al., 2010). Each card represented a simple base-product picture with the description of the
132
M. Dean et al. / Food Quality and Preference 24 (2012) 129–135
level of attribute ‘health claim’, ‘whole grain’ and ‘a symbol’. Respondents were asked to assume that the product would be available in shops they normally go to. The respondents were asked to rate each card on a seven-point scale of dependent variables ‘How healthy is this product’ (healthiness)? ‘How beneficial is this product to you’ (benefit to me)? ‘How likely is it that you would buy this product’ (likelihood to buy)? Responses ranged from ‘not at all – 1’ to ‘extremely – 7’. 2.2.3. Attitudes Consumers’ motivation in relation to nutritionally healthy eating was measured using the General health interest questionnaire (GHI) (Roininen, Lähteenmäki, & Tuorila, 1999; Roininen et al., 2001), whereas attitude towards using foods as tools to repair flaws in healthiness of the diet was measured with four items. Of the four selected items, three came from the Reward factor in Urala and Lahteenmaki (2007) and the fourth was added to emphasise the disease connection. The attitude measure was named ‘attitude towards using food as a medicine’ (AFM). The four items were chosen after testing 20 items in pre-tests (N = 114) on the ability to discriminate between individuals in all four participating countries. The items used were ‘I can prevent diseases by regularly eating foods with health claims’, ‘Foods with health claims can repair the damage caused by an unhealthy diet’, ‘Foods with health claims make it easier to follow a healthy lifestyle’ and ‘Eating foods with health claims will help me not to get some diseases’. These multi-item scales contain verbal statements that were rated on a seven-point scale (1 = ‘strongly disagree’; 7 = ‘strongly agree’). Reliabilities for the attitude scales were high (Cronbach’s alpha for GHI 0.84 and AFM 0.84). The scores between GHI and AFM were moderately correlated r = 0.43 (p < 0.001). 2.2.4. Familiarity and subjective knowledge Participants’ familiarity with functional foods was asked in relation to five product types: vitamin enriched, fibre enriched, cholesterol lowering, probiotic bacteria containing and omega-3 fatty acids containing food products, with examples of each given. To get an overall score of familiarity the responses to the five products were simply summed together and used as an indicator of familiarity with these products in the regression analyses. The means of the sum was 17.3 (SD = 3.19) with a range of 5–25. Most of the participants reported consuming functional foods at least occasionally. The reported use was highest in Finland and lowest in Italy (Table 1). As higher relevance may be related to higher perceived knowledge of diabetes-related issues subjective knowledge was measured with five items (Flynn & Goldsmith, 1999). Three items were negatively worded and these ratings were reversed before calculated the mean of the five items. The subjective knowledge items were highly correlated with Cronbach’s alpha of 0.88. 2.3. Data analysis The respondent’s task was to rate nine product profiles. The conjoint analysis procedure produces estimated partworth utilities which indicate how influential each attribute level is in the formation of consumer preferences for a particular combination (Wang & Sun, 2003). In this study we use these part-worth utilities to indicate the importance of attribute levels on perceived healthiness and benefit to me in addition to likelihood to buy, which can be regarded as an estimate of preference. Conjoint part-worth utilities were estimated using ordinary least squares regression (OLS). Mean differences between partworth utilities for perceived healthiness, benefit to me and likelihood to buy by relevance (relevance to self, relevance to others and not relevant) were investigated using repeated measure ANO-
VAs with Scheffe’s tests. These were conducted for health claims (benefit claim and risk reduction claim) and the nutrition claim (no label, contains wholegrain label). Statistical analysis was undertaken using SPSS v.17 (SPSS, 2007). Multiple regression was used to study the role of relevance in predicting the part-worth utilities for perceived healthiness, benefit to me and likelihood to buy as dependent variables by a model that consisted of socio-demographics factors (gender and age), subjective knowledge, familiarity with functional foods, general health interest and attitude towards foods as medicine as independent variables in addition to relevance. Relevance in the regression was entered separately as relevance to self and relevance to others. 