PERSPECTIVE A HEALTHY 2017 FOOD & HEALTH SURVEY

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1 A HEALTHY PERSPECTIVE Healthy is often at the heart of our discussions about food. Still, how Americans think about healthy in the context of dietary decisions remains hotly debated. Defining Healthy Health-promoting components are prioritized when consumers are asked to define healthy foods. Also important is the absence of artificial ingredients as well as a lack of less-healthful components. Vitamin D, fiber, and whole grains are the most widely regarded as healthy. Whole grains saw an uptick in positive ratings this year, with nine out of ten (88%) Americans rating them as healthy. More consumers also rated unsaturated fats, enriched refined grains, and fortified foods as healthy in But healthfulness ratings for many components differed significantly by subgroup. For example, nearly half (47%) of millennials rate animal protein as healthful, compared to only one quarter (25%) of adults over the age of 65.

2 In addition, new considerations emerge when asked about eating patterns rather than food itself. The majority (59%) of respondents define a healthy eating style as the right mix of different food groups. This is especially true for consumers over the age of 65. The absence of artificial ingredients and presence of natural foods were also popular attributes of a healthy eating style. How Consumers Define a Healthy Food High in healthy components of nutrients Free from artificial ingredients, preservatives, or additives Part of an imprortant food group that I need to build a healthy eating style Low in unhealthy components or nutrients Minimally processed Natural Organic Non-GMO 20% 40% 60% Ranked 1 Ranked % 20% 40% 60% 80% The Health Halo Interestingly, when Americans are presented with two products containing identical nutrition facts panels, many Americans are likely to choose one product as healthier based on characteristics beyond nutrition. For example, nearly two-thirds (58%) of Americans reported that a fresh product was at least somewhat more likely to be healthy than a canned product with the same nutrition facts panel. Also, over one-third (36%) of Americans believe that a product with a shorter ingredient list is at least somewhat more likely to be healthy than a product with an identical nutrition facts panel but a longer ingredient list. The health halo even extends beyond the foods themselves. For example, Americans are more likely to think that a product purchased at a natural foods store is healthier than the same product purchased at a convenience store. Canned Food Long List of Ingredients Convenience Store Purchase Cost $0.99 Fresh Food If Two s Have the Same Nutrition Facts Panel Which is Healthier? 60% 40% 20% 20% 40% 60% Nutrition Facts 8 servings per container Serving size 1 cup (85g) Amount per serving Calories 125 Total Fat 8g Saturated Fat 1g Trans Fat 0g % Daily Value* 10% 5% Cholesterol 0mg 0% Sodium 160mg 7% Total Carbohydrate 37g 13% Dietary Fiber 4g 14% Total Sugars 12g Includes 10g Added Sugars 20% Protein 3g Frozen Food Short List of Ingredients Natural Foods Store Purchase Cost $2.00 Frozen Food Name Brand Fresh Food Vitamin D 2mcg 10% Calcium 260mg 20% Iron 8mg 45% Potassium 180mg 4% * The % Daily Value (DV) tells you how much a nutrient in a serving of food contributes to a daily diet. 2,000 calories a day is used for general nutrition advice. 60% 40% 20% 20% 40% 60% Generic (Store Brand) Canned Food Highly Likely This is Healthier Somewhat Likely This is Healthier

3 THINKING BEYOND THE BOX When it comes to what Americans eat and why, considerations go far beyond the factors that traditionally drive purchases - taste, price and convenience. How food is produced, where it comes from, the ingredients list, and perceived corporate values also have a significant impact on food decisions. Food Values One in three believe it is important for a food company to hold their personal values. Most often, this means the perceived quality or healthfulness of the food (44%). About one in four (24%) value characteristics of the company or manufacturer itself, such as transparency, trade practices and How important are the following factors in your decision to purchase a food or beverage? business ethics. Questions like what s in my food? or where does my food come from? are more important to some subgroups than others. For example, women are more likely than men to care about recognizing the ingredients listed, knowing where food comes from, and understanding how the food is produced. 5 - Always Never Recognizing the ingredients listed on the package Knowing where the food comes from The number of ingredients on the food s label Knowing that the manufacturer has a commitment to reducing food waste Understanding how the food is produced Knowing that the manufacturer shares my values 25% 50% 75% 100%