3. Results The three dependant variables perceived healthiness, benefit to me and willingness to buy are highly correlated (Table 2). However, they are treated as separate variables since they portray different aspects of consumer responses to health-related claims in relation to relevance. 3.1. Relevance The more relevant diabetes was to participants (relevant to self compared to relevant to others) the more they saw the product with a claim, especially with a risk-reduction claim as healthy (F (4, 4566) = 23.1; p < 0.001), of benefit to them (F (4, 4552) = 69.1; p < 0.001) and were more likely to buy the product (F (4, 4568) = 51.3; p < 0.001) (Fig. 1). Hypotheses 1 and 2 were supported. Also (hypothesis 3) the magnitude of support for perceived benefit to me was higher than for perceived general healthiness (see Fig. 1). Interestingly, although increase in relevance (to both self and others) increased perception of benefit to me for the risk reduction claim, only those who said that diabetes was relevant to self were more willing to buy products with the risk reduction claim when compared to products with the benefit claim and no claim. The results indicate that while people may perceive products with risk reduction claims to be healthy, personal relevance is required to perceive these foods as being of benefit to them and for them to be willing to buy them. Results showed that contrary to prediction relevance did marginally affect people’s perceptions of healthiness of the product when a nutrition claim such as ‘contains wholegrain’ label is added (F (2, 2283) = 3.2; p < 0.05), and also affected perceptions of benefit to me (F (2, 2276) = 11.6; p < 0.001) and their likelihood of buying the product (F (2, 2084) = 5.7; p < 0.01). Thus people perceived the product with a nutrition claim such as a wholegrain label to be healthy and their perception of healthiness increase with level of relevance (see Fig. 2). Further when personally relevant, participants perceived the product to be of greater benefit to them and were willing to buy it. Thus hypothesis 4 was not supported. The relative magnitudes of support showed that while participants perceived the product with a nutrition claim such as ‘contains wholegrain’ to be healthy, and of benefit to them, this was not fully reflected in their likelihood of buying (healthiness = 0.25, benefit to me = 0.24, likelihood of buying = 0.13).
Table 2 The range of correlation (Pearson’s r) between perceived healthiness, perceived benefit to me and willingness to buy (n = 2381–2391; P < 0.001) in the nine sample descriptions presented to respondents.
Healthiness Benefit to me
Benefit to me
Likelihood to buy
0.68–0.79
0.53–0.70 0.77–0.82
133
M. Dean et al. / Food Quality and Preference 24 (2012) 129–135
Fig. 1. Effect of relevance and types of claim (no claim (none), benefit claim (BC) and risk reduction claim (RRC)) on perception of healthiness, benefit to me and likelihood to buy.
When it was relevant to self while perceived healthiness, benefit to me and likelihood to buy all increased for the risk reduction claim, only benefit for me increased for the nutrition claim. Also, relevance to others was a significant but weaker predictor for benefit for me and likelihood to buy for the risk reduction claim and subjective knowledge a significant predictor for the likelihood to buy variable for the nutrition claim. In addition, familiarity with functional foods was a significant and relatively strong predictor for both types of claims, and surprisingly the coefficients were higher for the dependent variables of the nutrition claim (Table 2). General health interest was positively linked to all three dependent variables, but had stronger coefficients for benefit to me and likelihood to buy ratings for the nutrition claim, as expected, supporting hypothesis 5. Attitude towards using foods as medicine was positively associated a risk reduction claim (with the exception of perceived healthiness), but negatively with the nutrition claim. Hypothesis 6 was partially supported. In relation to the socio-demographic variables age predicted higher support for nutrition claim in healthiness, benefit to me and likelihood to buy, whereas for the risk reduction claim only likelihood to buy was linked to age. The analyses were also run for the benefit claim, but the regression analyses only explain up to 3% of the variance in utilities with relevance to self on its own or in combination with familiarity with functional foods and attitude to foods as medicine as significant, but weak predictors. Due to the low explanatory value these analyses are not shown in the table. 4. Discussion 4.1. Relevance
Fig. 2. Effect of relevance and nutrition claim (no label, wholegrain label) on perception of healthiness, benefit to me and likelihood to buy.
3.2. Role of relevance linked to other predictors The relative role of relevance in relation to other variables was investigated by predicting perceived healthiness, benefit for me and likelihood to buy by gender, age, familiarity with functional foods, subjective knowledge, general health interest, attitude towards food as medicine and relevance. Overall, these independent variables explained less of variance in perceived healthiness (4%) than the benefit to me (8–9%) and likelihood to buy (11–12%) (see Table 3).
In this study two types of health claims were presented, namely a benefit claim and a risk reduction claim, with different messages and different levels of information. The benefit claim promoted overall general well-being, while the risk reduction claim made a strong promise to mitigate negative consequences by reducing a specific disease risk. Relevance was shown to increase the influence of both types of claims in terms of perceived healthiness, benefit to me and likelihood to buy, which supports our first hypothesis. However, when people were sub-divided depending on the level of relevance, those with relevance to self, gave higher ratings for the benefit to self and likelihood to buy compared to those with relevance to others. This indicates that respondents in this study recognised the benefit of the product to themselves. However for the healthiness utility the difference between
Table 3 Standardised regression coefficients predicting utilities of perceived healthiness, benefit to me and likelihood to buy for risk reduction and nutrition claims. Healthiness Risk reduction claim Beta Gender Age Subj. knowledge FF use Relevance to self Relevance to others GHI AFM R square (adj.)
.03 .03 .02 .09*** .07*** .04 .12*** .02 .042
Level of significance is marked with asterisks. p 6 .05). ** p < 0.01. *** p < 0.001. *
Benefit to me Nutrition claim Beta .02 .08*** .02 .13*** .00 .03 .13*** .07** .043
Risk reduction claim Beta .06** .02 .03 .05* .19*** .04* .12*** .07*** .094
Likelihood to buy Nutrition claim Beta .01 .11*** .01 .12*** .06** .00 .18*** .06* .075
Risk reduction claim Beta .04 .06** .04 .11*** .13*** .05** .12*** .09*** .108
Nutrition claim Beta .00 .12*** .05* .17*** .00 .00 .24*** .10*** .123
134
M. Dean et al. / Food Quality and Preference 24 (2012) 129–135
relevance groups was much smaller. Thus the healthiness attribute seems to represent a general healthiness of the product with all respondents agreeing on the order of claims regardless of relevance. However the difference in perceived healthiness between claims varied according to relevance. This implies that the rating of overall healthiness is not the most effective way to measure perceived personal benefit. In the more personal oriented benefit to me and likelihood to buy measures, the relevance to self group made a clear distinction between the benefit claim and the risk reduction claim, whereas the relevance to other group did not see any differences between the benefit claim and risk reduction claim. This supports the hypothesis that when people are motivated (high relevance) they are more likely to be influenced by the risk reduction claims that promise to deliver specifically targeted benefits. The results fit well with previous research (Urala et al., 2003; Van Kleef et al., 2005; Verbeke, 2005) which showed that people tend to prefer risk reduction claims, when claims relate to wellknown risk factors of common lifestyle-related diseases, as opposed to more general claims promoting nutritional well-being. However, our results go one step further to show that the effect of relevance on claim preference is rather small unless it is personally relevant and that people with high self relevance are the group that is most influenced by risk reduction claims. When not personally relevant risk reduction claims have very small utility values and the products are not likely to be purchased. However, it is important to note that, although consumers who consider themselves to be at risk recognise the healthiness and beneficial effects of products with health claims, they are not necessarily willing to buy the product which explains the low likelihood of buying utility. This suggests that even when personally relevant and the benefit perceptions of products with health claims are enhanced, people still have other preconceptions and barriers that stop them from buying these products (Lappalainen, Kearney, & Gibney, 1998). Therefore to understand and market products with health claims, manufacturers need to investigate not only how beneficial people see these products to be, but also how appealing the products are to consumers. In addition the study showed that subjective knowledge of participants does not necessarily increase the likelihood of buying of these products or mediate the impact of relevance. In addition the study showed that relevance had a very minor impact on perceptions relating to the nutrition claim and then only for the benefit for me utility. Nutrition claims, such as contains wholegrain, do not target specific risk groups or disease, although