4 Half of Americans believe that it is at least somewhat important for food to be produced in a sustainable way. Of these consumers, reducing the amount of pesticides (58%) and conserving the natural habitat (48%) were most commonly cited as important aspects of sustainability. In addition, women were significantly more likely than men to report that sustainability is important in food production. Labels Connect Americans to the Food System Similar to data from the 2016 Food and Health Survery, one-third (33%) of Americans regularly buy foods because they are labeled as no added hormones or steroids or natural (31%). One-quarter of Americans report that they regularly buy food labeled as organic (25%) and non-gmo (26%). Of those buying foods because they are advertised as non-gmo, nearly three quarters (73%) do so because they believe these foods are healthier, safer, or better for the environment. Millennials, compared to other age groups, are significantly more likely to choose options advertised as organic or natural. These trends hold even when it comes to choosing restaurants. Although factors like price, taste and convenience continue to play a large role in Americans purchasing habits, issues like sustainability, organic vs conventional and even corporate transparency continue to be significant issues driving food purchases and eating patterns. Which of the following, if any, do you do on a regular basis? Buy foods and beverages because they are advertised on the label as Eat at restaurants because they advertised their foods and beverages as No added hormones or Steroids Natural Raised without antibiotics Pesticide-Free Non-GMO Organic Locally-Sourced Sustainably-Sourced Non of the Above 0% 20% 40% 60%

5 FOOD CONFUSION Consumers rely on information they don t trust. Dietitians and healthcare professionals are among the most trusted sources, yet consumers are instead turning to friends and family to help guide food choices. This discrepancy - those trusted vs those relied on - adds to the confusing food information landscape consumers confront each day. Trust v. Reliance Conversations with registered dietitian nutritionists (68%) and personal healthcare professionals (65%) are the two most trusted sources of information on what foods to eat or avoid for Americans. About two-thirds of respondents cited that these individuals are at least trusted somewhat. Level of Trust vs. Reliance as a Source 80% High Trust, Uncommon Source High Trust, Common Source Healthcare Prof. (% 4-5 out of 5) RDN Degree of Trust How nutrition information is shared also seems to affect the degree to which the information is trusted. Overall, conversations with registered dietitians and health professionals were considered to be more trustworthy than information shared from these types of sources online. Wellness Counselor or Health Coach Scientific Study Fitness Prof. Health-Focused Website RDN on Social Media Government Agency Health Prof. on Social Media Bloggers Fitness Prof. on Social Media Friends/Family News Article or Headline Food Company Low Trust, Uncommon Source 0% Low Trust, Common Source 10% Reliance as Source (% 4-5 out of 5) 30% Yet, these trusted sources aren t always the most common sources of information. Friends and family are the most 40%

6 frequent sources of nutrition information, but are not regarded as highly trusted by most subgroups, especially boomers and older adults. This trend holds true even as individuals make personal decisions about their food choices. Friends and family are the most frequently cited source, more than even conversations with health professionals, that influence one s decision to follow a specific diet or eating pattern. Consumer Doubt One can likely assume that friends and family are dispensing nutrition advice that differs from the recommendations of dietitians or health care professionals. It s not surprising, then, that the majority of Americans (80%) report that there is a lot of conflicting information about which foods to eat and what to avoid. This web of information leads many Americans to question their eating habits. Half of respondents say that conflicting information causes them to doubt the choices they make. This doubt is even higher for millennials - about 60% compared to 45% of older adults. Dietary Disconnect Many Americans want health benefits from the food they eat but struggle to understand which foods are associated with specific benefits. This disconnect may be There is a lot of conflicting information about what foods I should eat or avoid. Strongly Agree Somewhat Agree Neither Agree or Diagree Somewhat Disagree Strongly Disagree fueled, at least in part, by the abundance of conflicting nutrition information. On average, fewer than half (45%) of respondents could name a food or nutrient associated with a desired health benefit. This percentage of consumers able to name a specific food or nutrient differed based on the health benefit. For example, of those interested in weight loss or management, only 40% could name a food or nutrient associated with it. Roughly half (49%) of consumers could name a food associated with cardiovascular benefits. Even when consumers could highlight a specific food or nutrient, few were able to name those that are directly linked with the health benefit. Of those interested in cardiovascular benefits, only a quarter named sources of heart-healthy fats (like olive oil and salmon), while less than 5% mentioned whole grains. The data also shows an increased understanding of foods and associated benefits with age - on average, boomers and older adults were more able to name a food or nutrient associated with their desired health benefit (60%) compared to their younger counterparts (40%). Split on Sweeteners 40% 20% 0% 0% 20% 40% The Conflicting information about what I should be eating makes me doubt the choices I Make. (of those who think there is conflictinginformation) Strongly Agree Somewhat Agree Neither Agree or Diagree Somewhat Disagree Strongly Disagree The abundance of conflicting nutrition information may also lead to the polarization in perceptions of sweeteners. Opinions on both low-calorie sweeteners and added sugars have become more divided in the past year, with friends and family driving theses opinion changes. Overall, about one in seven (14%) report that they have developed a more positive opinion of low-calorie sweeteners over the past year. But out of those who have a very positive opinion on low-calorie sweeteners, nearly two thirds (59%) report that their opinion of lowcalorie sweeteners has become more even positive over the past year. Similarly, out of those who have a very negative perception of low-calorie sweeteners, nearly half (43%) report that their opinion has become more negative in the past year. There is similar polarization in perceptions of added sugars. Out of those who currently have a very negative opinion of added sugars, over half report that their opinion has become more negative in the past year. The same is true for those who currently have a very positive opinion on added sugars, with nearly 60% stating that their opinion has become even more positive in the past year.