there is scientific evidence to support the beneficial effects of wholegrain products in lowering the risk of type 2 diabetes (Chatenoud et al., 1998; Liu et al., 2000; Meyer et al., 2009). This implies that consumers are either not aware of the link between whole grain intake and type 2 diabetes or the level of information given in the nutrition claim is not sufficient to activate this link. 4.2. Attitudes and perceptions of health related messages As expected the utilities of the nutrition claim was strongly linked to interest in nutritionally healthy eating (measured by GHI), and surprisingly nutritionally healthy eating interest was also positively related to the utilities of the risk reduction claim. It appears that risk of diabetes is associated in people’s minds with nutritional interests and the link between general health interest and perceived healthiness for the risk reduction claim was as strong as the link for the nutrition claim. However when the behavioural likelihood to buy was assessed the general health interest had a stronger predictive value for the nutrition claim than for the risk reduction claim. This indicates that consumers need to find the messages relevant to themselves and be positive about
general nutritional healthiness in order for them to be interested in products with health claims. The results demonstrate that health claims are unlikely to be perceived as magic bullets to health by those who are not interested in nutritional healthiness. It also highlights the challenge of marketing food products with health-related messages to all consumers as products with health claims are mostly appealing to those consumers who are already highly motivated about healthy eating. The positive attitude towards using food as medicine to repair flaws in diets to prevent disease added to the utility of risk reduction health claims, but decreased the utility of the nutrition claim. This suggests that health claims are perceived differently from nutrition claims. However the study showed that having a general nutrition interest supports the likelihood of buying products with health claims and the prediction of choices is better when attitude towards functional food products is included in the equation. These results are in accordance with earlier findings from Finland where, in addition to attitudes towards functional foods, general health interest was a significant predictor of willingness to use products for some functional foods (Urala & Lahteenmaki, 2007). The results confirm that some products with health claims are viewed as fitting into nutritionally healthy eating, but not by all respondents. This suggests that there are consumers who wish to find new solutions to healthy eating and the foods with health claims fulfil that role. In previous studies users of functional foods have been seen as more innovative consumers compared to those choosing nutritionally recommended foods (Saher, Arvola, Landeman, & Lahteenmaki, 2004). It could be argued that those with a negative attitude towards functional food products perceive higher utilities for nutrition claims, and are likely to seek more conventional solutions for healthy eating without including products with health claims. 4.3. Familiarity and subjective knowledge As seen in earlier studies (Grunert et al., 2009; Lähteenmäki et al., 2010; van Trijp & van der Lans, 2007), previous exposure to functional foods seems to facilitate their acceptance, especially when claims have more detailed information such as the risk reduction claim in this study. However, reported use of functional foods also increases the utility of nutrition claims. Exposure to foods with health-related claims may increase both the familiarity of different functional ingredients, but also the associative links related to them regardless of the legislative status of the claim, such as nutrition or health claim. Also previous exposure to claims may facilitate the processing of information in new claims as consumers use their exposure as reference material to draw upon to evaluate the new claims. Thus in markets where claims have existed new claims may become one more product attribute among many others, and consumers are likely to pay a varying amount of attention to these pieces of information based on their personal need when making choices. Further consumers may not necessarily categorise claims as health or nutrition claims, but assess them based on the benefits they promise. In this study the socio-demographics factors were weak predictors of the utilities, although age was positively linked to the utilities relating to the nutrition claim. Age has been linked in other studies to higher appeal of foods with health-related claims (Ares, Gimenez, & Gámbaro, 2009; Siegrist, Stampfli, & Kastenholz, 2008) although the effect has not been very strong and so is in line with our findings. 4.4. Limitations of the study The level of relevance in this study was measured by two questions and is a measure of perceived relevance, and is not an objective measure (e.g. BMI, waist circumference, blood pressure etc.).