7 UNPACKING PROCESSED FOODS Consumers definition of processed foods is arbitrary. In fact, Food & Health Survey respondents think of frozen carrots as more highly processed than bagged baby carrots, which are thought of as more highly processed than both organic bagged baby carrots and organic frozen carrots. Organic vs conventional, homemade vs store-bought and fresh vs frozen vs canned seem to all affect one s very personalized definition of processed foods. Defining Processed Overall, consumers have a narrow view of what he or she considers a processed food. Only three out of fourteen carrot-based products listed were considered processed by over half of respondents. Perceived alterations to the food, rather than the presence of packaging, seemed to drive many Americans to label a food as processed. Interestingly, consumers were only half as likely to categorize organic bagged baby carrots (7%) as processed compared to conventional bagged baby carrots (14%).

8 Yet despite how consumers consider and assess processed foods, many value the functional aspects made available through processing. Convenience and affordability are the primary reasons consumers seek out packaged and processed foods. Americans are less likely to connect packaged and processed foods to benefits related to nutrition or safety. Packaging Functionality Many functional aspects of packaging are important to consumers. Half (51%) highlight resealability as an important factor when deciding which foods to purchase, while slightly more than one-third (36%) cite ease of opening as at least somewhat important. Hispanic Americans are more likely than the general population to view all aspects of food packaging, including individual portions and recyclability, as important. Use of Packaging Information The expiration date (71%), nutrition facts panel (51%) and ingredients list (49%) are the packaging information most frequently consulted prior to purchasing. Compared to men, women are more likely to report consulting any of this information prior to purchasing. Significant generational differences also exist in reported use of packaging information. For example, boomers (51%) are much more likely to report consulting front of pack nutrition information than millennials (36%). Packaging Information Consulted During Purchase Expiration Date 5 - Always Never Nutrition Fact Panel Ingrediants List Calories and other Nutrition information on the front of the package via an icon or graphic Statements about nutrition benefits Brand Name Statement about health benefits 25% 50% 75% 100%

9 Funded by OLDER ADULTS: A PICTURE OF HEALTH AND HARDSHIP Older adults are highly motivated to achieve better health, and are more likely to adopt healthy eating behaviors compared to their younger counterparts. But this overall motivation doesn t translate into better health outcomes for all, especially the lower income aging population. This demographic faces barriers that lead them to lag behind in the pursuit of good health. The Health-Driven Generations Older adults are more confident about their food choices. Like other age groups, they encounter a lot conflicting information about which foods to eat but are much less likely to doubt their choices as a result. Nearly two-thirds of younger Americans (61%) report that they doubt their food choices because of conflicting nutrition information while less than half (47%) of Americans over 50 report this doubt. They also use fewer information sources to make their decisions. Boomers report using roughly two out of a list of 14 sources for information on what foods to eat and avoid, while millennials report using approximately three out of the 14 sources.

10 An Apple a Day Older adults are more likely to adopt and maintain healthy eating behaviors. More than eight in ten (84%) Americans over the age of 50 try to eat more fruits and vegetables, while only three-quarters (76%) of younger Americans do the same. Americans over the age of 50 may also be more nutrition savvy than their younger counterparts. This group is more likely than younger Americans to be able to name specific foods associated with the health benefits that they seek. Nearly two thirds (60%) of Americans ages 50 to 80 were able to name a food or nutrient associated with their desired health benefit, as opposed to half (49%) of those under 50. extra income for groceries, or to cover expenses for medication and health care. Those with higher income are more likely to save or invest the money. Also, if given an extra four hours per week, low income older adults are more likely to use it to catch up on sleep or rest. Those with higher incomes are more likely to the spend extra time with friends and family. Use of nutrition information is also linked to income. Compared to their wealthier counterparts, low income Americans ages 50 to 80 report lower use and familiarity with nutrition education tools like USDA s Myplate graphic. This group is also less likely to use nutrition information when eating out. Health Disparities The biggest differences among older adults lie along socioeconomic lines. Low income older adults report poorer health, higher BMI and higher rates of diabetes and stress. Low income older adults also have unique health priorities. This subgroup is more likely to prioritize