M. Dean et al. / Food Quality and Preference 24 (2012) 129–135
From a consumer study perspective this approach has both strengths and weaknesses. The main weakness is that when a positive link between perceived relevance and claim perception is found, we cannot be sure if the people who perceive themselves at risk are the right target group for the product when viewed from a health status point. However, having an elevated level of risk but not being aware of it is not likely to affect purchase behaviour. As perceived self-relevance was shown to have an impact on product choices the first task should focus on making people more aware of their risk factors in order to achieve the desired impact. This can be attained by informing consumers about the risk factors (e.g. BMI) or by providing opportunities to have physiological risk factors monitored e.g. blood pressure or blood cholesterol levels. The strength of the perceived relevance approach is that self-reported relevance measures the consumer’s motivation directly and therefore is an important predictor. Another limitation of this study was the use of a single example to represent each of the claims. However, our results demonstrate the importance of self-relevance on a targeted claim. The results suggest that the role of perceived relevance should be taken into account when investigating health claims. The carryover effect of self-relevance on one type of disease risk onto other risk reduction claims needs to be tested in future studies. 5. Conclusions The study showed that relevance has a strong influence on perceptions of personal benefit and willingness to buy products with health claims. However the impact of relevance is much stronger when the health risks are relevant to self than when it is relevant to those close to oneself, especially when claims promise a targeted risk reduction with detailed information given about the function and health outcome. Previous experience with products with health claims and interest in nutritionally healthy eating promoted the utilities of all claims, regardless of whether they were health or nutrition claims. However, for increase in utilities for health claims in addition to previous experience and nutritionally healthy eating consumers also needed to be positive about functional foods in general. Acknowledgements This study was financially supported by the European Commission in the Communities Sixth Framework Program, Project HEALTHGRAIN (PF6-514008). This publication reflects only authors’ views and the Community is not liable for any use that may be made of the information contained in this publication. References Ares, G., & Gámbaro, A. (2007). Influence of gender, age and motives underlying food choice on perceived healthiness and willingness to try functional foods. Appetite, 49, 148–158. Ares, G., Gimenez, A., & Gámbaro, A. (2009). Consumers perceived healthiness and willingness to try functional milk desserts. Influence of ingredient, ingredient name and health claim. Food Quality and Preference, 20, 50–56. Chatenoud, L., Tavani, A., La-Vecchia, C., Jacobs, D. R. J., Negri, E., Levi, F., et al. (1998). Wholegrain food intake and cancer risk. International Journal of Cancer, 77, 24–28.
135
de Jong, N., Ocké, M. C., Branderhorst, H. A. C., & Friele, R. (2003). Demographic and lifestyle characteristics of functional food consumers and dietary supplement users. British Journal of Nutrition, 89, 273–281. Dean, M., Shepherd, R., Arvola, A., Vassallo, M., Winkelmann, M., Claupein, E., et al. (2007). Consumer perceptions of healthy cereal products and production methods. Journal of Cereal Science, 46, 188–196. Flynn, L. R., & Goldsmith, R. E. (1999). A short, reliable measure of subjective knowledge. Journal of Business Research, 46(1), 5 7–66. Green, P. E., & Srinivasan, V. (1978). Conjoint analysis in consumer research: Issues and outlook. Journal of Consumer Research, 5, 103–123. Green, P. E., & Srinivasan, V. (1990). New developments with implications for research and practice. Conjoint Analysis in Marketing, 54, 3–19. Grunert, K. G., Lähteenmäki, L., Boztug, Y., Martinsdottir, E., Ueland, Ø., & Åström, A. L. (2009). Perception of health claims among Nordic consumers. Journal of Consumer Policy, 32, 269–287. Grunert, K. G., Wills, J. M., & Fernández-Celemín, L. (2010). Nutrition knowledge, and use and understanding of nutrition information on food labels among consumers in the UK. Appetite, 55(2), 177–189. Lähteenmäki, L., Lampila, P., Grunert, K., Boztug, Y., Ueland, Ø., Åström, A., et al. (2010). Impact of health-related claims on the perception of other product attributes. Food Policy, 35, 230–239. Lappalainen, R., Kearney, J., & Gibney, M. (1998). A pan EU survey of consumer attitudes to food, nutrition and health: An overview. Food Quality and Preference, 9, 467–478. Liu, S., Manson, J. E., Stampfer, M. J., Hu, F. B., Giovannucci, E., Colditz, G. A., et al. (2000). A prospective study of wholegrain intake and risk of type 2 diabetes mellitus in US women. American Journal Public Health, 90, 1409–1415. Meyer, K. A., Kushi, L. H., Jacob, D. R. J., Slavin, J., Sellers, T. A., & Folsom, A. R. (2009). Carbohydrates, dietary fiber, incident type 2 diabetes mellitus in older women. American Journal Clinical Nutrition, 71, 921–930. Poutanen, K., Shepherd, R., Shewry, P. R., Delcour, J. A., Björck, I., & Van Der Kamp, J.W. (2008). Beyond wholegrain: The European HEALTHGRAIN project aims at healthier cereal foods. Cereal Foods World, 53, 32–35. Regulation (EC) No 1924/2006 of the European Parliament and of the Council of 20 December 2006 on nutrition and health claims made on foods. Official Journal of the European Union L 404, 9–25. Roininen, K., Lähteenmäki, L., & Tuorila, H. (1999). Quantification of consumer attitudes to health and hedonic characteristics of foods. Appetite, 33, 71–88. Roininen, K., Tuorila, H., Zandstra, E. H., Vehkalahti, K., Strubenitsky, K., & Mela, D. J. (2001). Differences in health and taste attitudes and reported behaviour among Finnish, Dutch and British consumers: A cross-national validation of the Health and Taste Attitude Scales (HTAS). Appetite, 37, 22–45. Saba, A., Vassallo, M., Shepherd, R., Lampila, P., Arvola, A., Dean, M., et al. (2010). Country-wise differences in perception of health-related messages in cerealbased food products. Food Quality and Preference, 21, 385–393. Saher, M., Arvola, A., Landeman, M., & Lahteenmaki, L. (2004). Impressions of functional food consumers. Appetite, 42, 79–89. Siegrist, M., Stampfli, N., & Kastenholz, H. (2008). Consumers’ willingness to buy functional foods: The influence of carrier, benefit and trust. Appetite, 51, 526–529. SPSS (2007). SPSS statistics 17.0 for WindowsTM. Chicago, IL: SPSS Inc.. Urala, N., Arvola, A., & Lähteenmäki, L. (2003). Strength of health-related claims and their perceived advantage. International Journal of Food Science and Technology, 38, 815–826. Urala, N., & Lahteenmaki, L. (2007). Consumers’ changing attitudes towards functional foods. Food Quality and Preference, 18, 1–12. van Kleef, W., van Trijp, H. C. M., & Luning, P. (2005). Functional foods: Health claimfood product compatibility and the impact of health claim framing on consumer evaluation. Appetite, 44, 299–308. van Trijp, H. C. M., & van der Lans, I. A. (2007). Consumer perceptions of nutrition and health claims. Appetite, 48, 305–324. Verbeke, W. (2005). Consumer acceptance of functional foods: Socio-demographic, cognitive and attitudinal determinants. Food Quality and Preference, 16, 45–57. Wang, Q., & Sun, J. (2003). Consumer’s preference and demand for organic food: Evidence from a Vermont survey. In American agricultural economics association annual meeting, Montreal, Canada, July 27–30 (p. 12). Montreal, Canada: American Agricultural Economics Association. Wansink, B., Sonka, S. T., & Hasler, C. M. (2004). Front-label health claims: When less is more. Food Policy, 29, 659–667. Weiner, K. (2010). Configuring users of cholesterol lowering foods: A review of biomedical discourse. Social Science and Medicine, 71, 1541–1547. Wilkinson, S. B. T., Pidgeon, N., Lee, J., Pattison, C., & Lambert, N. (2004). Exploring consumer attitudes towards functional foods: A qualitative study. Journal of Nutraceutical, 4(3/4), 5–28.